FOPC Flashcards
what are the main causes of death in the UK
cancer and IHD
what is palliative care
a philosophy of care than emphasises quality of life
what are the key features of palliative care
provides relief from pain and other distressing symptoms
affirms life and regards dying as a normal process
intends to neither hasten nor postpone death
integrates physchological and spiritual aspects of patient care
offers a support system
helps the family cope during their own bereavement
what is the palliative performance scale §
useful way of assessing and reviewing functional changes in palliative care
what does a lower palliative performance score indicate
indicates power prognoses
what are worries surrounding palliative care that the patients often have
pain anxiety insomnia nausea all classed as distressing symptoms
what is the Scottish life expectancy
79
what is the physiology of ageing
loss of cells and function
less ability to respond to metabolic stress
less reserve capacity
less ability to recover
what is multimorbidity
the presence of 2 or more long term conditions
what is polypharmaxy
begin on multiple medications
what is resillience
the ability to recover quickly from difficulties, toughness
what factors aid resillience
interlectual interest self awareness tiem management and work life balance continuing progressional development support from tea professional attitudes societal attitudes structural changes
what is a long term condition
conditions for which there are no cure and which are managed with drugs and other treatments
they have lasted one year or more with ongoing medical attention
what is incidence
the number of new cases in a time period
what is prevalance
the total number of people in a population with a condition at a point
what is disability
an umbrella term for impairments
activity limitations and participation restrictions
what is the medical model of disability
that it is a feature of the person, directly caused by the disease - requires medical care
what is the social model of disability
it is a socially created problem no an attribute
disability requires a political response since the problem is created by an unaccommodating physical environmentt
what are the Wilson and juggler screening criteria
condition should be an important health issue
natural history of the condition should be understood
should be a recognised early symptomatic or latent stage
should be a suitable test
test should be acceptable to the population
should be an agreed policy on who to treat
cost of case- findings should be economically balanced
should be recognised as a need
defined target population
scientific evidence of effectiveness
overall benefits should outweigh the harm
what are the 6 national screening programs in scotland
cervical cancer bowerl cancer breast cancer AAA screening pregnancy and new born screening diabetic retinopathy screening
what is evidence based medicine
the use of mathematical estimates of the risk and harm to inform clinical decision making in the diagnosis investigation or management of patients
what is epidemiology
the science of applying the principles of population based evidence to the management of individual patients
what is a cohort study
used for looking at causality
occurs over a long time and follows research patients over many years
can be prospective or retrospective
what is a case control study
used for looking at causality
use two groups of people
one group of those with the disease and one nearly identical group but they don’t have the disease
advantages of a cohort study
incidence of disease can be calculated in exposed and non exposed individuals
possible to study multiple outcomes
less of an issue with bias compared to case control study
what is relative risk
the outcome measure reported in cohort studies
measure of the risk of the outcome of interest in the exposed group compared to the unexposed group
how do we calculate relative risk
risk in exposed group divided by risk in unexposed group
what does it mean if the relative risk is one
there is no difference in the effect between the two groups
are case control studies retrospective or prospectiveq
almost always retrospective
what are the advantages of a case control study
smaller sample size
quicker results
cheaper
disadvantages of a case control study
prone to bias
can be difficult to prove causation
not possible to calculate incidence
selecting controls can be difficult
what is the measure of outcome used in case control studies
odds ratio -
ratio of the odds of exposure in those with the outcome compared to those without the outcome
how do we calculate odds exposuer
odds exposure in those with the outcome divided by that in those without the outcome
what is a cross sectional/ longitudinal study
looks at the outcome and exposure in a population or individual at a specific point in time (cross sectional study)
when this is done many times it is a longitudinal study
what are lognitdunal studies good for
looking at trends in a population
can we infer causality from longitudinal studies
no
what helps us understand the risk of a disease
incidence
what helps us understand the burden of a disease
prevalence
what is the gold standard trial for assessing new treatmetns
randomised controlled trial
disadvantages for randomised control trials
time consuming
expensive
ethical considerations
what is causality
not correlation
but that a is associated with B
what is the criteria for causality
strength of association consistency specificity temporality biological gradient plausibility coherence experiment analogy
