FoPC 3 Flashcards
which 5 questions are patients encouraged to ask as part of the concept of realistic medicine?
- is this treatment/procedure/test necessary?
- what are the risks/benefits?
- what are the potential side effects?
- what are the alternatives?
- what if I do nothing?
according to the WHO, what are the seven aims of palliative care?
- provide patient with relief from pain/distressing symptoms
- affirm life and treat death as normal process
- does not aim to hasten/postpone death
- provide support for patients throughout disease
- provide support for family throughout disease and bereavement
- integrates psychological/spiritual aspects of care
- team approach to ensure patient’s/family’s needs are met along the way
name the features of a “good death”
- pain-free death
- aware death, with unfinished business resolved
- death according to patient’s wishes and their individuality
- death at home among family and friends
- open acknowledgement of imminence of death
- death as personal growth
what is the Gold Standards Framework?
a set of documents which outline the best way for primary care to provide palliative care at home
what are the stages of grief?
stability immobility denial anger bargaining depression acceptance
what are the possible ways people react to bad news?
anger denial distress anxiety relief guilt sadness shock bargaining
what tool can be used to assess the decline of a patient who is receiving palliative care?
palliative performance scale (PPS)
what tool can be used to assess a patient’s need for palliative care?
supportive and palliative care indicators tool (SPICT)
once primary care has identified the benefit of providing palliative care to a patient, how are the steps put into place?
through the Anticipatory Care plan, which is passed to Out of Hours and MDT
how does primary care keep track of patients who are currently receiving palliative care at home?
by adding these patients to the Palliative Care register
how many health boards are there in Scotland?
14
define primary, secondary and tertiary disease prevention
primary: measures taken to prevent onset of disease (eg vaccines)
secondary: early detection of disease at pre-clinical stage (eg screening)
tertiary: measures to limit distress/disability caused by disease (eg symptom relief)
what is the role of Scottish Health Boards?
- provide services
- appropriate use of resources
- R&D
how should you approach a conversation with a patient who wants to die?
- listen and acknowledge the issue
- explore reasons for patient’s request
- explore ways to increase patient’s control over disease
- identify treatable problems
- admit powerlessness
define health promotion
any planned activity that enhances health or prevents disease
define health education
communication activity which is aimed at enhancing positive health and preventing or diminishing ill health
what are the three theories underpinning health promotion?
educational - provide knowledge/education to enable necessary skills to make informed choices about health
socioeconomic - national policies (redistributing wealth, taxation on unhealthy choices)
psychological - impact of knowledge, behaviour, attitudes and belief in the individual willingness to make changes
what are the stages in the Cycle of Change?
pre-contemplation contemplation preparation action maintenance/relapse
what are Wilson’s criteria for assessing the screening for a certain disease?
- knowledge of disease (natural history, pathophysiology, causes)
- knowledge of tests (acceptable, sensitive, specific, cost effective)
- knowledge of treatment (available treatment options, appropriate facilities)
- cost effectiveness
what are the three main domains included in health promotion?
- health education
- health protection
- disease prevention
when is the Cycle of Change useful in practice?
it may help identify someone who is ready to make a positive change in their lifestyle
what specific lifestyle or risk factors may the Cycle of Change be useful for?
unhealthy habits - smoking, excessive alcohol, IVDU, diet
how would the Cycle of Change be applied in practice?
identifying patient’s position on the cycle of change, and introducing the topic of change based on their readiness
define health protection
collective activities directed at factors which are beyond the control of the individual. regulations/policies aimed at the prevention of ill health or the positive enhancement of well-being
what is empowerment in the context of health promotion?
it is a process which gives people more power over decisions or actions affecting their health
what are the benefits of empowerment in the contect of health promotion?
- ability to develop coping strategies against an unhealthy environment
- ability to resist social pressure
- hightened consciousness of actions
what are the six aims of realistic medicine?
- personalised approach to care
- shared decision making
- variability reduction in practice/outcomes
- harm and waste reduction
- risk management
- improvement/innovation
what is resilience?
the ability to bounce back from difficult situations
what are some of the personality traits that can promote resilience?
humour self-belief self-acceptance high frustration tolerance perspective meaning curiosity adaptability
name a few behaviours that can help promote resilience
support network assertiveness reflection avoiding procrastination planning work-life balance time management
for a doctor, name a few factors which can promote resilience
intellectual stimulation (job satisfaction, learning)
self-belief (less self criticism, awareness of limitations)
teamwork (good support mechanism at work)
good work-life balance
having coping mechanisms in place
what is an occupational and environmental history, and what is its aim?
it’s finding out all previous employment details from a patient, to try and determine whether their health deterioration is related/due to their work or environment
what is a fit note?
document signed by a doctor which facilitates returning back to work after being off for ill health for 7 days consecutively
what are the four options regarding return to work on a fit note?
- phased return
- amended duties
- altered time schedule
- workplace adaptation
