FoPC Flashcards
What are the values of the NHS?
- Respect and dignity
- Commitment to the quality of care
- Compassion
- Improving lives
- Working together for patients
- Everyone counts
- Care and compassion
- Openness, honest and responsibility
- Quality and team work
What are the 4 domains of good medical practice?
- Knowledge, skills and performance
- Safety and quality
- Communication, partnership and teamwork
- Maintaining trust
What is good clinical care?
- Accurately represent your position
- Recognise limits of competence
- Do not discriminate against patients
What is meant by professionalism?
Medical professionalism signifies a set of values, behaviours, and relationships that underpins the trust the public has in doctors, with doctors being committed to integrity, compassion, altruism, continuous improvement, excellence and teamwork
What are the common concerns with professionalism?
- Attendance
- Time keeping
- Cheating
- Dress
- Attitude
- Plagiarism
- Confidentiality
- Use of social media
What percentage of cases does primary care take care of?
90%
Who is primary care?
- GPs
- General dental practitioners
- NHS 24/ NHS direct and associated staff
- Nurses- practice, district, health visitor, advanced nurse practitioners
- Midwives
- Pharmacists
- Allied health professionals e.g. physiotherapy, OT
- Physician associates (PAs)
- Practice staff e.g. receptionists, medical secretary
- Opticians
What are the variety of symptoms in the community?
- 79% self care
- 20% GP
- 1% hospital
What is confidentiality?
- Not sharing information about people without their knowledge or consent
- ensuring that written and electronic information cannot be accessed/read by people who have no reason to see it
- Keeping information safe and private
When can you disclose confidential information?
- Consent
- Disclosure required by law
- Disclosure in the public interest
- Disclosure involving patients who are children and young people under 18 years (not competent adults)
- Patients lacking capacity
- Deceased patients
Name the people who work in primary care
- Manager
- IT/Admin staff
- Secretarial staff
- Nurses: Junior/ senior
- Advanced nurse practitioners/ physicians assistants
- Phlebotomist/ health care assistants
What are the three broad types of skills needed for a successful medical interview?
- Content skills
- Perceptual skills
- Process skills
What are the three styles of doctor/patient relationship?
- Authoritarian or paternalistic relationship
- Guidance/ co-operation
- Mutual participation relationship
What are the different types of questions that can be asked in an interview?
- Open ended questions
- Direct question
- Closed question
- Leading question
- Reflected question
What are the four point that are important to consider for body language?
- Culture
- Context
- Gesture clusturs
- Congruence
What should you consider when thinking about body language?
- Gaze behaviour
- Posture
- Specific gestures
What percentage of cases can psychological factors predict?
91%
What were the leading causes of death in 2000
- Tobacco use
- Poor diet and physical inactivity
- Alcohol consumption
- Collectively accounting for almost 40% of deaths
Name 5 behavioural risk factors and give a definition of each
- Smoking: any regular/prolonged
- Overweight/ obesity: BMI>25 (overweight), >30 (obese), abdominal fat
- Poor diet: high saturated fat, salt and red/processed meat, low fibre, fruit, veg and fish
- Lack of physical activity/ sedentary behaviour: <30 mins moderate intensity activity for 5+ days/week or <20 mins vigorous intensity activity on 3+ days/week or equivalent
- Excessive alcohol consumption: >14 units for woman, >21 for men, binge drinking=6 units for woman and 8 for men
Name 5 behavioural risks and the diseases associated with them
- Smoking: CVD (e.g. high BP, CHD, stroke), chronic obstructive pulmonary disease, some cancers
- Overweight/obesity: CVD, type 2 diabetes, some cancers
- Poor diet: obesity, type 2 diabetes, CVD, some cancers
- Lack of physical activity: obesity, type 2 diabetes, CVD, osteoporosis, back pain, some cancers
- Excessive alcohol consumption: obesity, liver disease, cardiovascular disease, some cancers, diabetes, osteoporosis, pancreatitis, psychiatric disorder
What works best for changing behaviours?
- Targeting women and older people
- Shorter interventions
- Those which clearly map what that do to change processes
What is the NICE 2015 behaviour change pathway?
- Behaviour change
- Training in behaviour change
- Principles for planning
- Principles for assessing social context
- Principles for selecting interventions and programmes aimed at individuals
- Principles for selecting interventions and programmes aimed at communities
- Principles for selecting interventions and programmes aimed at populations
- Evaluation
Give some examples of population level policies, interventions and programmes tailored to change specific health-related behaviours
- Fiscal and legislative interventions
- National and local advertising and mass media campaigns (for example information campaigns, promotion of positive role models and general promotion of health-enhancing behaviours)
- Point of sale promotions and interventions (for example, working in partnership with private sector organisations to offer information, price reductions or other promotions)
Give some examples of community level policies, interventions and programmes tailored to change specific health-related behaviours
- Support organisations and institutions that offer opportunities for local people to take part in the planning and delivery of services
- Support organisations and institutions that promote participation in leisure and voluntary activities, promote resilience and build skills, by promoting positive social networks and helping to develop relationships
Give examples of what commissioners, service providers and practitioners working with individuals interventions that they can select
- They should motivate and support individuals
- Feel positive about benefits of health-enhancing behaviours and changing their behaviours
- Plan their changes in terms of easy steps over time
- Recognise how social contexts and relationships may affect their behaviours
- Plan explicit “if-then” coping strategies to prevent relapse
What must information be to influence actions/behaviours?
- Relevant to current goals
- Easy to understand
- Readily available in the moment of decision or action
What motivates people to change?
- The advantages out way the disadvantages
- You anticipate a positive response from others to your behaviour change
- There is social pressure for you to change
- You perceive the new behaviour to be consistent with your self image
- You believe you are able to carry out the new behaviour in a range of circumstances
What does self-efficacy underpin?
- Goal setting
- Effort investment
- Persistence in the face of barriers
- Recovery from setbacks
What has research shown about changing behaviour?
- Neither willpower or knowledge alone lead to long-term change
- Small steps are more successful than big leaps
- Environment is important- change this to make the change work
- Create new behaviours rather than just avoiding old ones
- Don’t under-estimate the power of triggers
- Goals have to be concrete
- Set short term goals which help towards the long term goal
What is a smart goal?
- S: specific
- M: measurable
- A: achievable
- R- Realistic
- T: timely
What is a hazard?
Something with potential to cause harm
What is a risk?
The likelihood of harm occurring
What is a risk factor?
Increases the risk of harm
What is a protective factor?
Decreases the risk of harm
What is susceptibility?
Influences the likelihood that something will cause harm
Give a list of the types of hazards
- Physical: wet floors, loose electrical cables, objects protruding in walkways or doorways
- Chemical: Alkali solvents
- Mechanical
- Biological: hepatitis B, new strain influenza
- Psychological: heights, loud sounds, tunnels, bright lights
- Ergonomic: lifting heavy objects, stretching the body, twisting the body, poor desk sitting
What are the roots of exposure to hazards?
- Skin
- Blood/sexual
- Inhalation
- Ingestion
What are the factors that influence the degree of risk?
- How much a person is exposed
- How the person is exposed
- Conditions of exposure
What are the three principles that govern the perception of risk?
- Feeling control (voluntary v.s. involuntary)
- Size of the possible harm (more harm is worse than more likely)
- Familiarity with the risk
What are the individual variables in risk perception?
- Previous experience
- Attitudes towards risks
- Values
- Beliefs
- Socio economic factors
- Personality
- Demographic factors
What are the direct pathological effects of the environment?
-Physical: Ionising and non-ionising radiation, noise and vibration
Chemical: pesticides, VOCs (volatile organic compounds)
-Biological: infectious agents, allergic substances
What are the indirect effects of the environment?
- Housing e.g. overcrowding
- Transport e.g. does it encourage walking or car use
- Town planning e.g. access to amenities, social networks
- Income/ welfare/ wealth distribution
Give examples of hazardous exposure in diet?
- Fat
- Salt
- Bacteria
- Pesticides
- Acrylamide
- Phthalates
Give examples of hazardous inhalation exposure?
- Environmental tobacco smoke
- Smog
- Asbestos
- Legionella
- Pesticides
Give examples of dermal hazardous exposure
- UV-A/UV-B
- Bacteria
- Cosmetics
- Pesticides
How many occupational fatal injuries were there in 2010/11 in the UK?
171
How many occupational non-fatal injuries were there in 2010/11 in the UK?
Over 100,00 (1 in 2000)
How many death each year are a result of past exposure to harmful working conditions?
12000
How many deaths are related occupational cancer each year?
8000
How many deaths are related Asbestos each year?
4000
How many COPD deaths are there that are related to past occupational exposure to fumes, chemicals and dust
4000
How many cases of ill health each year are caused or made worse by work?
1.2 million
What is a cigarette?
- Tobacco (different types)
- Filter
- Filler
- Additives
- Paper
- Smoke
How many Scots die each year prematurely from smoking?
13,000
How many Brits die each year prematurely from smoking?
120,000
How many years, on average, do you loose from life as a smoker?
7.5 years
What fraction of pregnant women smoke?
1/3