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1
Q

Consultation models

A

Authoritarian, guidance, mutual participation

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2
Q

Effects of a long term health condition

A

Personal - denial, self pity
Family - financial, emotional
Society - isolation

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3
Q

Categories of disability

A

Body function + structure impairment
- abnormalities of structure, organ or system function

Activity limitation
- changed functional performance + activity

Participation restriction
- disadvantage is experienced by the patient as a result of impairment

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4
Q

Types of risk

A

Actual
Relative

  • can explain verbally, using fractions, illustrations
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5
Q

Plan done for old people by GPs

A

Anticipatory care plan

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6
Q

2 models of disability and 2 examples of each

A

Medical

  • individual / personal cause eg accident whilst drunk
  • underlying pathology eg morbid obesity

Social

  • societal causes eg low wages
  • social / political action needed eg facilities
  • conditions related to housing
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7
Q

Factors influencing a persons reaction to a diagnosis

A 
nature of disability
support network 
reaction of those around them 
patients personality 
information basis of the patient 
coping strategies of the patient
mood + emotional reaction 
role of individual
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8
Q

Types of scientific studies

A 
Descriptive studies (describe amount + distribution of the disease)
Cross sectional (observations made at a single point in time)
Cohort (follow people that don't have the disease through time to see if they are exposed and then get the disease) 
Case Control (compare a group with and a group without the disease to see if there are links with the exposure)
Randomised control trials (2 groups at risk of the disease and one group has an alteration to see if it effects the outcome of the disease, also used to test interventions eg drugs)
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9
Q

Sections of an audit

A 
Reason
Criteria to be measured
Standard set
Preparation + planning
Results + collection of data 1
Description of changes implemented
Results + collection of data 2
Reflections
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10
Q

Responsibilities of the sick role

A

Exempts patient from normal social roles
Sick person is not responsible for their condition
The sick person should try to get well
They should seek competent help and cooperate with health professionals to get better

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11
Q

5 principles of patient centred care

A
  1. Respect
  2. Choice + empowerment
  3. Patient involvement in health policy
  4. Access + support
  5. Information
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12
Q

Criteria showing exposure causes a disease

A

Temporality = exposure comes before disease
Consistency = repeated observations
Specificity = a single exposure leading to a single disease
Biological gradient = exposure increases as does risk of disease
Coherence = exposure does not conflict with known biology of the disease

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13
Q

Idea of ‘expert patient’

A

have an in depth knowledge of the condition (can exceed that of health care professionals)
Utilising this knowledge results in a better QOL
This knowledge is an under recognised resource

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14
Q

Sources of medical info for patients

A 
Peers
Internet
TV
Health pages of magazines
GP practice leaflet
GP practice website
Adverts in public places
Health awareness events 
Pharmacies
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15
Q

Definition of health literacy

A

People having the knowledge, skills, understanding and confidence to use health information to be active partners in their care and to navigate the health and social care systems

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16
Q

3 aims of SIGN guidelines

A

Help health care professionals and patients understand medical evidence + use it to make decisions about their care
Reduce variation in practice and make sure patients get the best care available no matter where they are
Improve healthcare across Scotland by focusing on patient important outcomes

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17
Q

Sources of epidemiological data

A 
Mortality data
Cancer
Accident
Social security statistics
Drug misuse databases
Hospital activity stats
Repro health stats
NHS expenditure data
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18
Q

Definition of confounding factor

A

factor that is associated independently with both the disease and the exposure and so distorts the relationship between the two

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19
Q

Causes of changes to population

A

Decreased birth rates
Better housing, sanitation, water supplies, nutrition, safety
Migration
War

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20
Q

Medical factors influencing going to see Dr

A 
New symptoms
Visible symptoms
Increasing severity of symptoms 
Duration of symptoms
Psychological impact of symptoms
21
Q

Non medical factors influencing going to see Dr

A 
Age
Gender
Ethnicity
Social class
Culture
Economic implications 
Interference with social activities
Peer pressure
Patient beliefs about illness
Patient expectations
22
Q

What tool is used to identify people in need of palliative care

A

SPICT

Supportive + Palliative Care Indicators Tool

23
Q

What tool is used to assess palliative care patients

A

Palliative Performance Scale

24
Q

Good death

A

Pain free
At home surrounded by friends + fam
Open acknowledgment of the imminence of death
“Aware” death where all conflicts and Unfinished business are resolved
Death as personal growth
Death according to personal preference in a manner that resonates with the persons individuality

25
Definition of a health inequality
differences in health status or in the distribution of health determinants between different population groups
26
Sick role of Dr
Must be objective + not judge patients morally Must not act out of self interest or greed but put the patients interests first Obey a professional code of practice Have + maintain the knowledge and skills to treat a patient Has the right to examine a patient intimately, prescribe treatment + has a wide autonomy in medical practice
27
Areas of health promotion
Educational (provides knowledge + education to enable skills to make informed choices about health) Socioeconomic (national policies making healthy choices the easy choice) Psychological (complex relationship between behaviour, knowledge, attitudes + beliefs)
28
Definition of health promotion
overarching principle which enhances health including disease prevention, health education and health protection
29
Definition of health education
activity involving communication with people aimed at changing knowledge, beliefs, attitudes and behaviours in a. direction which improves health
30
Definition of health protection
collective activities directed at factors that are beyond the control of the individual
31
Results of empowerment
Ability to resist social pressure Ability to use effective coping strategies when faced by an unhealthy environments Heightened consciousness of actions
32
Areas f the cycle of change
``` Pre contemplation Contemplation Action Maintenance Regression Maintaining healthier lifestyle ```
33
Criteria for screening for disease
Wilson's Criteria Illness = important, natural history is understood, clinically detectable pre symptomatic stage Test = easy, acceptable, cost effective, specific + sensitive Treatment = acceptable, cost effective, better if treated early
34
Define specificity + sensitivity
``` Specific = low false positive (doesn't detect other benign conditions) Sensitive = low false negative ```
35
Define Primary, Secondary and Tertiary prevention
``` Primary = prevent the onset of illness Secondary = detection of the illness at an early stage in order to cure, prevent of lessen symptoms Tertiary = measures to minimise distress or disability caused by the disease ```
36
Aspects of realistic medicine
Build a personalised approach to care Change our style to shared decision making Reduce unnecessary variation in practice + outcomes Reduce harm + waste Manage risk better Become improvers + innovators
37
Effects on health of unemployment
Higher mortality Higher medical consultation + hospital admission rates Poorer mental health Poorer physical health
38
Role of OH
- Help prevent work related ill health - Advise on fitness to work, workplace safety + prevention of occupational injuries / illness - Recommend adjustments to help people stay in work - Improve attendance + performance of the work force - Provide rehab to help patients return to work - Promote health in the workplace - Conduct research into work related health issues - Ensure compliance with health and safety issues
39
Effect on health of being homeless
``` Poorer oral health Alcohol + drug problems Increased risk of assault Increased suicide rates Premature death Increased rate of infectious diseases (HIV, Hep B/C) ```
40
Definition of culture
a complex whole which includes knowledge, beliefs, art, morals, law, customs
41
Effects of people from different cultures
Language barriers Presence of another person eg translator, family member Fear + distrust Lack of knowledge about NHS / illness Racism Stereotypes Examination taboos Gender differences between Dr and patient Difficulty using language line Religious beliefs Differences in expectations and perceptions
42
Definition cultural competence
The ongoing capacity of health care systems, organisations and professionals to provide for a diverse patient population high quality care than is safe, patient + family centred, evidence based and equitable
43
Hazards
``` Physical Chemical Mechanical Biological Psychosocial ```
44
Effects of being a carer
``` Poor mental health - stress anxiety Social isolation Effect on employment Financial effect Adaptions having to be made to home May enjoy it and feel it is worthwhile Lack of privacy Less time for hobbies ```
45
WHO thoughts on palliative care
Provides relief from pain + other distressing symptoms Affirms life + regards dying as a normal process Doesn't hasten or postpone death Integrates spiritual + psychological aspects of patient care Offeres a support system to allow patients to live actively until they die Offers family support during the illness and death Uses a team approach to address the needs of the patient and family
46
Breaking bad news
``` Listen Set scene Find out how much patient knows Find out how much the patient wants to know Share info using common language Review + summarise Allow opportunity for questions Agree follow up + support ```
47
Reducing health care inequalities
``` Social inclusion policies Integrating health + social care Government policies + legislation Improving access to health + social care Reduce poverty Improved employment opportunities Equal access to education Better housing in deprived areas ```
48
Areas of kids health
``` Diet Exercise Sleep Screen time Mental health Academic difficulties, home / relationship difficulties, bullying, social isolation ```

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