FoPC Flashcards
Consultation models
Authoritarian, guidance, mutual participation
Effects of a long term health condition
Personal - denial, self pity
Family - financial, emotional
Society - isolation
Categories of disability
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
Types of risk
Actual
Relative
- can explain verbally, using fractions, illustrations
Plan done for old people by GPs
Anticipatory care plan
2 models of disability and 2 examples of each
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
Factors influencing a persons reaction to a diagnosis
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
Types of scientific studies
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)
Sections of an audit
Reason Criteria to be measured Standard set Preparation + planning Results + collection of data 1 Description of changes implemented Results + collection of data 2 Reflections
Responsibilities of the sick role
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
5 principles of patient centred care
- Respect
- Choice + empowerment
- Patient involvement in health policy
- Access + support
- Information
Criteria showing exposure causes a disease
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
Idea of ‘expert patient’
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
Sources of medical info for patients
Peers Internet TV Health pages of magazines GP practice leaflet GP practice website Adverts in public places Health awareness events Pharmacies
Definition of health literacy
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
3 aims of SIGN guidelines
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
Sources of epidemiological data
Mortality data Cancer Accident Social security statistics Drug misuse databases Hospital activity stats Repro health stats NHS expenditure data
Definition of confounding factor
factor that is associated independently with both the disease and the exposure and so distorts the relationship between the two
Causes of changes to population
Decreased birth rates
Better housing, sanitation, water supplies, nutrition, safety
Migration
War
Medical factors influencing going to see Dr
New symptoms Visible symptoms Increasing severity of symptoms Duration of symptoms Psychological impact of symptoms
Non medical factors influencing going to see Dr
Age Gender Ethnicity Social class Culture Economic implications Interference with social activities Peer pressure Patient beliefs about illness Patient expectations
What tool is used to identify people in need of palliative care
SPICT
Supportive + Palliative Care Indicators Tool
What tool is used to assess palliative care patients
Palliative Performance Scale
Good death
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
Definition of a health inequality
differences in health status or in the distribution of health determinants between different population groups
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
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)
Definition of health promotion
overarching principle which enhances health including disease prevention, health education and health protection
Definition of health education
activity involving communication with people aimed at changing knowledge, beliefs, attitudes and behaviours in a. direction which improves health
Definition of health protection
collective activities directed at factors that are beyond the control of the individual
Results of empowerment
Ability to resist social pressure
Ability to use effective coping strategies when faced by an unhealthy environments
Heightened consciousness of actions
Areas f the cycle of change
Pre contemplation Contemplation Action Maintenance Regression Maintaining healthier lifestyle
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
Define specificity + sensitivity
Specific = low false positive (doesn't detect other benign conditions) Sensitive = low false negative
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
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
Effects on health of unemployment
Higher mortality
Higher medical consultation + hospital admission rates
Poorer mental health
Poorer physical health
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
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)
Definition of culture
a complex whole which includes knowledge, beliefs, art, morals, law, customs
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
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
Hazards
Physical Chemical Mechanical Biological Psychosocial
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
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
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
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
Areas of kids health
Diet Exercise Sleep Screen time Mental health Academic difficulties, home / relationship difficulties, bullying, social isolation
