FOPC Flashcards
List 2 methods of establishing a patient’s requirement for palliative care
Palliative performance scale
Supportive and palliative care indicators tool
List 7 WHO aims of palliative care
Provide relief from pain and other distressing symptoms
Affirms life and regards dying as a normal process
Does not intend to postpone death
Integrates psychological and spiritual care
Offers a support system to help patients live as actively as possible
Offers a support system for families in coping
Uses a team approach to address the needs of patients and families
List 6 factors of a ‘Good Death’
Pain-free At home surrounded by family and friends Awareness of the imminence of death Death as personal growth Personal conflicts are resolved Death in a manner that resonates with the person's individuality
What helps enable primary care to provide palliative care at home?
Gold Standards Framework
List 8 components of breaking bad news
Listen Set the scene Find out what patient understands Find out how much the patient wants to know Share information using a common language Review and summarise Allow opportunities for questions Agree follow up and support
What are the 3 subtypes of euthanasia? Give a definition of each.
Voluntary euthanasia - patients request
Non voluntary euthanasia - no request
Physician assisted suicide - physician provides the means and the advice for suicide
List 7 components of responding to euthanasia requests
Listen Acknowledgement Explore reasons Explore ways of giving more control to patient Look for treatable problems Remember spiritual issues Admit powerlessness
What is sociology?
The study of the development, structure and functioning of human society
List 4 considerations of the sick role
Exempts ill people from daily responsibilities
Patient is not responsible for illness
Patient must seek help from a healthcare professional
Social obligation to recover as soon as possible to take up social responsibilities again
List 8 social/socio-economic influences on health
Gender Ethnicity Housing Education Employment Financial security Health system Environment
What is a health inequality?
Differences in health status or in the distribution of health determinants between different population groups
List 5 vulnerable groups
Homeless LGBT Prisoners Refugees Learning disability
What is the Inverse Care law?
People who most need medical care are least likely to receive it and people who least need medical care utilise services more effectively
List 5 ways to reduce health inequalities
Policies and legislation e.g smoking ban Reduction in poverty Improve access to healthcare Equal access to education Increased employment
List 5 benefits of volunteering
Gain confidence Make a difference Meet new people Learn new skills Have fun
What is the definition of sustainability?
Able to continue over a period of time
List 6 issues of global sustainability that are relevant to healthcare
Material inequality Population and consumption Resource depletion Climate change Loss of biodiversity Crisis in healthcare (increased expenditure due to chronic conditions)
List 6 actions that can be taken to prevent global warming
Increase renewable energy Modify human behaviour Adopt plant-based diets Educate on carbon literacy and numeracy Promote patient resilience Teach healthcare students that we are part of an ecological system
List 6 ways of achieving low carbon clinical care
Prioritise environmental health Reduce and safely dispose of waste Use energy efficiently Improve travel strategies Serve sustainably grown food Adopt greener building design
What is resilience?
Ability to quickly return to a previous good condition
List 4 positive factors and 3 challenges to a sustainable career
Positive factors: Job security Financial security Working with a team Ability to develop knowledge and interests
Challenges:
Excessive workload
Time management
Increasingly complex care
List 5 factors of an occupational history
Description of present and previous jobs Exposure to chemicals or other hazards Symptom improvement when not working? Do other colleagues suffer symptoms Duration and intensity of exposure
What is the purpose of a fit note?
Facilitate earlier discussion about returning to work
List 4 effects of unemployment on health
Higher mortality
Poorer general health
Poorer mental health
More use of health services
What is health promotion?
Any planned activity designed to enhance health or prevent disease
What are the 3 theories of health promotion? Give a definition for each.
Educational - provides knowledge to enable necessary skills to make informed choices regarding health
Socioeconomic - makes the health choice the easy choice
Psychological - forming relationships between attitudes, beliefs and behaviours. Individual’s willingness to change is important
What is health education?
Educating individuals to change knowledge, beliefs and behaviours in a direction which improves health
What is health protection?
Protecting health by targeting factors which are beyond the control of the individual
What is empowerment? List 3 benefits of an empowered individual.
Refers to the generation of power in individuals to control situations that they once were unable to control.
3 benefits:
An ability to resist social pressure
Utilise effective coping strategies
Heightened consciousness of action
What are the 5 stages of change?
Pre-contemplation Contemplation Planning Action Maintenance (or regression)
What is primary prevention? What is secondary prevention?
What is tertiary prevention?
Primary prevention - measures taken to prevent onset of illness or injury
Secondary prevention - detection of a disease at an early stage in order to cure, prevent or lessen symptomatology
Tertiary prevention - measures to limit distress or disability caused by disease
What name is given to criteria for screening? What are the 3 components?
Wilson’s criteria
Illness (important, natural history understood, pre-symptomatic stage)
Test (easy, acceptable, cost effective, sensitive and specific)
Treatment (acceptable, cost effective, better if early)
List 2 legislation for child protection
National guidance for child protection (scotland 2010)
RCGP - safeguarding children
List 6 factors of realistic medicine
Build a personalised approach to care Adopt shared decision making Reduced variation in clinical practice Reduce harm and waste Manage risk better Become improvers and innovators
What is incidence? What is prevalence?
Incidence - number of new cases of a disease is a period of time
Prevalence - number of people in a population who have a disease at a single point in time
List 7 sources of epidemiological data
Mortality data Hospital activity statistics Health and household surveys Social security statistics Drug misuse databases Expenditure data from NHS Accident statistics
What is health literacy?
People having the knowledge, skills, understanding and confidence to use health information and navigate health and social care systems
What is a cross-sectional study? What is a cohort study? What is a case control study?
Cross-sectional - study whereby observations are made at a single point in time
Cohort - exposure data is collected from people who do not have disease and they are followed through time until such a time where enough people have developed illness to begin analysis
Case control - comparison of two groups of people (those with disease and those without disease)
When interpreting study results, what 6 factors must be considered?
Standardisation Standardised Mortality ratio Quality of data Ascertainment Case definition Coding and classification
List 4 forms of bias
Selection bias
Information bias
Follow up bias
Systematic error
What are the 5 stages of an audit?
Identify audit topic Set standard Collect data Analyse data Implement change
What is multi-morbidity?
The co-existence of two or more long-term conditions in an individual
List 5 options for care once discharged from hospital
Living in own home with support from family
Living in own home with support from social services
Sheltered housing
Residential care
Nursing home care
List 10 components of an Anticipatory Care Plan
Welfare power of attorney
Financial power of attorney
Guardianship
(legal)
Statement of wishes Next of kin Preferred place of death Consent to pass on information (personal)
Home care package
Assessment of capacity
Potential problems
(medical)
List 10 considerations needed before setting up a screening programme
Is the disease important?
Is the natural history of the disease understood?
Will the test detect the illness at a pre-symptommatic stage?
Will the test be accepted by the population?
Is the test sensitive?
Is the test speciific?
Is the test cost-effective?
Is the treatment effective?
Is the treatment safe?
Is the treatment acceptable to the population?
List 10 potential difficulties which may arise due to cultural differences
Lack of knowledge Fear and distrust Racism Bias Stereotyping Language barriers Presence of third party Religious beliefs Gender difference between doc and patient Differences in perceptions
List 6 reasons for an ageing population
Increased life expectancy Decreased birth rates Improvements in housing Improvements in sanitation Migration Greater availability of contraception
List 3 negative effects of an ageing population on health services and 3 negative social effects
Health services -
More geriatricians
More long-term conditions
Increased facilities for elderly
Social -
More emphasis on elderly social activities
High demand for home carers
Demand for nursing homes likely to increase
List 6 negative effects of being a carer
Poor mental health Financial implications Lack of privacy Less time for hobbies May have to give up work Social isolation
List 5 ways that a carer can avoid problems
Day care centre Respite care Psychological support Additional help from family Frozen food deliveries
List 6 non-illness factors that may cause tiredness in a child
Lack of sleep Poor diet Lack of exercise Bullying Excessive screen time Social isolation
List 5 aspects of a history which may indicate the need for palliative care
Not expected to live beyond 6-12 months Breathlessness at rest Spends more than 50% of day in bed or chair Long term oxygen therapy FEV1<30%
List 6 different factors which may increase uptake in medical care
Peers Internet TV GP practice leaflet GP practice website Health fairs
What is a confounding factor? List 2 common ones.
A confounding factor is a factor that is associated with the disease and the risk factor.
Age and sex are 2 common confounding factors.
What 8 headings might you use to structure an audit according to the RCGP audit guidelines?
Reason for audit Criteria to be measured Standard set Preparation and planning Result and data collection 1 Description of changes implemented Result and data collect 2 Reflections
