FOPC Flashcards
to not fail and have to com back in august
Skills needed for successful medical interviewing
Content Skills - the substance of their questions and responses
Perceptual Skills - to understand what the patient is thinking and feeling
Process skills - they way they structure and organise communication
Role of General Practice
To care for the whole person.
Promotion of healthy lifestyles, to act as first point of contact for secondary care.
Personal Qualities required by general practitioners
-Ability to care about their patients.
- A commitment to high quality care.
-An awareness of one’s limitations
- Organisational ability
- Clinical competence.
-Good communication skills
-Ability to work well within a team
Ability to deal with uncertanity
How does a GP prepare for appraisal
Reading literature, attending courses and performing audits.
When are GP’s appraised
Every five years by a colleague .
Why is effective conversation important in general practice
essential to high quality care.
Improves patient satisfaction, recall, understanding, concordance, and outcomes of care
Components of clinical competence
Good Knowledge
Examination
Communication
Problem solving
Physical factors affecting consultation
Site environment
Adequacy of medical records
Time Constraints
Patient Status
Personal Factors affecting consultation
Age Sex Backgrounds and Origins Knowledge and Skills The Illness
Patient Doctor relationships
Authoritarian
Guidance/Co-operation
Mutual Participation
Three components of interviewing in the consultation
Talking
Examination
Procedures.
Types of Questions
Open-ended - allows the patient to tell their story
Direct- ask about a specific item
Closed- yes/no
Leading presumes the answer
Reflective - allows the doctor to avoid answering a direct question
Type of Non-Verbal Commuinication
Instinctive - crying, laughing and expressions of pain.
Learned - from training and life experiences.
Points of Body Language
Culture
Context
Gesture Clusters
Congruence
Factors that influence the degree of risk
How amount of exposure
How the person is exposed
Conditions of exposure.
factors that govern the perception of risk
Feeling in control (involuntary vs voluntary)
Size of possible harm
Familiarity of risk
Individual Variables in risk receptions
Previous experience, attitudes towards risk, values and beliefs, socio-economic factors, personality, demographic factors
Environment Hazards
Physical- radiation, noise and vibration
Chemical - pesticides
Biological - infectious agents
Definition of Hazard, Risk, Risk Factor, protective factor and susceptibilty
Hazard - something with potential to cause right.
Risk - the likelihood of harm occuring.
Risk Factor - increases the risk of harm
Protective factor - decreases the risk of harm
Susceptibility - influences the liklihood that something will cause harm
Hazards
Physical Chemical Mechanical Biological Psycho-social
Route of Exposure
Skin Blood Sexual Contact Inhalation Ingestion
Psychological Factors influences health
Psychological factors can directly have impact on physical health
Or psychological factors can impact health indirectly through health behaviours
Health Behaviour
Behavior that may have implication for health
Poor Health Behaviours
Smoking
Poor Diet and Exercise
Alcohol consumption
Factors of Health Behaviour
Stable
Background
Social
Situational
Stable Factors
Individual Differences. 1. Emotional dispositions (present)
- Generalised Expectancies (future
- Explanatory Styles (past)
Emotional Dispositions
Negative affect - tendency towards negative affective states - depression
Emotional expression - low expression of negative emotional experience through repression
Generalised Expectancies
Locus of control. Future depends on self.
Self-efficacy - belief in one’s own ability to organise and execute a course of action. Belief in ability to change
Explanatory Styles
Optimism/Pessimism. Better health behaviour with positive outlook
Attribution Style - casual explanation of negative events. May be external or internal.
Background Factors of Health Behaviours
Cultural Norms, Gender, race, chronic health status
Social Factors
Perceived social support
Situational Factors
Situation-specific self efficacy. Perceived risk. Emotional response. Motivation Outcome evaluation
Reasons for socio-economic gradient of health
Social Inequities Institutional Power Living Conditions Risk Behaviours Disease and Injury Mortality
Access to Health care is dependant on
Affordability
Accessibility
Acceptability
Calgary and Cambridge Model
initiating the session gathering information providing structure building relationship explanation and planning closing the session
Neighbours Model of Tasks to be completed in a consultation
To connect with the patient.
To summarise and verbally check that the reasons for attendance are clear.
To handover and bring the consulation to a close.
To ensure a safety net is in place and that no serious possibilities have been missed
to deal with housekeeping of recovery and reflection
Uncertainity
The state of being not completely confident or sure of something.
Risk
chance of consequences
The two different types of normaility
Statistical-based on normal distribution
Cultural-based on norms and values within a group or community.
Definition of stress
pressure exceed’s ability to cope.
Safety Netting
Know the worsening symptoms, know who to contact and the duration.
how to manage risk
developing good relationship.
organisation, documentation of negative findings. Understanding of condition.
Apply reflective pracitce
Components of a consultation
Talking
Examination
Procedures
David Seedhouse wanker definitions of health
Health is: An ideal state A commodity . Personal Strength or ability Basis for personal potential
Laymans Definition of Health
Absense of Disease
Physical fitness
functional ability
What bridges the Gap between primary and secondary care
Public Health Specialists. Occupational Medicine. Mental Health. Palliative care. Management of long term conditions
Community hospitals
Components of a typical GP day
Consultations Paperwork House Calls, Phone calls. Duty doctor emergencies. Specialist clinics Practice business
Nicholas and Systke should
go the fuck to bed
