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FOPC > FOPC yr 2 > Flashcards

FOPC yr 2 Flashcards

1
Q

Patient centred care - 5 aspects?

A 
respect 
choice and empowerment 
patient involvement in healthcare policy 
access and support 
information
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2
Q

ICF?

A

International classification of function

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3
Q

ICF - 3 categroies?

A

Body and structure
Activity limitation
participation restriction

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4
Q

Body and structure?

A

abnormality of structure or organ/ system function

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5
Q

Activity limitation

A

functional performance

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6
Q

Participation restriction

A

struggle to interact at social and environmental level

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7
Q

vulnerability

A

ability to resist disease, repair damage and restore homeostasis

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8
Q

incidence VS prevalence

A 
incidence = new cases 
prevalence = existing cases at a given time
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9
Q

Common cold - incidence and prevalence?

A

High incidence

low prevalence

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10
Q

three types of natural history

A

acute onset - Stroke
gradual - angina
relapse and remission - cancer

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11
Q

biographical disruption

A

loss of confidence in self/ social interaction due to long term condition

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12
Q

Burden of treatment - caused by?

A

High demands of health care system on carers and patients

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13
Q

Burden of treatment - 4 aspects

A

Need to change behaviour, monitor others
Record and monitor things at home
Polypharmacy - lots of complex meds
Have to navigate a complex and unco-ordinated social and healthcare system

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14
Q

two models of disability?

A

social and medical model

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15
Q

Medical model of disability

A

individual cause - car crash
underlying pathology
treated by individual intervention and personal behaviour change

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16
Q

Social model of disability

A

caused by a societal factor - low wages, poor housing
needs political or social change - action to heat/ insulate houses better
needs society to change it’s attitude - use of more correct, less offensive language.

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17
Q

impacts on a patients reaction to disability

A 
nature of the disease
time to adapt - long course or short?
support network 
coping strategies 
impact on their role in society - stop, change
information base - education 
response of others 
emotional 
personality
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18
Q

The sick role

A

refrain from daily tasks
rest, excused from social responsibilities
need to try to get better
work with doctor and HC professionals to get better
take medication and comply with treatment plan
It’s not their fault

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19
Q

Three different impacts of disability

A

personal
social
economic

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20
Q

how many disabled people in the UK are in work?

A

1/3

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21
Q

criteria for a screening programme?

A

knowledge of the disease - a precursor stage that is recognisable
knowledge of the test - suitable to general population
treatment for the disease - that will stop the progression
cost consideration - cheaper to screen and treat early rather than just treating on diagnosis

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22
Q

factors affecting the uptake of care

A

lay referral - asking someone else whether they should go
Information - peers, internet, TV, NHS choices
Medical - worsening symptoms, duration, visible symptoms
non medical - wife sent me, crisis, ideas/concerns, class, gender, age

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23
Q

how to work out the relative risk

A

number of event in at risk group/ event in non at risk group

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24
Q

relative risk of lung cancer in smoking - calculation?

A

LC in smoker / LC in non smoker

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25
Q

problems with epidemiology?

A

describes the population not the individual

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26
Q

sources of epidemiology data

A 
mortality data 
GP data - morbidity and long term conditions 
Cancer statistics 
A and E
drugs misuse data 
expenditure data 
census and home surveys
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27
Q

define health literacy

A

knowledge, skills, understanding and confidence to use health data

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28
Q

highest grade of SIGN evidence?

A

A

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29
Q

role of a descriptive study

A

tells you the amount and distribution of a disease

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30
Q

name three analytical studies

A

cross section
case control
cohort

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31
Q

cross section

A

amount of people with disease at a given point

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32
Q

case control study

A

compare people with disease to those without, compare role of exposure to various risk factors

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33
Q

cohort study

A

take a group of people without

follow through to see who gets it

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34
Q

gold standard for clinical trials?

A

Randomised control trial

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35
Q

RCT?

A

take a group of people
give half new treatment
give other half placebo/ old treatment

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36
Q

Bias - four types

A

selection
information
follow up
systematic

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37
Q

selection bias

A

selecting people who are more likely to have the disease

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38
Q

follow up bias

A

following up closer on certain groups

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39
Q

systematic bias

A

measuring techniques are wrong

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40
Q

things to consider in interpreting data

A

standardisation - remove difference in age
quality of data
case definition - if people were selected for having a certain condition - was the condition defined the same way for all participants
coding - when data is collected and recorded, are they all being recorded the same way?
ascertainment - how was data collected, were people missed?

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41
Q

standardised mortality ratio of 83

A

death rate decreased by 17%

42
Q

confounding factor?

A

associated with the disease and the cause but not what is being measured. distorts the relationship

43
Q

examples of confounding factors

A

age, gender, social class

44
Q

how to minimise confounding factors?

A

eligibility criteria

analysis and adjustment of data

45
Q

causuality

A

proving that exposure A leads to Disease B

46
Q

criteria for causuality (6)

A 
strength of association 
specificity 
consistency 
temporality 
biological gradient 
biological plausibility
47
Q

temporality?

A

Cause A comes before disease B

48
Q

homeostatic reserve

A

ability of organism to stabilise internal environment

49
Q

by 2050 how much of the population will be over 60?

A

22%

50
Q

between 2000-2050 the population over 80 is expected to increase by?

A

4 fold

4 times

51
Q

where will the majority of older people live in 2050?

A

low or middle income countries

80%

52
Q

biggest killer in low income countries?

A

stroke, heart disease and COPD

53
Q

biggest cause of female deaths?

A

dementia and Alzheimer’s

54
Q

biggest male cause of death?

A

heart disease

55
Q

life expectancy in 2004

A

men = 74 female = 79

56
Q

life expectancy in 2031

A

men= 79 female = 83

57
Q

four impacts of the ageing population

A

medical
social
political
economic

58
Q

social impact of ageing population

A 
need to cater for social activities 
burden on carers 
demand for nursing homes and social care
have to provide accessible facilities 
changing roles of grandparents - now working longer
59
Q

political impact of ageing population

A

more voters in that age group

more of what they want even though they wont be here to see it

60
Q

economic impact of ageing population

A

retirement and pension age increases
more pressure on tax payers to fund state pensions
state pensions may become inadequate
people working for longer - younger people can’t find jobs
certain policies may become unsustainable

61
Q

healthy life expectancy?

A

63 for males 64 for females

62
Q

healthy life vs life?

A

the period people spend in poor health is increasing due to the life expectancy increasing faster than the healthy life expectancy

63
Q

How many people are carers?

A

3 in 5 at some point in their life

9 million by 2037

64
Q

value of carers?

A

119bn per year

65
Q

impact on the carer?

A 
may have to cut back on spending 
damage to health (>1/4 on DLA)
cut off from social life and own hobbies  
invasion of privacy 
financial burden 
may have to quit job or work less hours 
damage to relationships
66
Q

roles of the carer

A 
provide help around the house
companionship 
help with accounts, bills 
take them out 
keep an eye on them 
personal care
67
Q

carer and society?

A

many feel that society doesn’t care about them

68
Q

multi-morbidity?

A

people who have 2 or more long term conditions

69
Q

issues with multi-morbidity

A

lots of drugs for different things
one drug may make another thing worse
have to find the balance

70
Q

options for care in the community

A

home care
sheltered housing - independent but people nearby
residential home - 24hr help but no medical staff
nursing home - nursing staff 24hr but very expensive

71
Q

what can we put in place for those with long term conditions?

A

Anticipatory care plan

72
Q

what is in an anticipatory care plan? 3 sections

A

legal
personal
medical

73
Q

Legal aspects? (2)

A

power of attorney
(welfare and finances)
guardianship

74
Q

personal aspects? (3)

A 
Religious beliefs surrounding death 
preferred place of death 
consent to pass on information/ who to contact/ next of kin 
wishes for treatment 
current support
75
Q

medical aspects of ACP? (6)

A 
DNA CPR 
just in case treatment 
capacity assessment
current aids - assess function 
palliative care 
home care package 
communication to other HCP
76
Q

members of the PHCT

A 
GP partner, registrars, other GP 
receptionist 
community nurse 
practice nurse 
nurse practitioner 
health visitor 
midwives
77
Q

role of health visitor

A

support family and children from pregnancy to age 5
vulnerable families
safeguarding and child protection

78
Q

role of practice nurse

A 
child jags
men's health clinic's 
family planning 
leg ulcers 
Bloods 
ECG
79
Q

role of the district nurse

A

visit people in their own homes
support and educate
have their own case-load
duty of care

80
Q

when are midwives involved?

A

pregnancy, labour and early post natal

81
Q

role of Macmillan nurses?

A

information on cancer, treatment and side effects
information about other support services
emotional support for patients and families
pain and symptom control
cancer and palliative care experts

82
Q

Name 6 allied health professions

A 
physio 
OT 
dietetics 
podiatry
counselling 
pharmacist
83
Q

role of OT

A

assessment and treatment of physical and psychiatric illness through specific activities
aim to decrease disability an increase independence

84
Q

role of Physio

A

use movement to aid recovery

helpful in illness, accident or ageing

85
Q

role of dietetics

A

interpret and communicate information to patients and health care professionals
develop specialised diets for complex patients
give generalised advice on healthier eating/ lifestyles
provide unbiased advice

86
Q

input of secondary care in PHCT

A

radiology - investigations
hospital consultants - referrals
operations - surgery

87
Q

Who is the care manager and what is their role

A

highly trained social care workers
provide support and facilitate discussions to identify goals and identify support services
social and financial issues

88
Q

four ways in which PHCT is changing

A

economic
political
roles - new and evolving
ageing population

89
Q

economic factors affecting PHCT?

A

practices are too small
moving into large centres with a multitude of services
e.g. health village
requires effective teamworking

90
Q

political factors affecting PHCT?

A

Pressure to cut cost of treatments

people want to be treated closer to home

91
Q

new/ evolving roles in the PHCT

A

Pharmacist taking over role of minor illness in the community
nurses can now prescribe and triage
healthcare assistant - new roles

92
Q

impact of the ageing population on PHCT

A

long term conditions on the rise
make up 50% of GP consultations
more complex needs
increased demand for HC

93
Q

10 roles of an effective team according to the teamwork forum?

A

include the patient
promote teamwork
know and acknowledge the skills of all
set conditions and ways to resolve conflict
ensure everyone understands each others role
actively work towards awareness of the role of the team in the community
promote inter-professional collaboration
assign a leader based on leadership not status
have a common agreed purpose

94
Q

why integrate heath and social care?

A

to reduce unnecessary admissions and delayed discharge

efficient and effective use of resources

95
Q

which act joins health and social care?

A

Public bodies (joint working) (Scotland) 2014

96
Q

Which groups have to work together to facilitate the joint health and social care partnership?

A

NHS bodies

local authorities

97
Q

two models of facilitating the public bodies- joint working act?

A

IJB - integrated joint bodies

lead agency model

98
Q

Mneumonic for reactions to disability?

A

CONTAINER P

99
Q

CONTAINER P

A 
coping strategy 
others reaction 
Nature of disease
Time to adjust 
Additional support 
Information base
Network support
Emotional response
Role 
Personality
100
Q

benefits of health literacy

A

allows patients to be active partners

navigate the system easier

101
Q

role of SIGN guidelines?

A

reduce variation
help HC professionals understand medical evidence
putting patient important outcomes first

102
Q

the expert patient

A

has in-depth knowledge of condition

  • often exceeding the Dr
  • key part of decision making process
  • should be included in discussions about care
  • historically under-utilised

FOPC (2 decks)

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