Formative past papers 2 Flashcards
Aspects of a healthy lifestyle to discuss with patients
● diet
● exercise
● alcohol
● smoking
● illicit drug use
● sexual health
Aspects of health likely to be worse for children in the most deprived area
● lower birth weight
● less likely to benefit from breastfeeding in infancy
● poorer dental health
● higher rates of obesity
● more likely to smoke
Risks to foetal well-being
● smoking
● alcohol
● illicit or prescription drugs
● OTC medication or herbal medication
● X-rays
● poor nutrition/folic acid
● infectious diseases (Toxoplasma, Rubella, Cytomegalovirus, Herpes)
● maternal disease e.g DM
Factors to make pregnant women more likely to change lifestyle behaviour
● advantages (e.g a healthy baby) outweigh disadvantages
● ( patient) anticipates a positive response from others to her behaviour change
● social pressure to change
● (patient) perceives new behaviour to be consistent with her self-image
● (patient) believes she is able to carry out behaviour in a range of circumstances
WHO definition of health
- A state of completely physical
- mental
- and social
- well-being and not merely absence of disease or infirmity
Factors thast affect our beliefs about health and example
● age = older –> functional ability. younger –> physical strength and fitness
● social class = lower socioeconomic –>ability to provide and take care of others
● gender = men and women appear to think about health differently (women include a social aspect to health)
● culture = different perceptions of illness / disease,
Different routes to exposure to hazardous substances
● blood
● skin
● sexual contact
● ingestion
● inhalation
Categories of hazards and examples
● physical = heat / noise / radiation from equipment
● chemical e.g pesticide
● mechanical = trips / slips
● biological = spread of infection amongst colleagues
● psychological / stress = anxiety regarding job security
Common reasons for children to visit GP
● feeding problems (newborns)
● URTIs e.g colds & coughs
● rashes
● sore throat
● vomiting + / - diarrhoea
● abdominal pain
● behavioural problems
● developmental delay
Social influences on health
● gender
● ethnicity
● housing
● employment/financial security
● social class
● health system
● environment
Health and social care team members when to assist in the care of a COPD patient
● physiotherapist = help clear chest secretions
● pharmacist = advice on medication
● dietician = assessment of nutrition
● counsellor = assessment and management of low mood
● practise nurse = assessment and advice regarding inhaler use / immunisation
● occupational therapist = aids to assist daily living e.g stair lift
Ethical, psychological and social issues to consider in abortion
Ethical
- Beliefs regarding termination
- Any religious beliefs
- Thoughts regarding bringing a child into the world that you do not feel able to care for
Psychological
Anxiety about:
- being a parent
- going through with a termination
- level of support from family and friends
Social
- Support network - does patient feel her friends would be supportive
- social life will dramatically change after having baby
- Ability to find a job will be affected
Factors to increase chance of someone changing their behaviour
- You think advantages of change outweigh disadvantages
- anticipate a positive response from others
- social pressure for you to change
- perceive new behaviour consistent with your self-image
- believe you’re able to carry out new behaviour in a range of circumstances
Benefits of mutual participation style
- Greater participation by patient, so greater sense of autonomy
- patient adopts greater responsibility for their own health e.g decision making
- Patients more satisfied with consultations so less likely to complain about their care
- May increase compliance with advice/treatment
Authoritarian/paternalistic relationship
- Doctor uses their authority/ status. Patient has no autonomy.
- patient tries hard to please doctor and does not actively participate in their own treatment.
Content, perceptual and process skills
- Content skills: what doctors communicate-the information they gather/ give
- Perceptual skills: what they are thinking and feeling-their clinical reasoning;
- Process skills: how they do it- way doctors communicate with patients verbal and non-verbal skills they use;
Govenment strategies to promote population health
- Legislation on smoking/alcohol (e.g. minimum age)
- Improvements in housing
- Provision of health education
- Health and safety laws
- Transport legislation
Why people may feel smoking is normal
- Normal for her peer or social group, but would be abnormal perhaps for wider population
- Might watch TV programmes where smoking is normal behaviour.
Different health professionals in the health care of a new mother and baby
- GP-postnatal examination of Lisa, 8w baby check, medical problems?
- Midwife-follow up of Lisa and Kayleigh for first 10 days after birth, advice on feeding
- Health Visitor- advice on early child care from 10 days to school age, immunisations
- Pharmacist- advice OTC medication
Example of hypothetico-deductive reasoning
- patient history leads to making several diagnostic hypotheses
- Rare diagnoses excluded
- Strengthen case for diagnosis through more detailed history and examination and some initial investigations. This may help provide evidence for your initial hypotheses, but if not…
- Extend search if no diagnosis identified.
- If patient does not follow expected pattern of illness/recovery from the diagnosis, revise diagnosis
Hypothetico-deductive reasoning about likely diagnoses.
Safety netting advice
· Advise patient of expected course of the illness/recovery
· Advise of symptoms indicating deterioration
· Advise who to contact if patient deteriorates
Examples of the use of computers in patient care
- Store and book appointments
- Patient records
- Support prescribing
- Electronic management of hospital letters or blood results
- E-consultations
- Chronic disease management and recall
- Patient leaflets/resources
- Public health information
- Identify patients for screening programmes
Hazard and risk definition
Hazard = something with potential to cause harm
Risk = likelihood of harm occurring
Questions to ask patient to determine if symptoms are work-related
- Does it happen at work?
- Does it happen during holidays?
- Did it ever occur before she started working there?
- Is anyone else at work similarly affected?
Why are GPs the most appropriate professional to guide patients
- Aware of Hannah’s current and past medical history
- Aware of Hannah’s social circumstances
- GP has knowledge of a broad range of health conditions
- Trusted and known by patient/family
- GP is local to Hannah’s home and so accessible
- GP has role in prevention as well as diagnosing/treating illness/disease i.e. GP is responsible for holistic patient care
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Cultural competence
- ability of HC professionals to provide for diverse patient populations high quality care that is safe, patient- and family- centred, evidence-based, and equitable.
Ways risk can be minimised
- Safety netting
- Summarise and verbally check that reasons for attendance are clear
- Hand over and bring the consultation to a close
- Reflection, pausing to reflect before next patient
List the five core concepts associated with the Social Cognitive Theory
- Modelling
- Outcome expectations (positive)
- Self-efficacy (confidence)
- Goal setting
- Self-regulation
Environmental factors which may influence an individual’s behaviour.
- Culture
- Social support
- Location
- Income
- Time
What are the effects on a person’s partner if they have lost their job?
- Exhaustion due to working extra hours
- Worry and stress about family’s future
- Anger that their partner has been fired
- Change of family dynamics due to partner being home all the time
- Enjoyment due to extra time being able to spent with partner
What are the effects in a person if they lose their job?
- Feeling worthless –> Depression
- Guilt that they can’t support family
- Anxiety about finding a new job
- Anger at employers
- substance misuse to cope
- Positive outlook for new future employment
