FPC2 Tutorial 1 Long Term Conditions Flashcards

1
Q

What is Person Centred Care?

A

Person-centered care places the patient at the centre

Only the patient is in a position to make a decision on what this means to them

Care can be said to be patient-centered if it is based on the principles and values that define patient-centeredness

the provision of care that places the patient at the centre ensuring that the healthcare system is designed to meet the needs and preferences of patients as defined by patients themselves

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2
Q

The Declaration outlines five principles of person centered healthcare, what are they?

A
  1. Respect
  2. Choice and empowerment
  3. Patient involvement in health policy
  4. Access and support
  5. Information
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3
Q

What are possible impacts of someone living with a long term illness?

A

Sufferers may endure multiple handicaps that affect physical, social and psychological well-being

Constraints on family life

failure to re-establish the functional capacity to work and unremitting physical discomfort (often chronic pain)

all commonplace facts of life for patients with long-term conditions

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4
Q

In what groups are long term conditions more common in?

A

Long-term conditions are more prevalent in older people and in more deprived groups

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5
Q

How many appointments do patients with long term illnesses take up

A

50 per cent of all GP appointments

64 per cent of all outpatient appointments and over

70 per cent of all inpatient bed days

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6
Q

Whata re some examples of degenerative chronic disorders?

A

Parkinson’s disease, M.S, Arthritis

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7
Q

What does incidence mean?

A

the number of new cases of a disease in a population in a specified period of time

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8
Q

What does prevalence mean?

A

the number of people in a population with a specific disease at a single point in time or in a defined period of time (existing cases)

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9
Q

What is the aetiology of long term conditions?

A

Long-term conditions (chronic diseases) are usually the end result of a long term complex interaction of factors:

There may be genetic factors

There may be environmental factors

There might be both or neither

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10
Q

What is an individuals vulnerability to long term illnesses?

A

An individuals capacity to resist disease, repair damage and restore physiological homeostasis can be deemed vulnerability

Even certain organs can vary – to an extent the liver repairs well, whereas the brain does not

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11
Q

What is the natural history of a long term ilness?

A

Diseases vary:

● Some may have an acute onset such as stroke or MI

● Some may be gradual with a slow or more rapid deterioration (e.g. angina)

There may on the other hand be relapse and remission e.g. cancer

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12
Q

What is the treatment of a long term condition like?

A

This may be aimed at the disease, or the effect of the disease

In order to treat a disease, it is important to realise the chronic nature and come to terms with this

Both patient and doctor must admit failure in diagnosis or cure, with the payoff being better management

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13
Q

What may be the burden of treatment on patients and caregivers as they are often put under enormous demands by healthcare system?

A

Changing behaviour or policing the behaviour of others to adhere to lifestyle modifications

Monitoring and managing their symptoms at home

Complex treatment regimens and multiple drugs (polypharmacy) contribute to the burden of treatment

Complex administrative systems, and accessing, navigating, and coping with uncoordinated health and social care systems add to this

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14
Q

What is Biographical Disruption?

A

A long-term condition leads to a loss of confidence in the body

There is then a loss of confidence in social interaction or self-identity; this process is termed ‘biographical disruption’

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15
Q

What are the ffects of biographical disruption?

A

It may involve `re-negotiating’ existing relationships at work and at home

The chronically ill and disabled person also needs to be able to make some sense of their condition before they can begin the process of `adjusting’ to it

Involves redefining ideas of what is good' and bad’, such that the positive aspects of their lives are emphasised, and the negative impact of the illness lessened

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16
Q

Are long term conditions always visable to others?

A

Some are visibile and some are invisable and some are both

17
Q

Having a condition may subject osmeone to stigma so how can this be delt with?

A

Coping with stigma involves a variety of strategies including the decision about whether to disclose the condition and suffer further stigma, or attempt to conceal the condition or aspects of the condition and pass for normal

18
Q

Who can long term conditons impact and what may thta impact be?

A

On the individual - can be negative or positive. Can include denial, self pity and apathy

On Family - can be financial, emotional and physical

Other family members may become ill as a result

Community/society - Isolation of an individual may result

19
Q

What is the expert patient?

A

“my patient understands their disease better than I do.”

20
Q

What are the effects of an expert patient?

A

It is something that could greatly benefit the quality of patients’ care and ultimately their quality of life, but which has been largely ignored in the past

They can become key decision-makers in the treatment process

21
Q

What factors come under WHOs defnition of disability?

A

Body and Structure Impairment

Abnormalities of structure, organ or system function (organ level)

Activity Limitation

Changed functional performance and activity by the individual (personal level)

Participation Restrictions

Disadvantage experienced by the individual as a result of impairments and disabilities (interaction at a social and environmental level)

22
Q

What is the medical model of disability?

A

Individual/personal cause e.g. accident whilst drunk

Underlying pathology e.g. morbid obesity

Individual level intervention e.g. health professionals advise individually

Individual change/adjustment e.g. change in behaviour

23
Q

What is the social model of disability?

A

Societal cause e.g. low wages

Conditions relating to housing

Social/Political action needed e.g. facilities for disabled

Societal attitude change e.g. use of politically correct language.

24
Q

What is a doctors role in dealing with a patient with a long term disability and not simply being a spectator?

A

We assess disability

We co-ordinate the multi-disciplinary care team

We intervene in the form of rehabilitation

25
Q

How is a disability often managed?

A

A multidisciplinary approach is often required

26
Q

Is everyone reaction to disability the same?

A

no everyone is different and depends on multiple factors

The nature of the disability

The information base of the individual, i.e. education, intelligence and access to information

The personality of the individual

The coping strategies of the individual

The role of the individual – loss of role, change of role

The mood and emotional reaction of the individual

The reaction of others around them

The support network of the individual

Additional resources available to the individual e.g. good local self-help group, socio-economic resources

Time to adapt i.e. how long they have had the disability

27
Q

How can disability affect the fmaily?

A

It can cause distruption at different levels:

personal

economic

social

28
Q

What is the epidemiology of disability?

A

Different causes worldwide:

Congenital

Injury

Communicable Disease

Non-Communicable Disease

Alcohol

Drugs-iatrogenic effect and/or illicit use

Mental Illness

Malnutrition

Obesity

29
Q

What is the prevelance of diability like in the UK?

A

In the UK the prevalence and severity of disability rise with age

One third of those with a disability are in employment

30
Q

What is the criteria for screening?

A

Wilsons criteria:

knowledge of disease

knowledge of test

treatment for disease

cost considerations