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Foundations of Primary Care Year 2 > Impact of long-term condition > Flashcards

Impact of long-term condition Flashcards

1
Q

Person-centred care

- 5 principles

A

Patient at centre of decision making

International Alliance of Patients’ Organisation Declaration

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

Increasing problem/prevalence

A

Epidemiology

  • Incidence: number of new cases of a disease in a period of time (causation/aetiology)
  • Prevalence: number of people in a population with a specific disease at a defined period of time (current healthcare workload)
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3
Q

More common in older and deprived groups

A 
Older age 
- 58% of people over 60
- 14% of people under 40
Deprived
- 60% higher prevalence and 30% more severe disease in poor social class
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4
Q

Long-term condition statistics

A
  • 50% of GP appointments
  • 64% of outpatient appointments
  • > 70% of inpatient beds
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5
Q

Long-term conditions can lead to

A

Multiple handicaps

  • Physical
  • Social
  • Psychological
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6
Q

Chronic pain can lead to

A
  • Reduction in work capacity (1/3 with disability are employed)
  • Other disabilities
  • Constraints on family life
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7
Q

Broad impact

A

Individual

  • Negative: denial, self-pity and apathy
  • Positive: motivation

Family

  • Financial
  • Emotional
  • Physical
  • Contagious

Community/society

  • Isolation of individual
  • Community success judged on how it looks after ill members
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8
Q

Natural history

A
  • Acute onset
  • Gradual onset: rapid/slow
  • Relapse and remission
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9
Q

Aetiology of long-term conditions

A
  • Genetic factors
  • Enviromental factors
  • Both
  • Neither
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10
Q

Variety of individuals’ responses to long-term conditions

A

Vulnerability

- Individuals capacity to resist disease, repair damage and restore physiological homeostasis

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11
Q

Stigmatisation

A
  • Invisible/visible/both
  • By those who are unaffected
  • Coping: disclose or conceal condition
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12
Q

Treatment

A
  • Resolve disease or treat symptoms
  • Come to terms with chronic disease
  • Admit failure in diagnosis or cure is necessary
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13
Q

Burden of Treatment

A

Demands/workload of healthcare and its effects on those with long-term conditions

  • Lifestyle modifications
  • Monitoring and managing symptoms at home
  • Polypharmacy
  • Complex admin system working with uncoordinated health and social care system
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14
Q

Biographical disruption

A

Long term condition leads to loss of body confidence

  • in social interaction
  • renegotiation
  • need to make sense (good/bad) of condition before adjusting
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15
Q

Expert patient

A

Patient understands disease better than healthcare professional
- Key decision makers

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16
Q

Disease

A

Symptoms, signs, diagnosis (biomedical perspective)

17
Q

Illness

A

ICE, patient perspective

18
Q

Disability (WHO)

A
  1. Body and structure impairment
  2. Activity level/limitation
  3. Participation restriction
19
Q

Epidemiology of disability (6)

A
  • Congenital
  • Injury
  • Disease (non-/communicable)
  • Alcohol/drugs (iatrogenic/illicit)
  • Mental illness
  • Malnutrition/obesity
20
Q

WHO medical model of disability

A
  • Individual cause (accident whilst drunk)
  • Pathology (obesity)
  • Individual intervention (health professional advice)
  • Individual change (in behaviour)
21
Q

WHO social model of disability

A
  • Societal cause (low wage)
  • Housing conditions
  • Social/political action (facilities for disabled)
  • Social changes (language)
22
Q

Disability Legal rights

A
  • Disability Discrimination Acts 1995 and 2005
23
Q

Attitude towards disability

A
  • Listen to patients and learn
  • Take into account age and culture
  • Ensure empathy
  • Don’t spectate: assess, coordinate MDT, intervene with rehab
24
Q

Factors affecting an individuals reaction to disability

A
  • Nature of disability
  • Information (education, intelligence, access to info)
  • Personality
  • Coping strategy
  • Individual role
  • Mood and emotional reaction
  • Reaction of those around
  • Support network
  • Time to adapt
  • Additional resources e.g. benefits
25
Q

Sick role: patients

A
  • Exemption from societal norms
  • Not responsible for condition
  • Should try to get better
  • Seek professional help and cooperate
26
Q

Sick role: healthcare professional

A
  • Objective (not judge morally)
  • Act for patient interest (not greed)
  • Obey professionalism code
  • Maintain necessary knowledge and skill
  • Right to examine intimately and prescribe medication
27
Q

Wilson and Jungner Criteria for screening

A
  1. Disease knowledge (recognisable latent/early stage, known natural course)
  2. Test knowledge (suitable, acceptable to population)
  3. Disease treatment (accepted, facilities available, agreed policy for whom to treat)
  4. Cost considerations (economically balanced)

Foundations of Primary Care Year 2 (4 decks)

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