Impact of Long Term Conditions Flashcards
What is Patient Centred Care?
- Places patient at the centre
- Based on the principles and values that define patient- centredness
Where are principles and values that define patient-centredness found?
in the International Alliance of Patients’ Organizations (IaPO) Declaration on Patient- Centered Healthcare.
Five principles outlined in the Declaration on Patient-Centred Care
Respect. Choice and empowerment. Patient involvement in health policy. Access and support. Information
In what populous are long term conditions more common
Older people and more deprived groups
Long term Conditions account for what % of GP appointments
50%
Long-term conditions account for what % of outpatient appointments
64%
Long-term conditions account for what % of inpatient bed days
70%
Define Incidence
The number of new cases of a disease in a population in a specified period of time
Define Prevalence
The number of people in a population with a specific disease at a single point in timer in a defined period of time (existing cases)
Potential Aetiology of long term conditions
Long term conditions are usually the end result of a long term complex interaction of factors:
There may be genetic factors
There may be environmental factors
There may be both or neither
Define Vulnerability
An individuals capacity to resist disease, repair damage, and restore physiological homeostasis can be deemed vulnerability
Considerations of treatment in long term conditions
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.
This is often difficult.
Both patient and doctor must admit failure in diagnosis or cure, with the payoff being better management.
What is meant by the burden of treatment
The demand patients and caregivers are often put under by healthcare systems
4 Demands placed on caregiver or patient with LTC
- 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.
What is meant by “biographical disruption”
A LTC leads to a loss of confidence in the body, in social interaction
What are the implications of Biographical disruption
The meanings of LTC are not simply personal- may have to renegotiate existing relationships. This may involve redefining ideas of ‘good’ and ‘bad’- positive aspects of their lives, lessening negative impact of illness
“Adjustment”
Coping with stigma of LTCs
- Some visible, some not
- Coping involves strategies including the decision to disclose or conceal the condition
Impact of LTCs on the individual
- Can be negative or positive- denial, self pity, apathy
- Isolation of individual from community may occur
Impact of LTCs on family
Can be financial, emotional, physical. Other family members may become ill as a result
WHO definition of Disability
Body and Structure Impairment
Activity Limitation
Participation Restrictions
Medical Model for Disability
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
Social Model for Disability
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.
Legislation protecting the rights of the Disabled
Disability Discrimination Acts (DDA) 1995 and 2005
Equality Act 2010
What are the Disability Discrimination Acts (DDA) 1995 and 2005
Works to protect people with disabilities – including blind and partially sighted people – from discrimination. Please note that the DDA now only applies in Northern Ireland. England, Scotland and Wales are now covered by the Equality Act 2010.
Responsibilities of doctor treating patients with LTC
- Assess disability
- Co-ordinate with MDT
- Intervene in the form of rehabilitation
Typical approach when treating a patient with LTC
MDT
Personal reaction to LTC depends on
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
Consider the disruption disability can cause
- Personal
- Economic
- Social
Different causes of Disability
Congenital Injury Communicable Disease Non-Communicable Disease Alcohol Drugs-iatrogenic effect and/or illicit use Mental Illness Malnutrition Obesity
How many people with a disability are employed in the UK
One third
Screening for Disability
Wilson’s Criteria
