LEADERSHIP AND CITITZENSHIP Flashcards

Question

What is the transtheoetical model?

Answer 1

Focusses on the decision making of the individual and is a model of intentional change. Precontemplation - no intention. Identifies reasons for not considering exercise. Advice about health risks of inactivity. Contemplation - within 6 months. Identify barriers to exercise, solutions to overcome and set goals. Preparation - within 30 days. Set SMART goals, ensure that the patient understands the advice. Action - less than 6 months. Remind the patient of the heath benefits, establish possible reasons for relapse and address them. Maintainance - more than 6 months. Evaluate current exercise regime, and boost confidence with positive reinforcement. This is cyclical and not linear.

Answer 2

Ask - current and past PA Assess - stages of change Advise - depending on stage of change Assist Arrange - follow up

Answer 3

Frequency Intensity Time Type

Answer 4

Overlooking context - we must use personal context with patients Choice overload - we must simplify the options Decision fatigue - we must keep instructions simple Old habits - focus on consistency Social determinants - leverage social factors Incremental progress - make everything measurable Hyperbolic discounting - focus on short term results Relapse - set reasonable expectations Poor goal setting - create SMART goals.

Answer 5

In 3 distinct domains Health outcomes - improvement in their health Individual clinicians - expectations from clinicians and their previous experiences with clinicians Health care system - the 'system' as an entity. These 3 domains are interrelated.

Answer 6

Mutual respect Harmonized goals A supportive environment Appropriate decision partners The right information Transparency and full disclosure Continuous learning. Attentive listening Taking enough time Building patient's trust in the physician's competance Giving patients the feeling that the physician is doing all they can.

Answer 7

Migration status, refugee status, ethnicity, caste, social class, sexuality, age, co-morbidities, gender, disability, passive expectations, active expectations Social Location and Habitus Expectations of care Experiences of health system interaction Health systems response eg resources, policies, organisational processes.

Answer 8

Reduced patient symptom burden Improved quality of life Improved quality of care ratings

Answer 9

A philosphy of health care practice which reflects the needs, values and preferences of the individual to optimise their experiences of care. Key aspects: fully involving the person's perspectives, needs, values, or preferences. Optimising the person's experience with care, considering the relationship between the person and the professional.

Answer 10

Help me to understand what it feels like to...(be in your shoes, cope with the pain) You must be feeling...(overwhelmes, sad, frustrated, isolated, exhausted, anxious) How can I help you...(get through this, keep motivated, focus on the positives, cope) It sounds like you're...(nervous about, angry about, anxious about, confused about) You seem to get really...when...(you mention that, we talk about) What are some of the things you would like to achieve as a result of this support? What is important to you at the minute?

Answer 11

Attentiveness enables attunement builds trust generates therapeutic alliance produces better outcomes reinforces kinshippromotes kindess directs attentiveness...

Answer 12

S - setting up: privacy, relevant information, who else needs to be there, sit down, connect, manage time constraints and interruptions. P - patient's perception: before you tell ask, open ended questions, what have you been told so far, what are your understandings, if there a suggestion of denial or mismatch, correct misinformation if necessary. I - Obtaining patient's invitations: what level of disclosure does the patient desire? Are you the type of person who likes to know everything that is going on?, may have to stagger information delivery. K - giving knowledge to the patient: warning shot (eg unfortunately), tailor delivery to level of vocab, avoid bluntness, give info in small chunks, silence is vital, emotion reaction is likely, check regularly and repeatedly. E - emotions with empathetic responses: observe and identify the emotion, I can see this is not the news you were hoping for, connecting statement, avoid giving false hope, reduces patient's sense of isolation. S - strategy and summary: is the patient ready to make a plan, resent rehab options, shared decision making, framing hope in terms of what is achieveable, answer any questions.