Lecture 4 Health Literacy And The Expert Patient Flashcards
What are the 2 models of care?
- Biomedical model
- Biopsychosocial model
3 features of biomedical model?
- physical health
- biological disease
- pathology
What is the biomedical model about?
- about accurate diagnosis
- pathology focused on biology
- paternalistic: ‘ doctor knows best’
What are the 3 features/groups of the Biopsychosocial model ?
- Biology
- Social
- Psychological
What is the Biopsychosocial model about ? (3)
- Patient-centred
- Equal power between doctor and patient
- Engaging in full range of things impacting a patient’s experience of illness
Apply biomedical model to chronic obstructive pulmonary disease (6)
- Immune response to long term exposure to noxious particles and gases
- Short acting or long acting bronchodilator
- Steroids
- Smoking cessation
- Irreversible damage to the lungs
- Inflammation of airways
Apply Biopsychosocial model to chronic obstructive pulmonary disease (5)
- Psychological impact of diagnosis of long term chronic illness
- Impact on work and social like from illness and treatment
- Anxiety exacerbating and contributing to breathlessness
- Self-blame and guilt if caused by smoking
What are the 4 key features of person-centredcare?
- Develop knowledge, skills and confidence
- More efficiently manage and make informed decisions about their own health and care
- More tailored healthcare for the individual
- Delivered in collaboration with healthcare professionals
Who is an expert patient?
- Can have a physical or mental health condition
- Tend to have chronic/long term condition
- Often understand their condition better than professionals as they are living with it
- Can often take lead in managing their illness
- So many more ways of becoming literate about their condition and care - leaflets, internet, friends, family
Expert patient (5)
- doctor doesn’t always know problem
- patient perspective
- expert in condition
- better outcomes
-collaborative approach e.g. bipolar disease
What are the clinicalbenefits of the expert patient ? (2)
- illness management
- report side effects of treatment
What are the educational benefits of the expert patient? (2)
- educate other patients
- co-develop educational programmes
What are the research benefits of the expert patient? (2)
- advise on study design
- co-develop the research questions
What is the living library model? (4)
- learning from lived expertise
- a place where ‘books’ discuss their experiences with ‘readers’
- a space for stories and questions
- value of shared experience
When was the Expert Patients Programme launched in England ?
2002
What does the Expert patient programme do?
- promote self management and improve care support
- NHS and charities
- information, experience sharing, learning
What is deontology ethics?
The morality of the act itself
Some acts are intrinsically right and some are intrinsically wrong
Autonomy and the expert patient
- Respecting people’s rights to make their own decisions
- Individuals right to information
Informed, autonomous decision
Should patients by in involved in all decisions about their health care?
- Medical language and detail
- Potentially distressing - hypothetical
- Length of meetings
- informed decision
- “Nothing about me, without me “
- knowledge
What is the Patient and Public Involvemt (PPI) paradox ?
Patients:
- Many patients would like more involvement in treatment decisions
- But the desire to be actively involved tends to diminish when conditions are more serious
Public:
- Many citizens say they want to be involved in decisions about services
- But this desire diminishes as the decisions get more complex
Does a doctor have a duty of care beyond the patient in front of them?
- genetic inheritance
E.g. BRCA gene for breast cancer - results have implication for family
How can we engage patients and the public? (6)
- Simple to navigate information
- Easily accessible
- Paper-based and online
- Lay language vs professional biomedical model
- The healthcare professional to place themselves in the lived experience of the patient’s illness
- Seeing things from the patient’s perspective- what it’s like to live with that condition
Why expert patients in mental health research and services? (6)
- Individual’s autonomy - Koorsgard 2004
- Human rights considerations - Human Rights Act 2008
- Equality of opportunity
- Health services relationship with the community it serves
- Value of lived experience
- Role of service user within the wider service community
How has involvement developed ?
- academic acceptance & service user movement
- department of Health - INVOLVE 2003- guidelines and frameworks
- NHS constitution -‘No decision abut me without me’ and shared decision making
- Central funding for device user involvement projects
- Third sector organisations - a voice/specialist knowledge
- NHS and Universities - service user researchers
