Long term care (2nd year) Flashcards
what are the 5 principles of patient centred care?
respect choice and empowerment patients involvement in health policy information access and support
what are the 3 doctor-patient relationships?
altruistic/paternalistic
guidance/co-operation
mutual participation
what are the prinicples involved in patient centred care?
places the patient at the centre
only the patient in in the position to make a decision on what this means to them as an individual, in the treatments given and how they I’ve their lives
treatment options and models of care are the centre of patient centred health care
what are long term conditions?
persistent diseases that don’t lead to early death
with regards to GP appointments, outpatient appointment ad inpatient bays, how much does long term conditions account for?
50% GP
64% outpatient
> 70% inpatient beds
what is disability?
disability is the consequence that the illness has on the patient.
failure to re-establish the functional capacity that they once had to work and have unremitting physical discomfort
what is incidence?
the no. of new cases of a disease in a population in a specific period of time
what is prevalence?
the no. of people with a specific disease at a single point in a specific period of time
does long term illnesses have a low or high incidence and prevalence?
low incidence
high prevalence
give examples of the natural histories of different diseases?
alzheimers - gradual deteriortion
vascular dementia - step wise progression
cancer - slow deterioration then plummet
COPD - exacerbations, improve slightly but have another exacerbation and over time deteriorate
what are the main factors which underly ‘the burden of treatment’ for patients and carers?
modifying behaviour
managing care at home
polypharmacy
access to services
long term illness often leads to loss of confidence in social interaction or self identity - what is meant by this?
social: they may need to re-negotiate existing relationships at work or home
self identity: they need to make sense of their condition before they can adjust to it. this involves redefining ideas of what is good and bad so that the positives are emphasised and negatives of the illness are lessened
what impacts on the family and the individual can a long term illness cause?
family:
- financial
- emotional
- physical
- other family members may become ill as a result i.e. mental health
- isolation from community/society
individual:
- denial
- self pity
- apathy
what is the WHO classification of functioning, disability and health?
body and structure impairment activity limitation (changed functional performance) participation restrictions (disadvantage experienced)
what are the medical models of disability?
individual/personal cause e.g. accident whilst drunk
underlying pathology e.g. obesity
individual level intervention e.g. health professionals advise individually
individual change/adjustments e.g. change in behaviour
what are the social models of disability?
societal cause e.g. low wage
conditions relating to housing
social/political action needed e.g. facilities for disabled
societal attitude change e.g. use of politically correct language
what does some personal reaction to disability depend on?
the nature of the disability
the information base of the person e.g. education, intelligence
coping strategies of the individual
the role oft he individual - loss of role, change in 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
time to adapt e.g. how long they have had the disability
what are the benefits of the sick role?
financial sick pay may get off work that they don't like they don't have the stress of work more time to spend with family at home they have more time to themselves so feel more relaxed and mindful medications to relive symptoms relieved of certain responsibilities
what are the main causes of disability world wide?
obesity injury communicable diseases non-communicable diseases alcohol drugs - iatrogenic or illicit use malnutrition mental illness
what criteria is used to determine is screening for the condition is beneficial and thus should be carried out?
wilsons criteria
what are the 4 main factors which are addressed in the wilsons criteria ?
knowledge of the disease
knowledge of the test
treatment of the disease
cost consideration
with regards to long term illness what does it mean by biographical distribution?
long term illness only cause a loss in confidence in the body but also a loss in confidence in self identity and social interaction
what are the main causes of disability world wide?
communicable diseases non-communicable diseases obesity malnutrition trauma congenital mental illness drugs (iatrogenic and/or illicit use) alcohol
