Long term care (2nd year)

Question 1

what are the 5 principles of patient centred care?

Answer 1

respect
choice and empowerment
patients involvement in health policy 
information
access and support

Question 2

what are the 3 doctor-patient relationships?

Answer 2

altruistic/paternalistic
guidance/co-operation
mutual participation

Question 3

what are the prinicples involved in patient centred care?

Answer 3

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

Question 4

what are long term conditions?

Answer 4

persistent diseases that don’t lead to early death

Question 5

with regards to GP appointments, outpatient appointment ad inpatient bays, how much does long term conditions account for?

Answer 5

50% GP
64% outpatient
> 70% inpatient beds

Question 6

what is disability?

Answer 6

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

Question 7

what is incidence?

Answer 7

the no. of new cases of a disease in a population in a specific period of time

Question 8

what is prevalence?

Answer 8

the no. of people with a specific disease at a single point in a specific period of time

Question 9

does long term illnesses have a low or high incidence and prevalence?

Answer 9

low incidence

high prevalence

Question 10

give examples of the natural histories of different diseases?

Answer 10

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

Question 11

what are the main factors which underly ‘the burden of treatment’ for patients and carers?

Answer 11

modifying behaviour
managing care at home
polypharmacy
access to services

Question 12

long term illness often leads to loss of confidence in social interaction or self identity - what is meant by this?

Answer 12

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

Question 13

what impacts on the family and the individual can a long term illness cause?

Answer 13

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

Question 14

what is the WHO classification of functioning, disability and health?

Answer 14

body and structure impairment 
activity limitation (changed functional performance)
participation restrictions (disadvantage experienced)

Question 15

what are the medical models of disability?

Answer 15

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

Question 16

what are the social models of disability?

Answer 16

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

Question 17

what does some personal reaction to disability depend on?

Answer 17

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

Question 18

what are the benefits of the sick role?

Answer 18

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

Question 19

what are the main causes of disability world wide?

Answer 19

obesity
injury
communicable diseases
non-communicable diseases
alcohol 
drugs - iatrogenic or illicit use 
malnutrition
mental illness

Question 20

what criteria is used to determine is screening for the condition is beneficial and thus should be carried out?

Answer 20

wilsons criteria

Question 21

what are the 4 main factors which are addressed in the wilsons criteria ?

Answer 21

knowledge of the disease
knowledge of the test
treatment of the disease
cost consideration

Question 22

with regards to long term illness what does it mean by biographical distribution?

Answer 22

long term illness only cause a loss in confidence in the body but also a loss in confidence in self identity and social interaction

Question 23

what are the main causes of disability world wide?

Answer 23

communicable diseases
non-communicable diseases
obesity
malnutrition
trauma
congenital 
mental illness 
drugs (iatrogenic and/or illicit use)
alcohol