Long term conditions

Question 1

What is patient centred. care?

Answer 1

Placing the patient at the centre of their care

We treaty patients not disease or symptoms

Question 2

What are long term conditions?

Answer 2

Conditions for which there are no cure and which are managed by drugs and other treatments
Multiple body parts including mental health affected
Twice as likely to suffer LTC if living in a deprived Vs affluent area

Question 3

What is incidence?

Answer 3

Number of new cases in a specific time period

Question 4

What is prevalence?

Answer 4

Total number of people in a population with a condition either at a single point in time or over a given time period

Question 5

Aetiology of long term conditions

Answer 5

Complex and multifactorial
Genetoc factors
Environmental factors

Question 6

What is the aim of treating long term conditions?

Answer 6

To improve morbidity and mortality

Acceptance of lack of cure can be challenging for both patient and doctor

Question 7

What are the consequences of long term coniditons?

Answer 7

Biographical distribution
Stigma of long term conditions
Burden of treatent
Disability

Question 8

What is biographical disruption?

Answer 8

Significant and life changing event that alters life plans and direction
Applied to diagnosis of long term conditions
Presents a challenge to self identity and re-negotiation of relationships

Question 9

What do the burden of treatment include?

Answer 9

Monitor and self managing symptoms
Complex treatments/multiple medications, managing polypharmacy
Changing behaviours or helping to modify the behaviours of others
Engaging with health and social care services

Question 10

What does burden of treatment arise from?

Answer 10

Workload of healthcare

Endurance of deficiencies in healthcare

Question 11

What are the 6 key factors that influence ability to tolerate burden of treatment?

Answer 11

Personal attributes and skills

Physical and cognitive abilities

Support network

Financial status

Life workload

Environment

Question 12

What is the sick role?

Answer 12

Social model of health – our health is not only determined by our illness but by our own reactions and those of society.

Question 13

What are the patients rights?

Answer 13

Temporary exemption from normal social roles.

Not to be blamed for their illness and to be cared for until well

Question 14

What are the patients obligations?

Answer 14

To see illness as undesirable and to get well as quickly as possible.

To seek and co-operate with help, when required.

Question 15

What are the doctors rights?

Answer 15

Status and reward due to functional importance of role

Autonomy in practice

Position of authority in relation to the patient

The right to question and examine the patient

Question 16

What are the patients obligations?

Answer 16

To be highly trained (skilled and knowledgeable)

To be motivated by concern for the patient and community

To be objective and emotionally detached

To be bound by rules of professional conduct

Question 17

What is disability?

Answer 17

An umbrella term for impairments, activity limitations and participation restrictions. It is the interaction between individuals with a health condition and personal and environmental factors.

Question 18

What is the medical model of disability?

Answer 18

Disability is a feature of the person, directly caused by the disease, trauma or other health condition, which requires medical care provided in the form of individual treatment by professionals. Disability calls for medical or other treatment or intervention to ‘correct’ the problem with the individual.

Question 19

What is the social model of disability?

Answer 19

Disability is a socially created problem and not at all an attribute of an individual. In this model, disability demands a political response, since the problem is created by an unaccommodating physical environment brought about by attitudes and other features of the social environment.

Question 20

What are body functions?

Answer 20

Physiological functions of body systems

Question 21

What are body structures?

Answer 21

Anatomical parts of the body such as organs, limbs and their components

Question 22

What are impairments?

Answer 22

Problems in body function or structure such as a significant deviation or loss

Question 23

What is activity?

Answer 23

Execution of a task or action by an individual

Question 24

What is activity limitations?

Answer 24

Difficulties an individual may have in executing activities.

Question 25

What are participation restrictions?

Answer 25

Problems an individual may experience in involvement in life situations.

Question 26

What are environmental factors?

Answer 26

Make up the physical, social and attitudinal environment in which people live and conduct their lives.

Question 27

What replaced the disability discrimination act?

Answer 27

Equality act of 2010

Question 28

What is the screening criteria called?

Answer 28

Wilson and Jungner Criteria

Question 29

What is Wilson and Jugner Screening Criteria?

Answer 29

The condition sought should be an important health problem.

The natural history of the condition, including development from latent to declared disease, should be adequately understood.

There should be a recognizable latent or early symptomatic stage.

There should be a suitable test or examination.

The test should be acceptable to the population.

There should be an agreed policy on whom to treat as patients.

There should be an accepted treatment for patients with recognized disease.

Facilities for diagnosis and treatment should be available

The cost of case-finding (including diagnosis and treatment of patients diagnosed) should be economically balanced in relation to possible expenditure on medical care as a whole.

Case-finding should be a continuing process and not a “once and for all” project.

Question 30

Describe the evolution of sceeening criteria?

Answer 30

The screening programme should respond to a recognized need

The objectives of screening should be defined at the outset.

There should be a defined target population.

There should be scientific evidence of screening programme effectiveness.

The programme should integrate education, testing, clinical services and programme management.

Question 31

How does abdominal aortic aneuryism sreening work?

Answer 31

All men across Scotland are invited in their 65th year

Ultrasound used to detect aneurysm

If detected, will be followed up (annually or 3 monthly)

If large – treatment offered

Estimated prevalence of 1 in 20 (5%)