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FoPC Yr 2 > Long-term Conditions > Flashcards

Long-term Conditions Flashcards

1
Q

75yo lady, retired headteacher, no recent appointments at surgery since usual GP retired. Why might she not have attended recently?

A

Retirement of previous GP: longstanding relationship, trust, person-entered approach
Worries about new relationship with new GP
Might have been in good health
May have developed symptoms and be worried about what might be found

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2
Q

What is person centred care?

A

Places the patient at the centre, only the patient is in a position to make a decision on what this means to them
Designed to meet the needs and preferences of patients as defined by patients themselves

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3
Q

What are the principles and values that define patient-centeredness?

A

International Alliance of Patients’ Organisations (IaPO) Declaration on Patient-Centered Healthcare

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4
Q

What are the five principles the Declaration on Patient-Centered Healthcare outlines?

A
  1. Respect
  2. Choice and empowerment
  3. Patient involvement in health policy
  4. Access and support
  5. Information
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5
Q

What are some long-term diseases?

A

Osteoarthritis
Ischaemic heart disease
Repiratory disease e.g. COPD

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6
Q

How do long-term diseases impact patients lives?

A

On individual can be negative or positive: denial, self-pity, apathy
May endure multiple handicaps that affect social, physical and psychological well-being
Constraints on family life: financial, emotional, physical
Other family members may become ill as a result
Failure to re-establish functional capacity to work
Community/society: isolation
Unremitting physical discomfort/chronic pain

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7
Q

What percentage of GP appointments do long-term conditions account for?

A

50%

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8
Q

Who are long-term conditions more prevalent in?

A

Older people

Deprived groups

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9
Q

What is incidence?

A

The number of new cases of a disease in a population in a specified period of time

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10
Q

What is prevalence?

A

The number of people in a population with a specific disease at a single point in time or in a defined period of time

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11
Q

How can knowing incidence of a disease help?

A

Tells us about trends in causation and aetiology of disease

Can be helpful for planning staffing and services for the future

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12
Q

How can knowing prevalence of a disease help?

A

Useful in assessing the current workload for the health service but is less useful in studying the causes of diseases

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13
Q

Long term conditions are usually the end result of a complex interaction of factors, what are the main categories of factors?

A

Genetic factors
Environmental factors
Both or neither

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14
Q

What is vulnerability?

A

An individuals capacity to resist disease, repair damage and restore physiological homeostasis can be deemed vulnerability

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15
Q

How does natural history of a disease vary?

A

Some may have acute onset e.g. stroke or MI
Some have gradual onset with a slow or more rapid deterioration e.g. angina
Relapse and remission e.g. cancer

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16
Q

What can treatment be aimed at?

A

The disease or the effect of the disease

17
Q

What demands can the burden of treatment put on patients or caregivers?

A

Changing behaviour or policing the behaviour of others to adhere to lifestyle modifications
Monitoring and managing symptoms at home, can include collecting and inputting clinical data
Complex treatment regimes and multiple drugs
Complex administrative systems, and accessing, navigating and coping with uncoordinated health and social care systems

18
Q

What is biographical disruption?

A

Loss of confidence in social interaction or self-identity

19
Q

How do patients cope with stigma?

A

Decision about whether to disclose the condition or suffer further stigma
Attempts to conceal the conditions or aspect of the condition and pass for normal

20
Q

What is an expert patient?

A

Patients with long-term or chronic conditions who understand their disease very well

21
Q

What is the dictionary definition of disability?

A

Lacking in one or more physical powers such as the ability to walk or coordinate ones movements

22
Q

What is the legal definition of disability?

A

Disability Discrimination Act - difficulty can be physical, sensory or mental. A disability that makes it difficult for them to carry out normal day to day activities, ongoing for more than 12 months.

23
Q

What classification does the WHO use for disability?

A

ICIDH = International classification of impairments, disability and handicap has been updated with ICF which removes the term disability and handicap.
= International classification of functioning, disability and health (ICF)

24
Q

What are the components of the WHO ICF?

A

Body and structure impairment: abnormalities of structure, organ or system function
Activity limitation: changed functional performance and activity by the individual
Participation restrictions: disadvantage experienced by the individual as a result of impairments and disabilities (at social and environmental level)

25
Q

What is included in the medical model of disability?

A

Individual/personal cause e.g. accident whilst drunk
Underlying pathology e.g. morbid obesity
Individual level intervention e.g. health professional advise individually
Individual change/adjustment e.g. change in behaviour

26
Q

What is included in the social model of disability?

A

Societal causes e.g. low wages
Conditions related to housing
Social/political action needed e.g. facilities for disabled
Societal attitude change e.g. use of politically correct language

27
Q

What legislation give people with disabilities rights?

A

Disability Discrimination Acts 1995 and 2005

Equality Act 2010

28
Q

What do doctors do in terms of helping a patient with disability?

A

We assess disability
We co-ordinate MDT
We intervene in form of rehabilitation

29
Q

What does the personal reaction to disability depend on?

A

The nature of the disability
The information base of the individual ie. education, intelligence, access to info
The personality of the individual
The coping strategies of the individual
The role of the individual - loss of role, change of 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 e.g. good local self-help groups, socio-economic resources
Time to adapt ie. how long they have had disability

30
Q

What is the sick role?

A

When there are possible ‘benefits’ of illness

31
Q

How might disability cause disruption at a family level?

A

Personal
Economic
Social

32
Q

What are different causes of disability worldwide?

A 
Congenital
Injury
Communicable disease
Non-communicable disease
Alcohol
Drugs
Mental illness
Malnutrition
Obesity
33
Q

How many of those with disability are in employment?

A

1/3

34
Q

What is Wilson-Jungner criteria?

A

Criteria for appraising the validity of a screening programme

35
Q

What is the Wilson and Jungner criteria for screening?

A

Knowledge of disease:
- Condition should be important
- Must be a recognisable latent or early symptomatic stage
- Nature course of the condition should be adequately understood
Knowledge of test:
- Suitable test or examination
- Test acceptable to population
- Case finding should be continuous
Treatment for disease:
- Accepted treatment for patients with recognised disease
- Facilities for diagnosis and treatment available
- Agreed policy concerning who to treat as patients
Cost consideration:
- Costs of case finding economically balanced in relation to possible expenditures on medical care as a whole

FoPC Yr 2 (4 decks)

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