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Long Term Conditions Flashcards

1
Q

Why may someone not attend their regular GP following retirement of their usual GP?

A

-Loss of longstanding relationship, trust, person-centred approach. Worry about new relationship worth GP.

May be avoiding due to worrying symptoms. May be well.

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2
Q

Define person-centred care

A

The provision of care that places the patient at the centre, ensuring the healthcare system is designed to meet the needs and preferences of patients as defined by the patients themselves.

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3
Q

Who is in a position to make decisions about what patient-centred care means to them?

A

The patient

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4
Q

Where are the principles and values of patient-centredness brought together?

A

International Alliance of Patient Organisations (IaPO) Declaration on Patient-Centred Healthcare

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5
Q

What are the five principles of patient centred care defined by IaPO Declaration?

A

PAIR C

(P)ATIENT INVOLVEMENT in health policy
(A)CCESS and support
(I)NFORMATION
(R)ESPECT
(C)HOICE and empowerment
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6
Q

Name some common issues for patients with long term conditions?

A

Handicaps affecting physical, social and psychological well-being.

Constraints of family life, failure to re-establish the functional capacity to work and unremitting physical discomfort (pain).

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7
Q

What percentage of GP appointments are for long term conditions?

A

50

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8
Q

What percentage of outpatients appointments are for long term conditions?

A

64

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9
Q

What percentage of inpatient bed days are for long term conditions?

A

70

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10
Q

What categories of people are long-term conditions more prevalent in?

A

Older people

Lower socioeconomic class

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11
Q

What sort of conditions are becoming more prominent and causing disability?

A

Degenerative conditions eg Parkinson’s

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12
Q

What is the definition of incidence?

A

The number of NEW CASES of a disease in a population in a given period of time

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13
Q

What is the definition of prevalence?

A

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

EXISTING CASES

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14
Q

What can incidence be a good measure of?

A

Trends in causation and aetiology. Helpful for planning.

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15
Q

What can prevalence be a good measure of?

A

Amount of disease in a population. Assessing workload for the health service.

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16
Q

What sort of factors may be the aetiology of long term conditions?

A

Genetic factors (Genetics in cancer)

Environmental factors (Smoking)

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17
Q

What is meant by vulnerability?

A

An individual’s capacity to resist disease, repair damage and restore homeostasis

18
Q

How do the natural history of diseases vary?

A
  • Acute onset (ie MI)
  • Gradual/slow onset (Angina)
  • Relapse and remission (Cancer)
19
Q

What may treatment be aimed at in long term conditions?

A

Aimed at the disease (Disease-modifying), or effect of disease (Symptomatic)

20
Q

What are some demands placed on patients and caregivers?

A
  • Changing behaviour
  • Monitoring/managing symptoms
  • Complex treatment regimens and polypharmacy
  • Complex administrative systems and accessing
21
Q

What term is used for a loss of confidence in the body due to a long term condition?

A

Biographical disruption

22
Q

What adjustments might need to be made as a result of biographical disruption?

A

Reneogitating existing relationships

Redefining ideas of good/bad in terms of life aspects

23
Q

Give an example of a visible condition?

A

Paraplegia

24
Q

Give an example of an invisible condition?

25
Q

What sort of strategies are involved in coping with stigma?

A
  • Decisions about disclosing the condition (and suffer stigma)
  • Concealing the condition and pass for normal
26
Q

What impacts can long term conditions have?

A

Individual - Negative or Positive. Can include denial, self pity and apathy.

Family - financial, emotional and physical. May also become ill.

Community - Isolation of an individual

27
Q

Roughly what percentage of people in Scotland can be described as having a long-term activity-limiting health problem?

28
Q

What is meant by the expert patient?

A

A patient who has a great deal of expertise on their condition - possibly more than the health professional - often in conditions such as diabetes, or in parents.

29
Q

What is the dictionary definition of disability?

A

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

30
Q

What is the legal definition of disability?

A

Difficulty can be physical, sensory or mental. A disability that makes it difficult for them to carry out normal day to day activities

31
Q

What is the WHO definition of disability?

A

The International Classification of Functioning, Disability and Health (ICF)

-Body structure Impairment
Activity Liitation
Pargticipation Restrictions

32
Q

List some medical models of disability?

A
  • Individual/personal cause
  • Underlying pathology
  • Individual level intervention
  • Individual change/adjustments
33
Q

List some social models of disability?

A
  • Societal cause eg low wages
  • Conditions relating to housing
  • Social/political action needed
  • Societal attitude change
34
Q

List some legislation in relation to disability rights?

A

Disability Discrimination Acts 1995 and 2005

Equality Act 2010 –

35
Q

Why are doctors not spectators of disability?

A
  • Assessments
  • Coordinating the MDT
  • Rehabilitation
36
Q

What sort of factors may influence personal reaction to disability?

A
  • Nature of the disability
  • Information base (Intelligence/access)
  • Personality
  • Coping strategies
  • Role of the individual - Loss/change of role
  • Mood
  • Reaction of others
  • Support network
  • Self help groups
  • Time to adapt
37
Q

List some causes of disability worldwide?

A 
Congenital
Injury
Communicable Disease
Non-Communicable Disease
Alcohol 
Drugs-iatrogenic effect and/or illicit use
Mental Illness
Malnutrition
Obesity
38
Q

What happens to the presence and severity of diability with age?

39
Q

What fraction of people with disability are in employment?

40
Q

What is the Wilson and Junger criteria for screening?

A

Knowledge of disease:

  • Condition should be important.
  • Recognisable latent/early symptomatic stage.
  • Natural course adequately understood.

Knowledge of test:
Suitable test/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 whom to treat as patients.

Cost considerations:
Costs of case finding

FOPC (9 decks)

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