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FoPC Year 2 > Long-Term Conditions and Problem Solving > Flashcards

Long-Term Conditions and Problem Solving Flashcards

1
Q

Differences between acute and chronic illnesses

A

Acute illnesses more short-lived and amenable to cure with the demise of acute illness
Chronic illnesses have become increasingly prevalent due to ageing population causing a burden of disease on healthcare system

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2
Q

Examples of common chronic illnesses

A

Osteoarthritis
Ischaemic heart disease
Respiratory disease

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3
Q

Persistent diseases that don’t lead to early death constitute an important group of health problems as patients may endure multiple handicaps affecting physical, social and psychological wellbeing, leading to

A

Constraints on family life
Failure to re-establich functional capacity to work
Unremitting physical discomfort e.g. chronic pain

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4
Q

What is the incidence?

A

Number of new cases

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5
Q

What is the prevalence?

A

Number of existing cases

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6
Q

What is pathophysiology?

A

Pathological basis of underlying disease

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7
Q

What is clinical disease?

A

The specific clinical consequence which results from the pathophysiological process

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8
Q

What is the illness episode?

A

Time between illness onset and offset

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9
Q

What is the response?

A

Pattern of decrease in symptoms and/or signs indicating decrease in severity of underlying pathological process

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10
Q

What is recovery?

A

Sustained period of health following illness episode when clinical features are no longer present or insufficient to warrant further investigation or change in treatment

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11
Q

What is remission?

A

Period following episode of illness to warrant the use of “recovery” - signs and symptoms have lessened in insufficiency and remain insufficient to warrant further investigation or treatment

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12
Q

What is relapse?

A

Reinstatement in clinical features following an episode of illness

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13
Q

What is recurrence?

A

Reinstatement of new episode of illness following abatement of clinical features of sufficient duration to warrant the term “recovery”

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14
Q

What is body and structure impairment?

A

Disturbance to body structures, organ or system function which presents at birth or arises from disease or injury and equates to the presence of clinical disease

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15
Q

What is activity limitation?

A

Restriction or lack of ability to perform activity in a manner or within a range considered normal

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16
Q

What is participation restriction?

A

Social construct depending on the meanings and values - social disadvantage for the individual resulting from activity limitation or impairment that limits or prevents role normal for that individual

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17
Q

WHO definition of health

A

Health is a state of complete physical, mental and social well-being and not merely the absence of disease and infirmity

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18
Q

Factors affecting aetiology of chronic disease

A

Long-term complex interaction of factors
Genetic factors
Environmental factors

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19
Q

What is vulnerability?

A

Individual’s capacity to resist disease, repair damage and restore physiological homeostasis
Important in extremes of life

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20
Q

Who might chronic illness impact?

A

Individual affected
Family
Community/society

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21
Q

How is an individual affected by chronic illness?

A

Positive or negative

Can include denial, self-pity or apathy

22
Q

How is a family affected by chronic illness?

A

Financial
Social
Other family members may become ill as a result

23
Q

Natural history of disease

A

Acute onset
Gradual with slow or rapid deterioration
Relapse and remission

24
Q

Treatment is aimed at

A

disease or effect of disease

25
Factors affecting chronic illness
Stress and coping Personality Resilience Illness behaviour
26
Coping strategies
``` Problem-solving Support-seeking Escape avoidance Distraction Cognitive restructuring ```
27
Coping strategy classification
Emotion focused - modifying response to problem | Problem focused - action to change or address stressor
28
What is resilience?
Positive capacity to cope with change, stress and adversity | Adapt successfully to challenges
29
Behaviour is influenced by
Attitude - positive or negative Subjective norm Perceptions of control over behaviour
30
Person is more likely to make a behavioural change if
They have a positive attitude towards it It brings about consequences important to them They believe others think it is important that they do it They feel they have the necessary resources, skills or opportunities to overcome barriers
31
Stages of change
``` Pre-contemplation Contemplation Preparation Action Maintenance Relapse ```
32
How does stress affect health?
Prevents people from making rational health decisions | Stress hormones can exacerbate physical symptoms
33
Factors affecting symptom perception
Existing conditions Psychological factors Pain Emotions
34
Psychological impact of chronic disease
Anxiety and depression
35
What is illness?
What the patient experiences when unwell
36
What is disease?
What the doctor sees and interprets and what action they suggest
37
Patient sick role
Exempt from daily responsibilities Not responsible for being ill and unable to get better without help of health care professional Must seek help from HCP Under social obligation to get better as soon as possible to be able to take up social responsibilities again
38
Health care professional sick role
Must be objective and not judge patient morally Must not act out of self-interest or greed but put patients interests first Must obey to professional role of practice Have and maintain necessary knowledge and skills to treat patients Right to examine patient intimately, prescribe treatment and has wide autonomy in practice
39
Secondary gains from being classed as sick
Care and sympathy Concern from family and friends Financial allowances associated w/ disability Using apparently disabling illness as explanation for failures Avoiding work Restoring status or domination in family Achieving revenge for bad treatment or pay from employer or insurance company
40
Medical features of disability
Individual/personal cause Underlying pathology Individual level intervention Individual change/adjustment
41
Social features of disability
Societal causes Conditions relating to environment Social/political action needed Social attitude change
42
GMC good medical practice on disability
Doctors must not unfairly discriminate against patients by allowing their personal views to adversely affect their professional relationship with patients or the treatment they provide or arrange. This includes disability as well as many other factors. You should challenge colleagues who do not comply with this guidance and be aware of own attitudes and prejudices of disability and address this by finding out about common disabilities.
43
Equality act 2010 definition of disability
Disability is one of the characteristics protected under this legislation as well as age, race and sexual orientation. A person has a disability if they have a mental or physical impairment that has a continuing effect on their ability to perform day to day activities.
44
Disability discrimination act 1995 definition of disability
Person with disabilities is one with physical, sensory or mental impairment which has a substantial, adverse and long term (>12 months) effect on ‘normal’ day to day activities.
45
Causes of cognitive and physical under-development or physical limitation or absence
Genetic or chromosomal disorders Accidents Chronic disease
46
Medical models of disability
Disability intrinsic to individual and direct consequence of underlying disease Reduction can only be achieved via amelioration of underlying pathology Medical intervention means to restore “normality”
47
Social models of disability
Socio-cultural focus, disability placed outside individual People not per se limited by medical condition but by behavior of others towards them and environmental conditions Underpins legislation to remove barriers Reduces limitations e.g. wheelchair access, hearing aid loop systems etc
48
Psychological models of disability
Describes how activities performed by someone with a health condition underpinned by same psychological processes of nondisabled person. Includes motivation, mood disorders and self-efficacy. Also upbringing, resilience, coping and self-motivation Also lived experience of disability including self image, social and economic marginalization, uncertainty about wellbeing and feelings of powerlessness.
49
Types of problem solving
Pattern recognition Hypothetico-deductive reasoning Inductive reasoning
50
When is hypothetico-deductive reasoning used?
To rapidly narrow down list of differential diagnoses
51
When is inductive reasoning used?
If nothing is known about the presentation, systematically consider what could be wrong

FoPC Year 2 (5 decks)

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