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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
Q

Factors affecting chronic illness

A

Stress and coping
Personality
Resilience
Illness behaviour

26
Q

Coping strategies

A 
Problem-solving 
Support-seeking 
Escape avoidance 
Distraction 
Cognitive restructuring
27
Q

Coping strategy classification

A

Emotion focused - modifying response to problem

Problem focused - action to change or address stressor

28
Q

What is resilience?

A

Positive capacity to cope with change, stress and adversity

Adapt successfully to challenges

29
Q

Behaviour is influenced by

A

Attitude - positive or negative
Subjective norm
Perceptions of control over behaviour

30
Q

Person is more likely to make a behavioural change if

A

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
Q

Stages of change

A 
Pre-contemplation 
Contemplation 
Preparation 
Action
Maintenance
Relapse
32
Q

How does stress affect health?

A

Prevents people from making rational health decisions

Stress hormones can exacerbate physical symptoms

33
Q

Factors affecting symptom perception

A

Existing conditions
Psychological factors
Pain
Emotions

34
Q

Psychological impact of chronic disease

A

Anxiety and depression

35
Q

What is illness?

A

What the patient experiences when unwell

36
Q

What is disease?

A

What the doctor sees and interprets and what action they suggest

37
Q

Patient sick role

A

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
Q

Health care professional sick role

A

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
Q

Secondary gains from being classed as sick

A

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
Q

Medical features of disability

A

Individual/personal cause
Underlying pathology
Individual level intervention
Individual change/adjustment

41
Q

Social features of disability

A

Societal causes
Conditions relating to environment
Social/political action needed
Social attitude change

42
Q

GMC good medical practice on disability

A

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
Q

Equality act 2010 definition of disability

A

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
Q

Disability discrimination act 1995 definition of disability

A

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
Q

Causes of cognitive and physical under-development or physical limitation or absence

A

Genetic or chromosomal disorders
Accidents
Chronic disease

46
Q

Medical models of disability

A

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
Q

Social models of disability

A

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
Q

Psychological models of disability

A

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
Q

Types of problem solving

A

Pattern recognition
Hypothetico-deductive reasoning
Inductive reasoning

50
Q

When is hypothetico-deductive reasoning used?

A

To rapidly narrow down list of differential diagnoses

51
Q

When is inductive reasoning used?

A

If nothing is known about the presentation, systematically consider what could be wrong

FoPC Year 2 (5 decks)

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