LTC Flashcards
The impact of LTC
● Increasing problem
● More common in older and deprived groups
● 50% of GP appts
● Can lead to multiple handicaps affecting physical social and psychological well-being
● Chronic pain, reduction in work capacity, other disabilities
principles of patient centred care
Patient at centre of decision making: 5 principles 1. Respect 2. Choice of empowerment 3. Patient involvement in health policy 4. Access and support 5 Information
epidemiology: define incidence
number of cases of a disease within a population over a given time period (trend in causation and aetiology. of disease)
epidemiology: Prevalence
people in a population with a specific disease at single point in time or in define period of time (assess current workload in HC)
Causes of LTC
Environmental factors
Genetic factors
neither or both
Who is vulnerable to LTC
Individuals who lack capacity to resist disease, repair damage and restore physiological homeostasis
What are the natural history of diseases?
Acute onset (MI, stroke)
Gradual onset: rapid/slow (angina, dementia)
Relapse and remission (cancer, MS)
treatment
- Resolve disease, treat symptoms
- accept the chronic nature of the condition
- admit failure of diagnosis or cure
the border of treatment
Demands of healthcare systems on its and carers:
- changing behaviour of lifestyle modifications
- monitoring and managing symptoms at home
- complex treatment and multiple drugs
- complex admin systems: working with uncoordinated health and social care system
Biographical disruption: how does LTC affect body confidence
- Leads to loss confidence in social interaction/self identity
- renegotiates relationships in the workplace
- Need to make sense of condition before adjusting
- refine good or bad to emphasis positive life and lessen negativity of illness
Stigma
● Invisible/visible/both
● Stigmatization by those who are unaffected
● Decisions to disclose or conceal condition (appear normal)
Impacts on:
Individual: postive or negative, self pity ataphy
Family: emotional, financial, physical and contagious
Community/social: Isolation of the individual. Community can be judges on how it treats ill
Expert patient
Patient understands disease better than healthcare professional
- untapped resource - improvements in quality of care
What is the WHO definition of disability:
- Body and structure impairment :abnormalities of structure, organ or system function
- Activity level: changes functional perforation and activity by individual
- participation restriction: disadvantage caused by disability, interaction in society/ environment
What is the model of disability?
MEDICAL
1. individual cause (accident when drunk)
2. pathology (obesity)
3. individual intervention (health professional advise)
4. individual change (change in behaviour)
SOCIAL
1. societal cause e.g. low wage
2. housing conditions
3. social and political actions (FACILITIES FOR DISABLED)
4. social attitude (use of politically correct language)
