Main stuff to learn for exam

Question 1

5 ways to increase adherence

Answer 1

Listen and get patient to repeat instructions back; repeat as needed
 Keep prescriptions simple and give written instructions; be concrete
 Involve spouse or partner
 Ascertain patient worries and expectations; probe for barriers

 Emphasize importance of adherence at each meeting and gear scheduling to adherence needs
 Call for missed appointments

 Use pill containers and reminders
 Take patient’s lifestyle into account when determining regimen
 Acknowledge patient efforts
 Share decision-making with patients

Question 2

How is social support linked to health

Answer 2

1) Social support improves adherence to medical treatment
2) Social support influences health behaviours and lifestyle (diet, smoking, drinking, exercise, etc.)
3) Social support buffers against stress (protects against negative effects of stress, improves coping strategies during stress)
4) Social support protects against psychiatric disorders & cognitive decline

Question 3

4 barriers to effective communication - cross cultural

Answer 3

• Verbal communciation 0 stuff left out
• Errors - human errors
• Non-verbal communication -harder to portray, and is still important - different cultures may show slighlty different nonverbal communcaiton

-Loss in translation (long questions, short answers)
 Interpreter imposing personal ideas to clients
 Clients ask interpreter not to disclose specific content.
 Interpreter is from another country of origin who does not understand the specific slangs used by client
 Interpreters’ remarks (not being respected by clinicians and clients)
 Clients’ remarks (shame, worried if family secret will be disseminated by gossips)

to solve

• could get them to repeat back what they think is going on
• give clear instructions
• make sure interpreter speaks same dialect
• be careful if short answers are beign made hwen need longer ansers

Question 4

4 effective communication skills

Answer 4

• Warm, welcoming, kind - build a good repour, want to be trustworthy to the patient
• listenign to the patient, not avoding their concerns
• good at explaining things and having clear explanations
• show empathy to patient

Question 5

Conscious and unconscious factors that can influence decision making

Answer 5

Concious - slow, thinking thorugh the problme, normally for harder tasks - can improve for hard tasks, but sometimes can overhthink things for easier tasks
-evidence -can weigh up

Unconcious - memory, past expereneces
-personal - belifes, expereices
-

Question 6

How to approach a mental state examination

Answer 6

A mental state exam is a structured way of observing and describing a patients current state of mind

• -Appearance and behaviour
• cognition
• speech
• mood/affect
• thought process, form
• thought content
• perception
• suicide/homicide/self care risk
• insight/judgement

Question 7

Patient and doctor characteristics and contributing factors to challenging consultations

Answer 7

Patient - personality, attitudes, illness behaviour, culture

Doctor - burnout, distracted, depressed, junior

Question 8

Rebels framework

Answer 8

R- recognise the problem
E - express empathy
B - establish clear boundaries
E - emphasise the patients best interest
L - use inclusive language
S - focus on the solution

Question 9

Sexual health - communication barriers to good care

Answer 9

• establishing good rapour, good communication - make the patient feel comfortable and trust
• Barreirs - could be your own beliefs and values - dont let these get in the way
• Do NOT assume gendernormitivity - need to ask open questions not makign assumptins about anyines sexuality, or gender
• Good communication - be clear on what you are asking
• knowledge - have good knowledge about this
• confidentiality, signpost, power
• normalsie it

Question 10

Barriers to skillful and supportive talks about sex

Answer 10

Associated with embarrassment & negativity
 Sexual education is generally poor quality
 Fear of TMI (too much information)
 Fear of offending or intruding
 Often overlooked in general health care
 Fear of disclosures of sexual abuse
 Ethico-legal uncertainty

Question 11

SNAPC

Answer 11

S - signpost - need to ask you some questions about..
Normalise - say you always ask all your pateitns about this
Acknowledge - this is personal, may be uncorfortable
P - permit - dont have to answer anythign, share paower
C - confidenceitallyity

Question 12

5P’s

Answer 12

-Past history (STIs, sexual health, functioning problems)
-Partners - gneder, no. past and current, relationships
-Pregnancy - contraception, fertilitym past nad preset
-P practices - types of sexual behaviorus and with whome
Prevention - sexual healht protection habits

Question 13

HEadsss assememetn

Answer 13

Home
 Education and/or employment
 Eating
 Activities
 Drugs
 Sexuality
 Suicide & depression
 Safety

Question 14

How to respond to someone who has been sexually abused

Answer 14

Validate by saying“It’s not okay that that happened to you”; “I am very sorry that happened to you”.
Be utterly present (it is important to take a few minutes)
Stay calm, reinforce how common it is, don’t minimse
Normalise any traumatic responses and symptoms, e.g. “many people find….is that something that has affected you?”
Check out if they are currently safe (SAFETY protocols)
Offer opportunities for support and treatment
Check how they feel about reporting to the Police.

Question 15

Symptoms reporting - 5 factors that influence this

Answer 15

Patient - mood, social and occupational function, resilience to stress, immune competence

Clinicians - not asking the write questions, not building good rapour - patient does not feel comroftable, job satisfaciton

Question 16

What are the codes of rights

Answer 16

1. The right to be treated with respect
2. The right to freedom from discrimination, coercion, harassment, and exploitation
3. The right to dignity and independence
4. The right to services of an appropriate standard
5. The right to effective communication
6. The right to be fully informed
7. The right to make an informed choice and give informed consent
8. The right to support
9. Rights in respect of teaching or research
10. The right to complain

Question 17

EAch of the 4 coniditons must be meet in order for an action to be btoh good and bad effect to be justified

Answer 17

1. act must be good or at least morally neutral (independet of consequences)
2. the agnets intends only the good effect - the bad effect may be foreseen, toelrated and permitned but is not intented. if the good effect can be achievee without the bad it should be
3. the bad effect mustnot be a means to the good effect
4. the good effect must outeight the bad effect