Medical student to patient Flashcards
Define chronic illness.
What is the prevalence?
The course of the disease lasts for more than three months, e.g. arthritis, asthma, cancer, COPD, diabetes.
15 million people in the UK
Define impairment.
Define disability.
Explain the difference between the two.
Impairment - a problem in body function or structure; an activity limitation is a difficulty encountered by an individual in executing a task or action; while a participation restriction is a problem experienced by an individual in involvement in life situations.
Disability - an umbrella term, covering impairments, activity limitations, and participation restrictions. It is a complex phenomenon, reflecting the interaction between features of a person’s body and features of the society in which he or she lives.
Describe the impact chronic illness has on the person.
Symptoms, pain, fatigue Appointments, medications and side effects, test results A burden Depression, loss of confidence/self-esteem, anger, despair, frustration Deserted/isolated Impact on career, social life, cost Changes identity Can no longer do hobbies
What is meant by shared decision making? What is this useful for?
“Shared decision-making is an approach in which clinicians and patients communicate together using the best available evidence when faced with the task of making decisions.”
For patient interactions but also more generally (commissioning, research, policies etc)
What is meant by a sick role?
Being sick means the sufferer enters a role of deviance, because they are not a productive member of society. This deviance needs to be policed (by the medical profession). The individual is not only physically sick, but now adheres to the specifically patterned social role of being sick. They have customary rights and obligations based on the social norms surrounding being sick - they are exempt from normal social roles, they are not responsible for their condition, they should try to get well, they should seek help and cooperate with the medical professional.
This is the role that people sometimes create for themselves when suffering long-term conditions. They create a lifestyle, environment and culture that suits their condition and in which they are comfortable.
How does a long-term condition affect a patient’s identity?
Doctor may perceive their identity as ‘the 10 o’clock’ or the ‘Chiari patient in bed 6’.
For the patient they feel that parts of their identity gets taken away/changed/traded.
How can meeting other people with LTCs help patients?
They can use them as role models - it is a way of challenging the identity of living with a LTC – turn it into a more positive identity.
What is recovery?
Recovery is a deeply personal unique process of changing one’s attitudes, values, feelings, goals, skills and roles. It is a way of living a satisfying, hopeful and contributing life, even with the limitations caused by illness. Recovery involves the development of new meaning and purpose in one’s life as one grows beyond the catastrophic events of illness.
How might long-term conditions challenge the identity of the doctor?
It doesn’t match with their identity as they can’t fix it or cure these people. This challenges the reason they became a doctor.
How can a doctor help encourage a patient with LTC with regards to their self-management?
“Tell me what you are doing already to manage your health.”
Give them praise and affirmation.
