Patient Centered Centred

Question 1

List everything wrong with the Stafford hospital trust (5)

Answer 1

1) patients seen by unqualified staff
2) crucial equipment not in place or not working- nurses not able to use heart monitors
3) low staffing
4) excuse given - aiming for “trust” status , hitting targets
5) inquiry into why there were higher than normal number of deaths while the hospital was moving up league tables

Question 2

Outline the bio-medical model of health and disease (8)

Answer 2

1) dominant model worldwide based on the Cartesian philosophy of body as a machine
2) if a part malfunctions it can be repaired or replaced
3) concerned with the treatment of dysfunction
4) health is conceptualised as the absence of disease
5) theoretical framework is positivism:approach based on quantitative measurement I.e events that give knowledge and meaning are measurable
6) cause and effect
7) if you cannot measure it you cannot understand it
8) encouraged a reductionist approach

Question 2

Explain how reliance on technology relates to the bio medical model of health and disease

Answer 2

1) body- machine to be mended. Solutions to medical problem = technologies : drugs, new parts ( artificial hips, heart valves) , machinery ( dialysis machine)
- linked to mind body dualism - medicine only treats body but neglects the mind so it may not treat the true cause of the problem

Question 3

Explain what is meant by the phrase the body as a machine with regards to the bio-medical model of health and disease (4)

Answer 3

1) heart- engine , urinary system - waterworks/plumbing
2) series of inert connected parts which can be mapped
3) can be fixed/mended
4) doctors- engineers/mechanics can mend the dysfunctional body

Question 5

Define the term aetiology

Answer 5

Aetiology: The study of the causes. For example, of a disorder.

• all disease due to specific, identifiable agent ( parasite, gene, bacteria ect) which attacks the body
• all disease has a specific cause: can be treated through medicine.
• however does not account for multifunctional effects of social environment e.g. Stress , nutrition, risky behaviour.

Question 6

Outline the assumptions about the nature and causes of disease with regards to the bio- medical model of health and disease. (3)

Answer 6

1) all disease traceable to specific aetiology e.g. Virus
2) patients body as a machine can be made better through medical engineering
3) elimination of disease and return to health depend on medical technology and/or chemical engineering

Question 7

Outline the bio-psycho-social model of health and disease (5)

Answer 7

1) subjective feelings and perception of disease. I.e illness is important in understanding the socio-environmental model
2) People’s response to symptoms is as important as the disease stage itself illness not always measurable. A person can be diseased without feeling ill or a person may feel ill without any obvious biological cause.
3) focus on maintenance and promotion of health as opposed to fight against disease- challenges the mind body dualism
4) behavioural, social , economic and environmental changes influence health. Health beliefs influence health.
5) can a physical body be fixed treated or mended independently of the mind? We now need to consider a holistic approach as health, disease and illness are not just biological - influenced and shaped by the wider socio economic context

Question 8

Explain what is meant by patient centred care (3)

Answer 8

1) listening to the patient fully
2) exhibiting care and compassion
3) engaging in other agreeable behaviours to improve patients psychological and functional outcomes as the same time.

Question 9

Describe what patient centered care encourages (2)

Answer 9

1) focus on patients and their concerns, rather than nearly diseases and their assessment
2) practitioners are encouraged to see the illness through the patients eyes .

Question 10

What are SSRIs? (selective serotonin reuptake inhibitors) (3)

Answer 10

They are antidepressants -fluoxetine (Prozac) , others include paroxetine (seroxat) , citalopram (cipramil) and sertraline (lustral)

• drugs that selectively block the reuptake of serotonin from the space between neurones in the brain. This increases the amount available to the postsynaptic cell downstream
• serotonin is a neurotransmitter that is associated with good emotion

Question 11

Patient centred care encourages “seeing the illness through the patients eyes” . Outline what this means (5)

Answer 11

1) listening to and respecting the patients beliefs
2) understanding that patients are affected by different socio-economic circumstances - these impact on knowledge and beliefs
3) understanding that patients may want to behave in a way that is different to medical advice
4) involve patients in decision making
5) making sure that patients are consenting to services you provide