primary care exam Flashcards
calgary Cambridge model
Initiating the Session Gathering Information Providing Structure Building Relationship Explanation and Planning Closing the Session
how can you individualise care?
You must take into account their health beliefs, and their educational, social, cultural and economic backgrounds.
stress is
Stress is a controversial term but is broadly understood to result from an “imbalance between demands and resources” or occurring when “pressure exceeds one’s perceived ability to cope.”
techniques for minimizing risk and uncertainty
safety netting; arrange follow ups, know where help is, duration and red flags. Guidance Ask for advice reflection good organisation note keeping
what for of reasoning do GP’s use
hypothetico-deductive reasoning
what are some risk factors
sedentary lifestyle diet drinking smoking obesity
name the two basis’s for human behaviour
reflective or automatic
what are the five core concepts behind social cognitive theory
observational learning/modelling (people learn by observing others – learned behaviours), outcome expectations, self-efficacy, goal setting and self-regulation.
behavioural change theory looks at
personal beliefs, environmental factors and patterns of behaviour
to influence behaviour information must be
relevant, easy to remember and available
name hazards
physical, chemical, mechanical, biological, psychosocial
routes of exposure
skin, blood, inhalation, ingestion
3 principles of perception for risk
feeling in control (voluntary/involuntary)
size of the harm
familiarity of the risk
GMC values for medical excellency
partnership, communication, teamwork
WHO definition of health
A state of complete physical, mental, and social well-being
and not merely the absence of disease or infirmity.”
types of questions plus examples
Open-ended question Is not seeking any particular answer but simply signals to the patient to tell his story.
Direct question -Asks about a specific item.
Closed questio-Can only be answered by a “yes” or “no”.
Leading question - Presumes the answer and is best avoided.
Reflected question Allows the doctor to avoid answering a direct question from the patient. Examples, using pain as the problem:
Open-ended: “Tell me about the pain?”
Direct: “Where is the pain?”
Closed: “Is the pain severe?”
Leading: “The pain is severe?”
Reflected: “You want to know the cause of the pain?”
sytles of consultation
Authoritarian or paternalistic relationship
Guidance/co-operation
Mutual participation relationship
strategies during a consultation
listening and silence
facilitation
holisitc views of health
ideal state physical and mental fitness commodity strength and ability basis for personal potential
GPs are require to be revalidated every
5 years
the practice team
Manager IT/Admin Staff Secretarial Staff Reception Staff Nurses – Junior/Senior Advanced Nurse Practitioners/Physicians Assistants Phlebotomists/Health Care Assistants
three broad skills for interviewing
Content skills. What doctors communicate - the substance of their questions and responses, the information they gather and give; the treatments
Perceptual skills. What they are thinking and feeling - their internal decision making, clinical reasoning; their awareness of their own biases, attitudes and distractions.
Process skills. How they do it - the ways doctors communicate with patients
what can influence a consultation
physical factors; records, site, enviroment
personal factors; beliefs, religous
non verbal communication and cues
what comprises ethics
Principles
Values
Honesty
Standards, rules of behaviour that guide the decisions, procedures and conduct of individuals that respect the rights of all stakeholders affected by its operations
what are the four principles fo medical
Respect for Autonomy
Non-malfeasance
Beneficence
Justice
what are some ethical considerations you have to make
Non-judgmental approach Not imposing personal views & respecting patients’ views Confidentiality Not exceeding your competency Fitness to practise consent
ethical code of healthcare workers
“I understand and will uphold that all those caring for and treating patients are bound by a Duty of Candour”
some reasons for gradient in socioeconomic health
Access to health care Environmental exposures The physical environment The social environment Health behaviours Life course factors
Access to healthcare takes into account
Affordability
Accessibility
Acceptability
role of government in reducing exposure to health risk
Legislation
Regulation
Taxation
