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ICP > Ptsr > Flashcards

Ptsr Flashcards

1
Q

What is ethics

A

Moral principles that govern a persons behaviour

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2
Q

What is law

A

A system of rules that are created and enforced through social or governmental institutions which regulate behaviours.

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3
Q

3 ethical duties of care

A

Protect patient life and health
Respect autonomy
Act justly and fairly

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4
Q

Therapeutic relationship

A

Engagement between patient and dentist which has a beneficial impact on patient

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5
Q

Gd principle 5

A

Have a clear and effective complaints procedure

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6
Q

Outline complaints procedure (RDRD)

A

Resect patients right to complain
Deal with the complaint in a calm and constructive manner
Resolve the complaint by apologising and offering a practical solution
Dentist should have insurance and indemnity (financial protection).

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7
Q

Case law

A

Law that evolves with new decisions neing made by judges in court

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8
Q

Statute law

A

New law that is issues by governement

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9
Q

What happened in case of RvBrown 1989

A

Deception of NHS as dentist was claiming fees for work he had not done

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10
Q

Christie v Somerset Health Authority 1991

A

She suffered from permanent residual numbness following wisdom tooth extraction = Neglicence case as harm caused to patient

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11
Q

3 conditions for neglicence proving

A

Dentist had a duty of care to patient
Harm was resulted to patient
Dentist caused the harm

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12
Q

Montgomery v Lanarkshire 2015

A

Case law passed that patients must be informed of risk if treatment and reasonable alternatives - links to GDC standard principle 3 - valid consent

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13
Q

Gdc role

A

Provide a set of standards that must be abided
Protect patients abd regulate the dental team
- registration of dentists
- education and continual professional development
- discipline of health and professional misconduct

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14
Q

Carmichael vs GDC 1990

A

Professional misconduct leading to deregistratioj from GDC

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15
Q

Helsinki declaration 1960

A

Any research involving humans must take consent and be informed and voluntary and benefit should outweigh the harm.

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16
Q

Bolam test

A

Assesses medical negligence and used to base it on the reasonable dentist - which meant that it depended on whether another clinician wpuld testify in doing the same thing as what the doctor/dentist in the particular case did

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17
Q

New bolam test

A

Moves towards reasonable patient.. clinician must make patient aware if material risks so they must consider whether patient or any reasonable and prudent patient would attach significance to the risk

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18
Q

Appleton vs Garret 1997

A

Informed consent

Patients not given enough information on treatment so sued their dentist due to gross over treatment

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19
Q

What is battery

A

Unlawful touching of a person without their consent

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20
Q

Doctrine of necessity

A

If patient is unconscious the doctor must act in their best interest regardless of relatives opunujn

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21
Q

Paternalism

A

Restricting freedom and responsibility of patients, as the dentist acts as a parent and makes the decisions for the patient on the basis of what they believe is in the best interest of the patient.

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22
Q

Remember golden rule

A

Useful in every topic to mention

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23
Q

Maintaining confidentiality

A

Secure note storage
Privacy in the clinic
Dont discuss patient information when speaking on the phone in clinic
Privacy on social media
Verbally reassure patient about confidentiality
All staff on premises should be trained on the policies on maintaining confidentiality

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24
Q

Criteria for medical records

A

Up to date
Complete
Accurate

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25
Q

Tarasoff case 1976

A

Confidentiality- a case law that now states that confidentiality can be breached if there’s potential of harm to someone else eg tarasoff girl ended up killed.

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26
Q

3 stages pf making a competent decision on treatment

A

Take in and retain the information
Believe it
Weigh the info in terms of risks and needs

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27
Q

Re C (1994)

A

Patient with schizophrenia (delusions) refused amputation of gangrene in leg

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28
Q

F v West Berkshire 1990

A

36 year old woman had mental disability, the clinician acted in her best interest and a sterilisation occured without her consent, this was legal since she was incompetent.

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29
Q

Mental capacity act 2005

A

Appearance and behaviour shod not determine competence + unwise decisions + mental disability/learning difficulty
Capacity is assimed unless groubds for believing otherwise

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30
Q

Gillick case 1985

A

Case law on childrens competence - under 16 year olds - consent can be taken as long as they fit the competence criteria. If not then parent can give it.

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31
Q

Nhs plan for nhs dental services 2000

A

1) rewarding dentidts for their commitmentbto the nhs
2) more funding to dental practices to mskr services more accessible
3) dental access centres for ppl not registered with a dentist
4) increase availability of information about treatment and oral health advice

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32
Q

Thorndikes law of effect (1898)

A

The result of a behaviour influences the rate of occurence of the behaviour. Positive result = increase in behaviour frequency

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33
Q

Influence of knowledge on health behaviour

A

Has a short term effect as seen in a Brazilian study on school children (mayer et al 2003), after 5 years their dental health knowledge was greater in the intervention group however there was no longer a correlation with behaviour.

34
Q

3 stages of the learning theory (abc)

A

Antecedants
Behaviour
Consequence

35
Q

Antecedant?

A

Environmental stimuli associated with the behaviour. Increase it will increase the behaviour

36
Q

Describe the study by kegels et al 1978)

A

Positive reinforcement: Children given dental hygiene talk, those receiving rewards for compliance in the following 20 weeks had greater compliance %, compared to those who weren’t rewarded.

37
Q

Expectancy-value theory

A

The likelihood of a behaviour in an individual depends on their expectancy of the outcome and how much they value that outcome.

38
Q

Whats the citation of health beliefs model

A

Rosentock 1966

39
Q

Results in study by steele et al 1996 on dental attendance.

A

67% - no need to attend
32.4% fear of treatment
30% too expensive

40
Q

List the 3 theories for behaviour occurence

A

1) expectancy - value theory
2) health beliefs model
3) theory of planned behaviour (social norms about the behaviour affect the likelihood of it occurring)

41
Q

Primary appraisal

A

Perception of severity of a situation in terms of its demands

42
Q

Secondary appraisal

A

Perception of whether the individual has adequate coping resources to tackle the demamds

43
Q

Models of stress

A 
Physiological model 
Adaptation model (ARE) 
Transactional model (1/2 appraisal)
44
Q

Marucha 1996 (stress and physiological changes)

A

Reduced mucosal healing when students had punch biopsy during exam stress compared to summer vacation

45
Q

Sutton 1965 - stress effects

A

Caries group attending dental practice - 97% reported stress compared to 21% in non caries group
This may have been caused by behavioural changes:

46
Q

What is stress

A

Condition caused when an individual perceives an imbalance between demands of a situation and their coping resources.

47
Q

Shaping behaviour

A

Complex behaviours learnt in smaller steps via rewarding behaviours that are similar to the complex behaviour.

48
Q

Fear definition

A

Painful emotion caused by danger/apprehension of danger

49
Q

Anxiety ?

A

State of unease caused by fear and apprehension

50
Q

Wat is phobia

A

Fear that cannot be explained, and is out of proportion with the demands of the situation

51
Q

Adult dental health survey 1998 (surgery carried out every 10 years)

A

45% of adults always anxious about dental treatment

52
Q

What is the case law for Uk Professional standard for consent

A

Bolam vs friern HMC (1957)

53
Q

What are the types of risks

A

Significant risks affecting judgement of prudent reasonable patient.
Material risks which are more specific and subjective to the patient - the particular patient at hand may attach significance to it hence needs to be disclosed.

54
Q

Interpreter

A

An individual who interprets for the patient and health care professional so they can communicate and understand each other via a common language

55
Q

Advocate

A

Interprets for them plus supports the patient by ensuring they have all the knowledge and understanding and confidence to make an informed decision, and may also refer them to other organisations that can help them.

56
Q

Adult ego state describe

A

Rational and logical thinkers and not controlling

57
Q

Describe Wallstons Locus of control

A

Believing that the change in behaviour will actually have a positive effect eg reduced sugar freq reduces caries.

58
Q

Objectives for an appointment

A

Introduction- welcome n make patient feel at ease.
Accurate medical examination and history
Enquiring about patients expectations of the appointment (what is important to them n wat do they want)
Clear explanations of problems or treatment options - all information relevant disclosed
Check their understanding - be open to questions n summarise after every smalk chunk of info.
Shared decision making in treatment plan of action - take informed, valid, voluntary consent
Adult to adult relationship goal

59
Q

Improving patient recall

A

Reduce anxiety
Check current knowlefge/ understanding
Dont use jargon
Ensure info is relevsnt and is the appropriate time to talk

60
Q

List edamples of verbal communication

A 
Open/closed questions 
Tone of voice - soothing for anxious patients, speed n pitch 
Avoid jargon 
Check patient understanding 
Empathetic responses
61
Q

Non verbal

A

Listening - nod , smile, give cues eg “tell me more”
Eye contact, body language, facial expression
Level of seating
Show instruments - explaining of procedure
Show radiographs

62
Q

Health definition

A

Complete physical mental and social wellbeing

63
Q

Oral health

A

Having complwte and sound dentition with 32 straight teeth and no periodontal or soft tissue lesions, resulting in mental, social and physical health

64
Q

Disease

A

Pathological condition diagnosed via signs and symptoms

65
Q

Ilness

A

How a person feels when they are unwell and its effect on their daily life

66
Q

Ill health

A

The effects of disease and illness on a person

67
Q

Illness behaviour

A

The way that people monitor their bodies, they define and interpret their symptoms, take remedial action and utilise sources of help.

68
Q

Limiting long term illness

A

Health problem/disability impacting a persons daily activities

69
Q

Healthy life expectancy

A

How many years of life will be free pf long term limiting illness

70
Q

Wat is the study that showed better effect of sebsory info being goven to parients to prep them (reduced stress)

A

Johnson and Leventhal 1974

71
Q

Satisfaction with dentist correlating with attendance for preventive checkups (shane poor attendence)

A

Kent 1984

72
Q

Describe study by mineka et al 1984

A

Social learning theory - monkeys gained fear from parents fear of snake

73
Q

2 factor theory kf avoidance

A

Patiebt associates dentist (cs) with pain/fear (cr) hence avoid dentist and notice a remival of the pain n fear (negative reinforcement)

74
Q

A study where one group of chikdren who were shown a film on restoratibe procedure on a chikd were more compliant during their appts than comtrol group - social learning

A

Melaned et al 1975

75
Q

Indications of patient anxiety

A

Physiological - Hr n sweating
Behavioural - fidgeting, avoidance, facial expression
Patient telling you
Cognitively - patient poor ability to comprehend

76
Q

Patients with higher anxiety levels had greater pain levels

A

Wardle 1982

77
Q

Patients who were phobics had a greater reaction to painful stimuli- their pain threshold is reduced - wats the study :

A

Klepac 1982 (same yr as wardle)

78
Q

Equality

A

Everyone is treated in the same manner irrespective of their differences, doesnt consider needs and requirements of ppl

79
Q

Equity

A

Involves treating every individual according to his or her needs, it is fair and just, and considers needs of ppl.

80
Q

Wat is inequality

A

Unjust and unfair differences in health determinants and outcomes within and between populations

81
Q

Lower social class women have higher risk of mortality than upper class, in all ages

A

Langford and Johnson 2009

ICP (6 decks)

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