Quality Of Life Flashcards

1
Q

List 3 commonly used measures of health.

A
  • morbidity
  • morality
  • patient-based outcomes
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2
Q

What are patient-based outcomes? How do they normally work?

A

Patient-based outcomes assess well-being from the patients point of view - they work by comparing scores before and after treatment over longer periods

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3
Q

Why are patient-based outcomes being more predominantly used?

A

There has been an increase in conditions where the aim is managing, as opposed to curing, the condition

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4
Q

Give 2 examples of a patient-based outcome.

A
  • health-related quality of life (HRQoL)

- patient-reported outcome measure (PROM)

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5
Q

Give 2 reasons why using PROMs may be beneficial.

A
  • improve the clinical management of patients

- comparison of providers (hospitals)

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6
Q

What 4 clinical procedures in the NhS are currently using PROMs?

A
  • hip replacements
  • knee replacements
  • groin hernia
  • varicose veins
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7
Q

Define health-related quality of life.

A

Quality of life in clinical medicine represents the functional effect of an illness and its consequent therapy on a patient, as perceived by the patient

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8
Q

How may you measure the HRQoL using a PROM?

A

By using questionnaires known as instruments

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9
Q

What is an instrument? Briefly describe 2 types.

A

An instrument is a type of questionnaire that can be used to makes health-related quality of life (HRQoL):

  • generic instrument - can be used with any population
  • specific instrument - evaluates a series of health dimensions for a specific condition or disease
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10
Q

List 3 advantages and 3 disadvantages of generic instruments.

A

Advantages include:
- they can be used for a broad range of health problems
- they can be used if theres no existing disease-specific instrument
- they enable comparisons across treatment groups
Disadvantages include:
- they are inherently less detailed
- they may be too general and loss relevance to the condition
- they may be less sensitive to changes that result from an intervention

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11
Q

What is the SF-36 an example of? How is it scored?

A

The SF-36 is an example of a generic instrument - questions to 8 dimensions are scored, and within each dimension are added together - a score from each dimension is then calculated

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12
Q

List the 8 dimensions that compose an SF-36.

A
  • physical functioning
  • social functioning
  • role functioning (physical)
  • role functioning (emotional)
  • bodily pain
  • vitality
  • general health
  • mental health
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13
Q

In an SF-36, are the separate dimensions added together to give an overall score? Why?

A

No - this can make interpretation difficult in some cases and makes generalisations of results (ignoring outliers)

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14
Q

What is the EuroQol EQ-5D?

A

A generic instrument that generates a single index value for health status on which full health is assigned a value of 1 and death is assigned a value of 0

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15
Q

Where is a EuroQol EQ-5D particularly useful?

A

It is particularly useful in economic evaluations

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16
Q

What 5 dimensions does the EuroQl EQ-5D comprise? What 3 levels may these be rated?

A
  • mobility
  • self-care
  • usual activities
  • pain/discomfort
  • anxiety/depression
  • these are all rated as either no problem, moderate problem, or extreme problem
17
Q

What 3 types of specific instrument are there? Give an example of each.

A
  • disease specific eg arthritis impact measurement scale
  • site specific eg Oxford hip score
  • dimension specific eg McGill pain questionnaire
18
Q

List 2 advantages and 2 disadvantages of specific instruments.

A
Advantages:
- very relevant content
- sensitive to change 
Disadvantages:
- comparison is limited
- may not detect unexpected effects
19
Q

What is a long term condition?

A

Manifestations that vary day-to-day and can be controlled, but not cured

20
Q

What does an ageing population mean I’m regards to the prevalence of long term conditions?

A

Long term conditions will increase with an ageing population

21
Q

What percentage of healthcare in England is directed towards caring for those with a long term condition?

A

70%

22
Q

Give an example of a long term condition, and briefly discuss its pathology and symptoms.

A

Rheumatoid arthritis, caused by an autoimmune attack at joints - symptoms include joint swelling, pain, fatigue and osteoporosis

23
Q

How is a sociological approach to long term conditions distinct?

A

It focuses on how long term condition impact on social interaction and performance, concerning the effects of long term conditions and the experiences of the patients, and is interested in now these patients manage their everyday lives

24
Q

What is an illness narrative?

A

A patients description of their own experiences suffering from a long term condition

25
Q

List the 5 sociological theories of long term conditions.

A
  • illness work
  • every day life work
  • emotional work
  • biographical work
  • identity work
26
Q

In the illness work theory, why is optimum self management often difficult to achieve?

A

There are poor rates of adherence to the treatment, due to a reduced quality of life (side effects), and simply just a poor psychological wellbeing

27
Q

In everyday life work, what 2 forms of management are there, and what do they entail?

A
  • coping - the cognitive processes involved in dealing with illness
  • strategy - actions and processes involved in managing the condition and its impact
28
Q

In everyday life work, what is normalisation?

A

Attempting to keep your pre-illness lifestyle and identity intact, or re-designing your new life as a ‘normal’ life

29
Q

What coping mechanism is often associated with emotional work?

A

Downplaying pain and symptoms, in an attempt to present a ‘cheery self’

30
Q

How may social work have an impact of an individual’s role in society?

A

They may now be extremely dependent on others, which may lead to feelings of uselessness - this is particularly damaging in younger individuals

31
Q

What does biographical work entail?

A

The ‘loss of self’ where the former self image seems to crumble away - it entails the interaction between the body and identity

32
Q

What type of grief can biographical work lead to?

A

Grief of their former self or life, with the idea they have lost what they once took for granted

33
Q

What is a huge issue in identity work?

A

The illness itself can become the defining aspect of identity of an individual, affecting how an individual sees themselves and how others see the sufferer of the condition

34
Q

What is considered a defining word of identity stigma? How is this defined?

A

Stigma - a negatively defined condition or behaviour conferring ‘deviant’ status

35
Q

What types of stigma exist?

A
  • discreditable and discrediting stigma

- felt and enacting stigma

36
Q

What is the difference between a discreditable stigma and a discredited stigma?

A
  • a discreditable stigma is one that involves no physical manifestations (eg some mental illnesses, HIV)
  • a discredited stigma is on that involves physical manifestations or knowledge of a previous stigma (eg physical abnormalities or past suicide attempts)
37
Q

What is the difference between an enacted stigma and a felt stigma?

A
  • an enacted stigma is the real experience of prejudice and discrimination (stigma) as a consequence of a condition
  • a felt stigma is the fear of experiencing an enacted stigma, encompassing a feeling of shame