Self management

Question 1

Name 5 social changes that facilitate self management

Answer 1

• Increased (but not universal) access to telephones and the internet.
• DoH emphasis on primary prevention: increased promotion of self-checking behaviours, engaging with healthy lifestyles, mass media campaigns such as Change4Life.
• Rise of empowerment movements.
• Changes in social attitudes to** smoking, obesity**
• Legal changes such as the smoking ban, sugar tax.

Question 2

Name 6 factors that makes self management difficult

Answer 2

• Complicated regimes
• Long term habits hard to change (smoking)
• Hard to self manage chronic conditions - lose motivation
• Lack of understanding and remembering
• Comorbidiites: hard to manage multiple
• Financial barriers

Question 3

Health belief model & The Theory of Planned Behaviour – Ajzen and Fishbein

Question 4

Name 3 issues that can arise from a medical consultation from a patients perspective

Answer 4

Failure to agree on a diagnosis

Lack of agreement about the correct treatment

Dissatisfaction with the interaction – where patients feel they have not been listened to

Question 5

Name 4 concerns about medication patients may have [4]

Answer 5

Concerns about side effects
Worries about dependency
Beliefs about what is ‘natural’ and ‘unnatural’
Disruption to lifestyle – taking medication every day, at certain times of day

Question 6

Describe the difference between informed desicion making and shared decision making

Answer 6

Informed:
* Dr gives patient all the factual/medical information they need about treatments
* Patient decides what treatment/management to have
* Dr provides treatment/management
* Responsibility lies with patient

Shared decision making:
* Dr and patient are both involved
* Dr and patient discuss possible treatment/management options
* Dr gives expert opinion/recommendation
* Dr and patient decide on treatment/management together
* Responsibility lies with patient AND doctor

Question 7

What is Fundamental Attribution Error

Answer 7

The tendency to blame people for their illness rather than the circumstances

This occurs particularly for psychiatric patients, minorities, those with substance abuse issues and other marginalised groups

Question 8

What is expert patient programme?

Answer 8

• Improve QoL of patient by talking to other patient who often knows more about condition vs HCP.
• Teaching patients how to communicate better.

Question 9

Define the following types of support:

• Esteem support
• Companionship support
• Instrumental support
• Functional support

Answer 9

• Esteem Support: other people increase one’s self-esteem.
• Companionship support through activities
• Instrumental Support: physical help
• Structural Support: type, size, density and frequency of contact available.
• Functional Support: perceived benefit provided by structure. Available and enacted support.

Question 10

What is self help

Answer 10

• Can mean joining a group of people with similar health issues.
• Can equally take on the form of books, DVDs, online courses, virtual groups/forums.
• Groups can be peer/expert led.
• Can be carried out by individuals who would rather not join a group.