The Impact of Long Term Condition

Question 1

what is person centred care?

Answer 1

places the patient at the centre
only the patient can make a decision on what this means to them
declatation on patient centred care

Question 2

patient centred care: International Alliance of Patient’s Organsiations Declaration 5 principles

Answer 2

respect
choice and empowerment
patient involvement in health policy
access and support
information

Question 3

define incidence

Answer 3

the number of new cases of a disease in a population in specified period or time

Question 4

define prevalence

Answer 4

the number of people in a population with a specific disease at a single point in time or in a defined period of time

Question 5

draw a graph showing the FEV1 decline of smokers

Answer 5

see notes

Question 6

what is vulnerability

Answer 6

an individuals capacity to resist disease, repair damage and restore physiological homeostasis

Question 7

discuss the burden of treatment

Answer 7

Patients and caregivers are often put under enormous demands by healthcare systems:
Changing behaviour or policing the behaviour of others to adhere to lifestyle modifications.
Monitoring and managing their symptoms at home.
Complex treatment regimens and multiple drugs (polypharmacy) contribute to the burden of treatment.
Complex administrative systems, and accessing, navigating, and coping with uncoordinated health and social care systems add to this

Question 8

discuss biographical disruption

Answer 8

A long term condition leads to a loss of confidence in the body.
There is then a loss of confidence in social interaction or self‐identity, this process is termed ‘biographical disruption’.
This brings into focus the meaning of illness for the individual ‐ the meanings of long term conditions are not simply personal.
It may involve re‐negotiating' existing relationships at work and at home. The chronically ill and disabled person also needs to be able to make some sense of their condition before they can begin the process of adjusting’ to it.
Involves redefining ideas of what is good' and bad’, such that the positive aspects of their lives are emphasised, and the negative impact of the illness lessened.

Question 9

discuss the stigma of long term conditions

Answer 9

Some long term conditions are visible while others are invisible.
Still others are both visible and invisible.
Having a chronic illness or condition subjects a person to possible stigmatization
by those who do not have the illness.
Coping with stigma involves a variety of strategies including the decision about
whether to disclose the condition and suffer further stigma, or attempt to
conceal the condition or aspects of the condition and pass for normal.

Question 10

impact of LTCs: individual

Answer 10

negative - denial, self pity, apthy

positive

Question 11

impact of LTCs: family

Answer 11

financial
emotional
physical
other family members may become ill as a result

Question 12

impact of LTCs: community/society

Answer 12

isolation

Question 13

what is an expert patient?

Answer 13

An observation often made by doctors, nurses and other health professionals who undertake
long‐term follow‐up and care of people with particular long term conditions like diabetes
mellitus, arthritis or epilepsy is “my patient understands their disease better than I do.”
This knowledge and experience held by the patient has for too long been an untapped resource.
It is something that could greatly benefit the quality of patients’ care and ultimately their quality
of life, but which has been largely ignored in the past.

Question 14

medical model of disability

Answer 14

▪ Individual/personal cause e.g. accident whilst drunk
▪ Underlying pathology e.g. morbid obesity
▪ Individual level intervention e.g. health professionals advise individually
▪ Individual change/adjustment e.g. change in behaviour

Question 15

social model of disability

Answer 15

▪ Societal cause e.g. low wages
▪ Conditions relating to housing
▪ Social/Political action needed e.g. facilities for disabled
▪ Societal attitude change e.g. use of politically correct language

Question 16

name two laws in relation to disability

Answer 16

Disability Discrimination Acts 1995 and 2005

Equality Act 2010

Question 17

what does the personal reaction to disability depend on?

Answer 17

The nature of the disability
The information base of the individual, ie education, intelligence and access to information
The personality of the individual
The coping strategies of the individual
The role of the individual – loss of role, change of role
The mood and emotional reaction of the individual
The reaction of others around them
The support network of the individual
Additional resources available to the individual e.g. good local self‐help group, socio‐economic resources
Time to adapt i.e. how long they have had the disability

Question 18

discuss the sick role

Answer 18

The general idea is that the individual who has fallen ill is not only physically sick, but now adheres to the specifically patterned social role of being sick. ‘Being Sick’ is not simply a ‘state of fact’ or ‘condition’, it contains within itself customary rights and obligations based on the social norms that surround it. The theory outlined two rights of a sick person and two obligations:

Rights:
The sick person is exempt from normal social roles
The sick person is not responsible for their condition
Obligations:
The sick person should try to get well
The sick person should seek technically competent help and cooperate with the medical professional

Question 19

disability can disrupt families at 3 levels

Answer 19

personal
economic
social

Question 20

causes of disability

Answer 20

Congenital
Injury
Communicable Disease
Non‐Communicable Disease
Alcohol
Drugs‐iatrogenic effect and/or illicit use
Mental Illness
Malnutrition
Obesity

Question 21

list the Wilson’s criteria for screening

Answer 21

the condition should be an important health problem
the natural history of the condition should be understood
there should be a recognisable latent or early symptomatic stage
there should be a test that is easy to perform and interpret, acceptable, accurate, reliable, sensitive and specific
there should be an accepted treatment recognised for the disease
treatment should be more effective if started early
there should be a policy on who should be treated
diagnosis and treatment should be cost-effective
case-finding should be a continuous proces