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FOPC > The impact of long term conditions > Flashcards

The impact of long term conditions Flashcards

1
Q

What is person centred care?

A

Only patient in position to make decision

More access to info, self-management programs etc

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2
Q

What are the 5 principles of patient centred healthcare?

A 
Respect
Choice and empowerment 
Patient involvement in health policy 
Access and support 
Information

(Royal College of Paediatrics And I)

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3
Q

Mary, a 75yo lady has not been at the GP for years. Give three reasons why this could be?

A

Linked to GP retirement
May have been well
May have been worried about a problem being found

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4
Q

Define illness.

A

What people experience when they are unwell, how they interpret or define theses symptoms and what actions they take in response

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5
Q

Define disability as defined in the Disability and Discrimination Act.

A

“One with physical, sensory or mental impairment which has substantial, adverse and long-term (>12m) effect on ‘normal’ day-to-day activities”

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6
Q

When was the Disability and Discrimination Act made?

A

1995

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7
Q

When was the Disability and Discrimination Act updated and what does it describe disability as?

A

2010

Disability = protected characteristic

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8
Q

Define incidence.

A

Number of NEW cases

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9
Q

What does incidence tell you about?

A

Trends in causation and aetiology

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10
Q

What is incidence statistics useful for?

A

Planning

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11
Q

Define prevalence.

A

The number of people in a population with the disease at a certain time

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12
Q

What is prevalence statistics useful for?

A

Accessing current workload

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13
Q

What are long term conditions and provide 2 examples.

A

Persistent diseases that don’t lead to early death e.g IHD, OA

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14
Q

What affects do long term conditions have?

A

Constraints on family life
Failure to re-establish functional capacity to work
Unremitting physical discomfort

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15
Q

In what groups are long-term conditions more prevalent in?

A

Elderly and deprived groups

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16
Q

What percentage of those registered disabled are in employment?

A

33.3%

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17
Q

What percentage of all GP appointments are taken by long-term conditions?

A

50%

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18
Q

What percentage of in-patient bed days are taken by long-term conditions?

A

Over 70%

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19
Q

What are the two main concerns with long-term conditions?

A

Consequences

Establishing cause

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20
Q

What is commonly the aetiology of long-term conditions?

A

Genetic +/- environmental or NONE

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21
Q

Define vulnerability.

A

Individual’s capacity to RESIST disease, REPAIR damage and RESTORE physiological homeostasis

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22
Q

Why is there a ‘burden of treatment’ in life-long conditions?

A 
Patients/caregivers have to monitor and manage symptoms at home
Complex treatment regimes
Many drugs
Complex admin 
Lifestyle modifications
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23
Q

Describe biographical disruption in terms of long-term conditions.

A

Loss of confidence in social interactions or self-identity

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24
Q

What does a chronically ill patient need to do before being able to adjust to their new “normal”.

A

Make sense of their situation

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25
Q

Describe two different types of disability and give an example of each.

A

Visible - paraplegia

Invisible - diabetes

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26
Q

What does coping with stigmatism involve?

A

Decision whether to disclose in the first place

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27
Q

How can disability affect the individual?

A

Denial, Self-pity, distress, apathy, isolation from community

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28
Q

How can disability affect the family?

A

Financial, emotional, physical, social

other family members may become ill as a result

29
Q

What area in Scotland have the greatest percentage of long term conditions and the smallest percentage?

A 
Greatest = Glasgow and central belt
Smallest = North East
30
Q

What is the ‘expert patient’?

A

When patients understand their illness more than the professional therefore, they should be the key decision maker

31
Q

What is the dictionary definition for disability?

A

Lacking in one or more physical powers such as ability to walk or co-ordinate ones movements.

32
Q

What is the ICF?

A

International classification of function, disability and health (WHO, 2001)

33
Q

What are the three main points of the ICF (WHO) about disability?

A
  1. Body and structure impairment
  2. Activity limitation
  3. Participation restrictions
  • All influenced by contextual factors (personal and environmental) and influence the health condition
34
Q

What are the two main models of disability?

A

Medical and social

35
Q

Describe the medical model of disability.

A

Individual/personal cause
Underlying pathology
Individual change/adjustment
Individual level intervention

36
Q

Describe the social model of disability.

A

Society cause
Conditions relating to housing
Social/political action needed
Societal attitude changes

Places disability outside individual

37
Q

Give an example where the medical and social model of disability exists.

A

Patient with COPD with increasing breathlessness and inability to leave the house

38
Q

When was the Equalities Act written?

A

2010

39
Q

Name two factors that affect views on disability.

A

Age and culture

40
Q

Describe 6 factors that influence a persons reaction to disability.

A
  1. Nature of disability
  2. Education/intelligence
  3. Coping strategies
  4. Support network
  5. Additional resources available
  6. Reaction of others
  7. Mood/emotional reaction
41
Q

What did Parsons (1950) suggest about the sick role?

A

When individual considers possible “benefits” of illness e.g financial, social, family, exceptions from responsibilities

42
Q

What is Wilson’s criteria for screening?

A

Knowledge of disease
Knowledge of test
Treatment for disease
Cost considerations

43
Q

What is the medical model of health?

A

Belief that science should find cures

Doctor-patient authoritarian relationship

44
Q

What models are now used instead of the doctor-patient authoritarian relationship?

A

Guidance - cooperation

Mutual participation

45
Q

What is the WHO definition of health?

A

Health is a state of complete physical, social and mental wellbeing and not merely the absence of disease or infirmity.

46
Q

What does the social model of health consider?

A

BROADER DEFINITION

  • Changes that can be made in society and in people’s own lifestyles
  • Gender, education and politics can influence health-related behaviour
47
Q

What is QoL according to the WHO?

A

‘Individuals’ perceptions of their positions in life in the context of culture and value systems in relation to goals, standards and concerns

48
Q

In what 3 perspectives should illness be tackled?

A

Physical
Psychological
Social/environmental

49
Q

The Health Belief Model was one of the earliest models in 1974. Give an example of it when applied to stopping smoking.

A

Those who are susceptible to illness, realise the consequences and that the benefits of stopping outweigh the cons and those with a general motivation are more likely to quit.

50
Q

What is the theory of planned behaviours?

A

Demographic variables & personality characteristics —> Attitude, reflection
Subjective norm
Perceptions of control of behaviour

51
Q

What is self-efficacy?

A

Belief that one can perform a novel or difficult task or cope with diversity

52
Q

What does perceived self-efficacy facilitate?

A

Goal setting
Effort investment
Persistence in the face of barriers
Recovery from set-backs

53
Q

What is involve in the stages of change model?

A

Precontemplation -> contemplation -> preparation -> action -> maintenance -> relapse

54
Q

What do medical sociologists study?

A

Ways people interpret symptoms, make sense of illness and interact with professionals

55
Q

What does Parson’s model of the ‘sick role’ not take into account?

A

Patients participation in decisions

Being ‘sick’ doesn’t always lead to disability

56
Q

Give an example of preventing disability.

A

Antenatal screening

57
Q

What does disability require?

A

Holistic approach and MDT

58
Q

What does the psychological model of disability say?

A

Two people with same illness, social and environmental circumstances may have different activity limitations due to cognition, emotion and coping strategies. Reaction of family and friends also influences.

59
Q

Society can have negative views of disability that can lead to discrimination. Describe 7 types of discrimination according to the Equality Act.

A

DAVID H

Direct
Associative
Victimisation
Indirect
Discrimination 
Harassment (by perception)
60
Q

What are the two main things that disability is assessed by?

A

ADLs and QoL

61
Q

What are QALYs?

A

How many extra months or years of reasonable quality a person might gain as a result of treatment

62
Q

Describe 5 ways to prevent disability.

A 
Screening
Health education 
Public health promotion 
Immunisation programs
Occupational and environmental medicine initiatives
63
Q

Describe the primary, secondary and tertiary prevention of disease.

A

Primary - prevention of onset
Secondary - aged at early detection and treatment
Tertiary - reduce consequences and prevent deterioration

64
Q

Give an example of health protection regulations or policies.

A

Smoking in public places ban

65
Q

A patient is discharged from hospital, having suffered a major heart attack. Previously good health and very active. What issues does he now have to manage?

A 
Medications
Lifestyle changes
Pressure on family members
Financial implications
Medial 
Psychological issues
66
Q

A patient is discharged from hospital, having suffered a major heart attack. Previously good health and very active. How is this different to a patient presenting gradually with SOB which eventually turns out to be angina?

A

Different for each person, can still have psychological and social implications as well as medical.

67
Q

19yo boy, RTA, no seatbelt, injuries in spine resulting in permanent power loss to lower limbs. Attends outpatient clinic in wheelchair to discuss how he is managing in the community. What issues might he present to you with?

A 
Social 
Psychological
Medical 
Financial
Stigmatism
68
Q

19yo boy, RTA, no seatbelt, injuries in spine resulting in permanent power loss to lower limbs. Attends outpatient clinic in wheelchair to discuss how he is managing in the community. Are you prepared to help, can you truly empathise?

A

….

69
Q

19yo boy, RTA, no seatbelt, injuries in spine resulting in permanent power loss to lower limbs. Attends outpatient clinic in wheelchair to discuss how he is managing in the community. What communication tools can you use and which professionals may you turn to.

A

? Tools

OT, 3rd sector, support groups, social work, counselling services

FOPC (10 decks)

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