The Impact of Long Term Health Conditions

Question 1

Who is the best judge at deciding what patient centred care is?

Answer 1

The patient

Question 2

Who decides the principles and values of patient centred care?

Answer 2

The International Alliance of Patients’ Organisations (IaPO) They have a declaration on patient -centred healthcare

Question 3

What are the five principles of the declaration made by the IaPO?

Answer 3

1. Respect 2. Choice and empowerment 3. Patient involvement in health policy 4. Access and support 5. Information

Question 4

Which health groups have more long -term conditions?

Answer 4

Older people and more deprived groups

Question 5

What percentage of GP appointments are for long-term conditions?

Answer 5

50%

Question 6

What is just as important as understanding the cause of a health condition?

Answer 6

Understanding the consequence of a condition

Question 7

What is the definition of incidence?

Answer 7

Incidence - the number of new cases of a disease in a population in a specific period of time

Question 8

What is the definition of prevalence?

Answer 8

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 9

What are the two large subcategories of aetiology?

Answer 9

Genetic Environmental

Question 10

What is meant by vulnerability?

Answer 10

An individuals capacity to resist disease, repair damage and restore physiological homeostasis can be deemed vulnerability.

Question 11

What are the types of onset for long-term conditions?

Answer 11

Acute (stroke or MI) Slow onset (Angina) Relapse and remission such as cancer

Question 12

What is meant by ‘The Burden of Treatment’

Answer 12

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 13

What is meant by biographical disruption?

Answer 13

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.

Question 14

How might someone’s mindset change with the onset of a long term-condition?

Answer 14

Need to re-negotiate existing relationships at work and at home They need to understand their condition before ‘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 is lessened.

Question 15

Define stigma

Answer 15

a mark of disgrace associated with a particular circumstance, quality, or person.

Question 16

What kind of strategies exist to cope with stigma

Answer 16

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 17

What is the impact of long - term conditions?

Answer 17

On the individual – can be negative or positive. Can include denial, self pity and apathy. On Family – can be financial, emotional and physical Other family members may become ill as a result. Community/society. Isolation of an individual may result. It has been said that the success of a community can be judged on how it looks after its infirm members.

Question 18

What term is used to describe the patient that knows the disease better then the doctor does?

Answer 18

The expert patient - they become key decision makers in the treatment process - their quality has been largely ignored in the past

Question 19

What conditions may be associated with expert patients?

Answer 19

Diabetes Arthritis Epilepsey

Question 20

What are the categories of disability as defined by WHO?

Answer 20

Body and structure impairment Activity limitation Participation restrictions

Question 21

Define Body and Structure impairment

Answer 21

Abnormalities of structure, organ or system function (organ level)

Question 22

Define activity limitation

Answer 22

Changed functional performance and activity by the individual (personal level)

Question 23

Define participation restriction

Answer 23

Disadvantage experienced by the individual as a result of impairments and disabilities (interaction at a social and environmental level)

Question 24

What is the medical model of disability?

Answer 24

Medical 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

Illness or accident

Needs individuals to change

Question 25

What is the social model of disability?

Answer 25

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.

Wages, housing, social / political action required, change of societal attitude required

Question 26

What acts are in place to protect the rights of those who are disabled?

Answer 26

Disability discrimination acts 1995 and 2005 Equality act 2010

Question 27

What does the personal reaction to disability depend on?

Answer 27

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 28

What are the rights and responsibilities of those who are ill as described by Talcott Parsons in 1951 in the sick role theory?

Answer 28

Rights: They have the right not to be blamed for his or her illness They have the right right to be given some leeway by others in regards to normal obligations. Responsibilities: Making getting well a priority. Seeking the appropriate treatment for his or her condition

Question 29

What levels does disability cause disruption?

Answer 29

Personal Economic Social

Question 30

What are the different causes of disability?

Answer 30

Congenital Injury Communicable disease Non-communicable disease Alcohol Drugs (iatrogenic / illicit) Mental illness Malnutrition Obesity

Question 31

What percentage of disabled people are employed?

Answer 31

1/3rd

Question 32

What is the wilson and Junger criteria for screening?

Answer 32

Knowledge of disease: The condition should be important. There must be a recognisable latent or early symptomatic stage. The natural course of the condition, including development from latent to declared disease, should be adequately understood. Knowledge of test: Suitable test or examination. Test acceptable to population. Case finding should be continuous (not just a ‘once and for all’ project). Treatment for disease: Accepted treatment for patients with recognised disease. Facilities for diagnosis and treatment available. Agreed policy concerning whom to treat as patients. Cost considerations: Costs of case finding (including diagnosis and treatment of patients diagnosed) economically balanced in relation to possible expenditures on medical care as a whole.