The Impact of Long Term Health Conditions

Question 1

What is person centred care?

Answer 1

The provision of care that places patient at centre, ensuring the healthcare system is designed to meets the needs and preference of patients as defined by patients themselves.

• Only patient can make a decision on their healthcare
• Based on the principles that define patient-centredness

Question 2

List the five principles of the Declaration on Patient-Centered Healthcare by the International Alliance of Patients’ Organisations (IaPO).

Answer 2

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

Question 3

The highest prevalence of long term conditions is in what social groups?

Answer 3

• Older people

- More deprived groups

Question 4

Long term conditions account for __% of all GP appointments.

Answer 4

50%

Question 5

Long term conditions account for __% of all outpatient appointments.

Answer 5

64%

Question 6

Long term conditions account for >__% of all inpatient bed days.

Answer 6

> 70%

Question 7

Define ‘incidence’.

Answer 7

The number of new cases of a disease in a population in a specified period of time.

Question 8

Define ‘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 (existing cases).

Question 9

Define ‘vulnerability’.

Answer 9

An individual’s capacity to resist disease, repair damage and restore physiological homeostasis.

Question 10

Describe some of the ‘burdens of treatment’.

Answer 10

• Changing behaviour to adhere to lifestyle modifications
• Monitoring and managing symptoms at home, collecting and inputting clinical data
• Complex treatment regimens and polypharmacy
• Complex administrative systems
• Accessing, navigating, and coping with uncoordinated health and social care systems

Question 11

Define ‘biological disruption’.

Answer 11

Long term condition –> loss of confidence in the body –> loss of confidence in social interaction or self-identity; this process is ‘biological disruption’.

Question 12

Describe what consequences biological disruption may have for the patient.

Answer 12

• Bring into focus meaning of illness for the individual
• May involve ‘re-negotiating’ existing relationships at work and home
• May need to make sense of their condition before ‘adjusting’ to it
• Involves redefining ideas of ‘good’ and ‘bad’, emphasising the positive aspects of life while lessening the negative impact of the illness

Question 13

List impacts of long term conditions.

Answer 13

On individual;

• Denial
• Self-pity
• Apathy

On family;
- Financial
- Emotional
- Physical
(May result in ill health of family member.)

Community/society;
- May result in isolation of an individual

Question 14

What is the dictionary definition of disability?

Answer 14

Lacking in one or more physical powers such as the ability to walk or coordinates one’s movements.

Question 15

What is the legal definition of disability?

Answer 15

(Disability Discrimination Act)
- Difficulty can be physical, sensory or mental
A disability that makes it difficult to carry out normal day-to-day activities, ongoing for >12 months

Question 16

What is the WHO definition of disability?

Answer 16

• Body and structure impairment
• Activity limitation
• Participation restriction

Question 17

Describe the medical models of disability.

Answer 17

• 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

The medical model says that a person is disabled by their impairments/differences. The social model was developed to challenge this.

Question 18

Describe the social models of disability.

Answer 18

• 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

The social model says that disability is caused by the way society is organised.

Question 19

Name the two pieces of legislation that advocate for the right of disabled people.

Answer 19

• Disability discrimination act (DDA) 1995 and 2005

- Equality Act 2010

Question 20

What factors influence the personal reaction to disability?

Answer 20

• The nature of the disability
• The information base of the individual i.e. education, intelligence and access to information
• The personality of the individual
• The coping strategies of the individual
• The role of the individual e.g. 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. local self-help group, socio-economic resources
• Time to adapt i.e. how long they have had the disability

Question 21

In the UK, the prevalence and severity of disability rise ___ __.

Answer 21

with age.

Question 22

__ of those with a disability are in employment.

Answer 22

1/3

Question 23

Describe the Wilson’s criteria for screening.

Answer 23

Knowledge of disease;

• The condition should be important
• There must be a recognisable latent or early symptomatic stage
• The natural course of the condition should be adequately understood

Knowledge of test;

• Suitable test or examination
• Test acceptable to population
• Case finding should be continuous

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