Tutorial 1 - Impact of long term conditions Flashcards
What is meant by ‘the burden of treatment’?
The enormous demands that are placed on patients and caregivers by healthcare systems
What is meant by ‘biographical disruption’?
The loss of confidence in social interaction and self identity produced by the loss of confidence in the body that generally follows diagnosis/development of a long term condition
What is meant by ‘the sick role’?
The privileges and obligations which accompany illness
Chronic conditions mainly afflict which two groups of people?
The elderly
The deprived
Chronic conditions mainly afflict which two groups of people?
- The elderly
2. The deprived
What is incidence?
The number of new cases of a particular disease occurring within a population over a specified period of time
What is prevalence?
The total number of people afflicted with a particular disease at a fixed point or specified period of time
What are the two general categories of factors which cause long term conditions?
- Environmental factors
2. Genetic factors
What is vulnerability?
An individual’s ability to resist disease, repair damage and restore physiological homeostasis
Give four broad examples of the burden of treatment for patients
- Drastic alterations in the behaviour of oneself or others to adhere to lifestyle modifications
- Home monitoring of signs and symptoms of their condition (can also require the collection and recording of clinical data)
- Requirement for adherence to a complicated regimen of pharmaceutical management (sometimes multiple overlapping regimens are required in cases of patients with multiple comorbidities)
- Necessity to engage with and navigate complicated administrative systems as well as different health and social care services which are uncoordinated and often confusing
What is meant by ‘the expert patient’?
Patients with long term conditions will often have a much greater knowledge and understanding of their condition than any healthcare practitioner could ever have. Recent shifts in attitude have begun to involve patients more as key decision makers in their treatment process to take advantage of this depth of knowledge. This also applies to the parents of children with long term conditions.
What are the three main definitions of disability?
- Dictionary
- Legal
- WHO
What are the three main subcategories of disability according to the WHO definition?
Body and structure impairment
Activity limitation
Participation restrictions
What is meant by body and structure impairment under the WHO definition of disability?
Abnormalities of structure, organ or system function
What is meant by participation restrictions under the WHO definition of disability?
The difficulties experienced by the patient at a social and environmental level due to their impairments and disabilities
What is meant by activity limitation under the WHO definition of disability?
The change in functional performance and activities by the individual as a result of impairments and disabilities
What are the two main models of viewing disability?
- The medical model
2. The social model
What constitutes the medical model of disability?
Personal cause i.e. accident while drunk
Underlying pathological cause i.e. morbid obesity
Individual level intervention i.e. individual advice offered by health professionals
Individual change/adjustment i.e. alterations in behaviour
What constitutes the social model of disability?
Societal cause i.e. low wages
Environmental cause i.e. damp housing
Social/political action needed i.e. facilities for the disabled
Social attitude change needed i.e. use of politically correct language
Name two pieces of legislation which have been created regarding protecting the rights of disabled individuals
The disability discrimination act 1995 and 2005
The equality act 2010
What are some of the causes of disability worldwide?
Obesity Alcohol use Drug use Mental illness Communicable disease Non-communicable disease Congenital disease Iatrogenic Injury Malnutrition
What are Wilson’s criteria for screening tests?
Knowledge of disease
Knowledge of test
Treatment for disease
Cost considerations
What are the sub-criteria of knowledge of disease under Wilson’s criteria?
Disease must be important health concern
Course/progression of the disease must be understood
There must be a recognisable latent/early symptomatic presentation
What are the sub-criteria of knowledge of test under Wilson’s criteria?
Suitable test or examination available
Test acceptable to population
Case finding should be continuous
What are the sub-criteria of treatment of disease under Wilson’s criteria?
Accepted treatment available for those with the disease
Facilities for screening and treatment must be available
Agreed policy concerning who to treat as patients
What is meant by ‘cost considerations’ under Wilson’s criteria for screening?
The cost of diagnosing and treating patients with the disease must be balanced out in relation to total healthcare expenditure. In essence, the test and treatment should not be too expensive
