Tutorial 1 - Long-Term Conditions Flashcards
define person-centred care
Person-centered care places patient at center
who decides what person-centered care means
Only the patient is in a position to decide this
what makes care patient centered
if it is based on the principles and values that define patient-centeredness
the principles and values of patient centered care are brought together by which organisation in what declaration?
International Alliance of Patients’ Organizations (IaPO)
Declaration on Patient- Centered Healthcare.
Name the 5 principles outlined in the Declaration on Patient- Centered Healthcare by the IaPO
- Respect.
- Choice and empowerment.
- Patient involvement in health policy.
- Access and support.
- Information.
Long-term conditions now account for what proportion of GP appointments?
50%
long-term conditions are more prevalent in what two groups of people?
older people
deprived groups
what is equally as important as establishing the causes of a long term illness?
the consequences of such long-term illness
define incidence
the number of new cases of a disease in a population in a specified period of time
define prevalence
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)
aetiology - name the 2 broad factors
genetic
environmental
define vulnerability
an individuals ability/inability to resist disease, repair damage and restore physiological homeostasis
describe 3 categories of natural history of diseases
acute onset
gradual onset
relapsing remitting
what 2 things should any treatment aim to cure/allay ?
disease
effects of disease
briefly define the burden of treatment
patients and caregivers are often put under enormous demands by healthcare systems
give 4 examples of the burden of treatment
- changing behaviour (of patient) or policing behaviour (doctor) of others (i.e. to adhere to lifestyle modifications)
- monitoring + managing their symptoms at home
- complex treatment regimens and multiple drugs (polypharmacy)
- complex administrative systems - accessing, navigating + coping with uncoordinated health and social care systems
define the process of biographical disruption
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
define stigma
a mark of disgrace associated with a particular circumstance, quality, or person
outline why stigma might exist for those with a chronic illness
having a chronic illness or condition subjects a person to possible stigmatization by those who do not have the illness
what is the biggest decision in coping with the stigma of a condition?
the decision about whether to:
1) disclose the condition and suffer further stigma
or
2) attempt to conceal the condition and pass for normal
the long term condition of a particular individual may impact what people/groups of people
patient
family
community
discuss the impact of long term conditions on the individual
can be negative or positive
negative may be denial, self-pity, apathy
an individual’s long-term condition can impact their family in what 3 broad ways?
financial
emotional
physical
what might happen to an individual that has a long term condition with regards to their community
isolation of that individual
an observation often made by doctors/nurses who care for people with some long term conditions is “my patient understands their disease better than I do”
what is this concept known as?
the “expert patient”
name 3 conditions that typically creates a lot of these “expert patients”
diabetes mellitus
arthritis
epilepsy
describe the relevance of the “expert patient” in modern care
patient’s knowledge/experience has long been untapped
could greatly benefit patient care + quality of life
research/experience shows today’s patients with chronic conditions need not be mere recipients of care
they can become key decision-makers in treatment process
the WHO definition of disability may be split into what 3 categories
- Body and Structure Impairment
- Activity Limitation
- Participation Restrictions
define “body and structure impairment”
abnormalities of structure, organ or system function (organ level)
define “activity limitation”
changed fuctional performance and activity by the individual (personal level)
define “participation restrictions”
disadvantage experienced by the individual as a result of impairments and disabilities
(interaction at a social and environmental level)
describe 4 concepts in the medical model of disability
▪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
describe 4 concepts in the social model of disability
▪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.
describe 2 legislations that have been drawn up to support those with a disability
disability discrimation acts 1995 and 2005
equality act 2010
describe 3 roles of a doctor in the care of those with a disability
- assess disability
- co-ordinate MDT care
- intervention with rehabilitation
personal reaction to a disability depends on many factors
give 10 examples
- nature of disability
- information base of individual, ie education, intelligence and access to information
- personality
- coping strategies
- (previous) role of individual – loss of role, change of role
- mood and emotional reaction
- reaction of others around them
- support network of individual
- additional resources available to the individual? e.g. good local self-help group, socio-economic resources
- time to adapt (how long they have had the disability?)
consider 6 possible categories of “benefits” of illness
- social
- familial
- psychological
- financial
- medications
- responsibilities.
outline the concept of the sick role
a concept that concerns the social aspects of becoming ill and the privileges and obligations that come with it
describe 3 ways disability might cause disruption within a family
personal
economic/financial
social
with regard to the epidemiology of disability:
give 9 different causes worldwide
- congenital
- injury
- communicable disease
- non-communicable disease
- drugs-iatrogenic and/or illicit use
- mental Illness
- alcohol
- malnutrition
- obesity
in the uk, what proportion of those with a disability are in employment?
1/3rd
what happens to the prevalence and severity of disability with age?
rises
Wilson and Jungner criteria for screening
testing/examination for a disease - 3 factors
- suitable test or examination.
- test acceptable to population.
- case finding should be continuous (not just a ‘once and for all’ project as there’s limited evidence for single-ocasion screening).
Wilson and Jungner criteria for screening
treatment of disease - 3 factors
- Accepted treatment for patients with recognised disease.
- Facilities for diagnosis and treatment available.
- Agreed policy concerning whom to treat as patients
Wilson and Jungner criteria for screening:
knowledge of the disease - list 3 factors
- condition should be important.
- must be a early symptomatic stage or recognisable latent stage
- natural history should be adequately understood.
