Tutorial 1: The Impact of Long-Term Conditions

Question 1

Define the concept of patient centred care

Answer 1

Places patient at the centre

Only the patient is in a position to make a decision on what it means to them

Question 2

The International Alliance of Patients’ Organizations (IaPO) Declaration outlines what five principles

Answer 2

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

Question 3

Long term conditions account for how many GP appointments?

Answer 3

50%

Question 4

Long term conditions account for how many outpatient appointments?

Answer 4

64%

Question 5

Long term conditions account for how many inpatient bed days

Answer 5

70%

Question 6

Name prominent chronic disorders

Answer 6

Parkinson’s Disease
MS
Arthritis

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

Question 9

What are the aetiologies of long-term (chronic diseases)

Answer 9

Genetic factors

Environmental factors

Question 10

Define vulnerability

Answer 10

An individuals capacity to rests disease, repair damage and restore physiological homeostasis

Question 11

What cab add to the burden of treatment

Answer 11

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 12

What is Biographical Disruption

Answer 12

When a long-term condition leads to a loss of confidence in the body followed by a loss of confidence in social interaction or self identity

Question 13

What is the impact of a long term condition on the individual

Answer 13

Can be negative or positive

Can include denial, self pity and apathy

Question 14

What is the impact of a long term condition on the family

Answer 14

Financial, emotional and physical

Question 15

What is the impact of a long term condition on the community/society

Answer 15

Isolation of an individual may result

Question 16

What is the dictionary definition of disability

Answer 16

Lacking in one or more physical powers such as the ability to walk or coordinate ones movements

Question 17

What is the legal definition of disability

Answer 17

Difficulty can be physical, sensory or mental. A disability that makes it difficult for them to carry out normal day to day activities, ongoing for more than 12 months

Question 18

What is the WHO definition of a disability

Answer 18

Impairment in a person’s body structure or function, or mental functioning; examples of impairments include loss of a limb, loss of vision or memory loss. Activity limitation, such as difficulty seeing, hearing, walking, or problem solving.

Question 19

What is the medical model of disability

Answer 19

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

Question 20

What is the social medical model of disability

Answer 20

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.

Question 21

What is the Disability Discrimination Act (1995 and 2005)

Answer 21

Work to protect people with disabilities – including blind and partially sighted people – from discrimination

Question 22

What are doctors role in mangling disabilities

Answer 22

Assess disabilities
Coordinate the MDT
Intervene in the form of rehabilitation

Question 23

Personal reaction to disability depends on

Answer 23

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 – 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 24

Name different causes of disability worldwide

Answer 24

Congenital
Injury
Communicable Disease
Non-Communicable Disease
Alcohol 
Drugs-iatrogenic effect and/or illicit use
Mental Illness
Malnutrition
Obesity

Question 25

What proportion of disabled people in the UK are in employment

Answer 25

1/3rd

Question 26

What is Wilson’s Criteria for screening

Answer 26

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.