week 1 Health and contextual factors Flashcards
What is patient centred care
Care that is respectful and responsive to the individual patient preferences, needs and values and ensuring that patients values guide all clinical decisions
What is health
- It is the state of complete mental, physical and social wellbeing and not merely the absence of disease
- it adopts a biopsychosocial model of health and illness
- A holistic approach to health
What is EBM
- It is making decisions about the care of individual patients
- it is the integration of the best research evidence,, with clinical expertise and patient values and expectations
What is the patients agenda/ patient values
- the unique set of preferences, concerns, ideas and expectations that each patient brings to a clinical encounter and must be integrated into clinical decisions.
What are the key features of the hippocratic oath
It was a pledge to
- beneficence
- non maleficence
- to adhere to strict confidentiality
- to respect life
- to respect teachers and those who follow you
- to refer to others more skilled when necessary (scope of practice)
- to honour the social contract doctors have with society in return for benefits
- for devotion to the practice of medicine rather than fame or fortune
Define disease
- A syndrome of clinically identifiable signs and symptoms attributed to an underlying biological pathology
- WHO-ICD is the global standard to define diseases
- E.g. stroke, acute influenza
Define illness
- This is the individual’s experience of the disease or their response to symptoms
- It relates to a set of symptoms experienced by the individual
- it is subjective
- They may be asymptomatic so they don’t feel ill
- Where disease and illness overlap is the symptomatic disease
- Can have illness without disease
- E.g. 15-year-old girl with primary dysmenorrhea wanting check up
Define sickness
Pertains to the social model of health how society views the person (part of the functional model)
- The public or social component of ill health
- Society is prepared to sustain those it seems sick e.g. disability pension
What is the aboriginal model of health
not just the physical well being of the individual but the emotional, cultural and social well being of the whole community
Define cultural safety
- It is ensuring that people can recognise their own culture, beliefs, language, customs, attitudes and preferred way of doing things within the health system they are accessing
- it is an environment where people can feel safe that who they are and their identity or what they need will not be denied, challenged or assaulted.
how is cultural safety achieved
- through respectful engagement
- understanding power differentials
- Understanding that prejudice and stereotyping (personal and institutional) impact on the quality of health care delivery
- Understanding that we are all bearers of cultural belief and being self-reflective of our own attitudes, beliefs and values.
Define paternalism
This is the belief that ‘doctor knows best’ and can make decisions on the patients behalf without involving them.
How does paternalism impact on patient care
1) Disempowers the patient - undermines their authority
2) Fosters distrust in the health care system
3) Miss out on the benefits of partnership e.g. combining resources or negotiating preferences
The patient-centred clinical method
1) Exploring the disease and the illness - hx, physical examination and investigations but also exploring patients I, C, E, experiences
2) Looking at the person as a whole - proximal-distal context of the person
3) finding common ground - goals, problems and roles and mutual decisions
4) integration health promotion and prevention
5) enhancing doctor-patient relationship
6) Being realistic
The patient centred interview
- Unwellness
- Stems to the integration of the two models of health patients agenda (illness model) I,C,E and understanding the patient’s experience of the illness
- And the doctors agenda (disease model) hx, physical exam etc)
- means the biomedical and psychosocial aspects of health are addressed and the patients preferences, values ICE are considered in clinical decisions.
