WEEK 6 Flashcards
Define self-care
The care taken by individuals towards their own health and well-being, including the care extended to their children, family, friends and others in the community
What are the 4 functions of self-care (Barofsky’s model)?
1) Restorative: to alleviate illness
2) Reactive: to alleviate symptoms
3) Preventative: to prevent disease
4) Regulatory: to regulate body processes
What is self-care maintenance?
Behaviours performed to improve well-being, preserve health or to maintain physical and emotional stability
What is self-care monitoring?
Process of routine, vigilant body surveillance/listening
What is self-care management?
Evaluation to determine if action is needed
What is “Healthism”?
The representation of good health as a personal choice
Characteristic population associated with “Healthism”
Young/middle-aged, well educated, vocal/articulate, middle class (high consumer choice)
What is the predominant feature of the movement towards “healthism”?
Consumers looking externally and internally towards holistic/biopsychosocial approach to health
What is orthorexia?
Obsession with healthy eating
What are examples of being a DIY doctor?
Measuring body weight (scale), BP monitor, cholesterol monitor
What are the positives of being a DIY doctor?
Saves time (for you and GP) Confidential beyond HCPs
What are the negatives of being a DIY doctor?
+ve test can result in unwarranted complacency
-ve test can result in unnecessary anxiety/stress
Detail the 12 factors contributing to self-care
1) symptom management
2) definitions of health and illness
3) healthism/consumerism
4) body maintenance
5) changing beliefs about medical power/expertise
6) internet use
7) technology (self-testing kits)
8) OTC medication
9) increase in chronic conditions
10) expert patients
11) patient choice/empowerment
12) need to reduce NHS cost
What is co-morbidity?
Someone with two conditions
What is multi-morbidity?
Someone with three or more conditions
What are synergistic conditions?
Conditions with a common cause
What are non-synergistic conditions?
Conditions with no common cause
What is the most common disease related to multi-morbidity?
Hypertension
What is the Master Status in medicine?
The condition that people focus on the most
Why has the focus on patient expertise increased in recent times?
Rise in chronic conditions due to an ageing population resulting in increased health service demand
7 assumptions and characteristics of acute illness
1) Ongoing
2) Cure expected
3) QoL highly dependent on professional care
4) QoL highly dependent on acute healthcare services
5) HCP knowledge>Pt knowledge
6) Short-term goals set
7) Compliance expected
7 assumptions and characteristics of chronic illness
1) Episodic
2) Incurable
3) QoL highly dependent on Pt’s self-care and decision-making skills
4) QoL highly dependent on ongoing support services
5) Pt knowledge>HCP knowledge
6) Short-term goals for long-term outcomes
7) Compliance and self-reliance expected
What are the 12 self-management tasks in chronic disease?
1) Recognising and responding to symptoms
2) Using medications
3) Maintaining acute episodes and emergencies
4) Maintaining good nutrition and appropriate diet
5) Maintaining adequate exercise and physical diet
6) Not smoking
7) Using relaxation and stress-reducing techniques
8) Interacting appropriately with HCPs
9) Seeking information and using community resources
10) Adapting work and other role functions
11) Communicating with significant others
12) Managing negative emotions and psychological responses to illness
Define confidentiality
The need for the physician to keep secret all information a patient gives them
Why is confidentiality extremely important?
To maintain the trust and confidence of the patient in you and the profession
What is the result of a breach in confidentiality?
A lack of trust and collaboration which affects the practitioner’s ability to treat the patient to the best of their ability
Why is trust so central to the Dr-Pt relationship?
Healthcare information is inherently sensitive
Describe principlism in relation to confidentiality
Autonomy: Patient’s right to distribute personal information as they wish
Beneficence: rarity that breaching patient’s confidentiality would be in their interest
Non-maleficence: disclosure=potential harm
Justice: what if all doctors disclosed patient information?
What is the difference in response to confidentiality given by act and rule utilitarians?
Rule=support confidentiality generally
Act=assess on a case-by-case basis
Where does the principle of confidentiality arise from?
The Common Law
What does the Common Law detail about confidentiality?
All patient information received in the healthcare setting should remain confidential
What three things constitute a legal breach of confidentiality?
1) Information disclosed must have the quality of confidentiality
2) Information must have been gained in confidential circumstances
3) Plaintiff must show that there was unauthorized use of information
What would a successful legal case need to show?
Harm resulted from the breach but doesn’t have to be deliberate
Which four situations can confidentiality be breached only with patient consent?
1) Research
2) Publication
3) Teaching
4) Third party requests (eg. insurance companies)
Which two situations can confidentiality be breached without patient consent?
1) Disclosure required by law
2) Disclosure in the public interest
What are three examples of disclosures required by law?
1) Notifications of specific infectious diseases
2) Terrorism Act 2000
3) Medical Act 1983 (GMC can access Pt’s records to investigate fitness to practice)
What are possible justifications of breaching confidentiality in the public interest?
Risk of serious harm:
serious crime or serious communicable disease
What would you weight up when assessing disclosures in the public interest?
Public interest in maintaining confidentiality vs breaching confidentiality
What should you ensure you do when disclosing patient details?
Inform the patient unless it compromises reason for disclosure
What is the Data Protection Act (2018)?
Act covering all healthcare records of living patients (paper and electronic)
Who is the owner of medical records in the UK?
The NHS
Why might patients be refused access to their records?
Unsure of identity, disclosure relating to a third party would result, disclosure would cause serious harm or is not in the best interests of the data subject
What are Caldicott Guardians?
People responsible for safeguarding patient data
What are the 6 principles of the Caldicott Guardians?
1) Justify the purpose for use of confidential information
2) Only use it when absolutely necessary
3) Use minimum required
4) Access should be on a strict need-to-know basis
5) Everyone must understand his or her data protection responsibilities
6) Understand and comply with the law
