Year 2

Question 1

New GP – reasons why someone may not attend clinic:

Answer 1

They are well.
They are worried about what their new GP is like.
They have concerning symptoms and are worried of a problem being found.

Question 2

Person Centred Healthcare:

Answer 2

Putting the person at the centre of their care.
Declaration outlines 5 principles: respect, choice and empowerment, patient involvement in health policy, access and support, information.

Question 3

Long Term Conditions:

Answer 3

More prevalent in elderly/deprived.
Causes: Parkinson’s, MS, Arthritis, etc. (genetic/environmental factors/neither)
Increasing prominent, major source of disability
In treatment – both patient and doctor must admit failure in diagnosis/cure in order to reach better management.

Question 4

Incidence

Answer 4

Incidence – the number of new cases of a disease in a population in a specified period of time.

Question 5

Prevalence

Answer 5

Prevalence – the number of people in a population with a specific disease at a single point in time.

Question 6

Vulnerability

Answer 6

Vulnerability – an individual’s capacity to resist disease, repair damage and restore physiological homeostasis.

Question 7

Biographical disruption

Answer 7

Biographical disruption – loss of confidence in social interaction/self-identify.

Question 8

Complications of Rx

Answer 8

the burden of treatment, biographical disruption, affecting relationships at home/work, stigma of chronic illness (attempts to conceal illness?), psychological (denial, self pity, apathy), on the family – financial, emotional, physical, may become ill as a result, isolation.

Question 9

Burden of Rx

Answer 9

changing behaviour or policing behaviour of others to adhere to lifestyle modifications, monitoring and managing their symptoms at home, complex Rx and polypharmacy, complex administration, accessing, navigating and coping with uncoordinated health and social systems to add to this.

Question 10

WHO categories of disability

Answer 10

Body structure and function impairment
Activity limitation
Participation restrictions

Question 11

Body structure and function limitation

Answer 11

abnormalities of structure, organ or system function (organ level)

Question 12

Activity limitation

Answer 12

changed functional performance and activity by the individual (personal level)

Question 13

Participation restrictions

Answer 13

the disadvantage experienced by the individual as a result of the impairments and disabilities (interaction at social and environmental level)

Question 14

Medical model of disability

Answer 14

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 15

Social model of disability

Answer 15

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 16

Effects of disabilities on family/patients/those around them

Answer 16

Parents – guilt at passing on gene if genetic disorder, martial problems, psychological problems, have to give up work, leading to financial problems
Siblings – resentment at parents for time spent caring for disabled child, resentment at restrictions to normal family life, may have to develop a role as a carer
Peers – may look out for disabled child, may be stigmatised along with disabled child, may need to adapt activities to include disabled friend, teasing by peers
Teachers - tendency to over-protect the child, lack of willingness to integrate into mainstream education, stress of managing mainstream and additional support needs in same class

Question 17

Personal reaction to disability depends on:

Answer 17

Nature of disability
Information base of the individual, i.e. education, intelligence…
Personality
Coping strategies 
Role of individual – loss/change of role required
Mood and emotional reaction 
Reaction of others around them 
Support network
Time to adapt

Question 18

Expert patient

Answer 18

Has in-depth knowledge about their condition, sometimes exceeding that of healthcare professionals
Utilising knowledge of patient/carer (mutual decision making about management) is likely to greatly benefit the patient’s care and quality of care.
These patients have grown to understand their body and their condition very well, and will understand their flare ups or symptoms and what these mean better than healthcare professionals.

Question 19

Information used by general public that may affect their uptake of medical care

Answer 19

Peers/family/friends
Internet – google, social media
TV
Health pages of women’s magazines
GP leaflets
GP practice website
Health awareness, e.g. health fares
Pharmacies – posters and leaflets

Question 20

Health literacy

Answer 20

People having the knowledge, skills, understanding and confidence to use health information to be active partners in their care to navigate health and social care systems

Question 21

Disability and the family - causes disruption at different levels

Answer 21

Personal
Economic
Social

Question 22

Aims of the SIGN guidelines

Answer 22

Help health and social care professionals and patients understand medical evidence and use it to make decisions about health care.
Reduce unwanted variants in practice and ensure patients receive the best care available, regardless of where they live.
Improve healthcare across Scotland by focusing on patient-important outcomes.

Question 23

What is a confounding factor?

Answer 23

= A factor that is associated independently with both the disease and with the exposure under investigation and so distorts the relationship between the exposure and the disease.
Common ones: sex, age, social class.

Question 24

Legal issues which may be included in an ACP

Answer 24

Welfare power of attorney
Financial power of attorney
Guardianship

Question 25

Team members of the community health and social care team and their role:

Answer 25

GP – day to day medical support, monitoring of disease and other conditions, co-ordination of care
District nurse – dressings, management of pressure sores, and other care
Nurse practitioner/paramedic practitioner – acute home visits with GP phone support/visit
Home carer – practical tasks, e.g. bathing, dressing
Pharmacist –advice on medication, dosette box
Social worker/care manager – advice on benefits, e.g. attendance allowance, contact with agencies
OT – adaptation of living environment to maximise independence
CPN – assessment and management of low mood
Physiotherapist – continue to improve mobility and stability
Dietician – advice on improving appetite, assessment nutrition
NHS24 – out of hours for unexpected deterioration/new condition
________ nurse specialist – specialist advice to patient and family relating to their condition, assist contact with specialist groups