Year 2 Flashcards

1
Q

What is patient centred care

A

Where the patient is at the centre of their decision making

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2
Q

5 principles of patient centred care

A
Respect 
Choice and empowerment
Patient involvement in health policy 
Access and support 
Information
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3
Q

What is incidence

A

the number of new cases of a disease in a population in a specified period of time (trend in causation and aetiology of disease)

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4
Q

What is prevalence

A

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 (assess current workload on healthcare)

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5
Q

What factors contribute to aetiology

A

Genetic factors
Environmental factors
Both/neither

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6
Q

What is vulnerability

A

individuals capacity to resist disease, repair damage, and restore physiological homeostasis.

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7
Q

What are the different types of natural history of a disease

A

Acute onset (MI stroke)
Gradual: (angina, dementia)
Relapse and remission (MS)

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8
Q

What Burden of Treatments are patients with long term conditions often put under by the healthcare system

A

Changing behaviour for lifestyle modifications

Monitoring and managing symptoms at home

Complex treatment and multiple drugs

Complex Admin systems working with uncoordinated health and social care system

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9
Q

What are the types of stigma

A

Invisible
Visible
Both

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10
Q

What are the treatment aims in chronic disease

A

Resolve disease, or treat symptoms

Come to terms with chronic condition

Admit failure in diagnosis or cure if necessary

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11
Q

What is meant by biographical disruption

A

Long term condition leads to loss of body confidence

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12
Q

What are the effects of biographical disruption in long term conditions

A

Leads to lost confidence in social
interaction/self-identity

“Re-negotiate” relationships at work and home

Need to make sense of the condition before “adjusting”

Redefine “good/bad”, to emphasis positive life and lessen negativity of illness

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13
Q

Give an example of visible stigma

A

Being in a wheelchair

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14
Q

Give an example of invisible stigma

A

mental health

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15
Q

Who often stigmatises

A

those who are unnaffected

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16
Q

Why might people chose to not disclose their condition or disability

A

Fear of stigmatisation

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17
Q

What are the individual effects of long term conditions

A

negative/positive, denial, self-pity, apathy

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18
Q

What are the family impacts of long term conditions

A

Financial
Emotional
Physical
Contagious

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19
Q

What are the community/social impacts of long term conditions

A

Isolation of individual

Community can be judged on hos it treats ill

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20
Q

What is the expert patient

A

Patient understand disease better than healthcare professional”

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21
Q

What are the 3 types of disability as defined by WHO

A

Body and structure impairment:
- Abnormalities of structure, organ or system function

Activity level:
- Changed functional performance and activity by the individual

Participation restriction:
- Disadvantage caused by disability, interaction in society/environment

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22
Q

What are the medical models of disability

A
Individual cause (accident while drunk)
Pathology (obesity)
Individual intervention (health professional advise)
Individual change (change in behaviour)
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23
Q

What are the social models of disability

A

Societal cause (low wage)
Housing conditions
Social/political action (facilities for disabled)
Social attitude (use of politically correct language)

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24
Q

Which 2 acts give rights to disabled people

A

Disability Discrimination Acts 1995 and 2005

Equality Act 2010

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25
Q

What do reactions to disability depend on

A
Nature of disability
Information
Personality/mood/emotion
Coping strategy
Reaction of those around/support networ
Time to adapt
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26
Q

What are the rights of the sick role

A

Exemption from societal norms

Not responsible for condition

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27
Q

What are the obligations of the sick role

A

Should try to get well

Should seek professional help and cooperate

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28
Q

What areas of life can disability affect a family

A

Personal
Economic
Social

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29
Q

Epidemiology of disability

A
Congenital
Injury
Disease
Alcohol/drugs
Mental illness
Malnutrition/obesity
Rise in UK with age: ⅓ with disability are employed
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30
Q

What are the responsibilities of the healthcare professional regarding disability

A
Attitude
Listen to patients and learn
Take into account age and culture
Ensure empathy 
Don't spectate:
-> Assess
-> Coordinate MDT
-> Intervene with rehab
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31
Q

Definition of disease

A

Symptoms
Signs
Diagnosis
Biomedical perspective

The biological view on it

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32
Q

Definition of illness

A

ICE
Patient perspective

The disease relating to the patients view on it

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33
Q

What factors affect care uptake (going to get care)

A

Lay referral: going from family -> community -> traditional/cutureal healing -> medial system

Sources of info: peers, family, media

Medical factors: new symptoms, increasing severity, duration

Issues:
Patient believe self to be healthy: physically fit, doesn’t want to use tablets
Doctor: perform additional investigation, educate self of concerns

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34
Q

Definition of epidemiology

A

Describe amount and distribution of disease in human population

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35
Q

Describe explanation and epidemiology

A

To elucidate the natural history

Identify aetiological factors for disease usually by combining epidemiological date with date from other disciplines such as biochemistry, occupational health and genetics

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36
Q

What are the 3 main aims of epidemiology

A

Description
Explanation
Disease control

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37
Q

Describe disease control and epidemiology

A

Provide basis for preventative measures/public health practices

Therapeutic strategy for disease control

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38
Q

Why does epidemiology compare gourps

A

To detect differences pointing to:

Aetiological clues (what causes the problem)

The scope for prevention

Identification of high risk or priority groups in society

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39
Q

What are sources of date for studies

A

Mortality

GP Morbidity

Health and household surveys

Cancer Statistics

Accident Statistics

Fertility rates

NHS expenditure

Hospital data
–» Reproductive, cancer, accident

40
Q

Does clinical medicine deal with the individual or population

A

Individual

41
Q

Does epidemiology deal with the individual or the population

A

Population

42
Q

In ratios what the numerator and denominator represent

A

Events = numerator

Population at risk = denominator

43
Q

What does relative risk measure

A

The strength of association between a risk factor and disease

= Incidence of disease in exposed group/incidence of disease in unexposed group

44
Q

What is meant by health literacy

A

About people having the knowledge skills

Understanding and confidence to use health information to be active partners in their medical situation and to navigate health and social care systems

45
Q

What did the Scottish government publish to make health literacy easier

A

Making it Easy - A Health Literacy Action Plan for Scotland

46
Q

What does the CHA2DS2-VASc score calculate/estimate risk for

A

Atrial fibrillation

Stroke

47
Q

What is a descriptive study

A

describe amount and distribution of disease in a given population

48
Q

Pros and Cons of descriptive study

A

No definitive conclusions
May give clues about risk factors and aetiology
Cheap, quick, overview

49
Q

What is an analytical study

A

Cross sectional (disease frequency, prevalence study)

In cross sectional studies observations are made at a single point in time

50
Q

What is a Cohort study

A

When baseline data on a group, is then followed until disease developed in sufficient numbers to allow analysis

51
Q

What do trials test

A

Ideas about aetiology or evaluate interventins

52
Q

What is a randomised controlled trial

A

Varying intervention on patients then

Analysis of results

53
Q

What is standardisation

A

Set of techniques used to remove (or adjust for) the effects of differences in age or other confounding variables

54
Q

What is a counfounding factor

A

Factor associated independently with both the disease and exposure (age/sex/social class)

55
Q

How are co-founding factors counteracted

A

Randomisation, restriction of eligibility, subject grouping, result stratification/adjustment

56
Q

What is the standardised mortality ration

A

standardised death rate converted to ratio, e.g. standard is 100, 120 means 20% more death than expected

57
Q

What does quality data ensur

A

That data is trustworht

58
Q

What is case definition

A

decide if an individual has the condition of interest or not; varying definition from study maker to interpreter

59
Q

What is coding and classification relevant to

A

Case definition in data analysis

60
Q

What is bias?

A

Any trend in collection, analysis, interpretation, publication, or review that leads to conclusions different from the truth

61
Q

What is selection bias?

A

When the sample is not representative of whole study population

62
Q

What is information bias

A

Systematic errors in measuring exposure/disease e.g. researcher knowing “case”vs“control”, and working harder on “case”

63
Q

What is follow up bias?

A

one group of subjects is followed up more assiduously

64
Q

What is systematic error

A

measurement bias where measurements tend to fall on one side of the truth e.g. machine calibrated incorrectly, poorly written survey

65
Q

What is ageism

A

stereotyping and discriminating against people just because they are old

66
Q

Has data shown that recent with in life expectancy will slow down or speed up

A

Slow down

67
Q

What is the current life expectancy for males and females

A

Males -63yrs

Females - 64yrs

68
Q

How many people will be carers in their lifetime

A

3 in 5

69
Q

What are potential roles of carers

A

Practical help – preparing meals, doing laundry or shopping

Keep an eye on the person they care for

Provide company

Take them out

Help with financial matters

Personal care

70
Q

Who do carers care for

A
Grandparents
Parents 
Parents in law 
Spouse/Partner
Disable children 
Friends 
Neighbour
71
Q

What are the consequences for the carer of being a carer

A

Financial drop: cut back on essentials like food and heating

Health drop: caring was affecting their health

Impact on relationships: not getting out as much/seeing friends

Feel society doesn’t care/ feel isolated

72
Q

What is multi-morbidity

A

The coexistence of 2 or more long-term conditions in an individual

73
Q

What does multi-morbidity increase?

A

Complexity

74
Q

What are old age care options

A

Living in home with support from family

Living in own home with support from social services

Sheltered housing

Residential housing

Nursing Home Care

75
Q

What is an anticipatory care plan

A

Advance and anticipatory care planning as a philosophy promotes discussion in which individuals their care providers and often those close to them make decisions with respect to their future health or personal and practical aspects of care

76
Q

What are the legal aspects of anticipatory care plans

A

Power of attorney welfare

Power of attorney financial

Guardianship

77
Q

What are personal aspects of anticipatory care plans

A

Statement of wishes regarding treatment/advance directive

Next of kin

Consent to pass on info to relevant others

Who else to consult/inform

Religious and cultural beliefs re death

Current level of support

78
Q

What are medical aspects of anticipatory care plans

A

Potential problems

Wishes regarding boy use e.g organ donation or body use in science

Wishes regarding DNA CPR

Electronic care summary

Assessment of capacity/competence

Current functional level

79
Q

Name members of the Primary healthcare team

A
GP 
Practice nurses 
District nurses
Midwifes
Health visitor
Macmillan nurse
80
Q

Name members of the allied health professional

A
Pharmacists
Dietician 
Physio. 
OT 
Care manager 
Complementary therapist 
Social services 
Health promotion
81
Q

Who is the core of the MDT team

A

Patient

82
Q

Which factors can affect the primary health care team

A

Economy:
Moving to larger primary care premises
Wider range of services

Political pressure:
Pressure to reduce cost of treatments
Provide treatments closer to patients

Development of new and extended:
professional roles
Nurses now prescribe and triage
Pharmacists now manage medicines and minor illnesses

Growing number of ageing population:
more long term conditions
Greater demand for healthcare

83
Q

What are the principles of teamwork

A

Patient is core member of team
Agree on a team leader

Ensures everyone understands and acknowledges the skills and knowledge from each team member

Ensure communication (communication is vital!!) between members of team including patient

Ensure sharing of patients information within the team is accordance with current legal and professional requirements

Assure interprofessional collaboration

84
Q

What is the public bodies (Joint Working) (Scotland) Act 14

A

Scottish Gov plan to integrate adult health and social care

Created Integration Authorities

85
Q

Roles of GP

A

First point of contact for most patients

Work by consultations/home visits

Deal with combined physical, psychological and social problems

Independent contractors to NHS; employ own staff and have own premises

86
Q

Roles of practice nurse

A

Work in surgeries, supervise healthcare assistants

Blood samples, ecg, wound management(leg ulcer), vaccination, family planning

87
Q

Roles of district nurse

A

Visit homes/care homes

Teaching and support role with patients and families

Minimize potential hospital admissions

Assess healthcare needs

88
Q

Role of midwife

A

Care during pregnancy, labour and early post natal period

Work in community (home, children’s centres) surgeries hospitals

89
Q

Role of health visitor

A

Lead child and family health service (pregnancy to 5yr)

Additional service to vulnerable children and families

90
Q

Role of Macmillan Nurse

A

Cancer and palliative care, in variety of settings

Pain and symptom control, emotional support, providing info about treatment, coordinate with hospital

91
Q

Role of pharmacist

A

Medicine and use, advise medical/nursing staff and patients, can prescribe

Work in hospital, primary care or community

92
Q

Role of dietician

A

Work in hospital and community

Inform about nutrition, work with special dietary need patients

93
Q

Role of physiotherapist

A

Help and treat physical problems: manual therapy, exercise, electro-physical

Maximise movement; rehab, preventative healthcare, health promotion

94
Q

Role of OT

A

Assessment and treatment of physical and psychiatric conditions to prevent disability an promote independent function

Physical rehab, mental health help, learning disability, environment adaptation

95
Q

Role of care manager

A

Work with individuals to identify their goals and find specific support services

96
Q

Role of complementary therapist

A

Acupuncture

Homeopathy