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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
What do reactions to disability depend on
``` Nature of disability Information Personality/mood/emotion Coping strategy Reaction of those around/support networ Time to adapt ```
26
What are the rights of the sick role
Exemption from societal norms | Not responsible for condition
27
What are the obligations of the sick role
Should try to get well | Should seek professional help and cooperate
28
What areas of life can disability affect a family
Personal Economic Social
29
Epidemiology of disability
``` Congenital Injury Disease Alcohol/drugs Mental illness Malnutrition/obesity Rise in UK with age: ⅓ with disability are employed ```
30
What are the responsibilities of the healthcare professional regarding disability
``` Attitude Listen to patients and learn Take into account age and culture Ensure empathy Don't spectate: -> Assess -> Coordinate MDT -> Intervene with rehab ```
31
Definition of disease
Symptoms Signs Diagnosis Biomedical perspective The biological view on it
32
Definition of illness
ICE Patient perspective The disease relating to the patients view on it
33
What factors affect care uptake (going to get care)
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
34
Definition of epidemiology
Describe amount and distribution of disease in human population
35
Describe explanation and epidemiology
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
36
What are the 3 main aims of epidemiology
Description Explanation Disease control
37
Describe disease control and epidemiology
Provide basis for preventative measures/public health practices Therapeutic strategy for disease control
38
Why does epidemiology compare gourps
To detect differences pointing to: Aetiological clues (what causes the problem) The scope for prevention Identification of high risk or priority groups in society
39
What are sources of date for studies
Mortality GP Morbidity Health and household surveys Cancer Statistics Accident Statistics Fertility rates NHS expenditure Hospital data -->> Reproductive, cancer, accident
40
Does clinical medicine deal with the individual or population
Individual
41
Does epidemiology deal with the individual or the population
Population
42
In ratios what the numerator and denominator represent
Events = numerator | Population at risk = denominator
43
What does relative risk measure
The strength of association between a risk factor and disease = Incidence of disease in exposed group/incidence of disease in unexposed group
44
What is meant by health literacy
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
What did the Scottish government publish to make health literacy easier
Making it Easy - A Health Literacy Action Plan for Scotland
46
What does the CHA2DS2-VASc score calculate/estimate risk for
Atrial fibrillation | Stroke
47
What is a descriptive study
describe amount and distribution of disease in a given population
48
Pros and Cons of descriptive study
No definitive conclusions May give clues about risk factors and aetiology Cheap, quick, overview
49
What is an analytical study
Cross sectional (disease frequency, prevalence study) In cross sectional studies observations are made at a single point in time
50
What is a Cohort study
When baseline data on a group, is then followed until disease developed in sufficient numbers to allow analysis
51
What do trials test
Ideas about aetiology or evaluate interventins
52
What is a randomised controlled trial
Varying intervention on patients then | Analysis of results
53
What is standardisation
Set of techniques used to remove (or adjust for) the effects of differences in age or other confounding variables
54
What is a counfounding factor
Factor associated independently with both the disease and exposure (age/sex/social class)
55
How are co-founding factors counteracted
Randomisation, restriction of eligibility, subject grouping, result stratification/adjustment
56
What is the standardised mortality ration
standardised death rate converted to ratio, e.g. standard is 100, 120 means 20% more death than expected
57
What does quality data ensur
That data is trustworht
58
What is case definition
decide if an individual has the condition of interest or not; varying definition from study maker to interpreter
59
What is coding and classification relevant to
Case definition in data analysis
60
What is bias?
Any trend in collection, analysis, interpretation, publication, or review that leads to conclusions different from the truth
61
What is selection bias?
When the sample is not representative of whole study population
62
What is information bias
Systematic errors in measuring exposure/disease e.g. researcher knowing “case”vs“control”, and working harder on “case”
63
What is follow up bias?
one group of subjects is followed up more assiduously
64
What is systematic error
measurement bias where measurements tend to fall on one side of the truth e.g. machine calibrated incorrectly, poorly written survey
65
What is ageism
stereotyping and discriminating against people just because they are old
66
Has data shown that recent with in life expectancy will slow down or speed up
Slow down
67
What is the current life expectancy for males and females
Males -63yrs | Females - 64yrs
68
How many people will be carers in their lifetime
3 in 5
69
What are potential roles of carers
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
Who do carers care for
``` Grandparents Parents Parents in law Spouse/Partner Disable children Friends Neighbour ```
71
What are the consequences for the carer of being a carer
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
What is multi-morbidity
The coexistence of 2 or more long-term conditions in an individual
73
What does multi-morbidity increase?
Complexity
74
What are old age care options
Living in home with support from family Living in own home with support from social services Sheltered housing Residential housing Nursing Home Care
75
What is an anticipatory care plan
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
What are the legal aspects of anticipatory care plans
Power of attorney welfare Power of attorney financial Guardianship
77
What are personal aspects of anticipatory care plans
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
What are medical aspects of anticipatory care plans
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
Name members of the Primary healthcare team
``` GP Practice nurses District nurses Midwifes Health visitor Macmillan nurse ```
80
Name members of the allied health professional
``` Pharmacists Dietician Physio. OT Care manager Complementary therapist Social services Health promotion ```
81
Who is the core of the MDT team
Patient
82
Which factors can affect the primary health care team
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
What are the principles of teamwork
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
What is the public bodies (Joint Working) (Scotland) Act 14
Scottish Gov plan to integrate adult health and social care Created Integration Authorities
85
Roles of GP
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
Roles of practice nurse
Work in surgeries, supervise healthcare assistants Blood samples, ecg, wound management(leg ulcer), vaccination, family planning
87
Roles of district nurse
Visit homes/care homes Teaching and support role with patients and families Minimize potential hospital admissions Assess healthcare needs
88
Role of midwife
Care during pregnancy, labour and early post natal period | Work in community (home, children's centres) surgeries hospitals
89
Role of health visitor
Lead child and family health service (pregnancy to 5yr) | Additional service to vulnerable children and families
90
Role of Macmillan Nurse
Cancer and palliative care, in variety of settings Pain and symptom control, emotional support, providing info about treatment, coordinate with hospital
91
Role of pharmacist
Medicine and use, advise medical/nursing staff and patients, can prescribe Work in hospital, primary care or community
92
Role of dietician
Work in hospital and community | Inform about nutrition, work with special dietary need patients
93
Role of physiotherapist
Help and treat physical problems: manual therapy, exercise, electro-physical Maximise movement; rehab, preventative healthcare, health promotion
94
Role of OT
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
Role of care manager
Work with individuals to identify their goals and find specific support services
96
Role of complementary therapist
Acupuncture | Homeopathy

FOPC (4 decks)

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