Year 2 Flashcards
What members make the Primary Health Care Team?
GPs GP assistants & salaried doctors GP registrars Practice nurses Practice managers Receptionists Community nurses Midwives Health visitors Nurse practitione
What is the role of the GP?
Main point of contact with patient
Carry out consultations & home visits
Work in teams with other professionals & helping the patient to take responsibility of their own health
What aspects of patient care are practice nurses involved in?
Blood samples ECG Wound management Cervical smear test Sexual health screening Child immunisation Travel advice & immunisation
What is the role of district nurses?
Visit patients in their own home
What is the role of midwife?
Provide care throughout all ages of pregnancy, labour & early postnatal period
Work in community, working with GP practice
What is the role of the health visitor?
Lead & deliver child & family health services (pregnancy - 5yrs)
Provide ongoing additional services for vulnerable children & families
Contribute to MDT by safeguarding & protecting children
What is the role of Macmillan nurse?
Specialist nurse in cancer & palliative care providing support & info for patients with cancer (from point of diagnosis onwards)
What are the main jobs performed by Macmillan nurse?
Specialised pain & symptom control
Emotional support for patient & family
Care in various settings - hospital, home & clinic
Info about cancer treatment & side effects
Co-ordinate care between hospital & home
Advice on other forms of support (eg financial)
Who comprises the Allied Health Professionals?
Physiotherapist Occupational therapist Dietetics Pharmacy Podiatrist Couselling
What is the main role of pharmacist?
An expert on medicines & their use
Advise medical & nursing staff on selection of appropriate meds
Can practice in hospital pharmacy, community pharmacy or in primary care pharmacy
What is the role of dieticians?
Enable informed & practical choices about food & lifestyle in health & disease
Qahta re the main tasks of dietician?
Working with people with specialist dietary needs
Inform general public about nutrition
Evaluating & improving treatments
Educating, public, patients & healthcare workers
What is the role of physiotherapist?
Help treat people with physical problems caused by illness, accident or ageing
Maximise movement through health promotion
Use manual therapy & therapeutic exercise
What is the role of OT?
Work with people to overcome disability caused by physical or psychological illness, ageing or accident
Who do OTs work with?
Work with children, adults & older people in: Physical rehab Mental health services Learning disability Paediatrics Environmental adaptation Care Management Equipment for daily living
What are the Selected Secondary Care Services?
Hospital consultants
Diagnostic imaging
Operating services
What is the role of the care manager?
Identify specific support needs
Who is involved in social services?
Social workers
Social are workers
What do complimentary therapists perform?
Acupuncture
Homeopathy
What are the changes that are affected PHCT?
The professional groups part of the PHCT
The professional groups alongside PHCT
Working relationships between groups
What are the principles that underpin good team work?
Recognise & include patient as member of PHCT (patient centred-care)
Establish a common purpose
Set objectives & monitor progress
Agree team working conditions & process fr resolving conflict
Ensure that each member acknowledges their skills
Importance of communication
Select leader of team for leadership skills
Integration of _____ & ______ care team
Health
Social care
What are the reasons for an ageing population?
Decreased mortality (increased life expectancy)
Decreased birth rate
Due to: public health, housing, clean water, nutrition & migration
What are the different factors which are affected by ageing population?
Health implications
Economic implications
Social implications
Political implications
What are the health implications of an ageing population?
Increased number of health professionals required in care of older population
Increased number of facilities for healthcare
Care for long term conditions
Specific health promotion campaigns for elderly
What are the economic implications for an ageing population?
Increased retirement/ pension age
Less people paying into tax & pension funds
Elderly may find state pension inadequate
More difficult for younger people to find jobs as “top end” remain employed
What are the social implications of ageing population?
Increased dependance on families/carers
Increased demand for care homes/nursing homes
Socially in communities, increased emphasis on providing activities for elderly
Role of elderly may change as grandparents
What are the political implications of ageing population?
The increased elderly population will potentially have the power to influence political decision making
What is the leading cause of death in women?
Dementia/AD
What is the leading cause of death in men?
Heart disease
What is the role of carers?
Provide meal preparation, shopping
Company, social support
Personal care
Personal fiances
What is the impact of caring?
Not able to work in full-time employment- decreased household income
Have to cut back on food & heating
Affecting carers health
Missed out on financial support as a result of not getting right info or advice
Affects relationship with friends & family
What is the definition of multi-morbidity?
Co-existence of 2 or more long term conditions in an individual
What are the different options for care?
Living at home with family support Living in own home with support from social services Sheltered housing Residential care Nursing home Hospital admission Specialist unit (eg. Dementia)
What is the name of the document which details care plan?
Anticipatory care plan
What does the ACP demonstrate legally?
Financial & Welfare Power of Attorney
What are the medical components of ACP?
Home care packages
Wishes re DNA CPR
Electronic care summary
Assessment of capacity
What are the personal component of ACP?
Next of kin Consent to pass info onto others Preferred place of death Current level of support Statement of wishes regarding treatment
What are the 5 Principles of Patient Centred Care?
Respect Choice & empowerment Patient involvement in health policy Access & support Information
What are some examples of long term health conditions?
Osteoarthritis IHD COPD Diabetes mellitus MS Parkinsons
What is the definition of incidence?
The number of new cases of a disease in a population in specified period of time
What is the definition of prevalence?
The number of people in a population with a specific disease at a single point in time
What are the aetiology factors which contribute to chronic disease?
Genetic factors
Environmental factors
What is the definition of vulnerability with regards to chronic disease?
An individuals capacity to resist disease, repair damage & restore physiological homeostasis
What are the natural histories of chronic disease?
Some of acute onset (stroke)
Some maybe gradual with slow or rapid deterioration (angina)
Realpse & remit (cancer)
What is a “Burden of Treatment”?
The enormous demands put on patients & caregivers by the healthcare system
What are the factors which contribute to Burden of Treatment in CD?
Changing behaviour policing behaviour of other to adhere to lifestyle modifications
Monitoring & managing symptoms at home
Complex treatment regimes & multiple drugs
Complex admin systems & accessing, coping with uncoordinated health & social care systems
Biographical Disruption in terms of chronic disease leads to…
Loss of confidence in the body
Loss of confidence in social interaction or self-identity
What are the stigmatised ideas associated with long term conditions?
Some visible, non-visible
Can be subject to stigmatisation
Coping to stigma involves a number of strategies; whether to disclose info or attempt to cancel aspects of condition
What are the individual impacts of LTC?
Denial
Self pity
Apathy
What is the impact of LTC on families?
Financial
Emotional
Physical
What is the impact on society with regards to community?
Isolation of individual
What is the definition of The Expert Patient?
Those with LTC
Has extensive knowledge & take part in key decisions in their own care
What is the WHO classification of Impairments, Disabilities & Handicap?
Body & Structure Impairment (abnormality of structures, organs or systems) Activity limitation (changing functional performance & activity by individual) Participation Restriction (disadvantage experienced by individual as a result of impairments & disability)
What is the Medical models of Disability?
Individual/ personal cause
Underlying pathology
Individual level intervention
Individual change/adjust
What are the Social Models of Disability?
Society cause
Condition related to housing
Political/social action needed
Social attitudes change
What do the personal reactions to disability depend on?
Nature of disability Info based on individual Personality of individual Coping strategies of individual Mood & emotional reaction Support network of individual
What are the different causes of disability?
Congenital Injury Communicable disease Non-communicable disease Alcohol Mental illness Obesity Malnutrition
What are the 4 categories of the Watson’s Criteria for screening?
Knowledge of disease
Knowledge of test
Treatment of disease
Cost of findings
What aspects of knowledge of disease are required for screening?
Important disease
Recognised in early stage
Nature of condition understood
What aspects of knowledge of test required for screening?
Suitable test
Test acceptable to population
What aspects of treatment for disease are required for screening?
Acceptable treatment for patient with disease
Facilities for diagnosis & treatment
What aspects of cost of findings are required for screening?
Cost of one finding balanced against medical care as a whole
What is the definition of disease?
Signs
Symptoms
Diagnosis
What is the definition of illness?
Ideas
Concerns
Expectation
(Patients perspective)
What factors affect uptake of care?
Sources of info - peers, family, TV, health pages, leaflets
Family encouragement
Medical symptoms - new symptoms, visible symptoms, increased severity or duration
Non-medical factors - peer pressure, patient beliefs, social class, age, gender, culture
What are the 3 main aims of epidemiology?
Description
Explanation
Disease control
Epidemiology compares groups to detect differences pointing to?
Etiological clues
The scope of prevention
The identification of high risk or priority groups in society
Minor illness may have increased ______ & decreased _____.
incidence
prevalence
Chronic illness may have decreased ____ & increased _____.
Incidence
prevalence
Clinical medicine deals with individuals whilst epidemiology deals with _____.
Population
Numerator/Denominator =
No. of events/Population at risk
What is relative risk a measure of?
A measure of the strength of association between suspected risk factors & disease underlying it
What is the equation for Relative risK?
Incidence of disease exposed group/ Incidence of disease in unexposed group
What is the equation for Absolute risk?
The no. of events in exposed or control group/ No. of people in group
Where are the sources for epidemiology data collected?
Mortality data Reproductive health stats Accident stats Cancer stats GP mortality Expenditure data for NHS
What is the definition of health literacy?
The patients knowledge, skills, understanding & confidence to use health info to be an active partner in their care & navigate health & social care systems
What are the different types of clinical studies called?
Descriptive Study
Analytical Studies: Cross sectional, Case Control studies
Cohort studies
What do SIGN guidelines facilitate?
Help health professionals & patients understand medical evidence & use it to make decisions about healthcare
Reduce variation in practice & make sure patients receive best available
What do Descriptive studies do?
Describe the amount & distribution of disease in given population
Follow time, place & person framework
What do Cross-sectional studies do?
Observations are made at single point in time (prevalence study, disease frequency, survey)
Conclusions drawn about relationships between diseases
Quick results
What do Case control studies do?
Compare 2 groups of people (relative risk)
A group of individuals who do have the disease of interest
A group of individuals who do not have disease
Case-control comparison after previous exposure
What do Cohort studies do?
Baseline data on exposure are collected from groups of people who do not have disease are studied.
The group is then followed through time until a sufficient number have developed disease to allow analysis.
What type of control trials give a definitive method of accessing any new treatment in medicine?
Randomised control trials
When interpreting results, what factors are considered?
Standardisation Standardised mortality ratio Quality of data Case definition Coding & Classifcation Ascertainment
What is bias in data analysis?
Any trend in the collection, analysis, interpretation, publication or review of data that can lead to conclusions which are systematically different from truth
What are the different types of data bias?
Selection bias (study sample not representative of whole population) Information bias (Past exposure) Follow up bias(One group of subjects is followed up more) Systematic error (a tendency for measurements to always fall on one side of true value)
What are ways to deal with confounding factors?
Randomisation
Restriction of eligibility in criteria
Results stratified according to confounding factors
What is a confounding factor?
Is one that is independently associated with both disease & exposure & therefore distorts the relationship btw exposure & disease
(Age, Sex & Class)
What are the stages of the audit cycle?
Preparation Selection criteria Measure level of performance Making improvements Maintain improvements
