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FoPC > Year 3 > Flashcards

Year 3 Flashcards

1
Q

What are the two most common causes of death?

A

Cancer and IHD

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2
Q

What is the name of the national action plan in Scotland for palliative care?

A

‘Living and Dying Well’

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3
Q

How do you know if a patient is at a palliative stage? (What tool is used?)

A

‘Supportive and Palliative Care Indicators Tool’

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4
Q

What is the overall goal of palliative care?

A

Emphasise quality of life

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5
Q

What should be considered when thinking about a patient’s palliative care and what they want?

A

Where do they want to be cared for?
Do they want resuscitation?
Who do they want informed of their care and changes in their condition?
Are they/their family fully aware of their prognosis?

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6
Q

Who is the palliative care team made up of?

A

Health and Social Care partnership
+ MacMillan nurses, CLAN, Marie Curie nurses
Religious groups

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7
Q

What might be considered ‘A Good Death’?

A

Pain-free
Acknowledgement of its imminence
At home with family and friends
No personal conflicts or unfinished business
In a manner that resonates with person’s individuality

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8
Q

What are possible different reactions to bad news?

A 
Shock
Anger
Denial
Bargaining
Relief
Sadness
Fear
Guilt
Anxiety
Distress
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9
Q

How is a patient’s current functional level in palliative care measured?

A

‘Palliative Performance Scale’

- has prognostic value

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10
Q

What are the social/socio-economic influences on our health?

A 
Gender
Ethnicity
Housing
Education
Employment
Financial security
Health system
Environment
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11
Q

How does the WHO define ‘Health Inequality’? What is the key determinant factor?

A

Differences in health status or in distribution of health determinants between different population groups

Deprivation is the key factor

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12
Q

What might you expect to see in the general health of children from deprived areas?

A

Low birth weight
Poorer dental health
Higher obesity
Higher rates of teenage pregnancy

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13
Q

What are some examples of ‘vulnerable groups’?

A 
The homeless
Those with learning difficulties
Refugees
Prisoners
LGBT
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14
Q

What health challenges do the homeless face?

A
  • Average age of death ~45
  • Unnatural causes of death 4x more likely
  • Suicide 35x
  • Alcohol/drug problems increased
  • Increased prevalence of infectious diseases
  • Poorer oral health
  • Decreased access to healthcare
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15
Q

What health challenges do those with learning difficulties face?

A
  • Staff having poor understanding
  • If learning disability hasn’t been formally identified
  • Failure to recognise when those with learning difficulties are unwell
  • Inadequate aftercare/follow-up
  • Lack of joint working from different healthcare professionals
  • Anxiety/lack of confidence
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16
Q

What health challenges do refugees face?

A
  • Family integrity and social adjustments larger than medical issues
  • Competing demands of distinct services such as social welfare, housing, education, transport, public health, mental health, primary care, specialty care
  • Language barriers
  • Previous poorly controlled chronic conditions
  • exposure to violence/warfare
  • prevalence of PTSD, depression, anxiety
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17
Q

What health challenges do prisoners face?

A
  • High levels of alcohol use
  • higher levels of smokers
  • Less interest in socialising
  • more drug use
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18
Q

What health challenges do LGBT face?

A
  • Higher rates of depression - increased self-harm
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19
Q

What is the ‘Inverse Care Law’?

A

1971 - Julian Tudor Hart

‘Those who most need medical care are least likely to receive it, and conversely those with least need of health care tend to use health services more and more effectively

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20
Q

What range of factors can reduce health inequalities?

A
  • Effective partnership across a range of sectors and organisations e.g. to promote health, improve patient education about health
  • Evaluate and refine integration of health and social care
  • Government policies and legislation e.g. smoking ban, Keep Well campaign
  • Time to invest in the more vulnerable patient groups
  • Improve access to health and social care services and professionals
  • reduction in poverty
  • social inclusion policies
  • improved employment opportunities for all
  • ensuring equal access to education in all areas
  • improved housing in deprived areas
21
Q

What is the difference between equity and equality?

A

Equality - everyone gets the same

Equity - everyone gets enough to bring everyone to the same level

22
Q

What are the role of third sector organisations in health?

A

Provide a means of engaging effectively with communities and individuals
Deliver a range of services which may help to reduce health inequalities, including:
- promoting healthy living to groups of people who may not use mainstream services
- supporting people to access the relevant services of NHS Health Scotland

23
Q

What are the benefits to individuals who volunteer?

A 
Gain confidence
Make a difference
Meet people
Be part of a community
Learn new skills
Take on a challenge
Have fun
24
Q

What factors may lead to global unsustainability? How might this affect healthcare?

A 
Material inequality - rich getting richer
Population and consumption - growing
Resource depletion - oil, water
Climate change
Loss of biodiversity - animal depletion
Crisis in healthcare - ageing population
25
Q

What is the definition of sustainability?

A

“The ability to be maintained at a certain rate or level”

26
Q

How is climate change expected to affect health and healthcare?

A
  • Loss of healthy life years as a result of global
    environmental damage is predicted to be 500x greater amongst poor Africans
  • Half of world’s population could face severe food shortages as rising temperatures affect crops
  • Sea level rise could displace up to 1bn people
27
Q

What actions may be taken to address climate change?

A
  • Increase renewable energy sources
  • modifying human behaviour to be more active
  • plant-based diet
  • educate on carbon
  • promote patient resilience
  • teach that we are part of an ecological system
28
Q

How is sustainability relevant to the NHS?

A

Looked at in terms of environment and low carbon use

  • or the NHS’s ability to continue over time
  • ‘Realistic Medicine’ relates to this
29
Q

How does/can the NHS continue sustainability in terms of carbon/climate change?

A
  • Prioritise environmental health
  • Substitute harmful chemicals with safer alternatives
  • Reduce and safely dispose of waste
  • Improve travel strategies
  • Purchase and serve sustainably grown food
  • Safely manage and dispose of pharmaceuticals
  • Adopt greener building design and construction
  • Purchase safer, more sustainable, products
30
Q

What are some examples of overall health issues that may result from climate change?

A

Malnutrition
Diarrhoea
Infectious diseases

31
Q

What questions may be asked to determine a patient’s career sustainability in terms of their health?

A

Identify any exposure to chemicals or other hazards
Have symptoms improved when not working
Duration and intensity of exposure
Is PPE used?
What protective measures are in place
Do others suffer similar symptoms?
Any hobbies, pets, worked overseas, moonlighting

32
Q

What are some possible general overall effects of being unemployed, in terms of all types of health?

A
  • Higher mortality
  • Poorer general health, long-standing illness
  • Poorer mental health, psychological distress, minor psychiatric morbidity
  • Higher medical consultation, medication consumption and hospital admission rates
33
Q

What is the purpose of a ‘Fit Note’? When would it be required?

A

‘To facilitate earlier discussion about returning to work and about rehabilitation
Includes items of consideration for employers when signing a patient’s return to work
Can only be completed by a doctor
It is advice to patient as an employee

It is required if the patient has been off for more than 7 consecutive days (including non-working days)

34
Q

What is health promotion?

A

An overarching principle/activity which enhances health and includes disease prevention, health education and health protection
It may be planned or opportunistic

35
Q

What is health education?

A

An activity involving communication with individuals or groups aimed at changing knowledge, beliefs, attitudes and behaviour in a direction which is conducive to improvements in health

36
Q

What is health protection?

A

Involves collective activities directed at factors which are beyond the control of the individual. Health protection activities tend to be aimed at the prevention of ill health or the positive enhancement of well-being

37
Q

What are the three areas of health promotion?

A

Educational - enables informed choices
Socioeconomic - makes healthy choices the easy choice e.g. national policies
Psychological - e.g. person’s desire to change

38
Q

What is empowerment?

A

Power in individuals and groups which previously considered themselves unable to control situations nor act on the basis of their choices

39
Q

What are the benefits of empowerment?

A

An ability to resist social pressure
An ability to utilise effective coping strategies when faced by an unhealthy environment
A heightened consciousness of action

40
Q

What are the stages in the cycle of change?

A

Pre-contemplation
Contemplation
Action
Maintenance > regression/maintaining healthier lifestyle

41
Q

What are some examples of health promotion in primary care and by the government?

A

Primary care

  • planned: posters, chronic disease clinics, vaccinations
  • opportunistic: advice within surgery, smoking, diet, BP

Government

  • legislation: legal age limits, smoking ban, health and safety
  • economic: cigarette/alcohol tax
  • education: Health Education Board for Scotland
42
Q

What is the definition of prevention and what are the different types of prevention?

A

Primary prevention

  • measures taken to prevent onset of illness/injury
  • reduces probability and/or severity of illness/injury

Secondary prevention
- detection of a disease at an early (preclinical) stage in order to cure, prevent or lessen symptoms

Tertiary prevention
- measures to limit distress or disability caused by disease

43
Q

What are Wilson’s criteria for screening?

A

Illness - must be important, its natural history understood, and have presymptomatic stage
Test must be easy, acceptable, cost effective, sensitive and specific
Treatment - acceptable, cost effective, better if early

44
Q

What are some early effects on lifelong health?

A

Diet leading to heart disease

Smoking more likely if parents smoke

Neglect/abuse

45
Q

What are some common reasons for children presenting to primary care?

A 
Feeding problems
Pyrexia
URTI
Coughs/colds
Rashes
Otalgia
Sore throat
D and V
Abdominal pains
Behavioural problems
46
Q

What advice can be given to parents/children to improve their health?

A

Diet and reasons for suboptimal diet
Exercise - 60 minutes per day of moderate/vigorous exercise
Sleep - 8-10 hours

Screen time - importance in sleep quality and mental health

47
Q

What law relates to Child Protection in Scotland?

A

National Guidance for Child Protection SCOTLAND 2010

48
Q

What are the goals of realistic medicine?

A
  • build a personalised approach to care
  • change our style to shared decision-making
  • reduce unnecessary variation in practice and outcomes
  • reduce harm and waste
  • manage risk better
  • become improvers and innovators

“In striving to provide relief from disability, illness and death, modern medicine may have overreached itself and is now causing hidden harm – or at best providing some care that is of lesser value.

Doctors generally choose less treatment for themselves than they provide for their patients.”

49
Q

What 5 questions are patients being encouraged to ask their doctor?

A
  • is this test, treatment or procedure really needed?
  • what are the potential benefits and risks?
  • what are the possible side effects?
  • are there simpler, safer or alternative treatment options?
  • what would happen if I did nothing?

FoPC (4 decks)

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