Year 3 Flashcards
1
Q
palliative care:
-common causes of death?
A
- IHD
- cancer
- young people:
- accidents
- suicide
- esp young men
2
Q
what is palliative care?
A
this is the
MANAGEMENT OF CONDITIONS until terminal PHASE REACHED
3
Q
key features of palliative care?
A
- EMPHASIS ON QoL
- MDT approach
- communciation between members is v important
- primary care is mostly where palliative care is given
- GP acts as companion
- person will be put on palliative care register, and the practice discusses the register at regular meetings
4
Q
WHO description of palliative care?
A
- pain/ symptom relief
- support mechanism for patient / family
- aim is not to hasten death nor to postpone it
- aims to affirm life by acknowledging that death is a normal process
- spiritual and psychosocial support
5
Q
what patients are eligible for palliative care?
A
- worsening chronic conditions
- life-limiting diseases
6
Q
once you identify patients to be eligible for palliative care, what is done?
A
- anticipatory care plan drafted
- put them on palliative care register
7
Q
team involved?
A
- macmillan cancer nurses
- CLAN
- marie curie nurses
- consultant
- religious / cultural groups
8
Q
what is a good death described as? (5)
A
- pain-free
- open acknowledgement of imminent death
- at home surrounded by family and friends
- death as personal growth (accpetance and moving on)
- “aware” death where personal conflicts and unresolved issues have been dealt with
9
Q
what are some of the features of BBN?
A
- set the scene
- listen to patient / carer
- find out what they already know
- find out how much they would like to know
- tell them using common language / avoid jargon
- allow opportunities for questions
- agree on a forward management plan
10
Q
list some common reactions to being told bad news
A
- anger
- denial
- relief
- sadness
- anxiety
- fear
- grief
11
Q
what are some common reasons for euthanasia?
A
- unrelieved symptoms
- DREAD OF FURTHER SUFFERING
- depression
12
Q
responses to euthanasia on behalf of doctor?
A
- listen
- acknowledge concern
- explore reasons
- identify treatable problems
- admit powerlessness
13
Q
definition of sustainability?
A
the ability to BE ABLE TO CONTRIBUTE OVER A PERIOD OF TIME
14
Q
3 types of sustainability?
A
- personal and career
- global
- NHS
15
Q
outline the factors involved in global sustainability
A
- consumption and population
- climate change
- loss of biodiversity
- crisis in healthcare
- resource DEPLETION
16
Q
outline the factors involved in the sustainability of the NHS
A
- MATERIAL sustainability
-
low carbon clinical care
- greener building design
- renewable energy
- reduced water consumption
- safe management & disposal of pharmaceuticals
-
low carbon clinical care
- ability to continue over time
- funding
- support
- privatisation
17
Q
outline the fcators involved in personal and career sustainability
A
- job satisfacation / guarantee
- good relationship with colleagues
- work-life balance
- manageable workload
18
Q
when is a fit note required?
A
- when someone is off work for more than 7 days (including non-work days)
- it outlines considerations for going back to work
- ie alterations to workplace
19
Q
role of OH
A
- prevent ill-health in workplace
- promote health in workplace
- specialist rehab service
- improve work attendance and performance
20
Q
effect of unemployment on health
A
- increased mortality
- poorer general health
- poorer mental health
- increased medical appos, treatments and hospital admissions
21
Q
definition of sociology
A
the study of the development, structure and function of human society
22
Q
outline some of the socio-economic influences on our health (6)
A
- ethnicity
- being of ethnic origin & low socio-economic status is associated with higher morbidity and mortality compared to non-ethnic counterparts
- gender
- female - increased morbidity
- male- increased mortality
- housing
- mental health issues in warm houses- 1/20
- mental health issues in cold houses- 1/4
- environment
- more deprived areas have POOR URBAN PLANNING = increased risk of RTA’s etc
- education
- educated = healthier
- increased awareness etc
- educated = healthier
- employment
- unemployment = increased morbidity & mortality
23
Q
what is the key determinant of health inequality?
A
deprivation
24
Q
identify some vulnerable groups
A
- homeless
- average life expectancy = 40 y/o
- 35x more likely to die by suicide
- learning disability
- associated with shorter life expectancy
- LGBT
- prisoners
- REFUGEES
25
how can we reduce health inequalities?
* improved employment opportunites
* improved acess to healthcare and social care
* better housing in deprived areas
* equal access to education
26
role of 3rd sector?
DELIVERING SERVICES that help reduce inequalities
27
how many hours sleep should children get?
8-10 hours
28
definition of health promotion?
activities done to enhance health including preventing disease, health education and health protection
-can be planned or opportunistic
29
defintion of health education?
communication with person/group to change aspects of their beliefs, knowledge, attitude and behaviour to conduct improved health
30
defintion of health protection?
activites directed at factors beyond the patient's control
31
how is health promotion achieved?
* legislation
* PROVISION OF PREVENTATIVE SERVICES
* DEVELOPMENT OF activities that maintain and promote healthier lifestyle
32
theories of health promotion
* educational
* whereby patient is provided with _knowledge and education_ to make informed decisions for themselves and their care
* socioeconomic
* psychological
* complex interaction between attitudes, beliefs, behaviours and knowledge
33
outline some examples of health promotion by the government
* legislation
* legal age limits, smoking ban
* tax on alcohol / tobacco
34
what are the 3 types of prevention?
primary
* measures to prevent onset of disease / injury
* ie vaccine
secondary
* early diagnosis of disease / injury in order to prevent, cure or lessen symptomatology
* ie screening
tertiary
* measures to reduce distress or disability CAUSED BY disease
35
outline wilson's screening criteria
illness
* important
* pre-symptomatic stage
* natural history understood
test
* acceptable
* cost-effective
* easy
treatment:
* acceptable
* cost-effective
* better OUTCOME if treated early
36
aims of realistic medicine?
* personalised APPROACH TO CARE
* change style to shared decision making
* REDUCE unnecessary variations in practice or outcomes
* use of guidelines
* reduce waste and harm
37
definition of resilience
quickly return to a previously good condition
38
PPS
outline when assistance is required
* 60%= assistance
* 40% = full assistance
39
PPS
outline phases of ambulation
70% = reduced ambulation
30%= bed rest
40
outline at what point you can no longer do anything
40%
41
PPS
when can you take intake until?
until about 10/20%
and at the same time, you start getting drowsy/ coma
42
PPS categories?
* self-care
* activities of daily living
* consciousness
* intake
* ambulation
43
what are the factors in the ACP
* Prognosis
* Place of care
* Home generally preferred
* Hospice
* Resusitation
* Natural death
* Information to be provided
* Patient
* Family
44
outline cycle of change
