Year 3 FoPC Flashcards
What is the most common cause of death today?
Cancer
Ischemic Heart Disease
Accidents in young
Suicide in men aged 15-34yrs
What are some features of unexpected death?
Profound sense of shock
No chance to say goodbye or take back hasty words.
What is terminal care?
The last phase of care when a patient’s condition is deteriorating and death is close.
What are some features of Palliative care?
Emphasis the quality of life
Performed by a multi-disciplinary team.
Communication is essential
Most provided in primary care with support from specialist practitioners to palliative care units.
What are some stages of the Supportive and Palliative Care Indicators Tool?
Would it be a surprise if they died in next 6-12months.
2 or more general indicators:
-Progressive weight loss (>10%) over past 6 months.
-2 or more unplanned admission in the last 6months.
-Performance status poor or deteriorating.
-a new diagnosis of a progressive life limiting illness.
-2 or more advanced or complex conditions
-Nursing home or NHS continuing care unit, or needs more at home care.
Then look for disease related indicators.
Assess patient and family for supportive/palliative care needs. Review treatment, Plan care. Consider for GP practice palliative care register.
What can be used to measure the need for palliative care?
Palliative performance scale.
What are some features of palliative care in primary care?
Practices have a register of patients
Meet regularly to discuss cases
Enhances communication between team members
Out of Hours service also notified of palliative patients.
What is the WHO definition of Palliative care?
Provides relief from pain and other distressing symptoms.
Affirms life and regards dying as a normal process.
Intends neither to hasten nor postpone death.
Integrates the psychological and spiritual aspects of patient care.
Offers a support system to help patients live as actively as possible until death.
Offers a support system to help family cope during illness/bereavement.
Uses a team approach to address needs.
Who are some of the members of the palliative care team?
GP Specialist practitioners Specialist palliative units Macmillan Nurses CLAN Marie Curie nurses Religious or cultural groups Support networks
What is meant by a good death?
- Pain free
- Open acknowledgement of imminence of death
- Death at home surrounded by friends and family
- Death as personal growth
- An aware death in which personal conflicts and unfinished business are resolved.
- Death according to personal preference and in a manner that resonates with the person’s individuality.
What is the role of the Gold Standards Framework?
Offers tools to enable primary care to provide palliative care at home.
Includes setting up cancer register, reviewing patients and reflective practice.
What are some stages of receiving bad news?
Stability Immobilisation Denial Anger Bargaining Depression Testing Acceptance
What are some features of grief?
Individual experience
Process may take months/years
May need to be reassured it is normal
Abnormal or distorted reactions may need more help.
Bereavement is associated with morbidity and mortality.
What is euthanasia?
Deliberate ending of a person’s life with or without their request.
Voluntary
Non Voluntary
Physician Assisted suicide.
What are some reasons for requesting euthanasia?
Want to end suffering
Unrelieved symptoms
Don’t want to be a burden
What should be our response to a patient requesting euthanasia?
Listen Acknowledge issue Explore reasons for request Explore ways of giving more control to patient Look for treatable problems Remember spiritual issues Admit powerlessness
What is sociology?
The study of development, structure and functioning of human society.
What is the sociology of medicine?
Systematic theory Authority recognised by clientele Broader community sanction Code of ethics Professional culture sustained by formal professional sanctions.
What is the function of National Statistics Socio-economic Classification (NS-SEC)?
Measure the employment relations and conditions of occupations.
Good predictor of health, education etc.
What is social influence on our health?
Collective set of conditions in which people are born, grow up, live and work.
What are some examples of Social influences on health?
Gender Ethnicity Physical environment/housing Education Employment Income Social status Financial security Health system Social environment
What are some characteristics of gender in healthcare?
Men have higher mortality at every age.
Women have higher morbidity
Women consult more frequently in GP settings
What are some characteristics about ethnicity in health?
Type 2 diabetes higher in South Asian pops
Greater prevalence of sickle cell disease in African origin groups.
Minority ethnic groups have better general health than majority of white pop.
Mortality in Scotland is higher in white pop than black and minority ethnic pop.
What are some potential barriers to the use of health services?
Patient level - language barriers, understanding system, beliefs
Provider level - provider skills and attitudes, understanding differences due to ethnicity
System level - organisation of appointments/referrals.
What is meant by culturally competent care?
Combination of attitudes, skills and knowledge that allows an understanding and therefore better care of patients with a different backgrounds to our own.
Why are those with higher levels of education tend to be healthier than those with similar income but less educated?
- better understanding of health
- more effective engagement with health care services e.g screening programmes
- better engagement with health related advice
- better able to navigate health services
What is the WHO definition of health inequalities?
The differences in health status or in the distribution of health determinants between different population groups
What are some barriers that stop people with learning difficulties from getting healthcare?
Lack of accessible transport Staff have little understanding Failure to recognise they are unwell Anxiety or lack of confidence Not involvement allowed form carers Inadequate follow-up or aftercare.
What is the inverse care law?
This described that 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.
1971 - Dr Julian Tudor Hart
What factors can reduce health inequalities?
- Effective partnership across sectors.
- Refine integration of health and social care
- investing in more vulnerable patient groups
- reduction in poverty
- improve access
- social inclusion polices
- improved employment
- equal access to education
- improved housing
What is the role of voluntary sector organisations?
Provide a means to engaging effectively with communities and individuals
Deliver a range of services which may help to reduce health inequalities e.g. health promotion, supporting access to relevant services.
What are some benefits of volunteering?
Gain confidence Make a difference Meet people Be part of a community Learn new skills Take on a challenge Fun
What is the role of Citizens Advice?
Help people directly with negotiating difficult problems e.g. debt, finances, benefits, consumer rights
Support witnesses in courts
Advocacy work - help improve how big organisations work.
What is the role of Alcohol and Drugs Action?
7 day access to support, advice and targeted interventions for anyone affected by substance misuse and related issues
Telephone helpline, drop in service, needle exchange, ongoing support
Harm reduction service, support for families, services for women and girls including those at risk of sexual exploitation or those engaged in prostitution.
What is the role of CLAN?
Local charity providing emotional and practical support to people affected by cancer across NE Scotland, Orkney and Shetland.
