Year one and two Flashcards
1
Q
What are the three types of skills needed for successful medical interviewing?
A
Content, perceptual and process skills
2
Q
Szasz and Hollender describe three different types of Doctor-Patient Realationships. What are they?
A
- Authoritarian or Paternalistic, Guidance, Mutual Participation
3
Q
Name the 5 question types which can be asked during a consultation?
A
Open ended, closed, direct, leading or reflected
4
Q
Body language during consultations is highly important. What four points should be considered throughout the consultation?
A
Gesture Clusters, Congruence, Culture and Context
5
Q
Name the members of a primary care team?
A
GP, NHS 24 staff, Midwives, Phramacists, Dieticians, Nurses, PA’s, Physiotherapists, Counsellors, Reception staff
6
Q
What are the top risk factors for health in Scotland?
A
Excessive drinking, smoking, unhealthy diet, sedentary lifestyle, obesity
7
Q
- Albert Bandura proposed the Social Cognitive Theory in 1993. What are the 5 core concepts of SCT?
A
Self Efficacy, Goal Setting, Outcome Expectations, Self-Regulation, Observational Learning
8
Q
- According to SCT, an individuals behaviour can be influenced by what factors?
A
- Personal Factors (how confident the individual feels about changing etc.), Enviromental/Social factors, Behavioural Factors
9
Q
What does NICE recommend for GP’s to do to change patients behaviours?
A
- Take account of patients circumstances, Aim to develop and build on the individuals skills, tailor interventions to tackle the individuals beliefs and attitudes associated with target behaviours
10
Q
- What is the WHO’s definition of health?
A
- A state of complete physical, mental and social well-being and not just the mere absence of disease or infirmity
11
Q
Statistical normality corresponds to what ?
A
A bell curve
12
Q
- What is cultural normality?
A
- The norm which is based on the expectations and standards of a particular group of individuals
13
Q
- Health can be perceived as being holistic. Seedhouse (2001) identifies 5 major characteristics or qualities which define positive ideas about health. List all 5.
A
- Health as an ideal state, health as physical and mental fitness, health as a commodity, health as a personal strength or ability health as the basis for personal potential
14
Q
- Blaxter(1995) questioned 9000 individuals about their health. Lay people categorised their health into what categories?
A
- Functional ability, absence of disease and physical fitness
15
Q
- Name 6 duties of a doctor registered with the GMC.
A
- Make the care of your patient your first concern, treat every patient politely and considerately, respect patients dignity and privacy, listen to patients and respect their views, give patients info in a way that they can understand, keep your professional knowledge up to date, make sure that your personal beliefs do not prejudice your patients care, be honest and trustworthy, respect and protect confidential information, act quickly to protect patients from risk, avoid abusing your position as a doctor, work with colleagues in ways that best serve the patients interests, recognise the limits of your professional competence
16
Q
- Give Examples of the four pillars of medical ethics?
A
- Respect for autonomy (informed consent, confidentiality, promote capacity), Non-Maleficence (avoid harm – avoid unnecessary surgerys, procedures etc.), Beneficence (to do good – do the best for your patients), Justice (fairness, equity, triage, individual vs population)
17
Q
- According to the GMC Guide 2006, name 6 things you cannot discriminate against?
A
- Colour, age, culture, disability, ethnicity, gender, lifestyle, race, religion, sex, sexual orientation, social or economic status
18
Q
- Concerning ethics, what are the four principles of medicine?
A
Beneficence, non-maleficence, autonomy and justice
19
Q
- The Duty of Candor states that you must inform patients if something has gone wrong with their treatment. What other two things does it state you must do in this instance
A
- You must apologise to the patient and offer an appropriate remedy or support to put matters right and explain the short term and long term effects of what has happened.
20
Q
- Access to healthcare means the opportunity to use healthcare regardless of whether you come to use it. What are the 3 A’s of Access to Healthcare?
A
- Affordability, Accessibility, Acceptability
21
Q
- Name factors which influence the degree of risk?
A
- How much the person is exposed, how the person is exposed and the conditions of exposure
22
Q
- Name the three principles which govern the perception of risk?
A
- Feeling in control, Familiarity with the risk, Size of the possible harm
23
Q
- What are the individual variables in risk perception?
A
- Previous experience, attitude towards risk, values, beliefs, socio-economic factors, personality, demographic factors
24
Q
- List four aspects of lifestyle you MAY cover in a consultation with ANY patient when giving advice to promote a healthier lifestyle.
A
- Diet, Exercise, Sexual Health, Drug Use, Alcohol Intake, Smoking
25
Q
- Which factors enable you, as a GP, to be the most appropriate professional to guide a patient about their current worries.
A
- You are aware of patients PMH, You are aware of patients social circumstances, GP has a knowledge of a broad range of illnesses and health conditions, GP is likely to have known patients for some time, GP has a role in prevention as well as diagnosing/treating illness/disease i.e. GP is responsible for holistic patient care, GP is likely to be local and therefore accessible
26
Q
- List three examples of environmental factors which may influence an individual’s behaviour
A
- Culture, Social Support, Location, Income, Time
27
Q
- Give five factors which influence lay beliefs about health. Include examples.
A
- Age-older people concentrate on functional ability, younger people tend to speak of health in terms of physical strength and fitness
Social class- people living in difficult economic and social circumstances regard health as functional (ability to be productive, take care of others), women of higher social class or educational qualifications have a more multidimensional view of health
Gender-men and women appear to think about health differently (women may find the concept of health more interesting, women include a social aspect to health)
Culture-different perceptions of illness/disease, differences in concordance with treatment
28
Q
- List the factors in which the government can curb the rise in obesity?
A
29. Health education-diet and exercise Tax on unhealthy foods, “fat tax” Legislation-proper labelling, lists of ingredients/food content Enforcement of legislation Ban on advertising unhealthy food Improve exercise/sport facilities Subsidise healthy food Transport policy e.g. cycle lanes
29
Q
- Define Cultural Competence
A
- Cultural competence is the understanding of diverse attitudes, beliefs, behaviours, practices, and communication patterns attributable to a variety of factors (such as race, ethnicity, religion, SES, historical and social context, physical or mental ability, age, gender, sexual orientation, or generational and acculturation status).
30
Q
- List four potential difficulties which may arise from consulting with a patient from a different culture.
A
- Language barrier, examination taboos, third party present, fear and distrust, lack of knowledge about the NHS, racism, stereotypes, bias, religious beliefs. Patient may not be entitled to NHS care
31
Q
- Discuss the three steps of safety netting.
A
- Advise the patient of the expected course of the illness/recovery
Advise of symptoms indicating deterioration
Advise who to contact if patient deteriorates
32
Q
- Neighbour suggests that there are other ways to minimise risk whilst consulting. Give three examples of how you can do this?
A
- Summarise and verbally check that reasons for attendance are clear
Hand over and bring the consultation to a close i.e. hand over to the patient at the end to ensure all issues have been covered
Deal with the housekeeping of recovery and reflection e.g. record keeping, referral if necessary, pausing to reflect before next patient
33
Q
- Name 6 advantages of GP’s as gatekeepers.
A
- Identify those patients who are in need of 2° care assessment
Personal advocacy
Patient does not necessarily know which specialty to go to
Increases likelihood of referral to appropriate department
Increases likelihood of appropriate referral/use of resources
Limits exposure to certain investigations e.g. MRI scan, X-rays
GP acts as co-ordinator of care
Puts GP in position to provide patient education
34
Q
- What are the skills of a GP?
A
- Ability to relate to the public, seek help, self-reflect, recognise ones limitations, problem solve, good com skills, clinically competent
35
Q
- The consultation between the patient and doctor requires good communication skills for it to be successful. What are the three broad types of skills required for successful medical interviewing?
A
36. Content Skills (what doctor communicates) Perceptual Skills (picking up on how patient thinks or feels) Process Skills (how doctor communicates information)
36
Q
When is a patient more likely to change their lifestyle
A
- Benefits outweigh disadvantages
Patient anticipates a positive response from peers
Social pressure is forcing them to change
If they believe that a new lifestyle will be consistent with their new self-image
If they believe that they can carry out the new behaviour in a number of different situations
37
Q
- Define Hazard, Risk, Risk Factor, Protective Factor, Susceptibility
A
- Hazard – something that has the potential to cause harm
Risk – The likelihood of harm occurring
Risk Factor – something which increases the risk of harm
Protective Factor – something which decreases the risk of harm
38
Q
What kind of reasoning is used in GP Consultations
A
- HYPOTHETICO-DEDUCTIVE REASONING
39
Q
Discuss the principles behind patient centred care
A
Person-centered care is the provision of care that places the patient at the centre ensuring that the healthcare system is designed to meet the needs and preferences of patients as defined by patients themselves.
40
Q
What are the five principles of patient centred care?
A
Respect Choice and Empowerment Patient involvement in health policy Access and support Information
