Yr 3 Case study Flashcards
discussing risk with a pt - 2 different types
and the more important type
how to communicate risk
actual + relative
actual more important
communicate verbally with statistics + illustrations
kinds of studies? presented to its
cohort studies RCTs descriptive studies cross sectional studies case control studies
when a study describes the tendency to select preferentially from a group
bias
one variable increased in one group but not the others
confounding factor
unsure if practise following guidelines?
perform an audit
headings for an audit
reason criteria measured standards set prep + plannings results + data collection description of change implemented results + data collection two reflections
model when trying to quit smoking
stages of change model
steps of change model
pre contemplation
contemplation
action
maintenance - maintaining it or regression
define health promotion:
1) Any planned activity designed to enhance health or prevent disease
2) The process of enabling people to increase control over, and to improve, their
health. Applied to a wide range of approaches to improving health of people,
communities and populations.
3) An over-arching principle/activity which enhances health and includes disease
preventing health education and health protection. It is usually planned but may be opportunistic, e.g. in a GP consultation
3 theories of health promotion
- educational: knowledge to rate informed health choices: can be one-to-one or group
- socioeconomic: national policies to make being healthy an easy choice
- psychosocial: whether individual is ready to change
funding of group session on smoking cessation - type of health promotion?
education
smoking cessation education - form of prevention?
primary prevention - preventing onset of illness
example of secondary prevention?
screening
criteria that lists the appropriateness of a screening programme?
wilson + Jungner’s criteria
Illness - understand
test - easy, acceptable, cost effect, spec + sens
testment - acceptable, cost effective, better if early
diagnosis + prognosis if sharp lower back pain on physical activity
mechanical low back pain
rest, pain killers, mobilise
back pain - had OTC drugs - unsure if he can work - you’re a GP - what can you offer?
- different analgesia
- Med 3 Fit Note: alter duties, adaptations
- referral to physio
‘sick’ pt remaining at home - not distressed - what role is he adopting?
the sick role
expectation that they will get well and return to work
sketch pop for
1950
2000
2050
1950: pyramid
2000: fat ice cream cone
2050: slim ice cream cone with a bulge of ice cream
2 consequences of changes to population pyramids
- ageing pop with disease + care needs
- fewer younger people to pay taxes+ support the country/older pop
by 2050 - pop >80yo set to rise compared to 2000
4 fold
co-existence of two or more long term conditions in an individual
co-morbidity
problems of NSAIDs - if IHD
diclofenac has a detrimental effect on IHD + BP + renal function + irritates the stomach
problems of a drug having risk + prescribing
ask pt’s thoughts about risk
present risk + see what they decide.
or tailor meds - give a topical cream that will have less side effects
a plan that avoids predictable admissions?
an anticipatory care plan
what does an anticipatory care plan promote?
promotes discussion - where individuals, care providers + relatives - make decisions about future health, personal, practical aspects of care
anticipatory care plan include?
power of attorney
contact details of fam
strategy to manage care outwith hospital
resus status
details for out of hours team
modifications to the NHS to improve environmental sustainability?
local food suppliers teleconferencing car pooling / sharing hybrid vehicles NHSG mini buses reward multiple vehicle occupancy facilities for cyclists promote bus links
if house bound - care at home? who coordinates this?
care manager
- advice on care packages
- costs of care
- sheltered housing
Members involved in terminal care after discharge and their roles
- OT: mobility around the house, environ, aids
- care manager: financial aid, carers
- macmillan nurse: palliate symptoms, support
- GP: coordination of care, meds
- district nurse: administer meds, wounds, bedsores
- pharmacist: provides meds
scale to monitor changes in palliative conditions
palliative performance scale
factors contributing to a good death
- death as personal growth
- painfree
- comfortable
- open acknowledgement
- death at home
- death according to personal preference
10 emotions experienced following a bereavement
- sadness
- anger
- guilt
- denial
- shock
- bargaining
- relief
- fear
- anxiety
