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102 Cards in this Set
- Front
- Back
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Give three reasons for the need of patient-centred care.
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Looks at the patient holistically, finds out why the patient came, and enhances the doctor-patient relationship.
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What is the definition of patient-centred care?
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Health care that is closely congruent with and responsive to the patients' wants, needs and preferences.
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Give three things that a patient should do as part of a sick role.
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Should want to get better, should co-operate with staff and should get rid of some normal activities whilst getting better (eg housework)
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Give four things that are expected from the doctor as part of the sick role.
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They should have lots of skill and knowledge, they should act for the welfare of the patient and the community as a whole, be objective and emotionally detached, and be guided by rules of professional practice.
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Give two problems with the biomedical aspect of illness.
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Doesn't take into account the pyschological, behavioural or social dimensions of the illness, and treats the disease independently from any other factors, whilst assuming that the reason for illness is due to somatic processes.
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What four things does the psychological aspect take into account?
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Explores feelings about being ill, ideas about their illness, the impact it has on function and their expectations.
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Give the five parts of the Calgary Cambridge model.
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1. Initiating the session.
2. Gathering information. 3. Physical examination. 4. Explanation and planning. 5. Closing the session. |
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What are the give new genetics?
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DNA, human genome project, genetic testing, cloning and gene modification.
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What are the old genetics?
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Mendel, eugenics and industrial society.
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Give three uses of the new genetics.
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Gene identification and isolation, screening before birth and risk surveillance.
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Give three social implications of screening and genetic engineering.
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Gene piracy, employment and insurance issues and designer babies.
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What percent of people who have medical illness seek help?
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5-15%
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What does the top of the symptom iceberg represent?
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The amount of people who experience symptoms that seek medical help.
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Give four reasons why people don't seek medical help.
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May have past experiences with illness, different people act in different ways, giving the illness a timescale, and some people class the symptoms as part of everyday life.
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What is the lay referral system?
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When other people use other sources before going to the doctor eg pharmacist, NHS direct.
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Give four reasons why people seek medical help.
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Interference with social life, interpersonal crisis, putting a time limit on symptoms and being told to go by another person.
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What is the name given to the thing that makes people seek medical help?
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Triggers.
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Give five barriers that are in the way of people seeking help.
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Past experiences from attitudes of staff, social distance, geographical distance, transport, and cost vs benefits.
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What is autonomy?
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Freedom or independence to choose what a person wants free from controlling influences of others.
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What is beneficience?
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A moral obligation to act for the benefit of others.
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With beneficience, whose benefit could you be looking at?
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The patient's or the community's as a whole.
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What is paternalism?
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The intentional overriding of one person's known preferences or actions by another person.
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What are the justifications of paternalism?
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If it brings benefit or reduces harm for the person.
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What is weak paternalism?
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When someone intervenes to protect people against their own actions.
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What is strong paternalism?
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Intervention even when person actions are informed, voluntary and autonomous.
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Give four examples of denying requests for procedures.
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Amputating a healthy limb, abortion after 24 weeks, prescribing inappropriate medication and euthanasia.
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What is the Bolam test?
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Legal test for the appropriateness of a treatment.
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If someone is wanting a treatment and the doctor rightly refuses it, what is the patient entitled to?
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A second opinion.
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What five things does the patient need to be aware of with informed consent?
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The problem/diagnosis, recommended treatment/investigation, risks and benefits of this, prognosis with and without intervention, and alternative courses of action.
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Give four times when informed consent if required.
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When starting treatment, at the beginning of a physical investigation of examination, when providing personal care and when participating in research.
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What is needed for the consent to be valid and ethical?
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If the patient has all the information, if they're mentally fit to make the decision, and mustn't be forced into making the decision.
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What act needs to be taken into consideration with the capacity to consent?
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Mental capacity act 2005.
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What does the mental health capacity act 2005 state?
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Act in the best interest of the patient if they're not mentally competant to do so themselves.
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How old do children have to be to give informed consent?
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16-17 years old.
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What act stated that children age 16-17 can make informed consent?
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Family and law reform act 1969.
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What does the Gilick competence state?
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That if a child is under 16 and competent to make their own decisions, then they can.
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Give two ethical issues that may be concerned with consent to clinical examinations.
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Embarrassment and the person may need time to consider the consent.
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When can confidentiality be breached?
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If someone else is in danger or could be harmed by the information that the patient tells you.
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What act is concerned with confidentiality and the control of disease?
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Public health act 1984.
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What act is concerned with RTAs?
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Road and traffic act 1988.
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What act is concerned with terrorism and confidentiality?
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Prevention of terrorism act 1989.
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What two reasons can be given for breaching confidentiality?
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If the magistrate or judge from a court requests the information of if the patient lacks the mental competence.
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Who issues the guidelines for the advertising of OTC medicines?
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PAGB.
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What are the guidelines issued by PAGB for OTC medication?
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Must not be misleading and must be in line with the marketing authorisation.
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In 2004, how much was spent by the NHS on drugs?
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£2 billion.
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What percentage of the NHS budget was spent on drugs in 2004?
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20%
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In 1994, how much was spent by the NHS on drugs?
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£1.2 billion.
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What fraction of the NHS budget was spent on drugs in 1994?
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1/3
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Give four advantages of self-medication.
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Less unnecessary appointments and prescriptions, gives patient empowerment, reduces primary care bill and cost shifts from providers to consumers.
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Who are the types of medication regulted by?
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MHRA.
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What do the MHRA do?
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Monitor safety, efficacy and quality of drugs.
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What does GSL mean on medication?
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Available in garages, shops etc.
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Give four things that OTC medication can treat.
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Analgesics, antihistamines, cold remidies and steroid creams.
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Give four things that have controversally been changed from POM to OTC medication.
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H2-antagonists, emergency contraception, NSAIDS (to GSL) and simvastatin.
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Give three common problems that can occur with OTC medications.
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Overdose, misuse, drug interactions.
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Is ethnicity biologically or socially determined?
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Socially.
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Name a genetic anaemia.
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Sickle cell anaemia.
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Where is SCA prevalent?
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Equatorial regions.
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What is SCA caused by?
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Presence of a HB S instead of a normal HB A coz of a change in the quality of the beta globin chain.
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What AA replaces what in SCA?
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Valine replaces glutamic acid.
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What happens to the Hb S at high altitudes?
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It is less soluble and forms crystals.
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Why does a carrier or SCA have an advantage in areas with malaria?
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Coz malaria parasites are less likely to affect a A/S carrier.
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What are the most common hereditary disorder?
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Genetic anaemias.
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Is haemoglobinpathy gene frequency high or low in this country?
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Low.
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What are ADLs?
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Include everyday activites, functional activities and are an essential part of everyday life.
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What categories can ADLs be split into?
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Personal, locomotion, domestic and leisure.
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Give examples of ADLs.
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Tying shoe laces, walking up the stairs getting up.
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What is important to look at in recovery and rehab in reference to ADLs?
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Which ADLs are affected and how badly.
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Give three musculoskeletal problems that can have an impact on ADLs.
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Arthritis, back pain, osteoporosis.
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Give three neurological problems that could have an impact on ADLs.
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Stroke, Parkinson's and MS.
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Give the three main reasons for limitations of ADLs.
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Impairment, disability and handicap.
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What is an impairment?
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What is causing the abnormality eg amputation of limb.
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What is disability?
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Activities that are restricted due to impairment eg walking.
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What is a handicap?
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The individual disadvantage that occurs coz of the loss of ability to be able to do something eg going to the shops.
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What do physiotherapists do an assessment of?
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Physical impairment.
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Give three things that pyshiotherapists do.
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Set goals for rehab, make exercises to address specific impairment and teach patient for self management.
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What is the aim of OTs?
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Provide basis for independence at home.
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Give three things that OTs do.
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Set goals, look at quality of life issues and address ADLs.
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Give five ways of assessing ADLs.
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Barthel index, functional assessment measure, SF36, Nottingham health profile and EQ-5D.
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Give three ways of assessing back pain.
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Roland and Morris questionnaire, Owestry disability index and lower extremity functional scale.
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Give three categories of things that can be obstacles to recovery.
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Physical and biomedical eg prgressive condition, cognitive/emotional eg fear of falling, lack of motivation, and social eg deprivation, unsupportive family.
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What is the most common and 2nd most common cause of reported activity limitation in people <45?
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1st - stress
2nd - lower back pain |
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What approach is needed for the management of back pain?
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Biopsychosocial.
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What is much of the incapacity for work related to?
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Non-specific and subjective health complaints.
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What is the traditional medical model of disability?
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Problem and recovery are a matter for health care. Relief of pain or treatment will cure disability.
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What is the biopsychosocial model a partnership between?
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Health care and the individual.
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What must management do with the biopsychosocial model of pain?
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Relieve pain and prevent disability.
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What act gives new rights to people who have a disability that makes it hard for them to carry out ADLs?
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Disability discriminatin act 1995.
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Where are the highest rates of impairments in the world?
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In developing countries.
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How many people have impairments due to malnutrition?
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Over 100 million.
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How many women in Africa acquire impairments after chid birth?
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100,000.
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Give three major causes of impairment/disability.
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Malnutrition, health care systems and civil wars.
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Which revolution had factors that inscribed the medical model on society?
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Industrial revolution.
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What was social Darwinism?
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Survival of the fittest.
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What was power of the medical profession?
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Defined who was fit to work.
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What does the social model believe?
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External factors are responsible for disability eg access and obstacles.
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What is a problem with the social model?
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Creating a society where no problems ever exist is impossible and it doesn't take into account the complexity and range of disability in society.
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What happens when finding common ground with disability?
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It brings together the medical and social models.
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What does finding common ground draw parallels with?
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Feminism.
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What does finding common ground recognise?
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Individualism, despite disease.
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Give three examples of what the social model would say was the blame for disability.
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Prejudice, discrimination and inaccessible environments.
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What did the industrial revolution replace?
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Low tech work.
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