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Flashcards in Year 3 Deck (44)
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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
  • 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
  • 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
Q

how can we reduce health inequalities?

A
  • improved employment opportunites
  • improved acess to healthcare and social care
  • better housing in deprived areas
  • equal access to education
26
Q

role of 3rd sector?

A

DELIVERING SERVICES that help reduce inequalities

27
Q

how many hours sleep should children get?

A

8-10 hours

28
Q

definition of health promotion?

A

activities done to enhance health including preventing disease, health education and health protection

-can be planned or opportunistic

29
Q

defintion of health education?

A

communication with person/group to change aspects of their beliefs, knowledge, attitude and behaviour to conduct improved health

30
Q

defintion of health protection?

A

activites directed at factors beyond the patient’s control

31
Q

how is health promotion achieved?

A
  • legislation
  • PROVISION OF PREVENTATIVE SERVICES
  • DEVELOPMENT OF activities that maintain and promote healthier lifestyle
32
Q

theories of health promotion

A
  • 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
Q

outline some examples of health promotion by the government

A
  • legislation
    • legal age limits, smoking ban
    • tax on alcohol / tobacco
34
Q

what are the 3 types of prevention?

A

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
Q

outline wilson’s screening criteria

A

illness

  • important
  • pre-symptomatic stage
  • natural history understood

test

  • acceptable
  • cost-effective
  • easy

treatment:

  • acceptable
  • cost-effective
  • better OUTCOME if treated early
36
Q

aims of realistic medicine?

A
  • 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
Q

definition of resilience

A

quickly return to a previously good condition

38
Q

PPS

outline when assistance is required

A
  • 60%= assistance
  • 40% = full assistance
39
Q

PPS

outline phases of ambulation

A

70% = reduced ambulation

30%= bed rest

40
Q

outline at what point you can no longer do anything

A

40%

41
Q

PPS

when can you take intake until?

A

until about 10/20%

and at the same time, you start getting drowsy/ coma

42
Q

PPS categories?

A
  • self-care
  • activities of daily living
  • consciousness
  • intake
  • ambulation
43
Q

what are the factors in the ACP

A
  • Prognosis
  • Place of care
    • Home generally preferred
    • Hospice
  • Resusitation
    • Natural death
  • Information to be provided
    • Patient
    • Family
44
Q

outline cycle of change

A