Year 1 Paper 3 AI Cards [QUIZLET Ver]

Illness behaviour

How people experience, define and interpret their symptoms of illness/disease/injury and how they interact with various social networks as they try to cope with or accommodate these symptoms.

Biomedical models

An approach that assumes that all disease can be explained in terms of physiological processes, therefore treatment acts on disease and not on person.

Zola's 5 triggers to consultations

1. Perceived interference with vocational activity - work/hobbies impacted, loss of functionality.

2. Perceived interference with social/personal life - negative impact on friends/family.

3. Sanctioning - pressure from family/friends to seek healthcare.

4. Interpersonal crisis - something like a death within the family.

5. Temporalising of symptomology - setting deadline for resolution of symptoms; 'if I'm not well in a week I'll go to the GP.'

Factors influencing utilisation of medical services

1. Gender. 2. Age. 3. Social class. 4. Ethnic origin. 5. Marital status. 6. Family size.

Biopsychosocial model

Health is the state of complete physical, mental and social well-being, not simply the absence of infirmity.

Challenges of acute illness

1. Uncertainty of illness/treatment. 2. Unfamiliar people/environments and procedures. 3. Disclosing weakness, anxiety or suffering to others.

Mechanic and Volkart's Triggers to Consultations

FFPA

1. Frequency of illness in given population.

2. Familiarity of symptoms.

3. Predictability of illness outcome.

4. Amount of threat and loss that is likely to result from illness.

Hippocratic Oath

Outlines main obligations of doctors and requires them to uphold certain ethical standards.

Declaration of Geneva

Current day ethical framework for medical professionals, replacing outdated concepts of the Hippocratic Oath.

GMC Ethical Guidance

1. Patient should be your 1st concern.

2. Respect dignity, confidentiality and autonomy.

3. Don't abuse trust of pts. or public in the profession.

4. Work within limits of your competency.

5. Raising and acting on concerns for pt. safety.

GMC Domains of Good Medical Practice

1. Knowledge, skills and development.

2. Patients, partnership and communication.

3. Colleagues, culture and safety.

4. Trust and professionalism.

Professionalism

Set of values, behaviours and relationships that underpins the public's trust in doctors.

Knowledge

Continuous learning and application of medical expertise to provide the best possible care; working within the limits of your competence.

Safety

Commitment to pt. safety through adherence to clinical guidelines, vigilant monitoring and swift error correction.

Quality

Consistent delivery of high-standard care, including effective communication, pt-centred approaches, and evidence-based practices.

Ethical codes of conduct

Guidelines that govern the moral conduct of medical professionals.

Deontology

People need to act based in what they believe is morally right, regardless of the consequences.

Categorical imperative

Action must be universal - acceptable for everyone to do the same action.

Consequentialism

The morality of an action depends on the consequences of the choice.

Utilitarianism

Doing the most good for the most people.

Virtue ethics

Ethical behaviour of an individual should be based in trait-based behaviours, rather than action - i.e. what would a virtuous person do?

Epidemiology

The study of distribution and determinants of health-related status and the application of this study to the control of disease and other health problems.

Public health (WHO)

The art and science of preventing disease, prolonging life and promoting health through organised efforts of society.

Examples of public health

1. Change4life. 2. Stoptober for smoking. 3. John Snow and cholera.

Health protection

Action taken for clean air and water.

Sick role

Refers to the rights and obligations associated with illness that shape the behaviour of doctors and patients.

Exemption from normal social duties

A right of the patient in the sick role.

Patient not responsible for being sick

A right of the patient in the sick role.

Patient must seek medical care

A right of the patient in the sick role.

Patient must try to get better

A right of the patient in the sick role.

Access to taboo areas

A right of doctors in the sick role to have access to intimate areas of the patient.

Authority in regards to patient

A right of doctors in the sick role.

Remain objective

A right of doctors in the sick role to have no emotional attachment to the patient.

A right of doctors in the sick role

Follow professional practice

Qualitative interviews

Involves the application of logical, planned and thorough methods of collecting data and thoughtful analysis.

Problem-focussed coping

Approach based, take action to reduce demand of problem with long-term impact.

Emotion-focussed coping

Coping that can be approached or avoidance based, managing emotions evoked with short-term impact.

Maintaining boundaries

Do not mix social and professional relationships with patients.

Communication

Be honest, open and clear in consultations.

Trust

Be transparent and non-judgmental, maintaining confidentiality.

Duty of care

Legal duty to provide a reasonable standard of care to patients and to act in ways that protect their safety.

Beneficence

Duty of a doctor to act in the benefit of the patient.

Non-maleficence

Duty of a doctor to not harm the patient.

Justice

Appropriate treatment of persons, aka fairness, equitability.

Historical perceptions of hospitals

Associated with the church and monasteries, where doctors learned how to care, rather than treat.

Perceptions of hospitals now

Place that creates fear and anxiety, still a place of refuge and a human right based on clinical need.

Perceptions of HCPs now

Still highly respected, however no longer 'keepers of knowledge' due to patients.

Clinical audits

Measure the current level of practice against required or desired standards to ensure patients receive the best quality of care.

Cross-sectional studies

Provide a snapshot of health and measure the burden of disease in a population.

Case-control studies

Identify the relationship between exposure and disease by splitting subjects into diseased and not diseased groups and measuring exposure retrospectively.

Cohort studies

Identify risk factors by measuring exposures of interest at the start of the study among people who have not developed the outcome.

Stigma

A mark of disgrace associated with a particular circumstance, quality, or person, which brings shame.

Direct stigma

Verbal abuse and discrimination faced by an individual.

Indirect stigma

Staring at a person as a form of stigma.

Felt stigma

Internalized stigma, such as guilt or shame, that the stigmatised person feels.

Enacted stigma

Stigma that society imposes onto a person.

Discreditable stigma

Concealable stigma not known by most of society, such as a covered scar.

Discrediting stigma

Stigma that cannot be hidden from others, such as cerebral palsy.

Transtheoretical Model of Change

A model consisting of six stages: Pre-contemplation, Contemplation, Preparation, Action, Maintenance, and Relapse.

Ethnography

The scientific description of people's cultures, customs, habits, and mutual differences within a specific society.

Health Belief Model

A model that includes:

1. perceived susceptibility

2. perceived severity

3. perceived benefit

4. barriers

5. cue to action

6. self-efficacy

Health protective behaviours

Behaviours that promote health, such as dentist trips, sleep, exercise, screening, and good diet.

Health risk behaviours

Behaviours that can harm health, such as smoking, alcohol consumption, and unsafe sex.

PPVE principles

Four principles: Medical indications, Patient preferences, Quality of life, and Contextual features.

Prima facie duties

All principles have equal weighting unless they conflict; in such cases, the most important principle must be prioritized.

Absolute duty

A duty that is always morally binding regardless of circumstances, often seen in legal matters.

Autonomy

Patients' right to make their own decisions about their treatment.

Autonomy

Patients' own right to make their own decision about their treatment.

Paternalism

Outdated principle of that doctors decide what is best for pt. with minimal pt. input.

Health promotion

The process of enabling the population to exert more control over and improve their health.

Health protection

The actions taken to protect individuals or a population from factors in the external environment.

Health education

Raising awareness to the dangers of active and passive smoking.

Disease prevention

Strategies to prevent disease occurrence, progression, and limit consequences.

Primary prevention

Preventing a disease from occurring, e.g. promote healthy eating.

Secondary prevention

Preventing disease from progressing and treating early.

Tertiary prevention

Managing established diseases or injuries to minimize long-term effects, improve quality of life, and potentially increase life expectancy - e.g. Limiting physical/social consequences, e.g. rehab.

Demography

Study of changes in population size, composition and distribution in space.

PHE (Public Health England)

Exists to protect and improve nation's health and well-being and decrease health inequalities.

FSA

Reduces economic burden of food-borne illness and supports trade by ensuring food is safe and authentic.

Adherence

The extent to which a patient follows a HCP's recommendations as agreed upon through a mutual decision making process.

Compliance

The extent to which a patient's behaviour coincides with the prescriber's recommendations.

Concordance

Compromised agreement between a doctor and patient as to what the patient will do.

Lay epidemiology

Process through which health risks are interpreted and understood by lay people.

Influences of Lay Epidemiology

Internet, mass media, lay contacts.

Impact of Lay Epidemiology on HCP

Pts. may be scared they have a serious condition; pts. don't present as they self-diagnose and treat.

Human Rights

HRA 1998 - adapted from the ECHR (European Convention on Human Rights) and outlines all human rights.

Rights vs. Interests

Rights are defined by certain specific duties, justified to protect important individuals' interests.

Positive rights

Rights that provide something that people need to secure their well-being.

Negative rights

Rights that protect some form of human freedom or liberty.

rights that protect individuals from interference by others, particularly the government. They are about freedom from action, meaning people have the right to be left alone and not have their freedoms restricted

Absolute rights

Rights that cannot be violated at all.

Limited rights

These rights cannot be broken, save for some exceptions.

Qualified rights

Public authority can sometimes interfere with your rights if it's in the interest of the wider community.

Article 8

Your right to respect for private and family life.

Article 9

Freedom to manifest your religion or belief.

Article 10

Freedom of expression.

Informed consent

Enshrined in law by the case of Montgomery (2015); patient should be fully informed of the procedure: full risks and benefits thereof.

Moral principles in healthcare

Respect for autonomy, beneficence and non-maleficence.

Legal frameworks for informed consent

HRA 1998, GMC Guidelines, Montgomery (2015).

NHS Act 2006

Mandates provision of comprehensive health service, ensuring that patients receive necessary medical care without discrimination.

Equality Act 2010

Legal framework ensuring equal treatment and access to services.