Block 2 H&S

What are the six principle of patient centred care?

• Explores main reason for visit, concerns and need for information

• Seeks an integrated understanding of patient’s world (whole person, emotional needs, life issues)

• Finds common ground and mutually agrees on management

• Enhances prevention and health promotion

• Enhances continuing doctor-patient relationship

• Is realistic

What is the assumption of the conventional medical model?

Disease is fully accounted for by biology and physiology

Leaves no room for social, psychological or behavioural dimensions

What does the mnemonic FIFE stand for in relation to the social perspective of illness?

• Feelings

• Ideas

• Function (impact)

• Expectation

What are the five steps of the Calgary-Cambridge model?

• Initiating (establishing rapport and identifying reason)

• Gathering information (biomedical, patient’s perspective, context)

• Physical examination

• Explanation and planning (providing information, aiding recall and understanding, shared management decision)

• Closing (at appropriate point)

What can be asked about to understand the patient as a whole person?

• Family

• Finances

• Education/work

• Leisure

• Social support

• Culture

• Lifestyle

What is the definition of autonomy?

• Informing patients with capacity to make their own decisions

• Consequentialist - better consequences

• Deontologist - morally right

What is the difference between disease and illness?

• Disease - pathology, signs and symptoms, abnormal tests

• Illness - unique personal experience (ICEF)

What is the definition of paternalism?

• Interference with a person’s freedom of action or information, or the deliberate dissemination of misinformation, justified by reasons referring to welfare of the person

• Unwanted treatment is now unacceptable

• Paternalism is acceptable in withholding information to avoid serious harm or when treating children

• Doctors are not required to give a treatment they believe would provide no clinical benefit

What is the definition of epidemiology?

The study of the distribution and determinants of health-related states and events in populations, and the application of this to the control of health problems

What are examples of barriers to seeking help?

• Disruption of work

• Lack of transport

• Inability to travel distances

• Negative previous experience

• Psychological - do not want to believe they have a condition