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Extra Stuff


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Situational factors
Competition for cues Stress Situation specific self-efficacy Perceived risk Emotional response
Social Influences
Information from social cues Perceived Social Support Subjective Norms
Background factors
SES Ethnicity Gender Social knowledge
3 Stable factors
Explanatory Style Emotional Disposition Generalised Expectancies
Five belief dimensions of illness representation
Identity Cause Time Consequences Control-Cure
What 3 things can be done about consultation quality?
Understand the problem Intervene in the process Determine & evaluate effects
In bad consultations, patients are less likely to...
Adhere to treatment Seek help in future Attend checkups & prevention
Doctors are poor communicators because of...
Not listening / Interrupting Depersonalisation Explaining away distress as normal Attending only to physical aspects Jollying patients along Use of jargon
Communication inequalities affect:
Elderly Female Ethnic Low SES Chronically Ill Psychological Symptoms
Three types of screening
Population Screening Self-Screening Opportunistic Screening
Screening uptake affected by:
Patient Factors Provider Factors Organisational Factors
Health Beliefs that affects Screening Uptake
Perceived benefits Perceived barriers Subjective norms Behavioural intentions Emotional response
Two questions for depression screening
During the past month, have you often been bothered by feeling down, depressed or hopeless? During the past month, have you often been bothered by little interest or pleasure in doing things?
Alcohol Screening
Four phases of screening
Invitation Completion of test Wait for results Receive results & recommendations
Potential downsides of screening?
True positives - anxiety, fear, stress False positives - Unnecessary treatment True Negatives - Maintain damaging behaviours False Negatives - loss of trust in service etc
Screening ethics based on
Informed Uptake Consent Effect on others Confidentiality
Five tasks of Calgary Cambridge Guide
Commence Consultation Gather info Physical exam Explanation & Planning Closing consultation
Seven categories for Consultation Competence of Leicester Assessment package
Interview/Hx taking Physical exam Patient management Problem solving Patient relationship Anticipatory care Record keeping
Doctor Recreational User Gynaecological Sensitivities
Unit Strength
Pint of Premium Lager: 3.4 Units 1 shot of spirit: 1 Unit 13% Bottle of Wine: 10 Units
Can you always CONTROL Your Drinking NEGLECT of others TIME drinking? before? friends ask to REDUCE Drink to OVERCOME hangover Average Day, LEAVE nothing out
Feedback Responsibility Advise Menus Empathy Self-Efficacy
5 A\'s
ASK the patient if they use tobacco ADVISE them to quit ASSESS willingness to quit ASSIST them in their quit attempt ARRANGE a follow up
5 R\'s
RELEVANCE - Tailor advice to patient RISKS - Outline them REWARDS - Outline them ROADBLOCKS - Identify barriers to quitting REPETITION - Repeat at every visit
2 Screening Questions for Bipolar
Have you ever felt recently that you could get by on much less sleep than usual? Are you or have you been doing things that others may think of as inappropriate, such as spending too much money?

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