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Question 1 of 11
1. Question
Q. 7
The ‘heartsink’ patients are “patients in every practice who give the clinical and practice staff a feeling of ‘heartsink’ every time they consult…” .
It’s important to remember that there are often clinician factors that may contribute to the ‘heartsink’ patient as well as patient factors.
Which of the following are clinician factors?
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Question 2 of 11
2. Question
Q .1
- Which of the following are key skills for active listening?
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Question 3 of 11
3. Question
Q. 2
True or false:
The Pain Concerns Form can be used to gather the patients wider concerns about living with pain, so that you can go through each of their answers with them and tell them whether they have been doing the right or wrong things to help their pain.
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Question 4 of 11
4. Question
Q. 3
It is recommended that the 4A’s are used to explore the benefits and downsides of opioids.
Select the 4 As below.
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Question 5 of 11
5. Question
Q. 5
Match the 5 readiness to change stages with the steps you can take to help the patient move towards the next step.
Sort elements
- Let the patient know that you can support them through the journey
- Some suggestions about a plan may be welcome, for example, a discussion about the gradual tapering process
- More willingness to take suggestions and to make SMART goals
- May be open to support and guidance
- Affirmation of the positive steps already taken is important, encourage resilience, set-back planning
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Pre-contemplation
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Contemplation
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Preparation
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Action
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Maintenance
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Question 6 of 11
6. Question
Q. 6
True or false:
When using the UNITED negotiating process as part of your shared decision making, ‘U’ stands for understanding and this step should be focused solely on gaining the patient’s understanding.
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Question 7 of 11
7. Question
Q. 8
Shared decision making is defined as ‘an approach where clinicians and patients share the best available evidence when faced with the task of making decisions, and where patients are supported to consider options, to achieve informed preferences’.
The patient and clinician both have roles in shared decision making. Decide whether the below are the patients or clinicians areas of expertise. Type a P for patient or C for clinician next to each area of expertise.
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Diagnosis
Experience of illness
Social circumstances
Disease aetiology
Prognosis
Attitude to risk
Treatment options
Values
Outcome probabilities
Preferences
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Question 8 of 11
8. Question
Q. 9
It can be difficult to live with pain and it’s not uncommon for patient consulting with pain to be low in mood or have some anxiety. Although a lot of patients will have insight and a robust support system, there may be some patients that express suicidal thoughts.
True or false:
Immediate risk is when a patient has a specific suicide plan and intent to end life is apparent. When this is the case you should tell the patient of your concerns, encourage them to stay at the GP practice, stop work and speak to the GP as soon as possible.
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Question 9 of 11
9. Question
Q. 10
In the training manual we gave you some simple explanations relevant to commonly held beliefs and concerns about opioids, which you can use to aid a patient’s understanding.
One of these explanations is to help you explain why opioids don’t work for persistent pain:
“Opioids are strong painkillers and they work pretty well for short term pain and cancer pain at the end of life. Long-term (persistent, chronic) pain is different – it’s very complex and influenced by lots of different factors. Any medicine can only act on one part of this very complex system and if that isn’t what’s causing the pain, the medicine won’t help. Some pains don’t seem to respond to any medicines.”
Below are some beliefs from patients, for which of these could you go on to use the above explanation?
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Question 10 of 11
10. Question
Q. 4
Which of the following are some of the possible reasons patients might not want to make changes to their opioid medications?
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Question 11 of 11
11. Question
Q. 7
The ‘heartsink’ patients are “patients in every practice who give the clinical and practice staff a feeling of ‘heartsink’ every time they consult…” . It’s important to remember that there are often clinician factors that may contribute to the ‘heartsink’ patient as well as patient factors. Which of the following are clinician factors?
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