Community Based Management of Acute Malnutrition according UNICEF and WHO standards Implementation in Oromia Region, Ethiopia WIth Pablo Horstmann Foundation and Alegria Sin Fronteras
This document discusses infant mortality rates around the world. It defines infant mortality as deaths of children under age 1. The world infant mortality rate in 2008 was 49 per 1000 live births, while rates were lower in more developed countries (6 per 1000) and higher in less developed and least developed countries (54 and 85 per 1000, respectively). Infant mortality is an important indicator of overall health conditions and levels of development within a country. Many infant deaths are preventable through improved medical care and interventions.
This document provides information about childhood immunization and common childhood illnesses. It discusses the UK immunization schedule and reasons for immunizing children, such as providing resistance to diseases and potentially eradicating illnesses. It also addresses why some children may not be immunized. The document outlines several common childhood illnesses like measles, mumps, rubella, and meningitis. It describes signs and symptoms of these illnesses, as well as their treatments and exclusion periods. Practitioners are encouraged to understand illness signs in order to support ill children and prevent disease spread. Reporting requirements for notifyable diseases, injuries, and fatalities are also covered.
This document contains summaries of several pediatric OSCE stations, including:
- A station counseling a parent on their child's dyslexia diagnosis.
- Taking a history from the mother of a 2-year-old presenting with severe pallor.
- Examining the blood pressure of a 10-year-old child.
- Administering the MMR vaccine to a 17-month-old child.
- Taking a history of an 18-month-old boy presenting with fever and rash for 8 days.
- Performing a musculoskeletal exam on an 8-year-old boy.
- Counseling parents about the treatment and prognosis of their 29-week
The 4 categories of vaccines are:
1. Live attenuated vaccines: These are vaccines created from live weakened (attenuated) strains of viruses or bacteria. They mimic natural infection to stimulate immune response. Examples include MMR, BCG, chickenpox, rotavirus vaccines.
2. Inactivated vaccines: These are created from viruses or bacteria that have been killed (inactivated) using heat, chemicals, or radiation. Examples include influenza, hepatitis A vaccines.
3. Toxoid vaccines: These are created from bacterial toxins that have been inactivated with formaldehyde. Examples include tetanus and diphtheria vaccines.
4. Subunit, recombinant, polysaccharide, and conjugate vaccines
Paediatrics - General clinical examination tipspatrickcouret
- When evaluating children, always wash your hands before and after, and focus initially on observation. Talk to both the child and parents.
- For older children, introduce yourself first before parents and sit at their level. During exams, use the parent's lap if possible and distract the child with stories or a play specialist.
- Leave the most threatening parts of exams like ears and mouth for last. If the child remains upset, ask for help from superiors, colleagues, parents or a play specialist. Many hospitals now have play specialists to aid doctors and nurses.
Here are the key points from the question:
- 14-year-old girl presented with 3 weeks of high grade fever, progressive breathlessness, swelling of feet and abdomen
- No associated symptoms like chills, rigors, dysuria, coryza, jaundice or alteration in bowel habits
- Had a generalized seizure today
- Clinically pale, oral ulcers, arthritis of both knees, left sided pleural effusion, distant heart sounds, liver palpable 4cm below costal margin, free fluid
My diagnosis would be Rheumatic fever based on the following:
- History of preceding sore throat
- Fever for 3 weeks
- Arthritis of both knees
- Carditis
Community Based Management of Acute Malnutrition according UNICEF and WHO standards Implementation in Oromia Region, Ethiopia WIth Pablo Horstmann Foundation and Alegria Sin Fronteras
This document discusses infant mortality rates around the world. It defines infant mortality as deaths of children under age 1. The world infant mortality rate in 2008 was 49 per 1000 live births, while rates were lower in more developed countries (6 per 1000) and higher in less developed and least developed countries (54 and 85 per 1000, respectively). Infant mortality is an important indicator of overall health conditions and levels of development within a country. Many infant deaths are preventable through improved medical care and interventions.
This document provides information about childhood immunization and common childhood illnesses. It discusses the UK immunization schedule and reasons for immunizing children, such as providing resistance to diseases and potentially eradicating illnesses. It also addresses why some children may not be immunized. The document outlines several common childhood illnesses like measles, mumps, rubella, and meningitis. It describes signs and symptoms of these illnesses, as well as their treatments and exclusion periods. Practitioners are encouraged to understand illness signs in order to support ill children and prevent disease spread. Reporting requirements for notifyable diseases, injuries, and fatalities are also covered.
This document contains summaries of several pediatric OSCE stations, including:
- A station counseling a parent on their child's dyslexia diagnosis.
- Taking a history from the mother of a 2-year-old presenting with severe pallor.
- Examining the blood pressure of a 10-year-old child.
- Administering the MMR vaccine to a 17-month-old child.
- Taking a history of an 18-month-old boy presenting with fever and rash for 8 days.
- Performing a musculoskeletal exam on an 8-year-old boy.
- Counseling parents about the treatment and prognosis of their 29-week
The 4 categories of vaccines are:
1. Live attenuated vaccines: These are vaccines created from live weakened (attenuated) strains of viruses or bacteria. They mimic natural infection to stimulate immune response. Examples include MMR, BCG, chickenpox, rotavirus vaccines.
2. Inactivated vaccines: These are created from viruses or bacteria that have been killed (inactivated) using heat, chemicals, or radiation. Examples include influenza, hepatitis A vaccines.
3. Toxoid vaccines: These are created from bacterial toxins that have been inactivated with formaldehyde. Examples include tetanus and diphtheria vaccines.
4. Subunit, recombinant, polysaccharide, and conjugate vaccines
Paediatrics - General clinical examination tipspatrickcouret
- When evaluating children, always wash your hands before and after, and focus initially on observation. Talk to both the child and parents.
- For older children, introduce yourself first before parents and sit at their level. During exams, use the parent's lap if possible and distract the child with stories or a play specialist.
- Leave the most threatening parts of exams like ears and mouth for last. If the child remains upset, ask for help from superiors, colleagues, parents or a play specialist. Many hospitals now have play specialists to aid doctors and nurses.
Here are the key points from the question:
- 14-year-old girl presented with 3 weeks of high grade fever, progressive breathlessness, swelling of feet and abdomen
- No associated symptoms like chills, rigors, dysuria, coryza, jaundice or alteration in bowel habits
- Had a generalized seizure today
- Clinically pale, oral ulcers, arthritis of both knees, left sided pleural effusion, distant heart sounds, liver palpable 4cm below costal margin, free fluid
My diagnosis would be Rheumatic fever based on the following:
- History of preceding sore throat
- Fever for 3 weeks
- Arthritis of both knees
- Carditis
1. About 29,000 children under five die every day mainly from preventable causes like pneumonia, diarrhea, measles, malaria, and malnutrition.
2. One of the Millennium Development Goals was to reduce child mortality rates by two-thirds between 1990 and 2015. Many countries including India have seen a decline in child mortality rates in recent decades.
3. Malnutrition is a major cause of childhood deaths, contributing to over half of all deaths. It weakens the immune system, leading to increased susceptibility to infections. Proper nutrition is critical, especially for infants and young children.
The document provides information on adolescent health programs in India. It begins with introducing adolescence and defining the age groups. It then discusses why adolescent health is important in order to reduce disease burden and mortality. Some key health issues faced by adolescents are malnutrition, mental health problems, early and unprotected sex.
The document outlines two main adolescent health programs in India - ARSH (Adolescent Reproductive and Sexual Health) and RMNCH+A (Reproductive, Maternal, Newborn, Child and Adolescent Health). ARSH aims to address issues like teenage pregnancies, STIs, HIV, and maternal deaths. RMNCH+A is a comprehensive strategy that takes a continuum of care approach to
This document discusses the control of diarrhoeal diseases. It begins by defining diarrhoea and describing the types of diarrhoeal diseases such as acute watery diarrhoea, acute bloody diarrhoea, and persistent diarrhoea. It then discusses the magnitude of diarrhoeal diseases globally and in India, describing that diarrhoea is the second leading cause of death in children under 5 years old worldwide. The document outlines the three essential elements in managing diarrhoea - rehydration therapy, zinc supplementation, and continued feeding. It provides details on assessing and treating dehydration, including treatment plans for severe and some dehydration.
This document summarizes the differences between breastfeeding and artificial feeding, as well as the types and benefits of different milks. It discusses how breastfeeding is recommended for infants within one hour of birth and exclusively for six months. The benefits of breastfeeding for infants include reduced risks of various infections, SIDS, diabetes, mental health issues, and allergies. Benefits for mothers include stronger bonding, hormone release assisting weight loss and recovery, and long-term reduced risks of various cancers and diseases. It also outlines the composition differences between human milk, cow's milk, and buffalo's milk, as well as the unique composition and benefits of colostrum for newborn immunity and development.
ADHD - Attention Deficit Hyperactivity Disorder
ADHD is the most common neurobehavioral
disorder of childhood. It is characterized by developmentally inappropriate and impairing levels of gross motor over activity, inattention and
impulsivity. It can continue through adolescence and
adulthood.
This document describes key concepts in epidemiology including the natural history of disease, epidemiological triad, and measures of central tendency. It discusses the natural history of disease in terms of pre-pathogenesis and pathogenesis periods. The epidemiological triad involves the interaction between an agent, host, and environment. Examples are provided for tuberculosis. Measures of central tendency described include the mean, median, and mode, with explanations of how each is calculated.
This document summarizes a workshop on polio updates and end game strategies organized by the Community Medicine Department of GMERS Medical College in collaboration with the National Polio Surveillance Project of WHO, India. It provides global and national polio statistics, discusses epidemiology of polio including surveillance of acute flaccid paralysis cases, and strategies for polio eradication such as supplemental immunization activities and certification of polio-free status. Key updates on polio cases in India since 2011 and detection of wild poliovirus in environmental samples are also presented.
Theories of Motivation for Health Promotiondr natasha
The document discusses various theories of motivation including Maslow's hierarchy of needs theory and Freud's psychosexual development theory. Maslow's theory proposes that people are motivated to fulfill basic needs for survival, security, social belonging, and self-esteem before seeking self-actualization. Freud's theory suggests that human behavior is motivated by unconscious desires to fulfill sexual and aggressive instincts. The document also examines Erikson's psychosocial development stages and compares intrinsic versus extrinsic motivation. Overall, the theories discussed propose that human motivation involves fulfilling innate and learned needs and desires.
Female Community Health Volunteer Programme in Nepal Public Health
The Female Community Health Volunteer (FCHV) Programme was initiated in Nepal in 1988 to promote public health at the community level. There are currently over 51,000 FCHVs working across Nepal. FCHVs receive basic training and are supplied medicine kits to provide services such as distributing family planning devices, treating pneumonia, and educating communities on health issues. They play a major role in reducing maternal and child mortality. In the fiscal year 2075/76, FCHVs supported home deliveries and provided nutrition services to mothers and children. While FCHVs have achieved improvements in health indicators, issues like low utilization of funds and decreasing work performance need to be addressed.
1) The document presents guidelines from the Indian Academy of Pediatrics (IAP) on the integrated management of severe acute malnutrition (SAM) in children under five years of age in India.
2) It defines SAM based on weight-for-height Z-scores and mid-upper arm circumference (MUAC) cut-offs using WHO growth charts.
3) The guidelines recommend an integrated approach, treating SAM as part of broader nutrition and child health programs. They provide guidance on outpatient and inpatient treatment, including use of therapeutic foods.
Growth charts are used to monitor children's physical growth and development over time. They plot weight, height/length, and other anthropometric measurements against age and allow comparisons to reference standards. Monitoring growth helps determine if a child's development is normal or if problems exist that need addressing. Various indicators and classification systems exist to define and assess malnutrition based on anthropometric measurements, including weight-for-age, height-for-age, and weight-for-height. Growth charts first designed by David Morley have been modified over time by organizations like WHO and are an important tool to track children's nutrition and health.
Cache l2 working in partnership 10 02 16Nina Owusu
childcare-working in partnership unit 5
This is about professionals working with each other as well as with families. This professions can be social workers or polices.
Encopresis refers to the passage of feces into inappropriate places after age 4. There are two subtypes: retentive encopresis with constipation and overflow incontinence, and nonretentive encopresis without constipation. The first step in managing encopresis is assessing fecal retention through rectal examination or abdominal x-rays. The combination of constipation management and simple behavior therapy is successful in the majority of cases, though it may take months for soiling to fully stop.
This document discusses several pediatric endocrinology cases involving genetic syndromes and disorders of calcium and bone metabolism. It describes a 6-year-old boy with obesity, intellectual disability, and cataracts who is evaluated for pseudohypoparathyroidism. It also discusses a 13-year-old girl with obesity and abnormal retinal findings consistent with Bardet-Biedl syndrome. Finally, it presents the case of an 18-month-old infant with bowed legs, who upon evaluation is found to have biochemical and radiographic findings consistent with vitamin D-resistant rickets type 2.
1) COVID-19 infection in children is generally mild and self-limiting compared to adults, with most children recovering within 1-2 weeks. Symptoms are similar to adults but milder.
2) While infection rates are lower in children, infants may be at higher risk for severe illness. Asymptomatic transmission is still possible.
3) Diagnosis is made through RT-PCR testing of respiratory samples. Chest CT may show ground-glass opacities or consolidations.
4) Treatment is supportive and includes oxygen therapy. Antivirals like lopinavir/ritonavir are being studied but no proven therapy currently exists.
This document discusses the concept of deprofessionalization of medicine and community health workers. It provides definitions and outlines strategies used in various countries to address shortages of health professionals through task shifting and training community health workers. In India, strategies discussed include establishing new public health cadres, compulsory rural postings for doctors, and incentivizing rural service. Community health worker models discussed include ASHAs in India, barefoot doctors in China, and programs in Bangladesh, Brazil, and Iran that have expanded access and improved health outcomes through task shifting.
Rabies is a fatal viral infection transmitted through the saliva of infected animals. In children, rabies is commonly transmitted through dog bites, with approximately 35% of India's 20,000 annual rabies deaths occurring in children. Post-exposure prophylaxis, including thorough wound cleansing, vaccine administration, and potentially rabies immunoglobulin, is highly effective if administered promptly after exposure. The standard post-exposure prophylaxis schedule in children consists of 5 doses of rabies vaccine over 28 days.
This document discusses communication skills and concepts relevant to healthcare professionals. It covers definitions of communication, principles of communication like listening, probing and observing. It discusses consultation and counseling processes, models of breaking bad news, and dealing with angry patients. It provides guidance on initiating sessions, gathering information, building relationships, explaining and planning, and closing sessions. Quizzes are also included to test understanding of communication skills.
The document provides guidance on breaking critical or bad news to patients. It discusses that breaking bad news is a complex task that requires skills like assessing the patient's understanding, gauging how much information they want, sharing the news in a stepwise manner, responding to emotions, and planning follow up. The document outlines a six step protocol for breaking bad news, including preparing, assessing the patient's perspective, determining how much they want to know, sharing the information, responding to reactions, and planning next steps.
52.2 SPIKE MODEL FOR ENHANCED COMMUNICATION TO BREAK BAD.pptxQualityAIIMSUdr
The document outlines the SPIKES model for effectively communicating bad news to patients. It consists of 6 steps: 1) Setting up the interview, 2) Assessing the patient's perception, 3) Obtaining the patient's invitation to know more, 4) Giving knowledge and information to the patient in small chunks, 5) Addressing the patient's emotions with empathy, and 6) Creating a strategy and summary. Each step provides guidelines for doctors to have difficult conversations while maintaining patient autonomy, managing emotions, clarifying understanding, and planning follow up care. The document also lists unacceptable communication behaviors like abusive language or disrespect that should be avoided.
1. About 29,000 children under five die every day mainly from preventable causes like pneumonia, diarrhea, measles, malaria, and malnutrition.
2. One of the Millennium Development Goals was to reduce child mortality rates by two-thirds between 1990 and 2015. Many countries including India have seen a decline in child mortality rates in recent decades.
3. Malnutrition is a major cause of childhood deaths, contributing to over half of all deaths. It weakens the immune system, leading to increased susceptibility to infections. Proper nutrition is critical, especially for infants and young children.
The document provides information on adolescent health programs in India. It begins with introducing adolescence and defining the age groups. It then discusses why adolescent health is important in order to reduce disease burden and mortality. Some key health issues faced by adolescents are malnutrition, mental health problems, early and unprotected sex.
The document outlines two main adolescent health programs in India - ARSH (Adolescent Reproductive and Sexual Health) and RMNCH+A (Reproductive, Maternal, Newborn, Child and Adolescent Health). ARSH aims to address issues like teenage pregnancies, STIs, HIV, and maternal deaths. RMNCH+A is a comprehensive strategy that takes a continuum of care approach to
This document discusses the control of diarrhoeal diseases. It begins by defining diarrhoea and describing the types of diarrhoeal diseases such as acute watery diarrhoea, acute bloody diarrhoea, and persistent diarrhoea. It then discusses the magnitude of diarrhoeal diseases globally and in India, describing that diarrhoea is the second leading cause of death in children under 5 years old worldwide. The document outlines the three essential elements in managing diarrhoea - rehydration therapy, zinc supplementation, and continued feeding. It provides details on assessing and treating dehydration, including treatment plans for severe and some dehydration.
This document summarizes the differences between breastfeeding and artificial feeding, as well as the types and benefits of different milks. It discusses how breastfeeding is recommended for infants within one hour of birth and exclusively for six months. The benefits of breastfeeding for infants include reduced risks of various infections, SIDS, diabetes, mental health issues, and allergies. Benefits for mothers include stronger bonding, hormone release assisting weight loss and recovery, and long-term reduced risks of various cancers and diseases. It also outlines the composition differences between human milk, cow's milk, and buffalo's milk, as well as the unique composition and benefits of colostrum for newborn immunity and development.
ADHD - Attention Deficit Hyperactivity Disorder
ADHD is the most common neurobehavioral
disorder of childhood. It is characterized by developmentally inappropriate and impairing levels of gross motor over activity, inattention and
impulsivity. It can continue through adolescence and
adulthood.
This document describes key concepts in epidemiology including the natural history of disease, epidemiological triad, and measures of central tendency. It discusses the natural history of disease in terms of pre-pathogenesis and pathogenesis periods. The epidemiological triad involves the interaction between an agent, host, and environment. Examples are provided for tuberculosis. Measures of central tendency described include the mean, median, and mode, with explanations of how each is calculated.
This document summarizes a workshop on polio updates and end game strategies organized by the Community Medicine Department of GMERS Medical College in collaboration with the National Polio Surveillance Project of WHO, India. It provides global and national polio statistics, discusses epidemiology of polio including surveillance of acute flaccid paralysis cases, and strategies for polio eradication such as supplemental immunization activities and certification of polio-free status. Key updates on polio cases in India since 2011 and detection of wild poliovirus in environmental samples are also presented.
Theories of Motivation for Health Promotiondr natasha
The document discusses various theories of motivation including Maslow's hierarchy of needs theory and Freud's psychosexual development theory. Maslow's theory proposes that people are motivated to fulfill basic needs for survival, security, social belonging, and self-esteem before seeking self-actualization. Freud's theory suggests that human behavior is motivated by unconscious desires to fulfill sexual and aggressive instincts. The document also examines Erikson's psychosocial development stages and compares intrinsic versus extrinsic motivation. Overall, the theories discussed propose that human motivation involves fulfilling innate and learned needs and desires.
Female Community Health Volunteer Programme in Nepal Public Health
The Female Community Health Volunteer (FCHV) Programme was initiated in Nepal in 1988 to promote public health at the community level. There are currently over 51,000 FCHVs working across Nepal. FCHVs receive basic training and are supplied medicine kits to provide services such as distributing family planning devices, treating pneumonia, and educating communities on health issues. They play a major role in reducing maternal and child mortality. In the fiscal year 2075/76, FCHVs supported home deliveries and provided nutrition services to mothers and children. While FCHVs have achieved improvements in health indicators, issues like low utilization of funds and decreasing work performance need to be addressed.
1) The document presents guidelines from the Indian Academy of Pediatrics (IAP) on the integrated management of severe acute malnutrition (SAM) in children under five years of age in India.
2) It defines SAM based on weight-for-height Z-scores and mid-upper arm circumference (MUAC) cut-offs using WHO growth charts.
3) The guidelines recommend an integrated approach, treating SAM as part of broader nutrition and child health programs. They provide guidance on outpatient and inpatient treatment, including use of therapeutic foods.
Growth charts are used to monitor children's physical growth and development over time. They plot weight, height/length, and other anthropometric measurements against age and allow comparisons to reference standards. Monitoring growth helps determine if a child's development is normal or if problems exist that need addressing. Various indicators and classification systems exist to define and assess malnutrition based on anthropometric measurements, including weight-for-age, height-for-age, and weight-for-height. Growth charts first designed by David Morley have been modified over time by organizations like WHO and are an important tool to track children's nutrition and health.
Cache l2 working in partnership 10 02 16Nina Owusu
childcare-working in partnership unit 5
This is about professionals working with each other as well as with families. This professions can be social workers or polices.
Encopresis refers to the passage of feces into inappropriate places after age 4. There are two subtypes: retentive encopresis with constipation and overflow incontinence, and nonretentive encopresis without constipation. The first step in managing encopresis is assessing fecal retention through rectal examination or abdominal x-rays. The combination of constipation management and simple behavior therapy is successful in the majority of cases, though it may take months for soiling to fully stop.
This document discusses several pediatric endocrinology cases involving genetic syndromes and disorders of calcium and bone metabolism. It describes a 6-year-old boy with obesity, intellectual disability, and cataracts who is evaluated for pseudohypoparathyroidism. It also discusses a 13-year-old girl with obesity and abnormal retinal findings consistent with Bardet-Biedl syndrome. Finally, it presents the case of an 18-month-old infant with bowed legs, who upon evaluation is found to have biochemical and radiographic findings consistent with vitamin D-resistant rickets type 2.
1) COVID-19 infection in children is generally mild and self-limiting compared to adults, with most children recovering within 1-2 weeks. Symptoms are similar to adults but milder.
2) While infection rates are lower in children, infants may be at higher risk for severe illness. Asymptomatic transmission is still possible.
3) Diagnosis is made through RT-PCR testing of respiratory samples. Chest CT may show ground-glass opacities or consolidations.
4) Treatment is supportive and includes oxygen therapy. Antivirals like lopinavir/ritonavir are being studied but no proven therapy currently exists.
This document discusses the concept of deprofessionalization of medicine and community health workers. It provides definitions and outlines strategies used in various countries to address shortages of health professionals through task shifting and training community health workers. In India, strategies discussed include establishing new public health cadres, compulsory rural postings for doctors, and incentivizing rural service. Community health worker models discussed include ASHAs in India, barefoot doctors in China, and programs in Bangladesh, Brazil, and Iran that have expanded access and improved health outcomes through task shifting.
Rabies is a fatal viral infection transmitted through the saliva of infected animals. In children, rabies is commonly transmitted through dog bites, with approximately 35% of India's 20,000 annual rabies deaths occurring in children. Post-exposure prophylaxis, including thorough wound cleansing, vaccine administration, and potentially rabies immunoglobulin, is highly effective if administered promptly after exposure. The standard post-exposure prophylaxis schedule in children consists of 5 doses of rabies vaccine over 28 days.
This document discusses communication skills and concepts relevant to healthcare professionals. It covers definitions of communication, principles of communication like listening, probing and observing. It discusses consultation and counseling processes, models of breaking bad news, and dealing with angry patients. It provides guidance on initiating sessions, gathering information, building relationships, explaining and planning, and closing sessions. Quizzes are also included to test understanding of communication skills.
The document provides guidance on breaking critical or bad news to patients. It discusses that breaking bad news is a complex task that requires skills like assessing the patient's understanding, gauging how much information they want, sharing the news in a stepwise manner, responding to emotions, and planning follow up. The document outlines a six step protocol for breaking bad news, including preparing, assessing the patient's perspective, determining how much they want to know, sharing the information, responding to reactions, and planning next steps.
52.2 SPIKE MODEL FOR ENHANCED COMMUNICATION TO BREAK BAD.pptxQualityAIIMSUdr
The document outlines the SPIKES model for effectively communicating bad news to patients. It consists of 6 steps: 1) Setting up the interview, 2) Assessing the patient's perception, 3) Obtaining the patient's invitation to know more, 4) Giving knowledge and information to the patient in small chunks, 5) Addressing the patient's emotions with empathy, and 6) Creating a strategy and summary. Each step provides guidelines for doctors to have difficult conversations while maintaining patient autonomy, managing emotions, clarifying understanding, and planning follow up care. The document also lists unacceptable communication behaviors like abusive language or disrespect that should be avoided.
Communication: Empathy and How To Give Bad News -Journal Article and Discussionflasco_org
Providing a course that is relevant, practical and patient-centered that will positively impact the speed in which entry-level oncology specialists integrate into the oncology practice setting.
The document discusses delivering bad news to patients. It notes that delivering bad news is difficult for physicians due to fears around being blamed, evoking strong reactions, and lack of training. There are three main models for disclosure: non-disclosure where information is withheld, full disclosure where all details are shared, and individualized disclosure where details are tailored based on the patient's preferences. The SPIKES protocol is presented as a six step approach to effectively communicating bad news, including setting up the discussion, understanding the patient's perspective, determining how much they want to know, sharing key medical details, acknowledging emotions, and summarizing next steps.
This document discusses the importance of effectively breaking bad news to patients and provides two models - the SPIKES and KAYES models - for doing so. The SPIKES model involves setting up the interview, assessing the patient's perception, inviting their questions, providing knowledge about the diagnosis and prognosis, addressing emotions, and summarizing along with discussing future strategy. The KAYES model takes a 10 step approach that involves preparation, assessing the patient's existing knowledge, determining how much information they want, giving warning signs before fully explaining, allowing denial, explaining the diagnosis if requested, listening to concerns, encouraging discussion of feelings, summarizing and planning next steps, and offering continued availability. Both models emphasize the importance of addressing the patient
This document discusses strategies for effectively communicating bad news to patients. It begins by defining bad news and outlining objectives for discussing this topic. Some key strategies discussed for breaking bad news include the SPIKES protocol, which involves setting up the conversation, assessing the patient's perception, allowing them to invite information, providing knowledge of the medical facts, expressing empathy, and summarizing next steps. The document also identifies obstacles to communicating bad news and emphasizes practicing with compassion.
The document discusses effective communication when delivering bad news to patients. It provides guidance on how to approach patients and their families sensitively when breaking news of a terminal illness or poor prognosis. The document outlines several models for delivering bad news, including building rapport, assessing the patient's emotional state, communicating clearly, and dealing with reactions in an empathetic manner. It also addresses how to handle situations where family members request not informing the patient about their diagnosis.
BREAKING BAD NEWS ^0 CONFIDENTIAITY.pptxShahafazAli1
The document outlines the SPIKES protocol for delivering bad news to patients. It consists of 6 steps: 1) Setting up the interview, 2) Assessing the patient's perception, 3) Obtaining the patient's invitation, 4) Giving knowledge and information to the patient, 5) Addressing the patient's emotions with empathy, and 6) Creating a strategy and summary. The goal is to clearly and sensitively communicate the news in a way that helps the patient understand and feel supported.
This document discusses several approaches to breaking bad news to patients in a compassionate manner. It outlines the ABCDE and SPIKES protocols which involve preparing in advance, building a therapeutic environment, clearly communicating the news, dealing with reactions, encouraging emotions, setting up privacy, assessing understanding, inviting discussion, providing knowledge, addressing emotions, and creating a strategy and summary. The document emphasizes breaking news directly but gently, using plain language, allowing silence, validating emotions, and providing follow up support to empower patients during difficult conversations.
This document discusses best practices for delivering bad news to patients. It notes that delivering bad news is stressful for physicians due to feelings of anxiety, responsibility, and fear of upsetting patients. It recommends gathering information from patients about their expectations beforehand. When delivering the news, physicians should provide clear, plain language information and check for understanding. They should acknowledge and support patients' emotional reactions with empathic responses. After delivering the news, physicians should assess patients' readiness to discuss treatment plans and answer any questions before summarizing and following up. The goal is to reduce stress for both patients and physicians while ensuring patients receive information and support.
This document discusses best practices for communicating bad news to patients. It emphasizes that patients have a right to know their diagnosis but the most important consideration is how the news is delivered. The document recommends using a 6-step S-P-I-K-E-S protocol: setting the scene, understanding the patient's perspective, inviting the patient to share how much they want to know, providing knowledge of the disease, addressing the patient's emotions, and summarizing next steps. The goal is to convey the news with honesty, empathy and appropriate hope by carefully preparing, using clear language, acknowledging emotions and offering ongoing support.
This document discusses how to disclose a diagnosis to patients and provides guidelines for breaking bad news. It notes that breaking bad news is a basic medical skill that is often stressful for doctors. The document defines bad news as information that produces negative consequences for patients and families. It then discusses conditions that may require delivering bad news, such as terminal illnesses. The document outlines strategies for communicating bad news, including planning, delivering the news gradually, allowing time for questions, focusing on positive aspects, and never providing false information. It emphasizes showing empathy and being a compassionate listener.
This document outlines best practices for breaking bad news to patients based on several models, including SPIKES, ABCDE, and BREAK. It discusses preparing for the conversation, building rapport, exploring the patient's understanding, announcing the diagnosis, addressing emotions, and documenting the discussion. The goal is to disclose information compassionately while supporting the patient and addressing their needs.
Giving bad news to patients is an important but complex and stressful communication task. The SPIKES protocol provides a 6-step approach to effectively deliver bad news. The steps include setting up the conversation, assessing the patient's perspective, determining how much information they want, providing knowledge and information, addressing emotional reactions, and summarizing next steps. Following this structured approach can help ensure bad news is delivered sensitively while still being honest and involving the patient in decision-making.
Health assessment involves systematically collecting both subjective and objective data about a patient's general physical and mental condition using the senses. It is a holistic process that considers the patient, family, healthcare providers, and environment. Nurses collect data through comprehensive assessments, ongoing assessments, focused assessments, and emergency assessments. Effective communication is important during the assessment process and involves both verbal and nonverbal skills like active listening, clarifying, and reflecting. Building trust and rapport with patients through genuineness, respect, and empathy also supports quality assessments.
This document discusses effective communication of bad news in healthcare settings. It provides guidelines and frameworks for delivering difficult information to patients in a compassionate manner. The SPIKES protocol recommends six steps: setting up the interaction, assessing the patient's perception, obtaining permission to share, providing knowledge and information, addressing emotions empathetically, and developing a strategy and summarizing. Other tips include using plain language, conveying news gradually, acknowledging emotions, exploring treatment options, and encouraging questions. The overall goal is to inform patients while also supporting them emotionally.
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
Adhd Medication Shortage Uk - trinexpharmacy.comreignlana06
The UK is currently facing a Adhd Medication Shortage Uk, which has left many patients and their families grappling with uncertainty and frustration. ADHD, or Attention Deficit Hyperactivity Disorder, is a chronic condition that requires consistent medication to manage effectively. This shortage has highlighted the critical role these medications play in the daily lives of those affected by ADHD. Contact : +1 (747) 209 – 3649 E-mail : sales@trinexpharmacy.com
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
2. Objectives:
At the end of the session, the participant is able to:
1.Understand the elements of a good family conference
2.Identify scenarios wherein this must be initiated
3.Apply these to selected case scenario
5. PFC MATRIX
P
• Patient centered
• understanding of the interplay of biomedical psychosocial factors disease in order to implement
management that is tailor-fitted to the needs and values of the patient
F
• Family Focused
• utilizes family assessment to generate assumptions on how the family dynamics affect or
facilitate the prescribed management of the patient’s disease.
C
• Community Oriented
• enables the family physician to use social determinants of health and health systems as a lens to
understand how larger systems support or hinder the provision of care.
6. P
• Patient centered
F
• Family Focused
C
• Community Oriented
Respect and Dignity
Information sharing,
participation and
collaboration
8. FAMILY CONFERENCE
the patient’s condition, prognosis, and care preferences;
for listening to the family’s concerns;
for decision-making about appropriate goals of treatment.
9. ELEMENTS OF
A GOOD
FAMILY
CONFERENCE
V: Value family statements
A: Acknowledge Family Emotions
L: Listen to the Patient and Family
U: Understand the patient as a person
E: Elicit family questions
11. The S-P-I-K-E-S Strategy
• Setting, Listening Skills
• Patient’s Perception
• Invite patient to share Information
• Knowledge transmission
• Explore Emotions and Empathize
• Summarize and Strategize
12. 1.SETTING UP the meeting and getting the physical context
right
Arrange for some privacy
Involve ALL significant family members/surrogate decision
decision maker
Pre meeting of the medical team
Manage time constraints and interruptions
Look attentive and calm
Use your active listening SKILLS
The S-P-I-K-E-S Strategy
13. 1.SETTING UP the interview
and getting the physical
context right
Arrange for some
privacy
Involve significant
others
Sit down
Look attentive and calm
calm
Manage time
constraints and
interruptions
Use your active listening
listening SKILLS
The S-P-I-K-E-S Strategy
ACTIVE LISTENING:
Lean forward
Open stance
Verbal / Voice of compassion
Eye contact
Relaxed
Seating arrangement
14. 1.SETTING UP the interview
and getting the physical
context right
Arrange for some
privacy
Involve significant
others
Sit down
Look attentive and calm
calm
Manage time
constraints and
interruptions
Use your active listening
listening SKILLS
The S-P-I-K-E-S Strategy
2. Assessing the patient’s/families’
PERCEPTION
Determine how much the they know
“Before you tell, Ask”
Use open-ended questions
Ascertain their current understanding
to identify emotionally critical
misperception (ECMs)
15. The S-P-I-K-E-S Strategy
2. Assessing the patient’s/families’
PERCEPTION
Determine how
much the they
know
“Before you tell,
Ask”
Use open-
ended
questions
Ascertain their current
understanding
to identify
emotionally
critical
misperception
3. Obtain the patient’s INVITATION
Find out how much INFORMATION the patient wants
to know
“ARE YOU THE KIND OF PERSON WHO PREFERS TO
KNOW ALL THE DETAILS ABOUT WHAT IS GOING ON?”
“HOW MUCH INFORMATION WOULD YOU LIKE ME TO
GIVE YOU ABOUT WHAT IS GOING ON?”
“WOULD YOU LIKE ME TO GIVE YOU DETAILS OF WHAT
IS GOING ON OR WOULD YOU PREFER THAT I JUST TELL YOU
ABOUT TREATMENTS I AM PROPOSING?”
16. The S-P-I-K-E-S Strategy
3. Obtain the patient’s INVITATION
Find out how much
INFORMATION the patient wants
to know
“ARE YOU THE KIND OF PERSON
WHO PREFERS TO KNOW ALL THE
DETAILS ABOUT WHAT IS GOING ON?”
“HOW MUCH INFORMATION
WOULD YOU LIKE ME TO GIVE YOU
ABOUT WHAT IS GOING ON?”
“WOULD YOU LIKE ME TO GIVE
YOU DETAILS OF WHAT IS GOING ON OR
WOULD YOU PREFER THAT I JUST TELL
YOU ABOUT TREATMENTS I AM
PROPOSING?”
4. Giving the KNOWLEDGE and
information to the patient
Use ordinary language in giving
medical facts
Give information in small pieces and
always assess if understood well
Avoid excessive bluntness
Warn the patient that bad news is
coming (wish worry wonder)
17. The S-P-I-K-E-S Strategy
4. Giving the
KNOWLEDGE and
information to the patient
Warn the patient
that bad news is
coming
Use ordinary
language in giving
medical facts
Avoid excessive
bluntness
Give information
in small pieces and
always assess if
understood well
5. EXPLORING the patient’s EMOTIONS and
giving EMPATHY
Acknowledge patient’s emotions as they arise and to
address them
3 Step Empathic Response:
1. Listen for and identify the emotion
2. Identify the source or cause of emotion
3. Show that you have made the connection
between the above two steps
18. The S-P-I-K-E-S Strategy
4. Giving the
KNOWLEDGE and
information to the patient
Warn the patient
that bad news is
coming
Use ordinary
language in giving
medical facts
Avoid excessive
bluntness
Give information
in small pieces and
always assess if
understood well
5. EXPLORING the patient’s EMOTIONS and giving EMPATHY
Acknowledge patient’s emotions as they arise and to address them
3 Step Empathic Response:
1. Listen for and identify the emotion
2. Identify the source or cause of emotion
3. Show that you have made the connection between the above two steps
5. EXPLORING the patient’s EMOTIONS and giving EMPATHY
Validate or normalize his feelings
Let them know that showing emotion is perfectly
normal
Combine empathy and validation should show
the patient that you understand the human side of
the medical issue
19. The S-P-I-K-E-S Strategy
5. EXPLORING the patient’s
EMOTIONS and giving
EMPATHY
Acknowledge patient’s
emotions as they arise
and to address them
3 Step Empathic
Response:
1. Listen for and
identify the emotion
2. Identify the
source or cause of emotion
3. Show that you
have made the connection
between the above two steps
6. SUMMARIZE and STRATEGIZE
Ask the patient or family if ready to discuss
the prognosis and treatment options
Shared responsibility for decision making
Planning and following through further
meetings
Try to leave them with some hope
20. The S-P-I-K-E-S Strategy
FAMILY CONFERENCE
BREAKING THE BAD NEWS
• Explain the diagnosis in
clear and easily understood
• small information at a time
• checking comprehension
throughout.
• Acknowledge emotions as
they arise.
• NEWLY DIAGNOSED
PATIENTS
SERIOUS ILLNESS
CONVERSATIONS
• Share prognosis and tailor
information to patient
preference
• Explore key topics:
• Goals, Fears, worries,
Sources of strength,
Critical abilities, Tradeoffs
• Involvement of child &
siblings
• DISEASE
PROGRESSION/EOL
SETTING UP GOALS OF
CARE
• Set realistic goals
• Discuss Advance Care
Planning
• Place of Care
(Hospital/Home)
• Anticipatory Symptoms
• Symptom Management
Preferences
• Source of Support
• Encourage Memory
Making
• Siblings Support
• Spiritual Support
• Psychosocial Support
21. KEY TAKEAWAYS
FAMILY CONFERENCE
Hold pre-meeting to collect patient info from clinical team.
Make sure that every person in the room has an introduction.
Assess family understanding of medical issues and allow all to speak.
Ask family’s permission to give a medical update.
Acknowledge individual concerns, then pick a focus for discussion.
Notice and acknowledge emotions.
Let the family talk to each other before you interject.
Recognize that deep values influence planning discussions.
The family conference provides a forum for discussion about
In FC, the following elements summarizes the components that has been associated with :
increased quality of care
decreased fasmily psychological symptoms
improved family ratings of communication
therefore, we do fam con because
L: we want to know their goals, wishes and fears
U: so we would want to hear and respect their preferences
to be able to conduct organized and structured fam con, we follow the SPIKES strategy
The family conference provides a forum for discussion about
we are askng our institutions to always provide or alot a room for family conferences or family meetings
pre meeting: it is important for the medical team to huddle beforehand for a premeeting to gather and verify informations to be discussed during the family conference
manage: this can be discussed at the onset of the conference
to review some important Active listening skills
please be guided by the nmemonic LOVERS
it is best to conduct the meeting in seating arrangement to show non dominance resulting to better conversations
L: to show that you are listening and attentive
O: would tell family that you are ready to listen to their concerns
this ECMs when not discussed or corrected could hinder their understanding for your proposed medical plans of care
Use ordinary language: Use drawings
use humor with care
Avoid excessive bluntness: Be empathic and be not afraid to say sorry or I do not know
Do not argue
Avoid the words, “There is nothing I can do for you”
I wish an sana naging maganda ung reaction ng anak ninyo sa chemotherapy
pero I worry that base sa CT scan result ay alo pang lumaki ung kanyang bukol
napansin ko po na parang umiiling kayo an naiiyak kapag nababangit ung salitang chemotherapy, maari ko po bang malaman kung ano ang iniisip ninyo