Australian Doctor 14th February 2025

HOW TO TREAT 27

ausdoc . com . au 14 FEBRUARY 2025

HOW TO TREAT 27

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She says they did not have access to healthcare , as they were very poor as children . This provides an opportunity to explain that Leo is very fortunate to have the right medication to use , and this is why he will recover well from this illness .

The practice nurse shows Li Ming how to administer the salbutamol via a spacer , and when the GP reviews them after seeing their next patient , Li Ming looks much calmer . Nevertheless , the GP asks her to bring Leo back tomorrow to make sure she is confident in using the medication , as the GP is not sure she has absorbed the instructions well and may still have concerns .

At the next consultation , it takes a while to get Li Ming to tell the GP about using the inhaler . She admits she has not used it yet , because she has seen a lot of Australian children with inhalers , and she is worried Leo will become dependent on it . The GP explains a little more about the medication and how it works and it seems she is comfortable with the approach . The GP arranges to see Leo in a week to ensure he has recovered and also provides Li Ming with written information about viral induced asthma to take home .

Case study two

Harry is a 68-year-old stonemason who has been recently diagnosed with silicosis of the lung . His respiratory physician has written to his GP to let the GP know that he has arranged for Harry to have a visit from the palliative care team , to discuss his oxygen requirements , but he is worried that Harry and his wife Mary “ seemed to be having difficulty taking all this in ”.

1 . Which THREE statements regarding coping are correct ? a To survive in this world , most of us carry a sense of security and safety by placing our trust in important institutions and people . b There are social consequences for the person who is ill . c People who are aware of their own deep vulnerability feel profoundly unsafe and isolated . d GPs will help people cope if they remind them of the challenges of their condition and its management , so that their carers are ready to take over when needed .

2 . Which TWO statements regarding the natural trajectory of coping are correct ? a Patients generally remember most of the information regarding bad news when it has been explained in a first consultation . b It is common in general practice for patients to take bad news well . c It is best to leave people for a few weeks after breaking bad news to give them space to consider their options .

Figure 11 . It can be particularly challenging coping with a child who is in hospital for a prolonged period . Parents of sick children who are also doctors can struggle to manage the interpersonal complexity of this role .

The GP makes a home visit . Harry is sitting in his armchair watching the footie , while Mary is bustling around the kitchen . When chatting with Harry , he seems quite depressed . His oxygen saturation levels are stable , and he has no need for supplemental oxygen at this time . However , he has noticed he gets a bit “ puffed ” when he tries to

How to Treat Quiz .

do the gardening . Mary is hovering , and brings him a cup of tea , talking all the while about how unwell he is . She also comments when asked that she is getting a little tired , “ because it ’ s all a bit worrying ”. When the GP asks Mary what Harry does all day , she tells the GP he watches television .

When the GP talks to Harry

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d After three months , many people and their families will have adjusted to their new situation .

3 . Which THREE are mechanisms that assist with coping ? a Self-focused coping . b Appraisal . c Problem-focused coping . d Emotion-focused coping .

4 . Which TWO statements regarding health literacy are correct ? a People we consider highly literate may have no idea about healthcare and be completely confused about the language . b Around 30 % of year nine students cannot interpret the meaning of a graph and apply that to their own context . c Literacy in English in Australia is lower than many expect . d It is best to supply patients with all the information they might need to manage their illness in the longer term .

5 . Which THREE are strategies for appraisal ? a Ensuring patients have an accurate idea of the seriousness of the condition . b Asking patients what they know about the illness . c Giving patients a detailed list of treatment options . d Reminding patients about their personal history of coping in the past .

6 . Which ONE is not part of structured problem-solving ? a Make a list of all the problems you can identify . b Evaluate the options . c Avoidance of the problem . d Review your progress .

7 . Which THREE are healthy emotion-focused coping strategies ? a Cognitive reframing . b Journalling .

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• RACGP points are uploaded every six weeks and ACRRM points quarterly . alone , he works out that Harry is bored , lonely and feels completely useless . He used to like going “ down to the pub ” with his mates , and “ having a few beers ” and sometimes “ playing a bit of darts ”. He also liked to “ potter around in the shed ” but Mary insists he cannot do that anymore , because of the dust . He is fed up with everyone “ tiptoeing ”

COPING

c Exercise . d Busyness

8 . Which THREE are unhealthy emotion-focused coping strategies ? a Controlled distraction . b Toxic positivity . c Alcohol . d Denial and behavioural disengagement .

9 . Which TWO statements regarding meaning-focused coping skills are correct ? a Meaning-focused coping is about religious and spiritual beliefs . b Encouraging values-based activities , like community service , help people cope . c Patients in nursing homes benefit most from distraction . d The distraction aspect may not be avoidant , it is a reminder that there is more to life than trauma .

10 . Which THREE are meaningfocused coping skills ? a Healthy distraction . b Patient education . c Connection . d A sense of purpose and meaning . around him and seems quite depressed . He tells the GP “ this isn ’ t much of a life ”.

The GP tells him he is not that sick and it is about time he got to enjoy his retirement . There is no reason , the GP says , that he should not do what he wants to do , providing he has his oxygen concentrator on hand , and his puffers in case he needs them . The GP realises that Harry thinks he is likely to die in the next few months , and explains that palliative care is involved simply because they manage home oxygen , and that they are expecting to see him for a quite a few more years yet .

The GP takes Mary aside in the kitchen and explains that Harry needs to be a bit busy to keep his mental health on track . They discuss ways in which he could get to see his mates , and also “ potter around ” the shed . The GP re-educates her on the risks of the dust , and they agree that he can keep the shed doors open to allow the air to circulate . The GP also asks her , kindly , to stop hovering , and suggests she engage with some of her own hobbies so she can continue to care for Harry in the longer term . The GP also suggests she arrange to go to a meeting with other stonemasons , and suggests she tell Harry it is so she gets to talk to the other wives , but hopefully both of them can learn a little more about silicosis . The GP tells them to come into the surgery from now on , because Harry is “ perfectly capable ” and it would do him good to get out of the house .

CONCLUSION

COPING is not an inherent trait with which people are born ; it is a series of learned behaviours . People can have underlying vulnerabilities that make it difficult for them . They live in an individual context , with unique social support networks , illness understanding , health literacy and previous experience . One of the most important things a GP can do is to make sense of this context , and see where there may be gaps that need addressing to give patients the best chance of managing their unique situation .

Australian Doctor 14th February 2025 | Page 27

HOW TO TREAT 27

HOW TO TREAT 27

How to Treat Quiz .