2 - HaDSoc - Lay beliefs + Health promotion + PROMs Flashcards
What is a lay belief?
The understanding someone with no specialised knowledge has of health and illness
What is the negative definition of health, and which group of people commonly hold this belief?
- Health is simply the absence of illness
- Lower socio-economic class
What is the functional definition of health, and which group of people commonly hold this belief?
- Health means you can function normally
- Elderly
What is the positive definition of health, and which group of people commonly hold this belief?
- Health is a state of wellbeing and fitness to work towards
- Higher socio-economic class
If someone has a negative perception of health, how will this impact on their health-related behaviours?
- Will not reduce risky health behaviours as they are not currently causing illness
- May not think to change current behaviours to more positive health behaviours, as do not view health as a state to work towards
What are the main factors determining whether someone goes to see a healthcare professional or not?
- Culture
- Visibility of symptoms
- How much the symptoms disrupt life
- Frequency and persistency of symptoms
- Tolerance threshold
- Own understanding of symptoms
- Advice of friends/family
What is meant by ‘lay referral’?
When an ill person seeks the advice of a lay person before/instead of seeing a healthcare professional
What are the 3 main ways people respond to a diagnosis and susequent treatment?
1) Denial - refuse diagnosis and treatment
2) Accepting - fully adhere to treatment
3) Pragmatic - only comply when illness is bad (will not take preventative treatment)
What is the ultimate goal of health promotion?
Enable people to increase control over and improve their overall health, via social and environment interventions
What are the 7 principles of health promotion?
1) Empowering
2) Holistic (includes physical/social/mental/spiritual health)
3) Participatory
4) Intersectoral (not just health)
5) Equitable
6) Sustainable
7) Multi-strategy
What are the 5 main approaches of health promotion?
1) Medical/preventative ie immunisation/screening/rehab
2) Behaviour change ie persuasive campaign
3) Educational
4) Empowerment - provide people with the tools to implement change
5) Social change ie public smoking ban
What are the sociological criticisms of health promotion?
- Too much surveillance, not enough self-empowerment
- ‘Victim blaming’ - responsibility of illness is due to individual rather than environment
- Privileges certain lifestyles
What dilemmas can result due to health promotion?
- Interfering = ‘nanny state’ - removes personal choice
- Victim-blaming
- Dis-empowering - behaviour may not be due to ignorance but other social/environmental factor that they cannot change
- Reinforce negative stereotypes
- Unequal distribution of responsibility ie healthy-eating campaign targeted at women
What are the 3 types of health promotion evaluation?
1) Process - assess how it is being implemented
2) Impact - assess immediate impact
3) Outcome - assess long-term impact
What factors make it difficult to define whether a campaign resulted in an effect?
- Lag time from intervention to effect
- Many other factors could have contributed to effect
- Evaluation is expensive
What type of health promotion is the ‘Dry January’ campaign?
- Preventative
- Educational
- Empowering
- Behaviour change
What type of health promotion is the planned sugar tax?
- Preventative
- Behaviour change
- Educational
- Social change
What are the possible dilemmas which will result due to the sugar tax?
- Interfering ‘nanny state’
- Disempowering
What are ‘PROMs’ and how do we use them?
Patient Reported Outcome Measures
Assess well-being from patients point of view to:
- Improve clinical management of patients
- Compare providers of services = improves quality of services
Why use Patient Reported Outcomes?
- Good measure of care management (important as chronic illness is increasing)
- Allow patient-centred care - can address concerns
- Alerts to iatrogenic effects of care
What are the challenges of using PROMs?
- Not always cost-effective
- Lack of patient participation
- Misuse
What is ‘Health-Related Quality of Life (HRQoL)’?
The impact of health on someones life, taking into account:
- Physical function
- Symptoms
- Psychological well-being
- Social well-being
- Cognitive functioning
- Personal view (stigma/self-satisfaction)
- Satisfaction with care
What are the advantages and disadvantages of using qualitative methods to assess HRQoL?
Ad: Good at accessing wide range of information
Useful to inform further quantitative research
Disad: Expensive/resource hungry
Not easy to evaluate
What are the advantages and disadvantages of using generic quantitative methods to assess HRQoL?
Ad:
- Good for broad range of problems
- Enable comparisons
- Good at detecting unexpected effects of interventions
Dis:
- Less detailed, results may be too generic (compared to qualitative)
- Less sensitive
What are the advantages and disadvantages of using specific quantitative methods to assess HRQoL?
Ad: Relevant information - specific
Sensitive
Disad: No good for people without the disease
Allows limited comparison
