Biopsychosocial/economics Flashcards
SF-36
Short form health survey. Can be 36 qs, 8qs, 12qs.
8 sections : vitality, physical functioning, bodily pain, general health perceptions, physical role functioning, emotional role function, social role function, mental health.
Each scale put onto 0-100 scale, lower score = more disability
Used in health economics for QALYs
Eq-5D
Euroquol 5 dimension. Rate mobility, self care, usual activities, pain/discomfort, anxiety/depression. Then rate globally on 100pt scale.
Used in health economics for QALYs
WHOQoL 100
WHO quality of life scale, BREF is shorter version). 4 Domains: physical health, psychological, social relationships, environment (includes finances, leisure)
AQoL-8D
Assessment of qualit of life, 8 dimensions.
Independent living, happiness, mental health, coping, relationships, self worth, pain, senses
MQOL
McGill quality of life questionnaire: 16 item on 1-10 scale. Covers 4 domains (psychological, physical symptoms, physical wellbeing and existential wellbeing). Geared towards palliative care/terminal conditions
ECOG
The ECOG performance status is a scale used to assess how a patient’s disease is progressing, assess how the disease affects the daily living abilities of the patient, and determine appropriate treatment and prognosis
SS-QoL
The SS-QOL assesses health-related quality of life specific to stroke survivors.
Manchester short assessment
QoL in mental health conditions
PHQ-9
9 question instrument to screen for depression and assess severity. according to DSM IV. If mild then FU. Mod needs treatment plan. Mod/severe then drugs and counselling. Severe needs referral.
Beck’s inventory
21 item self scoring screen for depression
Cost minimisation analysis
Two options with equal effect on outcomes (e.g. equal increase in life expectancy) then looks for tech with lowest associated costs. Rarely used as outcome probably not exactly the same, and can’t be specified in prospective economic evaluation as wont know same outcomes beforehand
Cost effectiveness analysis
Two options compared by measuring same single outcome (e.g. life expectancy, reduction in stroke), and then incremental cost effectiveness ratio : ICER = cost of A-cost of B/ outcome from A-outcome from B. ICER = extra costs required to generate each additional unit of outcome if new replaces old.
Pros: easy, routinely measured parameters. Can use if two different outcomes and costs.
Cons: Only looks at health effects, doesn’t incorporate patient issues on qol
Cost utility analysis
Uses QALYs (where 1 = year in perfect health, 0=dead) QALY = life expectancy x health related QoL. Uses natural units (years alive). ICER can be used: Cost of new-cost of old/new QALY-oldQALY
Cost benefit analysis
Measures everything in cash value, so must be converted.
Pros: advantage over CUA and CEA that not just health outcomes, but social and infrastructure measurements. Can also evaluate standalone interventions (with no comparator).
Cons: very complex to determine, and involves monitorising everything.
Technosexuality
Can be an extension of biopower, with technological advances allowing increased surveliance on individuals. Includes contact tracing, dating apps, porn,digital access to test results and screening services
Sexual citizenship
Balance between disease eradification and treatment access, as well as citizens right to sexual enjoyment and wellbeing.
sex and gender definition
sex if biologically determined (structural, functional, behavioural characteristics). Gender is socially determined
Crisis of masculinity
theory that men are less sure of themselves/identity due to growing gender equality
Hegemonic masculinity
Male dominance role/leadership/men staying men
Communities of practice
Expected roles and norms, being told what to do and how you behave if part of certain community.
Sexual health concerns
Relate to situations around socialy/political/education issues.
E.g. freedom from sexual violence, public health campaigns, information about eroticism, freedom from discrimination on orientation, information about emotional attachments.
Access to safe motherhood, access to care for infertility
Sexual Health problems
Specific problems requiring intervention/treatment. E.g. ED in individual, problems with specific sexual behaviour, PTSD post abuse, sterility, STIs
Pronatalism
“normal family life”, thinking that everyone should want/have kids
Advocacy
Having someone to help stand up for rights (legal right in some contexts). Self advocacy is a person’s ability to speak up for themselves
Goffman stigma
People who show stigma conditions are discredited. People who have hidden stigma conditions are discreditable.
7 Types of stigma: public, self, perceived, label avoidance, stigma by association, structural and health care professional.
Social causation in mental health
Accepts some psychiatric dconditions, but explores importance of structural social factors and phenomena on mental health. Looks at why certain groups get certain diagnosis.
Critical theorist in Mental Health
Look at alienating effect that working class life has on mental health. Ties into ideas about state control through psychiatry and asylums.
Social construction in mental health
Looks at forces shaping and defining “mental health”, where mental health conditions can be seen as constructs/invented/medicalised.
Foucault etc suggest psychiatry is about external control (surveillance) and internal control (us controlling our own sanity)
Labelling, stigma and social reaction in mental health
Centres around micro lebel and labels. Ties in with primary and secondary deviance, where people receive slabel and then act accordingly.
Maslow heirarchy
Ranges from physiological, safety, love/belonging, esteem, self actualisation.
Maslow criticism
very linear, life isn’gt, so needs may go in other orders. Do we rank our needs like this? No room for needs that are counter to each other. Ignores cultural variation
ERG motivation theory
Existence, relatedness and growth given as 3 metacatergories of wellbeing
Motivational systems theory (MST)
three key dimensios: goal setting, emotions and self-efficacy (belief in one’s agency). How these interact predicts whether we achieve goals/happiness
Flow
Optimal/peak experiences that make everything else worthwhile. Motivation is less important.
Habitus, and social/cultural capital
What counts as quality of life can be different depending on culture/class/status.
Hedonism
objective, wish fulfilment
Nussbaum’s capability approach
non-hedonistic alternative based around humanitarian efforts and individual dignity.
Positive psychology (seligman)
Positive cognition and practices lead to happiness
Optimism bias
Believing we will get the best outcome. But, people who are optimistic often do have better outcomes
Nozick’s experience machine
If we could simulate happiness, would this equate to QOL?
Technology impacts on WOL?
social network theory of happiness, contagious positivity/wellbeing.
Affective computing is that computers could respond to emotions/mimic emotions and provide social interactions.
Increasing tech can be seen as extension of government/big business survelance.
