Children's health and health promotion

Question 1

What is health promotion?

Answer 1

Any planned activity designed to enhance health or prevent disease.

Overarching principle/activity which enhances health and includes disease prevention, health education and health protection. It may be planned or opportunistic

Question 2

What factors can health be affected by?

Which of these can be affected by health promotion?

Answer 2

■Genetics,

■Access,

■Environment and

■Lifestyle.

• Access, environment and lifestyle

Question 3

Please explain the educational theory of health promotion:

Answer 3

Provides knowledge and education to enable necessary skills to rate informed choices re health – may be menone –to-one group workshop

​ ​e.g. smoking, diet, diabetes

Question 4

Please explain the socieconomic theory of health promotion:

Answer 4

‘Makes healthy choice the easy choice’

National policies e.g. re unemployment, redistribute income.

Question 5

Please explain the psychological theory of health promotion:

Answer 5

Complex relationship between behaviour, knowledge, attitudes and beliefs. Activities start from an individual attitude to health and readiness to change. Emphasis on whether individual is ready to change. (e.g. smoking, alcohol).

Question 6

What is the defintion of health education:

Answer 6

Activity involving communication with individuals or groups aimed at changing knowledge, beliefs, attitudes and behaviour in a direction which is conducive to improvements in health.

Question 7

What is the definition of health protection:

Answer 7

Involves collective activities directed at factors which are beyond the control of the individual. Health protection activities tend to be regulations or policies, or voluntary codes of practice aimed at the prevention of ill health or the positive enhancement of well-being.

Question 8

What is empowerment and what are the benefits of this?

Answer 8

• Refers to the generation of power in those individuals and groups which previously considered themselves to be unable to control situations nor act on the basis of their choices.
• It results in a number of benefits –
  
  • An ability to resist social pressure.
  • An ability to utilise effective coping strategies when faced by an unhealthy environment.
  • A heightened consciousness of action.

Question 9

What are challenges to successful health promotion?

Answer 9

Cynical doctors

Poor evaluation of previous health promotion

Question 10

What is the cycle of change?

When is it useful?

Answer 10

• Used when someone is trying to break an addiction
• Or to try and quit something - smoking

Question 11

What are some examples of health promotion?

Answer 11

Primary care:

Planned – Posters, Chronic disease clinics, vaccinations, QOF

Opportunistic – Advice within surgery, smoking, diet, taking BP

Government:

Legislation – Legal age limits, Smoking ban, Health and safety, Clean air act, Highway code

Economic – Tax on cigarettes and alcohol

Education – HEBS: posters

Question 12

What is primary prevention?

Answer 12

Measures taken to prevent onset of illness or injury

Reduces probability, severity

e.g. smoking cessation

Question 13

What is the vaccination regime for children?

Answer 13

2 MONTHS (D)Diphtheria, (T)Tetanus, (aP)acellular pertussis, (IPV) Inactivated Polio Vaccine, (Hib) H.influenzae type b and (PCV) Pneumococcal Vaccine.

3 MONTHS D,T,aP, IPV, Hib & Men C

4 MONTHS D,T, aP, IPV, Hib PCV & Men C

12 MONTHS Hib & Men C

13 -15 MONTHS MMR & PCV

3.4 YEARS TO 5 YRS D,T, aP, IPV, MMR

13-18 YEARS T, d (low dose diphtheria) IPV, (plus MMR x2 and Men C x1 if not had)

18-24 years Men C if not had already

65 onwards Annual ‘Flu vaccine and PVC (once)

Girls aged 12-13 Cervarix x3 (day 1, 4 weeks later and 6 months later

Question 14

What is secondary prevention?

Answer 14

“Detection of a disease at an early (preclinical) stage in order to cure, prevent, or lessen symptomatology”

Earliest opportunity is when a disease becomes evident or detectable. Ends when disease becomes symptomatic.

Question 15

What is Wilson’s criteria for screening?

Answer 15

Illness – important, natural history understood, pre-symptomatic stage

Test – easy, acceptable, cost effective, sensitive and specific

Treatment – acceptable, cost effective, better if early

Question 16

What needs included in a letter inviting someone to a screening session?

Answer 16

• Do they mention risks vs benefits? Informed consent

Question 17

What is tertiary prevention?

Answer 17

“measures to limit distress or disability caused by disease”

Question 18

What is notable different about old/v young people compared with general adults?

Answer 18

Homeostatis

Question 19

How can establishment of a healthy lifestyle benefit lifelong health?

Answer 19

• Growth and development fuelled by food
• Scotland has the highest incidence of premature death due to heart disease
• High saturated fats and low fruit and veg are important factors in this

Question 20

What is the role of parenting in lifelong health?

Answer 20

• Habits and lifestyles established in adolescence
• Smoking is more than twice as likely if your parents smoke
• Neglect and abuse recur.

Question 21

What are the common reasons for a child seeing their GP/Health Visitor?

Answer 21

Feeding problems (new babies especially) pyrexia, URTI, coughs/colds, rashes, otalgia, sore throat, vomiting +/- diarrhoea, abdominal pains, behavioural problems (older infants and will depend on area / parent(s) situation).

Question 22

What are the important aspects of these consultations with young children?

Answer 22

(Listening, watching, observing, examining properly, putting child at ease as well as parent / guardian, be seen to take it seriously, parental understanding, explain in clear language what your thinking is and plans are. [So introducing the Cambridge-Calgary model] Ethnic issues, language issues, referring if necessary, reporting if necessary [child protection issues])

Question 23

Why might parents bring their child to the GP?

Answer 23

They might well be correct, someone else urging them to act, anxiety re a normal illness, inexperience, single parent with no support, parenting difficulty manifesting as child illness, parent depression / anxiety, social issues, child presenting to them with difficult symptoms to interpret, child abuse by a partner

Question 24

What measures can the GP take to be sure of what is happening to the child?

Answer 24

Listen, observe, read the notes of child and parent(s), examine properly, explain clearly what you are thinking / doing, discuss with other Health Professionals, review, ‘open door’ policy, reassure appropriately, investigate appropriately, refer appropriately, care re over- investigating, no dogmatic statements

Question 25

How do you think a GP might manage apparently over anxious parent / guardian?

Answer 25

Striking a balance between what needs to be done and what does not. Again, listening, examining, considering ICE, rapport, explaining properly, consensus, allowing questions, offering second opinion, no dogma, facilitating a return visit.

Question 26

How is the modern day diet for children?

Answer 26

But how many teens implement it (or how many parents can afford to or have time to implement a ‘Healthy diet’

Often children arrive home at different times to their parents, and only 58% of families eat together on weekdays, rising to 61% at weekends.

In these circumstances, is it reasonable to expect a child to eat healthily - whose responsibility is that?

Question 27

What is NHS guidance for exercise for teenagers?

Answer 27

NHS Guidelines for teens suggest at least 60 minutes of moderate to vigorous exercise daily for teenagers.

Question 28

What is recommended sleep for teens?

Answer 28

Teens need about 8 to 10 hours of sleep each night to function best. Most teens do not get enough sleep — one study found that only 15% reported sleeping 8 1/2 hours on school nights.

Question 29

What recent social change has had a detrimental effect on teenagers sleep, mental welfare and obesity levels?

Answer 29

Increased screen usage