Community Flashcards
Physical consequences of loneliness
Earlier death
Take more risks
Harder to self regulate
Risk factors for loneliness
Lives alone Bereavement/ recent transition Suffering from an illness/ chronic disease Mobility Sensory impairment Close family nearby Quality of social contact
Define the social theory of disengagment
Ageing is an inevitable,mutual withdrawal or disengagement, resulting in decreased interaction between the raging person and others in the social system he or she belongs to
Innate, universal and unidirectional
Define social exclusion
Dynamic process of being shut out, fully or partially from any social, economic, political or cultural systems which determine the social integration of a person in society.
List the domains of social exclusion
Material resources Basic services Civil activities Neighbourhood Social relationships
List the potential causes of social exclusion
Poor health Sensory impairment Poverty Housing issues Fear of crime Transport Discrimination
List initiatives currently attempting to combat loneliness
Age UK Siverline Circle of friends Dementia Housing (flexible care, planing for older people) Mindfullness of ageing Sod 70
Explain Maslows Hierarchy of needs
1) Physiological: breathing, food, water, sex, sleep, excretion
2) Safety: Security of body, of employment, of resources, of morality, of the family, of health, of property
3) Love/Belonging: Friendship, family, sexual intimacy
4) Esteem: Self-esteem, confidence, achievement, respect of others, respect by others
5) Self-actualization: Morality, creativity, problem solving , lack of prejudice
List the possible groups who are vulnerable to homelessness and the possible causes
Ex-service men
Mentally unwell
Local authority care leavers
Ex-prisioners
Causes
- Eviction/Economic hardship
- Relationship breakdown
- Mental illness
- Unemployment
- Substance abuse
- Bereavement
List the health issues that may affect those who are homeless
Infectious diseases Poor foot and teeth health Resp problems (TB) Sexual health Serious mental health illness Poor nutrition Addictions/substance misuse
Define the inverse care law
The availability of good medical or social care tends to vary inversely with the need of the population served
Barriers to healthcare
- Difficulties with access
- Lack of integration between mainstream care services and other agencies
- Other worries
- Lack of knowledge
- Discrimination
What factors affect the travelling communities health and what barriers do they face when accessing healthcare
- Education
- High rates of smoking
- Poor uptake of ANC
Barriers
- Reluctance to vist healthcare professionals
- Illiterate
- Communications difficulties
- Lack of a permanent site
- Lack of choice
Define refugee
A person granted asylum and refugee status. Leave to remain for 5yrs and then reapply
Out of their home and country
Define asylum seeker
Person who has submitted an application to be recognised as a refugee and is waiting for their claim to be decided by the home office
1951 convention on refugees
Anyone has the right to apply for asylum in the UK and remain until a final decision on their applications has been made
Define Humanitarian Protection
Failed to demonstrate a claim for asylum but face a serious threat to life if they return to their country
What health issues affect refugees
Illness linked to country of origin Injuries linked to warfare and travel No health screening Malnutrition Infections Untreated chronic disease Mental health - PTSD -Depression -Sleep disturbance -Psychosis -Self harm
Define an unaccompanied asylum child
Crossed an international border in the search of safety and refugee status
Applying for asylum in his/her right
Under the age of 18 or in the absence of documentary evidence appears to be under that age
Without family members or guardians to trust in this country
Define epigenetics
Expression of the genome dependent on the enviroment
Define allostasis
Stability through change, our physiological systems have adapted to react rapidly to environmental stressors
Define allostatic load
Long term overtaxation of our physiological systems that leads to impaired stress
Define salutogenesis
Favourable physiological changes secondary to experiences which promote healing and health
Define emotional intelligence
The ability to identify and mange ones own emotions as well as those of others
List the dangers of overprescribing antibiotics
Unnecessary side effects
Medicalise self-limiting conditions
Antibiotic resistance
Role of primary health care
Managing illness and clinical relationship overtime
Finding the best available clinical solutions to clinical problems
Preventing illness
Promoting health
Managing clinical uncertainity
Shared decision making with the patients
Define public health
The science and art of preventing disease, prolonging life and promoting health through organised efforts of society
List the three domains of public health
Health improvement
- Societal interventions to promote health and prevent disease
- Reduce inequalities
Health protection
- Measures to control infections diseases
- Reduce environmental hazards
Improving services
- Organisation and delivery of safe, high quality services for prevention, treatment and care
- Clinical effectiveness
Key concerns for public health
Inequalities in health care
Wider determinants of health
Prevention
Define health needs assessment
Systematic method for reviewing the health issues facing a population.
Leading to agreed policies
Resource allocation
Improve health and reduce inequalities
Discuss the domains of health needs assessment
Need: Ability to benefit from an intervention
Demand: What people ask for
Supply: What is provided
Health need: Need for health, measured using mortality, morbidity and socio-demographic measures
Health care need: Need for health care, ability to benefit from health care
Sociological perspective on need
Felt need: Individual perceptions of variations from normal health
Expressed need: Individuals seek help to overcome variation in normal health
Normative need: professional defines interventions appropriate for the expressed need
Comparative need: Comparison between severity, range of interventions and cost
Different approaches to health needs
Epidemiological
Comparative
Corporate
Discuss the epidemiological approach to health needs assessment and list the advantages and disadvantages
Epidemiological: Define the problem Available services Evidence base Models of care ( outcomes measured)
ADVANTAGES
- Uses existing data
- Provides data on disease incidence/mortality/morbidity
- Evaluate services by trends over time
DISADVANTAGES
- Quality of data variable
- Data collected may not be the data required
- Does not consider the felt needs or experiences of the people affected
Discuss the comparative approach to health needs assessment and list the advantages and disadvantages
Compares the services received by a population with others
Examine
- Health status
- Service provision
- Service utilisation
ADVANTAGES
- Quick and cheap
- Compares health service provisions in different areas
DISADVANTAGES
- Difficult to find a comparative population
Discuss the coparate approach to health needs assessment and list the advantages and disadvantages
Ask the population what their needs are
Use focus groups, interviews and public meetings
ADVANTAGES
- based on felt and expressed needs
- Recognised detailed knowledge of those working in the population
- Takes into account a wider range of view
DISADVANTAGES
- Difficult to distinguish need from demand
- Vested interest
- Influenced by political agendas
List the different types of prevention
Primary prevention: preventing disease before it has happened
Eg: Lifestyle advice
Secondary prevention: Intervention to prevent symptoms of the disease. Catching the disease in the pre-clinical/early phase.
Eg: Statins, lifestyle
Tertiary preventions: Preventing complications of the disease
Eg: Dual antiplatlets
List the different approaches to prevention
Population approach: preventative measures (Dietary salt reduction through legislation)
High-risk population: Identify individuals above a chosen cut off and treat. (Screening for a high BP)
Define the prevention paradox
A preventative measure which brings much benefit to the population often offers little to each participating individual
Define screening
A process which sorts out apparently well people who have the disease or a precursor or suitability to a disease from those who do not
List the different types of screening
Population based screening programmes Opportunistic screening Screening for communicable diseases Pre-employment and occupational needs Commercially provided screening
Names and discuss the screening criteria
Condition must be an important health problem
An acceptable treatment must exist for the condition
Facilities available for diagnosis and treatment
A clear latent or early phase of the disease
Suitable test of examinations
The test must be acceptable for the popluation
Clear policy of who to treat and when to treat them
The disease must have a natural history
Continous process
Economically viable
Disadvantages of screening
Exposure of well individuals to distressing or harmful diagnostic tests
Detection and treatment of sub-clinical disease that would never have caused any problems
Preventive interventions that may cause harm to individuals or population
Important screening calculations
Sensitivity: the proportion of people with the disease who are correctly identified by the screening test (a/a+c)
Specificity: the proportion of people without the disease who are correctly excluded by the screening test (d/b+d)
Positive predictive value: the proportion of people with a positive test results who actually have the disease (a/a+b)
Negative predictive values: the proportion of people with a positive test result who do not have the disease (d/c+d)
This goes down as prevalence goes up.
PREDICTIVE VALUES ARE DEPENDENT ON PREVALENCE
Lead time basis
Screening identifies an outcome earlier than it would otherwise have been identified this results in an apparent increase in survival time, even if screening has no effect on outcome
Length time basis
Type of basis resulting from the differences in the length of time taken for a condition to progress to severe effects
Affect the efficacy of the screening method
