Definitions Flashcards
What is the definition of Epidemiology?
This looks at the nature and the type of illness using the numerical science of epidemiology
It looks at the time, place and person affected by the illness
What are the 3 main objectives of epidemiology?
Description - to describe the distribution of the disease in the human population
Explanation - to give clues to the natural history of the disease and possible etiological factors
Disease control - to provide a basis in which we can find areas to implement and develop therapeutic strategies
What is relative risk?
Strength of association
What is the equation for relative risk?
Incidence of disease in the exposed group divided by the incidence of disease in the unexposed group
How can you show someone about relative risk?
Discussing it, verbal explanation, graphs or pictures
Name 10 sources of epidemiological data
NHS expenditure data Cancer statistics Accident statistics Drug abuse statistics Reproductive health statistics GP morbidity data Hospital activity statistics Mortality data Health and household statistics Social security statistics
What are 5 types of studies?
Descriptive Case control Cohort studies Cross-sectional studies RCT's
What are the 6 things to consider when you are interpreting results?
Standardisation Standard mortality ratio Quality of data Case definition Coding and classification Ascertainment
What are the 4 types of bias?
Selection bias
Information Bias
Follow up bias
Systematic error
What are the 9 Criteria for causality?
Strength of association Consistency Coherence Specificity Temporality Analogy Experiment Biological gradient Biological plausibility
What is a variable that can have an impact on 2 sets of data that will lead it to favour one?
Confounding variable
Define health promotion
An over-arching principle which aims to enhance health or prevent disease achieved through legislation or activity modification
Define the 3 types of health promotion and describe each
Educational -where knowledge is given in order to allow the person to make the informed choice about their health
Socio-economic - the health choice is the easy choice
Psychological - the complex relationship between a person’s beliefs, knowledge, attitudes and beliefs, focusing on whether the person is ready to change
Define health education
Any activity where one communicates with an individual or group aimed at challenging those knowledge or beliefs to improve health
Define Health Protection
A policy beyond the scope of the individual which aims to prevent ill health or improve health
Define empowerment
This refers to the generation of power in an individual who previously considered themselves unable to a control a situation on the basis of their choices
What are the 3 advantages of empowerment?
Able to withstand social pressure
Able to put into place effective coping strategies in an unhealthy environment
Heightened state of self-conciousness
What model refers to an individuals ability to modify their behaviour?
The cycle of change
What are the 6 steps of the cycle of change?
Pre-contemplation Contemplation Planning Action Maintenance Relapse
What are the 4 Catford criteria for assessing health promotion?
Does the activity understand and respond to peoples needs fairly?
Is it built upon an identifiable approach to health promotion?
Does it demonstrate a sense of direction and coherence?
are there connections made between settings, individuals and community approaches?
What is Primary Prevention?
Where measures are taken to prevent the onset of illness or the probability or severity of the resulting symptoms, ie vaccination schedule
What is Secondary Prevention?
Where a disease is identified at an early stage so that we can prevent the progression of symptoms
What is Tertiary Prevention?
A activity which aims to lessen disability or distress of the disease
Give examples of heath promotion on the 4 following areas: Primary Care Government Economic Education
Primary Care: Posters, chronic disease clinics vaccination
Government: legislations on smoking and legal drinking age limits
Economic: Taxing on cigarettes and alcohol
Education = HEBS
Who’s criteria os used for screening in a population?
Wilson and Jugner’s Criteria
What are 10 screening criteria?
The condition is important
There is a pre-symptomatic phase if the disease
The natural course of the disease is known
Is the test safe
Is the test specific
Is the test sensitive
Is the test cost-effective
Is the test acceptable to the public?
If s there acceptable treatment for the illness
Is the treatment cost-effective
Is the treatment more effective is ti is implemented early
What is the definition of sustainability?
The ability to continue over a period of time
What are the global sustainability reasons for being important to healthcare?
Material inequality Climate changes Population and consumption Resource depletion Loss of biodiversity Healthcare crises
How can we reduce global warming? (5)
Plant based diet Promote patent resilience Modify human behaviour Increase use of renewables Educate on literacy and numeracy
What can we do to make the NHS sustainable?
Use sustainable grown food
Greener building design and construction
Priorities environmental health
Reduce/ be safe in the deposition of waste
Use energy efficiently
Reduce water consumption
Improve travel strategies
What is the definition of resilience?
Ability to quickly return to a previous good condition
What are the factors that contribute to a sustainable career?
Job security
Financial security
Job satisfaction
Respect for the professionalism and knowledge
Ability to work in a team over a period of time
Appreciation for being in the role of a doctor
Ability to develop knowledge and interests
Work life balance
What are the challenges to a sustainable career?
Considerable and rapid workload Time management Increasingly complex care Care vs cure Relentless arrival of mail and blood results and not having enough time to go through them diligently Running a business Harmonious and effective
What is a sick not now called?
Medical 3 Fit note
What are the roles of occupational health 10?
Advice on work related illness
Advice on fitness to work and workplace safety
Ajustements to keep people in work
Research into work related illness
Help people integrate back into work
Improve attendance and performance
Promote health in the workplace and lifestyle
Ensure compliance with heath and safety regulations
Advice on medical health and ill-heath retirement
Describe the following times in graph form?
1950
2000
2050
Pyramid
Bulge at middle age
Bulge at over 60
What are the 2 things to observe form the population graphs?
The population is ageing
There are fewer younger people
What may have caused the change in the population graphs?
Increased contraception
Better healthcare which prolongs life eg immunisations
Define Multi-morbidity
The co-existanece of 2 or more long-term conditions in an individual
What does anticipatory care planning promote?
Philosophy that promotes discussion with individuals, their caress and those close to them, to make decisions about their future health including personal and practical aspects of care
Who should get an anticipatory care plan?
Anyone who is deemed appropriate
Done in advance
Communicated on a Key information summary
What is the WHO definition of Palliative care?
Improves quality of life for the patient and their families by providing pain and symptom relief along with spiritual and psychosocial care, from diagnosis’s though to the end of bereavement
What scale can you use to select a patient suitable for this?
Palliative performance scale
Who should get a palliative care plan?
Anyone who it is deemed appropriate
What should be considered when putting a care plan into place?
Where the person wishes to be caused for?
Do they have a DNA CPR?
Do they want to be informed in changes in their condition?
Do they know the full prognosis of their disease?
Does the family know the full prognosis of their disease?
What are the 6 criteria of WHO’s Palliative care?
Provides relief from pain and symptoms
Affirms life and dying as a normal process
Gives spiritual and psychological support
Neither hastens or postpones death
Provides a support network for the patient to help them to live as actively as possible
Provides a support network for the family through bereavement
What are the 5 things that can contribute to a good death?
Pain free Surrounded by family members Their wishes and affairs for after death are in order Death as personal growth Death according to personal preference
What are the 8 things you should do when breaking bad news?
Listen Set the scene Find out what the patient already knows Find out what the patient wishes to know Share the info using common language Review and summaries Allow time for questions Arrange a next meeting and a plan of action and support
What are the 10 emotions to bad news?
Shock Anger Denial Sadness Guilt Bargaining Relief Fear Anxiety Distress
What are the responses to someone who asks for euthanasia?
Listen
Acknowledge the issue
Explore the reason for request
Explore how to give the patient more control
Treat any causative symptoms or problems
Remember spiritual issues
Admit powerlessness
List points relating to the proactive care resulting from anticipatory care planning
Patient on the GP palliative care register and discussed at team meetings
Information on financial support given to patients and careers and referred to the appropriate services
Usual GP and district nurse home visit and support calls
Symptoms dressed with the partnership of allied health professionals as appropriate
Overall care assessed including spiritual and psychological needs
Place where patient wishes to be cared for noted and organised
Care plan and medications at home put in place
End of life pathway used
Noted the patients wishes on where they would like to die, with family bereavement support offered
Staff selection with audits etc
