Formative Flashcards
What is health?
Health is a state of complete physical, emotional and psychological well-being, not just the absence of disease or infirmity.
What is Risk?
the likelihood of harm occurring
List four aspects of lifestyle you MAY cover in a consultation with ANY patient when giving advice to promote a healthier lifestyle
Diet, Exercise, Alcohol, Smoking, Illicit drug use, Sexual health
List four aspects of health which are likely to be worse for children (of all ages) living in the most deprived areas compared to those living in the least deprived areas
Teenage pregnancy Lower birth weight Less likely to benefit from breast feeding in infancy Poorer dental health Higher rates of obesity (More likely to take up smoking)
List six other recognised risks to foetal well-being
Alcohol
Smoking
Illicit drugs
Prescription drugs
OTC medication, internet sourced remedies, herbal medication
X-rays
Diet e.g. poor nutrition, lack of dietary folic acid, soft cheese, pate
Infectious diseases e.g. TORCH (Toxoplasma, Rubella, Cytomegalovirus, Herpes)
Maternal disease e.g. diabetes, epilepsy
List four factors which would make Hannah more likely to be motivated to change her behaviour and stop drinking alcohol whilst pregnant. For each factor, give an example relating to Hannah during pregnancy
The advantages of not drinking (e.g. healthy baby) outweigh the disadvantages
Hannah anticipates a positive response from others to her behaviour change e.g. Hannah’s boyfriend/family also wants the unborn child to be healthy.
There is social pressure to change e.g. very socially unacceptable to drink when obviously pregnant
Hannah perceives the new behaviour to be consistent with her self-image e.g. perceives herself as an “earth mother”
Hannah believes she is able to carry out the behaviour in a range of circumstances e.g. at home, at parties
What is the World Health Organisation (WHO) definition of health
Health is a state of complete physical (1 mark), mental
(1 mark) and social (1 mark)
well-being and not merely the absence of disease or infirmity
(1 mark)
List four factors which influence lay beliefs about health AND give an example of how each of these factors may influence lay beliefs about health
Age-older people concentrate on functional ability, younger people tend to speak of health in terms of physical strength and fitness Social class-people living in difficult economic and social circumstances regard health as functional (ability to be productive, take care of others), women of higher social class or educational qualifications have a more multidimensional view of health Gender-men and women appear to think about health differently (women may find the concept of health more interesting, women include a social aspect to health) Culture-different perceptions of illness/disease, differences in concordance with treatment
List six actions the government could take to stem the rise in obesity
Health education-diet and exercise Tax on unhealthy foods, “fat tax” Legislation-proper labelling, lists of ingredients/food content Enforcement of legislation Ban on advertising unhealthy food Improve exercise/sport facilities Subsidise healthy food Transport policy e.g. cycle lanes Funding of NHS treatment for obesity e.g. specialist clinics, bariatric surgery
Define culture
Culture - a complex whole which includes knowledge, beliefs, art, morals, law, customs etc. (Tyler, 1874) OR systems of shared ideas, systems of concepts rules and meanings that underlie and are expressed in the way that human beings live (Keesing, 1981)
List five potential difficulties which may arise when consulting with a patient from a different culture
Lack of knowledge about NHS/UK health care system
Lack of knowledge about common health issues/different health beliefs
Fear and distrust
Racism
Bias and ethnocentrism
Stereotyping
Language barriers
Presence of a third party e.g. family member, translator in the room
Differences in perceptions and expectations between patient and doctor
Examination taboos
Gender difference between doctor and patient
Religious beliefs
Difficulties using language line
Patient may not be entitled to NHS care
List three different routes via which someone may be exposed to a hazardous substance
Skin, Blood, Sexual contact, Inhalation, Ingestion
List two categories of hazard (other than chemical) AND give an example of each in relation to Jenni’s work in the chemistry lab.
Physical - heat, noise, radiation from lab equipment
Mechanical - trips and slips
Biological - spread of infection amongst colleagues e.g. respiratory, GI
Psychological/stress - anxiety re job security, relationships with colleagues, stressful when busy/deadlines to meet
List four other common reasons for a child (of any age) in the UK seeing their GP and/or Health Visitor
Pyrexia (fever), Feeding problems, URTIs/colds, Coughs, Rashes, Sore throat, Vomiting +/- diarrhoea, Abdominal pain, Anxiety re milestones
List four other social influences on health
Education, Ethnicity, Housing, Employment, Housing, Financial security, Health system, Environment, Social class
What is meant by the term “gatekeeper” in this context of a GP
The person who controls patients’ access to specialist or secondary care
List four advantages of GPs as gatekeepers
Identify those patients who are in need of 2° care assessment
Continuity of care enhances knowledge of patient
Personal advocacy
Patient does not necessarily know which specialty to go to
Increases likelihood of referral to appropriate department
Increases likelihood of appropriate referral/use of resources
Limits exposure to certain investigations e.g. MRI scan, X-rays
GP acts as co-ordinator of care
Puts GP in position to provide patient education
Approximately what percentage of illnesses occurring in the community are referred on to secondary care?
3% (accept 2-5%)
List three health and social care team members who work within the community whom you may decide to contact to assist with Michelle’s care AND give an example of their role.
Physiotherapist e.g. help to clear chest secretions
Pharmacist e.g. advice on medication/interactions/timing of antibiotic medication/encouragement re concordance
Dietician - assessment of nutrition and advice on improving appetite/weight gain
Counsellor - assessment and management of low mood
Practice nurse - assessment and advice re inhaler use/chronic disease (long term condition) monitoring clinics/flu and pneumococcal immunisation
Occupational therapist – assess for aids to assist daily living e.g. stair lift, shower rail
List the three ethical principles
Justice, Beneficence (do good), Non-maleficence (do no harm), Autonomy
Explain how each of the ethical principles you have listed in may apply to the scenario about Michelle
Beneficence - her care has been maximised i.e. treatment of infection, discussion with colleagues in microbiology, involvement of practice team, referral for specialist opinion
(1 mark)
Non-maleficence - culture of sputum and discussion with microbiology to minimise risk antibiotic resistance (1 mark)
Autonomy - patients right not to take advised treatment (inhalers) even if fully informed of benefits
(1 mark)
Lisa comes to see you in the early stages of pregnancy. She wonders whether she should keep the baby or not. List two ETHICAL, two PSYCHOLOGICAL and two SOCIAL issues that Lisa may be considering?
Ethical (List two issues)
Beliefs regarding termination
Any religious beliefs
Thoughts regarding bringing a child into the world that you do not feel able to care for
Psychological (List two issues)
Does Lisa feel ready to be a parent
Does Lisa feel able to go through with a termination
Does Lisa feel that she has support from family and friends
Social (List two issues)
Support network- does Lisa feel her friends would be supportive
Her social life will dramatically change after having a baby
Lisa may need to give up work in the short or longer term
why might you feel ‘healthy’ according to WHO definition
no illness, exercise regularly, on no regular meds, manage to work/socialise, healthy diet
Why might people think smoking is normal behaviour?
Might be normal for her peer or social group, but would be abnormal perhaps for the wider population
Might watch TV programmes where smoking is normal behaviou
What definition applies to babies below 2500grams
Low Birth Weight
Five advantages of using developmental milestones
Provide GPs and HVs with aid to management in child development and clear cut off points for referral
Makes it easier to reassure anxious parents about range of normality and to provide parents with a logical explanation about developmental progress
Provides a structure for developmental assessment
Aids parental interaction in child development e.g. encourage speaking and reading to aid development
Use in research - allows comparison across peer groups
Can you list five disadvantages of using developmental milestones?
May result in parental anxiety
Potential for different interpretations of guidelines
Medicalisation of “normality”
May place doctor in difficult situation e.g. parental anxiety resulting in unnecessary referral
May be difficult to balance confounding factors such as prematurity against guidelines
Which country in EU has highest number of single parent families?
UK (all the people from seamus’s school)
How many single parent families are there in UK
Approx 2 million
What characteristics make people believe they are healthy
Functional ability, Absence of disease, Physical fintess
What are the rights and obligations attached to the Sick Role?
- The sick role exempts an individual from ‘normal social roles’
- The sick person is not responsible for his/her condition
- The sick person should try to get well.
- He/she should seek competent help and cooperate with the doctor/health professional to get better
Define Hazard
something with potential to cause harm
Define Risk
The likelihood of harm occuring
What are the kinds of Hazards?
Chemical, Physical, Mechanical, Biological, Psychosocial
Can you list any health indicators that differ between deprived and less deprived areas of Scotland?
Life expectancy, Alcohol related admissions to hospital, Percentage of adults who smoke, Number of GP consultations (for anxiety), Breastfeeding rates
What are the factors of a Comunity
Geography, Culture, Social stratification, and Functional groups
Describe the Inverse Care Law
This described that those who most need medical care are least likely to receive it and conversely, those with least need of health care tend to use health services more and more effectively.
If you have a part-time Job which social class are you in?
D (semi routine occupations)
What social class are the unemployed?
E (long-term unemployed)
What social class would a doctor belong to?
A (higher professional and managerial workers)
How can health inequalities be reduced
Effective partnerships across a range of sectors and organisations e.g. to promote health, improve patient education about health
Planning to integrate health and social care
Government policies and legislation e.g. smoking ban, Keep Well campaign
Time to invest in the more vulnerable patient groups
Improve access to health and social care services and professionals
Reduction in poverty
Social inclusion policies
Improved employment opportunities for all
Ensuring equal access to education in all areas
Improved housing in deprived areas
What coping mechanisms are used to deal with stress?
Problem focused e.g. enlist help of family and friends to help with Kayleigh’s care
Emotion focused e.g. seek counselling/stress management (positive response), alcohol or drug misuse (negative response)
Combined problem and emotion focused
Briefly explain the difference between statistical and cultural definitions of normality (2 marks)
Statistical: based on normal distribution (curve)/standard deviation
Cultural: based on norms and values within a certain group or community
List three members of the health care team in the community who may be involved in Jane’s care and give a brief description of their role (6 marks)
GP: co-ordination of care, review of progress, changes to medication, on-going care of other health issues
Practice nurse: wound dressings, suture removal, monitoring of hypertension
District nurse: wound dressings suture removal
Pharmacist: advice on medication, prepared daily medication
Physiotherapist: aim to improve post-op mobility
OT: aids and appliances to assist with tasks of daily living
Receptionist: first point of contact at surgery for appointments
