Formative Flashcards
Wilson + Jungner 1968 - screening programme factors? (10)
Is the disease an important public health problem?
Disease understood?
Test:
- available for the condition?
- detect the condition at an early stage?
- sensitive?
- specific?
- safe?
- acceptable?
- cost effective?
- cost benefit analysis worthwhile?
treatment:
- proven effectiveness?
- safe?
- acceptable to public and professionals?
Are facilities for diagnosis and treatment available?
describe a case control study?
2 groups of people are compared:
- a group of individuals who have the disease of interest are identified (cases),
- group of individuals who do not have the disease (controls)
Data gathered to determine whether or not they’ve been exposed to the suspected aetiological factor(s)
and whether a conclusion can be drawn that the suspected aetiological agent is a likely cause of the disease in question.
describe a cohort study?
baseline data on exposure are collected from a group of people who do not have the disease under study.
The group is then followed through time until a sufficient number have developed the disease to allow analysis.
sources of epidemiological data?
Mortality data
Hospital activity statistics
General Practice morbidity/disease registers
Health and household surveys/population census data
Social security statistics
NHS expenditure data
determining occupational contact dermatitis
Does he work with chemical irritants?
How much exposure does he have to these irritants?
Do his symptoms improve when not at work e.g. onshore, holiday?
Is personal protective equipment (PPE) used?
Does the patient comply with PPE use?
Does the company enforce PPE use?
Do other work colleagues have similar symptoms?
Has he any hobbies/pets/other activities which may be a likely cause?
Does he use hand cream or other topical agents he may be allergic to?
psychological, social issues from working offshore?
- Anxiety re travel
- Depression perhaps secondary to loneliness/away from family
- Stress due to shift pattern
- Pressure to maintain standard of living
- Difficulty adjusting back in to family life when onshore
- Abuse of drugs or alcohol
- “Misses” Russian culture/ethnic isolation
- Anxiety re job security
model of change
pre contemplation contemplation prep and planning action maintenance regression
problems in consultations from cultural differences
- lack of NHS knowledge
- fear/distrust
- racism
- bias
- stereotyping
- ritualistic behaviour
- language barriers
- 3rd party
- Dif expectations
- ex taboos
- gender Dif between doctors + pt
- religion
- difficulties with language line
differences in pop demographics from 1951, 2031?
reasons for these changes?
increasing elderly pop
decreased in young pop
- increased life expectancy
- migration
- contraception
- improvements in housing/sanitation
2031 pop demographic:
- 3 health care issues
- 3 social care issues
health care:
- increased number of geriatricians, allied health professionals.
- increased facility needs
- increase long term conditions
social care:
- increase dependence on families
- demand for home carers,, nursing homes
- house demands as more elderly people live alone
affect of being a carer
- stress, anxiety, depression
- work less
- financial stress
- lack of privacy
- restriction on social activities
- less time for hobbies
- adapting house
- may gain satisfaction
alleviating problems a carer faces
- sitter services
- home carers to assist
- elderly frozen food deliveries
- day care
- respite care
- benefits
- disabled badge scheme
- OT assessment
- addition help from other family members
health care members involved in palliative care?
- district nurse: BP monitoring
- home carer: bathing, dressing
- pharmacist: meds
- social worker: benefits
- OT: environ, aids
- physio: mobility
- GMED: out of hours care
- receptionist: first point of contact
emotional reactions to BBN + how they manifest
- sadness: low mood
- anger: with the pt who smoked e.g. or with health care workers
- denial: fail to acknowledge reality of situation
- bargaining
- guilt
- fear
- anxiety: unable to cope with news
aspects that indicate pt should receive supportive + palliative care?
(from the formatives blurb… )
Not expected to be alive in next 6-12 months Breathless at rest/minimal exertion FEV1<30%
Spends more than 50% of day in bed or chair Long term O2 therapy
Three hospital admission with acute exacerbations in last 6 months
