Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

ΩΩ 3a Bateman - Public Health > General Practice and Public Health > Flashcards

General Practice and Public Health Flashcards

1
Q

What are the 5 level’s of Maslow’s hierarchy of needs?

A
  1. Physiological needs.
  2. Safety needs.
  3. Love and belonging.
  4. Self-esteem.
  5. Self-actualisation.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is epigenetics?

A

The study of how genes interact with the environment.

Changes in organisms caused by modification of gene expression rather than alteration of the genetic code itself.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is allostasis?

A

The process of achieving stability, or homeostasis, through physiological or behavioural change.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is allostatic load?

A

The wear and tear on the body that accumulates as an individual is exposed to repeated or chronic stress. The price we pay for allostasis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Define domestic abuse.

A

Incidents of controlling, coercive, threatening behaviour, violence or abuse between those aged 16+ who are, or have been, intimate partners or family members regardless of gender or sexuality.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Give 3 examples of domestic abuse.

A
  1. Emotional abuse.
  2. Physical abuse.
  3. Financial abuse.
  4. Sexual abuse.
  5. Psychological abuse.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How can domestic abuse impact on health?

A
  1. Traumatic injuries following assault e.g. fractures, miscarriage.
  2. Somatic problems or chronic illness e.g. chronic pain, headaches.
  3. Psychological problems e.g. PTSD, depression, anxiety.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Give 3 potential indications of domestic abuse.

A
  1. Unwitnessed by anyone else.
  2. Repeat attendances to GP or A+E.
  3. Delay in seeking help.
  4. Multiple minor injuries.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What assessment tool can be used to determine someones risk of domestic abuse?

A

The DASH assessment.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What action would you take if someone was at high risk of domestic abuse?

A

Refer to MARAC or IDVAS.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is Public Health?

A

The science and art of preventing disease, prolonging life and promoting health through organised efforts of society.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Define epidemiology

A

The study of the frequency, distribution and determinants of diseases and health-related states in populations in order to prevent and control disease.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Define incidence

A

The rate at which new diseases occur in a population in a certain time period

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Define prevalence

A

The proportion of a population found to have a disease at a point in time.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is person-time a measure of?

A

Person-time is a measure of risk.

It is the sum of each individual’s time at risk ie. the length of time they were followed up in the study.

It is the denominator in incidence rate calculations.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What value is used as the denominator in incidence rate calculations?

A

Person-time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is absolute risk?

A

Absolute risk of a disease is your risk of developing the disease over a time period

E.g. 4 in 100 people

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is relative risk?

A

The risk in one category relative to another, for example, the ratio of risk of disease in the exposed to the risk in the unexposed.

It tells us about the strength of association between a risk factor and a disease.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is absolute risk reduction?

A

Absolute risk reduction (also called risk difference) is the absolute difference in outcomes between one group (usually the control group) and the group receiving treatment.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is relative risk reduction?

A

The relative risk reduction is the difference in event rates between two groups, expressed as a proportion of the event rate in the untreated group.

For example, if 20% of patients die with treatment A, and 15% die with treatment B, the relative risk reduction is 25%.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What calculation can be used to work out relative risk?

A

Incidence in exposed ÷ incidence in unexposed.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Define attributable risk.

A

The rate of disease in the exposed that may be attributed to the exposure. It tells us about the size of effect in absoloute terms.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How can you calculate attributable risk?

A

Incidence in the exposed - incidence in the unexposed.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is NNT?

A

Number needed to treat is the number of patients that need to be treated in order to have an impact on one person.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

How can you calculate NNT?

A

1 / absoloute risk reduction.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Define bias

A

A systematic deviations from the true estimation of the association between exposure and outcome.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Name 2 forms of bias

A
  1. Selection bias.
  2. Information bias.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is selection bias?

A

The people who choose to participate in screening programmes may be different from those who don’t. Proper randomisation is not achieved.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is information bias?

A

Information or measurement bias can be due to observer, participant or instrument error.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is length-time bias?

A

Diseases with a longer period of presentation are more likely to be detected by screening than ones with a shorter time of presentation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is lead-time bias?

A

Screening identifies diseases earlier and so gives the impression that survival is prolonged but in reality survival time is unchanged.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Define confounding.

A

Confounders are associated with exposure and outcome but are not on the causal path from exposure to disease.

Confounders may affect the validity of a study.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is the Bradford Hill criteria for causation?

A
  1. Consistency.
  2. Biological plausibility.
  3. Temporality - cause before disease.
  4. Dose response.
  5. Reversibility.
  6. Strength of association.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Name 3 types of study design.

A
  1. Ecological.
  2. Cross-sectional.
  3. Case-control.
  4. Cohort.
  5. RCT.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Which type of study uses routinely collected population level date to show trends and to generate hypotheses?

A

An ecological study.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Which type of study looks at the population at a point in time?

A

A cross-sectional or prevalence study.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Which type of study compares people with a disease to those without a disease for age, sex, habits, class etc?

A

A case-control study. These are retrospective.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Which type of study follows a population over time to see if they’re exposed to the agent in question and if they develop the disease?

A

A cohort or incidence study. These are prospective.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What is a RCT?

A

Where a population is randomised to either an interventional or a control group. Often these are blind or double-blind trials.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Which type of study is also known as an incidence study?

A

A cohort study - follows a population over time to see if they’re exposed to the agent in question and if they develop the disease.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Which type of study is also known as a prevalence study?

A

A cross-sectional study. It looks at the population at point in time.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Define primary prevention.

A

Preventing a disease/condition from occurring in the first place. Eliminating RF’s that contribute to the disease.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Give an example of a primary prevention method.

A

Immunisations.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Define secondary prevention.

A

Detecting a disease as soon as possible in order to alter its course and to improve health outcomes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Give an example of secondary prevention.

A

Screening e.g. cervical smears.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Define tertiary prevention.

A

Trying to slow down disease progression, avoiding complications and helping people to manage their illness effectively.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Give an example of tertiary prevention.

A

Diabetes management - diet advice, exercise programmes, self-monitoring, annual foot checks etc.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What is the population approach to prevention? Give an example.

A

Preventative measures delivered on a population wide basis e.g. dietary salt reduction.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

What is the high risk approach to prevention? Give an example.

A

Identifying individuals above a chosen cut-off and treating them. E.g. treating those with high cholesterol to avoid heart disease.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Describe the prevention paradox

A

A preventative measure that brings much benefit to the population often offers little to each participating individual.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Define screening.

A

Identifying seemingly healthy individuals who may be at increased risk of disease.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Give 4 different types of screening

A
  1. Population based.
  2. Opportunistic.
  3. Screening for communicable diseases.
  4. Pre-employment and occupational.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

What is the Wilson and Jungner criteria for screening?

A

Before Screen

  1. The condition being screened for should be an important health problem.
  2. The natural history of the condition should be understood.

Screen

  1. There should be a detectable early stage.

Test

  1. Facilities for diagnosis and treatment need to be available.
  2. There should be a suitable test.
  3. The test should be acceptable to the population.

Treatment

  1. There should be a treatment available.
  2. There should be an agreed policy on whom to treat.
  3. The costs of screening must be balanced against benefits.
  4. Screening should be a continuous process, not just a one off.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Define sensitivity

A

The proportion of people with the disease who are correctly identified (a/a+b).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Define specificity

A

The proportion of people without the disease who are correctly excluded by the screening test; how well a test detects those without a disease (c/c+d)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Define PPV

A

The proportion of people with a positive test result who actually have the disease (a/a+c).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Define NPV

A

The proportion of people with a negative test result who do not have the disease (d/b+d).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

What are the 4 main determinants of health?

A
  1. Lifestyle.
  2. Access to healthcare.
  3. Genes.
  4. Environment.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Define the following:

a) Equity
b) Equality

A

a) Equity - what is fair and just.
b) Equality - equal shares.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Define horizontal equity

A

Equal treatment for equal need

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Define vertical equity

A

Unequal treatment for unequal need e.g. someone with a common cold would need a different treatment to someone with pneumonia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Give 2 factors that can affect equity.

A
  1. Spatial factors - geographical.
  2. Social factors - age, gender, class, ethnicity.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

What are the 3 domains of public health?

A
  1. Health promotion.
  2. Health protection.
  3. Improving health services.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Domains of public health: give examples of health promotion.

A

Health promotion looks at interventions e.g. immunizations, smoking cessation, screening.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Domains of public health: give examples of health protection.

A

Putting measures in place to control infectious diseases.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Domains of public health: what are the aims of health service improvements?

A

To ensure that there is delivery of organised, safe and high quality services.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

What is health psychology?

A

Health psychology emphasizes the role psychological factors in the cause, progression and consequences of health and illness.

It aims to put theory into practice by promoting healthy behaviors and preventing illness.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

Give 3 types of health behaviour.

A
  1. Health behaviour.
  2. Illness behaviour.
  3. Sick role behaviour.
69
Q

Define health behaviour.

A

Health behaviour is aimed at preventing disease e.g. eating healthily.

70
Q

Define illness behaviour.

A

Illness behaviour is aimed at seeking remedy e.g. going to the Dr’s.

71
Q

Define sick role behaviour.

A

Sick role behaviour is activity aimed at getting better e.g. taking medications.

72
Q

What are health damaging behaviours?

A

Health damaging behaviours are often related to mortality e.g. smoking, alcohol, high risk sexual behaviours.

73
Q

What are health promoting behaviours?

A

Behaviours that seek and maintain health e.g. exercise, eating healthily, having vaccines.

74
Q

What is a meta-analysis?

A

A statistical technique where you pool all the results of the available evidence and look at effect.

75
Q

Define compliance.

A

The extent to which a patients behavior coincides with medical advice. It is professionally focused and assumes that the doctor knows best.

76
Q

Give 3 factors that can effect compliance.

A
  1. Side effects of medications.
  2. Patient perception of risk.
  3. If the patient is asymptomatic.
  4. Socioeconomic status.
77
Q

Give 3 examples of population level interventions.

A
  1. PH campaigns e.g. Change4Life, Movember.
  2. Screening e.g. cervical smear.
  3. Immunisations e.g. MMR.
78
Q

What is unrealistic optimism?

A

Unrealistic optimism is when individuals continue to practice health damaging behaviour due to inaccurate perceptions of risk and susceptibility.

79
Q

Give 3 factors that contribute to unrealistic optimism e.g. factors that can influence someones perception of risk.

A
  1. Lack of personal experience with a problem.
  2. Belief that it may be preventable by personal action.
  3. Belief that if not happened now, its not likely to.
  4. Belief that the problem is infrequent.
  5. Other reasons: health beliefs, situational rationality, cultural variability, socioeconomic factors, stress, age.
80
Q

Why is it important to understand a patient’s perception of risk?

A

A patient’s perception of risk can impact on medication adherence and keeping appointments etc.

81
Q

Briefly describe the NICE guidance on behaviour change.

A
  1. Plan interventions.
  2. Assess social context.
  3. Educate and train.
  4. Look at individual level and community level interventions.
  5. Evaluate effectiveness and assess cost effectiveness.
82
Q

What is the single greatest cause of illness and premature death in the UK?

A

Smoking.

83
Q

What 3 diseases are smoking related deaths normally due to?

A
  1. Cancers.
  2. COPD.
  3. CHD.
84
Q

When does smoking prevalence peak?

A

In the mid 20’s.

85
Q

What is the role of NCSCT?

A

NCSCT supports the delivery of effective evidence-based tobacco control programmes and smoking cessation interventions provided by local services.

86
Q

What is ‘Health Needs Assessment’?

A

A systematic method for reviewing the health issues facing a population, leading to agreed priorities and resource allocation that will improve health and reduce inequalities.

87
Q

Health Needs Assessment: define need.

A

The ability to benefit from an intervention.

88
Q

Health Needs Assessment: briefly describe the planning cycle.

A

Needs assessment -> planning -> implementation -> evaluation -> needs assessment etc…

89
Q

What is felt need?

A

Individual perceptions of variation from normal health.

90
Q

What is expressed need?

A

When an individual seeks help to overcome variation in normal health.

91
Q

What is normative need?

A

When a professional defines interventions that are appropriate for expressed need.

92
Q

What is comparative need?

A

Comparison between severity, range of interventions and cost.

93
Q

Health needs assessment: define demand.

A

What people ask for.

94
Q

Health needs assessment: define supply.

A

What is provided.

95
Q

Describe the difference between health need and health care need.

A

Health need: need for health.

Health care need: need for health care. It is more specific and looks at someone’s ability to benefit from health care.

96
Q

Name 3 different types of health needs assessment.

A
  1. Epidemiological.
  2. Comparative.
  3. Corporate.
97
Q

Give 3 negative points for epidemiological health needs assessments.

A
  1. Required data may not be available.
  2. Variable data quality.
  3. Ignores felt needs.
98
Q

Briefly describe a comparative health needs assessment.

A

Compares services received by one population with other populations.

99
Q

Give 3 negative points for comparative health needs assessments.

A
  1. Required data may not be available.
  2. Variable data quality.
  3. It is hard to find comparable populations.
100
Q

Who might be involved with corporate health needs assessment?

A
  1. Politicians.
  2. Press.
  3. Providers.
  4. Professionals.
  5. Patients.
101
Q

Give 3 negative points for corporate health needs assessments.

A
  1. Difficult to distinguish need from demand.
  2. Groups may have vested interests.
  3. May be influenced by political agendas.
102
Q

Give one health related example of something that you consider is demanded but not needed or supplied.

A

Cosmetic surgery.

103
Q

Give examples of secondary prevention methods for cardiac failure.

A
  1. Regularly checking BP.
  2. Regularly checking blood cholesterol.
104
Q

Give examples of tertiary prevention methods for cardiac failure.

A
  1. Exercise based cardiac rehabilitation.
  2. Revascularisation procedures e.g. PCI, CABG.
  3. Implantable defibrillators.
105
Q

What is erectile dysfunction?

A

The inability to attain and maintain an erection sufficient for satisfactory sexual performance.

106
Q

Give 3 RF’s for erectile dysfunction.

A
  1. Lifestyle factors e.g. obesity, smoking, alcohol.
  2. Hypercholesterolaemia.
  3. Hypertension.
  4. Diabetes mellitus.
107
Q

Give 5 potential causes of erectile dysfunction.

A
  1. Neuro: brain injury/spinal cord disease.
  2. CV disease: atherosclerosis, HTN.
  3. Psychogenic: psychosexual disorders, depression, anxiety.
  4. Endocrine: thyroid disease.
  5. Medications: beta blockers, diuretics, anti-depressants.
108
Q

ED: What points in a history are suggestive of a psychogenic cause?

A
  1. Sudden onset.
  2. Early collapse.
  3. Problematic relationship.
109
Q

ED: What points in a history are suggestive of an organic cause?

A
  1. Gradual onset.
  2. Normal ejaculation.
  3. Normal libido.
  4. RF’s present.
110
Q

What investigations might you do to determine the cause of someone’s erectile dysfunction?

A
  1. Fasting glucose.
  2. HbA1c.
  3. Lipid profile.
  4. FSH/LH/Prolactin.
111
Q

Briefly describe the management of ED.

A
  1. Treat RF’s.
  2. Refer for counselling.
  3. Phosphodiesterase inhibitors e.g. Tadalafil.
  4. Vacuum devices.
  5. Injections.
  6. Penile prosthesis.
112
Q

Name a phosphodiesterase inhibitor and briefly describe how they work.

A

Tadalafil.

They increase the blood flow to the corpus cavernosum

113
Q

Give 3 potential side effects of phosphodiesterase inhibitors.

A
  1. Headaches.
  2. Flushing.
  3. Indigestion.
  4. Priapism.
  5. Impaired vision.
114
Q

Give 3 potential causes of homelessness.

A

Relationship breakdown due to:

  1. Mental illness.
  2. Domestic abuse.
  3. Dispute with parents.
  4. Bereavement.
115
Q

Give 3 groups of people who are more vulnerable to homelessness.

A
  1. Substance misusers.
  2. Failed asylum seekers.
  3. People who are/have been in care.
  4. Ex-service men and women.
  5. LGBTQ+.
116
Q

What health problems do homeless adults face?

A
  1. Infectious disease inc. TB and hepatitis.
  2. Dental problems.
  3. Respiratory problems.
  4. Injuries following violence/rape.
  5. Sexual health problems.
  6. Serious mental illness - schizophrenia, depression.
  7. Malnutrition.
117
Q

What barriers to care do homeless people face?

A
  1. Difficulty accessing health care.
  2. Lack of integration between primary care services and other agencies.
  3. People may not priorities health when there are other more immediate health problems.
  4. May not know where to find help.
  5. Communication difficulties.
118
Q

Define refugee

A

A person granted asylum and refugee status in the UK. They have the rights of a UK citizen

119
Q

Define asylum seeker.

A

A person applying for refugee status. They are entitled to £35 a week, housing and NHS care.

120
Q

What barriers to care do asylum seekers and refugees face?

A
  1. Language/cultural/communication problems.
  2. Money/other priorities.
  3. Different perceptions of care.
  4. Racism, prejudice, discrimination, stigma.
  5. May not understand how the NHS works.
121
Q

What health problems do refugees and asylum seekers face?

A
  1. Injuries from war/travelling.
  2. No previous health surveillance/immunisations.
  3. Malnutrition.
  4. Injuries from torture and sexual abuse.
  5. Blood borne and infectious disease.
  6. Untreated chronic disease.
  7. PTSD, depression, psychosis.
122
Q

Define social exclusion.

A

The process of being shut out from any of the social, economic, political or cultural systems which determine the social integration of a person in society.

123
Q

Give 3 causes of loneliness.

A
  1. Poor health, sensory impairment.
  2. Poverty.
  3. Housing issues.
  4. Fear of crime.
  5. Lack of transport.
  6. Discrimination.
124
Q

Give 3 signs of loneliness.

A
  1. Talkative, clinging.
  2. Lives alone.
  3. Recent bereavement or transition.
  4. Mobility problems or sensory impairment.
125
Q

Give 3 national initiatives to combat loneliness.

A
  1. Age UK.
  2. Silverline.
  3. Dementia Friends.
126
Q

Give 3 Sheffield initiatives to combat loneliness.

A
  1. Age Better.
  2. Active Sheffield.
  3. Darnall Dementia Care.
127
Q

What is the Health Belief Model (Becker 1974)?

A

Individuals will change if they:

  1. Believe that they are susceptible to the condition in question
  2. Believe that is has serious consequences
  3. Believe that taking action reduces susceptibility
  4. Believe that the benefits of taking action outweigh the costs
128
Q

What are the 4 key aspects to the health belief model?

A
  1. Perceived benefits.
  2. Perceived barriers - most important factor for addressing behaviour change!
  3. Perceived susceptibility.
  4. Perceived severity.
129
Q

‘Cues to action’ are another important aspect of the health belief model. What is meant by this?

A
  1. Internal cues e.g. worsening pain or breathlessness may trigger someone to want to change their behaviour.
  2. External cues e.g. reminder letters or phone calls from GP.
130
Q

Give 3 disadvantages of the health belief model.

A
  1. Health beliefs may be affected by alternative factors e.g. outcome expectancy and self efficacy.
  2. The model does not consider the influence of emotions on behaviour.
  3. Cues to action are often missing in research.
  4. It does not differentiate between first time and repeat behaviours.
131
Q

The Theory of Planned Behaviour proposes that the best predictor of behaviour is intention. What are the 3 predictors of intention?

A
  1. A persons attitudes to behaviour.
  2. Subjective norm: the perceived social pressure to undertake the behaviour.
  3. Perceived behavioural control: a person’s appraisal of their ability to perform the behaviour.
132
Q

Theory of Planned Behaviour: Only 50% of intentions transfer to behaviours. How can we bridge this gap?

A
  1. Perceived control.
  2. Anticipated regret.
  3. Preparatory actions.
  4. Implementation intentions!
  5. Relevance to self.
133
Q

Give 3 disadvantages to the Theory of Planned Behaviour.

A
  1. Lack of temporal element and lack of direction or causality.
  2. The model doesn’t taken into account emotions.
  3. The model doesn’t explain how attitudes, intentions and perceived behavioural control interact.
  4. Relies on self-reported behaviour.
  5. Good for predicting intentions but not as successful for actual behaviours.
134
Q

Describe the transtheoretical model.

A
  1. Pre-contemplation - no intention of stopping smoking.
  2. Contemplation - thinking about giving up.
  3. Preparation - getting ready to quit in near future.
  4. Action - engaged in giving up.
  5. Maintenance - steady no smoker, state of change reached.

Relapse?

135
Q

Give 3 advantages and 3 disadvantages of the transtheoretical model.

A

Advantages:

  1. Acknowledges individual stages.
  2. Accounts for relapse.
  3. Temporal element.

Disadvantages:

  1. Not all people move through every stage.
  2. Change might operate on a continuum, not discreet stages.
  3. Doesn’t take into account habits, culture, social and economic factors.
136
Q

Give 3 external factors that are important when thinking about behaviour change.

A
  1. Impact of personality traits.
  2. Assessment of risk perception.
  3. Impact of past behaviour/habit.
  4. Social environment.
137
Q

NICE guidance suggests that there are certain transition points in a person life where they are more susceptible to behaviour change. Name 3.

A
  1. Leaving school.
  2. Entering workforce.
  3. Becoming a parent.
  4. Becoming unemployed.
  5. Retirement and bereavement.
138
Q

What is safety netting?

A
  1. Verbal and/or written advice about warning signs/symptoms with a plan of action should these be noticed.
  2. Arrange follow-up at a specific time and place.
  3. Liaising with other health care professionals to ensure direct access should the child require it.

Advice needs to be clear and easy to follow.

139
Q

Name 3 groups of people who are less likely to have vaccines.

A
  1. Homeless.
  2. Refugees/asylum seekers.
  3. Children in care.
140
Q

Give 3 factors that contribute to the promotion of excessive energy intake.

A
  1. Genetics.
  2. Employment e.g. shift work.
  3. Advertisements.
  4. Characteristics of food - energy density, macronutrient composition, portion size.
  5. Reduced physical activity.
  6. Sleep.
  7. Psychological factors.
141
Q

Define malnutrition.

A

Deficiencies, excesses or imbalances in a person’s intake of energy and/or nutrients. Malnutrition covers under-nutrition and overweight.

142
Q

If associations are not causal, what might they be due to?

A
  1. Confounding factors.
  2. Chance.
  3. Bias.
  4. Reverse causation.
143
Q

When treating substance misuse, what are the treatment aims?

A
  1. Reduce harm to user, friends and family.
  2. To improve health.
  3. To stabilise lifestyle and reduce illicit drug use.
  4. Crime reduction.
  5. Reduce risk taking behaviour and blood borne virus transmission.
144
Q

Opioid misuse: name a drug that can be used for detoxification.

A
  1. Buprenorphine.
145
Q

Opioid misuse: name 2 drugs used for maintenance/stabilisation.

A
  1. Methadone.
  2. Buprenorphine.

Titrate up from a low starting dose.

146
Q

Describe the mechanism of action of heroin.

A

Acts at opiate receptors. Addictive because it is high reward for minimal effort.

147
Q

Describe the mechanism of action of cocaine.

A

Cocaine blocks re-uptake of mood enhancing neurotransmitters at the synapse leading to feelings of intense pleasure.

148
Q

How could you treat a heroin (opioid) addiction?

A

Provide a substitute e.g. methadone.

149
Q

How could you treat a cocaine addiction?

A

There is no substitute available therefore harm reduction is key e.g. advice on risky behaviour, safe sex, BBV advice, Hep B/C testing.

150
Q

Opioid misuse: how could you prevent relapse?

A
  1. Provide plenty of support.
  2. Naltrexone tablets can prevent relapse.
  3. Stabilise and offer maintenance therapy.
151
Q

When assessing the quality of health services, Maxwell’s classification lists six dimensions. What are they?

A
  1. Effectiveness.
  2. Efficiency.
  3. Equity.
  4. Accessible.
  5. Acceptable.
  6. Appropriate.
152
Q

Although using measures of health outcomes is desirable in evaluation of health services, there are potential limitations. Explain why it may be difficult to attribute a health outcome to the service provided.

A
  1. Other factors may be involved.
  2. There may be a time lag between service and outcome.
  3. Large sample sizes may be needed.
  4. Data may be unavailable or there may be issues with data quality.
153
Q

Give 4 criteria for negligence.

A
  1. Duty of care.
  2. Breach in duty of care.
  3. Patient harmed.
  4. Patient was harmed due to breach in duty of care.
154
Q

What is an NHS never event.

A

A serious, largely preventable patient safety incident that should never happen if the available preventable measures have been implemented e.g. checklists.

155
Q

Give an example of an NHS never event.

A
  1. Patient misidentification.
  2. Misplacement of an NG tube.
156
Q

Clinical errors can be managed using a systems approach and a persons approach. Describe the persons approach.

A

Errors are due to wayward mental processes e.g. negligence, inattention, distraction. Focuses on unsafe acts of staff on the front-line e.g. nurses, doctors.

157
Q

Clinical errors can be managed using a systems approach and a persons approach. Describe the systems approach.

A

Adverse events are the product of many causal factors - a whole system is to blame (swiss cheese). Implementation of standardised working and developing error free processes.

158
Q

What is Donebedian’s evaluation of health care?

A
  1. Structure
  2. Process
  3. Output
  4. Outcomes
159
Q

“Structure, process, outcome” is a useful framework to use when carrying out evaluation of health services. Explain what is meant by “structure”.

A

Structure looks at what there is - buildings, staff, equipment. E.g. no. of ICU beds per 1000 or no. of vascular surgeons per 1000 or no. of locations screening takes place.

160
Q

“Structure, process, outcome” is a useful framework to use when carrying out evaluation of health services. Explain what is meant by “process”.

A

What is done?

E.g. number of patients seen in A&E, number of operations performed, process of going to A&E

161
Q

“Structure, process, outcome” is a useful framework to use when carrying out evaluation of health services. Explain what is meant by “outcome”.

A

Classically classified as mortality, morbidity, quality of life and patient satisfaction

Or by the 5Ds: Death, Disease, Disability, Discomfort, Dissatisfaction

162
Q

What are Lohr (1988) 5D’s of healthcare outcome?

A
  1. Death
  2. Disease
  3. Disability
  4. Dis-satisfaction
  5. Discomfort
163
Q

What are Maxwell’s dimensions of quality??

A
  1. Effectiveness: Does the intervention/service provide the desired effect?
  2. Efficiency: Is the output maximised for a given input
  3. Equity: Are patients being treated fairly?
  4. Acceptability: How acceptable is the service offered to the people needing it
  5. Accessibility: Is the service being provided? E.g. geographical access, cost, waiting times, information available
  6. Appropriateness: Is the right treatment being given to the right people at the right time?
164
Q

What is a QALY?

A

one year at perfect health

165
Q

What two parts comprise a QALY?

A
  1. Number of lives expected to gain
  2. Quality of life of those years
166
Q

What are the different parts of health economics?

A
  1. Opportunity cost
  2. Economic efficiency
  3. Economic equity
  4. Economic evaluation
167
Q

What are the different types of economic evaluation?

What are they measured in?

A
  1. Cost-effectiveness (natural units, cost per life year gained)
  2. Cost-utility (measured in QALYs)
  3. Cost-benefit (measured in monetary units)
  4. Cost-minimisation (Outcomes same in both treatments so just minimise cost)
  5. Incremental analysis
168
Q

What is a DALY?

A

Disability adjusted life years

1 DALY = 1 year lost at complete health

ΩΩ 3a Bateman - Public Health (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions