GP Flashcards
what are the 3 domains of public health
health protection
health improvement
health services
what are the determinants of health (Progress)
Place of residence
Race/ethnicity
Occupation
Gender
Religion
Education
Socio-economic status
Social capital/resources
describe the inverse care law
availability of medical/social care tends to vary inversely with the need of the population served
how does equity differ from equality
horizontal: equal treatment for equal need
vertical: unuequal treatment for unequal need
what is a health needs assessment
systematic approach for reviewing the health issues affecting a population which leads to agreed priorities and resource allocation to improve health and decrease inequalities
what is an epidemiological health needs assessment and what are its limitations
defines problem and size of problem
current services
recommends improvements
X:
data may be poor
may be inadequate evidence base
doesnt consider felt need
what is a comparative health needs assessment and what are its limitations
compares services received by populations
X:
data available may vary in quality
hard to find comparable pops
comparison not perfect
what is a corporate health needs assessment and what are its limitations
takes into account views of interested parties e.g. patients/health pros/media etc
X:
hard to distinguish need from demand
groups have vested interest/bias
dominant individuals have undue influence
describe need vs supply vs demand
need = ability to benefit from an intervention
supply = what is provided
demand = what people ask for
describe the 4 types of need
felt need = individual perception of deviation from. normal health
expressed need = seeking help to overcome variation in normal health
normative need = professional defines intervention for expressed need
comparative need = comparisons between severity/range of intervention/cost
name the 5 areas of maslows hierachy of need
- physiological
- safety
- love/belonging
- esteem
- self-actualisation
describe egalitarian resource allocation
provide all care to is necessary and required to everyone
+ = equal
- = economically restricted
describe maximising resource allocation
based solely on consequence + = resources to those who most likely to benefit from it
- = those with less need receive nothing
describe libertarian resource allocation
each individual responsible for own health
+ = onus on patient = more engaged?
- = not all diseases self-inflicted
what are the 3 As and 3Es of assessing the quality of a service (maxwells dimensions)
access
appropriate
acceptability
equity
efficient
effective
describe donabedians approach to assessing quality of a service
structure
process
outcome
what is health behaviour
aimed at preventing disease
what is illness behaviour
seeking remedy
what is sick role behaviour
activity aimed at getting well
describe the transtheoretical model
- pre-contemplation
- contemplation
- preparation
- action
- maintenance
- relapse
what are the advantages of the transtheoretical model
acknowledges individual stages of readiness
accounts for replace
time element
what are the disadvantages of the transtheoretical model
some individuals skip stages
change may be continuous not discrete
doesnt consider cultural/social factors
describe the theory of planned behaviours
attitudes, subjective norms and perceived behaviour control all contribute to intention which leads to behaviour
describe PPAIR
bridges gap between intention and behaviour
Prep actions
Perceived control
Anticipated regret
Implementation intentions
Relevance to self
describe 3 levels of public health intervention
individual e.g. vaccines
community level e.g. playground
ecological (population) level e.g. clean air act
primary prevention
prevent a disease from occurring
secondary prevention
detection of early disease in order to alter the course of the disease and maximise chance of recovery
tertiary prevention
trying to slow down progression of a disease
what are the advantages and disadvantages of theory of planned behaviours
+
can apply to wide variety behaviours
useful predicting intention
takes importance of social pressures into account
- no temporal element, direction, causality
doesn’t consider emotions
describe the health belief model
key factors that influence health beliefs and therefore health behaviours:
perceived susceptibility
perceived severity
health motivation
perceived benefits
perceived barriers
demographic variables + psychological characteristics also contribute
THESE all contribute to likelihood of action
what are the advantages and disadvantages of the health belief model
+
applied to wide variety
cues to action are unique component
longest standing model
- other factors may influence outcome
doesnt consider emotions
doesnt differentiate between first time/repeated behaviours
what aspects help people act on their intentions
perceived control
anticipated regret
prep actions
implementation intentions
relevance to self
describe some transition points examples
leaving school
entering workforce
becoming a parent
becoming unemployed
retirement
bereavement
describe the eGFR levels for levels of CKD
G1 >90
G2 60-90
G3a 45-59
G3b 30-44
G4 15-29
G5 <15
what does UK law say about patients rights about DNACPR
patients are not allowed to demand CPR if doctors feel it would be futile
however seek 2nd opinion if this is the case
whos decision is DNACPR
it is ultimately a medical one
must consult patient and family
if urgent/cant consult F/F = work in best interests
what is illegal in the UK with regards to end of life prescribing and what is the ‘double effect’
it is illegal to prescribe drugs to deliberately shorten life
HOWEVER some drugs used for symptom relief may shorten life (double effect)
what is a DoLS
deprivation of liberty safeguards
procedure in law when its necessary to deprive someone of their liberty if they lack capacity to consent
what are the 6 geriatric giants
iatrogenic
instability
immobility
impairment of cognition
inanition
incontinence
