GP

Question 1

what are the 3 domains of public health

Answer 1

health protection
health improvement
health services

Question 2

what are the determinants of health (Progress)

Answer 2

Place of residence
Race/ethnicity
Occupation
Gender
Religion
Education
Socio-economic status
Social capital/resources

Question 3

describe the inverse care law

Answer 3

availability of medical/social care tends to vary inversely with the need of the population served

Question 4

how does equity differ from equality

Answer 4

horizontal: equal treatment for equal need
vertical: unuequal treatment for unequal need

Question 5

what is a health needs assessment

Answer 5

systematic approach for reviewing the health issues affecting a population which leads to agreed priorities and resource allocation to improve health and decrease inequalities

Question 6

what is an epidemiological health needs assessment and what are its limitations

Answer 6

defines problem and size of problem
current services
recommends improvements

X:
data may be poor
may be inadequate evidence base
doesnt consider felt need

Question 7

what is a comparative health needs assessment and what are its limitations

Answer 7

compares services received by populations
X:
data available may vary in quality
hard to find comparable pops
comparison not perfect

Question 8

what is a corporate health needs assessment and what are its limitations

Answer 8

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

Question 9

describe need vs supply vs demand

Answer 9

need = ability to benefit from an intervention
supply = what is provided
demand = what people ask for

Question 10

describe the 4 types of need

Answer 10

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

Question 11

name the 5 areas of maslows hierachy of need

Answer 11

1. physiological
2. safety
3. love/belonging
4. esteem
5. self-actualisation

Question 12

describe egalitarian resource allocation

Answer 12

provide all care to is necessary and required to everyone
+ = equal
- = economically restricted

Question 13

describe maximising resource allocation

Answer 13

based solely on consequence + = resources to those who most likely to benefit from it
- = those with less need receive nothing

Question 14

describe libertarian resource allocation

Answer 14

each individual responsible for own health
+ = onus on patient = more engaged?
- = not all diseases self-inflicted

Question 15

what are the 3 As and 3Es of assessing the quality of a service (maxwells dimensions)

Answer 15

access
appropriate
acceptability
equity
efficient
effective

Question 16

describe donabedians approach to assessing quality of a service

Answer 16

structure
process
outcome

Question 17

what is health behaviour

Answer 17

aimed at preventing disease

Question 18

what is illness behaviour

Answer 18

seeking remedy

Question 19

what is sick role behaviour

Answer 19

activity aimed at getting well

Question 20

describe the transtheoretical model

Answer 20

1. pre-contemplation
2. contemplation
3. preparation
4. action
5. maintenance
6. relapse

Question 21

what are the advantages of the transtheoretical model

Answer 21

acknowledges individual stages of readiness
accounts for replace
time element

Question 22

what are the disadvantages of the transtheoretical model

Answer 22

some individuals skip stages
change may be continuous not discrete
doesnt consider cultural/social factors

Question 23

describe the theory of planned behaviours

Answer 23

attitudes, subjective norms and perceived behaviour control all contribute to intention which leads to behaviour

Question 24

describe PPAIR

Answer 24

bridges gap between intention and behaviour
Prep actions
Perceived control
Anticipated regret
Implementation intentions
Relevance to self

Question 25

describe 3 levels of public health intervention

Answer 25

individual e.g. vaccines
community level e.g. playground
ecological (population) level e.g. clean air act

Question 26

primary prevention

Answer 26

prevent a disease from occurring

Question 27

secondary prevention

Answer 27

detection of early disease in order to alter the course of the disease and maximise chance of recovery

Question 28

tertiary prevention

Answer 28

trying to slow down progression of a disease

Question 29

what are the advantages and disadvantages of theory of planned behaviours

Answer 29

+
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

Question 30

describe the health belief model

Answer 30

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

Question 31

what are the advantages and disadvantages of the health belief model

Answer 31

+
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

Question 32

what aspects help people act on their intentions

Answer 32

perceived control
anticipated regret
prep actions
implementation intentions
relevance to self

Question 33

describe some transition points examples

Answer 33

leaving school
entering workforce
becoming a parent
becoming unemployed
retirement
bereavement

Question 34

describe the eGFR levels for levels of CKD

Answer 34

G1 >90
G2 60-90
G3a 45-59
G3b 30-44
G4 15-29
G5 <15

Question 35

what does UK law say about patients rights about DNACPR

Answer 35

patients are not allowed to demand CPR if doctors feel it would be futile
however seek 2nd opinion if this is the case

Question 36

whos decision is DNACPR

Answer 36

it is ultimately a medical one
must consult patient and family
if urgent/cant consult F/F = work in best interests

Question 37

what is illegal in the UK with regards to end of life prescribing and what is the ‘double effect’

Answer 37

it is illegal to prescribe drugs to deliberately shorten life
HOWEVER some drugs used for symptom relief may shorten life (double effect)

Question 38

what is a DoLS

Answer 38

deprivation of liberty safeguards
procedure in law when its necessary to deprive someone of their liberty if they lack capacity to consent

Question 39

what are the 6 geriatric giants

Answer 39

iatrogenic
instability
immobility
impairment of cognition
inanition
incontinence