GP and PPS Flashcards
What is the Libertarian approach?
each is responsible for their own health, well being and fulfilment of life plan
What is the Bolam test and how does it relate to consent?
The Bolam test, which asks whether a doctor’s conduct would be supported by a responsible body of medical opinion, no longer applies to the issue of consent following the case of Montgomery vs. Lanarkshire health board 2015. The law now requires a doctor to take “reasonable care to ensure that the patient is aware of any material risks involved in any recommended treatment, and of any reasonable alternative or variant treatments.”
So doctors must now ask themselves three questions:
•Does the patient know about the material risks of the treatment I am proposing?
•Does the patient know about reasonable alternatives to this treatment?
•Have I taken reasonable care to ensure that the patient actually knows this?
what is Ethnocentrism?
The tendency to evaluate other groups according to the values and standards of one’s own cultural group, especially with the conviction that one’s own cultural group is superior to the other groups.
What is the theory of Epigenetics?
The expression of the genome depends on the environment.
No individual ever has the same experience as another
We are utterly unique and need to be regarded as such
Genetic PREDISPOSITION is key
What is the theory of Allostasis and Allostatic load?
Allostasis means:
Stability through Change
Our physiological systems have adapted to react rapidly to environmental stressors,
and are programmed to be turned on and off efficiently, but not too frequently.
The body can ‘rise to a challenge’
Allostatic load is the price we pay for allostasis
Long-term overtaxation of our physiological systems leads to impaired health
THE PATHOPHYSIOLOGY OF STRESS
Example:
Cardiovascular System
Allostasis - works to maintain our erect posture, and enable physical exertion
Allostatic load - Over-activation leads to hypertension, stroke MI
What is Salutogenesis?
A new word which means…
Favourable physiological changes
secondary to experiences
which promote healing and health
What is Domestic Abuse?
Any incident or pattern of incidents of controlling, coercive, threatening behaviour, violence or abuse between those aged 16 or over who are, or have been, intimate partners or family members regardless of gender or sexuality. The abuse can encompass, but is not limited to: psychological physical sexual financial emotional
How does Domestic Abuse impact upon health?
traumatic injuries following an assault:
e.g. fractures, miscarriage, facial injuries, puncture wounds, bruises and haemorrhages
somatic problems or chronic illness consequent on living with abuse:
e.g. headaches, gastrointestinal disorders, chronic pain, low birth weight, premature delivery
psychological or psychosocial problems secondary to the abuse:
e.g. PTSD, attempted suicide, substance misuse, depression, anxiety, eating disorders
What is the difference between equity and equality?
Equity is about what is fair and just
Equality is concerned with equal shares
What are the 3 domains of public health practice?
Health improvement:
Concerned with societal interventions (not primarily delivered through health services) aimed at preventing disease, promoting health, and reducing inequalities
Inequalities Education Housing Employment Lifestyles Family/community
Health protection:
Concerned with measures to control infectious disease risks and environmental hazards
Infectious diseases Chemicals and poisons Radiation Emergency response Environmental health hazards
Improving services (Health care): Concerned with the organisation and delivery of safe, high quality services for prevention, treatment, and care
Clinical effectiveness Efficiency Service planning Audit and evaluation Clinical governance Equity
Explain the difference between primary, secondary and tertiary
prevention.
Primary prevention:
Primary prevention targets individuals who may be at risk to develop a medical condition and intervenes to prevent the onset of that condition.
Examples include childhood vaccination programs, water fluoridation, anti-smoking programs, and education about safe sex
Secondary prevention:
Secondary prevention targets individuals who have developed an asymptomatic disease and institutes treatment to prevent complications.
Examples include routine Papanicolaou tests (pap test for cervical screening) and screening for hypertension, diabetes mellitus, or hyperlipidemia.
Tertiary prevention:
Tertiary prevention targets individuals with a known disease, with the goal of limiting or preventing future complications. Examples include screening patients with diabetes for microalbuminuria, rigorous treatment of diabetes mellitus, and post-myocardial infarction prophylaxis with b-blockers and aspirin.
Explain the difference between horizontal and vertical equity in relation to health care.
Horizontal equity:
Equal treatment for equal need
e.g. Individuals with pneumonia (with all other things being equal) should be treated equally
Vertical equity:
Unequal treatment for unequal need
e.g. Individuals with common cold vs pneumonia need unequal treatment
e.g. Areas with poorer health may need higher expenditure on health services
Explain the difference between public health interventions delivered at the population (ecological) and individual levels, using one example for each to illustrate your answer.
population intervention aimed at improving the health of an entire population. examples include public smoking bans, minimum unit pricing, change 4 life campaigns
individual intervention aims at improving the health of an individual. examples include, smoking cessation support, weight loss classes,
What are the types of health behaviour?
Health Behaviour: a behaviour aimed to prevent disease (e.g. eating healthily)
Illness Behaviour: a behaviour aimed to seek
remedy (e.g. going to the doctor)
Sick role Behaviour: any activity aimed at
getting well (e.g. taking prescribed
medications; resting)
Explain what is meant by the comparative approach
to health needs assessment.
Compares the services received by a
population (or subgroup) with others
Spatial
Social (age, gender, class, ethnicity)
May examine: Health status Service provision Service utilisation Health outcomes (mortality, morbidity, quality of life, patient satisfaction)
Problems with this approach:
May not yield what the most appropriate level
e.g. of provision or utilisation should be
Data may not be available
Data may be of variable quality
May be difficult to find a comparable
population
Give three potential limitations of the epidemiological
approach to health needs assessment.
Data may not be available
Data may be innaccurate or of variable quality
Evidence base may be inadequate
Does not consider felt needs of people affected
Give one health related example of something that
you consider is demanded but not needed or
supplied, clearly explaining the reasoning for your
example.
Cosmetic surgery. This is demanded by some people but it is not strictly needed for health reasons or supplied on the NHS.
Explain what is meant by the epidemiological approach
to health needs assessment.
Define problem Size of problem incidence / prevalence Services available prevention / treatment / care Evidence base effectiveness and cost-effectiveness Models of care including quality and outcome measures Existing services unmet need; services not needed Recommendations
Problems with this approach: Required data may not be available Variable data quality Evidence base may be inadequate Does not consider felt needs of people affected
Explain what is meant by the corporate approach
to health needs assessment.
Various groups e.g. commisioners, providers, proffessionals, patients, press, politicians, opinion leaders all influence what the health needs are.
problems with this approach: May be difficult to distinguish need from demand Groups may have vested interests May be influenced by political agendas Dominant personalities may have undue influence
What is Maslow’s Hierarchy of Needs?
from base to top:
Phsiological needs (breathing,sleep, food, water, sex etc…)
Safety (security, employment, family safety etc…)
Love/belonging (friendship, family, partner)
Esteem (self esteem, confidence, achievement, respect etc…)
Self actualisation (morality, creativity, spontaneity etc…)
you cant progress to the next level without fulfilling the needs in the levels below
What is the difference between an asylum seeker, a refugee and humanitarian protection?
An asylum seeker is someone who is temporarily resident in the UK whilst a decision is made by the home office upon whether they can remain in the country or not.
a refugee has been granted asylum and allowed to stay due to fear of harm/death upon returning to home country.
Humanitarian Protection: Failed to demonstrate claim for asylum but face serious threat to life if returned. Usually 3years then reapply
What does refugee status grant an individual?
Indefinite leave to remain (ILR) :when a person is granted full refugee status and Given permanent residence in the UK.
They have all the rights of a UK citizen.
They are eligible for family reunion- one spouse, and any child of that marriage under the age of 18
What rights does an asylum seeker have?
Are entitled to money- currently £35 pounds per week
Are entitled to housing- no choice dispersal
Are entitled to NHS care
If under 18, have the services of a social services key worker and can go to school
Are NOT allowed to work
and are not entitled to any other form of
benefit.
FAILED Asylum Seekers
Are NOT entitled to any money
Are NOT housed
Are NOT entitled to full NHS care
What is social exclusion?
the dynamic process of being shut out, fully or partially, from any of the social, economic, political or cultural systems which determine the social integration of a person in society.”
5 Domains: Material Resources, Civic Activities, Basic Services Neighbourhood, Social Relationships
Name 4 causes of social exclusion?
Poor Health, Sensory Impairment,
Poverty, housing issues, fear of crime
Transport, problems on the roads,
Discrimination (Internalised), sexuality, gender, ethnicity, belief.
Services: insufficient range. Fragmentation.
Lack of imagination. Bureaucracy
Poor coordination, Lack of information,
Fragility of networks
Name the local and national initiatives to reduce social exclusion
Sheffield: Age Better- £6m Lottery Funding Age UK 50+ Club (IT etc) Active Sheffield Darnall Dementia Care Dementia Cafes
National: Age UK Silverline Dementia Friends Men in Sheds U3A
Housing: Intergenerational - Housing/Activities Co-Housing Flexible Care Planning for Older People
Self Help (books): A Compass for Old Age Mindful Ageing ‘Sod 70’ ‘Retirement with Attitude’
What is the health belief model?
Individuals will change if they:
Believe they are susceptible to the condition in question (e.g. heart disease)
Believe that it has serious consequences
Believe that taking action reduces susceptibility
Believe that the benefits of taking action outweigh the costs
What is the theory of planned behaviour?
Proposes the best predictor of behaviour is ‘intention’ e.g. I intend to give up smoking
Intention determined by:
A persons attitude to the behaviour
The perceived social pressure to undertake the behaviour, or subjective norm
A persons appraisal of their ability to perform the behaviour, or their perceived behavioural control
Example with regard to smoking:
Attitude – I do not think smoking is a good thing
Subjective Norm – most people who are important to me want me to give up smoking
Perceived Behavioural Control – I believe I have the ability to give up smoking
Behavioural Intention – I intend to give up smoking
