Health Full Flashcards
what is health according to the Anglo Saxons?
‘wholeness of body’
what are the 3 domains of health?
- Biological/Physical
- Psyhchological
- Social
describe the Biological/Physical domain of health
- having a ‘sound and disease free body’
- restore health by treating the ailing body
what are the limitations of the biological/physical domain of health?
- reductionist(only physical terms)
- only deals with illness instead of promoting health
- separates the mind and body
what is Cartesian Dualism
the idea that the mind and body are separate
describe the Psychological domain of health
- ‘general feeling of psychological wellbeing’
- cognition=ability to think clearly, reason and problem solve
- emotion=ability to think positively and maintain self-esteem
describe the Social domain of health
- ‘good level of social functioning’
- maintain strong social networks, maintain relationship and interpersonal skills
- factors include: socio-economic status, culture, education, ethnicity, gender
describe the Bio-Psycho-Social model of health
Biological, psychological and social domains of health interact with each other
what is the WHO definition of health?
‘a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity’
what is a strength of the WHO definition of health?
acknowledges psychosocial factrs are important for health
what is a limitation of the WHO definition of health?
not everyone can be in a state of complete wellbeing for long periods of time
describe the Wellness Continuum of health
- most people are neither sick or healthy, they’re in-between
- acknowledges that a person’s health can improve or deteriorate
prehistoric period (10, 000 BC) description of health
- ill health caused by supernatural/magicio-religious reasons (invasion by evil spirits and sorcery)
- treatments:exorcism, use of portions/torture, trephination (drilling a hole in the skull to release evil spirits)
ancient Greeks concept of health
- rejected supernatural causes of disease
- identified role of bodily function in diseases
- humoral theory=diseases was caused by imbalance of bodily fluids
Greek god of health and medicine
- AESCULAPIUS
- carries a staff with twisted serpent representing rejuvenation/healing
AESCULAPIUS’ daughters that represent aspects of medicine
- Hygeia=Hygiene
- Panacea=universal remedy
- Iaso=recuperation
- Aglaea=healthy glow
- Aceso=healing
what is caused by an imbalance of phelgm? according to the Greeks
- PHLEGMATIC person (detached)=cold/headaches
- treatment=hot bath, warm food
what is caused by an imbalance of blood? according to the Greeks
- SANGUINE person (impulsive)=angina/epilepsy
- treatment=blood letting
what is caused by an imbalance of yellow bile? according to the Greeks
- CHOLERIC person (irritable)=jaundice
- treatment=blood letting/liquid diet
what is caused by an imbalance of black bile? according to the Greeks
- MELANCHOLIC person (serious)=hepatitis, ulcers
- treatment=hot bath
Middle ages definition of health
- punishment by God for misdeeds
- treatments=exorcism and prayer
- scientific scrutiny was prohibited
what was the definition of health during the Renaissance?
- mind/body dualism (Cartesian Dualism)
- physicians=guard body
- theologists=guard mind
- scientific enquiry re-emerges
what was the definition of health in the post renaissance?
- development of microscopy
- blood cells and muscle structure investigated
define health in the 19th century
- X-RAYS=see bodily organs
- cellular theory=disease is caused by damaged cells
- germ theory=identifying germs that cause diseases
- development of biological treatments
define health in the 20th century (biomedical model)
- separation of mind and body
- disease is caused by infected cells/hormone imbalance
- views people as biological machines
- treatment=fix the machine
success of the biomedical model
- major killers were communicable
- treatments=discovery of penicillin, vaccinations, better hygiene, nutrition and public health
how does the Bio-Psycho-Social model link to definition of health in the 20th century?
- 3 major killers= heart disease, cancer, vascular disease
- proven to directly link with psycho-social factors (smoking, stress, diet and exercise)
who uses health services and why?
- children (developing immune systems)
- elderly people (failing immune systems)
- women (pregnancy and childbirth)
- men (most likely to ignore symptoms)
how does attention affect the recognition of health?
- INTERNALLY FOCUSED people=focus on themselves so more likely to notice & report illness
- EXTERNALLY FOCUSED people=focus on environment so may not report illnesses
what are Sensitizers/monitors?
people who seek out information about their lillness
what are repressors/blunters?
people who avoid symptoms of bad health and health related information
what types of delay cause misuse of health services? (4 points)
- APPRAISAL delay
- ILLNESS delay
- UTILISATION delay
- SCHEDULING delay
what is APPRAISAL delay?
the time for individuals to decide they are ill
what is ILLNESS delay?
the time between recognising symptoms as illness and deciding to seek treatment
what is UTILISATION delay?
time between deciding to seek advice and actually seeking it
what is SCHEDULING delay?
time between making appointment and receiving treatment
what is a malingering?
- believing you are ill and remaining ill for secondary rewards
- form of overusing the health service
what are the reasons for malingering?
- emotional rewards:increased attention
- practical rewards:access to controlled medication/free from responsibility/financial gain
what emotional problems cause overusing of the heath service?
stress can cause high BP which is often mistaken for an illness
what factors help us to visit a practitioner?
- persistence of symptoms
- critical incident (sudden change in symptoms)
- treatment expectations (believing that the GP can make a difference
two types of consultations
- doctor centered
- patient centered
doctor centered consultation
- doctor is dominant->doctor makes decisions->patient is passive
- used in serious/terminal illnesses
- maximizes chances of being correct
patient centered consultation
- patient is active->joint decision between doctor and patient->doctor actively listens
- used in less serious illnesses
what factors can influence the success of a consultation?
-physical=appearance of the doctor, eye contact, tone of voice, gestures, gender, age
situational= items in the office, how busy the doctor appears to be
factors that affect making a successful diagnosis
- primacy effect-.importance placed on what physician heard first
- knowledge of the patient-frequency could mean a known malingerer
- self-report-absence of obvious signs, physician must rely on what patient said
effect of computers in health diagnosis
people may not seek medical advice for embarrassing symptoms
what is compliance?
- how well patient’s behaviour matches treatment plan set up BY DOCTOR
- DOCTOR CENTRED and patient is passive
what is adherence?
- how well the patient’s behaviour matches the treatment plan they AGREE with the doctor
- PATIENT CENTRED (joint effort)
what is concordance?
-RECIPROCAL ALLIANCE between patient and doctor
what affects medical non-adherence?
-severity of illness (60%of terminally ill patients don’t take medication due to fatalistic beliefs OR mild illnesses)
what are medical non-adherence behaviours?
- not taking pills
- skipping doses
- altering the medical plan
- not adhering to eating, drinking/resting guidelines
methods of measuring non-adherence? (6 points)
- self report (ask the patient)
- therapeutic outcome (patient getting better)
- doctor estimates their health
- pill and bottle counts
- electronic methods (data recorded in pill bottles)
- biochemical tests
limitation of self-report techniques to measure non-adherence
patients may not be truthful
limitation of ‘therapeutic outcome’ to measure non-adherence
even non-adherers get better