Health Promotion Flashcards
What is meant by health promotion?
Health promotion is the process of enabling people to increase control over, and to improve, their health
State some situations in which there may be opportunity for health promotion
- Appointment with healthcare professional e.g. check-up, medication/chronic illness review, pre-natal and post-natal appointments, childhood vaccinations etc…
- Following major health event- may involve them or their family e.g. MI
- When a pt approaches you saying they want to quit
- When a pt approaches you with an alternative problem that might improve with helath promotion
What is MECC (making every contact count)?
Fundamental idea of MECC is that staff across healthcare local authority and voluntary sectors have thousands of contacts every day with individuals and are ideally places to promote behaviour change, health and healthy lifestyles.
Describe the transtheoretical (Stages of Change) model
The transtheoretical model posits that health behavior change involves progress through six stages of change: precontemplation, contemplation, preparation, action, maintenance, and termination
What is the behaviour change wheel?
Behaviour change wheel is a model to help us understand behaviour changes at individual, community and population level. It is used by clinicians to identify and address barriers to behaviour change with individual patients aswell as being used to help develop public healh interventions. It is centred around the COM-B model
What is the current government UK reccomended ‘low risk’ level of alcohol consumption (2021)
- No more than 14 units per week
- Spread your drinking over 3 or more days if you regularly drink as much as 14 units per week
- If you want to cut down, try several drink free days each week
Describe how to calculate how many units is in an alcoholic drink
[ABV x volume (ml)] / 1000 = units
State the number of units in some popular drinks
**IGNORE goverment advice bit on photo- same for men and women (14 units spread over 3 or more days)
Why is the term ‘low risk’ used as opppose to ‘safe’ alcohol consumption?
No ‘completely safe’ level of alcohol and the effects of alcohol can be dependent on individual. Hence, use term low risk to signify that there is always a risk with alcohol consumption.
State some potential dangers of alcohol consumption (just asking about high alcohol consumption in general- not binge drinking)
- Increased risk of cancer e.g. mouth, breast, oesophagus, liver
- Pancreatitis
- Liver disease
- Hypertension
- Stroke
- Dementia
- Depression
- Erectile dysfunction
- Infertility
- Social implications e.g. unwise decisions, financial problems, domestic abuse, umemployment etc…
State some potential dangers of binge drinking
- Accidental injuries e.g, burns, falls
- Alcohol poisoning
- Memory loss and low mood
- Atrial fibrillation (GP mentioned)
Define binge drinking
In the UK, binge drinking is drinking more than:
- 8 units of alcohol in a single session for men
- 6 units of alcohol in a single session for women
What advice, regarding alcohol, should be given to pregnant women?
- If you are pregnant or think you could become pregnant the safest approach is to not drink alcohol at all
- Drinking in pregnancy can lead to long-term harm to baby; with the more you drink, the greater the risk. Risk incude:
- FASD (fetal alcohol spectrum disorders) range of lifelong conditions due to alcohol consumption in pregnancy
- FAS (fetal alcohol syndrome) is a serious condition in which children have restricted growth, facial abnormalities, learning & behavioural difficulties
Discuss potential issues of alcohol consumption in the elderly and those on medications
- Elderly are more at risk from alcohol because firstly they are more likely to be on medication and secondly because as we age our liver function decreases so we break down alcohol less efficiently and are more sensitive to it’s toxic effects.
Discuss how alcohol can interfere with medications and vice versa
Give some examples of medications affected by alcohol
Alcohol could:
- Increase effects of medication
- Make your liver work harder to metabolise both drugs
- Make exisiting condition, for which you take medication for, worse
- Mask signs of other conditions you take medication for
Examples:
- Sedatives: combining increases effects of both
- Pain killers (paracetamol): liver has to work harder as both broken down by liver
- Pain killers (anti-inflam): irritate stomach
- Pain killers (opiods): combining increases effects of both
- Antidepressants: alcohol can make symptoms worse & make more drowsy than medication already makes you
- Anticoagulants: binge drinking increases riks of bleeding/major bleed
- Antihyperglycaemics: alcohol can mask signs of hypoglycaemia
- Anticonvulsants: combining can make very drowsy
- Antihypertensives: alcohol long term can increase BP
Discuss the difference between:
- Harmful/high risk alcohol use
- Dependence
- Harmful/high risk: pattern of alcohol consumption causing health problems directly related to alcohol. Could include psychological problems (e.g. depression), alcohol related accidents or physical illness (e.g. acute pancreatitis).
- Alcohol dependence: characterised by craving, tolerance, a preoccupation with alcohol and continued drinking in spite of harmful consequences (e.g. liver disease or depression caused by drinking). Dependence exists on a continuum of severity; helpful, from clinical prespective, to divide into mild, moderate and severe.
What questionnaire/screening tool can be used as quick simple screening tool to check for signs of possible alcohol dependency
CAGE questionnaire:
If someone scores >2 on CAGE questionnaire this should prompt further action; this may involve use of further questionnaires. State two other questionnaires that might be used and what/why they are used
- AUDIT - alcohol use disorders identification test (more detailed questionnaire to assess for high risk alcohol use)
- SADQ- severity of alcohold dependence questionnaire (assesses severity of alcohol dependence)
Discuss the difference between:
- Abstinence
- Moderation
- Risk reduction
… in regards to alcohol consumption
- Abstinence: not consuming any alcohol
- Moderation: does consume alcohol, but not to excess
- Risk reduction: trying to reduce the risk to their health (for some, this might mean cutting down drinking but their drinking is still more than moderation, but it is less than what is previously was)
When would you consider referral to specialist services for psychological intervention for alcohol use?
Offer to harmful/high risk drinkers and people with mild alcohol dependence offer psychological intervention (e.g. CBT, behavioural therapies etc…) focusing specifically on alcohol-related cognitions, behavioural problems and social networks.
If the indiviudal has a regular partner who is willing to participate in treatment, offer behavioural couples therapy (focuses on alcohol related problems and their impact on relationships).
*NOTE: most of psychological interventions ~12 weeks
When would you consider referral to specialist community services for assisted alcohol withdrawal?
If person typically drinks over 15 units of alcohol per day and/or they score 20 or more on the AUDIT questionnaire, consider offering:
- An assessment for and delivery of a community based assisted withdrawal
- Assessment and management in specialise alcohol services if there are safety concerns about a community based assisted withdrawal
Programme intensity can vary dependent on severity of dependence. Community based programmes should include drug regimes, pyschological support +/- fmaily support etc…
One of risk of excess alcohol consumption is Wernicke’s encephalopathy and Korsakoff syndrome; describe the two
Both result from thiamine deficiency.
-
Wernicke’s encephalopathy:
- Triad: confusion, occulumotor disturbances (e.g. nystagmus), ataxia
- Reversible
-
Korsakoff’s syndrome:
- Memory impairment
- Behavioural changes
What are the benefits of stopping smoking?
- Decrease risk of certain smoking-related diseases e.g. lung cancer, COPD, cardiovascular disease
- Increased life expectancy
- Benefits to children (if have them) as not passive smoking
- Less likely for children to smoke if you don’t smoke
What withdrawal symptoms might be expected when someone stops smoking?
Pt may experience physical and mental changes when they stop smoking- usually temporary.
*Weight gain is usually a concern for people who want to stop smoking. It is often progressive over a number of years. However, the small amount of weight gain presents as a minor health risk compared with the risk of continued smoking
What support/options are available to a person who wants to stop smoking?
- Local NHS stop smoking services, they offer:
- Behavioural support
- Advice about stopping smoking treatments e.g. nicotine patches, varenicline, buproprion, e-cigarettes etc..
- Can supply/arrange prescription or give voucher for stop smokign medicines
- Offer practical advice
- Drug treatment to redcues withdrawal symptoms
- *Varenicline: parital nicotine receptor agonist*
- *buproprion: selective dopamine & serotonin reuptake inhibitor*
Summarise the NHS reccomendations for a healthy diet
To have a healthy, balanced diet should try to:
- Eat at least 5 portions of a variety of fruit and vegetables each day
- Base meals on higher fibre, starchy foods like potatoes, rice, bread, pasta
- Have some dairy or dairy alternatives
- Eat some protein: beans, pulses, fish, eggs, meat
- Choose unsaturated oils ans spreads and eat them in small amounts
- Drink plenty of fluids (6-8 glasses of water per day)
Describe the eat well plate, include:
- What it’s purpose is
- What proportions of each food group you should eat
To try and help people understand what is meant by a healthy balanced diet. Roughly:
- 1/3 fruit & veg
- 1/3 starchy foods
- 1/3 split between dairy, protein and fatty/sugary foods
How do you calculate BMI?
Remind yourself of the interpretation of different BMI scores
Discuss the importance of fat distribution (reflected in waist circumference)
Carrying too much fat around the waist is associated with conditions such as:
- Heart disease
- T2DM
- Cancer
- Stroke
If waist greater than _____ you should try to lose weight:
- Men: >94cm/37inches
- Women: >80cm/31.5 inches
What is meant by substance misuse/abuse?
