Health Promotion (Alcoholic liver disease) Flashcards
What are the main symptoms of alcohol liver disease ?
Often vague symptoms, include: Nausea Weight loss Jaundice Oedema Ascites Confusion Heamaturia/hematemesis
What are the main stages of alcohol liver disease ?
1) Steatosis (build up of fat in liver, reversible with abstinence)
2) Alcoholic hepatitis (unrelated to infective hepatitis, can be reversed if mild)
3) Liver cirrhosis (significant scarring, generally irreversible)
Describe the epidemiology of chronic liver disease in Scotland.
TIME- Chronic liver disease mortality generally decreased over past few years, although increase from 2015 to 2016
PERSON- Chronic liver disease mortality more male than female, highest in 55-64 age range
PLACE- Highest in most deprived groups/areas
Identify barriers to reducing alcoholic liver disease in Scotland.
Agriculture and food production Education Work Unemployment Water and sanitation Healthcare services Housing
Identify social determinants of health.
1) ECONOMIC
– Alcohol related industries employ approx 155,000 people in Scotland, with 10,000 of these employed directly in alcohol production (remainder in secondary alcohol enterprises)
– Alcohol taxes account of 7% of all customs and excise revenue
2) CULTURAL/BEHAVIOUR
– 2/3 of respondents agreed that drinking is a major part of the Scottish way of life
– Perceived social stigma to not drinking
3) POLITICAL
– Political parties and politicians want to be in office, for which they need to be voted in
– Economic factors + Cultural factors= Political Barriers
4) ORGANISATIONAL • Different organisations different aims and objectives, e.g. -Scottish Government -UK Government -Retailers -NHS -Police
Define health promotion and the main elements of this health promotion.
This charter defines health promotion as “the process of enabling people to increase control over, and to improve, their health”. (Ottawa Charter)
This has 3 important elements:
– A focus on tackling the determinants of health
– Working in partnership with a range of agencies and sectors
– Adopting a strategic approach using a range of complementary actions to promote the health of the population
Identify the main elements of the Ottawa Charter for Health Promotion.
- Develop Personal Skills
- Strengthen Community Action
- Reorient Health Services
- Build Health Public Policy
- Create Supportive Environments
Explain the Tannahill’s Model of Health Promotion.
“Tannahill (in Downie et al. 1996) developed a model of health promotion where health promotion comprises three overlapping spheres of activity”:
1) Prevention
2) Health Education
3) Health Protection
These overlap with each other. All in all, this model comprises:
1) Preventive services (e.g immunization, cervical screening, hypertension case finding, developmental surveillance, use of nicotine chewing gum to aid smoking cessation) JUST PREVENTION
2) Preventive health education (e.g. smoking cessation advice and information) MIX OF PREVENTION AND HEALTH EDUCATION
3) Preventive health protection (e.g. fluoridation of water) MIX OF PREVENTION AND HEALTH PROTECTION
4) Health education for preventive health protection (e.g. lobbying for seat belt legislation) MIX OF ALL THREE
5) Positive health education (e.g. life skills with young people) JUST HEALTH EDUCATION
6) Positive health protection (e.g. workplace smoking policy) JUST HEALTH PROTECTION
7) Health education aimed at positive health protection (e.g. pushing for a ban on tobacco advertising) MIX OF HEALTH EDUCATION AND HEALTH PROTECTION
Identify the main approaches to prevention in health promotion.
– Population approach
• aim is to lower the average level of risk
factor in the population
– High-risk approach
• people at particularly high risk are identified through screening, and offered appropriate advice and treatment
(^^ complement each other)
– Targeted population approach
• identifying communities at greater risk of disease and using population strategies within these targeted groups.
When is the population approach to prevention useful ? Give examples of population approaches to prevention.
– The disease/risk factor is distributed among large proportions of the population
– The results of not intervening to prevent the disease even in one person are very severe
Examples:
• Adding folic acid to flour
• Fluoridation of water
When is the high risk approach to prevention useful ? Give examples of high risk approaches to prevention.
– It may be difficult to change behaviour at population level
– Where there is concentrated risk within the population
Examples:
• Cancer Screening Kits
• Radical surgical solutions
Give examples of population approaches to reducing alcoholic liver disease and alcohol related harm.
POPULATIONS APPROACH
- “Provision of information on product labels and at the point-of-sale on the alcoholic content of drinks and the risks related to different levels of consumption”
- “Provision of non-alcohol related activities for young people”
- Community and workplace action (provision of information)
- Regulate availability of alcohol + restrict marketing of alcoholic beverages
- Policies with focus on cheaper alcohol (e.g. minimum pricing)
Give examples of high risk approaches to reducing alcoholic liver disease and alcohol related harm.
HIGH RISK APPROACH
- Questionnaire-based screening to “identify people whose alcohol consumption places them at increased risk of physical, psychological or social problems”
- Brief advice/motivational interviewing for those identified as being high risk
- Referral to specialist
- Drink driving policies and countermeasures
- Reduce negative consequences of drinking and intoxication
Show the effect of high risk and population approaches to prevention in diagrammatic form.
Refer to Google.
Identify any specific measures taken by the Scottish government for alcohol liver disease prevention.
1) “Changing Scotland’s Relationship with Alcohol: a Framework for Action”.
- Calls for action in four areas:
a) Reduced alcohol consumption
b) Supporting families and communities
c) Positive public attitudes, positive choices
d) Improved treatment and support
2) Minimum Pricing Legislation
