HSPH PBL 4: No Symptoms No Asthma Flashcards
What is the prevalence of asthma in the UK?
5.9% affected
When is asthma most common?
5-15 years of age
What are modifiable risk factors for asthma?
Urban environment, deprivation, obesity, low brith weight, maternal smoking, anxiety, depression
What are risk factors for hospitalisation from asthma?
Geographical area, age, ethnicity, poor control of asthma symptoms, asthma admission in the last year, lack of shared-decision making with health professionals in care, lack of regular medication review and lack of personal asthma care plan
What are examples of preventer inhaler drugs?
Inhaled glucocorticoids and leukotriene modifiers
What are examples of reliever inhaler dugs
Rapid/long-acting B agonists, anticholinergics or short-acting theophylline
What should the management of asthma in the UK involve?
Personal asthma action plan, at least one annual review by a healthcare professional with specialist asthma knowledge, review of patients adherence to medication in those with severe asthma and preventer treatment started if >6 reliever inhalers are prescribed in the previous 6 months.
What is the principle behind the theory of planned behaviour?
Attitude towards behaviour, subjective norms and perceived behavioural control together shape an individual’s intentions for their behaviour
What is attitude in relation to the theory of planned behaviour?
An individual’s overall evaluation of how they feel about an action
What are the main components of the theory of planned behaviour?
Attitude, subjective norm, intention and perceived behavioural control
What is subjective norm in relation to the theory of planned behaviour?
An individual’s belief about others’ approval of an action relative to how much they care about others’ approval
What is intention in relation to the theory of planned behaviour?
How hard the individual is going to try to change their behaviour
What is perceived behavioural control in relation to the theory of planned behaviour?
An individual’s assessment of their ability to undertake an action
What is self-efficacy?
An individual’s perception of the degree to which they are capable of performing a given behaviour.
What are the three key elements to self-efficacy?
Magnitude - an individuals perceived efficacy for their most capable performance
Strength - the confidence in their assessment of magnitude
Generality - where this sense of efficacy translates to different situations
What is social cognitive theory?
Situation-outcome expectancies
Outcome expectancies
Self-efficacy expectancies
What is mastery in relation to social cognitive theory?
Involves the individual attempting the behaviour in question
What is vicarious experience in relation to social cognitive theory?
Modelling of the behaviour (may reinforce self-efficacy), especially if they relate to the model
What is social persuasion in relation to social cognitive theory?
When someone persuades them of their abilities by highlighting past successes and helping them to avoid failures
Describe the common sense model of illness
An illness or symptoms will presence and this will be perceived relative to how they are seen by society; the health threat will be assessed according to identify, time-line, consequences, cure/control and causes (in addition to emotional fear/anxious response). They will then cope by approach or avoidance, and then they will eventually appraise whether their coping strategy was effective and start the whole process again.
What is identity in relation to the common sense model of illness?
Considering when an illness or symptoms become diagnosable i.e. when does indigestion become acid reflux?
What is time-line in relation to the common sense model of illness?
How long will the illness last, and whether it is worth seeking help i.e. is it short-term, cyclical or chronic
What are consequences in relation to the common sense model of illness?
What are the perceived consequences of the symptoms e.g. debilitating migraine vs. rash
What is cure/control in relation to the common sense model of illness?
Patient is more likely to seek help or adhere if they believe there is an appropriate, effective management available
What are causes in relation to the common sense model of illness?
What the individual perceives to be the cause of their illness i.e. if it’s stress they may believe it’s a short-term complaint, or believe it is karma and not seek help
What is illness coherence?
The extent an individual makes sense of their illness
Describe the behavioural change wheel
Behaviour is influenced by an individual’s capacity, opportunity and motivation
What is capacity in relation to the behavioural change wheel?
Must have physical and psychologic capacity to perform new behaviour e.g. diabetic with no arms can’t inject themselves HAHAHAHAH
What is opportunity in relation to the behavioural change wheel?
Factors outside of the individual must allow for the behaviour change including social and physical factors e.g. having no running shoes to go to the gym to lose weight (physical factor) or being asthmatic and trying to avoid allergens but living in a house of smokers (social)
What is motivation in relation to the behavioural change wheel?
If the individual is not motivated then they will have no incentive to change their behaviour (automatic or reflective motivation0
What is automatic motivation?
Innate or learned emotions and impulses
What is reflective motivation?
Involves planning and evaluating prior to making a decision
Define self-management
Theindividual’s ability to manage the symptoms, treatment, physical and psychosocial consequences and life style changes inherent in living with a chronic condition.
What does effective self-management involve?
Ability to monitor one’s condition and to effect the cognitive, behavioural and emotional responses necessary to maintain a satisfactory quality of life
Which ethnicity is more likely to be hospitalised from asthma?
South asian
How may the GP get Shahid to manage/improve his asthma control?
Use patient-centred approach, using active listening to gain an insight into his beliefs about his asthma. Ensure he has a PAAP. Ask how confidence he is to carry out self-management and adjust where necessary
