HSPH PBL 4: No Symptoms No Asthma

Question 1

What is the prevalence of asthma in the UK?

Answer 1

5.9% affected

Question 2

When is asthma most common?

Answer 2

5-15 years of age

Question 3

What are modifiable risk factors for asthma?

Answer 3

Urban environment, deprivation, obesity, low brith weight, maternal smoking, anxiety, depression

Question 4

What are risk factors for hospitalisation from asthma?

Answer 4

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

Question 5

What are examples of preventer inhaler drugs?

Answer 5

Inhaled glucocorticoids and leukotriene modifiers

Question 6

What are examples of reliever inhaler dugs

Answer 6

Rapid/long-acting B agonists, anticholinergics or short-acting theophylline

Question 7

What should the management of asthma in the UK involve?

Answer 7

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.

Question 8

What is the principle behind the theory of planned behaviour?

Answer 8

Attitude towards behaviour, subjective norms and perceived behavioural control together shape an individual’s intentions for their behaviour

Question 9

What is attitude in relation to the theory of planned behaviour?

Answer 9

An individual’s overall evaluation of how they feel about an action

Question 10

What are the main components of the theory of planned behaviour?

Answer 10

Attitude, subjective norm, intention and perceived behavioural control

Question 11

What is subjective norm in relation to the theory of planned behaviour?

Answer 11

An individual’s belief about others’ approval of an action relative to how much they care about others’ approval

Question 12

What is intention in relation to the theory of planned behaviour?

Answer 12

How hard the individual is going to try to change their behaviour

Question 13

What is perceived behavioural control in relation to the theory of planned behaviour?

Answer 13

An individual’s assessment of their ability to undertake an action

Question 14

What is self-efficacy?

Answer 14

An individual’s perception of the degree to which they are capable of performing a given behaviour.

Question 15

What are the three key elements to self-efficacy?

Answer 15

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

Question 16

What is social cognitive theory?

Answer 16

Situation-outcome expectancies
Outcome expectancies
Self-efficacy expectancies

Question 17

What is mastery in relation to social cognitive theory?

Answer 17

Involves the individual attempting the behaviour in question

Question 18

What is vicarious experience in relation to social cognitive theory?

Answer 18

Modelling of the behaviour (may reinforce self-efficacy), especially if they relate to the model

Question 19

What is social persuasion in relation to social cognitive theory?

Answer 19

When someone persuades them of their abilities by highlighting past successes and helping them to avoid failures

Question 20

Describe the common sense model of illness

Answer 20

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.

Question 21

What is identity in relation to the common sense model of illness?

Answer 21

Considering when an illness or symptoms become diagnosable i.e. when does indigestion become acid reflux?

Question 22

What is time-line in relation to the common sense model of illness?

Answer 22

How long will the illness last, and whether it is worth seeking help i.e. is it short-term, cyclical or chronic

Question 23

What are consequences in relation to the common sense model of illness?

Answer 23

What are the perceived consequences of the symptoms e.g. debilitating migraine vs. rash

Question 24

What is cure/control in relation to the common sense model of illness?

Answer 24

Patient is more likely to seek help or adhere if they believe there is an appropriate, effective management available

Question 25

What are causes in relation to the common sense model of illness?

Answer 25

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

Question 26

What is illness coherence?

Answer 26

The extent an individual makes sense of their illness

Question 27

Describe the behavioural change wheel

Answer 27

Behaviour is influenced by an individual’s capacity, opportunity and motivation

Question 28

What is capacity in relation to the behavioural change wheel?

Answer 28

Must have physical and psychologic capacity to perform new behaviour e.g. diabetic with no arms can’t inject themselves HAHAHAHAH

Question 29

What is opportunity in relation to the behavioural change wheel?

Answer 29

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)

Question 30

What is motivation in relation to the behavioural change wheel?

Answer 30

If the individual is not motivated then they will have no incentive to change their behaviour (automatic or reflective motivation0

Question 31

What is automatic motivation?

Answer 31

Innate or learned emotions and impulses

Question 32

What is reflective motivation?

Answer 32

Involves planning and evaluating prior to making a decision

Question 33

Define self-management

Answer 33

Theindividual’s ability to manage the symptoms, treatment, physical and psychosocial consequences and life style changes inherent in living with a chronic condition.

Question 34

What does effective self-management involve?

Answer 34

Ability to monitor one’s condition and to effect the cognitive, behavioural and emotional responses necessary to maintain a satisfactory quality of life

Question 35

Which ethnicity is more likely to be hospitalised from asthma?

Answer 35

South asian

Question 36

How may the GP get Shahid to manage/improve his asthma control?

Answer 36

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