HSPH practitioner Flashcards
Inverse care law
Those how need care the most actually receive the least
Patient education
Set of planned education activities that intend to improve health behaviours
Health education
Interventions that provide learning opportunities directed towards improving health beliefs and behaviours
Patient centred care
Providing care that is respectful of and responsive to patients individual preferences, needs and values where their views guide all clinical decisions
Controlling behaviour
Acts designed to make a person subordinate by regulating their everyday behaviour
Coercive behaviour
Acts designed to harm, punish or frighten the victim
Number of female murders by partner
54%
Number of male murders by partner
5%
Risk factors for DVA
Women
Younger age
Poverty
Separation
Presentation of DVA
Most consistent = gynaecological problems Chronic pain GI disorders Mental health problems - depression - PTSD - alcohol abuse - suicidal thoughts
HARKS template
Humiliate Afraid Rape Kick Safe
Lifetime prevalence of DVA
1/3
People experiencing physical violence in the past year
1/10
Ethnicity
Distinct set of cultural characteristics that can include common geographic and ancestral origins, language, rituals and traditions
Epidemiology
Study of patterns of disease that influence the emergence, propagation and frequency of a disease in a population
Institutional racism
Collective failure of an institution to provide an appropriate service to people because of their colour, culture or ethnic origin
Social capital
Network of relationships among people who work and live in a particular society, enabling that society to function collectively
Problems with EBM
Limitations of RCTs - this - rare diseases - emergency cases - time lag Design of RCT - bias - internal and external validity Cost Politics --> who funds? Deproffesionalisation
Mechanic’s 10 variables to influence illness behaviour
Visibility of symptoms Perceived severity Disruption to daily life Frequency of symptoms Tolerance threshold of person Available information and understanding Denial of symptoms Normalisation Availability of treatment resources Need to compete with illness responses
Zola’s triggers to consultation
Interpersonal crisis
Perceived interference with vocational or physical activity
Temporalisation = setting deadline
Sanctioning = pressure/permission from other people to seek help
What does health inequality loop describe?
Places during the planning and delivery of care in which inequalities can occur
Most deprived boroughs in London
Hackney
Newham
Tower Hamlets
Child poverty in Tower Hamlets
49%
London average = 37%
Leading cause of premature death
Ischaemic heart disease
Enacted stigma
Unfair treatment because of having a conditions
Felt/anticipated stigma
Fear of discrimination occurring that leads to behaviour change
Courtesy stigma
Stigmatisation of the people association with the stigmatised person
Define poverty
Where people lack many of the opportunities available to the average citizen
Define absolute poverty
Set standard that is the same in all countries and does not change with time
Define relative poverty
Standard that is defined in terms of the society in which an individual lives and therefore differs depending on country and time scale
Define child poverty
Child living in a household that learns <60% of the median income
General rate of adherence
50%
Adherence rate for acute illness with short term treatment
78%
Adherence rate for chronic illness with long term treatment
54%
Adherence rate for medication to prevent illness
60%
Adherence rate for lifestyle changes
2-10%
Memory in adherence
More told, more you forget
Remember first and last things said best
More medical knowledge means you remember more
Practical barriers to adherence
Cost
Mobility
Healthcare hours
Define compliance
How much the patient does what they were told by the doctor
Define adherence
Extent to which patients behaviour corresponds with the agreed recommendations from the HCP
Define concordance
Process of consultation that is based on partnership
Components of adherence
Initiation = do they start Persistence = how long do they do it for Execution = how well do they follow the regime, e.g. dosing hours
