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Phase 3A Public Health > Lecture Content > Flashcards

Lecture Content Flashcards

1
Q

Domestic Abuse Definition

A

Coercive and threatening behaviour to a person over the age of 16 years who has an intimate or family relationship with the offender. Action may be physical, emotional, financial, psychological or sexual.

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2
Q

Types of injury from domestic abuse

A

traumatic e.g. miscarriage or broken bone. somatic illness or chronic disease e.g. pelvic pain or headaches. psychological or psychosocial injury e.g. eating disorder or PTSD

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3
Q

Children who live with domestic abuse in environment

A

Type of emotional abuse to child. Need safe guarding.

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4
Q

Toxic triangle

A

domestic abuse –> parental substance misuse –> parental mental health problems.

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5
Q

Risk assessment and tool for domestic abuse. Organisations involved

A

DASH risk assessment. Standard, medium or high. If high must refer to MARAC and IDVAS

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6
Q

Domestic homicide review

A

a review of the circumstances of death of a person over the age of 16 which could have resulted from violence, abuse or neglect by a person to whom (s)he was related or with whom (s)he was or had been in an intimate personal relationship, or (b) a member of the same household as himself.

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7
Q

Determinants of health

A

genes, environment (physical, social and economic), lifestyle, healthcare.

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8
Q

Equality definition

A

equal shares, objective measure.

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9
Q

Equity defintion

A

what is fair or just, subjuective

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10
Q

2 types of equity and definitions

A

horizontal = equal treatment for equal needs. Vertical equity = unequal treatment for unequal needs.

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11
Q

Determinants of health equity which can be used to measure health equity

A

equal expenditure, equal access/allocation, equal utilisation, equal outcomes from needs, equal health.

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12
Q

Dimensions of health equity

A

Spatial = geographical. Social = age, gender class/socialeconomic status, ethnicity.

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13
Q

3 domains of public health practise

A

Health improvement, health protection, health care

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14
Q

Definition of health improvement

A

societal interventions for preventing disease, improve health, prevent inequalities

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15
Q

definition of health protection

A

concerned with communicable disease and controlling infectious disease risks and
environmental hazards

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16
Q

definition of health care

A

Improving services and creating an organisation which delivers the best safest care.

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17
Q

3 health behaviour categories and alternative classification with 2

A

health behaviour, illness behaviour, sick role behaviours or health damaging and health promoting behaviours

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18
Q

Definition of health behaviours

A

behaviour aimed to prevent disease e.g. healthy eating

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19
Q

Definition of illness behaviour

A

behaviour aimed at seeking remedy e.g. seeing Dr

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20
Q

sick role behaviour definition

A

behaviour aimed at getting well e.g. taking prescribed drugs

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21
Q

Impact of poor health behaviours

A

Increased disease, increased cost (direct on NHS and indirect), increased days off from work

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22
Q

Factors influencing compliance

A

education, socioeconomic status, symptomatic, misinformation, side effects

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23
Q

Synergy of behaviours

A

damaging health behaviours co-occur. e.g. smokers more likely to have poor diet or little exercise etc.

24
Q

Interventions for health behaviours

A

Population level = health promotion, screening, vaccine. Give people ability to have control over their health. Individual level = patient centred approach responding to their individual needs. Community level = assessing local patterns e.g. A&E admissions, crime rates.

25
Q

Why do people engage in damaging health behaviours

A

stress, situational rationality, unrealistic optimism, age, culture, self-serving bias, health beliefs.

26
Q

Factors which influence a perception of risk

A

Lack of personal experience, belief it is preventable with personal action, if it has not occurred now it is unlikely to occur to them, problem is infrequent belief.

27
Q

Unrealistic optimism

A

continue to do damaging behaviour due to inaccurate perception of risk and susceptibility.

28
Q

Outcomes of low perception of risk

A

Poor medicine regime adherence, do not attend appointments.

29
Q

NICE guidance on behaviour changes

A
  1. Planning interventions
  2. Assessing the social context
  3. Education and training
  4. Individual-level interventions
  5. Community-level interventions
  6. Population-level interventions
  7. Evaluating effectiveness
  8. Assessing cost-effectiveness
30
Q

Health needs assessment definition

A

Systematic method for reviewing the health issues facing population. Gives rise to agreed priorities and resource allocation which will improve the health and reduce the inequality in the population.

31
Q

Needs Led Planning Cycle

A

Needs assessment –> planning –> implementation. –> education.

32
Q

Need, demand and supply definition

A

Need = ability to benefit form an intervention. Demand = what the population ask for. Supply = what the population are provided with.

33
Q

Difference between health need and health care need

A

Health care need is more specific needs and is ability to benefit from the health care.

34
Q

Sociological perspective types of needs and definitions

A

Felt need = individual perceptions of variation from norm. Expressed need = individual seeds help to overcome variation from norm. Normative need = professionals define an intervention appropriate for expressed need. Comparative need = comparison between severity, range of interventions and cost.

35
Q

3 approaches for health needs assessment

A

epidemiological, comparative, corporate.

36
Q

Concepts of epidemiological approach to health needs assessment

A

Define problem, Size of problem, Services available, Evidence base (effectiveness/cost), Models of care and measures, Existing services, Recommendations

37
Q

Drawbacks of epidemiological approach

A

Required data may not be available, variability in the quality of the data, the evidence based may not be adequate to come to good conclusion,􏰀 does not consider felt needs of people affected (i.e. biopsychosocial aspect, only looks at biomedical aspect)

38
Q

Concept of comparative approach to health needs assessment

A

Contrasts the services received by the population in one area with those of another population (spatial, societal differences). Measure health status, provision of service, use or outcomes

39
Q

Drawbacks of comparative approach

A

May not yield what the most appropriate level should be, Data may not be available, variability in quality of data, may be difficult to find a comparable population

40
Q

Concept of corporate approach to health needs assessment

A

Based on the demands, wishes and alternative perspectives of stakeholder parties including professional, political, patient, commissioners, press, providers and the public.

41
Q

Drawbacks of corporate approach

A

difficult to distinguish the demand, vested interest of groups, political agenda influence, dominant personality or group may have disproportionate influence.

42
Q

Physical consequences of loneliness

A

self neglect, earlier death, more risky behaviours, increase in poorer health, physical changes

43
Q

Recognising loneliness in a consultation

A

talkative, clingy, frequent attender and trivial symptoms, sensory impairment, recent bereavement, deny boredom, no close family, mobility issues, SINGLE MEN OVER 50

44
Q

Causes of loneliness

A

poor health & sensory impairments, transport issues fear of crime, housing issues, poverty, discrimination (sex, gender, race), technology, poor communication, unavailable community services.

45
Q

Diseases of poverty

A

psychiatric problems e.g. depression, sleep disorders, substance misuse, infection including STI and TB

46
Q

Diseases of neglect

A

Infections including dental, podiatry.

47
Q

Name for the classification of types of needs

A

Bradshaw’s Taxonomy of Needs

48
Q

3 types of evaluation frameworks

A

Donabedian - evaluate structure, process, output, outcome
Black - priority
Maxwell - 6 dimensions appropriateness, acceptability, accessibility, effectiveness, equity and efficiency.

49
Q

6 parts to Maxwell’s evaluation

A 
Appropriateness
Accessibility
Acceptability
Efficacy
Efficiency
Equity
50
Q

4 parts to Donabedian evaluation

A

Structure, process, output, outcome.

51
Q

Name of the criteria for a good screening service

A

Wilson and Junger

52
Q

Some points in the Wilson and Junger screening criteria

A

Condition must be important health problem.
Acceptable treatment for the condition must be available.
Facilities to diagnose and treat condition must be available.
Test in screening should be repeatable.
Test for screening should identify early stage of disease.
Costs should be balanced out against benefit.
Agreed policy on whom to offer screening to and whom to treat from screening results.

53
Q

Types of bias in a screening programme

A

Length-time
Selection
Lead-time

54
Q

Sensitivity

A

People who have the disease and are correctly identified

55
Q

Specificity

A

People who don’t have disease and are correctly excluded.

56
Q

Positive predictive value

A

Patients who receive a positive results from screening and on further tests do suffer from disease

Phase 3A Public Health (8 decks)

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