PAss rushed Flashcards

(46 cards)

1
Q

Black report, when was it?
4 explanations

A

1) artefact - statistics bad
2) social selection - sick people move down social class, - plausable but only minor contribution
3) Behaviour- cultural - Ill health based on choices, eg smoking, assumes certain things are choices
4) Materialist (best) - Differing levels of access to resources.

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2
Q

Who uses more primary care but less of another type, and what is type

A

People in deprived areas see gps more often, underuse of preventative and specialist services.

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3
Q

Negative
functional
positive
definitions of health

A

negative - Health is absense of illness
functional - health is ability to do certain things
positive - health is a state of physical social and mental wellbeing, not just the absence of disease
(Health is a state of wellbeing and fitness)

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4
Q

(3 thigns) Why are individuals from lower areas more likely to engage in health damaging behaviours

A

1) less likely to have positive definition of health
2) higher social classes have incentive on giving up these bahaviours as they expect to remain healthy
3) Lower social classes focus on immediate importovement

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5
Q

symptom illness iceberg

A

Only 12% of symptoms make it to doctor,
culture, visibility, frequencyu, tolerance threshold, understanding all cause lack of communication

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6
Q

Lay referal

A

sick people ask other lay people before seeking help
Important to understand why people delay seeking help

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7
Q

lay beliefs and adherance to treatment

A

denier and distancer -
acceptor
pragmatist

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8
Q

4 types of stigma

A

1) discredited - can be seen eg physical disability, known suicide attempt
2) discreditable - cant be seen, mental illness, HIV
3) Enacted - Real experience of prejudice, as a consequence of condition
4) Felt - fear of enacted stigma, leads to feeling of shame.

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9
Q

5 ‘works’ you put into long term conditions

A

everyday life work - coping with work from everyday before illness
biographical work - Loss of self, work required to maintain positive definitions of self
identity work - Struggling with how they see themselves, real and imagined reactions of others
illness work - work required to get diagnosis, manage symptoms
emotional work - Work required to protect emotional wellbeing of others, eg kids. Dowlplaying symptoms

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10
Q

what are health related behaviours

A

behaviours that impact health

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11
Q

3 types of conditioning

A
  1. Classical - Pavlovs
  2. Operant - Shaped by previous personal knowledge of consequence, good/bad
  3. Social learning theory - Learning through observation and modelling. Learn what is rewarded sympathetically from others
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12
Q

lmitations on 2 of learning theories

A

classical and operant arent conscious, arent affected by congnition, beliefs etc.

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13
Q

3 social cognition models used to explain health related behaviours

A

1) cognitive dissonance - Discomfort when actions dont match belief
2) Health belief model - health threat and beliefs about behaviour lead to behaviour
3) Theory of planned behavior - attitutde to behaviour, subjective norm and percieved control over behaviour combine to form intention of person.

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14
Q

what is cognitive dissonacne

A

1) cognitive dissonance - Discomfort when actions dont match belief

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15
Q

what is health belief model

A

2) Health belief model - health threat and beliefs about behaviour lead to behaviour

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16
Q

what is theory of planned bahaviour?

A

3) Theory of planned behavior - attitutde to behaviour, subjective norm and percieved control over behaviour combine to form intention of person.

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17
Q

Why dont people always engage in positively impacting behaviours 3 factor model

A

Capability - lack of knowledge and skills
Opportunity - Lack of opportunity
Motivation - Lack of motivation

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18
Q

which model used for targeted intervention

A

COM-B model used (capability opportunity, motivation, behaviour)

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19
Q

Substance missuse what is it

A

Harmful, hazardous use of alcohol and illicit drugs, lead to dependence syndrome, cluster of behavioural cognitive and physiological phenomena.

20
Q

2 types of dependance

A

physical and psychosocial

21
Q

risk factors associated with drug use (6)

A

Family life issues
Mental health
EMplotment?educatio
Social groups
Biology
ACEs

22
Q

3 theories of dependence

A
  1. Classical conditioning - environmental effects paired with drug effect, seeing food makes you hungry
  2. imitation theory, social learning theory, we develop behaviours based on vicarious observation
    split into MODELLING - risk if we see others
    EXPECTATION - Expect positive reward from behaviour
    SELF- EFFICACY - Think you can abstain
  3. Rational Choice theory - Dependency involves making rational choices that favour dependency, dont want to stop smoking eg.
23
Q

Aims of treatment of substance abuse?

A

reduce harm to user and others
improve health
stabilise life - reduce crime etc

24
Q

6 steps in transtheoretical model of change (Prochaska and diclimente)

A

1 pre contempation
2 contemplation
3 preperation
4 action
5 maintainance
6 relapse

25
compliance adherance concordance definitions
the degree to which patient complies to medical advice The extent to which a patient behaves relative to reccomendations, medication diet etc Concordance is a new approach that allows agreement after negociation between doctor and patient respecting wishes of patient
26
Examples of non adherance consequences of non adherance
Failure to complete medication course at right time right dose etc Health benefits foregone, wider economic burden
27
WHat interventions increase adherance? what type do they improve
Education of patient, phusical aids/ reminders etc. These strategies only target unintentional
28
What problems are homelss people more impacted by?
premature death (age around 47) 2.5x more liely to have asthma 6x more likely to have heart disease 12x more likely to have epiepsy alcohol and drug dependencies mental health problems
29
Define health promotion
The concept of promoting healthy living on a wider scale than doctors issuing treatment, eg funding into sports facilities
30
3 levels of health care promotion
1. primary - prevent onset of disease eg immmunisation, smoking stopping before disease 2. secondary, detect amd treat diseases early, eg screening, monitoring blood pressure 3. tertiary, aiming to minimise effects of already established disease, medications transplants etc
31
5 ottowa charter aspects
1 build healthy public policy across different sectors 2 create supprtive environments 3 strengthen commnity acction 4 develop personal skills 5 reorientating health services
32
universal and targetted health promotions
universal - equal impact across population - more useful if more common targetted - identify those at risk and tailer to group eg breast feeding in new mums. - assumes homologous groups, risky towatds offence
33
define obesity
Abnormal excessive fat accumulation presents risk to health
34
Burdens of increased obesity
increased mporbidity and mortality economic burden - 27 billion £
35
what strategies outlines in national childhood obesity plan
labelling sugar reduction Retail Local communities Schools
36
Screening process
1. screening test 2. Positive in screen declared high risk, given tests for disease
37
5 ares of critera for screening programme
1.condition - important health problem, primary interventions aready in place 2. the test- simple safe validated screening test- distribution of values and agreed cut off levels. 3. The intervention - effective for patients identified through screening - evidence presymptoatic diagnosis leads to vetter outcomes 4. screening evidence for better out come1s, benefits outweigh harms 5. Implementation - adequate staffing and facilites for effective introduction of screening
38
3 main difficulties evaluating screening processes
lead time bias - early diagnosis falsely appears to prolong survival, patients actually just diagnosed earlier Length time bias - Screening better at picking uo slow unthreatening cases, more likely to have better outcums that may have never actually caused pronle,s Selection bias - Studies skewed by healthy volunteer effect. Those who volunteer for screenings more likely ontop of their health.
39
two types of errors of test -
false positives false negatives
40
sensitivity and specificity
sensitivity - percentage of people wotj disease who test positive, high sensitivity better at picking up disease. percentage of positive tests out of diseased patients higher = better specificity - percentage of people with negative tests , which dont have disease. high specificity = better
41
Positive predictive value
of people with positive tests, what percentage have the disease
42
Negative predictive value
Propotion of people who test negatively who actually dont have disease
43
Uptake and coverage of screening programme
Uptake - Proportion who take up programme from people asked Coverage - Proportion of eligible population that have been screened over a time period
44
What factors affect screening uptake?
Awareness of benefitys Acceptability Accessibility COnvenience Reminders
45
2) Health belief model - health threat and beliefs about behaviour lead to behaviour
46
2) Health belief model - health threat and beliefs about behaviour lead to behaviour