PAss rushed

Question 1

Black report, when was it?
4 explanations

Answer 1

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.

Question 2

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

Answer 2

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

Question 3

Negative
functional
positive
definitions of health

Answer 3

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)

Question 4

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

Answer 4

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

Question 5

symptom illness iceberg

Answer 5

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

Question 6

Lay referal

Answer 6

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

Question 7

lay beliefs and adherance to treatment

Answer 7

denier and distancer -
acceptor
pragmatist

Question 8

4 types of stigma

Answer 8

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.

Question 9

5 ‘works’ you put into long term conditions

Answer 9

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

Question 10

what are health related behaviours

Answer 10

behaviours that impact health

Question 11

3 types of conditioning

Answer 11

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

Question 12

lmitations on 2 of learning theories

Answer 12

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

Question 13

3 social cognition models used to explain health related behaviours

Answer 13

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.

Question 14

what is cognitive dissonacne

Answer 14

1) cognitive dissonance - Discomfort when actions dont match belief

Question 15

what is health belief model

Answer 15

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

Question 16

what is theory of planned bahaviour?

Answer 16

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

Question 17

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

Answer 17

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

Question 18

which model used for targeted intervention

Answer 18

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

Question 19

Substance missuse what is it

Answer 19

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

Question 20

2 types of dependance

Answer 20

physical and psychosocial

Question 21

risk factors associated with drug use (6)

Answer 21

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

Question 22

3 theories of dependence

Answer 22

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.

Question 23

Aims of treatment of substance abuse?

Answer 23

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

Question 24

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

Answer 24

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

Question 25

compliance
adherance
concordance
definitions

Answer 25

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

Question 26

Examples of non adherance
consequences of non adherance

Answer 26

Failure to complete medication course at right time right dose etc
Health benefits foregone, wider economic burden

Question 27

WHat interventions increase adherance?
what type do they improve

Answer 27

Education of patient, phusical aids/ reminders etc.
These strategies only target unintentional

Question 28

What problems are homelss people more impacted by?

Answer 28

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

Question 29

Define health promotion

Answer 29

The concept of promoting healthy living on a wider scale than doctors issuing treatment, eg funding into sports facilities

Question 30

3 levels of health care promotion

Answer 30

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

Question 31

5 ottowa charter aspects

Answer 31

1 build healthy public policy across different sectors
2 create supprtive environments
3 strengthen commnity acction
4 develop personal skills
5 reorientating health services

Question 32

universal and targetted health promotions

Answer 32

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

Question 33

define obesity

Answer 33

Abnormal excessive fat accumulation presents risk to health

Question 34

Burdens of increased obesity

Answer 34

increased mporbidity and mortality
economic burden - 27 billion £

Question 35

what strategies outlines in national childhood obesity plan

Answer 35

labelling
sugar reduction
Retail
Local communities
Schools

Question 36

Screening process

Answer 36

1. screening test
2. Positive in screen declared high risk, given tests for disease

Question 37

5 ares of critera for screening programme

Answer 37

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

Question 38

3 main difficulties evaluating screening processes

Answer 38

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.

Question 39

two types of errors of test -

Answer 39

false positives
false negatives

Question 40

sensitivity and specificity

Answer 40

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

Question 41

Positive predictive value

Answer 41

of people with positive tests, what percentage have the disease

Question 42

Negative predictive value

Answer 42

Propotion of people who test negatively who actually dont have disease

Question 43

Uptake and coverage of screening programme

Answer 43

Uptake - Proportion who take up programme from people asked
Coverage - Proportion of eligible population that have been screened over a time period

Question 44

What factors affect screening uptake?

Answer 44

Awareness of benefitys
Acceptability
Accessibility
COnvenience
Reminders

Answer 45

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

Answer 46

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