Population Health And Wellbeing Flashcards
What is Maslow’s hierarchy of needs?
Bottom to top
- Basic physiological needs
- Safety/Security needs
- Affiliation/belongingless/social needs
- Esteem needs
- Self-actualisation
What systems can old age effect?
General health
Malnutrition and dehydration
Hearing, eyesight
Memory loss, dementia, delirium
Joint pain, reduced mobility, falls
Bladder and bowel problems
Mental health problems
Compounded by socio-economic and commercial determinants of health.
What is Dahlgreen and Whiteheads 1991 diagram?
The broad social and economic circumstances that together influence health throughout the life courses are known as social determinants of health.
What are kitwoods malignant tendencies?
Ways not to look after people with dementia:
Infantilisation
Labelling
Outpacing
Banishment
Ignoring
Withholding
Disruption
Disempowerment
Intimidation
Stigmatisation
Invalidation
Accusation
Mockery
What is Mehrabian’s communication theory?
How we pass on communication
Body language - 55%
Tone, speed and volume - 38%
Words - 7%
What is delirium?
Acute confusion - a change in a persons mental state or consciousness
Can be caused by an underlying physical condition (stroke, infection, medication)
Most common complication of hospitalisation for older people.
What are the signs and symptoms of delirium?
Cognitive function (worsened concentration, slow responses, reduced alertness, confusion)
Perception (visual or auditory hallucinations, delusions)
Physical function (reduced mobility/movement, restlessness, agitation, changes in appetitite, sleep disturbance)
Social behaviour (lack of cooperation with reasonable requests, withdrawal, or alterations in communication, mood)
Emotional disturbance (mood swings)
What are the 3 main types of delirium?
Hypoactive - lethargic, subdued, slow to answer questions. Most common, most dangerous. Less frequently diagnosed.
At risk for pressure ulcers, pulmonary embolus, aspiration pneumonia
Hyperactive - agitated, calling out, restless, wandering, least common, most frequently diagnosed
At risk of falls and injury
Mixed - a mix of hypoactive and hyperactive delirium. Eg different from 11am to 5pm. Quite common.
What is the Mental Capacity Act (2005)
NICE 2018
Mental capacity is the ability to make a decision and understand the consequences of that decision
The MCA provides a framework to empower and protect people who may lack capacity to make some decisions for themselves.
Can the person (free from undue pressure)
- Understand the information?
- Retain the information (for long enough to make a decision)?
- Use it to make a decision?
- Communicate the decision?
If yes to all questions, then the patient has capacity
If no to any questions, then the patient lacks capacity.
What are the 5 key principles for The Mental Capacity Act?
Assume people have capacity
Support people to make decisions
Unwise decisions do not necessarily mean lack of capacity
Decisions must be in a persons best interest
Can a decision be made in a way that is less restrictive of a person’s freedom?
What factors indicate that an individual may be deprived of liberty?
That the person is confined to a restricted place for a non-negligible period of time
That the person does not have the capacity to consent to their care and treatment in those circumstances
That the person is subject to ‘continuous and complete supervision and control’ and
That the person is not free to leave
What dies MAcmillan say about lung cancer?
Around 70% is preventable
What is population health?
An approach aimed at improving the health of the entire population. About improving physical and mental health outcomes and wellbeing of people within and across a defined local, regional or national population, while reducing health inequality.
What are the 5 cardinal signs of respiratory disease?
Cough
Wheeze
Dyspnea
Chest pain
Sputum
What are the foundational principles of population health?
Social determinants of health
Equity and health disparities
Hollistic approach
Prevention
Interdisciplinary collaboration
Data and research
Community engagement
Policy and advocacy
Health promotion
Global health
Health literacy
Systems thinking
What factors contribute to health inequalities, access to healthcare?
Cultural barriers
Language barriers
Accessibility
Transportation
Financial costs
Immigration status
Geographic location
Parental work constraints
Healthcare Literacy
Stigma and discrimination
How might social determinants affect health inequalities in children?
Material: living conditions, housing, poverty, basic items
Psychosocial: feeling and perceptions, inferiority and social equity, linked to physical wellbeing, stressors - social disadvantage/adversity
Behavioural - smoking, alcohol, drugs, diet, parental interaction eg family meals, rules, screentime
Structural - socioeconomic, political, cultural and commercial infrastructure eg health visitors, paediatric services, school, social housing, and welfare system.
Parenting and child health behaviours
Parents and carers
Household resources
Community
Living and working conditions
Socio-economic, cultural, commercial, political and physical climate
What factors increase the risk of poverty?
Single in work parents
Those with 2+ siblings
Households with declared disabilities
Ethnically diverse households
What are some complications and comorbidities of obesity?
Hypertension
Abnormal glucose metabolism
Idiopathic intracranial hypertension
Non-alcoholic fatty liver disease
Sleep apnoea requiring active intervention, severe asthma, exercise tolerance
Polycystic ovary syndrome
Dyslipidemia
Significant psychological co-morbidity
Pain
Reduced bone-density/Increased fracture risk
Weak muscles
SUFE
Lower limb malalignment (vagus knee, flat feet)
Posture (lordosis)
Blounts disease - disorder in the growth plates around the knee
What are some ways to treat obesity?
Do not treat weight loss, this will be a side effect of managing the obesity
Think physical activity/movement, not exercise.
Expoloration of current physical activity
Reducing sedentary behaviours
Managing barriers to physical activity
Readiness/motivation to change
Goal setting and offer expertise eg to swim 100m (inadvertently lead to weight loss, but not the main goal)
Linking with community services
Virtual activity class
What are inflammatory signs with chronic pain?
Stiffness
Pain in the morning
Eg arthritis, axial spondyloarthiritis
What is a sign of systemic inflammatory response?
Greater than 1 hour of morning stiffness - they need to see rheumatology.
Alternatively, less than 5 - 10 minutes is a sign of inflammatory and local joint.
What do we need to consider with night pain?
Unremitting - nothing makes it better
If the pain at night is worse than in the day
Associated with other symptoms like night sweats, unexplained weight loss, numbness, bladder and bowel, past cancer
What is multi morbidity?
The presence of two or more long term health conditions
Can include: physical or mental health conditions of long duration, such as diabetes, schizophrenia, or an infectious disease.
