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Finals > Public Health > Flashcards

Public Health Flashcards

1
Q

Three domains of public health

A

Health protection

Health Improvement

Improving services

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2
Q

Determinants of health

A

Genetic
Lifestyle
Environmental
Health care

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3
Q

Inverse care law

A

the availability of medical or social care tends to vary inversely with the need of the population served

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4
Q

Health needs assessment definition

A

A systematic approach for reviewing the health issues affecting a population which leads to agreed priorities and resource allocation that will improve health and decrease inequalities

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5
Q

Health needs assessment cycle

A

Needs assessment
Planning
Implementation
Evaluation

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6
Q

Health needs assessment types

A

Epidemiological
Comparative
Corporate

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7
Q

Types of need

A 
FENC
Felt
Expressed
Normative
Comparative
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8
Q

Maslow’s hierarchy of need

A

Physiological -> Safety -> Love/belonging -> Esteem -> Self-actualization

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9
Q

Resource allocation types

A

Egalitarian
Maximising
Libertarian

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10
Q

Wright’s matrix for assessing the quality of a service

A

Maxwell’s Dimensions and Donabedian’s approach

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11
Q

Maxwell dimensions

A

3As and 3Es
Access, appropriateness, Acceptability

Equity, Efficient, Effective

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12
Q

Donabedian’s approach

A

Structure, Process, Outcome

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13
Q

Health Psychology

A

Health behaviour, Illness behaviour, Sick role behaviours

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14
Q

Transtheoretical model

A

PC PAM

precontemplation
Contemplation
Preparation
Action
Maintenance
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15
Q

Transtheoretical advantages

A

Acknowledges individual stages of readiness
Accounts for relapse
Temporal element

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16
Q

Transtheoretical disadvantages

A

Some individuals skip stages
Change may be continuous, not discrete
Doesn’t consider values e.g cultural and social factors

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17
Q

Theory of planned behaviour

A

ASP
Attitudes, Subjective Norms, Perceived behaviour control

Lead to intention

P PAIR takes to Behaviour -

Preparatory actions
Perceived control
Anticipated regret
Implementation intentions
Relevance to self
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18
Q

Theory of planned behaviour advantages

A

Can be applied to wide variety of health behaviours
Useful for predicting intention
Takes into account importance of social pressures

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19
Q

Theory of planned behaviour Disadvantages

A

No temporal element, direction or causality
Doesn’t consider emotions
Assumes attitudes can be measured

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20
Q

Health belief model

A 
Perceived susceptibility
Perceived severity
Health motivation
Perceived benefits
Perceived barriers
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21
Q

Variables contributing to the HBM

A

Demographic variables

Psychological characteristics

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22
Q

HBM advantages

A

Can be applied to wide variety of health behaviours
Cues to action are unique component
Longest standing model (who cares?!)

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23
Q

HBM Disadvantages

A

Other factors may influence the outcome
Doesn’t consider emotions
Doesn’t differentiate between first time and repeated behaviours

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24
Q

Medical negligence process

A

Was there a duty of care?
Was there a breach in that duty?
Was the patient harmed?
Was the harm due to the breach in care?

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25
Q

Medical negligence rules

A

Bolam Rule: Would a reasonable doctor do the same?

Bolitho rule: Would that be reasonable?

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26
Q

Types of error

A 
Sloth
Fixation/loss of perspective
Lack of skill
System error
Mistriage
Ignorance
Bravado/timidity
Playing the odds
Communication breakdown
Poor team working
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27
Q

Swiss cheese model of human error causation steps

A

Latents failures: Organizational influences
Unsafe supervision
Preconditions for unsafe acts

Active failures: Unsafe acts

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28
Q

Never event definition

A

a serious, largely preventable patient safety incident that should not occur if available, preventative measures have been implemented

29
Q

Three bucket model of error

A

Self, Context, Task

30
Q

Self bucket

A

Level of:

Knowledge, Skill, Expertise, Current capacity to do task

31
Q

Context bucket

A 
Equipment
Physical environment
Workspace
Team/support
Organisation and management
32
Q

Task bucket

A

Errors
Complexity
Novel task
Process

33
Q

Screening

A

identifying apparently well individuals who have (or are at risk of having a particular disease)

34
Q

Screening criteria

A

Wilson and Jungner

Disease
test
outcome

35
Q

Screening disease criteria

A

Important, Natural history known, Early treatment better than late

36
Q

Screening test criteria

A

Acceptable to the population
Facilities available
Simple, safe, precise and validated

37
Q

Screening outcomes criteria

A

Ongoing feasibility
Treatment available
Cost-benefit analysis

38
Q

Cross-sectional study design

A

Snapshot data of those with and without disease to find associations at a single point in time

39
Q

Cross-sectional study +ves

A

Quick and cheap

Few ethical issues

40
Q

Cross-sectional study -ves

A

Prone to bias

No time reference

41
Q

Case-control study design

A

Retrospective observational study which looks at a certain exposure and compares similar participants with and without the disease

42
Q

Case-control study positives

A

Good for rare diseases

Inexpensive

43
Q

Case-control study negatives

A

Can only show association (not causation)

Unreliable due to recall bias

44
Q

Cohort study design

A

Longitudinal prospective study which takes a population of people recording their exposures and conditions they develop

45
Q

Cohort study positives

A

Can show causation

Less chance of bias

46
Q

Cohort study negatives

A

Large amount lost to follow up

Expensive

47
Q

RCT Design

A

Similar participants randomly controlled to intervention or control groups to study the effect of the intervention
Gold standard

48
Q

RCT positives

A

Can infer causality

Less risk of bias/ confounders

49
Q

RCT negatives

A

Time consuming and expensive

Ethical issues can interfere

50
Q

Factors to assess causality

A

Bradford-Hill

Biological plausibility
Temporal relationship
Dose-response relationship
Strength association
Specificity
Consistency
Altered by experimentation
Coherence with existing themes
Consider reverse causality
51
Q

Confounders definition

A

risk factors, other than those being studied, that influence the outcome

52
Q

Bias types

A

Selection bias: discrepancy of who is involved
Information bias:
Measurement bias: different equipment
Observer bias
Recall bias: past events incorrectly remembered
Reporting bias: responder doesn’t tell the truth
Publication bias: some trials are more likely to be published than others

53
Q

Bias definition

A

a systematic error that results in a deviation from the true effect of an exposure on an outcome

54
Q

Epidemiological Health needs assessment description

A

Defines problem and size of problem
Looks at current services
Recommends improvements

55
Q

Epidemiological Health needs assessment limitations

A

Data available may be poor
May be inadequate evidence base
Doesn’t consider felt need

56
Q

Comparative Health needs assessment description

A

Compares services received by one population to another

57
Q

Comparative Health needs assessment limitations

A

Data available may vary in quality
May be hard to find comparable population
Comparison may not be perfect

58
Q

Corporate Health needs assessment description

A

Takes into account views of any groups that may have an interest eg patients, health professionals, media, politicians

59
Q

Corporate Health needs assessment limitations

A

May be hard to distinguish need from demand
Groups have vested interest – leads to bias
Dominant individuals may have undue influence

60
Q

Felt need description

A

Individual perceptions of deviations from normal health

61
Q

Expressed need description

A

Seeking help to overcome variation in normal health

62
Q

Normative need description

A

Professional defines intervention for expressed need

63
Q

Comparative need description

A

Comparison between severity, range of interventions and cost

64
Q

types of economic evaluation

A

BUME - Cost/Benefit analysis (Monetary units), Cost utility analysis (QALY)s, cost minimisation analysis (minimise cost for the same outcome), cost effectiveness analysis (natural units)

65
Q

Units economic evaluation

A

QALYs, Natural units, Monetary

66
Q

equity

A

fair and just distribution of costs and benefits

67
Q

Opportunity cost

A

The benefits lost from not allocating resources to the next best option

68
Q

Define efficiency

A

When resources are distributed in such way as to maximise benefit.

Finals (18 decks)

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