public health

Question 1

what is public health

Answer 1

science and art of preventing disease, prolonging life and promoting health through organised efforts of society

Question 2

what are the 3 domains of public health

Answer 2

health improvement
health protection
improving services

Question 3

what are the key concerns of public health

Answer 3

inequalities in health
wider determinants of health
prevention

Question 4

What needs to be done/performed before a health intervention is made?

Answer 4

health needs assessment

Question 5

what is a health needs assessment

Answer 5

systematic method for reviewing health issues facing a population
this leads to agreed priorities and resource allocation that will improve health and reduce inequalities

Question 6

what are the 3 different approaches of health needs assessments

Answer 6

epidemiological
comparative
corporate

Question 7

define need

Answer 7

ability to benefit from an intervention

Question 8

define demand

Answer 8

what people ask for

Question 9

define supply

Answer 9

what is provided

Question 10

what is a health need and how is it measured

Answer 10

need for health
measured using mortality, morbidity, socio-demographic measures

Question 11

what is a health care need

Answer 11

need for healthcare
depends on the potential of prevention, treatment and care services to remedy health problems

Question 12

epidemiological approach to a health needs assessment

Answer 12

• define the problem
• look at the size of the problem (incidence/ prevalence)
• services available
• evidence base (effectiveness and cost-effectiveness)
• models of care incl. quality and outcome measures
• existing services (what is already there and unmet needs)
• recommendations

Question 13

problems with epidemiological approach

Answer 13

required data may not be available
evidence base may be inadequate
doesn’t consider felt needs of people affected

Question 14

advantages of epidemiological HNA approach

Answer 14

uses existing data
provides data on disease incidence/ mortality/ morbidity
can evaluate services by trends over time

Question 15

what are potential sources of data for epidemiological HNA

Answer 15

disease registry
hospital admissions
GP databases
mortality data
primary data collection e.g. patient survey

Question 16

comparative approach to a HNA

Answer 16

compares services for a particular health issue in 2 different areas

Question 17

advantages of comparative HNA

Answer 17

quick and cheap if data available
indicates whether services is better/ worse than comparable areas

Question 18

problems of comparative HNA

Answer 18

data may not be available
data may be or variable quality
may be difficult to find a comparable population

Question 19

corporate approach to HNA

Answer 19

obtaining views of a range of stakeholders e.g. patients, families professions etc
asking local population what their health needs are
e.g. focus groups, interviews, public meetings

Question 20

advantages of corporate HNA

Answer 20

based on felt and expressed needs of the population in question
takes into account wide range of views

Question 21

disadvantages of corporate HNA

Answer 21

may be influenced by political agendas
difficult to distinguish need from demand

Question 22

acute physical effects of dependant drug abuse

Answer 22

respiratory depression
constipation, dry mouth (side effects)
complications of injecting- DVT, abscesses, SBE

Question 23

How often must heroin be used in people with heroin dependency to avoid withdrawal?

Answer 23

8 hourly

Question 24

effects of heroin

Answer 24

euphoria
intense relaxation
miosis
drowsiness

Question 25

adverse effects of heroin

Answer 25

dependence withdrawal symptoms nausea itching sweating constipation

Question 26

Which medications can be used for maintenance of staying off heroin?

Answer 26

Methadone (full opioid agonist) Buprenorphine (partial agonist/antagonist)

Question 27

what is theory of planned behaviour determined by

Answer 27

person's attitude subjective norms perceived behavioural control

Question 28

problems of theory of planned behaviour

Answer 28

- doesn't take into account emotions - lack of temporal element (no timescale) - Assumes that attitudes, subjective norms and perceived behavioural control can be measured

Question 29

what are the stages of the stage/ transtheoretical model

Answer 29

Precontemplation Contemplation Preparation Action Maintenance

Question 30

advantages of stage model

Answer 30

- acknowledges individual stage of readiness - accounts for relapses - gives an idea of time frame

Question 31

problems of stage model

Answer 31

- not all people move through every stage - Doesn’t take into account values, habits, culture, social and economic factors

Question 32

what is the nudge theory

Answer 32

Changing the environment to make the best/healthiest option the easiest For example placing fruit next to the checkouts at supermarkets instead of sweets, opt-out schemes such as pensions

Question 33

What are the typical transition points in life which may influence how someone changes their behaviour?

Answer 33

- Leaving school - Starting work/new job - Becoming a parent - Becoming unemployed - Retirement - Bereavement

Question 34

what are the 4 factors of the health belief model

Answer 34

perceived susceptibility perceived severity perceived benefits perceived barriers

Question 35

Health belief model individuals will change behaviour if they:

Answer 35

- believe they are susceptible to the condition in question (e.g. heart disease) - believe that that it has serious consequences - believe that taking action reduces susceptibility - believe that the benefits of taking action outweigh the costs

Question 36

problems of health belief model

Answer 36

- doesn't consider influence of emotions and behaviour - doesn't differentiate between first time and repeat behaviour - cues to action are often missing

Question 37

what is cues to action in health belief model

Answer 37

stimulus needed to trigger the decision-making process

Question 38

examples of cues to action which may influence behaviour change

Answer 38

Cues can be internal or external Internal = increase in pain, decrease in ADLs External = reminders in the post, reminders for GP apts, pressure from families etc.

Question 39

when does social norm not have an impact on health behaviour

Answer 39

when risky behaviour is the social norm