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Public health Flashcards

1
Q

What are the 3 domains of public health

A

Health improvement - efforts and strategies to improve health (housing, education, employment)

Health protection - measures taken to avoid disease (radiation, pollution, immunisation)

Health care - services aimed at treating disease or preventative medicine (clinical effectiveness, governance and audit)

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2
Q

What are health improvements in public health

A

Health improvement - efforts and strategies to improve health (housing, education, employment)

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3
Q

what are health protections in public health

A

Health protection - measures taken to avoid disease (radiation, pollution, immunisation, emergency response)

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4
Q

What is health care in public health

A

Health care - services aimed at treating disease or preventative medicine (clinical effectiveness, governance and audit)

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5
Q

What are the 3 behaviours in health psychology

A

Illness behaviour - to seek remedy eg go to doctor
Sick role behaviour - to become well eg take medication
Health behaviour - to prevent disease eg eating healthy

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6
Q

What is illness behaviour

A

to seek remedy eg go to doctor

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7
Q

what is sick role behaviour

A

to become well eg take medication

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8
Q

what is health behaviour

A

to prevent disease eg eat healthy/exersice

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9
Q

What is medication adherence in developed countries

A

50%

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10
Q

What is Intervention at a population level

A

the process of enabling people to exert control over their own health
eg awareness campaigns (5 a day)
eg screening and immunisation

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11
Q

what is intervention at an individual level

A

patient centred approach - care based on individual needs

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12
Q

why do individuals continue to engage in health damaging behaviour

A

inaccurate perceptions of risk and susceptibility.

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13
Q

What 4 factors influence perception of risk

A

1 lack of personal experience with the problem
2 belief that the problem is not preventable by personal action
3 the belief is the problem has not yep happened, it is not likely to
4 The belief the problem is infrequent

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14
Q

What 4 factors make up the health belief model

A

i) the belief they are susceptible
ii) the belief it has serious consequences
iii) the belief taking action reduces susceptibility
iv) the belief the cost of taking action is less than the benefit

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15
Q

Positives of the health belief model

A

percieved barriers have been shown to be the most important factor for addressing behaviour change

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16
Q

Critiques of the health belief model

A

1 does not differentiate between first time and repeat behaviours
2 does not consider the influence of emotions or behaviours
3 does not consider outcome expectancy or self efficacy

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17
Q

what does the theory of planned behaviour propose

A

the best indicator of behaviour change is intention (made up of persons attitude to the behaviour, social pressure to change eg social norm and the persons percieved behavoural control)

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18
Q

What factors make up intention in the theory of planned behaviour change

A

1 Personal attitudes to the behaviour
2 social pressure to change behaviour (eg norm)
3 persons percieved behavioural control

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19
Q

What are critiques of the theory of planned behaviour change

A

Does not include a temporal element or causality
Does not consider emotions
does not consider habits or routines
does not consider how the factors that make up intention interact

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20
Q

What stages make up the stages of change/trans-theoretical model

A

PC PAM

precontemplation
contemplation
Preparation
action
maintenance

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21
Q

Advantages of the stages of change/trans-theoretical model

A

Includes temporal element
accounts for relapse

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22
Q

Disadvantages of the stages of change/trans-theoretical model

A

Not everyone moves through the same stages linearly
Does not consider social or economic influences
does not consider habits or culture
Change may be a continuum not discrete stages

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23
Q

What factors influence the development of food behaviours

A

Maternal diet
breastfeeding
age of solids introduction
parenting practices

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24
Q

What are the determinants of health

A

Genetics
environment
lifestyle
healthcare

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25
when are non-organic feeding disorders most common
under 6
26
What is malnutrition
Deficiencies, excesses or imbalances within a persons energy or nutritional intake
27
types of malnution
undernutrition obesity
28
food insecurity definition
Eating smaller portions than usual or skipping meals Not eating when hungry not eating the whole day Due to being unable to afford or access food
29
4 dimensions of food insecurity
1Availability (affordability of food) 2 Access (economic and physical) 3 Utility (ability to prepare food) 4 Stability (of the 3 factors over time)
30
What is horizontal equity
equal treatment for equal need eg all with pneumonia are treated the same
31
What is vertical equity
unequal treatment for unequal need eg colds and pneumonia get different treatment
32
Equality definition
Everyone is treated the same regardless of circumstance or need
33
equity definition
Everyone receives what they need to achieve similar outcomes
34
what is felt need in healthcare needs
Individuals perception of a variation from normal health
35
what are health need assessments
a systemic method for reviewing the health issues facing a population
36
what is expressed need in healthcare need
individual seeks to overcome variation in normal health
37
what is comparative need in healthcare need
comparison between need, range of intervention, and cost
38
what is normative need in healthcare need
health professional describes intervention appropriate for expressed need
39
What are the negative effects of opioids
Constipation (Stimulant laxative) Nausea/vomiting drowsiness Headache Respiratory depression tolerance low testosterone
40
What type of laxative for opioid constipation?
Stimulant (Senna)
41
what reverses the effect of opioids
Naloxone
42
3 founding principles of NHS
meet the needs of everyone free at the point of delivery dependent on clinical need not ability to pay
43
What is health inequality?
avoidable and unfair differences between groups of people or communities, causing marked differences in health outcomes
44
What is the inverse care law
those who need care the most are least likely to have access availability of good medical care tends to vary inversely with the needs of the population
45
Health inequalities - things that affect the social gradient and health outcomes
a good start in life being in control of your life having good/fair employment having a healthy standard of living a safe home and good community
46
Maslow's hierarchy of needs content
physiological - breathing, food, water safety - security of body/employment love/belonging - friends/family/sexual intimacy esteem - respect of others, confidence self actualisation - creativity, problem solving, lack of prejudice
47
how do you evaluate the effectiveness of a health need intervention (Donerbedian)
Structure, process, outcome
48
What is structure and what is a quantitative denominator
All resources available - building, staff, equipment number of Doctors per 1000 patients number of ICU beds per 1000 population
49
what is process and what is a quantitative denominator
What is done with existing structure - tests, counselling, prescriptions number of blood tests per 1000 appointments Number of operations per 1000 patients
50
what is outcome in service evaluation and how are they measured
result of services provided - death, disability, dissatisfaction, discomfort, Measured with Quality of life assessment , Patient Reported Outcome Measures, Satisfaction
51
give a quantitative outcome and denominator for Hip replacement with OA
number of infections per 1000 operations
52
give a quantitative outcome and denominator for colorectal screening programme
number of cancer diagnosis per 1000 patients
53
give a quantitative outcome and denominator for diabetes management in GP
HBA1C below 53 per 1000 patients
54
What is a denominator
X per Y when x/y
55
Methods of research for evaluating healthcare
focus groups, patient interview, audit, Patient reported outcome measures, patient records review
56
what makes up the Planning cycle for service improvement
needs assessment planning implementation evaluation
57
Evaluation definition
the assessment of whether a service is achieving its objectives
58
Examples of healthcare evaluation
single investigation evaluation of public health interventions cost effectiveness evaluation
59
anticholinergic side effects
Eye: blurred vision, dry eyes Dr mouth Brain: drowsiness, dizziness, hallucinations Heart: rapid heart rate Constipation urinary retention skin flushing
60
3 components of health needs assessment
Need - health issues requiring intervention Demand - the services people seek Supply - the availability of services to meet needs
61
health needs assessment framework
identify health need problem assess demand for services evaluate supply prioritise intervention
62
who do you engage in a corporate Health needs assessment
stakeholders: patients policy makers healthcare workers community representative
63
comparative perspective of HNA
identify inequality between health outcomes, services or resources
64
primary prevention
an intervention to prevent disease before occuring
65
secondary prevention
after a disease has become but before symptoms develop - screening/early identification
66
tertiary prevention
managing established disease
67
sensitivity definition
true positive - correctly identifies as having disease out of those who have disease
68
specificity definition
true negative - correctly identified as not having disease out of those who do not have disease
69
positive predictive value
chance of person testing positive having disease
70
negative predictive value
chance of person testing negative not having disease
71
wilson jungner criteria
acceptability of test to public/cost/healthcare policy has been agreed for treatment effective treatment natural history well understood important disease - prevalent/substantial burden of disease simple and safe
72
length time bias
slower growing disease has longer to detect
73
lead time bias
detected sooner so survives longer
74
Maxwell's dimensions of quality of healthcare
accessibility - can people use this service acceptability - is it safe/comfortable/doable appropriateness - in line with religions/personal belief effectiveness - fit for purpose, does it achieve its goals efficiency - optimal use of resources to achieve outcomes equity - different treatment to allow everyone to reach the same outcomes

3A Flashcards (9 decks)

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