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3A Flashcards > Public health > Flashcards

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
Q

when are non-organic feeding disorders most common

A

under 6

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26
Q

What is malnutrition

A

Deficiencies, excesses or imbalances within a persons energy or nutritional intake

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27
Q

types of malnution

A

undernutrition
obesity

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28
Q

food insecurity definition

A

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

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29
Q

4 dimensions of food insecurity

A

1Availability (affordability of food)
2 Access (economic and physical)
3 Utility (ability to prepare food)
4 Stability (of the 3 factors over time)

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30
Q

What is horizontal equity

A

equal treatment for equal need eg all with pneumonia are treated the same

31
Q

What is vertical equity

A

unequal treatment for unequal need eg colds and pneumonia get different treatment

32
Q

Equality definition

A

Everyone is treated the same regardless of circumstance or need

33
Q

equity definition

A

Everyone receives what they need to achieve similar outcomes

34
Q

what is felt need in healthcare needs

A

Individuals perception of a variation from normal health

35
Q

what are health need assessments

A

a systemic method for reviewing the health issues facing a population

36
Q

what is expressed need in healthcare need

A

individual seeks to overcome variation in normal health

37
Q

what is comparative need in healthcare need

A

comparison between need, range of intervention, and cost

38
Q

what is normative need in healthcare need

A

health professional describes intervention appropriate for expressed need

39
Q

What are the negative effects of opioids

A

Constipation (Stimulant laxative)
Nausea/vomiting
drowsiness
Headache
Respiratory depression
tolerance
low testosterone

40
Q

What type of laxative for opioid constipation?

A

Stimulant (Senna)

41
Q

what reverses the effect of opioids

A

Naloxone

42
Q

3 founding principles of NHS

A

meet the needs of everyone
free at the point of delivery
dependent on clinical need not ability to pay

43
Q

What is health inequality?

A

avoidable and unfair differences between groups of people or communities, causing marked differences in health outcomes

44
Q

What is the inverse care law

A

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
Q

Health inequalities - things that affect the social gradient and health outcomes

A

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
Q

Maslow’s hierarchy of needs content

A

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
Q

how do you evaluate the effectiveness of a health need intervention (Donerbedian)

A

Structure, process, outcome

48
Q

What is structure and what is a quantitative denominator

A

All resources available - building, staff, equipment
number of Doctors per 1000 patients
number of ICU beds per 1000 population

49
Q

what is process and what is a quantitative denominator

A

What is done with existing structure - tests, counselling, prescriptions

number of blood tests per 1000 appointments
Number of operations per 1000 patients

50
Q

what is outcome in service evaluation and how are they measured

A

result of services provided - death, disability, dissatisfaction, discomfort,

Measured with Quality of life assessment , Patient Reported Outcome Measures, Satisfaction

51
Q

give a quantitative outcome and denominator for Hip replacement with OA

A

number of infections per 1000 operations

52
Q

give a quantitative outcome and denominator for colorectal screening programme

A

number of cancer diagnosis per 1000 patients

53
Q

give a quantitative outcome and denominator for diabetes management in GP

A

HBA1C below 53 per 1000 patients

54
Q

What is a denominator

A

X per Y when x/y

55
Q

Methods of research for evaluating healthcare

A

focus groups, patient interview, audit, Patient reported outcome measures, patient records review

56
Q

what makes up the Planning cycle for service improvement

A

needs assessment
planning
implementation
evaluation

57
Q

Evaluation definition

A

the assessment of whether a service is achieving its objectives

58
Q

Examples of healthcare evaluation

A

single investigation
evaluation of public health interventions
cost effectiveness evaluation

59
Q

anticholinergic side effects

A

Eye: blurred vision, dry eyes
Dr mouth
Brain: drowsiness, dizziness, hallucinations
Heart: rapid heart rate
Constipation
urinary retention
skin flushing

60
Q

3 components of health needs assessment

A

Need - health issues requiring intervention
Demand - the services people seek
Supply - the availability of services to meet needs

61
Q

health needs assessment framework

A

identify health need problem
assess demand for services
evaluate supply
prioritise intervention

62
Q

who do you engage in a corporate Health needs assessment

A

stakeholders:

patients
policy makers
healthcare workers
community representative

63
Q

comparative perspective of HNA

A

identify inequality between health outcomes, services or resources

64
Q

primary prevention

A

an intervention to prevent disease before occuring

65
Q

secondary prevention

A

after a disease has become but before symptoms develop - screening/early identification

66
Q

tertiary prevention

A

managing established disease

67
Q

sensitivity definition

A

true positive - correctly identifies as having disease out of those who have disease

68
Q

specificity definition

A

true negative - correctly identified as not having disease out of those who do not have disease

69
Q

positive predictive value

A

chance of person testing positive having disease

70
Q

negative predictive value

A

chance of person testing negative not having disease

71
Q

wilson jungner criteria

A

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
Q

length time bias

A

slower growing disease has longer to detect

73
Q

lead time bias

A

detected sooner so survives longer

74
Q

Maxwell’s dimensions of quality of healthcare

A

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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