Public health Flashcards

1
Q

What is compliance?

A

Older terminology which describes how well a patient sticks to the allotted medical regime. It assumes the doctor knows best and is professional focussed rather than patient focussed.

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2
Q

What is adherence?

A

Newer terminology which describes the extent to which the patients actions match the agreed medical recommendations. It is patient focussed.

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3
Q

Examples of non-adherence:

A
  • Not taking prescribed medication
  • Taking bigger/smaller doses than prescribed
  • Taking medication without finishing the course
  • Modifying treatment to accommodate other activities
  • Continuing with behaviours against medical advice
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4
Q

What are unintentional reasons for non-adherance?

A
  • Difficulty understanding instructions
  • Problems using treatment
  • Inability to pay
  • Forgetting
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5
Q

What are intentional reasons for non-adherance?

A
  • Patients’ beliefs about their condition
  • Beliefs about treatment
  • Personal preference
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6
Q

What is the necessity-concern framework?

A

This is the concept that patients adhere to prescriptions etc based on necessity beliefs and concerns:
Necessity beliefs - perceptions of personal need for treatment
Concerns - about a range of potential adverse consequences

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7
Q

What is the beliefs about medicines questionnaire?

A

A method to asses cognitive representations of medicine. One section assesses representations of the medicine prescribed and one which assess beliefs about medication in general.

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8
Q

Why is good doctor-patient communication important?

A
  • Leads to higher adherence
  • Better health outcomes
  • High patient and clinician satisfaction
  • Decrease in malpractice risk
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9
Q

What is concordance?

A

An interaction between a clinician and patient where an agreement is formed.

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10
Q

What are barriers to patient-clinician concordance?

A
  • Patients not wanting to engage in discussion
  • Might worry patient more
  • Patient may want to be submissive
  • Time/resources
  • Patience choice vs evidence
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11
Q

What are ethical parameters which need to be considered in patient-clinician concordance?

A
  • Mental capacity
  • Decisions detrimental to patients wellbeing
  • When decision is a potential threat to others
  • When the patient is a child
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12
Q

What legislation is in place to support medical decisions when a child is involved?

A

Children act 1989 - child’s welfare should be paramount. When child is of sufficient understanding the medical treatment may only be given with child’s consent.

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13
Q

What legislation is in place to protect the public when a patients decision is a potential threat to others?

A

Public health act 2010 - provides a legal basis to isolate patients with an infectious disease of category 4 (bird flu, sars, tuberculosis, typhoid) or category 5 (HIV, AIDS)

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