Public Health

Question 1

Describe the epidemiology of chlamydia.

Answer 1

• Peak in 15-25 y/o.

- Women > men.

Question 2

What can cause chlamydia?

Answer 2

Chlamydia trachomatis.

Gram negative

Question 3

Give 2 symptoms of chlamydia/gonorrhoea infection in men.

Answer 3

1. Dysuria.

2. Urethral discharge.

Question 4

Give a potential complication of chlamydia infection in men.

Answer 4

Epididymo-orchitis.

Question 5

What is the primary site for chlamydial infection in men?

Answer 5

Urethra - > urethritis

Question 6

What is the primary site for chlamydial infection in women?

Answer 6

Cervix

Question 7

What is the definition of patient compliance?

Answer 7

The extent to which the patients’ behaviour (in terms of taking medications, following diets or other lifestyle changes) coincides with medical/health advice

Question 8

What is the ‘paternalistic relationship’ model of healthcare?

Answer 8

Patient must follow doctor’s orders; professionally focussed rather than patient focused (assumes doctor knows best); doesn’t look at the problems patients have in managing their health

Question 9

Give 3 examples of non-adherence

Answer 9

1. Not taking prescribed medication
2. Taking larger/smaller doses than prescribed
3. Taking medication more/less often than prescribed

Question 10

Give 2 unintentional reasons for non-adherence

Answer 10

1. Difficulty understanding instructions
2. Problems using treatment
3. Inability to pay

Question 11

Give 2 intentional reasons for non-adherence

Answer 11

1. Patient’s beliefs about their health/condition
2. Beliefs about treatments
3. Personal preferences

Question 12

Suggest 2 impacts of good doctor-patient communication

Answer 12

1. Better health outcomes
2. Higher patient/doctor satisfaction
3. Higher compliance to therapeutic regimens in patients

Question 13

What is the necessity-concerns framework?

Answer 13

Key beliefs of the patient divided into:

a) Necessity beliefs - perceived personal need for treatment
b) Concerns - about adverse effects

Question 14

How does the necessity-concerns framework affect adherence?

Answer 14

Adherence needs increased necessity beliefs, and decreased concerns

Question 15

Give 3 measures than can be taken to increase patient adherence.

Answer 15

1. Improve communication
2. Increase patient involvement
3. Understand patient perspective

Question 16

What is the ‘adherence’ model of communication?

Answer 16

1. Focus on adherence, not compliance.
2. Acknowledge patient’s beliefs.
3. Health professional as expert, conveying knowledge. 4. Aim is for a patient-centred approach

Question 17

What was the findings of the Black Report (1980)?

Answer 17

1. Confirmed social class health inequalities in overall mortality
2. Health inequalities were widening