Public health Flashcards
Consent must be 3 things
Voluntary
Informed
Made by someone with mental capacity
4 things that need to be told to patient about their treatment
What it involves
Risk
Benefits
Alternative options (and their risks/benefits)
Mental capacity act 2005
Used to empower and protect individuals over 16 who lack mental capacity to make decisions about their care and treatment
E.g. people with dementia, stroke, disabilities
Before deciding completely whether the individual does have proper mental capacity, the following things need to be considered
Have they been given all the info they need
Have different ways of communication been explored (non verbal)
Could anyone else help communicate with them (family/relatives)
Does capacity fluctuate with time/environment
Can decision be delayed until person is able to make one
What happens when it is found that individual lacks mental capacity to make a decision
Decision must be made in their best interests - weight up advantages/disadvantages
Advance statement/ADRT (Advanced Decision to Refuse Treatment) - Made by someone before they become incapable of making a decision
LPA (Lasting Power of Attorney) - Can grant another person authority to make decisions about your healthcare, and even property and finance affairs
What is used for individuals under 16
Gillicks competency/Fraser guidelines
The laws are mostly specific to contraceptive advice
Substance misuse
Ingestion of a substance that affects the CNS, leading to behavioural and physiological changes, for a non-therapeutic reason
Substances used for misuse
Opiates for pain relief and euphoria (heroin, morphine)
Depressants for sedation and relaxation (valium)
Stimulants for improved mood and activity (caffeine, cocaine, nicotine)
Hallucinogens for altered sensory perception and thinking patterns (ketamine, magic mushrooms)
Addiction - Causes
Illness
Genetics
Bad habit
Social problems
Addiction - Risk factors
Family history of misuse, conflict, poor familial management/parenting
Community - low academic commitment, substance availability
Individual/peer - risk taking behaviour/rebelliousness, anti-social behaviour, substance abusing peers, experience of trauma (bereavement, abuse)
Addiction - Management
National drug strategy 2010 - reducing demand, restricting supply, suport services through local councils
GP support
Needle exchange programs
Rehab/detox programmes
Compliance
Patient’s behaviour coincides with medical advice
Adherence
Patient involvement and autonomy throughout course of treatment
Concordance
Patient is equal to doctor in care-giving, involving them in decision making
Reasons for non-adherence
Financial barriers
Forgetfulness (dementia)
Language barriers
Patient’s beliefs
Necessity-concerns framework
Key beliefs influencing patients put into 2 categories - Necessity and concerns (perceived need for treatment and adverse consequences)
Adherence requires more necessity and less concern beliefs
Coronary heart disease - Risk factors
Smoking Diabetes Hypertension Obesity High cholesterol
Population attributable risk
The disease incidence in the population that would be eliminated if the exposure (smoking) were eliminated
Type A personalities
Competitive
Hostile
Agression
Occupational health - Respiratory
Inhaling fumes, dust, gas, aerosols
Acute irritant asthma, pulmonary oedema, infection, allergy, chronic inflammation (COPD), destruction of lung tissue (fibrosis of lungs/pleura), carcinogenesis
Lung disease - Causes
Smoking
Occupational hazards
Geographical variation is due to socioeconomic differences, historic industry (mining, shipping, building)
Pandemic influenza - 3 Types
A, B, C (A/B more common)
Pandemic influenza - Symptoms
Upper/lower respiratory tract symptoms Fever Headache Malaise Weakness
