Public Health Flashcards
Epidemiology of back pain
- May be simple (mechanical) or nerve root (neurological)
- Simple back pain normally presents between 20-55, mechanical in nature, normally lumbrosacral
Epidemiology of back pain - neurological back pain
- Spreads to legs, feet and toes
- Numbness/ paraesthesia can accompany pain
- Red flags - very old/young, violent trauma, systemic upset, wipespread neurology
Physical activity advice in clinical consultations
- Important, but no prioritised over medical management elements
- Barriers for implementation of behaviour change interventions
4 broad categories that can influence an individual’s public health
- Biological factors e.g. gender, ethnicity
- Personal lifestyle e.g. exercise, diet
- Physical and social environment e.g. air pollution
- Public health services
What did the Black Report 1980 confirm?
that health inequalities were widening
Why do women tend to suffer more illness than men?
- Biological - role in reproduction
- Ageing - women live longer
- Material - women still seen as ‘carers’
4 main reasons men have higher mortality than women
- EMPLOYMENT - often higher risk occupations
- RISK TAKING BEHAVIOUR
- MEN SMOKE MORE
- MEN DRINK MORE ALCOHOL
What is the disengagement theory?
Process by which older people disengage themselves from roles they previously occupied in society
Theory of third age?
Describes an era after retirement with health, vigour and positive attitude
Association between social class and life expectancy
Higher socio-economic classification = higher life expectancy
Association between social class and smoking
greater % of people smoke in lower socio-economic classes
Association between mortality and unemployment
Greater in the unemployed
Define patient compliance
Extent to which a patient’s behaviour coincides with medical/health advice
3 disadvantages of patient compliance
- Passive - patient must follow doctor’s orders
- Professionally focussed and assumes Dr knows best
- Ignores problems patients have in managing their own health
What is patient adherence?
extent to which a patient’s actions match agreed recommendations
Difference between patient compliance and adherence?
Patient adherence is more patient centred, it empowers patients and considers them as equals.
Patient compliance is often viewed as uncaring, condescending and passive
Key principles of adherence?
- Improves communications
- Increases patient involvement
- Understands patient’s perspective
- Provision and discussion of information
- Assess adherence
- Review medicines
Necessity-concerns framework
Looks at what influences adherence, adherence increases when necessity beliefs are high and concerns are low
2 factors that encourage patient centred care?
- Holistic approach - focus on the patient as a whole
2. Shared control of consultation, shared decisions
What is concordance?
Expectation that patients will take part in treatment decisions and have a say in the consultation
5 barriers to concordance?
- Patient may not want to engage in discussions
- May cause worry
- Might just want doctor to tell them what to do
- Time, resources constraints
- Patient choice may differ from medical advice
4 advantages of doctor-patient communication?
- Better health outcomes
- Higher compliance
- Higher patient and clinician satisfaction
- Decrease in risk of malpractice
5 main duties of a doctor?
- Work in partnership with patients, treat as individuals, respect their dignity
- Work with colleagues in a way that best serves patients’ interests
- Protect and promote health
- Recognise and work within your limits of competence
- Provide a good standard of care
Where might norovirus outbreaks be?
School, cruise ships, restaurants, hospitals
