Public health Flashcards
What does consent have to be? (3)
- Voluntary
- Informed
- With capacity
What would you tell the patient to inform their consent (4)
- What is involved
- Risks
- Benefits
- Other options available
How would you tell if a patient has capacity (4)
- They understand information
- They can retain information
- They can weigh up the information
- They can make an informed decision based on information provided
What do you do if patient does not have capacity (3)
- Decision made in best interest of patient (include family members)
- Advance statement
- Attorney - someone assigned to make decisions for them
What if the patient is below 16 (3)
- Fraser-Gillicks guideline
- Asses if patient is deemed mature and competent enough
- If not parents decision
When can you legally break patient confidentiality (3)
- To protect the patient from harm (eg. abuse)
- To protect the general public from harm (eg. infectious disease or terrorism)
- When patient gives you consent
What is compliance
- The extent to which the patients behaviour coincides with medical or health advice
What is Adherence
- The extent to which the patients actions match agreed recommendations (more patient centred)
What is Concordance
- The expectation that patients will take part in treatment decisions and have say in consultation
What are the reasons for non-adherence (3)
Unintentional - Forgetting - Misunderstanding Intentional - Patients beliefs
What are the reasons unsafe practice may occur (4)
- Poor communication
- Training problems
- Staffing/staff incompetence
- Human error
What is sensitivity
- Proportion of people with the disease that are correctly identified
What is specificity
- Proportion of people without the disease who are correctly excluded
What is incidence
- The rate at which new cases occur in a specified time period (often as a rate per 100,000)
What is prevalence
- The proportion of a population who have a disease at any point in time (%)
What is an ecological study
- A study using population level data (eg. mortality)
What is a cross sectional study
- Look at the population at any point in time (eg. prevalence)
What is a case control study
- Retrospective study that compares people with and without disease to see if they were exposed to a certain agent
What is a cohort study
- Follows a group of people over time to see if they are exposed to an agent/if they get the disease
What is a random control trial
- Intervention given and compared to a control
What is primary prevention
- Attempting to stop disease from occurring in first place by eliminating risk factors
What is secondary prevention
- Detecting a disease as soon as possible to alter progression/outcome
What is tertiary prevention
- Trying to slow down the progression of a disease/prevent re-occurrence/exacerbations
What is the medicalisation hypothesis
- The idea that doctors see everything medically, so a condition may appear medical in nature when actually caused by a social factor
What is the inverse care law
- Availability of good healthcare varies inversely with need for it
What is the prevention paradox
- The idea that a large number of people with low risk for a disease may contribute more cases than a small number of people at high risk
What is the doctrine of dual affect
- If you administer a drug to relieve pain in doses that you know may be fatal, then provided your intention is not to shorten life but to relieve pain, the administration is not unlawful.
What is relative risk
- The risk of an event in an exposed group divided by the risk in a non-exposed group
What is absolute risk difference/reduction/excess
- Risk in an exposed group - risk in non-exposed group
What is the number needed to treat
- Number of patients needed to treat in order to cure one extra person
- 1 over absolute risk reduction
- Also number needed to harm is same
