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primary care > studies > Flashcards

studies Flashcards

1
Q

studies aim

A

to give an available source of data that gives an epidemiological picture of the UK society

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2
Q

descriptive studies show

A
  • Amount and distribution of disease in a population

- Insight into aetiology = health service needs

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3
Q

descriptive studies are useful because they

A
  • Identifying health problems + monitoring and surveillance
  • Any effects worthy of further investigation
  • Assess effectiveness of measures of prevention and control
  • Assess needs for health services and planning
  • Ideas on disease aetiology
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4
Q

advantages of descriptive studies

A

cheap, quick, good overview

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5
Q

disadvantages of descriptive studies

A

no evidence about cause, doesn’t need hypotheses

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6
Q

examples of analytical studies

A

cross sectional
case control
cohort

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7
Q

cross sectional studies investigate

A

disease frequency, survey, prevalance

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8
Q

process of cross sectional studies

A
  • Observations made at a specific point in time

- Conclusions made about relationship of disease and variables in a defined population

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9
Q

+ and - of cross sectional studies

A
  • Advantages: Quick and easy

- Disadvantages: gives no cause

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10
Q

case control study process

A
  • Compare two groups of people; a group who have the disease and group who don’t (ie cases and controls)
  • Data gathered to see if individuals have been exposed to the suspect aetiological factors
  • Results are given as RR
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11
Q

cohort study process

A
  • Collect baseline data from a group of people who don’t have the disease
  • Group then followed until a sufficient number have developed the disease to allow analysis.
  • Original group separated into subgroups according to original exposure and then compared to see incidence of disease according to exposure.
  • Allow calculation of cumulative evidence for follow up over time
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12
Q

study called that involves trials?

A

randomised controlled trial

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13
Q

point of trials?

A

Experiments used to test ideas about aetiology or evaluate interventions

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14
Q

RCT used to

A

assess new treatment

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15
Q

process of RCT

A
  • 2 groups at risk of developing disease are assembled; split into study (intervention) group and control group)
  • Study group = new drug and the control = placebo.
  • Treatment outcomes are compared.
  • Calculate a relative risk (aetiological components)
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16
Q

standardisation?

A

removal/adjustments of confounding variables (e.g. age) when comparing pops

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17
Q

SMR?

A

standardised mortality ratio - death rate converted into ratio for easy comparison

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18
Q

quality of data - is a measurement of

A

trustworthiness

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19
Q

case definition

A

Purpose is to decide if an individual has the condition or interest or not

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20
Q

coding and classification

A

data converted into coding via analysis + storage - rules for this

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21
Q

ascertainment

A

data set complete? missing subjects

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22
Q

Bias is

A

any trend in the collection, analysis, interpretation, publication or review of data that can

lead to conclusions that are systematically different from the truth.

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23
Q

types of bias x4

A

selection bias: not representative of whole study pop

information bias: errors in measuring exposure

follow up bias: 1 group followed up more than another

systematic error bias: measurements tend to always fall on one side of the true value

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24
Q

confounding factor?

A

one that’s INDEPENDENTLY associated with the disease and the exposure under investigation

EG AGE, SEX,

25
Q

ways to deal with confounding factors

A
  • randomise
  • restrict eligibility criteria
  • stratify
  • adjust
  • matching
26
Q

criteria for causality means

A

Criteria demonstrate weight of evidence in favour of a causal relationship.

27
Q

aspects of the criteria of causality

A
  • strength of association as measured by RR
  • consistency: different pops
  • specificity: single exposure leads to single disease
  • temporality: exposure before disease
  • biological gradient: increase exposure increase risk of disease
  • bio plausibility: makes sense in bio
  • coherence: doesn’t conflict with bio
  • analogy: use another disease to act as model
  • experiment: controlled experiment to prove association
28
Q

levels of health promotion - prevention

A

primary: prevention - vaccines
secondary: prevention of disease: screening - cervical smear
tertiary: prevent disease progression, limit disability, distress: rehab
primordial: wider environ and social - smoke free cities

29
Q

health promotion definition

A

over arching principle. enhances:

  • health
  • disease prevention
  • health protection
  • health education

planned or opportunistic

30
Q

health education definition

A

strategies to improve health knowledge, attitudes, skills or behaviours

31
Q

health protection definition

A

collective activities directed at factors that are OUTSIDE of the control of the individual

e.g. smoking ban

32
Q

empowerment

A

helping people identify their OWN concerns

33
Q

Health and life skills to facilitate control

A
  • Communicate effectiveness
  • Influence people and systems
  • Make relationships
  • Be assertive
  • Work in groups
  • Manage conflict
  • Build strengths in others.
34
Q

many approaches to health promotion…

A

assessment of ongoing health problems

assess RFs

check ups

advice on healthy lifestyle

services comply with own advice

stress reduction protocol

counselling services

travel advice

sexual health advice

35
Q

why has health promotion become a component of NHS

A

more cost effective that treating disease

wider public health + wellbeing

advances health status

36
Q

challenges to assessing the quality and outcomes of health promotion

A

hard to achieve long term behaviour change

hard to devote resources to 50yrs

hard to measure QOL

pts can be cyclical or dismissive

people continue to do harmful behaviours despite understanding health implications

NHS dont dedicate resouces

37
Q

NNT?

A

number needed to treat

number of people you need to give a drug to to prevent one additional bad outcome

38
Q

NNH?

A

number needed to help

number needed to be exposed to risk factor to cause harm that wouldn’t other wise have been harmed

39
Q

fit notes

A

note of inclusion

sick note (of exclusion

40
Q

life limiting illness

A

reduces life expectancy or/+ quality of life

41
Q

palliative care

A

improve QOL for pts, carers, families - providing pain relief, spiritual, psychosocial support

from diagnosis to end of life bereavement

42
Q

ACP?

A

anticipatory care pplan

43
Q

aspects of ACP?

A
  • Where do they want to receive care
  • DNR?
  • Natural death?
  • Do they want to be informed about any changes in their condition
  • Are they fully aware of the prognosis
  • Are family involved in the care
  • placed on palliative care register
44
Q

palliative performance scale (%)

A 
ambulation 
self care 
evidence of disease 
intake (food drink)
conscious level
45
Q

ACP psychological impact:

A

shock denial, disbelief

anger, bargaining

despair depression

acceptance and adjustment

46
Q

ACP social impact

A 
social withdrawal 
strain on relationships
disputes with families 
financial
isolation
47
Q

ACP medical impact

A

pain Mx
depression
cost

48
Q

aspects of a good death in western culture

A
  • personal preference
  • personal growth
  • awareness
  • at home
  • with family
  • power of attorney
  • dignity, consent
  • PAIN FREE
49
Q

ethical aspects of ACP

A

Dignity, confidentiality, consent, use of DNRs, autonomy, following their wishes.

50
Q

impacts of palliation of family

A
  • reduced hobbies
  • lack of privacy
  • financial strain
  • satisfaction
  • grief
  • anxiety/depression
  • work less
  • restriction socialising
  • adapt house
51
Q

support for families/carers

A 
meals on wheels 
OT - adjust home 
rest bite 
chairites
voluntary groups 
support groups 
palliation nurses 
social worker 
counsellor
52
Q

how does age affect health

A
  • Increases risk of disease
  • Social stigma impacting on mental health
  • Reduced mobility
  • Isolation
  • Inability to work; financial problems impact on well-being
  • Cognitive decline
  • Reduced ADLs
53
Q

how does age affect own views on health

A
  • More accepting of conditions
  • Understanding of normality; range changes
  • Active Ageing = optimisation of physical, social and security
  • More likely to seek help as believe more likely to have serious illness
54
Q

how does age affect others views on your health

A
  • Detrimental
  • Burden
  • Costly
  • Take up space in hospital
  • Wisdom, knowledge, life experience.
55
Q

challenges of ageing pop on NHS

A
  • increased need for geriatricians
  • increased need for nurse/wards
  • increased prevalence of long term conditions
  • need to for specific elderly health promotion
56
Q

challenges of ageing pop on social aspects

A
  • increased need for care homes, sheltered housing, carers
  • dependence on families
  • emphasis on social activities for elderly
  • house demands
  • pensions
57
Q

services available to the elderly community

A 
panic alarms 
home care 
assisted living 
sheltered housing
very sheltered housing 
care house 
nursing house 
hospice/hospital
58
Q

how elderly people feel when depending on others

A
  • Guilt/burden
  • Resentment
  • Depression
  • Loss of independence
  • Social isolation
  • Decreased will to live
  • Well look after
  • Comfortable
  • Relieved
  • Happy to be with family
  • Feel safe
  • Better social life/activities/don’t have to sort out shopping

primary care (5 decks)

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