Trigger 2: Social Prescribing Flashcards

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1
Q

Definition of health

A

Health is a state of complete physical, mental and social wellbeing. It is not merely the absence of disease or infirmity.

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2
Q

what are social determinants of health

A

The social determinants of health are the conditions in which people are born, grow, live, work and age.

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3
Q

social determinants of health are responsible for…

A

most responsible for health inequalities , which are the unfair and avoidable differences seen within and between social groups, regions and countries.

  • Unfair
  • Avoidable
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4
Q

social determinants of health are shaped by

A

distribution of money, power and resources at local, national and global levels

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5
Q

examples of SDoH

A
food
employment
addiction
childhood and in utero
peace
transport
sexuality
ethnicity
disability
education
housing
poverty
indigenous status
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6
Q

Intersectionality

A
The interconnected nature of social categories such as race, class and gender as they apply to a given individual or group, regarded as creating overlapping and interdependent systems of discrimination, oppression or disadvantage. 
E.g. if you fit into multiple categories which compound over lifetime, you are screwed.

e. g. if you are a refugee and live in a rural community
e. g. if you are a women and homeless
e. g. low education, live remotely and addicted

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7
Q

What is the medical model

A

the medical model runs on the assumptions that all symptoms (physical and mental) to be outward signs of an inner physical disorder

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8
Q

assumptions of medical model

A

That disorders have an organic or physical cause

e.g The medical model of mental illness treats mental disorders in the same way as a broken arm, i.e. there is thought to be a physical cause.

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9
Q

Limitations of medical model

A

1) Cash strapped NHS cant afford to treat everyone with drugs and surgery
2) New treatments being developed are very expensive
3) Diseases are often linked to social aspects- e.g. can prescribe ant-depressants, however if a women is still being beaten by her husband, the drugs will only conceal the deeper issue
4) Cant medicalise non-medical treatment
5) Doesn’t focus on prevention
6) Often medical interventions do not tackle the worst part of the diseases e.g. the anxiety and depression associated with being unwell

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10
Q

How can social prescribing address limitations of medical model?

A

 Been shown to reduce GP visit rates of patients who frequently use primary care
 Could provide long-term solutions for individuals with chronic disorders- tackling the root of the problem
 May reduce the use of expensive drugs, which can have unpleasant side effects

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11
Q

Biopsychosocial model

A

takes into account all relevant determinants of health and disease, supporting the integration of biological, psychological and social factors in assessment, prevent and treatment

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12
Q

Define social prescribing

A

A mechanism for linking primary care patients with non-medical sources of support within their local communities
- Designed to expand treatment options available in primary care, address the social determinants of health and enhance community well-being and social inclusion.

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13
Q

social prescribing mainly targets

A

older and isolated patients

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14
Q

social prescribing shifts which model to which model

A

the biomedical healthcare model to the biopsychosocial model

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15
Q

aim of social prescribing

A

to help people manage chronic conditions and prevent more serious health problems arising.

and
to address the inequalities created by society - SDoH

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16
Q

Give 5 reasons social prescribing has arisen

A

1) population growth- ageing and advances in medical technology means demand for healthcare has increased
2) existing medical model does not address the social determinants of health
3) Without adequate funding universal healthcare is no longer possible
4) continuing to medicalise non-medical problems is unsustainable
5) adresses the psychosocial model

17
Q

by 2020 the NHS will be

A

£30 bill short

18
Q

why research social prescribing

A

⎝ To increase the provision and implementation of social prescribing, it is important for existing and planned schemes to conduct thorough evaluations of the health and wellbeing benefits at both individual and community levels and extrapolate those findings to the health of the nation.

  • Everything has to be funded, funders want EVIDENCE
  • Evaluation is key
  • Evidence has to be given with specific example
19
Q

summary of why social prescribing is researched

A

if we think it is a good schemes, we need evidence to support this (through thorough evaluations) so they can be funded and rolled out into practice.

20
Q

how is SP delivered

A

GPs (or other health professionals) refer patients either directly or through a link worker, to services and programs available in their local community.

21
Q

3 ways social prescribing can be used

A

1) The referral can be the only treatment
2) Can be adjunct to medical treatment
3) Or be an interim measure while waiting for medical treatment (e.g. swimming for bad knees)

22
Q

linker workers role

A
  • Provides support, education and problem-solving for the primary health care team:
  • Helps GPs assessments
  • Manage common mental health problems
  • Act as a signpost for patients to other services which may benefit them
    They ensure people access the best route into a service
23
Q

outcomes targeted with SP

A
  • improved health
  • improved wellbeing
  • improved work opportunities
24
Q

examples of social prescribing

A
  • arts on prescription
  • museums on prescription
  • books on prescription (bibliotherapy)
  • education on prescription
  • exercise on prescription
  • time banks
  • green gyms
25
Q

does social prescribing work

A

its effectiveness remains uncertain

26
Q

12 evaluations of UK social pressing services showed that

A

the rigour of evaluations was limited and that none of the evaluations had an adequate control group

27
Q

some service evaluation reports some beneficial changes such as

A

anxiety, depression, wellbeing, social isolation and GP attendance

28
Q

Limitations of existing research on social prescribing

A
  • lots of the research does not follow formal reporting standards that would be expected in report to funding agencies or journals
29
Q

Lots of the research does not follow formal reporting standards that would be expected in report to funding agencies or journals.

  • give 5 weaknesses in reporting
A
  • small sample sizes
  • short follow up period
  • inadequate comparative control group
  • lack of standardisation and validated measuring tools
  • failure to consider confounding factors
  • missing data
  • methodological shortcoming
30
Q

longitudinal studies are..

A

expensive and therefore gov unlikely to fund further research into social prescribing if there is a lack of evidence to say it is effective

31
Q

Link workers and the research

A

often link worker role varied significantly between projects.

  • make it diff to know the type of skill set or level of training and knowledge people require to effectively to fill the role!
  • makes it hard to see if cost-effective