Understanding Health Flashcards
1
Q
What is health?
A
not being ill, no disease, behaviour, role functioning.
2
Q
what is the biomedical model for health?
A
• Health is freedom from disease &
abnormalities.
3
Q
what are the limitations of the biomedical model for health?
A
negative, doesn’t look at mental health.
4
Q
what is the WHO model for health?
A
• Health is a complete state of physical,
mental and social well-being, not merely
the absence of disease or infirmity.
5
Q
what are the limitations of the WHO model for health?
A
unrealistic.
6
Q
what is the sociological model for health?
A
• Health is the state of optimum capacity (physical and
mental fitness) of an individual for the effective
performance of the roles and tasks for which he has
been socialised.
• Health and illness are normatively defined, constituting
standards of adequacy relative to capacities, feeling
states and biological functioning needed for the
performance of activities expected of members of
society, expectations which may vary by sex and age.
7
Q
what are the limitations of the sociological model for health?
A
just making someone better so they can preform their role does not always look at what is best for the individual.
8
Q
what is illness?
A
The subjective state which is experienced by an
individual – a feeling of ill-being.
9
Q
what is disease?
A
• A pathological condition recognised by
indications agreed among biomedical
practitioners. Indicated by signs and symptoms.
10
Q
what is sickness?
A
The social state that results as a consequence
of feeling ill or being diseased. Sickness is
reflected in a changed lifestyle (sick role)
11
Q
what the definition of oral health from ‘An Oral Health Strategy for England
Department of Health 1994’?
A
a standard of health of the oral and related tissues which enables an individual to eat, speak and socialise without active disease, discomfort or embarrassment and which contributes to general well being.
12
Q
what are health influencing factors?
A
Fixed factors
Lifestyle & behaviours (diet,smoking, drinking)
Social, psychological and cultural factors
Socio-economic factors (social class)
Access to services (transport, funding)
Environment (pollution, fluoride in the water)
13
Q
Name common risk factors to health…
A
smoking, alcohol, diet, stress,
14
Q
what is meant by upstream factors?
A
individuals have very little control - eg government effect people but cannot control.
15
Q
what is meant by downstream factors?
A
individuals, how you can personally change things.
16
Q
what causes inequalities in oral health?
A
- age
- social class
- area of residence, regions
- rece, culture, ethnicity?
17
Q
how can health relate to an individuals quality of life?
A
- Physical functioning
- Somatic sensation eg pain
- Daily activities or roles
- Psychological well being
- Social interaction and support
- Personal relationship
- Life satisfaction
18
Q
what is health promotion?
A
a combination of health education and
organisational, economic and environmental
supports for behaviours of individuals,
groups or communities conducive to health.
any effort to enhance positive health &
prevent ill-health, through the overlapping
spheres of health education, prevention and
health protection.
19
Q
What is included in Health education?
A
Positive health education: e.g. OHI, lifeskills teaching, info, edu, empowerment, etc
20
Q
what is prevention in health?
A
Preventive services: F,
FS, smoking cessation,
Immunisation, screening,
etc.
21
Q
what is health protection?
A
Positive health protection: e.g. PH treaty, national policies, laws, workplace smoking policy, healthy eating policy, junk food advertising regulations, etc.
22
Q
what is an example of health education, prevention and health protection?
A
Health education for preventive health protection: e.g. lobbying for legislation and licensing, for better environments, etc.
23
Q
what is health promotion as deffined by WHO Ottawa Charter?
A
the process of enabling people to increase
control over and to improve their health
24
Q
when was the WHO Ottawa charter?
A
1986
25
what is helath education as stated by WHO 1984?
opportunities created for learning aimed at a
| health related goal: cognitive, affective, behavioural.
26
what factors could help via health education to improve an individuals health?
-community empowerment
- self empowerment
healthy public policy
- environment and social circumstances
- equity (fair distribution of power and resources. )
27
what where the main points of the Ottawa Charter for Health Promotion
(WHO, 1986)?
1. building healthy public policies
2. creating supportive environment
3. strengthening community action
4. developing personal skills
5. reorienting health services
28
what are examples of public health policys?
-legislation, fiscal measures, taxation and
organisational change
-No smoking policy, health eating policy,
seat belt law, water (fluoridation) act etc.
29
How can creating a supportive environment aid in improving public health?
• Establishment of a social, economic and
legislative environment that is conducive to
health
• Making healthier choice the easier choice
30
what are examples of creating a supportive environment to aid in public health?
smoke free, stress free
environments; safe buildings and playgrounds;
availability of healthy foods, exercise and
changing facilities, etc
31
how can strengthening community action aid in public health?
community participation in setting priorities, making
decisions, planning strategies & implementing them
to achieve better health
• work together on community issues of common
concern
32
what is needed to strengthen community action to aid in better public health?
requires full & continuous access to information,
| learning opportunities for health & funding support
33
what are examples of Strengthening community action to aid in better oral health?
Jamie Oliver’s healthy eating campaign,
pressure groups, community development projects,
etc
34
what personal skills can an individual develop to aid in better health?
• education
• information
• empowerment
• enhancing life skills
• enable to take control over own health and over
their environments
• ability to make choices that are conducive to health
35
what are examples of personal skills that can be developed to improve oral health?
OHI, brushing for life campaign, school
| based health education programmes, etc
36
how can reorienting health services aid in health?
• move beyond providing clinical & curative services
• address health needs and move towards the goal of
health gain
• sensitive to social, psychological & cultural needs
• encourage acceptance by those whose needs are the
greatest
37
what are examples of reorienting health services?
any initiatives that reorientate towards
health promotion and disease prevention, improve
access and health gain.
38
what is a pro about the Ottawa Charter for Health Promotion
| (WHO, 1986)?
it adresses both upstream and downstream factors.
39
What are the 5 approaches to health promotion outlined in the (Ewles & Simnett, 2003) (5th edition)
Promoting Health: A practical guide.?
```
Medical
Behavioural
Educational
Client centred
Societal change
```
40
How does the Medical approach define health?
freedom from medically-defined disease and
| disability
41
How does the Medical approach believe health should be promoted and prevented?
-promotion of medical intervention to prevent or
ameliorate ill-health
• patient compliance with preventive medical
procedures
• Top down authoritative style
42
what is a con with the medical approach to health?
doesn't look at any underlying causes of the disease.
43
How does the behavioural approach understand health?
individual behaviour conducive to freedom from disease
44
How does the behavioural approach believe health can be improved?
attitude and behaviour change to encourage adoption of
‘healthier’ lifestyle – individual’s responsibility
• healthy lifestyle as defined by health promoter
• Expert-led, changes are normatively defined, imposed on the
patient
45
what are cons of the behavioural approach to health?
- it assumes that health education will lead to sustained change.
- blames the victim
46
How does the educational approach understand health?
individuals with knowledge and understanding
enabling well informed decisions to be made and
acted upon
47
How does the educational approach believe health can be improved?
* exploration of values & attitudes
* Advice , info, support
* right of free choice
48
what are the cons of the educational approach to health?
Largely expert-led, ignore
| factors/determinants/barriers to change
49
what is an example of the educational approach?
school-based oral health educational
| programmes
50
what is an example of the behavioural approach to health?
OHI and advice, smoking cessation advice aim at changing
| behaviours
51
what is an example to the medical approach to heath?
Screening, F and FS.
52
what are the key points of the client centred approach in regards to health?
working with clients on the clients’ own term
• clients identify problems, set the agenda and
priorities
53
How does the client centred approach believe health can be improved?
* self-empowerment of clients
* help develop confidence & skills to address issues
* Bottom-up
54
what is an example of the client centred approach in regards to health?
counselling, self-help groups, community
| development initiatives
55
What does the societal change approach believe influences health?
acknowledges physical & socio-economic and
environmental factors
enables choice of healthier lifestyle
56
what does the societal change approach believe is needed to improve public health? and why do they believe this is needed
• requires changes in policy, political support & social
action to change the environment
• Influencing policy makers
- they believe this is needed as Many health professionals are uncomfortable
working in the political climate
57
what are examples of the societal change approach?
social movement, changing social norms,
| changing the environments
58
What is the principles of the settings approach based on?
Ottawa Charter.
59
On what basis is the settings approach based?
Evidence based.
60
where does the setting approach believe should be promoting health?
- Schools
- Hospitals
- Workplace
- Dental practices.
61
What does the setting approach believe will better public health?
```
Healthy policies in place
Supportive environments
Appropriate trained staff
Health promotion services/programmes for staff
On going evidence-based improvements for better services
appropriate facilities
Community collaboration
Health education
Developing personal skills
Appropriate services
```
62
what does the common risk facto approach believe about diseases?
A number of diseases share common risk factors
63
what are the pros of the common risk factor approach (CRFA)?
offers the potential for effectively dealing with
a combination of problems together
more effective in the long term and more
efficient in the use of resources
64
What would the Common risk factor approach say risk factors influence?
(Health and Oral Health)
- Cancers
- Sexual Health
- Cardiovascular Disease
- Mental Health
- Accidents
- Oral disease
- Oral cancers
- Dental erosion
- Peri disease
- Dental caries
- Dental trauma.
65
what are risk factors as determined by the common risk factor approach?
```
diets,
Stress,
Smoking,
Alcohol,
etc.
```
66
Who are partners in oral health according to the multidisciplinary approach?
health professionals
Education
professional bodies
local authority staff
local, national and international government
charities & voluntary organisations, NGOs
commerce, industry e.g pharmaceutical companies,
water companies, food manufacturers, advertising
industry
67
what are the models of health behaviour understandings?
• Based on health behaviour theories
• Understand the decision making process in
taking health actions
• Help explain and predict health behaviours of
individuals
68
how does the health belief model believe improves an individuals health?
- Perceived susceptibility (what you think about it)
- serious consequences perceived (what could happen to you if you continue)
- awareness of effective measures (how to improve your health)
- benefits outweigh barriers (it will get better and is worth the struggle)
69
according to the Health Belief Model what needs to happen for an individual to improve their health?
the individual will have to be psychologically ready for it
and believe that they could get the disease if they continue with the same actions.
that visiting the doctor /dentist is worthwhile or beneficial.
Benefits outweigh the barriers and costs associated with going to the dentist/doctor.
70
according to the Health Belief Model why wouldn't an individual act on a health change?
they don't feel they would get the disease if they continued.
and example of this is caries.
71
what are the major systems that influence the decision to change your health according to the Health Action Model?
the belief system, the motivation system and the
| normative system.
72
what are the differences between the Health Action Model and the Health Belief model?
the Health Action Model acknowledges the powerful drive factors that may overwhelm competing values and attitudes in determining health outcomes.
73
what does the biopsychosocial model believe influences health?
Biological - Organs/physiology/genetics
Social - Society/ community/ family.
Psychological - cognition/ emotion/ motivation.
74
what does the biomedical model believe influences health?
Biological
Genetics
Chemcical/cellular
75
what are common findings showing that OH hasnt been effective in from assessing the effectiveness of OH promotion?
-OH improves short term through education
-Health info alone doesn't produce long term behaviour changes.
- Interventions at an individual level are effective at reducing plaque levels only in the short term.
-School based tooth brushing campaigns aimed at improving oral hygiene are largely ineffective.
Mass media campaigns are largely ineffective at promoting either
knowledge or behaviour change; they may have some value in raising
awareness and agenda setting.
• Few studies have assessed the effect of oral health promotion on sugar
consumption.
76
what are common findings showing that OH has been effective in from assessing the effectiveness of OH promotion?
* Water fluoridation is effective in preventing dental caries.
* Fluoride toothpaste is effective
77
What was the problems with the studies assessing the effectiveness of OH promotion?
• Many studies were poorly designed and lacked a contemporary theoretical basis.
• The quality of evaluation of most studies was poor.
• Outcomes measures used were of limited value and were not comparable.
• Data analysis was mostly very basic – confounding factors were not assessed.
• Inappropriate inclusion/exclusion criteria, leading to
selection bias
• Overemphasise on RCTs which may not be appropriate
for OHP evaluations
Inappropriate quality assessment criteria, e.g. based on
RCT criteria
• Inappropriate outcome measures, e.g. focusing on
clinical measures such as DMFT, overemphasising on
outcomes related to individual behaviour change, etc
• Publication bias
• Not assessing quality of interventions, only relying on
reported outcomes
• Not assessing process or impact
• Political and funding issues
78
what are the strengths of the OH promotion reviews?
• Reviewing a large number of studies
• Using standardised and scientific
methodologies
79
what has been shown to be important in health promotion effectiveness? (International Union for Health Promotion & Education, 2000)
Comprehensive approaches using all five Ottawa Charter strategies
are the most effective
• Certain ‘settings’, such as schools, workplaces, cities and local
communities, offer practical opportunities for effective health
promotion
• People, including those most affected by health issues, need to be
at the heart of health promotion action programmes and decision
making processes to ensure real effectiveness
• Real access to education and information, in appropriate language
and styles, is vital
• Health promotion is a key ‘investment’ – an essential element of
social and economic development
80
what has been shown to be important in ORAL health promotion effectiveness? (International Union for Health Promotion & Education, 2000)
Oral health promotion should be aimed at achieving
rational use of sugar products, fluoridation of the mouth,
effective oral hygiene, reductions in smoking and
drinking, prevention of trauma and appropriate use of
dental care.
81
what are common problems with traditional approaches to health?
- information giving and expert advice
are largely ineffective.
-
82
what are some examples of good practice in terms of promoting good oral health?
- Adopt a Common Risk Factor Approach
- Recognise the important underlying social, economic
and environmental determinants
• Work with the community to develop locally sensitive
interventions
- Work in collaborative partnerships
• Use appropriate evaluation methods and outcome
measures to assess the effects of interventions
- Respecting target group’s needs, demand, norms,
culture, values and priorities
• Providing support to make changes easier
• Using understandable language
• Community participation, working with people, involving
them
• Plan thoroughly
• Integrate oral health into general health promotion
83
what is the multi-disciplinary approach to healthcare?
2+ agencies working together to achieve a health gain.
84
what are fixed factors affecting health?
something an individual cannot change
eg. age, sex, race.
85
who can help/aid with a multidisiplinary approach?
- government
- Primary care trusts
- NHS
- Local authorities
- Communities/individuals
- Non-gov organisations
- Businesses, advertisers, retailers.
- Media.
86
what are some examples of a multi-disiplinary approach?
Smoking Cessation -
Government legislation:
Price rises:
Ban promotion/advertisement, NHS recommendations,
Dental health professionals recommendations,
Voluntary organisations: ASH- action on smoking
Oral health promotion - Government legislation: water fluoridation
PCTs: develop food policies.
NHS: visit schools, milk fluoridation schemes
Pressure groups: action+info on sugars eg 'chuck sweets off the checkouts'
Business, advertisers, retailers, media: more available health food/drinks.
87
what are the key aspects of oral health education?
- Oral hygiene
- Diet
- Fluoride
- Smoking
- Alcohol
88
Please name some exaples to barriers to good OH?
-Lack of knowledge
-Jargon
-Fear
-Intimidating environment
-Body language
-Perceived level of benefit
-Expectations
-Lack of goals
-Peer pressure
-Environmental
-Physical disability
-Learning disability
-Culture
-Religion
-Extensive medical history
-Too much information
of goal
89
Why might an individual struggle due to a lack of knowledge regarding oral health?
- no able to follow instructions given
- havent make an informed choice
- havent been advised clearly and simply.
- havent been given written instructions or prompts.
90
what may prevent an individual from coming to see a dental health professional?
- Fear
- Intimidating environment
- professionals body langues
91
what do individuals need to perceive before seeing a dentist or getting treatment carried out?
perceived level of benefit.
92
what needs to be based on perceived benefit when seeing a dentist or getting any treatment done?
expectations.
93
What is best to know to advise an individual on the best oral health regime?
- Know the patient:develop a relationship, be professional, open, approachable.
- Medical history: aware of anything that could contribute to disease, put the patient at risk.
- Current OH regime: adequate? risks?
- Physical capabilities: movement, do they need assistance or aids?
- Learning capabilities: plain explanations, no jargon, no patronising, retention.
- identify patient need/expectations.
- tx plan and its benefits
- setting goals
- monitor
- evaluate
94
what influences a patient to better OH?
- Appearance
- Peers
- Fashion/trend
- Function
- Being pain free
