Week 11 Flashcards

1
Q

Key objective for any society, including any work or educational environment

A

Trying to achieve equality, fairness and justice
Avoid discrimination, unconscious bias and micro aggressions
Treating others with respect and offer support other students, staff and patients

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2
Q

What is unconscious bias

A

How a person thinks can depend on their life experiences and sometimes they have beliefs and views about other people that might not be right and reasonable
When a person thinks:
Better of someone because they believe they’re alike
Less of someone because that person is differently to them
This means they could make a decision influenced by false beliefs or assumptions sometimes called stereotyping

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3
Q

Unconscious bias, stereotyping and discrimination can be based on:

A

One of the 9 protected characteristics by the law (Equality act)
Other characteristics not protected by the law e.g. class (socioeconomic background), body shape , where people grew up etc

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4
Q

2010 Equality Act

A

Protected characteristics are:
Age
Disability
Gender reassignment
Marriage and Civil partnership
Race
Religion or belief
Sex
Pregnancy and maternity
Sexual orientation

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5
Q

Age protected characteristics

A

Being treated unfairly because of your age or because you’re part of a particular group
E.g. limiting job offer to applicants under 30
Age limitation is sometimes allowed but has to be justified example- assuming that a 90 year old immobile and physically fragile patient does not have mental capacity to consent to their own medical treatment

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6
Q

Disability protected characteristics

A

A person has a disability if they have a physical or mental impairment, and the impairment has a substantial and long-term adverse effect on their ability to carry out normal day-to-day activity Must be substantial and long term
Some impairments are automatically treated as a disability. People are covered if they have:
Cancer, including skin growths
A visual impairment
Multiple sclerosis
A HIV infection
A severe long term disfigurement
E.g.being refused position because of mentioning in job interview that you suffer with depression or other mental health illness

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7
Q

Gender reassignment

A

A person proposing to undergo, is undergoing or has undergone a process for the purpose of reassigning the persons sex by changing physiological or other attributes of sex
Protection to transsexual people
Gender reassignment is a personal process rather than a medical one you dont undergo medical treatment or be under medical supervision to be protection under the equality act as a transgender person

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8
Q

Marriage and civil partnership protected characteristics

A

Sex or sexual orientation of the people in marriage or civil partnership is irrelevant
E.g. a nurse showing surprise and smirking that’s you are in same-sex marriage

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9
Q

Race. Protected characteristics

A

Race includes: colour, nationality, ethnic or national origins

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10
Q

Religion or belief. Protected characteristics

A

Religion means any religion and a reference to religion includes a reference to a lack of religion
Belief means any religious or philosophical belief and a reference to belief includes a reference to a lack of belief
A philosophical belief is a non-religious belief and includes things like humanism, secularism and atheism

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11
Q

Sex. Protected characteristics

A

Reference to a man or woman
Reference to persons who share a protected characteristic is a reference to persons of the same sex

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12
Q

Pregnancy and maternity. Protected characteristics

A

Counts as pregnancy discrimination if you’re treated unfavourably because you:
Are pregnant; have a pregnancy-related illness; are on maternity leave
The protected period runs from start of pregnancy to end of maternity leave
This applies so far only to women, so men cannot be discriminated under Equality Act for being on parental leave
E.g. hospital withdrawing their offer of FY placement after you disclose you will need maternity leave

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13
Q

Other biases and discriminations not covered by equality act

A

Class, socioeconomic background or wealth
Body shape
Other body features
Food drink preferences and allergies
Certain names and local associations
What school you went to

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14
Q

Intersectionality

A

Discrimination and prejudice can occur across multiple characteristics
Multiple discrimination can be greater

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15
Q

Patient compliance/adherence

A

Adherence refers to the following:
Preventative health behaviour
Keeping medical appointment
Self care actions
Taking medication as directed
Insistence on discharge against medical advice (lack of adherence)
Parents administering medication to children

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16
Q

Non-adherence

A

Describes the failure of a patient to follow recommend health behaviours and treatment advice given by a clinician
Non-adherence focuses better on a collaborative clinician patient relationship and shared decision making

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17
Q

What affects patient adherence

A

Treatment- while patients comply with one treatment, they may not comply with another
Condition
Beliefs
Good predictor of long term adherence is adherence at entry
Complex regimens have low adherence
Intrusive treatments have lower adherence
Expense decreases adherence
Adherence for asymptomatic conditions generally poorer
Fear of side effects
Confusion
Don’t understand treatment process
Doctors underestimate patients comprehension level

18
Q

When do patients comply (adhere)
Ley’s model of compliance (1981,1989)

A

Understanding
Satisfaction —> compliance
Memory ^

19
Q

Stanton’s model of adherence 1987

A

Doctor communication
Increased knowledge and satisfaction
Patients beliefs locus of control perceived social support

Adherence

20
Q

Information- motivation- strategy model (Martin 2010)

A

Information- patients do not understand what they are supposed to do
Motivation- patients are not motivated to carry out their treatment recommendations
Strategy- patients do not have a workable strategy for following treatment recommendations

21
Q

Information

A

Communicate info effectively to patients
Build trust and encourage patients to participate in decision making and to be partners in their own healthcare
Have patients share why and how they’re to carry out their treatment recommendations.
Listen to patients concerns and give them full attention

22
Q

Motivation

A

Help patients to believe in the efficacy of the treatment
Elicit, listen to and discuss negative attitudes towards treatment
Determine the role of the patients social system in supporting or contradicting elements of the regimen
Help the patient to build commitment to adherence and to believe that they’re capable of doing it

23
Q

Strategy

A

Assists in overcoming practical barriers that stand in the way of patients effectively carrying out a course of action
Identify individuals who can provide concrete assistance
Identify resources to provide financial aid or discounts
Provide written instructions/ reminders
Sign a behavioural contract
Link to support groups
Provide electronic reminders or follow up phone calls
Empowerment and self care

24
Q

What is health promotion

A

The process of enabling people to increase control over and to improve their health. It moves beyond a focus on individual behaviour towards a wide range of social and environmental interventions

25
Q

Health belief model

A

Perceived susceptibility
Perceived severity
Motivation
Perceived benefits
Perceived barriers
Cues for action

26
Q

Theory of planned behaviour

A

Attitude towards behaviour
Subjective norm
Perceived behavioural control

27
Q

COM-B model

A

Capability, opportunity and motivation interact to generate behaviour that in turn influences these components

28
Q

Capability

A

Defined as the individuals psychological and physical capacity to engage in the activity concerned. It includes having the necessary knowledge understanding and skills as well as physical capability

29
Q

Motivation

A

Defined as those brain processes that energise and direct behaviour, not just goals and conscious decision making. It includes habitual processes, emotional responding as well as analytical decision making

30
Q

Opportunity

A

Defined as all the factors that lie outside the individual that make the behaviour possible or prompt it e.g financial and material resources

31
Q

How can we address physical inactivity through health promotion.

A

Interventions with the NHS:
GPs/ practice nurses identify people who are inactive and encourage them
Refer to the “exercise referral scheme”
Provision of supervised exercise (cardiac rehabilitation) for people who have heart disease
Community based interventions :PSHE lessons, school encourages and provides opportunity for physical activity, improve availability of public transport and safety
National/ governmental actions: Facilitating: provide resources in councils budget for leisure centres etc. Taxation: tax work-place car parking spaces/ company cars

32
Q

General approaches to health promotion

A

Change determinants of behaviour:
Promote/ sustain desirable habits
Infrastructure
Economic incentives
Regulatory change to reinforce behaviour
Large numbers of people influenced
Expensive/ difficult to implement
Focus on individuals at risk:
Education/ motivational strategies
Some success not good at sustained long term change

33
Q

Types of prevention

A

Primary prevention: aims to prevent the onset of disease
Secondary prevention: aims to minimise the consequences of disease after it has arisen by detection and treatment to prevent worsening
Tertiary prevention: aims to prevent death or permanent disability once a disease has become established

34
Q

Health promotion in diverse communities

A

Generic campaigns may have different effects on different sectors of society
May also have unexpected negative consequences
Important to understand awareness attitudes perceptions and beliefs of those targeted and at risk

35
Q

Alaszewski risk

A

Distinguishes between scientific approaches that define risk as an objective hazard that can be measured independent of social and cultural processes and socio-cultural approaches that acknowledges the importance of the SOCIAL, CULTURAL, POLITICAL AND INDIVIDUAL context in which people make decisions about their health

36
Q

Risk definition

A

The probability that an event will occur

37
Q

Absolute risk

A

Risk of developing a disease over time period

38
Q

Relative risk

A

A comparison of the risk of developing a disease in 2 different groups

39
Q

What determines how people perceive risk

A

Resistance of info from experts
Cultural traditions
Failures of knowledge, understanding and memory
Emotional states affect the meaning of risk and behaviours associated with it
Attitudes towards info

40
Q

Approaches to studying risk

A

Social science approaches (anthropology, sociology, psychology)
Rational approaches
Sociocultural approaches