Year Two Flashcards
The international alliance of patients’ organisation (IAPO) ‘s declaration of patient centred healthcare defines patient centred healthcare as based on these principles and values…
Respect Choice and empowerment Patient involvement in health policy Access and support Information
The definition of incidence
and what it is used for
The no. of new cases of a disease in a population in a specified period of time
Tells us about trends in causation and aetiology
Can help with planning when and where extra care and provisions will be needed
The definition of prevalence
and what it is used for
The no. of people in a population with a specific disease at a single point in time or a defined period of time
Useful in assessing current workload for the health service
Vulnerability definition
An individual’s capacity to resist disease, repair damage and restore physiological homeostasis
(varies between organs)
Examples of the “burden of treatment” on patients and carers
Charging their behaviour for lifestyle modifications
Monitoring and managing symptoms at home
Adhering to complex treatment regimes
Navigating complex administrative systems
Biographical disruption definition
A loss in confidence in social interaction or self-identity due to a loss in confidence in the body from a long term condition
may involve having to “renegotiate” existing relationships
Who do chronic conditions impact
The individual (denial, self-pity, apathy) The family (physical, emotional, financial) The community/ society
Legal definition of disability
a physical, sensory or mental difficulty that makes it difficult for them to carry out day to day activities ongoing for more than 12 months
The WHO “international classification of functioning, disability and health”
divides disability into 3 levels…
- Body and structure impairment
- organ level (e.g. damage to leg)
- abnormalities of structure, organ or system function - Activity limitation
- personal level (e.g. mobility difficulty)
- changed functional performance and activity by the individual - Participation restrictions
- social and environmental level (e.g. difficulty participating in sports)
- disadvantage experienced by the individual as a result of impairments and disabilities
the 2 different models of disability
Medical model
- individual/ personal cause
- underlying pathology
- individual level intervention
- individual change/ adjustment
Social model
- social cause
- social/ political action needed
- societal attitude change
” examples of disability legislation
Disability discrimination acts 1995 and 2005
Equality act 2010
Personal reaction to disability depends on…
The nature of the disability The information base of the individual The personality of the individual The coping strategies of the individual The reaction of others around them The support network of the individual Additional resources available to the individual Time to adapt
Causes of disability
Congenital Injury Communicable disease Non-communicable disease Alcohol Drugs (iatrogenic or illicit) Malnutrition Obesity
The Wilson and Junger criteria for screening
Knowledge of the disease
- it must be important, recognisable early and well understood
Knowledge of the test
- it must be suitable, acceptable to the population and continuous
Treatment of the disease
- must be acceptable, available and have an agreed policy on who to treat
Cost considerations
The difference between disease and illness
Disease - to do with signs, symptoms and diagnosis, the medical perspective
Illness - to do with ICE and experience, the patient perspective
(e.g. HT is often a disease without illness)
(in up to 50% of GP appointments there is no disease)
Factors affecting uptake of care
Lay referral
Sources of information
Medical factors (what the symptoms are)
Non-medical factors (ICE, beliefs, age, class, gender, culture…)
Aims of epidemiology
Description (of amount and distribution of disease)
Explanation (of natural history and aetiological factors)
Disease control (the basis for preventative measures)
Epidemiological studies try to point to…
Aetiological clues
The scope for prevention
Identification of high risk/ priority groups
Calculating incidence
Events / Population at risk
Everyone in the denominator must have the possibility of entering the numerator.
The denominator must be specific
Calculating relative risk (RR)
incidence in exposed group / incidence in unexposed group
Measures the strength of an association between a suspected risk factor and the disease being studied
Sources of epidemiological data
Mortality data Hospital activity statistics Reproductive health statistics Cancer statistics Accident statistics General practice morbidity Health and household surveys Social security statistics Drug misuse databases Expenditure data from NHS
Health literacy is
Having the knowledge, skills, understanding and confidence to…
Use health information
Be active partners in their care
Navigate health and social care systems
SIGN guidelines intend to…
Help health and social care professionals and patients understand medical evidence and use it to make decisions
Reduce unwarranted variations in practice to make sure patients get the best care available, no matter where they live
Improve healthcare across Scotland by focusing on patient-important outcomes
(they aim to aid the translation of new knowledge into action)
Descriptive studies
Attempt to describe the amount and distribution of disease in a given population
does not provide definitive conclusions about causation
Do not test hypotheses
Usually quick and cheap
Cross-sectional studies
Observations are made at a single point in time
Provides results quickly
Conclusions are drawn about the relationship btw diseases and other variables in a defined population
Usually impossible to infer causation
e.g. venous reflux scanned and a questionnaire about risk-factors given to participants to assess risk factors for venous reflux
Case-control studies
A group of individuals with the disease (cases) are compared to a control group
Data is gathered on each individual to determine if they have been exposed to each aetiological factor
Results are expressed as relative risks, sometimes with P values (confidence intervals)
Types of analytic studies
Cross-sectional studies
Case control studies
Cohort studies
Cohort studies
Baseline data is collected from a group of people who do not have the disease
This group is followed until enough of them have developed the disease to allow analysis
- the group is split into subgroups with different exposures
Results are usually expressed as relative risks with confidence intervals (p values)
