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Primary care > young adults > Flashcards

young adults Flashcards

1
Q

list some behavioural risk factors in death

A

alcohol and drug use
dietary risks
tobacco smoke
low physical activity

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2
Q

list some metabolic risk factors in death

A

High BMI
High systolic blood pressure
High total cholesterol
High fasting plasma glucose

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3
Q

List some environmental risk factors

A

air pollution

occupational risks

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4
Q

WHAT IS THE ROLE OF PRIMARY CARE WORKERS WITH RESPECT TO EMPLOYMENT?

A 
Prevention
Occupational health
Vaccinations
Risk factor reduction
Promoting baseline health
Specific advice e.g. Covid-19, driving or 
infection
Fit notes and certification
Suggesting amendments
What position should GPs take when people 
request sick notes?
Is there a conflict of interest? 
What if the doctor and patient disagree?

Treatment
Could work be a cause of ill health
presenting to them?
How is health impacting on work?

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5
Q

FIT NOTES AND SICKNESS CERTIFICATION

A 
Doctor certification
 Opportunity for treatment
 Opportunity for prevention
 Opportunity for ‘reach in’ to working conditions
 Is the worker fit for work? 
 Can they work full time and do all tasks?
 Would amended duties be suitable? 
 Would reduced hours be suitable?
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6
Q

what are some inequalities in health caused by?

A 
Genes
Parental health
Birth
Childhood
Educational opportunities
Income
Work 
Environment
Individual behaviours
Social behaviours – community
Structural inequalities: race, disability, sexuality, gender, faith etc
Access to health care
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7
Q

what are some reasons that umemployment occurs?

A
  1. Never worked – ill health, no skills or no jobs
  2. Macro Economic failure: redundancy
  3. Incompetence: employment terminated
  4. Ill-health unrelated to work
  5. Ill-health related to work
  6. Retirement
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8
Q

what are some health consequences of unemployment

A
  1. Depression
  2. Low self esteem
  3. Increased damaging health behaviours
  4. Increased cardiovascular risk
  5. Less likely to successfully engage with health promotion strategies
    Increases with time of unemployment
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9
Q

FISCAL BENEFITS FOR PEOPLE ECONOMICALLY INACTIVE

A 
Universal credit (previously JSA/ESA/HB/IS/WTC
 Personal independence payment (long term disability)
 Carer’s Allowance
 Attendance allowance (only one not means tested)
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10
Q

IMPACT ON INEQUALITIES & HEALTH:THE WORKPLACE

A 
Race
 Disability
 Gender reassignment
 Sex
 Sexual orientation
 Faith
 Marriage and civil 
partnership
 Age
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11
Q

What are the positive impacts of work on physical health

A

Immediate – Mental health / Physical activity

Delayed – Income/Access to health care/ Physical Health/ Income / Mental health

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12
Q

What are the negative impacts of work on physical health

A

Immediate harm – injury, toxins, environmental exposures e.g. Covid19 assault.
Delayed harm – sedentary jobs, shift working, diet, mental health, injury, toxins.
Reduced access to health care

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13
Q

when was the health and safety at work act established?

A

1974

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14
Q

IMPACT OF HEALTH CARE ENVIRONMENT ON HEALTH WORKERS

A

Hazardous environment
Radiation
Infection
Chemical hazards

Physical risks
Manual handling
Confused patients/assault
Lifting/slips
Shifts

Interpersonal stressors
Moral distress

Income
Occupational health

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15
Q

what is the NHS Practioner health programme

A

free and confidential NHS Service for doctors and dentists with issues relating to a mental or physical health concern or addiction problem, in parrticular where these might affect their work.

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16
Q

depression - improving access to talking therapies.

steps

A

step 1 - Gp, practice nurse, recognises and assesses level of depression.
reffers to primary care team/primary care mental health worker. mild depression = watchful waiiting, guided self-help, brief psychologicsl interventions
moderate/severe = medication, psychological interventions, social support.
later steps for more severe / atypical psychotic depression referred to mental health specialists, including crisis team. treatment involves medication, complex psychological interventions, combined treatments.

17
Q

mental health services in primary care?

A 
Managing distress due to SMI
Diagnose
Signpost to services & wellbeing
Treat
Monitor
Refer when needed
Manage physical health & comorbidities
Emergencies
Chronic care
18
Q

mental health services in secondary care?

A 
Managing distress due to SMI
Diagnose
Treat
Care co-ordination
Decision making re use of Mental health law
Refer back to primary care
Living well network
19
Q

SMI: EFFECTIVE SECONDARY CARE TREATMENTS

A 
Admission (voluntary and compulsory)
 Medication/treatments
 Complex talking therapies
 Crisis management
 Case management incl. social support
 Early intervention
20
Q

ADVANTAGES OF SMI MANAGEMENT IN PRIMARY CARE

A 
De-stigmatizing
 Respect
 Maintaining dignity
 Longitudinal relationship
 Communication skills
 Integrated physical and psychological care
 Holistic approach
 Prescribing
 Managing physical consequences of SMI and treatment
21
Q

what is SMR and how to calculate?

A

STANDARDISED MORTALITY RATIO = SMR

Observed death in a population
___________________
Expected deaths in a population

22
Q

PHYSICAL HEALTH: CHALLENGES

A

Smoking: 30-50% of people with SMI smoke c/w ~ 20% general population
Recreational drug and alcohol use: 44% of people with SMI
Metabolic consequences of anti-psychotic medication: diabetes,
hypercholesterolaemia, obesity, hypertension.
Physical activity
Poor self care of chronic health conditions, and reduced uptake of health care

23
Q

PHYSICAL HEALTH IN SMI

A

Current service:
Reduced use of preventive services e.g. bowel screening for people with SMI
Non-attendance
Increased rates of hospitalisation (especially emergency) for physical health problems

Challenge:
Lack of evidence base for preventive work in people with SMI e.g. smoking cessation
Motivating attendance for physical checks
Managing mental health conditions alongside physical health

24
Q

PRIMARY CARE: ANNUAL PHYSICAL HEALTH CHECKS

A 
CHECKS Mental health review: mental state, 
care, crisis management, carers
 Employment/Housing/Finances
 Efficacy and side effects medication
 Screening e.g. cervical or bowel
 Blood pressure
 Weight
 ECG
 Smoking status
 Bloods (Diabetes, cholesterol, kidney 
function, liver function, Vitamin D, full 
blood count)
 Physical activity

Primary care (10 decks)

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