6. Promoting Individual Health

Question 1

compliance - definition

Answer 1

acting in accordance with a condition.

Question 2

concordance

Answer 2

agreement between patient and prescriber

Question 3

why is compliance a bad term

Answer 3

referes to paternalistic perspective of doctors giving orders

Question 4

adherence - definition

Answer 4

persistence in practice, steady observation or maintenance

Question 5

non adherence - 4 examples

Answer 5

• too little of a prescribed treatment
• too much of the treatment
• not taking treatment priority at proper intervals
  taking other meds along with treatment without professional knowledge

Question 6

continum of adherence

Answer 6

• think about in terms of a scale of more or less adherence instead of just adherence or non adherence

Question 7

measuring adherence

Answer 7

• dr report
• patient repor
• pharmacy records
• behvaioural obs
• blood/urine tests
• electronic records

Question 8

2 types of non adherence

Answer 8

• intentional

- unintentional

Question 9

intentional non adherence

Answer 9

• conscious decision not to adhere with treatment

Question 10

unintentional non adherence

Answer 10

• not repsonsible for doing their own tretament and deciding adherence or couldn’t adhere for certain reasons

Question 11

5 parts of multidimensional model

Answer 11

disease
treatment
patient 
psychosocial 
healthcare

Question 12

disease

Answer 12

• characteristics of illness
  better adherence
• when people experience symptoms
• less serious condition causes poor health = better adherence
• more serious condition causes poor health = less adherence

Question 13

treatment

Answer 13

• complex treatment or high dosage = low adherence

consider

• side effects
• behavioural changes
• multiple daily doses

Question 14

patient

Answer 14

• percieved benefits of adherence
• motivations
• few barriers to treatment = increase adherence
• beliefs on their condition

Question 15

common sense model of self regulation

Answer 15

1. identity = what illness is
2. consequence = side effects of illness
3. causes
4. timeline - of disease worsening, duration , of treatment how long does it take to work
5. cure/control - does treatment work

Question 16

theory of planned behavior

Answer 16

attitude
subjective norm
percieved behavioural control

impact patient intention

impacts behaviour

Question 17

transtheoretical model

Answer 17

precontemplation
contemplation 
preparation 
action 
maintenance 
relapse

Question 18

psychosocial - multidimensional model

Answer 18

• consider psychosocial support

- more adherence in those a patients with good support

Question 19

healthcare - multidimesional model

Answer 19

practical issues

• accessibility
• wait time
• costs

practitioner patient interaction

Question 20

AIDES - strategies improving adherence

Answer 20

assessment 
- how complicated is treatment 
individualisation 
- treat patient as a person 
documentation
- written communication 
education 
- knowledge
supervision 
- check ups

Question 21

P-P communication

Answer 21

practitioner patient communication

effective when
- patient centred approach
equal weighting ti patent agenda and clinician agenda

Question 22

P-P communication principles

Answer 22

develop discrepancy
= welcome patients arguments and discuss

avoid augmentation
- use patient resistance as a signal for change

• roll with resistance
  = invite patient to adhere think of change. shift perspective

express empathy
= reflective listening
empathy and acceptance

Question 23

3 domains of public health

Answer 23

health improvement (health promotion)
health protection (health prevention)
healthcare service delivery

Question 24

prevention is better than cure

Answer 24

better health
= stronger economy
= reduce pressure on NHS making it sustainable

Question 25

health promotion/protection levels

Answer 25

``` individual interpersonal institutions and organisations community structures and systems ```

Question 26

4 levels of prevention

Answer 26

--> move up levels based on where we are at in clinical course of disease primordial prevention primary prevention secondary prevention tertiary prevention

Question 27

population strategy ps

Answer 27

shifts curve to left

Question 28

high risk strategy

Answer 28

small targeted strategy | interventions supporting high risk group ratio than the whole population

Question 29

primordial prevention

Answer 29

health promotion | wider pop

Question 30

primary prevention

Answer 30

disease prevention= screening and immunisation and precautions susceptible pop - reduce exposure to risk factors - prevent contact with risk factors - precautions - immunisation

Question 31

secondary prevention

Answer 31

catch disease early via = screening and treatment disease progression, risk prediction - patients with pathology but are asymptomatic

Question 32

tertiary prevention

Answer 32

treatment and rehab for symptomatic patient minimise consequences - transplants and drugs

Question 33

health promotion definition

Answer 33

- enabling people to increase control over and improve their health

Question 34

health promotion actions

Answer 34

``` building healthy public policy creating support environments strengthening community actions developing personnel skills re-orientating health services moving into future ```

Question 35

model for health promotion

Answer 35

scale than can sit anywhere - authoritative - collective - negotiated - individual health persuasion legislative action community development personnel counselling heck slides

Question 36

legislative action

Answer 36

ban smoking in public places

Question 37

community development

Answer 37

time to change campaign developed by local champions

Question 38

personal counselling

Answer 38

counselling for someone with alcohol problems

Question 39

health persuasion

Answer 39

doctor advising a pregnant woman to stop smoking

Question 40

universal approaches

Answer 40

aim to reduce risk across whole population = good to use when there is a common risk factor

Question 41

universal approaches | examples

Answer 41

sugar tax

Question 42

targeted approaches

Answer 42

aim to identify those most at risk then tailor messaged and approaches to them = problem can lead to blaming different groups

Question 43

targeted approaches | example

Answer 43

breast feeding initiatives in young moms

Question 44

health promotion in action 5 approaches

Answer 44

1. medical - difficulties 2. behavioural change - campaigns 3. educational - system changes, policy 4. empowerment - services, community 5. social change - regualtions

Question 45

health promotion strategies

Answer 45

policy, legislation, system change community development health communciation

Question 46

education

Answer 46

``` info must be recieved understood change attitudes or beliefs stimulate behavioural change ```

Question 47

policy, systems, environmental change

Answer 47

social policy = whole pop fiscal approaches = taxation or other approaches to reduce bad behaviours bans and restrictions = reduce availabilty, use legal restrictions

Question 48

community development

Answer 48

``` participation communication action facilitation interface strategy ```