GP Flashcards

1
Q

what are the 3 domains of public health

A

health protection
health improvement
health services

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2
Q

what are the determinants of health (Progress)

A

Place of residence
Race/ethnicity
Occupation
Gender
Religion
Education
Socio-economic status
Social capital/resources

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3
Q

describe the inverse care law

A

availability of medical/social care tends to vary inversely with the need of the population served

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4
Q

how does equity differ from equality

A

horizontal: equal treatment for equal need
vertical: unuequal treatment for unequal need

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5
Q

what is a health needs assessment

A

systematic approach for reviewing the health issues affecting a population which leads to agreed priorities and resource allocation to improve health and decrease inequalities

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6
Q

what is an epidemiological health needs assessment and what are its limitations

A

defines problem and size of problem
current services
recommends improvements

X:
data may be poor
may be inadequate evidence base
doesnt consider felt need

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7
Q

what is a comparative health needs assessment and what are its limitations

A

compares services received by populations
X:
data available may vary in quality
hard to find comparable pops
comparison not perfect

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8
Q

what is a corporate health needs assessment and what are its limitations

A

takes into account views of interested parties e.g. patients/health pros/media etc
X:
hard to distinguish need from demand
groups have vested interest/bias
dominant individuals have undue influence

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9
Q

describe need vs supply vs demand

A

need = ability to benefit from an intervention
supply = what is provided
demand = what people ask for

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10
Q

describe the 4 types of need

A

felt need = individual perception of deviation from. normal health
expressed need = seeking help to overcome variation in normal health
normative need = professional defines intervention for expressed need
comparative need = comparisons between severity/range of intervention/cost

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11
Q

name the 5 areas of maslows hierachy of need

A
  1. physiological
  2. safety
  3. love/belonging
  4. esteem
  5. self-actualisation
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12
Q

describe egalitarian resource allocation

A

provide all care to is necessary and required to everyone
+ = equal
- = economically restricted

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13
Q

describe maximising resource allocation

A

based solely on consequence + = resources to those who most likely to benefit from it
- = those with less need receive nothing

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14
Q

describe libertarian resource allocation

A

each individual responsible for own health
+ = onus on patient = more engaged?
- = not all diseases self-inflicted

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15
Q

what are the 3 As and 3Es of assessing the quality of a service (maxwells dimensions)

A

access
appropriate
acceptability
equity
efficient
effective

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16
Q

describe donabedians approach to assessing quality of a service

A

structure
process
outcome

17
Q

what is health behaviour

A

aimed at preventing disease

18
Q

what is illness behaviour

A

seeking remedy

19
Q

what is sick role behaviour

A

activity aimed at getting well

20
Q

describe the transtheoretical model

A
  1. pre-contemplation
  2. contemplation
  3. preparation
  4. action
  5. maintenance
  6. relapse
21
Q

what are the advantages of the transtheoretical model

A

acknowledges individual stages of readiness
accounts for replace
time element

22
Q

what are the disadvantages of the transtheoretical model

A

some individuals skip stages
change may be continuous not discrete
doesnt consider cultural/social factors

23
Q

describe the theory of planned behaviours

A

attitudes, subjective norms and perceived behaviour control all contribute to intention which leads to behaviour

24
Q

describe PPAIR

A

bridges gap between intention and behaviour
Prep actions
Perceived control
Anticipated regret
Implementation intentions
Relevance to self

25
describe 3 levels of public health intervention
individual e.g. vaccines community level e.g. playground ecological (population) level e.g. clean air act
26
primary prevention
prevent a disease from occurring
27
secondary prevention
detection of early disease in order to alter the course of the disease and maximise chance of recovery
28
tertiary prevention
trying to slow down progression of a disease
29
what are the advantages and disadvantages of theory of planned behaviours
+ can apply to wide variety behaviours useful predicting intention takes importance of social pressures into account - no temporal element, direction, causality doesn't consider emotions
30
describe the health belief model
key factors that influence health beliefs and therefore health behaviours: perceived susceptibility perceived severity health motivation perceived benefits perceived barriers demographic variables + psychological characteristics also contribute THESE all contribute to likelihood of action
31
what are the advantages and disadvantages of the health belief model
+ applied to wide variety cues to action are unique component longest standing model - other factors may influence outcome doesnt consider emotions doesnt differentiate between first time/repeated behaviours
32
what aspects help people act on their intentions
perceived control anticipated regret prep actions implementation intentions relevance to self
33
describe some transition points examples
leaving school entering workforce becoming a parent becoming unemployed retirement bereavement
34
describe the eGFR levels for levels of CKD
G1 >90 G2 60-90 G3a 45-59 G3b 30-44 G4 15-29 G5 <15
35
what does UK law say about patients rights about DNACPR
patients are not allowed to demand CPR if doctors feel it would be futile however seek 2nd opinion if this is the case
36
whos decision is DNACPR
it is ultimately a medical one must consult patient and family if urgent/cant consult F/F = work in best interests
37
what is illegal in the UK with regards to end of life prescribing and what is the 'double effect'
it is illegal to prescribe drugs to deliberately shorten life HOWEVER some drugs used for symptom relief may shorten life (double effect)
38
what is a DoLS
deprivation of liberty safeguards procedure in law when its necessary to deprive someone of their liberty if they lack capacity to consent
39
what are the 6 geriatric giants
iatrogenic instability immobility impairment of cognition inanition incontinence