Flashcards in HPHD 2 - Cultural/Sexual Diversity, LGBT Health + Health-Related Behaviours Deck (38):
Define cultural identity:
Identity formed by each person in relation to the group(s) they identify with. May be based on heritage, race, ethnicity, beliefs, sexual orientation, gender, occupation
Why is does the delivery of healthcare need to take diversity into account?
- Allows patient-centred approach
- Ensure no disparity in care across cultures
- Diversity is increasing
How can discrimination lead to poorer health for LGBT patients?
- Increased stress
- Low self-esteem
- Encourages sub-culture (drinking/smoking/drug use)
- Distrust of authorities
Approximately what proportion of LGBT patients suffer depression?
Prejudice or discrimination against homosexuals on the assumption that heterosexuality is the normal sexual orientation
What is the difference between a transsexual person and a transgender person?
Both = Gender identity/expression differs from their birth sex
Transgender person has undergone gender reassignment
Name some specific health needs which are prevalent in the LGBT population:
- Mental health: anxiety, depression, suicidality
- Substance abuse
- Cervical cancer
- Anal cancer
Why can terminology around sexual behaviour be a problem when talking to patients?
The word sex can mean different things to different people
Describe the NATSAL survey:
National survey of Sexual Attitudes and Lifestyles
- ~15,000 people aged 16-75 interviewed about their sexual behaviour:
- Types of sex
- Freq. of sex
- No. partners etc
Why is it difficult to obtain accurate information about sexual behaviour?
- Relies on recall
Define health-related behaviour, and give some examples:
Anything that promotes good or bad health:
Good: Healthy-eating, safe sex, exercising
Bad: Unhealthy diet, smoking, drinking, drug-use
Name the 3 learning theories of health-related behaviour:
1) Classical conditioning
2) Operant conditioning
3) Social learning theory
What is classical conditioning?
Behaviour becomes paired with environment = habit
The use of Disulfiram to treat alcohol dependence is an example of which learning theory?
- Learn to associate taste/ingestion of alcohol with nausea
What is operant conditioning?
Behaviours are shaped by consequences: reward/punishment
Smoking to alleviate stress is an example of which learning theory?
- Smoking is associated with immediate reward (dopamine release)
What is the social learning theory of health-related behaviour?
People perform behaviours which they believe are rewarded, and which they believe they can enact:
- watch and learn from others
- influenced by role models
Name the 2 social cognition models of health- related behaviour:
- Health belief model
- Theory of planned behaviour
What is the stages of change model?
Natural stages experienced when changing a behaviour:
- Relapse or Maintenance
The extent to which a patient 'complies' with medical advice
The extent to which patient behaviour coincides with medical advice
When the doctor and patient work together to make decisions regarding the patients health
Why does concordance lead to better adherence?
- Patient is involved in decision making
- Patients beliefs, expectations, lifestyle and priorities have been taken into account
- Barriers to adherence have been addressed
- Promotes patient trust and satisfaction with care
Approximately what percentage of people with chronic illness are non-adherent with their treatment plan? Which illnesses have the highest rate of non-adherence?
- Pulmonary disorders
- Sleep disorders
List some methods of directly measuring adherence, and some disadvantages of these:
- Blood/urine test
- Limited to clinical practice
- Non-adherence can be masked
List some methods of indirectly measuring adherence, and their main drawback:
- Pill counts
- Mechanical/electronic measures of dose
Does not measure if patient actually took medication
What can cause unintentional non-adherence?
- Lack of capacity
- Lack of resources
- Mobility/dexterity constraints
Define low-risk drinking:
Drinking within the Department of Health's sensible drinking recommendations
If someone regularly drinks excessively but has no significant alcohol-related problems, how would their drinking behaviour be classified?
What is hazardous drinking?
Drinking over the sensible drinking limit: regularly drinking excessive amounts of alcohol, with no significant alcohol-related problems
What is the Department of Health's sensible drinking recommendations?
~ 14 units/week
= around 6 pints of beer or 175ml glasses of wine
What is harmful drinking?
Drinking over the sensible drinking limit: regularly drinking excessive amounts of alcohol, with clear evidence of alcohol-related harm
What are the 3 subtypes of harmful drinking?
1) Moderate dependence
2) Severe dependence
3) Severe dependence + complex needs
If someone currently drinks to relieve withdrawal symptoms, how would you classify their drinking behaviour?
Harmful drinking with severe dependence
How would you manage an acutely intoxicated patient, who is a known alcoholic?
- Monitor vital signs, electrolytes and glucose
- Administer Thiamine
- Management of withdrawal symptoms
Describe management of a detoxing alcoholic:
- Vitamin B1 + B complex
Counselling + advice
Relapse prevention ie Disulfiram
Which symptoms of alcohol withdrawal can Chlordiazepoxide reduce?