SocPop Flashcards
(73 cards)
1
Q
Define health behaviours
A
Behaviours that are related to the health status of the indiviudal
2
Q
Describe the dual pathway model
A
There are 2 ways in which psychological processes may influence physical health:
Psychological processes may DIRECTLY cause physical issues e.g. stress causes physiological impact
Psychological processes may INDIRECTLY cause physical problems through behaviour e.g. those more stressed drink more alcohol and therefore negatively impact health
(Health behaviours lecuture 7/1/19)
3
Q
What are the five personality traits (emotional dispositions)?
A
- Openness to new experiences
- Conscientiousness
- Extroversion
- Agreeableness
- Neuroticism
OCEAN
4
Q
Describe what lay beliefs are (5)
A
- Non-professional views
- Perspecitves of ordinary people; beliefs or assumptions that people hold to be true about their health
- May be sensible or irrational
- Does not mean that they are not informed; often complex and sophisticated
- Distinguishable from theoretical or professional perspectives
e. g. catch a cold because you’ve got wet hair outside
5
Q
Why are lay beliefs important? (6)
A
- Insight into the needs of the patient for information and support
- Influences health-seeking behaviour
- Influences how people respond to symptoms
- Influences decisions about consulting
- Influences expectations about treatment
- Influences concordance with treatment plans
6
Q
Define culture
A
Values, norms and traditions that affect how individuals of a particular group percieve, think, interact, behave and make judgements about their world
7
Q
List 5 social triggers to seeking medical help
A
- Interference with social and personal relationships
- Interference with vocational or physical activity
- ‘Sanctioning’ by others e.g. family and friends
- ‘Temporalising’ symptomology - If I’m not better in 2 weeks then I’ll go to the doctors
- Interpersonal crisis - something else goes wrong in life which triggers them to do something e.g. someone close to them has cancer diagnosis
8
Q
What are the stages in the transtheoretical (stages of change) model?
A
- Precontemplation
- Contemplation
- Preparation
- Action
- Maintenance
(Relapse)
Each time someone goes through the cycle, their self-efficacy increases. They may go through the cycle several times before reaching maintenance.
9
Q
What are the 3 models assocaited with health behaviours?
A
- Health-belief model
- Theory of planned behaviour
- Transtheoretical model (stages of change)
10
Q
Describe the health-belief model
A
There are percieved barriers/benefits which lead to percieved efficacy and perceieved severity/susceptibility which lead into percieved threat. These together lead into a health behaviour.
11
Q
Describe the theory of planned behaviour
A
Behaviour is governed by behavioural intention, which itself is governed by behavioural attitude, subjective norm and percieved behavioural control.
Behavioural attitude = behavioural beliefs + outcome evaluation (e.g. i like the gym, the gym keeps me fit)
Subjective norm = normative beliefs + motivation to comply
Percieved behavioural control = control beliefs + self-efficacy (if you don’t have self-efficacy, you won’t engage in the behaviour)
12
Q
What are the 3 types of individual differences (in refernce to health behaviours)?
A
- Emotional dispositions (psychological processes involved in the experience; OCEAN personality traits)
- Generalised expectancies (psychological processes involved in formulating expectations in relation to future outcomes e.g. locus of control (internal - I am in control of my health) and self-efficacy (belief to execute)
- Explanatory styles (optimism vs. pessimism in explaining causes of negative events - optimism better for health and recovery)
13
Q
What are lay health beliefs?
A
Non-professional views from ordinary people; beliefs and assumptions that people hold to be true about their health.
Often complex and sophisticated
May be sensible or irraitonal
e.g. I’m not at risk of heart disease because I’m thin
14
Q
Name 4 things which shape people’s health beliefs
A
- Place in society
- Culture
- Personal biography (experience)
- Social identity (gender, sexuality, ethnicity, occupation)
15
Q
Define culture
A
Values, norms and traditions that affect how individuals of a particular group percieve, think, interact, behave, and make judgements about their world.
16
Q
Name 5 reasons why lay health beliefs are important to doctors
A
- Insight into needs of patient (information and support)
- Influences how people respond to symptoms
- Influences health seeking behaviour
- Influences expectations about treatment
- Influences concordance with treatment plans
17
Q
What factors are involved in a patient’s decision to consult a doctor?
A
Complex interplay of physical, social and psychological factors
Involves:
- Perception of symptoms e.g. how severe, how familiar, how long they last
- Explanation of symptoms e.g. try and make sense; if have headache after drinking alcohol less likely to consult
- Evaluation of symptoms e.g. costs and benefits of seeking help; what doctor will think of them; are symptoms serious enough e.g. men delay because feel they shouldn’t go
18
Q
Name 5 social ‘triggers’ to seeking medical help
A
- Interference with social and personal relationships
- Interference with vocational or physical activity
- ‘Sanctioning’ by others e.g. friends and family (50% referrals due to advice from them)
- ‘Temporalising’ symptomology - If I’m not better in 2 weeks then i’ll go to the doctors
- Interpersonal crisis - something else goes wrong in life which triggers them to go e.g. someone close to them has a cancer diagnosis
19
Q
Name some bio, psycho and social factors which are in the bio-psycho-social model
A
Bio: Viruses, genetics, bacteria
Psycho: Behaviour, emotions, beliefs, coping, stress
Social: Class, employment, ethnicity
20
Q
Name the 4 determinants of health behaviour (factors)
A
- Background factors (characteristics that define the context in which people live their lives)
- Stable factors (individual differences in psychological activity)
- Social factors (social connections in immediate environment )
- Situational factors (appraisal of personal relevance that shape responses)
21
Q
What are the 3 broad types of indvidual differences?
A
- Emotional dispositions (psychological processes involved in both the experience and expression)
- Generalised expectancies (psychological processes involved in formulating expectations in relation to future outcomes)
- Explanatory styles (psychological processes involved in explaining the causes of negative events)
22
Q
What do people with an internal locus of control believe about their health?
A
- They are responsible for their own health
- Illness can be avoided by taking care of themselves
- Ill health results in part from not eating correctly or not getting enough exercise
23
Q
Define self-efficacy
A
Belief in one’s own ability to organise and execute a course of action, and the expectation that the action will result in, or lead to, a desired outcome
24
Q
Name the criteria for inferring causality (Bradford Hill’s criteria, 9 things)
A
- Strength of association (measured with odds ratio)
- Specificty of association (more likely if associated with one specific factor)
- Consistency of association (observed in different studies and sub-groups)
- Temporal sequence (if exposure has been shown to precede the outcome)
- Dose response (causal link more likely if different levels of exposure have a different risk of acquiring outcome)
- Reversibility (causal link very likely if removal or prevention of factor leads to a reduced or non-existent risk of acquiring outcome)
- Coherence of theory (more likely if conforms with current knowledge)
- Biological plausibility (more likley if biologically plausible mechanism demonstrated/likely)
- Analogy (more likely if an analogy exists with other diseases)
First 3 are association features, middle 3 are exposure/outcome, last 3 are other evidence
25
Name 3 types of observational studies
1. Cross sectional surveys
2. Case-control studies
3. Cohort sutdies
26
Name 4 types of experimental studies
1. RCTs
2. Controlled studies
3. Natural experiments
4. Uncontrolled studies
27
Define bias
Any trend in the collection, analysis, interpretation, publication or review of data that can lead to conclusions, that are systematically different from the truth
28
Name 3 types of bias in epidemiological studies
1. Selection (volunteer, loss to follow up, admission)
2. Information (interviewer, recall, questionnaire)
3. Confounding
29
Name some limitations of epidemiological studies
1. Provide average information; hide indivudal variation
2. For some patients it will be better not to do what is best on average
3. Limited when many different factors interact with each other in complex pathways
30
Define caring
Displaying kindness and concern for others; the work or practice of looking after those unable to care for themselves
31
How many carers are there in the UK?
6.5 million (10% of adults)
| 3 in 5 people will be carers at some point in their lives
32
Name some possible advantages of using the term 'carer'
1. Identify the need and get access to services
2. Recognition of work and contribution of carers
3. Sense of identity - more likely to attend support groups
33
Name some possible disadvantages of using the term 'carer'
1. Lock people into a role they do not want
2. May prefer to define themselves as a son, daughter, mother etc.
3. Undermines person being cared for
4. May only be seen in terms of being a carer (identity)
34
Name 5 things that caring impacts on (for the carer)
1. Financial
2. Work
3. Relationships and social
4. Health
5. Education (young carers)
35
Name 4 financial implications of being a carer
1. Lower income
2. Higher costs: laundry, heating bills
3. Have to give up job to care
4. Cut back on essentials to make ends meet
36
Name 3 impacts of being a carer on relationships
1. Difficulty accessing holidays, leisure pursuits and other social activities
2. Harder to maintain social network/relationships
3. Few or no breaks from caring responsibilities (especially if caring for a relative or BME population)
37
Name 4 health impacts of being a carer
1. Poorer mental and physical health (72% had mental ill health, 61% physical ill health as a result)
2. Injuries due to manual handling
3. Lack of time to care for own health
4. Evidence that caring for a child with LLTI increases risk of parent developing LLTI
38
Name 5 negative impacts of being a young carer
1. Absence from school; low educational attainment
2. Stress
3. Social exclusion/isolation
4. Physical health problems
4. Lack of support and benefits
39
Name 3 possible methods of support for young people
1. Social services (legal entitlements via young carer's needs assessment)
2. Schools
3. Young carers projects
40
Describe some things young carers projects do to help
- Provide opportunity for young carers to take a break from their caring responsibilities
- Provide advice and emotional support through counselling
- Liasing with schools so teachers can better support students
- Provide opportunities for young carers to learn more about their parent's illness or diability
- Support young carers to use local services such as sports clubs, support groups and health centres
41
What should doctors do if they meet someone who is a carer
1. Identify whether someone has caring responsibilites when discussing their health
2. Consider carer when planning care of patient and discharge planning
3. Give early information about rights and entitlements
4. Signposting carers to services
5. Provide responsive health care for carer and person they care for
42
Describe the difference between paid carers and unpaid carers
```
Paid carers (social care workers) include staff who work with people in residential care homes, in day centres and who provide personal care in someone's home.
Unpaid carers: provide unpaid care by looking after an ill, frail or disabled family member, friend or partner.
```
43
Define chronic illness
The experience of a long-term condition for which there is currently no cure, and which is managed with drugs and other treatment.
E.g. Diabetes, COPD, arthirits
44
Name 4 major things which chronic illness impacts on
1. Daily activities e.g. work, hobbies, self-care
2. Social relationships
3. Sense of self (biographical disruption)
4. Social identity (how others see you)
45
Name some common coping strategies for chronic illness
1. Denial (only presents difficulty if persists)
2. Normalisation
3. Resignation
4. Accommodation
46
Describe an expert patient
Someone who:
- Feels confident and in control of their life
- Aims to manage their condition and its treatment in partnership with healthcare professionals
- Communicates effectively with professionals and willing to share responsibility for treatment
- Realistic about their condition
47
Describe the expert patient programme
- A peer-led self-management programme
- Aims to improve self-management
- Six week programme suitable for any long-term health condition
- Covers topics such as: healthy eating, exercise, pain management, relaxation
- There are some disease specific programmes
48
Name some evidence-based benefits of the expert patient programme
1. Patients felt more confident that their symptoms would not interfere with their lives
2. Felt better prepared for appointments with healthcare professionals
3. Fewer visits to GP
4. Fewer visits to emergency department
49
Name some potential problems of the expert patient programme
1. Not attractive to everyone
2. Everyone not able to participate
3. Extra pressure on patient organisations
50
What are illness beliefs?
Refer to a patient's own implicit common-sense understanding of their illness
Patient's may have numerous beliefs for a particular illness
51
Describe the self-regulatory model of chronic illness
The model has 5 components:
- Representation of illness (identity, cause, consequences, timeline, cure/control)
- Interpretation (symptom perception, social messages)
- Coping (approach or avoidance coping)
- Appraisal (was my coping effective?)
- Emotional response to illness (fear, anxiety, depression)
All components interlink.
52
What are the five illness belief dimensions?
1. Identity: what is it?
2. Cause: what caused it?
3. Time: how long will it last?
4. Consequence: how will it impact my life?
5. Control-cure: can it be treated, controlled, managed etc.?
53
Name 5 things that patient's with chronic illness need to do
1. Adjust to symptoms and disability
2. Maintain a reasonable emotional balance
3. Prepare for an uncetain future
4. Learn about symptoms, treatment and self-management
5. Form and maintain relationships with healthcare professionals
54
What is crisis theory?
How people manage and cope with chronic illness - need to find a social and psychological equilibrium
Challenges, setbacks and social influences are important and can influence coping responses
55
Describe a pain management programme
Reinforce message of gate control theory - a combination of psychological and physical factors can open and close the gate
Practice relaxation, mindfullness, challenge unhelpful thoughts
Involve clinicans, specialist nurses, physiotherapists, psychologists
Can be intense, residential or spread over 6-8 weeks
May invite expert patients to talk about experiences
56
Name 4 benefits of a pain management programme
1. Helps patients manage their pain rather than the pain controlling them
2. Learn to change cognitive perceptions of pain, challenge unhelpful thoughts
3. Management of stress and anxiety, low mood, depression
4. Not feeling so isolated with the condition when in a group
57
Name 4 challenges of a pain management programme
1. Managing group dynamics
2. Stages of change - are they ready to change their behaviours
3. Committment
4. Managing fears
58
What is evidence based medicine?
Use of current best evidence in making decisions about the care of individual patients; integrating individual clinical expertise with the best available external clinical evidence from systematic research.
59
Name some reasons for maintaining confidentiality
Consequentialist arguments:
- Impact on the patient (Breach may upset them, may affect trust and make thme less likely to share in future)
- Impact on others generally (loss of public trust and therefore less effective care for many)
Resepct for autonomy
- Self determination includes determining how information about oneself is used and how or whether this is shared
Virtue ethics
- Promise keeping and trustworthiness as virtues
Other duties
- Duty of care (data must be shared with healthcare team but usually not beyond)
- Patient-doctor relationship
60
Name the 4 conditions on which implied consent can be sufficient
1. The data is being accessed to support a patient's direct care
2, Information is available to patients explaining how data will be used, and how they can object
3. You have no reason to believe they would object
4. You are satisfied that anyone you disclose information to will understand it is given to them in confidence
61
Name some examples of patient information use not directly relevant to a person's medical care (would require explicit consent)
1. Research
2. Public health
3. Education
4. Health service planning
5. Certain types of audit e.g. financial
62
Name the 4 circumstances in which you may disclose personal information for secondary purposes without breaching confidentiality
1. The disclosure is required by law, including by the courts
2. The patient has given explicit consent
3. The disclosure is approved through a statutory process that sets aside the common law duty of confidentialty
4, The disclosure can, exceptionally, be justified in the public interest
Anonymised information will normally be sufficient for purposes other than direct care
63
Describe the difference between anonymised and psedonymised data
Anonymised data: no identifiable factors
Pseudonymised data: there is a way of linking data back to original records e.g. number
64
Who must be notified if a patient has a notifiable disease?
1. Hospital infection control (duty microbiologist)
2. Public health england (diagnosing clinician's duty to report the case to the local health protection team, urgent cases within 24 hours)
Legislation (public health (infectious diseases) act 1988)
Public health england regulations (health protection regulations 2010)
65
Who may access health records?
- Patients (access their own; NHS trusts have 1 month to respond to request)
- Person with parental responsibility can access child's records (if not contrary to competent child's wishes)
- Power of attorney if patient lacks capacity
- Police (by court order)
- Executor of will/dependants for deceased patient's records
66
What 3 things are required for consent to be valid?
1. Capacity
2. Informaiton
3. Voluntariness (freedom from coercion)
67
If a person lacks capacity, proxy consent may be possible by whom? (Mental capacity act)
- Lasting power of attorney (appointed by patinet in advance)
- Court-appointed deputy (appointed when patient lacks capacity)
68
Describe the legal framework for treating without consent (in the ED for example)
- Doctrine of necessity (common law)
Urgency - emergencies may be life-threatening and may mean reduced time for assessing capacity
-Treatment must be immediately necessary to save their life or prevent serious deterioration of their condition
- Treatment must be least restrictive of patients future choices
- If patient lacks capacity, treatment must be in their best interests (mental capacity act)
- Patient can be detained under the mental health act (whether or not they have capacity), but only under very specific conditions
69
What 4 things must a patient be able to do to determine if they have capacity
1. Understand the information necessary to make a decision
2. Retain the information long enough to make a decision
3. Weigh up the information
4. Communicate their decision
70
When considering best interests for a patient, which factors must be considered?
- Person's past and present wishes and feelings (in particular any relevant written statement made when they had capacity)
- Beliefs and values that would be likely to influence their decision if they had capacity
- Other factors they would consider if they were able to
E.g. religious views, relatives
71
Define restraint
"D restrains P if he:
(a) uses, or threatens to use, force to secure the doing of an act which P resists, or
(b) restricts P's liberty of movement, whether or not P resists"
72
Under what conditions is restraint allowed
Firstly, D must reasonably believe that it is necessary to do the act in order to prevent harm to P
Secondly, the act should be a proportionate response to (a) the likelihood of P suffering harm and
(b) the seriousness of that harm
73
Who is involved in the consent of treating children?
The competent child
Parents
- Parental responsibility (under Children Act 1989) is with the Mother
- Father if married to mother at time of child's birth or if registered on birth certificate, parental responsibility agreement, court order
Mother has parental responsibility by default
One parent's consent is legally sufficient but would want this to be avoided where possible
