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Flashcards in Week 2 Deck (105):
1

Define health inequality

Difference in the health outcomes of individuals or groups

2

Name some ways health inequality may be measured

- Life expectancy
- Infant mortality
- Number of comorbidities
- Suicide rate
- Risk factor behaviour
- Self reported health

3

Name 2 acts which aim to reduce health inequalities

Equality act 2010
Human right act 1998

4

What are the acts

Public sector duty regarding socio-economic inequalities

5

What values are human equality acts based upon

Dignitity, fairness, respect and independence

6

Name some protected characteristics

Age, gender, disability, gender reassignment, pregnancy, maternity, race, religeon and belief, sex and sexual orientation

7

Define health improvement

Inter and multi-disciplinary/ sector process of quality improvement based on evidence, partnerships, collaboration and theory

8

What is public health surveillance

Continuous, systemic collection, analysis and interpretation of health- related data needed for the planning, implementation and evaluation of public health practice

9

What are the aims of disease surveillance

- Early warning system for impending public health emergencies
- Documents impact of intervention, tracks progress towards specific goals
- Monitor and clairifies epidemiology of health problems, allowing priorities to be set

10

What do public health models focus upon

Individual behaviour change and supportive environments

11

Define absolute poverty

Set standard the same in all countries
Does not change over time

12

What is extreme poverty

< $1.25 a pday

13

What is relative poverty

Standard defined in terms of society in which an individual lives, differs between countries and over time

14

What is relative poverty defined as in UK

15

What is social exclusion

Alienation or disenfranchisement of certain people within society

16

What % of Gp consultants relate to chronic illness

50

17

What % of medical emergencies are an exacerbation of a chronic disease

2/3

18

Define prevalence

A statistical concept referring to number of cases of a disease that are present in a particular population during a period of time or at a particular date

19

3 most common causes of UK deaths

Heart disease
Cancer
Medical error

20

How many people in the UK receive treatment of asthma

5.4m

21

What % of people in Uk have diabetes

6.2%

22

What is single biggest cause of severe disability in UK and other developed countries

Stroke

23

What is the prevelance of depression alone? What about depression and anxiety

2.6%
9.7%

24

What is meant by DALYS

Disability adjusted life years
How many days lost to ill health

25

4 ways health systems can manage chronic disease

- Self care and self management
- Disease management
- Case management
- Social prescribing

26

What are the aims of healthcare for chronic illness

- Mortality and morbidity through optimum management and prevention of co-morbities
- Improve patient function and quality of life
- Patient actively involved in management of disease
- Doctor- patient partnership and multi-disciplanary approach
- Enables people to work/ life independently
- Cost effectiveness

27

Define impairment

Body lack part of all of limb o rhaving defective limb or other bodily mechanism
Causes or is likely to cause difference in physiological or psychological function

28

Define disability

Refers to the many social and other disadvantages imposed by society on people with physical impairments
Loss/ limitation of oppurtunities to take part in society on equal level due to social and environmental barriers

29

What does the international classification of functioning disability and health document aim to do

Integrates medical and social needs
Recognises significance of environemnt
Focuses on components of health

30

What does Parsons say about society and sickness

Society needs to manage sickness
Illness is form of deviance as disrupts social systems, so a person may be viewe as a deviant

31

What is meant by a persons illness

Patients interpretation of his/ her disease, feelings that accompany it and life events it turns into

32

What is biographical disruption

When people develop a chronic illness, map they have of their lives is disrupted
Consequences at the practical and social level
Illness will have significance on person identity

33

In what way may serious chronic illness lead to loss of self

Restricted life
Social isolation
Being discredited
Burdening others

34

What are the 3 aspects of symptom perception

Intensity and severity of symptom
Familiarity of symptom
Duration and frequency

35

Name Mechanics 10 variables known to influence illness behaviour

1. Visibility and recognisability of the symptoms
2. Perceived seriousness for symptoms for present/ future
3. Extent to which symptoms disupt life
4. Frequency and persistence of symptoms
5. Tolerance threshold of patient
6. Available information, knowledge and cultural assumptions
7. Denial of symptoms
8. Need that compete with illness response
9. Competing possible interpretations assigned to symptoms once recognised
10. Availability of treatment resources

36

Name the 3 stages of Leventhals self regulatory model of illness behaviour

1. Interpretation
2. Coping
3. Appraisal

37

What does leventhals self regulatory framework focus upon

Representation of a health threat
Identity, time lin,e consequences, cure/ control, causes

38

Describe how the health belief model isi thought to show how people decide whether to take action

Perceived susceptibility (how likely am I to face problem) interplays with perceived severity to establish a threat perception
Perceved benefits of behaviour and perceived barriers/ costs of behaviour, combined with the threat perception and health motivation (do i value health) will help decide as do cues to action

39

Describe how the theory of planned behaviour may influence an action

Attitude (overall evaluation of action) and subjective norm (belif about others approval of the action) feeds to intention
As does perceived behavioural control (how able am i to complete this action)
this intention can lead to a behaviour change

40

How do health belief models help in the real world

Help doctors make health promotion most effective

41

What is meant by self management (4)

- Taking charge of ones health
- Dealing with symptoms and change over time
- Working more effectively with healthcare professionals
- Improvings ones quality of life

42

What must be managed in long term conditions

-Symptoms
- Medication
- Behaviour changes
- Role adjustments
- Emotional impact
- Negociating medical team
- Decision making
- Accepting conditions

43

Is medical adherence better in acute or chronic illness

Acute

44

What social changes can facilitate self management

Increased access to phones/ television
Emphasis on primary prevention
Changes in social attitude to smoking etc

45

What makes self management difficult

Numerous conditions
Lack of social support
Environment affects attempts to maintain lifestyle changes
Financial barriers to adherence

46

What theory are expert patient programmes based on

Social cognition and learning theory

47

What is the aim of expert patient programme

Helps patients feel more in control of their lives
Teaching patients to communicate with doctors better

48

What are some negative effects of social support

- May encourage unhealthy coping mechanisms
- Friends may underestimate the stress
- Not all support helpful

49

What is meant by the buffering effect of social support

Social support leads to better health by protecting people from negative effects of high stress

50

What is meant by self help

Joining group, books, DVDS etc

51

Why do self help groups work

-Normalising coneditions
- Sharing experiences
- Emotional support
- Learning from those who had condition longer
- Space to construct narrative of illness
- Place to talk honestly without upsetting family members

52

Define domestic violence and abuse

Any incident/ pattern of incidents of controlling, coercing and threatening behaviour
Violence/ abuse between those aged 16 or over who have been intimate partners or family memberrs regardless of gender/ sexuality

53

Give some examples of types of abuse

Psychological
Physical
Sexual
Financial
Emotional

54

What is the lifetime prevalence of violence against women by men

10-40%

55

Whats the prevelance of physical violence against women by men in last year

2-20%

56

How many cases of DV are reported to tower hamlets police

6000

57

What are some risk factors for domestic violence

- Gender
- Younger age
- Relative poverty
- Separation

58

What % of people suffering domestic violence are women

89%

59

How many women are killed by partner/ ex partner per week

2 women

60

What is the most consistent, longest lasting and largest physical health difference in women who have been abused

Gynaecological problems

61

What health problems can be complications of DV

Chronic pain
Increased minor infectious illness
Neurological symptom
GI disorders
CHD

62

What % of women in violent relationships were assualted for the first time during pregnancy

25

63

Women who have been abused are how much more likely to have
a) depression
b) PTSD
c) alcohol abuse
d) suicidal thoughts

a) 2.8
b) 7.3
c) 5.6
d) 3.6

64

What are the 2 key guidelines from NICE re DV

Recommendation 5= create a disclosing environment
Recommendation 6= ensure trained staff ask about DVA

65

What is the IRIS model used for

Identification and referral to improve safety
Essentially, training, care pathways, medical record prompts, recording and flagging system leads to clinical enquiry, health education material, validation which leads to identifcation and referral of DV

66

What are the 5 components of the IRIS pathway

1) Training
2) Involvement w local GP
3) Expert named recognisable AE
4)HARK- electronic prompt reminding clinicians to ask about DV
5) AE sees woman affected by DV

67

When should doctors ask about DV

- PTSD, depression, anxiety, self harm, suicide etc
- STI
- Chronic unexplained health probs
- Non specific symptoms
- During ante/pre natal care
- Injuries

68

How should you ask about DV

Only when woman is alone
Keep confidential

69

What are the 4 social science traditions to explore gender

1- Nature vs nurture
2- social structure creating gendered behaviour
3- social interaction and accountability to others expectations
4- children are cultural natives in a patriarchal world.

70

Define gender identity

Refers to a persons innate sense of being male or female

71

How do we express gender

externally- based on individual and societal expectations and conceptions
clothing, body language, hair styles, mannerisms, how we speak, how we play

72

What is gender dysphoria

Condition where a person experiences discomfort or distress due to mismatch between biological sex and gender identity

73

What is gender fluidity

Conveys a wider, more flexibile range of gender expression
Do not feel confined by restrictive boundaries of stereotypical expectations

74

What is meant by genderqueer

Blurring of lines surrounding societies rigid views around gender and sexual orientation
More exclusive term in terms of sexual orientation

75

What is meant by a gendered social practice

Shape men and womens bodies in a way that reinforce particular cultural images of femininity and masculinity

76

What is epidemiology

Study of distribution of disease across all sorts of populations

77

What 5 things make a good epidemiological category

Impact on health in individuals/ population
Accurately measurable
Differentiates population in experiences of disease/ health
Differentiates population in some underlying characteristic relevant to health
Aids our understanding, control and management of disease

78

What is race

The group a person belongs to as a result of a mix of physical features such as skin colour, hair texture which reflect ancestry and geographically origins

79

Is race a social construct

Yes

80

What is somebodys ethnicity

A social group that a person belongs to as a result of a mix of cultural and other factors such as language, diet, religion and physical features

81

Define migrant

Any person who lives temporarily of permenantly in a country where he or she was not born

82

Is there a race gene

no

83

What is racism

A belief that some races are superior to others
Used to justify a position that racial inequalities are natural

84

Define prejudice

A positive or negative evaluation of a person based on their perceived group membership

85

Define discrimination

Prejudicial treatment of an individual based on his or her membership in a certain group

86

Define stereotype

A conventional, formulaic and over simplifiied conception opinion or image of a group of people

87

Whats the difference between inequality and inequity

-Inequality: difference in health status or in the distribution of health determinants between different population groups
- Inequity: differences in health status or in the distribution of health determinants between different population groups that are considered to be unjust and avoidable.

88

What is culture

The values, norms and traditions that affect how individuals of a particular group perceive, think, interac t behave and make judgements about their world

89

What is cultural competence

The ability of providers and organisations to effectivelly deliver health care services that meet the social, cultural and linguistic needs of patients

90

Define medical adherence

Extent to which a persons behaviour such as taking medications, following diet/ executing lifestyle changes corresponds with agreed recommendations from a health care provider

91

What is compliance

Doctor recommending a treatment plan which the patient follows

92

What are the disadvantages of compliance

Paternalistic
Assumes passive patient
Apportions blame to those who don't take prescribed treatment

93

What is adherence

Doctor and patient agree about recommended treatment
Patient follows the treatment plan

94

What are the advantages of adherence

Acknowledges active role of patient and that they are free to chose not to take treatment
Attempts to reduce blame/ guilty

95

What is concordance

Doctor and patient communicate about treatment in therapeutic alliance
Patient then makes an informed choice about treatment plan

96

Name 3 ways we can measure adherence

Clinical/ direct observation
Indirect observation
Self report methods

97

What are the financial costs of non-adherence

Health and monetary costs of second/ third line treatment
Costs to wider economy in lost productivity

98

Whar drug class had the highest primary adherence

Antimicrobials

99

What patient age had highest primary adherence

Under 18 y olds

100

What are some intentional reasons for non adherence

Concern abt side effects
Treatment isn't necessary
Explore other treatment
Don't like treatment/ activity

101

What are some non intentional reasons for non adherence

Forgetfulness
Confusion
Can't afford
Can't access
Dexterirty

102

Describe the principal behind the necessity concerns frameowkr

Whether somebody adheres to treatment is guided by weighing up concerns vs necessity beliefs

103

What is a necessity belief

Belief in treatment efficacy and belief that illness requires treatment

104

What is a concern belief

Worries about side effects
Unsure of self efficacy

105

4 types of people when medicine taking

1. passive acceptors who accept medicines without question
2. active modifiers who modify imiplementation of drug after self evaluation
3. active acceptors self evaluate before accepting
4. complete rejectors refuse to take medication at all