What is normal?
3 types + explanation
Statistical Normality: Based on the normal (Gaussian) distribution - 95% of population should be within +/- 2.5 SD of the mean
Social Normality: What society finds acceptable or desirable. Changes within a given society, culture and time.
Optimal Normality: ‘Normal’ value is determined by what is required for optimal health, not the mean/median of a population
Deifine Illness
subjective experience, varying between people, one can be ill in the absence of disease
Define sickness
A social role given or taken on by a person perceived to be ill
Define Disease
Objctive diagnosis using specific signs and symptoms. Deviation from the biological norm. Changes with medical advances
Outline the medical model of health and criticisms
Health stems from biology and is the absence of disease.
Believes it is the health profession’s job to cure/treat/lessen symptoms
Criticisms: Power is in the hands of the medical profession, rather than the patients. Does not include chronic disease for which there is no treatment). Does not consider social influences on health
Outline the social model of health
HEalth is a social construction and is determined by a range of external factors.
It is determined by the social and cultural, socioeconomic influences of a person and is therefore not confined to biological factors
What is definition of health?
WHO: A state of complete social, physical and mental wellbeing and not merely the absence of disease or infirmity.
HEalth as abscence from disease
Health as functionality (ADLs)
Health as freedom
Health as an equilibrium
Define prevalence. How is it calculated and what are the 3 types?
PRevalence is a measure of how common a disease is as a proportion.
P= (no. of people with disease/total no. of people) x 100 for a percentage
3 types: Point, period & lifetime
Outline Incidence and how it is calculated
The rate at which new events occur in a population, over a defined period of time. Either expressed as per n people of n years or as n-person years (basically the same thing).
Incidence = (no. of new cases)/(no people observed x years observed) x units
WName some factors that affect prevalence
Incidence Rate
Recovery (cure) rate
Death rate
Transfer (migration) rate
What is meant by a P value?
P Value = a number somewhere between 0 and 1
Small P value = strong evidence against null hypothesis, so can reject null hypothesis.
Name sources of health and demographic information
Census
Birth Registration
Death Registration
What is a census
The simultaneous recording of demographic data by the government at a particular time, pertaining to all the persons living in a particular territory (UN)
UK census: every 10 years, legal requirement. Taken since 1841. 98% coverage but some low enumeration groups. Data goes to the Office of National Statistics.
What is the UK census used for?
- Measurement and demographics of material deprivation. (identify and target inequalities)
- Baseline population size and structure estimate. (Rates of birth and death)
- Service requirements based on demographics (age, ethnicity etc.)
What are population estimates/projections used for?
Why are they important?
- Resource allocation and planning of services
- Must understand what has happened in the past, what is currently happening and make predictions to plan for the future.
How do you work out population estimate?
What are the pros and cons?
Census baseline + births - deaths +/- migration
Pro: More up to date than census, more accurate than projections
Con: Less reliable further away from the census, migration info isnt great, says nothing about future trends
What is population projections?
What are the pros and cons??
-Population projections are based on assumptions about the future migration, fertility and mortality. Forecasts future structure of the population
Pros: Can aid in planning, more long term
Con:less accurate the further forward you go. Unforeseen changed can render invalid
What is person-centred care?
Key concepts are that the patient is treated how they wish to be treated, care is tailored to them, they are included in the decision making and the care is hollistic
Person centred care should be… (3)
Personalised - Seeing the whole person, putting their needs first, as they define them etc.
Coordinated = Continued across episodes, time, from childhood to adulthood
Enabling = The patient is part of the decision making and are taught to manage their own condition (self-care) i.e. Empowering
Why is Person-centred care important?
Evidence of positive outcomes for patients - better care satisfaction.
Less emergency visits, greater concordance.
social and political drivers
Concurs with the ethical principles underpinning the duties of a Dr.
What are the drivers of person centred care?
Wider society = less hierarchical relationships, less defence, more critical public, patients want to be involved more.
Helping to reduce spiralling costs of NHS
it is better, more COMPASSIONATE Care
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