Ottawa Charter for Health Promotion Relevance to Physiotherapy
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A - Actively involve the patient
B - Build patient skills
C - Create a supportive environment
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What is Policy?
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- It states matters of principle
- It is focused on action, stating what is to be done and by whom
- It is an authoritative statement, made by a person or body with power to do so
- Above all, good policy is a tool which makes administration easier, and allows people to get on with the organisation's core business more efficiently and effectively
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Purposes of Epidemiology
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1. Measuring health problems in populations (and comparing)
2. Identifying and measuring determinants
3. Measuring effects of interventions
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Incidence
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The number of new cases of a health condition occurring in a population during a specified period of time (usually 1 year).
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Why do we communicate in physiotherapy?
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- Build relationships
- Take a case history & make a diagnosis (the subjective interview)
- Educate
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What is equity?
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Equity is the absence of avoidable difference among groups of people, whether these groups are defined socially, economically...
What does health equity look like?
- Access to health care
- Patient safety
- Person centred care (Whanau)
- Treatment received
- Quality of care
- Underlying determinants of health
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A rate
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The number of people with a health issue in a specified population and time period reported in a way that allows comparison between populations of different size.
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Any factors that influence a person's health positively or negatively (e.g. person's environment, person's behaviours, person's own characteristics)
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Determinants
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Loss of independence, inability to work, costs of treatment, disability or complications due to a health condition, are all measures of
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Morbidity
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Demography
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A study of human population (size, structure, and distribution of populations). E.g. age, sex, ethnicity
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Incidence of type II diabetes in New Zealand will fall if there are
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Less new cases of type II diabetes during a specified period of time
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How Does Physiotherapy Fit With The NZ Health Priories?
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Although in many cases physiotherapists are treating relatively minor things like ankle sprains, many people have comorbidities i.e. the ankle sprain patient may also have diabetes which the physiotherapist could be beneficial in treating that. Therefore we have to keep considering the 'bigger picture' and the 'whole person' in line with the socio-ecological model of health.
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Social Determinants
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Aspects of society and the social environment, the area which someone works, lives and grows. Sometimes called environmental determinants. E.g. Work place, Housing, Deprivation, Cancer screening access are examples of social determinants of health
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4 big health challenges in NZ and similar countries today and in the future
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- Increasing chronic health conditions
- Increasing health inequalities
- Aging population
- Increasing in health care costs (unsustainable)
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Government
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Biomedical Determinants
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Determinant that is based on personal biology, genetics, physiology. E.g. Age, Gender, Weight, Blood Pressure
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Ottawa Charter for Health Promotion Overview
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- Published by the World Health Organisation in 1986
- Comprises a framework of strategies;
o Strengthen personal/community actions
o Develop personal skills
o Create supportive environments
o Build healthy public policy
o Re-orient health services
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Primary Health Organisations (PHOs)
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Morbidity
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The burden or severity of a health condition for individuals or society is called
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Ministry of Health (MOH)
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Epigenetics
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Study of trait variations that are caused by external or environmental factors that switch genes on and off, and affect how cells read genes instead of being caused by changes in the DNA sequence itself.
Epigenomes can change throughout the lifespan (based on pregnancy etc or stress or diet etc) or can be hereditary.
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Health Promotion
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Health promotion is a process of enabling people to increase control over and to improve their health.
This is a changing processes. Over 50% of physiotherapists work involves helping people improve their health through making behaviour changes and thus health promotion is very important.
Traditionally health promotion has been provider centred and underpinned by the biomedical model of health, focussing predominantly on providing information and instructions as this was assumed to change patient behaviours.
However, more progressive treatment has become patient centred, which primarily involves actively involving the patient and building their skills.
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DHB Services
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Prevalence
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The number of existing cases of a health condition in a population at a specified time (snapshot).
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Determinants of Health
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The range of personal and environmental factors that influence health status
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20 District Health Boards (DHBs)
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Epidemiology
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Measures health problems in a population
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DALY's (Disability Adjusted Life Years)
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A measure of health loss that combines years of life lost due to early death and years lived with disability or illness; 1 DALY = 1 hear health life lost; Increasingly being used to measure the burden of chronic conditions
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What is equality?
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Everyone gets the same things
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Behavioural Determinants
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Behavioural determinants are those behaviours that may influence health status. Behaviour is the way in which one acts or conducts oneself and is observable, they are often potentially modifiable. E.g. Unhealthy diet, Physical inactivity, Tobacco use