12 questions
8 on exam
Answer 5 – remember at least 9

1. Discuss the role self-efficacy and locus of control play in adaptation to chronic illness, such as
cardiovascular disease.
 For a condition such as cardiovascular disease, self-management is a very important element.
This element is as effective as a person’s locus of control and self-efficacy. To make changes
in their diet, add some aerobic activities into their daily routine, taking medications on time,
not smoking and reduced alcohol.
 Locus of control is one’s perception on their control over a chronic condition
 
2. Social support is seen as one of the social determinants for overall health in the general population.
Discuss in detail the association between social support and mental health conditions such as
depression.
SOCIAL SUPPORT
  Types of social support
o Emotional – listening
o Informational
o Tangible – time, skills, knowledge, expertise, material ($)
o Appraisal
o Social companionship
 Other dimensions of social support
o Size of support
o Structure of support
o Perceived vs actual support
o Unhelpful when creates dependency

MENTAL HEALTH – DEPRESSION

 Type of supports most important by gender
Males Females
1. Social 1. Social
2. Tangible 2. Emotional
 Effect of perceived support is greater for m/f with depression (Grav et al., 2011)

 People with depression have a greater need for “perceived social support” than those without
depression (Grav et al., …)
 In other words, people with depression need to feel like people will be / are there for them.
This need is greater than the need for actual support
 A telephone support group deduced depression in older care givers
 Beyond Blue (2014) found that “poor social connectedness is a significant issue for many men
in their middle years”

 Loneliness ↑ depression
 Negatives of social support
o ↑ stress
o Encourage unhealthy behaviours
o Pressure to ‘be normal’
o Feeling pitied
 Social support helps
o Reach goals
o Deal with crisis
 o Lift mood
o ↓ loneliness
o ↑ psychological health
o Have good quality relationships
o Be physically active
o Get out of the house – into community activities
o ↓ stress
o ↑ motivation
 

3. Broadly speaking, there has been a shift of disability care approaches from institutional-based care to
contemporary disability-based practice. Discuss.
  Difficulties an individual might have while executing activities or problems they might face in
life situations
 Since World War Two, the Western world has been implementing a deinstitutionalisation of
mental health systems (MacKinnon & Coleborne, 2003) and creating a community care system
to treat patients outside of institutions. MacKinnon and Coleborne (2003) name two models
that have governed the shift, a medical model and a sociological model. Serving as a bridge
and enabling access to services in this new fragmented system, are Case Managers. A
recommendation from a 1957 Royal Commission in England stated that “no patient should be
retained as a hospital inpatient when he has reached the stage at which he could go home”
(Killapsy, 2007), and so patients must navigate numerous services outside of hospitals. Since
the introduction of community-based care in the 1950s, European countries have recorded
“greater patient satisfaction and quality of life” in comparison to the institutionalised model
(Killapsy, 2007). However, despite the successes of this model, improvements are needed to
better meet the needs of all people accessing mental health services in Australia
 
4. In planning future expansion of disability services, in order to increase social inclusion, it is important
to acknowledge the efforts of individuals and small groups. Discuss.
  Social inclusion in disability refers to:
o Experiencing respect
o Opportunities to contribute/participate in society
o Significant reciprocal relationships
 The NDIS is not only supposed to provide tangible support, but also to change the way
disabled people are treated in communities
 Small community groups provide people with opportunities to build relationships and engage
with the wider community
 Craig & Bigby (2015) reported on 5 participants that attended programs in different
community groups like walking, cooking, op shop, shed work
o This provided an outlook at how different communities, big or small, have different
work environments of working effectively – catering different audiences and their
aspirations
 
5. What are the four pillars of the TAC towards zero campaign? Discuss one in detail and how it impacts
the Victorian public.
 Safe roads
 Safe speeds
o …
 Safe vehicles
 Safe people
 
6. The World Health Organisation attempted to standardise terminology in the field of disability by
introducing ICIDH (International Classification of Impairments, Disabilities and Handicaps) in 1980 and
more recently ICF (International Classification of Functioning, Disabilities and Health).
a. Nominate and define at least three constructs from either scheme and
  …

b. Explain the advantages that the use of ICF terminology has brought to service provision for
those living with a disability
  The ICF terminology has improved as it reduced stigma associated with people
 This model focuses on what people can do instead of what they can do
 It has reworded words such as “disability” and “handicap” to replace them with participation
restrictions and activity limitations

 Changed terminology to reduce stigma???

 
7. According to Wagner (1998), there are six essential elements in the chronic care model. Identify one
of the elements and discuss in detail why you believe this to be important in supporting individuals
experiencing a chronic health condition.
 Self-management support
o This refers to effective self-management strategies that include:
 Assessment
 Goal setting
 Action planning
 Problem solving
 Following
o Agencies should consider change to models of care, process and practice that impact on
effective and efficient service provision of self-management support. At the end of the
day, only the patient knows and understands the most of their illness and it is up to them
to make living with a chronic condition easier or harder
o Steps to take:
 Learn about your illness
 Good GP who understands your needs
 Work with team of healthcare providers, specialists, counsellors, etc.
 Case manager or healthcare professional to have a management plan – agreed
upon by patient
 Understand your medications
 Support for carers if required
 Delivery system design
 Decision support
 Clinical information systems
 Organisation of health care
 Community
 
8. There are many risk factors that lead to serious injury, e.g. road traffic accidents, which can be
evident among certain at-risk populations such as young adults. According to Bates, Davey, Watson,
King and Armstrong (2014), what are some of the social factors that attribute risk among young
drivers? What public health initiatives or preventative measures have been designed to reduce road
trauma among young adults?
http://www.saferpplaters.com.au
  Socio-economic status – young drivers from lower SES experience higher crash risks and are
twice as likely to be hospitalised as a result of a crash than young drivers from higher SES
backgrounds
 Passengers
  Alcohol and drugs
 Social group and peers

 Victoria’s Graduated Licensing System provides a structured transition as a new driver’s

experience and maturity increases – ensures new drivers move through the learner permit and
probationary license stages to earn their full drivers licence without being exposed to high risk
driving situations before they are ready

 
9. According to the National Asthma Strategy 2018, how can we create supportive community
environments to promote health and prevent asthma risk?
 Explore innovative strategies to reduce modifiable risk factors for asthma and strengthen
asthma prevention
o Make changes to support the development of health-promoting community
environments that encourage people to increase their levels of physical activity, reduce
sedentary behaviour and tobacco use, and improve healthy eating
o Address maternal, family and child health, enhancing early life and growth patterns
 Raise awareness for exposures that can trigger asthma symptoms and flare ups
o Drive policy, and practice changes to reduce exposure to known harmful agents
 E.g., unflued gas heaters in schools/homes, wood fire heaters in winter, and poor
air filtration in road tunnels
o Identify high-risk people and populations for evidence-based targeted interventions
 Explore new approaches to create healthy workplace environments and reduce work-related
asthma
o Two types of work-related asthma:
 Work-exacerbated asthma – the worsening of asthma
 New-onset asthma (occupational asthma) – due to workplace conditions
o Identify high-risk occupations and industries for evidence-based targeted interventions
o Develop and test innovative workplace strategies, including interventions to reduce
exposure to airborne sensitising agents in the workplace
 Explore new approaches to predict and manage public health advice and clinical treatment in
relation to specific environmental risk events
o E.g. thunderstorms
o Implement monitoring and warning systems so people can avoid exposure where
possible to bushfire smoke, thunderstorms, high pollen levels and poor air quality/air
pollution

10. Management of chronic conditions focuses on the physical functioning of the patient to reduce
impairments, activity limitations and participation restrictions. The wider rehabilitation concept and
plan for patients experiencing musculoskeletal conditions should also include a greater focus on
supporting individual's social and environmental aspects. Discuss.
  …
 SOCIAL SUPPORTS MENTALLY WELL MOTIVATED PHYSICAL ACTIVITY
(to keep) (and) (to keep up) (for)

HEALTHIEST BODY ACTIVE / DOING THE WELLBEING

POSSIBLE THINGS THEY LOVE and GOOD QUALITY
(to keep) (to maintain) OF LIFE

11. Initiatives with ongoing community involvement are more likely to be responsive to changing needs
and be more sustainable. Discuss.
  …

12. Chronic disease contributes to over 70% of the disease burden in Australia, a figure that is expected
to increase to 80% by 2020. What are the aims of chronic disease self-management education
programs? Discuss.
 Chronic disease self-management education programs aim to empower patients through
providing information and teaching skills and techniques to improve self-care and doctor-
patient interaction, with the ultimate goal of improving quality of life
 …
 Glasgow et al, 2008
o Self-management and self-management support are key aspects of optimal chronic
disease care, and are effective if implemented appropriately
o Health literacy is the foundation for self-management programs and should be fostered
within the whole population
o We should invest in research and evaluation of self-management because the evidence
base is under-developed and inherently difficult to expand
o Because patient carer, clinician and organisational engagement with self-management
and self-management support programs are uneven, we need to prioritise activities
designed to engage known hard-to-reach groups
o We should strive to improve integration of self-management into clinical, educational
and workplace contexts
o Education and psychological theories can help guide self-management support