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HBS compilation past year papers for rcsi
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PAST YEAR 2006 & 2007 QUESTIONS AND ANSWERS COMPILATIONCREDIT TO: RCSIans ‘08
SUMMER 2006
Q1. Describe stigma and the relevance of this concept to disability.
HBS 36 –
• Stigma:
– Definition: A condition/attribute marking an individual as culturally
inferior/unacceptable. Stigma can be:
• ‘Discreditable’ (not known by the world at large)
versus
• ‘Discrediting stigma’ (condition that is obvious and visible to others).
• ‘enacted’ stigma (actual behavioural discrimination)
versus
• ‘felt’ stigma (individual’s expectations of negative reactions).
• Language concerning disability stigmatising
– Dis - ‘ability’
– Invalid [2 meanings]
– Handicap [cap in hand = beggar]
-Link & Phelan Conceptualisation of Stigma
Overall outcome of Stigma
1. For individual
• Secrecy
• Fear
• Unwilling/afraid to access support
• Increased anxiety/stress
2. For society
• Discrimination and victimisation
• ‘Innocent’ versus ‘Guilty’
• ‘Risk group’ versus ‘Risk behaviour’
Q2. Describe the four factors which contribute to persuasion in health
promotion.
Source factors in persuasion
1. Credibility[e.g. messages on dangers of recreational drug use -
doctor or rock star? ]
2. Expertise[e.g. messages on caring for young babies -mother vs
doctor?]
3. Trustworthiness[e.g. messages on benefits of food
supplements -supplement manufacturer vs doctor]
,4. Likeability[e.g. messages on donations to charity -media
person vs politician]
5. Attractiveness[e.g. messages in advert promoting on eating a healthy
diet -a more/less physically attractive actor]
6. Similarity[e.g. messages on sensible alcohol use -same or different in terms of age,
sex, culture, dress sense etc]
WHAT?: Message factors in persuasion
Fear appeal vs logic[fear appeal may work if motivation needed to
change behaviour]
One-sided vs two-sided argument[more educated prefer two-sided]
Number of strong vs weak arguments [strong is
better]
Repetition[more is better…booster adverts, etc]
BY WHAT MEANS?: Channel factors in persuasion
In person[e.g. drug reps calling on doctors vs posting information /
election campaigners calling]
On radio vs TV vs newspaper[ -which medium heard by which
audiences -older/younger; late at night etc]
On audiotape or videotape [e.g. time to listen/rehear message]
On computer/internet
TO WHOM?: Receiver factors in persuasion
Personality[e.g. those with internal locus of control less easily
persuadable]
Expectations[e.g. prior forearming about the nature of the
persuasion…’this person will try to convince you to have
surgery’…….forearming often increases resistance]
Strength of pre-existing attitudes[e.g very wary of taking
any medication vs never really thought about it]
Level of pre-existing knowledge about issue[little/lot]
Q3. Discuss if and when fear can be a useful strategy in health promotion
messages.
Fear-drive model proposes that greatest change occurs with moderately fearful
message
(no fear = no reason to change)
(too frightening = denial of the message)
Parallel responses model proposes that individuals engage in 2 parallel
responses
1) danger control – coping with external environment to avert danger
2) fear control – coping with internal environment to reduce unpleasant
emotions
if information is given to reduce both danger and fear, then high fear message
will increase level of behavioural change achieved
, for eg TV advertising for seatbelts (boy causes head injury to girlfriend in car
crash)
Q4. List 3 criteria for measuring health systems performance and describe one of
these in detail.
Coverage what % of people access services
Effectiveness use of proven interventions that bring
+ Efficiency maximum benefit for least cost
Equity of access to care based on need, not on
ability to pay (“fairness” as important as
“effectiveness”)
Responsiveness to service users needs
Equity: everyone should get an equal chance of getting a health services regardless of
their social economy status. A carpenter being sent to the hospital with serious
external bleeding should get the same treatment with a politician being admitted to the
hospital because of stroke.
Q5. Discuss how poverty can affect people’s health.
limited access to education
- in south Africa for e.g, economic forces compel men to live and work away from
their families in. Girls grow up with limited access to education and economic
opportunities; and these factors in turn promote commercial sex, sexually transmitted
infections, including AIDS.
- pregnant mother is not educated about pregnancy and things related to it. E.g: lack of
nutritional supplements and infectious disease screening during pregnancy, lack of
post partum care lead to death of mother and premature infant death.
poor= no money
- prefer to stay at home when sick and before they knew it, the disease has reach a
critical stage and can’t be treated.
- Spread of communicable disease is inevitable. One sick young infant left
untreated can cause the whole family to get infection. E.g: diarrhoea
Poor people has limited access to clean water, adequate dietary supplement and
suitable environment.
- they usually live in area with low sanitation.
Q6. Explain the ethical principles of autonomy and justice. Illustrate ONE of
these principles using the case study from your team project.
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