This action might not be possible to undo. Are you sure you want to continue?
Define community health nursing (CHN) and public health nursing (PHN) Community health nursing o Synthesis of nursing practice and public health practice applied to promoting and preserving the health of populations o Directs care to individuals, families, or groups o Broader and more general specialty o A community can be geopolitical (has boundaries/physical place) or phenomenological (no boundaries, abstract; relational, interactive group; example churches, universities, online group) Public health nursing o The practice of promoting and protecting the health of populations using knowledge from nursing, social, and public health services o Population focused, with the goals of promoting health and preventing disease and disability for all people through the creation of conditions in which people can be healthy o Nursing practice generally delivered within official or governmental agencies o Focus is on the community as a whole and the effect of community health status (resources) on the health of individuals, families and groups o Consideration of the health of individuals, families, and groups and their effect on the health of the community as a whole 2. Differentiate upstream thinking from downstream intervention in CHN/PHN practice Upstream Thinking (Macroscopic Approach) Society is the locus of change (prevention/early intervention) Focuses on modifying economic, political and environmental factors that are the precursors of poor health throughout the world Nursing interventions may include modifying social or environmental variables May involve social or political action Downstream Thinking (Microscopic Approach) The individual is the locus of change (cure) Emphasizes behavioral responses to illness or lifestyle patterns Nursing interventions aimed at the individual to change lifestyles or to change perceptions/belief system 3. Compare and contrast CHN with clinical nursing, community-based nursing, and public health nursing according to goals, clients, processes used, and settings for practice Goals Clients Processes Used Settings for Practice CHN Emphasizes Community the nursing process Where individuals, families and groups preservation and live, work or go to school protection of health Clinical Improve the health Patients of Nursing process, Inpatient nursing of patients the health treatment and patient care system care procedures Community Emphasizes Individual Nursing process, Where individuals and families need -based managing acute or and the diagnosis and nursing care outside the hospital or nursing chronic conditions; family treatment nursing home. help them manage Acute and chronic care (home health illness among health nursing, nursing in outpatient or care settings ambulatory settings, school clinics) Public Protect and promote Population/c Nursing, social and Home health nursing, palliative & health the health of the ommunity public health services hospice nursing, public health nursing nursing entire population (official agencies), school nursing, occupational health nursing, correctional nursing 4. Explain determinants of health and indicators of health for individuals and communities Determinants of health Health and illness are influenced by a web of factors, some that can be changed (diet, exercise) and some that cannot (genetics, age, gender)
worksites. behavior. social environment access to quality of health care [these determinants are in a revolving circle] o Policies and interventions can improve health by targeting detrimental or harmful factors related to individuals and their environment (example policies against smoking in public places. economic. exposure to emerging technology. physical activity. housing. friends. health service and related trends. family history. or a toxic or infectious agent may produce illness or disability that changes an individual‟s biology. social interactions. rise in PHN. Identify theories applicable to CHN/PHN practice Health Belief Model Focuses on a person‟s perceptions of a threat or a health problem and related appraisal of a recommended behavior to elicit change Addresses attitudes and beliefs of individuals Focus was on increasing the use of preventive health services Primary assumption is that people fear disease and that health actions are motivated based on the extent of the fear and belief in benefits obtained by preventative action 5 primary constructs: o perceived susceptibility – one‟s belief regarding the chance of getting a given condition o perceived severity – one‟s belief regarding the seriousness of a given condition o perceived benefits – one‟s belief in the ability of an advised action to reduce the health risk or seriousness of a given condition .CH nurses must work with policy makers and community leaders to identify patterns of disease and death and to advocate for activities and policies that promote health at the individual. If an individual has a family history or colon cancer they may choose to have regular screenings to prevent advanced cancer development) o Biology is an individual‟s genetic makeup. his or her biology may be changed as a result. schools. Describe the historical development of community/public health nursing Pre 1850: home visiting to sick as an act of charity 1850 – 1900: home visiting to sick 1900 – 1960: nursing in community centers for the poor 1900 – 1960: communicable disease control and immunizations. and others in the community. violence. seat belt and child restraints) o Physical environment is that which is experienced with the senses (examples – natural environment. (examples – availability of resources. and any physical and mental health problems developed in the course of life. and community levels Policies & Interventions physical environment. diet. schools and OH nsg 1960 – 1980: care provided in public health clinics 1980 – present: health promotion and education. stress. Behaviors interact with biology in a common relationship as one may influence the other. biology. home visits. social norms and attitudes. exposure to crime and violence. injury. o Social environment includes interactions and relationships with family. aesthetic elements) o Behaviors are the individual‟s responses to internal stimuli and external conditions. smoking. recreational settings. homes. family. exposure to toxic substances. health care access improvement - 6. (example – one chooses behaviors such substance abuse or smoking. 5. alcohol or drug abuse. co-workers. neighborhoods. transportation options) o Access to quality of health care: expansion of health care access is essential to decrease health disparities and to increase the quality of life and the quantity of years of healthy life Leading Health Indicators: physical activity overweight and obesity tobacco use substance abuse responsible sexual behavior mental health injury and violence environmental quality immunization access to health care Changes in mortality reflect a number of social. physical barriers. Aging.
progressing through a sequence of stages Precontemplation – the individual has no intention to take action toward behavior change in the next 6 months. to reduce the effects of disease and injury and to restore individuals to their optimal level of functioning . Consists of 2 elements – general health promotion and specific protection o Example: promotion of good nutrition. Weighing pros and cons to change Preparation – the individual intends to take action within the next month and has taken steps toward behavior change. This phase may last months to years Example used for this model: Bereavement Critical Social Theory Societal awareness to expose social inequalities that keep people from reaching their full potential by promoting equality and reduce disparities Aims to provide an environment in which individuals can become empowered (encourages people to undertake activities to improve their situation). provision of adequate shelter. Has an action plan Action – the individual has changed overt behavior for less than 6 months. encouraging regular exercise. enlightened (raising the consciousness of the oppressed) and emancipated (new arrangements replace oppressive ones) Example used for this model: Respite services for caregivers o 7. scoliosis screening. In the phase due to lack of information about the consequences of the behavior. immunization Secondary Prevention: refers to early detection and prompt intervention during the period of early disease pathogenesis. Pap smears Tertiary Prevention: targets populations that have experienced disease or injury and focuses on limitation of disability and rehabilitation. Aims of this level are to keep health problems from getting worse. Has changed behavior sufficiently to reduce risk of disease Maintenance – the individual has changed overt behavior for more than 6 months. Implemented after a problem has begun but before signs and symptoms appear and targets those populations who have risk factors o Examples: mammography. Discuss the preventative approach to health care and give examples of health promotion and the levels of prevention Health Promotion Activities that enhance resources directed at improving well-being Disease Prevention Activities that protect people from disease and the effects of disease Levels of Prevention Primary Prevention: relates to activities directed at preventing a problem before it occurs by altering susceptibility or reducing exposure for susceptible individuals. Strives to prevent relapse.perceived barriers to action – one‟s belief regarding the tangible and psychological costs of an advised action o cues to action: strategies or conditions in one‟s environment that activate readiness to take action Example used for this model: perceived risk of infection in drug users Health Promotion Model explores biophysical factors that influence individuals to pursue health promotion activities o prior related behavior o personal factors o behavior specific cognitions and affect o perceived benefits of action o perceived barriers to action o perceived self-efficacy o activity-related affect o interpersonal influences o situational influences o commitment to a plan of action o immediate competing demands and preferences o health-promoting behavior Transtheoretical Model based on the assumption that behavior changes takes place over time. or due to failure on previous attempts to change Contemplation – the individual has some intention to take action toward behavior change in the next 6 months. blood pressure screening.
Access to health services Adolescent health Diabetes Disability & secondary conditions Educational & Community-based programs Early & middle childhood Environmental health Family planning Food safety Genomics Heart disease and stroke HIV Mental health and mental disorders Occupational safety and health Older adults QOL and wellbeing Respiratory disease STDs o Arthritis. chronic back conditions Blood disorders & blood safety Cancer Hearing & other sensory or communication disorders Global health Healthcareassociated infections Health communication and health IT Immunization and infectious diseases Injury & violence prevention Maternal. and/or communities to identify and access necessary resources to prevent or resolve problems or concerns Referral and follow-up: assists individuals. 8. referral of a patient with spinal cord injury for occupational and physical therapy. Goals – to attain high quality. groups. attitudes. disability. leading a support group for grieving parents. healthy development. organizations and/or communities to identify and access necessary resources to prevent or resolve problems or concerns Case Management: optimizes self-care capabilities of individuals and families and the capacity of systems and communities to coordinate and provide services Delegated functions: direct care tasks that are registered professional nurse carries out under the authority of a health care practitioner as allowed by the law Health teaching: communicates facts. ascertains the source of the threat. are enjoyed by all. osteoporosis. and professionals to take specific steps to ensure that good health. ideas. families. injury and premature death. to a patient with diabetes. Describe the purpose of Healthy People 2020 and give examples of focus areas that encompass the national health objectives Purpose – challenges individuals. communities. what can be done about it. eliminate disparities and improve the health of all groups. beliefs. families. infant and child health Medical product safety Oral health Physical activity and fitness Public health infrastructure Chronic kidney disease Substance abuse Social determinants of health Tobacco use 9. as well as long life. families. create social and physical environments that promote good health for all. and promote quality of life. behaviors. identifies cases and others at risk. and skills that change knowledge. and a family or individual.Examples: teaching how to perform insulin injections and disease mgmt. and practices of individuals. systems and/or communities Counseling: establishes an interpersonal relationship with a community. and how services can be obtained Screening: identifies individuals with unrecognized health risk factors or asymptomatic disease conditions Case finding: locates individuals. a system. values. achieve high equity. with the intention of increasing or enhancing their capacity for self-care and coping Consultation: seeks information and generates optional solutions to perceived problems or issues through interactive problem solving with a community system and family or individual Collaboration: commits 2 or more persons or an organization to achieve a common goal through enhancing the capacity of one or more of the members to promote and protect health Coalition building: promotes and develops alliances among organizations or constituencies for a common purpose . and determines control measures Outreach: locates populations of interest or populations at risk and provides information about the nature of the concern. and healthy behaviors across all life stages. analysis and interpretation of health data for the purpose of planning. groups. implementing and evaluating public health interventions Disease and other health event investigation: systematically gathers and analyzes data regarding threats to the health of populations. longer lives free of preventable disease. organizations. Identify potential public health nursing interventions for a variety of health issues emphasizing health promotion Surveillance: describes and monitors health events through ongoing and systematic collection.
Each state is responsible for its own public health laws. Public Health law focuses on legal issues in public health practice and on the public health effects of legal practice. Each state has a health officer. a. Personal health care efforts are curative. and custodial care.works with international organizations (WHO and Red Cross) to promote vatrious health programs throughout the world. and practices of the population of interest Policy development and enforcement: places health issues on decision makers‟ agendas. the federal government protects the population through regulation and funding. Alaska natives. and promoting good health. At the state level. treating. rather than preventing it. regulations. regulations. At the federal level. and activities vary widely from state to state. promote. and restore the people‟s health. Its functions sometimes overlap with public health functions. Analyze opportunities to apply community health nursing standards in all areas of nursing practice. maintains vital and health statistics. ordinances and policies. rules. disease and injury prevention. 10.protection against hazards. Public health refers to the efforts organized by society to protect.S. policy. ordinances. beliefs. and court decisions enacted by government. Describe the focus of public health and differentiate it from personal health care. Congress enacts laws and writes rules and regulations. with a focus on developing the community. armed forces etc. and the legal basis for governmental involvement in health care. provides health care for veterans. hospital ambulatory centers. attitudes. the student should be able to: 1. state and federal level. .protects workers against hazardous occupations and work conditions. The state is responsible for the collection of data pertaining to vital statistics. Describe the organization of the public health care system on the local. Public health law typically has 3 major areas of practice: police power. at the federal. and guidance. state. and are the central authorities in the public health system. and international health. the state health department does not stand alone and depends heavily on the federal level for funds. native americans. federal prisoners. skilled care facilities. The federal government targets health areas for the general population. system. acquires a plan of resolution. a healthy environment. hospitals. Describe the sources of Public Health law in the U. 2. scientific research. and curing illness and disease. and license health care facilities and personnel. b. prevention and early detection of disease. and local levels to protect the public‟s health. It is required by law to address the health of populations. behaviors. These services are provided in physicians‟ offices. food stamps Special populations. Services include health promotion. International arena. 3. General population. mobilize resources. other resources. It provides services for the general population. native americans. disaster relief. values. states are responsible for the health of their citizens. diagnosing. Public health activities are covered at the local. resulting in laws. and develop and implement strategies for realizing the goals they collectively have set Advocacy: please someone‟s cause or acts on someone‟s behalf. They establish health codes. and the law of populations. Policy enforcement compels others to comply with laws. Most health related activities at the federal level are implemented and administered by the Department of Health and Human Services. rules. therefore public health services. special populations (veterans. and members of armed services. and policies. regulate the insurance industry. Module 2 OBJECTIVES: At the conclusion of this module. meaning they focus on. The major focus of the public health system is prevention of disease and illness. a. state. diagnosis and treatment of disease. prisoners.) and international health b. and determines needed resources. health facilities. Public health law consists of legislation. special populations. Federal policies and practices have an increasing influence on local and state governments. usually an MD. However. This officer sometimes directs the health department. It is concerned with the health of the population.- Community organizing: helps community groups to identify common problems or goals. regulations. national and international levels a. and homes. rehabilitative care. and individual or family‟s capacity to plead their own cause or act on their own behalf Social marketing: utilizes commercial marketing principles and technologies for programs designed to influence the knowledge. WIC.
Inform.administers those services? Administration for Children and Families. Substance Abuse and Mental Health Services Administration. They include Administration on Aging. Assurance focuses on the availability of necessary health services through out the community. Agency for Healthcare Quality and Research. ii. iii.works to improve quality. Local Health departments services fall into four major categories including: community health services. assists during epidemics. It promotes establishment of local consortiums of health care providers to coordinate services for low-income uninsured and underinsured populations. head start. health screening. and resources in a community. Diagnose and investigate health problems and health hazards in the community. a. Mobilize community partnerships to identify and solve health problems. Monitor health status to identify community health problems. x. The 2010 Healthcare reform act addresses improvement of quality and access to care. j. iv. and information sharing about health conditions. It also substantially increases funds for community health centers and finances newly developed school based health centers and nurse-managed health clinics. Agency for Toxic Substances and Disease Registry. Enforce laws an regulations that protect health and ensure safety. LHDs establish local health codes.develops health facilities and health services programs. and professional development/training. At the local level. and empower people about health issues. v. and resource development.provides programs to prevent and control infectious diseases. Assessment is the regular collection.and human resources. epidemiological activities. to strengthen family unit. safety. viii. Develop policies and plans that support individual and community health efforts. Centers for Medicare and Medicaid Services. Describe the three core functions and ten essential services of public health. recognize examples of each a. and set standards for local health agencies. educate. d. environmental health services. efficiency. and promotes health. local health departments are generally responsible for the direct delivery of public health services and protection of the health of citizens though not all communities/counties have local health departments.coordinates home & community services for older persons and their caregivers. c. child support. Food and Drug Administration. and consumer goods.performs and supports research programs. Identify major agencies and types of programs provided at each level. g. policy development. vii. It includes maintain the ability of both public health agencies and private providers to manage day-to-day operations and the capacity to respond to critical situations and emergencies. National Institutes of Health. Research for new insight and innovative solutions to health problems. h.funds research related to problems with substance abuse and mental health. education. 10 essiential services of public health include i. Centers for Disease Control and Prevention. and mental health services. The US Department of Health and Human Services is composed of several agencies that provide different servces related to US health care. The three core functions of public health are assessment.surveils the safety and efficacy of foods. They also formulate goals. Assure a competent public health and personal health care workforce. b. personal health services. They are also involved in inspections. 4. health education. c. lab analysis. b. e.prevents harmful exposures and diseases related to toxic substances by providing trusted health info. Assure a competent public health and personal healthcare work force. and participation in research projects. Health Resources and Services Administration. to develop and extend scientific knowledge. such as communicate disease control.. It has a division of nursing who‟s major focus is funding grants for nursing education/training. etc. analysis. environmental safety. Policy development uses the info gathered during assessment to develop local and state health policies and directs resources toward them. licensing. Link people to need personal health services and assure the provision of health care when otherwise unavailable. personal health services. taking responsive public health actions. Evaluate effectiveness accessibility and quality of personal and population-based health services. risks. and assurance. vi.provides Welfare. i. develop health plans. ix. . 5. fund public hospitals. pharmaceuticals. and using “best” science to do so. f. and effectiveness of healthcare for all Americans. and provide services to populations and individuals at risk who often lack health insurance.
Registered nurses are the larges healthcare professional group. The 3 core functions of public health are assessment. cultural competency skills. mortality. and Community Health Nursing Module 3 OBJECTIVES: At the conclusion of this module. in the real world. or an entity before legislation. Legislation. the student should be able to: Module 4. Relate the demographic characteristics of the population with the risk for disease. There are about 3 million registered nurses in the United States. Health policy is a statement of a decision regarding a goal in health care and a plan for achieving that goal. another individual. It is directed by values.Chapter 10: The Health Care System Nies and McEwen . and empower people on health issues. 7. contributes to the health of the total population. natality. Community health nurses should be competent in the following domains. Nurses can also form coalitions to maximize resources. and caring concern are used to promote both the individuals and the communities well-being. etc. 2. increasing influence and chances of success. There are currently 3 nurses in th the 111 Congress. Nies and McEwen . Examine nurses‟ roles in political activities and policy-making a. amend. or judicial branches of one of the three levels of government (local. Examine CHN practice in terms of public health‟s core functions and essential services a. and seniors. women. Legislators rely heavily on lobbyists to educate them on issues and they usually want to hear from all sides before taking a position on an issue. or groups. industries. injury. They are affected by government funds and the private business sector. citizens. Nurses can also form PACs. Analytic assessment skills. Policy should be determined by group need and group demand and the DHHS should rationally determine actions to create. or federal). policy development and assurance.6. skills. families. financial planning and management skills. The policies come from decisions made by legislative. or rescind health care policy. institutions. It directs care to individuals. and life expectancy) of children. program planning skills. seen as professionals whose knowledge. state. disability or death. develop policies and plans that support individual and community health efforts. - . Community health nursing is the synthesis of nursing practice and public health practice applied to promoting and preserving the health of populations. A lobbyist basically represents him or herself. Nurse lobbyists are also very important. many nurses serve in legislature. this care in turn. an organization. community dimensions of practice skills. executive. With these skills. communications kills.Population Health 1. basic public health sciences skills. and leadership and systems thinking skills. To lobby is to try to influence legislators. So. the effect would be tremendous. Define health policy and explain the social and political processes that influence health policy development a. so if every registered nurse voted. men. These groups promote the election of candidate who support their ideals. Small donations from it‟s members add up to make a significant donation to a campaign. Also. Nurses must know how to influence the creation of health care legislation and how to contribute to the election and appointment of key officials. educate. Identify major indicators of the health status (morbidity. (see 10 essential functions in previous question). implement. CHNs will be able to monitor/identify community health problems/ hazards. Nurses are also. Politics. It is estimated that about 1 in 44/45 voters are nurses. inform. health policy is the product of continuous interactive processes in which interested professionals. There are also REQUIRED READING: 8. it is an art of persuasion. However. nurses must know how to participate in the political process. political action committees. adolescents.Chapter 12: Policy. (See table 1-3 on page 11 for full description). an other interested groups compete with one another for health dollars and policy initiatives.
the more likely he or she is going to have a hazardous occupation (fishing. and spread of infectious diseases. wholesale traders) 7. construction. -One‟s occupation is associated with level of education and influences economic status so the less education one has. 5. injury and disability increases on both spectrums of population size and density. transportation and warehousing.Women live longer than men but have more chronic illnesses and are more likely to seek healthcare. and increased in morbidity and mortality Rural communities are an example of this concept: access to health care is limited. economic status. higher rates of substance abuse. agricultural accidents. and occupation with the risk for disease. disability or death. . higher rates of liver cancer (due to higher rates of hepatitis B). and higher rates of HIV in comparison to whites . people leave and services are lost.Low educational status is associated with low socioeconomic status = poverty = inadequate nutrition. .3. followed by American Indians.Hispanics also make up a larger portion of uninsured individuals in the United States. economics (lower income levels among minority populations) . Describe the relationship between population size and density with the community’s risk for disease.Diabetes is 33% higher for African Americans -Homicide is the most frequent cause of death for African American men 15-34 . .Age is the risk factor most strongly correlated with disease and death with the most vulnerable being those under age 1 and those over age 65. there are limited economic opportunities. -Contributors to health disparities in the United States include genetics. non adherence with medical care.Hispanics have higher rates of diabetes.Health problems related to low density include isolation. injury. and less use of preventative practice.Health problems related to high density include crime.The community‟s risk for disease. . death and disability. injury.Blacks have higher mortality rates than do whites for all ages and income levels and they live 5 fewer years . environmental degredation. and there are higher rates of poverty in comparison to urban communities. pollution. or death. culture. inadequate access to health services (uninsured individuals). lack or access. Unlicensed teens driving cars. less access to health care. and disability . disability or death. lack of resources. Analyze contributors to health disparities in the United States and suggest potential interventions to help reduce health disparities. low wages. younger people are leaving the area. injury. . higher rates of LBW babies. depression/suicide. including higher numbers of uninsured individuals across all ages. Describe the relationship between population age and gender with the risk for disease. more accidents. Describe the relationships among education levels. .AIDs is 3x higher in African Americans . and higher incidence of TB are found among Asian populations . not wearing seatbelts.Minorities are also more likely to receive poorer quality of care 6. people in rural areas tend to smoke more than those in urban areas. disability.African American men have almost twice as many strokes as white men . hunting. injury. and are more likely to die of unintentional injuries (eg. All of those factors lead to poor health among individuals living in rural areas. shortage of resources. noise. mining. higher infant mortality rates. Describe the relationship between race and ethnicity with the risk for disease. forestry. . more likely to consume alcohol) 4. higher rates of disease. African Americans and then Asians -Higher rates of breast cancer. increased traffic and related accidents. accidents.
herbicides and other chemicals combined with cultural. homeless women have higher rates of pregnancy and unintended pregnancy. economic and mobility barriers 9.race and ethnicity. linguistic. transportation for the homeless to get to clinics. experience intimate partner violence. Potential interventions include making healthcare more accessible (affordable health insurance. who in turn lower rents for low income tenants Access to an apartment located in a public housing facility Housing choice vouchers. and to experience a lack of available health care providers and access to health care. preterm births and low birth-weight infants. economic and mobility barriers. are less likely to be employed and are more likely to live in poverty. exposure to pesticides. people with disabilities earn less. and telecommunications Social Security Disability Insurance (SSDI): a program that receives disability trust fund monies (Social Security taxes paid by workers. Those who qualify receive Medicare health benefits.Homeless Population: lack of health insurance.Populations Affected by Disabilities: Americans With Disabilities Act: guarantees equal opportunities for people with disabilities related to employment. limitations in activities of daily living and instrumental activities of daily living. Migrant workers may have the poorest health of any aggregate in the United States and the least access to affordable healthcare due to cultural. . and usually have limited education. undertreatment of comorbid health conditions. low education. Migrant workers experience higher incidences of accidents and injuries. inadequate health care provider knowledge of appropriate and effective treatments. the person with disabilities must be insured through FICA earnings of self. public accommodations. and acceptability. they are more likely to die of unintentional injuries and have more problems associated with negative health behaviors (smoking. transportation. ect). Also. . accommodation. which may be used by low-income persons to “pay” all or part of their rent (“Section 8 housing”) „ . to live in poverty. and effective communication between patient and health care provider. are more likely to do poorly in school and repeat grades. affordability. and tobacco use) . are more likely to abuse drugs or alcohol. family. homeless children experience higher rates of mental health problems. 8. higher occurrences of acute and chronic respiratory conditions. to lack health insurance. Identify key legislation and policies related to caring for vulnerable populations. physical or sexual assault. obesity. increased risk of incarceration. . public services. and providers and increased risk for accidental injuries. limited earning power. which makes it difficult to pay for costs associated with their disabilities. accessibility.Homeless Populations: US Department of Housing and Urban Development works with state and local governments and nonprofit housing organizations to provide financial housing assistance to low-income families by giving: o o o Direct payment to apartment owners. Access to health care for homeless populations is limited by availability. overcoming cultural and linguistic barriers. and self-employed workers) and to qualify. serious mental illness.Rural and Migrant Populations: Community Health Centers Migrant Health Clinic Program Migrant Health Program . Analyze the concept of vulnerability of selected populations. barriers to effective communication between client. employers.Rural and Migrant Population: members of rural populations are more likely to be older. linguistic. parents and/or spouse. to be less educated. alcohol. . underutilization of age-appropriate preventive health care. more healthcare providers in rural areas. and fragmented support networks. -Populations affected by disabilities: limitations in functional abilities.
gender and race specific mortality rates. Risk. case fatality Natality – birth rates.e. mortality and natality Morbidity – disease incidence rates/prevalence rates Mortality – crude mortality rates. Define and describe major epidemiological concepts and their role in community nursing practice: a. Crude rates (mortality and birth rates) d. climate and environmental conditions and political and social environment Time – when factors such as time of day. etc in a population. recognize and be able to calculate biostatistical measures used in epidemiology: a. such as demographic characteristics. or environmental chemicals e. Agent. gender. Describe. Ratios c. Case fatality 4. or month and secular trends over months and years 3. 2 types: o Descriptive – focus on amount and distribution of disease in population (person/place/time) “where and what” o Analytic – focus on causes of disease by determining why disease rate lower in 1 population group than in another “why/causes” Goal of epidemiology is to identify causes. the likelihood that healthy people exposed to a specific factor will acquire a specific disease) Risk factor refers to the specific factor. Medicare‟s Rural Hospital Flexibility grant program. such as geographical location. Morbidity. place and time Person – who factors. cause. such as cigarette smoke.allows small hospitals the flexibility to reconfigure operations and be licensed as Critical Access Hospitals and provides cost-based reimbursement for inpatient Medicare and outpatient service.. Describe principles of screening tests and recognize examples of sensitivity and specificity of the tests Screening tests purpose is to identify risk factors and diseases in their earliest stages. defects. week. identify solutions in order to prevent and improve the health of the entire population 2. excessive stress. Multiple causation b. Screening is a secondary prevention activity because indications of disease appear after a pathological change has occurred Concern with accuracy of testing for diagnosis. high noise levels. health and disease status Place – where factors. establishment of diagnosis is essential and tests are considered either positive (abnormal) or negative (normal) . disease. specific mortality. Module 4 OBJECTIVES MODULE 4: EPIDEMIOLOGY 1. age. infant and maternal mortality) e. Natural history of disease and levels of prevention associated with each disease stage d. Proportions (percentages) b. risk factors and populations at risk Risk is the probability of an adverse event (i. Incidence and prevalence Incidence – measure of new occurrences of an event during a designated time period (new cases) Prevalence – measures the probability that healthy people will develop a disease in a specified period of time [all cases (new and old)] g. Incidence and prevalence morbidity rates f. Specific rates (age. disability and death among groups of people in a particular place over a specific period of time. the study of the factors that determine the occurrence and distribution of health. etc) of the population Epidemiology is the science that allows us to study disease. Distribution of disease according to person. host and environment interaction and web of causation models c. Define Epidemiology and Demography and discuss application of both to the community nursing process Demography is the study of the structure and characteristics (size. fertility rates f.
A highly specific test is rarely positive in absence of disease or few false positives. Often used before patients are subjected to extensive treatments. Used to rule out diseases during diagnostic work-up. Want to find all true positives Specific Tests are useful in confirming or ruling in a diagnosis. Discuss the levels of prevention and their application to intervention in the community REQUIRED READING: Nies and McEwen – Chapter 5: Epidemiology - . Most helpful when the test result is positive. 5. Most helpful when test result is negative.Sensitivity tests are important to use when dire consequences could occur for missing a disease diagnosis. Apply epidemiological concepts and measures to the description of the distribution of health problem in a community 6.
This action might not be possible to undo. Are you sure you want to continue?
We've moved you to where you read on your other device.
Get the full title to continue listening from where you left off, or restart the preview.