470- first exam Flashcards
Most often associated with public health
Focus: HEATLH
Community-orientated nursing
Most often associated with care of individuals and families
Focus: ILLNESS CARE
Community based nursing
Established nursing as a discipline
“District nursing” w/ Rathbone
Nursing’s first epidemiologist
Florence nightingale
Established Henry Street Settlement w/ Brewster
Provided nursing care to poor families in their homes
Advocated for fee-based home care
Advocated for health-promoting social policies
Lillian Wald
Started Frontier Nursing Services in Kentucky, modeled after the district nursing of England
Set up health centers and visited people in their homes
Introduced midwives
Mary Breckinridge
3 core functions of public health nursing
Individual-focused
Community-focused
Systems-focused
systematic data collection on population, monitoring of population’s health status, and making information available on health of the community
Assessment
provide leadership in developing policies which support the health of the population, including use of the scientific knowledge base in decision-making.
Policy development
role of PH in ensuring that essential community-wide health services are available including:
Assurance
Medicare, part A
Hospital, covers:
- Hospital care
- Skilled nursing facility care
- Nursing home care
- Hospice
- Home health services
Medicare, part B
Medical
2 types: medically necessary services and preventive services
Covers:
- clinical research
- ambulance services
- DME
- Mental health
- Getting a 2nd opinion b4 surgery
- Limited outpatient drugs
Medicare, part D
Drug plan
a. Responsible for monitoring health status and enforcing laws and regulations that protect and improve the public’s health
b. Distribute federal and state funds to local public health agencies to implement programs at the community level
c. Examples of programs: communicable disease programs, maternal and child health programs; chronic disease prevention programs; injury prevention programs
d. Provide oversight and consultation for local public health agencies
e. Do not provide health services
State public health agencies
Develop regulations that implement policies formulated by Congress and provide a significant amount of funding to state and territorial health agencies to:
Provide public health services through the National Health Services Corps to medically underserved areas
Survey the nation’s health status and health needs
Set practice and standards
Provide expertise that facilitates evidence-based practices
Coordinate public health activities that cross state lines
Support health services research
Federal public health agencies
Responsibilities vary depending on locality
Governed locally by a board of health appointed by county or city elected officials
Generally responsible for implementing and enforcing local, state, and federal public health codes and ordinances
Provide directly or assure the provision of essential public health programs to a community such as communicable disease monitoring
Local public health agencies
Morbidity
Is the incidence rate of a disease. It can be measured in incidence rate, prevalence rate (prevalence proportion), attack rate
Mortality
a measure of the number of deaths from a specific cause in a population, usually calculated for a specific group, i.e age- specific, gender-specific, or race-specific
incidence rate
The frequency of rate of new cases of an outcome in a population; it provides an estimate of the risk of disease in the population over the period of observation. The incidence rate is an indication of how rapidly disease is developing in a population.
-Calculated by number of new cases divided by the population times 100,000
Prevalence rate
A measure of existing disease in a population at a particular time
-Calculated by taking the number of existing cases divided by current population
Describes the extent of an outbreak in terms of who, where, and when
Descriptive epidemiology
- Person: demographic data
- Time: Days, weeks, decades, epidemic period
- Place: home, school, hospital/hospital unit, community/county, country, state
Analytic epidemiology
Seeks to answer how and why a disease occurs and the effects of the disease (causal relationship between a risk factor and a specific disease or health condition)
-The occurrence of diseases is studied in two ways: experimental & observational (cohort and case-control)
Once referred to as prospective (concurrent) studies because a cohort study follow the population forward in time from suspected cause to effect.
They may also be called retrospective (historical).
Cohort study design
Dividing a group of people on the basis of smoking status and then following them for 20 years to see if they develop lung cancer.
Cohort study design
The researcher works backward from the effect (health outcome/condition) to the suspected cause.
These studies are often referred to as retrospective studies since they look back in time.
Case-control study design
study of social conditions that play a role and influence the health of populations.
-measures the impact of the social environment on health outcomes
Social epidemiology
Contextual effect
individual level
ex: relationship between income and income inequality. Women make less than men.
Compositional effect
Environmental level
ex: proportion of people living in poverty
Socioeconomic status, income, income inequality, education, occupation, discrimination
Social determinants
how has your dx affected your family?
Family as context
-individual at center
tell me what has been going on with your health since your mother was diagnosed with cancer?
Family as client
-family at center
how do you feel your son’s long term rehab will affect the family?
Family as system
-Focus is on interaction/family as a system)
how do you view your family’s role in the community?
Family as society
-family as an institute
- Social science
- Similar to family as part of society
- Goal: Reconnect the family w/community
Structure-function
- Physics and biology
- Similar to family as a system
- Clients are participating members of a family
- Attention to families interactions with one another and the community
- Goal: restore equilibrium
Systems
- Psychology
- Views family systems over time
- Family has predictable history
- Emphasizes transitions
- Goal: facilitate transitions
Developmental
- Interacting personalities and symbolic communication
- Define role expectations through perceptions of role demands
- Dependent on responses of others
- Predict expectations for roles
- Communication is a major focus
- Goal: streamline
Interactional
