Chapters 6-10 Flashcards
What is epidemiology?
Study of the distribution and determinants of states of health and illness in a human population
How is epidemiology used as a research methodology
For studying states of health and illness
How is epidemiology used as a body of knowledge
Results from the study of a specific state of health or illness
What is the goal of epidemiology?
Preventing or limiting consequences and to maximize health status
What is an epidemic?
An outbreak that occurs when there is an increased incidence of disease beyond that which is normally found in the population
What is rates?
The primary measurement used to describe either the occurrence or the existence of a specific state of health or illness
Discoveries in early attempts at understanding the reasons for disease were direct result of what
Trial and error observations of individual people
If you had a disease or a disability, how are you perceived in the olden days?
Like you had a great curse in Devine punishment from the spiritual world
When was the study of illness in groups of people developed?
Gradually, and began in the 17th century
List the founders of epidemiology
John Graunt
William Farr
Jon Snow
Florence nightingale
Who was John graunt and the bills of mortality 1662
Study of patterns of disease
analyzed weekly reports of births and deaths in London
Who is William Farr registrar, general 1839
Set up a system for consistent collection of numbers and causes of death/contributing to the understanding of distribution of illness and death
Who is Jon Snow in the Broad Street pump
A physician of the 19th century
Through observation in population data, he investigated the outbreak of Cholera
How did John snow investigate the outbreak of cholera
Observation in population data, he investigated 500 people died within 10 days where it was particularly high by two interwoven, water, mains and heavily sewage populated area
Who is the best known epidemiologists?
Jon Snow
What did Florence Nightingale nurses an epidemiologists do?
Learning from experience gathering data for poor sanitation, leading to infectious disease and documented her results for sanitary reform
Compared soldiers and civilians mortality, rate leading to military healthcare reforms
The epidemiologic triad/triangle health status is determined by the interactions of what
Characteristics of the host agent and environment
What is a host in the epidemiologic triad?
Who’s health status is a concern and what are the host factors modifiable and non-modifiable
What is an agent in the epidemiologic triad?
Five groups:
Physical (heat trauma)
Chemical (pollutants medication’s drugs)
Nutritional (proteins, fats, water, vitamins)
Psychosocial (stress, social, isolation, social report)
Biologic( bacteria, Texans viruses)
What is interfering with normal function?
What is the environment in an epidemiologic triad?
Three categories
Biologic (plants and animals)
Physical (structure of the environment)
Social environment ( culture, technology demographics, political system)
The wheel of causation emphasizes what
the interaction or interplay between physical biological and social environment De-emphasizing the
Agent as the sole cause of disease
What model emphasizes multiple causation in order to interrupt the chain of adverse events?
The web of causation
What is the web of causation?
A model strongly, emphasizing multiple causations to design ways to interrupt the chain of adverse events
Direct and indirect factors can be identified .) drug use
What is an indirect in a direct factor of the web of causation?
Drug use
The natural history of disease integrates what preventative measures
Primary secondary and tertiary preventative measures
What is the primary preventative measure in natural history of diseases?
To prevent onto and healthy people
Pre-pathogenesis
What is the second preventative measure in the natural history of diseases
Secondary signs and symptoms have developed what can be implemented during the early stages
What is the tertiary preventative measures in the natural history of disease?
What can be implemented rehab palliation to help the person
Aggregate to function the capacity
What is the application of the nursing process/problem-solving Focus on
Individual care and epidemiologic care of community
What do the individual assessment and community assessment both due in the epidemiologic principles
Surveillance of behavioral risks of an individual group, or community
A thorough accurate database that provides the evidence and rationales for interventions
What are the seven principles of the application of nursing process?
Promoting healthy lifestyles in education
Using assessment data for planning and implementation of interventions
Preventing in controlling outbreaks
Contributing to a safe and healthy environment
Evaluating the effectiveness of health services
What are epidemiologic descriptive studies design to?
Acquire more information on the occurrence/frequency of the distribution of health and health problems in the community and its magnitude
Acquire more information on the characteristics of person, place and time it affects
Design to show how people different terms of health
Epidemiologic descriptive studies have determined, measurable risk factors for what
Major illnesses
What do epidemiological descriptive studies groups consider?
A population at risk
Information about population at risk
What is an epidemiologic knowledge base
A plan for control and prevention
How can a person be profiled for certain disease?
Look at what factors have been shown through epidemiological research that associate with a disease
Look at what body of epidemiologic knowledge is presenting
What are more valid descriptions of frequencies of state of health?
Ratios proportions in rates
What is a ratio
Fraction, which represents the relationship of two numbers
Number of boys in school to number of girls in school
What is a proportion
Type of ratio includes the quantity in the numerator as the part of the denominator, a relationship of a part to the whole
total number of children in a school divided by the number of boys
What is a rate?
The primary measurement used to describe the occurrence quantity of a state of health in a specific group of people giving a time period
What is crude rates
General or summary rates that measure the occurrence of the health problem or condition being investigated in the entire population
What is adjusted rates
Statistical procedure that removes the effects of differences in the composition of the population,
such as age to compare one group to another/adjusting rates controls for differences
A change in an existing rate for the establishment of a new rate compared to another
What is an incidence rate?
Measure of probability or occurrence that people without a certain condition, will develop that condition over a period of time
Measures the piece of a new illness occurring in a disease free population over time
What is a relative risk ratio?
The ratio of the incidence rate in the expose group, and the incidence rate in the non-expose group
A comparison
What is a prevalence rate
The number of people who have developed the condition compared to the duration of their illness
What is the prevalence period
Measures the number of people, and given population, who have a specific condition that already exist during a specific time
What is a specific rate?
Calculated by person, place or time, more detailed and use smaller groups
What is a periodic change?
Čilić or seasonal respiratory disease, influenza and pneumonia
What are types of incident rates?
Mortality rates
Incidents density
Relative risk ratio
Sensitivity in specificity
What is incidents density?
Unequal periods of observation, for study subjects
What is sensitivity and specificitity
Statistical measures that evaluate the validity and reliability of a test
What is public health research?
To identify community/public health problems, and describe natural history and ideology of diseases
What is a descriptive study?
Collects information to characterize and summarize the Health event or problem when Little is known about the phenomenon
Provides a foundation and testing a hypothesis
What does hypothesis generating research include
Case studies and cross-sectional studies
What does hypothesis testing include
Analytical studies testing relationship between variables
What is an analytical study?
Researcher relies on comparisons between groups of determine the whole roll of various respecters and causing the problem
What kind of study is most frequently used in public health research and practice?
Descriptive studies because it identifies the characteristics of individual situations or groups
What is a case study?
An in-depth analysis of an individual group or social institution
What is survey research?
Collection of data from surveys in interviews
What is a cross-sectional study?
Examines the relationship of health, Related characteristics, and other variables of interest
What is a Cohort study?
Also called perspective or longitudinal studies which monitor subjects overtime to find associations between risk factors in health outcomes
What is a case control study?
Retrospectively, compare subjects(case) with a condition(disease) and match subject/control with the condition/disease
What is the gold standard for researched?
Randomized control group design
What is a quasi experimental study?
They are weaker because assign subjects into groups are not randomized
What is an intervention study?
The epidemiologic investigation designed to test a hypothesize relationship by modifying an identified factor in a population
What do preventative trials focus on?
Primary prevention to reduce the incidence of disease
What do therapeutic trails focus on?
Secondary prevention, focusing on limiting the spread of the disease
Descriptive studies, army more used in what kind of research and practice
Observational, public health, Resurgence practice
Descriptive studies use case studies involving what
In-depth analysis of an individual group or institution
What is double blind?
Double blind neither the participant more the experimenter know who is receiving the particular treatment
What is a randomize study
Randomly assign participants to an experimental group or a control group
What is a placebo?
Looks like the drug, but has no effect on the disease to see if the drug has intended treatment or if you’re mine is making it up
What is a controlled study experiment or clinical trial?
Two groups are used for comparison purposes
What landmark therapeutic study noted in the text after the trial the US task force recommended
477 HIV, infected pregnant woman between 14 and 34 weeks of gestation randomly assign to receive either a drug or a placebo. There was no significant difference
Health planning is ongoing and episodic basis, organized, and systematic process in which
Problems are identified priorities, selected and objectives are set for the development of community programs
What are the development of community programs based on?
The community health assessment and surveillance data
What are some factors health planning depends
What are the responsibilities of the agency planning the program?
What is the nature of the health problem
What assessment data has been collected/what outcomes have been documented?
What are the levels that health planning occurs at?
Global
National
Regional
State county and local levels
What is health planning driven by?
Trends noted in the health outcomes in health behaviors identified from disease surveillance
State department coordinate data with who
Federal CDC, EJ, just behavioral risk youth risk
What is the common theme providing health, promotion, and disease, prevention and health planning occur at?
The population level
What is the common theme of addressing social determinants in Health planning
Circumstances in which people are born, grow up, live work, age and health systems in place
What is the common theme achieving social justice in Health planning
Everyone has equal economic, political and social rights, fairness in healthcare housing in employment
What is achieving health equity in Health planning
Everyone can attain full health potential without disadvantages of social position
What is HIA?
Health impact assessment
What does the health impact assessment do?
Helps communities make informed choices on public health by community design
What is the obesogenic environment?
The promotion of obesity
What is the Salutogenic environment?
Available healthy foods in activities/reducing found your ability to obesity
Planning programs or intervention to change community health status include
An assessment of the communities readiness to undertake the change process related to specific health issues
To bring about change in health status of community, and its members may come about in changes in
Health behaviors
The environment
Public policy
Health delivery
Social and cultural norms
What is the CHA?
A systematic process whose goal is to develop priority, intervention, and address what resources are available for what need?
What are the several approaches included in the CHA?
Key informant interview
Analysis of data and health status
Analysis of health behavior indicators
Observation
Community surveys
What are the systematic processes that are involved in CHA
Involves all sectors of the community
Identifies priorities for action
Is a Guide for future community decisions
Is a Guide for future resource allocations develop an implement a community health improvement plan (CHIP )
What is the social ecological model?
Multiple determinants of health interact at different levels to affect the health status of individual people, population or communities
What is the multi level interventions?
Are needed to achieve change in complex community health conditions that have multiple determinants
What does upstream in multilevel interventions?
The societal, environmental and political level
What is the main stream in the multilevel interventions?
At the population or community level
What does downstream at the multilevel interventions?
At the individual level
Focusing on the underlying causes of poor health, and disparities, requires what perspective first
And upstream perspective
What is the change theory?
Envisioned a plan organizational change has a three step process, unfreezing, changing and refreezing
What is unfreezing in the change theory?
Unfreezing the status quo changes in belief language in group norms
What is changing in the change theory?
Awareness/of the needs to change or it’s community sufficiently dissatisfies with the current status of the community needs to understand what is needed. How will the change take place in what it will look like after
What is refreezing in the change theory?
Stabilization/sustainability after the change has happened can the new behaviors become the norm or the new status quo?
What is the force field analysis tool?
Used to identify the force is driving or restraining change
What are the forces
Are the equal
What direction are
What strength are they?
What forces cannot be changed?
What is the purpose of using levers of change?
To increase driving forces, and or decrease restraining forces
Public policy such as tax increase on tobacco, alcohol or soft drinks
What is the health impact pyramid model?
From bottom to top of pyramid, the impact of the population increases along with the individuals effort
What is the community empowerment model?
Utilization of the local medical community in interventions to engage low income minority neighborhoods
Educate
How do you successfully plan community level interventions?
Requires programs with well conceived interventions in an implement a plan
What is a Guide to community preventative services?
Engage task forces that do systematic reviews of research for evidence of effectiveness of prevention in health promotion programs
What is the logic model?
A map or flow diagram to illustrate have a program or interventions are expected to produce desired outcomes
What does SMART objectives?
Anacronym for developing community program objectives that are specific measurable, achievable, relevant, and
Do community health nurses work alone
Rarely community members and other professionals are part of a team
What can help bridge the gap between the community health nurse in the community especially when there are cultural and language differences
Community health worker is having local knowledge and access
How do community health workers fine and secure program funding
The program must be accountable sustainable in replication
What is accountability in finding in securing program funding
CHN accounts how the program was implemented
What does sustainability in finding in securing program funding
Plant needs to be clear, plan or outline
What is replication in finding in securing program funding
Replication can the program be reproduced
Community benefit programs of local original hospitals MHMO’s may be valuable partners, to who
Public health department
Community health nurse in nursing implementing
Funding programs to improve population
What do community benefit programs commonly focus on?
Services related to direct care, free care, or un reimbursed care
What do nurse managed? Health centers provide?
Health promotion in primary care in management to vulnerable and underserved populations
What does a nurse managed health center run by?
Advanced practice nurse is to serve the underserved
What are some services offered in the NMHS nurse managed health centers
Subsidize housing
Homeless shelters
Correctional institute
Anywhere where is easy access to those in need?
What is culture?
Knowledge, values, practice, customs, and beliefs of a group
What are properties of culture?
Dynamic not static
Shared, not private
Learned not inherited
What is cross-cultural or transcultural nursing?
Any nursing encounter in which the client and nurse or from different cultures?
What is cultural competency?
An attitude of openness respect and curiosity
For community in public health agencies to be culturally competent, they must
Have a define set of values and principles
Demonstrate behaviors, attitudes, and policies
Structures that enable them to work effectively cross culturally
What is cultural humility?
Acknowledging that everyone’s views beliefs are culturally influenced, and that your own or not inherently better than others
How do you practice cultural humility?
Ask open ended questions allow the patient to teach us ask about traditions
What does ethnocentrism
Assumption that others believe in behave as the dominant culture does
Believe that the dominant culture is superior to others
