Community Diagnosis Flashcards
1
Q
Family definition
A
Intergenerational social group organized and governed by social norms regarding descent and affinity, reproduction, nurturant socialization
2
Q
What are assumption made about the family concept
A
Dominance of men
Head ensure welfare of members
Fathers and mothers have joint responsibility for childrens maintenance
Parents support children
When children are economically able they support parents
Family members reside in same household
3
Q
Type of families
A
Extended Multigenerational Nuclear Single parents with children Reconstituted
4
Q
Basic features of families
A
Intimate
Interdépendant
Stable over time
Identity
5
Q
Anthropology view of family
A
Source and carrier of culture
6
Q
Social psychology view of family
A
Small groups with task to master
7
Q
Clinical psychology view of family
A
Environment within which normal or abnormal behavior begins
8
Q
Why is family important in healthcare
A
Disease genetics Health promotion Disease and injury prevention Chronic disease management Health surveillance
9
Q
Types of relation in families
A
Blood
Marriage
Adoption
Affiliation
10
Q
Main way of formation of Families
A
Marriage
11
Q
Types of marriage in African society
A
Légal marriage Civil Religious Customary Combinations
12
Q
What is consensual union
A
Cohabitation
13
Q
Visiting union
A
Persons do not live together but marital relationship with children
14
Q
Cause of family dissolution
A
Divorce
Seperation
Widowhood
15
Q
Variations of family structure
A
Single parent family Blended family Grandparents headed family Foster care family Adoptive family Unmarried couple as parent
16
Q
What are some issues that bring community together to solve them
A
Public goods ( security,Infrastructure , Roads , Schools)
Amenities (water, electricity, services, healthcare )
Environmental issues ( noise, sanitation ) Social problems, unemployment , streetism
17
Q
Types of membres of the community
A
Local community individuals Opinion leaders Organized groups Religious organizations Businesses NGOs Government
18
Q
What is a community
A
People living together in some social organization and cohesion
Members kno each other, have interpersonal relationships and communicate
19
Q
Characteristics of community
A
Location
Identification ( norms, values, )
20
Q
Is a community completely homogeneous
A
No can differ in religion, politics, ideological affiliations
21
Q
What is a healthy community
A
Members come together to improve community conditions health and well-being
22
Q
Déterminants of healthy community
A
Income
Water
Sanitation
Social relationship
23
Q
Characteristics of healthy community
A
Safe clean physical environment
Basic need met
Social harmony and involvement of all
Good knowled of structures in community and how they function
Participation in solving community problems
Accès to varied experiences , interactions, communication
Primary healthcare services available, accessible and affordable
Upheld cultural and social values
Diverse local economy
Sustainable and available community resources
24
Q
Community stakeholders definition
A
Individuals, groups, organizations, affected by issues affecting coMmunity and benefit from programmes institued for community
25
Why are community leaders important stakeholders
Have power to influence decisions in community
26
Type of community leaders
Tribal leader
Political leader
Religious leader
27
Social institution definition
Organized body in which members participate and pool resources to promote collective wellbeing of group members
Légal Rules , norms and valued upheld by members
28
Community mobilization definition
Process of bringing together as many stakeholder as possible to raise awareness and demand programme , assist in delivery of resources and services and strengthen community participation for sustainability and self reliance
29
Community mobilization steps
Bring people together
Raise people awareness
Assist in delivery of resources
Facilitate and strengthen community participation
30
Advantages of community mobilization
```
Power to influence
Sharing of resources
Effective problem solving from different skills, experiences, background
Accountability and transparency
Barriers or obstacles reduced
Motivation to bring change
Awareness
```
31
Structured of community important in decision making
Political
Traditional
Religious
32
National level of political structure
Ministry of local government
33
Regional level of political structure of community
Regional coordination council
34
District level of political structure of community
District assembly
| district chief executive
35
Community level of political structure of community
Assembly
| Unit committee head
36
Traditional structure of community
Chiefs , elders
| Traditional council members
37
Religious structure of community
Churches, mosque
| Etc
38
Key components of community mobilization
```
Thé Community
Community participation
Community ownership
Sustainability
Dialogue of knowledge
```
39
Even with medical research And good education of the population there’s still low adherence to good health, why
Because of people believe system and values which affect health
40
Definition of culture by Robert Redfield
Peoples congressional understanding manifest in acts and artifacts
41
Components of culture
```
Environment
behaviors
the way things are done
values
attitudes
fundamental assumption’s
beliefs
```
42
Is culture objective or subjective
Subjective
43
What concept was created to avoid poor health outcomes due to proximate cultural factors
Cultural
44
What is cultural competence
Awareness and understanding of the culture of people and the appropriate use of these understanding in professional setting
45
How can clinicians demonstrate cultural competence
Incorporate patients and caregivers perception of health status and expectation of outcomes of healthcare delivery into management and communication
Reconcile this is perspective of the biomedical framework and that of the patients
Incorporate patient values into healthcare decisions
46
What are some question that clinicians can ask in cultural competency
What is the cause of this condition
what do you think this health problem is
is it serious
how do you think the course of this problem will be
what effect do you believe this condition will have on your organs
how do you think it will affect your life ,relationships ,and finances
how do you harbor any fears about this condition
what is your greatest fear about this treatment
47
Should orthodox medicine still consider cultural system as primitive an obstacle to science and evidence-based medicine
No
48
How does increasing wealth improve health
Improved health infrastructure, technology
improved nutrition
improved public health systems like sanitation ,hygiene , waste management etc.
increased lifespan
Increased trial survival
49
Why is it important for community to participate in health decision
Make them more convinced about health development processes and make them more involved in the processes
Make those programmer cost effective more sustainable more effective
50
What is a communicable disease
This is transmit it directly from one person to another by actual contacts
51
What is a non-communicable disease
This is in a person with absence of infectious agents
52
What is an endemic disease
Disease that is present at relatively low level or with habitual presence in a given geographic area
53
What is an epidemic
This is that is in excess of cases in the community from what is normally expected
54
Can both communicable and noncommunicable disease be endemic and become epidemic
Yes
55
What is the beings model in risk factor of disease
```
Biological behavioral factors
environmental factors
immunological factors
nutritional factors
genetic factors
services social sexual factors
```
56
Direct route of transmission
Human to human through water or food
| Autoinfection person to person
57
Intermediate host to route of transmission
Snails
Copepods
animals tapeworm
58
What is a vector host
Insect which act as an agent of this is dissemination or inoculation or both of a parasite which causes disease
59
What is a definitive host
Host in which adults and sexually mature forms of parasite found
60
What is a Intermediate host
Who sandwich on the immature forms of parasites or sounds
61
Type of vector transmission
Biological transmission
| mechanical transmission
62
What is biological transmission
Essential part of life cycle of parasites take place in body of the vector
63
What is mechanical transmission
No essential part of life cycle take place in the body of the Victor
64
What is Infectivity
Proportion of exposed persons who become infected
65
What is pathogenicity
Population of exposed persons would who develop clinical diseases
66
What is virulence
Proportion of persons with clinical disease will become severely I’ll or die
67
Formula number of newly infected person
Forces infection x number of susceptible
68
Force of infection formula
Number of infectious individuals x transmission rates
69
Prevalance compared to incidence in endemic disease
Prevalence equal to incidence
70
Routes of entry of parasites in host
```
Alimentary tract
respiratory tract
penetrate skin
penetrate mucous membrane
bites of bloodsucking insect
```
71
How do parasite exit a host to another
Natural secretioN
biting insect
direct contact with skin or mucous membrane
contaminated food or drink
survival adaptation likes spore or cysts
72
What is the natural history of disease
The way disease progresses in absence of medical or public health intervention
73
Difference between symptoms and signs
Symptom is manifestation of disease seen by patient himself
sign is manifestation of disease that physician perceives
74
What is a sub clinical disease
Not clinically apparent
should not become disease
very slight reaction
75
What is preclinical disease
Not clinically apparent but destined to become clinical disease
76
What is an abortive disease
Reaction between host and parasites not sufficient in intensity and duration so cannot be diagnosed clinically
77
What is a persistence disease
Person feels to sheds of the infection in persist for years
78
What is disease carrier
Harbors and disseminate causative organism
79
Two types of carrier
Incubating carrier
| convalescent carrier
80
What is the latent period in disease
Time interval from initial infection to start of infectiousness
81
What is th. Incubation period
Time interval from initial infection until onset of clinical disease
82
Period of communicability
Period in which individual is infectious
83
Three stages of disease
P pre-disease stage
latent stage
symptomatic stage
84
Pre-disease stage
Before pathologic process begins
85
Latent stage
No clinical symptoms but disease process started
no active multiplication of agent
Parasite in inactive state
86
Symptomatic stage
Evident this is manifestation
87
What is primary prevention
Prevent disease process from starting
88
What is secondary prevention
Prevent progression to symptomatic disease
89
What is tertiary prevention
Slow arrest or reverse progressive disease to complications or death
90
What are the three classes of clinical severity of infection
```
Class a -> Inapparent infection frequent
class B -> Clinical disease frequent ,few deaths
class c -> infections usually fatal
```
91
What is immunity
Process by which body mounts defense against invading germs
| ability of human body to tolerate presence of material indigenous to the body And to eliminate foreign material
92
Two type of immunity
Active or passive
93
Type of active immunity
Natural ( Previous infection)
| Acquired - artificial vaccines etc
94
Type of passive immunity
Natural (Trans placental antibody transfer , milk breasts)
| artificial ( Antibody injection)
95
What is immune tolerance
State of unresponsiveness to specific antigen to which person is normally responsive
Suppressed immune rxns
96
Causes of immune tolerance
Prior contact with antigen in fetus or a newborn
Prior contact with antigen in high or low doses
exposure to radiation chemotherapy drugs or agent that impaired immune system
heritable disease of immune system
Acquired disease of immune system like HIV
97
What is herd immunity
State of accumulation of immunity in a population where the causative agent has greater difficulty in finding a non-immune or susceptible host
98
Reasons why herd immunity declines after epidemic
New births
deaths of immunes
Immigration of non immunes
immigration of immunes
99
What are the different step in controlling diseases
Eliminate the reservoir either human or in animals
interrupt the transmission
Reduce the susceptibility through vaccination and chemoprophylaxis
Create a supportive environment
Input public health laws
enhance community mobilization and participation
100
What is the strategies and disease control (steps)
identification of disease
Interruption of transmission
prevention of recurrence (safe water supply, food safety ,injection safety blood ,safety vector control ,immunization ,chemoprophylaxis )
notification
analysis
report writing
surveillance
101
Measure of impact of disease
Morbidity
mortality
disability
102
Disease that have strong epidemic potential
Cholera
meningitis
measles
103
Peripheral and Primary level of disease control
Generalists who manage all disease
data surveillance
Clinical care with case management and mass drug administration
Prevention services with community mobilization ,immunization, injection safety ,advocacy ,vector control
104
Disease control at the district level
Training ,management of supplies and equipment
technical support
Data collection and analysis from primary level
Investigate follow up outbreaks
feedback information to primary level
105
Disease control at the national or central level
```
Coordination National prevention and control activities
centralized teams
technical guidance
financial resources
Analyze data from district level
sets priorities and standard
Report to who as required
```
106
What is a community
Cluster of people with at least one characteristic in common
107
What are some features of a community
```
Physical environment
education
safety
transportation
politics and government
health
social services
communications
economics
recreation
```
108
4 determinants of health 4Hs
Hereditary
Habitat
Habits
Health services
109
What are other determinants of health
```
DemoGraphic
environmental
socioeconomic factors
Health sources and services
reproductive and child health
policies
indicators
variables to assess health of community
```
110
What are important information demographic of a community
```
Population of the community
age
sex distribution
religious group predominant
marital status
educational level
occupation
ethnicity
migration
```
111
Important factors in the environment of the community
Sanitation facilities ( drainage ,solid waste disposal, liquid waste disposal, pest rodent control ,food hygiene )
water facilities (water sources ,clean water ,storage ,supply ,cost ,safe usage )
housing type and condition ( ventilation ,overcrowding ,type of floor of ceiling ,mosquito netting ,measures of pollution ,vector density)
112
Factor in disease pattern important in community diagnosis
```
Most common causes of illness , death
most frequently diagnosed disease
special health problems
usual health problems
number of health facilities
number Health personal
sources of finances for health programs
```
113
Socioeconomic factors in community diagnosis
```
Socioeconomic factors
level of unemployment
rate of population increase
literacy rates female
housing conditions
suicide and homicide rates
Road traffic accidents
alcohol and drug abuse
```
114
Maternal and Child health factors in community diagnosis
```
For children under five
Age at first pregnancy
number of children and birth spacing
pregnancy and birth complications
Antenatal and post natal attendance
breast-feeding and complementary feeding practices
immunization
vitamin a supplementation
family planning practices
nutritional indicators
```
115
What is community diagnosis
Comprehensive assessment of health status of the community in relation to eat social physical and biological environment
116
How is community diagnosis a process
Helps in gathering and interpreting information
prioritizing needs
developing strategies
conducting and evaluating health programs
117
How is community diagnoses a product
Produces a report
| further and future intervention
118
What are the goals of community diagnosis
Analyze health status of community
evaluate health resources, systems and services
Assess attitudes towards community health services
identify priorities
establish goals
determien course of action to improve health status
119
What is our community diagnosis
Household survey
120
What is a household survey
Process of collecting and analyzing data to understand general situation of individuals in the household or all households
121
What are the steps in community diagnosis
```
Exploration
interaction with community leaders
objectives
planning a survey
planning the survey and questionnaire
training interviewers
Pretesting
samples for survey
executing a survey
analysis of the results
writing reports
feedback to the community
initial Health action after community diagnosis
analysis and interpretation of results
```
122
Method of observation used
Non-participatory
123
Two sources of data collection
Primary sources
| secondary sources
124
Type of primary sources of data
Record analysis
Observation
structured interviews
125
Type of records to analyze for data collection
| Any flaws ?
Clinical records
disease registries
notification registries
May not be complete ,may not be standardized , may be inaccurate
126
What is a questionnaire
Set of questions to be asked from respondent in an interview with appropriate instructions indicating which answers are to be asked and in what order
127
What are the advantages of using a questionnaire
Enable data collection from respondents
give structure to interview
provide standard means for writing down answers
helps in processing data collected faster
128
How can you tell that the objectives of a researcg are good
```
Because they are smart
specific
measurable
achievable
realistic
time bound
```
129
What type of research was done in community diagnosis
Descriptive cross-sectional survey
130
Health definition
Complete physical mental and social well being rather than solely absence of disease
131
Education definition
Giving information, teaching, learning, schooling tutoring, instruction, edification
132
Health education definition
Part of health care concerned with promoting healthy behavior
Enable people to understand their behavior and how it can affect health
Identify practices that cause, cure or prevent a health problem
133
Health education goals
Promote development and proper use of health services
Promote immunization
Resolve problems that prevent people from making healthy choices
Prepare individuals to assume responsibility for protecting their own life and not when they are sick
Push communities to carry activities that maximize health
134
What type of disease prevention is health education
Primary prevention
| But can help support other forms of prevention
135
Health education in which settings
```
Clinic
Outpatient
Ward
Antenatal clinic
Postnatal clinic
Child welfare clinic
School clinic
School nurse talk
Church health talks
Work place Health talks
Patient groups
Parents groups
```
136
Goal of communication in health education
Promote improvements in health by modifying human, social, and political factor that influence risky health behavior
137
4 component of health education communication \
Message (advice, nonverbal, pictures, appeals )
Channels ( tv, radio, newspaper, leaflets…)
Receiver (Education , visual literary , media habits, culture)
Source (credibility , age, sex, culture, language )
138
Stage 1 of health education communication
Reach intended audience
139
Stage 2 of health education communication
Attract audiences attention through appeals techniques
140
What are some appeal techniques to use when communicating about health education
Fear by emphasis of serious outcomes,
Humor
Logic and facts
Emotion through images
141
Types of appeals
One sided message - Advatanges of taking action
Two sided message - benefits and disadvantages of taking action
Positive appeal - do something
Negative appeal - dont do something
142
Stage 3 health education communication
Understanding of the message which depends on the visual and the pictorial perception of the message
143
Stage 4 of health education communication
Promotion of change by acceptance of this change by audience
144
Stage 5 of health education communication
Change in behavior
145
What is reason why people will change attitude and belief about health after education but not their behavior
If during health education communication the emphasis was only the dangers and not on how to help change
146
Stage 6 health education communication
Improvement of health based on accuracy and evidence of information given
147
Healthy education methods
Interpersonal method
Face to face
Mass media (radio, tv, newspaper, social media )
148
Techniques used in face to face health education
Spoken work
| Non verbal communication with visual, models, pictures, written words
149
Techniques used in radio for health education
Spoken word
150
Techniques used in tv for health education
Spoken word
Visual format
Nvc
Written word
151
Techniques used in newspaper for health education
Written words
Visual
Pictures
152
Printed Material used in health education
```
Leaflets
Posters
Displays
Books
Models
Flip chart
Newsletter
Magazine
News paper article
Advertisement
```
153
Multimedia used in health education
```
Slide shows
Presentation
Video
DVDs
CDs
Radio
Tv
```
154
Health education tools
```
Talks
Presentation
Counseling
Drama
Role play
Puppetry
Simulation
Skills training
Demonstrations
Celebrities
Slogans
Song
Case studies
Stories
Games
Debates
Quiz shows
Question and answer sessions
```
155
What is readability of written materials
```
Short words
Short sentences
Short paragraphs
Large clear font
Welll spaced text
Subheadings
```
156
How to calculate readability
Random large paragraph
Count number of words in first 2 sentences
Count number of words more than 5 letters
Divide number of words with more than 5 letters by number of words in first 2 sentences
Multiply result by sum of both prompts above
157
Ranges of readability
8 or less is easy to understand
Near 15 means moderate understanding
Near 30 means complicate to understand
158
Communication at the individual and family level
One to one
counseling
patient education
home visit
159
Communication methods at the district level and community level
Group teaching
community participation
exhibitions
demonstrations
160
Communication method at the national level
Mass media
| social mobilization
161
Advantages of face-to-face communication
```
Different approaches available
good for low literacy rate communities
opportunity for questions from community
targeting of population
Fast adaptation to locals
fast behavioral change
```
162
Disadvantages of face-to-face communication
Slow spread of information
require some privacy
Costly due to high human resources
Need training of workers
distortion of messages if not reinforced
163
Small group and participatory learning advantages
```
People think for themselves
share experience
learn from other
problem-solving skill development
good for people with limited education
eliminate loneliness in issues
active participant
```
164
Disadvantages of participatory methods in communication
```
More involving
More planning
preparation time consuming
required skills
and limited by obstacles group dynamics
```
165
Role play communication advantages
```
Try several options and possibilities
People more sympathetic
Communication and counseling skills
Practice an event
Safe environment
```
166
What is the Rogers communication theory
That’s even the mass media is important in providing good background information for change face-to-face communication is still required to induce health behavior change
167
Diagnostic test
Presence or absence of a disease when subject shows signs and symptoms
168
Screening test
Identifies asymptomatic individuals who may have disease
169
Examples of screening test
```
Pap smear
Fasting blood sugar
Blood pressure
Mammography
PSA test
Ocular pressure
Fasting blood cholesterol
```
170
Validity of test
Ability to differentiate between people suffering from disease and those not suffering
171
Sensitivity of test
Ability Detect those who have disease
172
Specificity of test
Ability to detect those who do not have the disease
173
Sensitivity formula
True positive / true positive + false negative
174
Specificity formula
True negatives / false positive + true negative
175
Positive predictive value
Proportion of patients who test positive who actually have disase
176
Negative predictive value
Proportion of patient who test negative who are actually negative
177
PPV formula
True positive / true positive + false positive
178
NPV Formula
True negative / true negative + false negative
179
Who has more impact on preductiv values , specificity or sensitivity
Specificity
