Exam Flashcards
Public Health
Described as the art and science of preventing disease, prolonging life, and promoting health through organized community efforts to benefit each citizen
Health
State if complete well-being, physical, social and mental, and not merely the absence of disease or infirmity
Community
Collection of people who interact with one another and whose common interests or characteristics from the basis for a sense of unity and belonging
Population
Group of people having common environmental or personal characteristics
Aggregates
Subgroups or subpopulations that have some common characteristic or concern
3 core public health functions
Assessment - regular collection
Policy Development - use of information gathered
Assurance - analysis of resources available
Community Health
Extends the realm of public health to include organized health efforts and the community level through both government and private efforts
health promotion
Activities to enhance resources directed at improving well-being
Disease prevention
Are activities that protect people from disease and the effects of disease
Three Levels of Disease Prevenetion
Primary, Secondary, and Tertiary
Definition and examples of primary prevention
Preventing problem before it occurs
Ex: promotion of good nutrition, immunizations, seatbelt use, water purification, encouragement of regular exercise
Definition and examples of secondary prevention
Early detection and intervention during the period of early disease
Ex: screenings, mammogram, blood pressure screenings, scoliosis screening
Definition and examples of tertiary prevention
Populations that have experienced disease or injury and focused limitation of disability or rehab
Ex: teaching how to perform insulin injections, refer all to therapist, and support groups
What does thinking upstream mean?
Examining the origins of disease, nurses identify social, political, environmental, and economic factors that often lead to poor health options for both individual and populations
Prevention v cure
Cure: spending additional dollars for a cure in the form of health care services does little to improve the health of the population
Prevention: spending money on prevention does a great deal to improve health and decrease dollars spent on a cure
What is the vision of Healthy People 2020?
A society in which all people live long, healthy lives
What are the overreaching goals of healthy people 2020?
Attain a high-quality, longer lives free of preventable disease, disability, injury, and premature death
Population Focused Nursing
Concentrates on specific groups of people and focuses on health promotion and disease prevention, regardless of geographic location
Goal of population focused nursing
Provision of evidence-based care to targeted groups of people with similar needs to improve outcomes
Focuses on:
- entire population
- emphasizes all levels of prevention
-considers the broad determinants of health
- Emphasizes all levels of prevention
- intervenes with communities, systems, individuals, and families
Aggregate Impact on Health
- increased population
- increased population density
- imbalanced human ecology
- results in changes in cultural adaption
- these imbalances continue today because of climate, natural disaster, and war
Endemic
Diseases that are always present in population (colds and pneumonia)
Epidemic
Diseases that are not always present in a population but flare up on occasion (measles)
Pandemic
The existence of disease in a large proportion of the population - a global epidemic (HIV, AIDS, and influenza outbreaks)
Elizabeth Poor Law
Enacted in England in 1601 the law governed health care for two centuries and became a prototype for later US
Edward Jenner
Observed that people who worked around cattle were less likely to contract smallpox
Edwin Chadwick
Called attention to unsanitary conditions that resulted in health disparities that shortened life spans of the laboring class
John Snow
Demonstrated that cholera was transmissible through contaminated water
Lemuel Shattuck
Boston bookseller and publisher with an interest in public health, organized the American Statistical Society in 1839. High overall mortality and very high infant and maternal mortality rates
Florence Nightingale
Credited with establishing modern nursing
- concern for environmental determinants of health
- emphasis on sanitation, community assessment, and analysis
- use of graphically depicted statistics and comparable census data
- political advocate
- education reform for nurses
Louis Pasteur
Theory of existence of germs, discovered immunizations in 1881 and the rabies vaccine in 1885
Robert Koch
Discovered causative agent for cholera and tubercle bacillus in 1882
Jospeh Lister
Surgical success with wound care
Lillian Wald
Established a district nursing service called the House on Henry Street
- played an important role in establishing public health nursing in the US and starting the “visiting nurses association of NYC”
- bringing medicine home
District Nursing
First established in England
Determinants of Health
Factors that contribute to a persons current state of health
1. Biology and genetics
2. Individual behavior
3. Social enviroment
4. Physical Enviroment
5. Health Services
Social Determinants of Health and Disease are…
- the conditions in which people are born, grow, live, work and age
- shaped by the distribution of money, power, and resources at global, national, and local levels
- mostly responsible for health inequities
New causes of mortality
- change from infectious diseases to chronic conditions
- modern medical advances
- holistic approach to health
- better sanitation and nutrition
Contemporary Issues and Challenges for Public Health Nursing
- promote the health of populations
- need a broadened focus on the multiple causes of morbidity and mortality
- aware of increases technological advances
- understand the community need for a focus on prevention, health promotion, and home care
- focus on holistic care
Microscopic Approach to Solving Community Health Problems
- individual response to health and illness
- emphasizes behavioral responses to illness or lifestyle patterns
- nursing interventions aimed to the individual by changing his or her perceptions or belief system
Macroscopic Approach to Solving Community Health Problems
- interfamily and intercommunity themes
- emphasizes social, economic, and enviromental precursors of illness
- nursing interventions may include modifying social or enviromental variables
- may involve social or political action
Microscopic
- the individual is the locus of change
- Oreos self-care deficit theory of nursing
- The Health Belief Model
Macroscopic
- thinking upstream: society is the locus of change
- millions framework for prevention
- critical social theory
Health Protection
Consists of those behaviors in which one engages with the specific intent to prevent disease, to detect disease in the early stages, or to maximize health within the constraints of a disease
Ex: immunizations and cervical cancer screening health protection activities
Healthy People 2020
- challenges, individuals, and professionals…to take specific steps to ensure that good health, as well as long life, are enjoyed by all
- broad goals:
to increase quality and healthy years of life, to eliminate health disparities - Content addressed:
Organized into focus areas and corresponding priorities of action for each objective - leading health indicators (determinants of health) to help track progress toward meeting the goals
Pender’s Health Promotion Model
Depicts the complex multidimensional factors with which people interact as they work to achieve optimum health
Example: Jamie feels better after working out, she gets many compliments about her body, she found that working out in the morning minimizes the competing demands that may keep her from exercising
Health Belief Model
Provides the basis for much of the practice of health education and health promotion today. It was developed for psychologists to attempt to explain why public failed to participate in screening for TB> “Why do people who have a disease reject health screenings?”
Transtheoretical Model
Change is difficult, even for most motivated individuals. Changes may be unpleasant, require giving up pleasure, stressful, painful, jeopardize social relationships, and much more
Theory of Reasoned Action
Attempts to predict a persons intention to perform or not perform a certain behavior. It assumes that all behavior is determined by ones behavioral intetions
Risk
The probability that a specific event will occur in a given time frame
Risk factor
Exposure that is associated with disease
Risk assessment
Systematic way of distinguishing the risks posed by potentially harmful exposures
Steps in risk assessment
- hazard identification
- risk description
- exposure assessment
- risk estimation
Modifiable Risk factors
- individual has control
Ex: smoking, activity, eating habits
Non-modifiable risk factors
- individual has little or no control
Ex: genetics, gender, age, environmental exposure
Risk reduction
Proactive process in which individuals participate in behaviors that enable them to react to actual or potential threats to health
Risk communication
The process through which the public receives information regarding possible or actual threats to health
Epidemiology
The study of the distribution and determinants of health and disease in human populations and is the principal science of health
Person-Place-Time Model
Organized epidemiologists’ investigations of the disease pattern in the community
Person: who?
Place: where?
Time: when?
Two main types of epidemiology
- Descriptive 2. Analytic
Analytic Epidemiology
Investigates the causes of disease by determining why a disease rate is lower in one population group than another
Descriptive Epidemiology
Used in the person-place-time model
The Epidemiological Triangle
Three elements: agent, host, and environment
Agent of Disease
Expose host to disease cause; may result in disease
- nutritive elements
- chemical agents
- physical agents
- infectious agents
Host
Host factors
- genetic
- age
- sex
- ethnic group
- physiological state
- prior immunological experience
- active immunity v passive immunity
- preexisting disease
- human behavior
Environment
Influence exsistence of the agent, exposure, or susceptibility to agent
- physical Enviroment
- biological enviroment
- socioeconomic environment
Incidence rates
Describe the occurrence of new cases of a disease (tuberculosis, influenza) or condition (teen pregnancy) in a community over a given period relative to the size of the population at risk for that disease or condition during that same period
Prevalence rates
The number of all cases of a specific disease or condition in a population at a given point in time relative to the population at the same point in time
Mortality Rates
- routinely collected birth and death rates
- other rates
- crude rates
- age specific rates
- age adjusted rates
- infant mortality rate
Risk
Refers to the probability of an adverse event (the likelihood that health people exposed to a specific factor will acquire a specific disease)
Risk factors
Refers to the specific exposure factor, such as cigarette smoke, hypertension, high cholesterol, excessive stress, high noise levels, or an environmental chemical
Disease Prevention
- primary, secondary, and tertiary prevention
- establishing causality
- screening - secondary prevention
- surveillance
Surveillance
A mechanism for the ongoing collection of community health information
Windshield survey
Driving or walking through an area and making organized observation
Vital statistics
Official registration records of births, deaths, marriages, divorces, and adoptions form the basis of data
Census tract
Subdivide larger communities. They facilitate the organization of resident information in specific community geographic locales
Environmental health
Built enviroment
Consists of the connections among people, communities, and their surrounding environments that affect health behaviors and habits, interpersonal relationships, cultural values, and customs
Work related exposures
Happen as a result of poor working conditions and can lead to potential injury or illness
Ex: occupational toxic poisoning, machine-operation hazard (falls, crushing injuries, burns)
Outdoor air quality
Refers to the purity of the air and the presence of air pollution
Healthy homes
Refers to the availability, safety, structural strength, cleanliness, location, and indoor air quality of shelter
Water quality
Refers to the water supply’s availability, volume, mineral content levels, toxic chemical pollution, and pathogenic microorganism levels
Food safety
Refers to the availability, accessibility, and relative cost of health food free of contamination by harmful herbicides, pesticides, and bacteria
Ex: malnutrition, bacterial food poisoning, carcinogenic chemical additives, improper food labeling
Waste management
Entails the handling of waste materials results from industry, municipal processes, and human consumption as well as efforts to minimize waste production
Participatory Action Research
Form of research calls for nurses, community members, and other resource people to work together in identifying health problems, designing the studies, collecting, and analyzing the data, disseminating the results, and posing solutions to the problem
Environmental justice
This directive has served to increase public participation and access to information as well as provision of education about multiple risks and cumulative exposures
IPREPARE
Globalization
The process of increasing social and economic dependence and integration as capital, goods, persons, concepts, images, ideas, and values cross state boundaries
World Health organization (WHO)
Considers health to be the state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity
WHO is working to prevent, treat, and care for communicable diseases
Centers for Disease Control and Prevention (CDC)
National level
Committed to achieving true improvements in peoples life by accelerating health impact and reducing health disparities
world population and urbanization
Global infectious diseases
Developed countries
Developing countries
Social factors affecting womens health
- health care access
- education
- work
- employment and wages
Healthy People 2020 for women
Chronic illness common to women
Sexually transmitted diseases
Pelvic inflammatory disease
Unintentional injury
Domestic violence
Single largest causes of injury to women between the ages of 15-44
Sexual harassment
Unwelcome conduct of a sexual nature severe enough to create a intimidating hostile work environment
Diseases common to the older adult
Cardiovascular disease, hypertension, type 2 diabetes, osteoporosis, cancer, cataracts, macular degeneration, glaucoma, hearing loss, dental concerns, incontinence, falls, TBI, depression, anxiety, Alzheimer’s
Interventions for the older adult
Screening and exams, physical activity and fitness, and nutrition
Ageism
The stereotypes, prejudice, and discrimination towards others or oneself based on age
Elder abuse
Serious problem throughout the US abuse is generally defined as the willful infliction of pain, injury, or debilitating mental anguish
Falls
Number one cause of fractures
Disability
Umbrella term describing impairments, activity limitations, and participation restrictions
The Americans with Disabilities Act
Refers to a qualified individual with a disability as a person with a physical or mental impairment that substantially limits one or more major life activities or bodily function
Activities of daily living
Getting around inside the home, bathing, dressing, eating, or toileting
Veteran
A person who has served in the military
WW2 veterans
High levels of noise, radiation at Hiroshima & Nagasaki, cold injuries, exposed to mustard gas experiments
Korean War Veterans
Extreme cold injuries, noise, and occupational hazards
Vietnam Veterans
Agent orange: herbicide used to kill the vegetation that provided cover for the enemy
Gulf War and the Global war on terror
Sand, dust exposure which causes respiratory disorders, burn pits which caused toxic smoke, TBI’s, heat stroke/heat exhaustion, chemical exposure
Service-connected disability
Disease or injury that was incurred as a result of or during the veterans active duty, or one that was aggravated by military service
OHN Population
Mandated reporter
Key elements of faith community nursing
Role of the Faith Community Nurse
Referral agent, health educator, health counselor, health advocate, coordinator of volunteers, developer of support groups, integrator of health and healing
Issues encountered by the faith community nurse
- Providing care for vulnerable populations
- end of life issues: grief and loss
- family violence prevention
- confidentiality
- accountability
