Nurs. 404 Midterm

Question 1

What is community based nursing?

Answer 1

Community-based nursing – minor acute and chronic care that is comprehensive and coordinated where people work, live or attend school; illness care provided outside the acute care setting

Question 2

What is community health nursing?

Answer 2

Community health nursing – use of systematic processes to deliver care to individuals, families, and community groups with a focus on promoting, preserving, protecting, and maintaining health

Question 3

What is community oriented nursing?

Answer 3

Community-oriented nursing – care of a population of individuals, families, and groups, or the community as a whole

Question 4

What is public health nursing?

Answer 4

Public health nursing – population-based practice, defined as a synthesis of nursing and public health within the context of preventing disease and disability and promoting and protecting the health of the entire community

Question 5

1.Differentiate between: community-based nursing, community health nursing, community-oriented nursing, and public health nursing

Answer 5

The primary difference between community based nursing, community health nursing, public health nursing, and community oriented nursing is the focus, either on populations and the health of the entire community or on individual people, families and groups within the community. In most cases, however, nursing care in the community is a combination of both. Services are provided to individual clients and families as a means of improving the health of the population. Public health nursing is distinguished from other specialties by the adherence to eight principles

Question 6

2.Describe the primary goals for Healthy people 2010 and 2020

Answer 6

• Healthy People 2020
• Eliminate preventable disease, disability, injury, and premature death
• Achieve health equity, eliminate disparities, and improve the health of all groups
• Create social and physical environments that promote good health for all
• Promote healthy development and healthy behaviors across every life stage
• Healthy people 2020 is a national, science based plan designed to reduce certain illnesses and disabilities by reducing disparities in healthcare services in people of different economic groups.
• Healthy people programs have measured and tracked national health objectives to encourage collaboration, guided people toward making informed health decisions, and assessed the impact of prevention activity.
• Specific objectives with baseline values for measurement are developed, setting specific targets to be achieved by 2020.
• 4 goals 2010: eliminate preventable disease, disability, injury and premature death; achieve health equity, eliminate disparities, and improve the health of all groups; create social and physical environments that promote good health for all; promote healthy development and healthy behaviors across every stage of life.
• Healthy people 2020 is a national consensus plan identifying focal areas that need active and specific plans and implementations based on the levels of illness and death that account for physical, psychosocial, and financial suffering of citizens

Question 7

Know the Governmental Public Health Functions of assessment, policy development and assurance. Be able to apply to specific examples.
Assesses healthcare problems – via Department of Health and

Answer 7

Assesses healthcare problems – via Department of Health and Human Services, CDC, the state and local governments
Intervenes by developing relevant healthcare policy that provides access to services – policy focuses on cost, access to care, and quality of care
Ensures that services are delivered and outcomes achieved – outcomes are ensured by a continual evaluation system liking in part with the CDC surveys

Question 8

Define public health

Answer 8

Public health – what society does collectively to ensure that conditions exist in which people can be healthy; ensuring that every person in the community has a standard of living adequate for the maintenance of health. This involves the science and art of preventing disease, prolonging life, and promoting physical health and efficiency through organized community efforts for the sanitation of the environment, the control of community infections, the education of the individual in principles of personal hygiene, the organization of medical and nursing services for the early diagnosis and preventive treatment of disease, and the development of the necessary social machinery.

Question 9

Define community nursing centers

Answer 9

Community nursing centers – organized and managed by nurses in partnership with the communities they serve to provide community health services and primary care to vulnerable and underserved population aggregates (Chapter 8)

Question 10

Define communities of solution

Answer 10

Communities of solution- phenomenological communities include groups that are referred to as “communities of solution.” A community of solution is formed by an aggregate specifically to address health concerns within a particular area. Communities of solution are composed of persons not only from the area of need but also members of neighboring communities who have a vested interest in a challenge the community faces. These communities can form in response to a health threat, such as contaminated water or industrial air pollution. Other examples include certain political action groups or the formation of ad hoc task force groups.

Question 11

Define epidemiology

Answer 11

Epidemiology –study of the distribution and determinants of states of health and illness in human populations; used both as research methodology to study states of health and illness, and as a body of knowledge that results from the study of a specific state of health or illness

Question 12

Define risk factors

Answer 12

Risk factors – personal habits and behaviors, environmental conditions, or inborn or inherited characteristics that are known to affect a health-related condition that could be alleviated or managed

Question 13

Define Aggregate/Population

Answer 13

Aggregate/Population – population group with common characteristics

Question 14

Define outbreak

Answer 14

Outbreak – epidemic usually limited to a localized increase in the incidence of the illness

Question 15

Define epidemic

Answer 15

Epidemic – an outbreak that occurs when there is an increased incidence of a disease beyond that which is normally found in the population

Question 16

Define risk

Answer 16

Risk –probability or likelihood that a disease or illness will occur in a group of people who presently do not have the problem

Question 17

Define population risk

Answer 17

Population at risk – groups of people who have specific characteristics, or risk factors, that increase the probability of developing health problems

Question 18

Define community assessment

Answer 18

Community assessment- Conceptualizing the community as a client is difficult for the individual-oriented nurse. Assessing the health needs and assets of a community involves creating a comprehensive community profile or database. The individual nurse may be solely responsible for the assessment, but usually he or she contributes to the assessment as a member of a team. Epidemiologic statistical methods, such as calculation of rates, are used in this process (see Chapter 6).Epidemiologists gather available demographic data that provide information about the age and sex distribution, socioeconomic characteristics, and cultural and ethnic distributions. They access vital statistics, including applicable epidemiologic morbidity and mortality rates. Additional data can be obtained from community members or community groups. Information about the accessibility and avail-ability of healthcare services, such as health manpower, may or may not be community assets. To obtain information about health beliefs, norms, values, goals, perceived needs, and health practices, healthcare workers may use focus groups, interviews or observation, or surveys. Nurses may participate in field-testing new tools for data collection

Question 19

Define health planning

Answer 19

Health planning- an organized and systematic process in which problems are identified, priorities selected, and objectives set for the development of community health programs based on the findings of community health assessments and health surveillance data. Health planning occurs at the global, national, regional, state, county, and local levels. Ideally, health planning is coordinated and consistent among each of these levels. Health planning occurs on both an ongoing and an episodic basis.

Question 20

Define program replication

Answer 20

Program replication- What may have succeeded in one location may reflect how ready the community was to change, not how well a pro-gram was designed and/or how well it was implemented. The ability to replicate or reproduce a successful program within a different community or with a new population aggregate is a test of the strength of the design of an intervention. When an intervention has yielded positive results in one community, the next step in establishing evidence for practice is to test the intervention by replication.

Question 21

Define sustainability

Answer 21

Sustainability – establishing the conditions for the health improvements achieved by an intervention to continue beyond the period of formal community health program or for a program to continue after grant funding ends.

Question 22

Define WHO

Answer 22

• WHO- a state of complete physical, mental, and social well being, not merely the absence of disease or infirmity

Question 23

define Winslow

Answer 23

• Winslow (father of public health) defined public health as- the science and art of preventing disease, prolonging life, and promoting physical health and efficiency through organized community efforts for the sanitation of the environment, the control of community infections, the education of the individual in principles of personal hygiene, the organization of medical and nursing service for the early diagnosis and preventive treatment of disease, and the development of the social machinery which will ensure to every individual in the community a standard of living adequate for the maintenance of health”

Question 24

Define Halbert Dunn

Answer 24

• Halbert Dunn-placed health on a continuum ranging from premature death to wellness to high-level wellness, which can be equated to self-actualization. In this model, the environment (factors outside of the person) plays a major role in health

Question 25

Define Smith

Answer 25

• Smith- identified four models of health:
o Clinical model- elimination of disease or symptoms
o Role performance model- health that involves a fit between people and social roles
o Adaptive model- health that involves adaptation to the environment
o Eudaimonistic model- health that is the actualization or realization of human potential

Question 26

Define the institute of medicine

Answer 26

• Institute of Medicine (IOM) defined global health as- “health problems, issues, and concerns that transcend national boundaries and may best be addressed by cooperative actions and solutions.” Each of Smith’s four models can be viewed within the definition of the IOM
• A person’s definition of health actually determines how and when he or she seeks assistance from the healthcare system and may ultimately affect the outcome of long-term health

Question 27

Assessment

Answer 27

Assessment-
• Monitor health status to identify community health problems
• Diagnose and investigate health problems and health hazards in the community

Question 28

Policy Development

Answer 28

Policy Development
• Inform, educate, and empower people about health issues
• Mobilize community partnerships to identify and solve health problem
• Develop policies and plans support individual and community health efforts

Question 29

Assurance

Answer 29

Assurance-
• Enforce laws and regulations that protect health and ensure safety
• Link people to needed personal health services and assure the provision of health care when otherwise unavailable
• Ensure a competent public health and personal health care workforce
• Evaluate effectiveness, accessibility, and quality of personal and population-based health services
• Assurance is a word used in public health to identify an important concept: that individual people, families, and populations have the healthcare personnel and systems needed to address their respective healthcare needs. Assurance as a goal is highly related to the goal of maintaining healthcare professionals in the work force who are competent and staying n the work force. It is possible to think about nursing school as a way the nursing program is supporting assurance.

Question 30

Define police power

Answer 30

Police Power- state power concerning health care is called police power. It allows states to act to protect the health, safety, and welfare of their citizens. Example #1: require immunizations of children before being admitted to school. Example #2: states require infectious diseases to be reported. Example #3: requiring case finding, reporting treatment & follow-up care for individuals with TB

Question 31

Define health indicators

Answer 31

Health Indicators – descriptors of the general health of a nation that are grouped into four categories: morbidity and mortality, risk factors, health service coverage, and health system resources

Question 32

Define determinants of health

Answer 32

Determinants of Health – factors that affect outcomes of health status, such as physical environment, social environment, health behaviors, and individual health, as well as broader factors such as access to health services and overall health policies and interventions

Question 33

Who was Clara barton?

Answer 33

Clara Barton- achieved widespread recognition during the civil war, distributing supplies to wounded soldiers and caring for the causalities with the help of her team of nurses. recognized the need for neutral relief society that could be activated in times of war and convinced congress to ratify treaty of Geneva, and the American red cross was established with an extended mission (to provide aid for natural disasters)

Question 34

Who was florence nightingale

Answer 34

Florence Nightingale- Devoted her life to the prevention of needless illness and death. She formed a team of nurses that assisted soldiers during the Crimean War and statistically documented her successes saving lives through prevention of infections and improving environmental conditions. She opened the first school of nursing and is credited with founding the profession of nursing. As a pioneering epidemiologist, she effectively demonstrated that statistics provide an organized way of learning from experience.

Question 35

Who was lillian Wald?

Answer 35

Lillian Wald- Founder of public health nursing. While attending school of nursing, she became involved in organizing a class in home nursing for poor immigrants and later donated her time working with this population. Her and other patrons established the Henry Street Settlement with fees being based on ability to pay and their focus was on teaching health and hygiene to the immigrant women, stressing the importance of preventative care. This project incorporated housing, employment, educational assistance, recreational programs, as well as school nurses and work health systems. In 1912, found the National Organization for Public Health Nursing which set the first professional standards for the practice of public health nursing. She also layed the foundation for nursing education in institutes of higher learning. She was an advocate for children and women rights helping establish Children’s Bureau, National Child labor committee, and national women’s trade union league.

Question 36

Who was mary breckinridge?

Answer 36

Mary Breckinridge- Founded the Frontier Nursing Service in 1925. Studied mountain people and found women lacked prenatal care and had self taught midwifery practices. She realized that children’s healthcare must begin before birth with care of the mother and continue throughout childhood. She established the Frontier Graduate School of Midwifery, one of the first midwifery programs in the country.

Question 37

Who was lemuel shattuck?

Answer 37

Lemuel Shattuck- prepared a report for the Massachusetts sanitary commission that pointed out that much of the ill health and disability in American cities in 1850 could be traced to unsanitary conditions. Report is now considered one of the fundamental documents in public health in the US. It provided for the first systematic use of birth and death records and demographic data to describe the health of a population. Recommendations became the foundation of the sanitation movement. The Shattuck Report recommended the establishment of state health departments and local health boards.

Question 38

Who was john snow?

Answer 38

John Snow- best known epidemiologist of 19th century. He used population data and his own observations to investigate the epidemic of cholera. He observed that deaths were particularly high in connection with two water supplies in London. He used his investigative skills and linked the cause of cholera with the water supply even before the era of bacteriology

Question 39

Eight domains of public health nursing practice (p9)

Answer 39

• Analytic assessment skills
• Policy development and program planning skills
• Communication skills
• Cultural competency skills
• Community dimensions of practice skills
• Basic public health science skills
• Financial planning and management skills
• Leadership and systems thinking skills

Question 40

Social determinants of health p4?

Answer 40

• Social conditions in which people live, their income, social status, education, literacy, home and work environment, support networks, gender, culture, and availability of health services. These conditions have an impact on the extent to which a person or community possesses the physical, social, and personal resources necessary to attain and maintain health

Question 41

Common themes in national and international health planning

Answer 41

• Providing health promotion and disease prevention at the population level, addressing social determinants of health, and achieving health equality.

Question 42

Healthcare disparities (p 143)

Answer 42

• Racial or ethnic difference in the quality of healthcare that is not due to access related factors or clinical needs, preferences, and appropriateness of intervention. Health disparities are differences in health status that result from (1) systematic disadvantages in access to basic needs or healthcare services or (2) systemic deficiencies in the organization and delivery of healthcare services due to financing problems or lack of cultural or linguistic competence. Where disparities found: cardiovascular disease, cancer, HIV, diabetes, end stage renal disease, and certain surgical procedures. What department of Health and Human services watches over: infant mortality, cancer screening, CV disease, diabetes, HIV/AIDS, and immunizations?

Question 43

Bottom-up and top-down approach to health planning (p134)

Answer 43

• Bottom-up: the impetus for health planning and program development comes from local or state level.
• Top-down: comes from regional, national, or global initiative

Question 44

Health impact pyramid (p 140)

Answer 44

• Framework that describes the public health impact of interventions at 5 different levels
• Lowest level: interventions to address socioeconomic conditions such as poverty, lack of education, and lack of access to clean water or sanitation.
• Second Level: Interventions that change the environmental context to make healthy options the default choice, regardless of education, income, service provisions, or other social factors such that individuals would have to expend significant effort not to benefit from them. Ex. Food and drug safety, iodization of salt, elimination of trans-fats in food, and restrictions on smoking in public places and on work sites.
• Middle level: Community health interventions such as immunizations that have long-term protective effect as well as periodic screenings such as colonoscopy.
• Fourth level: Clinical interventions such as treatment of hypertension, hyperlipidemia, and diabetes
• Fifth level (top): Counseling and health education. Require largest effort by individuals and achieving sustained health behavior change is the exception rather than the rule.
o *As you move up the pyramid the individual effort increases. As you move down the pyramid the population impact increases.

Question 45

Change theory (p 143-144)

Answer 45

• Lewin’s model: 3 step process of unfreezing, changing, and refreezing
• unfreezing: necessary precursor to change. Unfreezing moves a community from a stage of denial or lack of awareness of the need to change a condition or to address an issue, to a stage of preplanning or preparation for change. Creating dissatisfaction with the current state and raising awareness of a need for change are catalysts for unfreezing.
• Changing: Change is more often achieved incrementally through repeated cycles or steps than it is by large paradigm shifts. Changing requires an understanding of what needs to be changed, how the change will take place, and an idea of what the change will “look like” when the desired state has been achieved.
• Refreezing: process of stabilizing once a change has occurred with the goal of sustaining the change in the community’s state of health or health behavior. Establishes the new status quo. Sustainability is a concern.
• Force Field analysis: change management technique. Involves identifying factors within a community that are driving or reinforcing change in the desired direction as well as those that are restraining or resisting change. Ex. Fig 8.4
• Levers of change: purpose of using is to increase driving forces and/or to decrease restraining forces.

Question 46

Types of communities

Answer 46

• Geopolitical communities:
o Group of people who live within identified boundaries and governing systems (city, municipality, township)
• Phenomenological Communities:
o Group of people who have interpersonal and intrapersonal connections. Share common interests or beliefs. Community members share common interests, beliefs, goals, and together they identify what activities, structures, and outcomes are meaningful specifically to them. Ex. Homeless or people with disabilities, certain political action groups, formations of ad hoc task force groups, undocumented immigrants and people living with HIV.
• Societal, National, or International Communities:
o Broad context used to describe society in general or a nation. Ex. US citizens have a common federal government and share ideals, whereas individual communities within the country have different state and local governments and priorities in relation to individual needs and interests. Global community interests include member’s health and safety.
o First step to plan to help any community is to assess the community’s needs

Question 47

SMART goals/objectives

Answer 47

• Objectives that are Specific, Measurable, Achievable, Relevant, and Time bound. Example in box 8.4 on p 149.

Question 48

Social marketing (box 8.5)

Answer 48

• Know your AUDIENCE. Understand you are not the target audience
• It’s about ACTION! The process of heightening awareness, shifting attitudes, and strengthening knowledge is valuable if and only if it leads to action.
• There must be an EXCHANGE. If you want someone to give up, or modify, an old behavior or accept a new one, you must offer that person something very appealing in return.
• COMPETITION always exists. Your audience can always choose to do something else.
• Keep the 5 Ps of Marketing and policy in mind. The 5 Ps are:
o PRODUCT represents the desired behavior you are asking your audience to do and the associated benefits, tangible objects, and/or services that support behavior change.
o PRICE is the cost (financial, emotional, psychological, or time-related) or barriers the audience faces in making the desired behavior change.
o PLACE is where the audience will perform the desired behavior, where they will access the program products and services, or where they are thinking about your issue.
o PROMOTION stands for communication messages, materials, channels, and activities that will effectively reach your audience.
o POLICY refers to the laws and regulations that influence the desired behavior.
• It is important to understand that change mostly happens on the “installment plan”

Question 49

Epidemiologic triad:

Answer 49

• Model based on the belief that health status is determined by the interaction of the characteristics of the host, agent, and environment, not by any single factor. Host=the client whose health status is the concern (person, family, group, or community). Agents=element or force that under proper conditions can initiate or perpetuate a problem. Environment=Refers to the context within which the agent and host interact. Figure 5.2 p 94

Question 50

Wheel of causation:

Answer 50

• Epidemiological model that deemphasizes the agent as the sole cause of disease while emphasizing the interplay of physical, biological, and social environments. Center of circle is the genetic core of the host which is surrounded by a segmented wheel representing the biologic, physical, and social environments. The interaction between the host and environment remains the major determinant of health status.

Question 51

Web of causation:

Answer 51

• epidemiological model that strongly emphasizes the concept of multiple causation while de-emphasizing the role of agents in explaining illness. In this model it is necessary to identify all possible antecedent factors that could influence the development or prevention of a particular health condition. Each factor is a link in multiple interrelated chains. This model can be helpful in understanding the multiple pathways and factors that contribute to the development of chronic disease. Ex. On p 142

Question 52

Natural history:

Answer 52

• Course of a disease or condition from the onset to resolution. Integrates pathogenesis with prevention. The initial interaction between the agent, host, and environment occur during the prepathogenesis period (Primary prevention). The period of pathogenesis begins when there are biological, psychological, or other responses with the host (secondary prevention). Tertiary prevention is rehabilitation measures. P. 94

Question 53

Epidemiologic approach to community assessment:

Answer 53

• create comprehensive community profile or database. Uses statistics such as rates. Analyze data for health needs and assets, identify patterns of disease, illness, and injuries. Critical thinking! Set goals and objectives (NURSING PROCESS!) p.97-98

Question 54

Community as partner framework:

Answer 54

• People as central members of the community. 8 parts of the community interact with the various members, (see fig 10-3). The word “partner” demonstrates the equity of the nurse’s relationship with the community. P.185/186.

Question 55

Functional health status approach:

Answer 55

• for individual, family, or community assessment. GORDON. Provides insight into hoe groups respond to problems and take action. (Box 10.4). p. 186

Question 56

Collaborative model:

Answer 56

• emphasizes interdisciplinary nature of task, (nurse, SW, community member) collaboration between expert and those with health concerns. Community members need to have active voice in identifying issues and making decisions. “We can do it!” But very time consuming. p.189.

Question 57

Screening programs: Box 4.5

Answer 57

• Mass screening: applied to entire population
o Blood lead level
o Papnicoluaou (PAP) smears
o Phenylketonuria of newborns
• Selective screening: performed for specific high-risk populations
o Mammograms for young women at high risk for cancer
o Tuberculin test for hospital employees
o Occupational diseases
o Exposure to radiation
• Multiphasic screening: variety of screening tests applied to the same population on the same occasion. Data can be used for establishing baseline data in a healthcare facility and for risk factor appraisal.
o Series of tests performed on a single blood sample
o Periodic surveillance of drug therapy
o Monitoring the state of an illness
• Case findings: clinician’s search for illness as a part of a client’s periodic health examination
o Monitoring the health of individuals in a case load.

Question 58

Public Health Laws- source for laws, types of law:

Answer 58

o course of action: a program of actions adopted by a person, group, or government, or the set of principles on which they are based
o prudence: shrewdness or prudence, especially in the pursuit of a course of action a settled course of action to be followed by a government or institution to obtain a desired end.

Question 59

What is health policy?

Answer 59

• Health policy is a set course of action to obtain a desired health outcome for an individual, family, group, community or society.

Question 60

Define politics

Answer 60

• Politics- Art of influencing others to accept a specific course of action

Question 61

Define legislative law

Answer 61

• Legislative Law – what we all know!

Question 62

Define administrative law

Answer 62

• Administrative Law – rule written by administration (Nurse Practice Act, MBN)

Question 63

Define judicial law

Answer 63

• Judicial or Common Law – Affordable Care Act (supreme determined it’s constitutional)

Question 64

What are states rights?

Answer 64

• State’s rights- 10th amendment of the Constitution
o The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people
• State power concerning health care is called POLICY POWER. Power point.
• Nice charts in the Health Policy pp.

Question 65

Levels of government at which public health is provided:

Answer 65

Levels of government at which public health is provided:
• Federal government creates policy, financing, and regulatory enforcement, department of human services. State governments play a role in public health regulations, program responsibilities, and resource allocation. Local governments implement the public health activities. *the private sector often does not provide services that would improve social welfare. P.27

Question 66

US Health Care system- focus , cost as compared to other countries:

Answer 66

• cure not prevent, and most expensive, per capita spending on health care $7,290, 16% of GDP. P.30

Question 67

Levels of Prevention:

Answer 67

• Primary – no signs and symptoms of the disease. Maximize health and wellness. Secondary – planned effort to minimize the impact of the disease and injury once it’s realized, screening. Tertiary prevention – long-term management and treatment of clients with chronic conditions. Maintain quality of life. P.71-74

Question 68

Behavioral models:

Answer 68

• models that assist clients, groups, and communities to redirect activities toward health and wellness. P. 65. “Describe, explain, or predict prevention health behaviors.” P.76

Question 69

Learning theories:

Answer 69

• A behavioral change model emphasizing reinforcement of social competence, problem solving, autonomy, and sense of purpose. P.65. “a goal is established and reinforced by the nurse, with rewards given as reinforcement.” P.76.

Question 70

Health belief model:

Answer 70

• A behavioral change model that considers the severity of the potential illness or physical challenge, the level of conceivable susceptibility, the benefits of taking preventive action, and the challenges that may be faced on taking action toward the goal of health promotion. Uses “cues” as an important way to remind people of health behavior, “Got milk?” p. 77.

Question 71

Theory of reasoned action:

Answer 71

• A behavioral health model emphasizing that individual performance of a given behavior is primarily determined by a person’s intention to perform that behavior. P. 65. Behavior determined by intention to perform the behavior, which is determined by the attitude of the behavior. P.78.

Question 72

Social learning theory:

Answer 72

• A behavioral change model that considers environmental influences, personal factors, and behavior as key components to change. P.65. person must believe in his/her ability to perform the behavior (self-efficacy) p.78.

Question 73

Ecological model:

Answer 73

• models that consider intrapersonal attribute, interpersonal dynamics, person/environment interactions, cultural beliefs, and attitudes. P.65. All are interdependent. P.79-80
o Ontogenetic: attitudes and beliefs that influence decisions, trauma history, level of acculturation, self-efficacy, positive outcome expectancies, communication skills, risk appraisal.
o Microsystem: relationship stage, intimacy, communication patterns between sexual partners, association with peers, family environment, church.
o Exosystem: Socioeconomic and employment status, degree of social isolation, social networks and support, poverty.
o Macroculture: Social norms regarding HIV/AIDS, attitudes about gender roles, racism.

Question 74

What is a logic model?

Answer 74

• Logic Model: visual representation of the logic behind the operation of the program, who, what, where, when, why. It’s both a planning tool and communication tool. P.147.

Question 75

Principles of public health?

Answer 75

• Principles of Public Health: focus on the aggregate, promote prevention, encourage community organization, practice the ethical theory of the greater good, model leadership in health, use epidemiologic knowledge and methods.

Question 76

Epidemiologic measures : rate

Answer 76

Rate –measurement used to describe the occurrence of a state of health in a specific group of people in a given period of time, p. 105
Rate = # of conditions or events within a designated period of time x base multiple of 10
Population at risk during the same period of time

Question 77

Epidemiologic measures: crude rate

Answer 77

Crude rate – general or summary rates that measure the occurrence of the condition being investigated in the entire population. Calculation of these rates usually involves averaging the population numbers at the beginning and end of the year and that number is used in the denominator, p. 106

Question 78

Epidemiologic measures : Adjusted rate

Answer 78

Adjusted rate – there is often a need to remove the effects of differences in the composition of a population when comparing one with another. For example, an investigator may want to compare two or more groups knowing they differ in terms of a characteristic, such as age, that may influence the results. The process of adjusting rates controls for these differences, p. 106

Question 79

Epidemiologic measures: period prevalence

Answer 79

Period Prevalence – type of prevalence rate that indicates the existence of a conditions during a period or an interval of time, p. 107

Question 80

Epidemiologic measures: sensitivity

Answer 80

Sensitivity –the ability of the test to identify correctly people who have the health problem under study, the probability of testing positive if the health problem is truly present, p. 116

Question 81

What is a descriptive study?

Answer 81

Descriptive study – study in which information is collected to characterize and summarize (describe) a health event or problem. Descriptive epidemiology is fundamental in the work of epidemiologists, p. 120

Question 82

What is an analytic study?

Answer 82

Analytic study –investigation that uses comparisons between groups to determine the role of various risk factors in causing the problem, p. 120

Question 83

What is a retrospective study?

Answer 83

Retrospective study –type of analytic study in which participants are enrolled after the health outcome of interest has occurred, subjects are selected on the basis of the presence or absence of the disease or outcome in question, p. 125

Question 84

What is an experimental study?

Answer 84

Experimental study – also known as “intervention studies”, investigation designed to test hypothesized relationships by modifying an identified factors in a population, can be categorized as preventative trials and therapeutic trials and both can be either quasi-experimental or true experimental studies, p. 126

Question 85

What is a prospective study?

Answer 85

Prospective study – also known as “cohort studies”, an analytic study in which participants are enrolled before the health outcome of interest has occurred, the study monitors subjects over time to find associations between risk factors and health outcomes, p. 124

Question 86

Define health literacy

Answer 86

• Health Literacy - The degree to which an individual has the capacity to obtain, communicate, process, and understand basic health information and services to make appropriate health decisions

Question 87

Define stages of change

Answer 87

• Stages of Change - describes how individuals go through a series of stages when change occurs

Question 88

Medicare coverage

Answer 88

Medicare Coverage
• Part A – hospital insurance, covers inpatient hospital care, skilled nursing care, hospice care and some home health care
• Part B – medical insurance, covers certain doctors’ services, outpatient care, medical supplies and preventative services
• Part D – prescription drug coverage

Question 89

Ecological model

Answer 89

dd. Ecological model: models that consider intrapersonal attribute, interpersonal dynamics, person/environment interactions, cultural beliefs, and attitudes. P.65. All are interdependent. P.79-80
i. Ontogenetic: attitudes and beliefs that influence decisions, trauma history, level of acculturation, self-efficacy, positive outcome expectancies, communication skills, risk appraisal.
ii. Microsystem: relationship stage, intimacy, communication patterns between sexual partners, association with peers, family environment, church.
iii. Exosystem: Socioeconomic and employment status, degree of social isolation, social networks and support, poverty.
iv. Macroculture: Social norms regarding HIV/AIDS, attitudes about gender roles, racism.