NURS 430 Flashcards
Primary Health Care
Umbrella term - broader scope, about groups and communities (not individual)
Primary Care
Falls under PHC - Focuses on preventing, diagnosing, treating and managing conditions - focuses on individual
PHC Principles
- Accessibility
- Public Participation
- Health Promotion
- Appropriate Technology
- Intersectoral collaboration/cooperation
Health Promotion
The process of enabling people to increase control over, and to improve health
Levels of Prevention
Primordial Prevention
Primary Prevention
Secondary Prevention
Tertiary Prevention
Quaternary Prevention
Primordial Prevention
Initiatives that prevent conditions that would enable risk factors to develop
Primary Prevention
Impact of specific risk factors is lessened.
Secondary Prevention
Early identification of disease and conditions and timely treatment
Tertiary Prevention
Once an individual becomes symptomatic, or disease or injury is evident.
Quaternary Prevention
Actions that identify populations at risk of overmedicalization.
Lalonde Report (1974)
Focus on health, not illness
External forces influence health - biology, lifestyle
Community Definition
Group of people who live, learn, work, worship, and play in an environment at a given time - share common characteristics and interests and function within a larger social system.
Public Health
Organized efforts in society to keep people healthy and prevent injury, illness and premature death - combination of programs and services and policies that protect and promote the health of Canadians
Community Assessment
Ongoing systematic appraisal of the community - looking for trends/changes
Epidemiological Framework
CHN examines the frequency and distribution of disease/health in the population using the epidemiology triangle
a) Host-environment agent
b) CHNs determine what the community is, the host, environment and agent.
Community Capacity (assets) approach
Capacity building - strengthens the ability of the community to develop and implement health promoting initiatives
a) Deficit based: needs and problems
b) Assets approach: capacities and assets
c) Clients vs citizens
d) Consumers vs producers
Matuk’s community health promotion model
Apply community health promotion strategies to achieve collaborative community actions and improve sustainable health outcomes of the community
Types of Community Assessment
Environmental scan - windshield survey
Problem Investigation - outbreak
Needs Assessment
Resource Evaluation
Roles of Public Health Nurse
Promoting Health with Individuals
Promoting Health with Small Groups of Classrooms
School-Wide Health Promotion
Board or District-Wide and Community-Level Health Promotion
Program Logic Model
Visual tool - Helps clarify relationship between program activities and planned outcomes
Stage 1: CAT
Stage 2: SOLO
Stage 1: CAT
C: Components/Inputs - what is invested (ex. time, money, materials)
A: Activities/outputs - what is done for each component (ex. teach, delivery service)
T: Target groups - intended recipients (ex. clients, agencies)
Stage 2: SOLO
SO: Short-term outcomes (Learning)
LO: Long-term outcomes (Actions and Conditions)
Precede-Proceed Planning Model
Community oriented participatory model for creating community health promotion interventions - multiple assessments
SWOT Analysis
S: Strengths
W: Weaknesses
O: Opportunities
T: Threats
Formative (Process) Evaluation
Assessment of program implementation
a) Progress - monitor program activities
b) Relevance - is program suitable to meet the needs of the target group
c) Adequacy - extent program addresses the entire health issues defined in the assessment
Summative (Outcome) Evaluation
a) Effectiveness - client and staff satisfaction and whether program met objectives (ex. short-term - knowledge)
b) Impact - longer term results of program (ex. changes in morbidity or mortality)
c) Sustainability - long-term viability of the program
Economic Evaluation (Process and outcome)
Cost Effectiveness Analysis (CEA) - compare program to similar objectives to determine the most cost-effective
Cost-Benefit Analysis (CBA) - quantify all costs and benefits
CHNC Practice Standards
- Health Promotion
- Prevention and Health Protection
- Health Maintenance, Restoration and Palliation
- Professional Relationships
- Capacity Building
- Health Equity
- Evidence-Informed Practice
- Professional Responsibility and Accountability
Epidemiology
The study of the distribution and determinants of health-related states or events and the application of this study to the control of diseases (deterrents) and other health problems
Distribution
The frequency and patterns in terms of person, place, and time (who, where, and when)
Determinants
Factors that cause or contribute to a disease or change in health
Deterrents
Factors that prevent or reduce the chance of developing a disease
Descriptive Epidemiology
Describes the distribution of health events - patterns of those events in populations
Analytic Epidemiology
Searches for the determinants of health events - factors, characteristics and behaviours that determine patterns
Host
Person in which health event occurs
Agent
Health challenge/force that begins or continues a health event
a) biological (infection agent)
b) chemical (toxins, pesticides, smoke, alcohol, etc.)
c) physical (radiation, heat, cold, machinery, trauma, etc.)
d) others (absence of substance, psychological stress)
Environment
Context that promotes the exposure of host to agent
a) physical (climate, geography, pollution)
b) biological (plants/animals - reservoir for agents)
c) social (neighborhood, housing, work, socioeconomic factors)
Screening
The testing of individuals who do not have symptoms in order to detect a health problem
Surveillance
The constant watching or monitoring of diseases to assess patterns and quickly identify events that do not fit the pattern
Association
Reasonable evidence that a connection exists between two factors (ex. stressor and health challenge)
Causation
Definite cause and effect relationship between two factors
Criteria for Causation
Temporal relationship
Strength of Association
Dose-Response
Specificity
Consistency
Biologic Plausibility
Experimental Replication
Measurements in epi - rate
Measure of the frequency with which an event occurs in a defined population
Most common epi rates
Mortality rate = number of deaths in a population
Morbidity rate = number of cases of disease or health challenge in a population
Morbidity - prevalence rate
people with disease in a given population at one point in time/total in given population at same point in time x 1000
Morbidity - incidence rate
new cases of disease in population in given period/#persons at risk in the same period x1000
Communicable Diseases
Illness caused by a specific infectious agent, or its toxic products that arise through transmission of that agent or its products from infected susceptible host
Types of Communicable Diseases
Airbourne
Blood bourne
Foodbourne
Waterbourne
Blood Borne Pathogen Examples
HIV
Food and Water Borne Examples
Bacterial: Clostridium botulism
Pathogenic micro: listeriosis, salmonellosis
Water - fecal contamination: cholera, typhoid fever, e.coli.
Zootonic and vector borne example
Rabies, hantavirus, east equine encephalitis, lyme disease, west nile virus, zika
Healthcare acquired infections
MRSA, VRE, C. diff, CPE
Outbreak
When new cases exceed what is expected - limited to a localized increase in incidents (village, institution)
Epidemic
Similar to outbreak where cases exceed what is expected - can be large or small
Pandemic
When disease spreads to affect a large number in populations worldwide
Endemic
Steady presence in a defined population or region
Immunization
Primary Prevention - modify a susceptible host into a resistant host by introducing a substance that creates antibodies
Prophylaxis
Secondary Prevention - reduces the ability of the agent to multiply in a susceptible host
Active Surveillance
Using screening tools interviews, and sentinel systems (ex. WNV, COVID-19)
Passive Surveillance
When a notifiable CD is reported, contact tracing occurs
Prophylaxis/Screening/Treatment
ex. immunoprophylaxic agents to prevent illness from an infectious agent following an exposure
Sex Positivity
an attitude that celebrates sexuality as a part of life that can enhance happiness, bringing energy and celebration.
Harm reduction
Policies, programs, and practices that aim to minimize negative health, social, and legal impacts associate with certain practices.
Intersectionality theory
Emphasizes that the root causes of marginalization cannot be traced to one specific social location
Internalized Stigma
An individual’s acceptance of negative beliefs, views, and feelings towards the stigmatized group they belong to and oneself
Perceived Stigma
An individual’s awareness of negative societal attitudes, fear of discrimination, and feelings of shame.
Enacted Stigma
Encompasses overt acts of discrimination, such as exclusion or acts of physical or emotional abuse
Layered or Compounded Stigma
A person holding more than one stigmatized identity
Institutional or Structural Stigma
Stigmatization of a group of people through the implementation of policy and procedures
Stibbis
Testing for STIs - urine, blood, swab, visual
Recommended every 3-6 months or anytime you have a new sexual partner
Stibbis - Viral
Human Immunodeficiency Virus (HIV)
Hepatitis C (HCV)
Herpes Simplex Virus (HSV)
Human Papillomarvirus (HPV)
Stibbis - Parasitic
Trichomoniasis (Trich)
Public Lice
Scabies
Stibbus - Bacterial
Chlamydia
Lymphogranuloma vereneum (LGV)
Gonorrhea
Mycoplasma Genitalium (MG)
Congenital Syphilis
Major health impacts on infants - stillbirth, deformed bones, miscarriage, prematurity, blindness
Immunization
protect people from disease by introducing a vaccine into the body that triggers an immune response, just as though you had been exposed to a disease naturally.
Types of Passive Immunity
Injected
Maternal
Types of Active Immunity
Innate Immunity (born with)
Adaptive Immunity (antibodies produced)
Types of Active Vaccines
Replicating vaccines
Live vaccines
Contain weakened virus or bacteria to induce immunity
Need fewer doses
MMR, Varicella, MMRV, Rotavirus
Types of Active Vaccines
Non-Replicating vaccines
Killed, engineered, protein, toxoid
Takes longer to achieve protection, need more doses
Boosters may be needed
Tetanus, whooping cough, Hep B, HPV, Polio
