Culture in Nursing Wk5 DQ

Culture in Nursing Wk5 DQ

Culture in Nursing Wk5 DQ

Review the attached PowerPoint presentation.  Once done answer the following questions;

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  1.  Analyzed how culture influences the beliefs and behaviors of the childbearing woman and her family during pregnancy.
  2. During an outpatient contraception teaching session for a diaphragm, Sita, a Hindu woman states that she cannot use her left hand for handling the clean device.
  3.  What are the health beliefs that underpin Sita’s hesitation and why?
  4.  How can the nurse offer support to Sita’s based on Leininger’s theory?
  • attachment

    CHNChapter_005.pptx

    Chapter 5

    Epidemiology

    Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

     

    Epidemiology Is …

    … the study of the distribution and determinants of health and disease in human populations

    (Harkness, 1995)

    … the principal science of public health

    Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. Culture in Nursing Wk5 DQ

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    Historical Perspective

    Investigations of disease pattern in the community; comparing people who had disease or who remained healthy

    Person-Place-Time Model

    Person: “Who” factors, such as demographic characteristics, health, and disease status

    Place: “Where” factors, such as geographic location, climate and environmental conditions, political and social environment

    Time: “When” factors, such as times of day, week, or month and secular trends over months and year

    Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

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    Different Types of Epidemiology

    Descriptive Epidemiology

    Study of the amount and distribution of disease

    Used by public health professionals

    Identified patterns frequently indicate possible causes of disease

    Analytic Epidemiology

    Examine complex relationships among the many determinants of disease

    Investigation of the causes of disease, or etiology

    Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

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    Epidemiological Triangle

    Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

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    Figure 5-1

     

    Agent of Disease (Etiologic Factors)

    Nutritive elements

    Excesses, deficiencies

    Chemical agents

    Poisons, allergens

    Physical agents

    Ionizing radiation, mechanical

    Infectious agents

    Metazoa, protozoa, bacteria, fungi, rickettsia, viruses

    Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

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    Host Factors–Intrinsic Factors (Susceptibility, or Response to Agent)

    Genetic

    Age

    Sex

    Ethnic group

    Physiological state

    Prior immunological experience

    Active/, passive

    Intercurrent or preexisting disease

    Human behavior

    Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

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    Environmental Factors— Extrinsic Factors…

    … influence existence of the agent, exposure, or susceptibility to agent

    Physical environment

    Biological environment

    Human populations, flora, fauna

    Socioeconomic environment

    Occupation, urbanization and economic development, disruption

    Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. Culture in Nursing Wk5 DQ

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    Wheel Model of Human-Environment Interaction

    Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

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    Figure 5-2

    Redrawn from Mausner JS, Kramer S: Mausner and Bahn epidemiology: an introductory text, ed 2, Philadelphia, 1985, Saunders.

     

    Web of Causation

    Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

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    Figure 5-3

    From Friedman GD: Primer of epidemiology, ed 4, New York, 1994, McGraw-Hill.

     

    Ecosocial Approach

    Emphasize the role of evolving macro-level socioenvironmental factors along with microbiological process in understanding health and illness (Smith & Lincoln, 2011)

    Challenges the more individually focused risk factor approach to understanding disease origins

    Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

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    Calculation of Rates

    Rates are arithmetic expressions that help practitioners consider a count of an event relative to the size of the population from which it is extracted

    Number of health events in a specified period

    Population in same area in same specified period

    Proportion multiplied by a constant (k)

    For example, the rate can be the number of cases of a disease occurring for every 1000, 10,000 or 100,000 people in the population

    Can make meaningful comparisons

    Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

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    Morbidity Rates

    Incidence rates

    New cases or conditions

    Attack rate

    Number of new cases of those

    exposed to the disease

    Prevalence rates

    All cases of a specific

    disease or condition at

    a given time

     

     

    Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

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    Prevalence Pot The relationship between incidence and prevalence

    Figure 5-4

    Redrawn from Morton RF, Hebel JR, McCarter RJ: A study guide to epidemiology and biostatistics, ed 3, Gaithersburg, MD, 1990, Aspen Publishers. Culture in Nursing Wk5 DQ

     

    Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

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    Morbidity Rates (Cont.)

     

     

    Incidence Rate

     

     

     

     

     

     

     

     

     

     

    Prevalence Rate

    Number of existing cases Total Population  _____

     

     

     

     

     

     

     

     

    Number of new cases _in given time period Population at risk in same time period ___75___ 4000–250

    × 1000

    = 0.02

    0.02 × 1,000 = 20 per 1000 per time period

    250

    4000

    = 0.0625

    0.0625 × 1000 = 62.5 per 1000

     

    Mortality Rates (routinely collected birth and death rates)

    Other rates

    Crude rates

    Age-specific rates

    Age-adjusted rates or standardization of rates

    Proportionate mortality ratio (PMR)

    Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. Culture in Nursing Wk5 DQ

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    Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

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    Number of deaths in year Total population size _1720_ 200,000

    × 100,000

    = 0.0086

    Number of births in year Total population size _2900_ 200,000

    × 100,000

    = 0.0145

     

    Concept of Risk

    Risk—probability of an adverse event

    Risk factor

    Refers to the specific exposure factor

    Often external to the individual

    Attributable risk

    Estimate of the disease burden in a population

    Relative risk ratio

    Divide the incidence rate of disease in the exposed population by the incidence rate of disease in the nonexposed population.

    Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

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    Use of Epidemiology

    Disease prevention

    Primary prevention

    Health promotion and specific prevention

    Secondary and tertiary prevention

    Establishing causality

    Screening

    Surveillance

    Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

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    Use of Epidemiology (Cont.)

    Health services

    Used to describe the distribution of disease and its determinants in populations

    Study population health care delivery

    Evaluate use of community health services

    Nurses must apply findings in practice

    Incorporate results into prevention programs for communities and at-risk populations

    Extend application into major health policy decisions

    Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

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    Community health nurses should exercise “social responsibility” in applying epidemiological findings, but this will require the active involvement of the consumer.

    Community health nurses collaborating with community members can combine epidemiological knowledge and aggregate-level strategies to affect change on the broadest scale.

    Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

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    Epidemiological Methods

    Descriptive epidemiology

    Focuses on the amount and distribution of health and health problems within a population

    Analytic epidemiology

    Investigates the causes of disease by determining why a disease rate is lower in one population group than in another

    Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

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    Analytic Epidemiology

    Observational studies

    Descriptive purposes

    Etiology of disease

    No manipulation by investigator

    Cross-sectional studies

    Sometimes called prevalence or correlational studies

    Examine relationships between potential causal factors and disease at a specific time

    Impossible to make causal inferences

    Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. Culture in Nursing Wk5 DQ

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    Analytic Epidemiology (Cont.)

    Retrospective studies

    Compare individuals with a particular condition or disease with those who do not have the disease

    Data collection extends back in time

    Prospective studies

    Monitor a group of disease-free individuals to determine if and when disease occurs

    Cohort shares a common experience within a defined time period

    Monitors cohort for disease development

    Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

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    Analytic Epidemiology (Cont.)

    Experimental design

    Also called a Randomized Clinical Trial (RCT)

    Subjects assigned to experimental or control group

    Apply experimental methods to test treatment and prevention strategies

    Ethical considerations with human subject rights review

    Also useful for investigating chronic disease prevention

    Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc.

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