Community Health Nursing NCM 113A Module 3 PDF

COMMUNITY HEALTH NURSING NCM 113A Module 3: Health Statistics and Epidemiology Lesson 1: Tools in Public Health 3. Relative Increase (Demography) - the actual difference between the tw...

COMMUNITY HEALTH NURSING NCM 113A Module 3: Health Statistics and Epidemiology Lesson 1: Tools in Public Health 3. Relative Increase (Demography) - the actual difference between the two census counts expressed in percent relative to the DEMOGRAPHY population size made during the earlier census. - science which deals with the study of human population’s size, composition & distribution in space. - helps the nurse find reasons or rationale on a particular population group is influenced by a variety of factors resulting to vulnerability to certain diseases (Maglaya, 2009). Components of Demography B. Population Composition - population is characterized by its relation to A. Population Size variables such: Refers to the number of people in a given place 1. Age or area at a given time. 2. Sex It involves analysis of three observable 3. Occupation phenomena: changes in population size, the 4. Educational level composition of the population and the The nurse uses this data to decide who among the distribution of populations in space. population group merits attention in terms of health Demographers study five processes: fertility, services and programs. mortality, marriage, migration and social mobility. These processes determine populations’ size, Calculations: composition and distribution 1. Sex Composition – computes for sex ratio Not only know how large or small the population (compares # of males to # of females in the is but to make comparisons between population population) changes in time Helps rationalize types of health programs or interventions that will be provided in the community Methods of Calculating Population Size 2. Age Composition a) Median Age – divides the population into two 1. Natural increase equal parts - the difference between the number of births ex: if median age is said to be 19 years old, it and the number of deaths occurring in a population means half of the population belongs to 19 years and in a specified period of time. above, while the other half belongs to ages below 19 years old b) Dependency Ratio – compares the number of economically dependent with the economically productive group in the population 2. Rate of Natural increase - Dependency ratio represents the number of - the difference between the Crude Birth Rate economically dependent for every 100 and the Crude Death Rate occurring in a population economically productive in a specified period of time - Economically dependent – 0-14 & 65 and above age groups - Economically independent – 15 to 64 years old  COMMUNITY HEALTH NURSING NCM 113A Module 3: Health Statistics and Epidemiology 3. Age and Sex Composition - can be described 3. Indispensable tool in planning, using a population pyramid. (A graphical implementation, evaluation of any health presentation of the age and sex composition of the program population) Statistics of disease (morbidity) and death C. Population Distribution (mortality) indicate the state of health of a can be described in terms of urban-rural community and the success or failure of health distribution, population density & crowding index. work. These measures help the nurse decide how resources can be allocated based on Statistics on population (demography) and the concentration of population in a certain place. characteristics such as age and sex, distribution are obtained from the NSO, the office charged 1. Urban-rural distribution – illustrates proportion of with registering vital facts in the country. the people living in urban compared to rural areas BIRTHS AND DEATHS 2. Crowding Index – describes the ease by which a are registered in the office of the Local Civil communicable disease will be transmitted from one Registrar of the municipality and is usually host to another susceptible host. headed by the Municipality Local Registrar or Municipal Health Officer. In the city, these records are registered in the City Local/Local Civil Registrar (LCR) Office and Dividing the # of persons in a household with the number of rooms used by the family for sleeping. data is forwarded to the National Statistics Office (NSO) 3. Population Density – determines how congested a place is and provides implications in terms of the Republic Act No. 3753 - "Civil Registry Law" adequacy of basic health services present in the requires that all birth and deaths, including fetal community. deaths are registered with the National Statistics Office (NSO). Presidential Decree 651 Dividing the number of people living in a given land area. requires all health workers to register births within 30 days following delivery. Lesson 2 : Tools in Public Health (Vital Statistics) SOURCES OF DATA: 1. Population Census - An official and periodic (Tools in Identifying Community Health enumeration of population which includes the Needs) demographic, economic, and social data 2. Registration of vital data VITAL STATISTICS 3. Health Surveys Refers to the systematic study of vital events 4. Studies and researches such as births, illnesses, marriages, divorces/separations and deaths. Types of Data A helpful tool in estimating the extent or 1. Primary Data magnitude of health needs and problems in the - data which have not been collected before community - through observation (ocular/windshield), informant interview, focused group Uses of Vital Statistics in the care of I, F, C discussions (FGD) 1. Serves as index of the health condition of the 2. Secondary Data people in a community - data from existing sources 2. Provides valuable clues to nature of health - vital registries, publications services - health records and reports  COMMUNITY HEALTH NURSING NCM 113A Module 3: Health Statistics and Epidemiology Health Indicators Interpretations: - a list of information which would determine the a. 17% of the Filipinos in 2016 died at the age health of a particular community like population, of 50 years and above. crude birth rate, crude death rate, infant & maternal death rates & etc. or b. 83% of the Filipinos in 2016 died before the age of 50 years old. Common Health Indicators 1. Birth Lesson 3 : Tools in Public Health 2. Death (Epidemiology) 3. Marriages 4. Migration (Tools in Identifying Community Health Needs) Common Vital Statistical Indicators 1. Fertility rates EPIDEMIOLOGY ❖ Crude Birth Rate (CBR) The study of the distribution and determinants of ❖ General Fertility Rate (GFR) health-related states of events in specified populations and the application of this study to 2. Morbidity rates the prevention and control of health problems ❖ Incidence Rate (IR) (Last, 1988) ❖ Prevalence Rate (PR) The study utilizes concepts and methods form other fields of study such as biology, sociology, 3. Mortality rates demography and environmental science and ❖ Crude Death Rate (CDR) statistics. ❖ Cause of Death Rate (C-DR) ❖ Infant Mortality Rate (IFR) Study ❖ Maternal Mortality Rate (MMR) - surveillance, observation, research and ❖ Proportionate Mortality Rate (PMR) experiments ❖ Swaroop's Index (SI) Distribution Puerperium - may last up to 6 weeks or 42 days - time, places, groups of people affected Maternal death - refers to the death if any woman while pregnant or with 90 days of termination of the Determinants pregnancy - physical, biological, chemical, economic, genetic and behavioral factors that affect health Additional Notes of Swaroop's Index (SI): - a sensitive index of the standards of health care in Health-related States/Events a country - disease, cause of death, lifestyle, use of health - the higher the SI, the better health services, better services health status, longer life span and more people would reach up to 50 years old. Specified Populations - Identifiable characteristics (eg. Occupational Better interpretation of the Swaroop's Index in an hazards) example: If the number of deaths in the Philippines among 50 Application to Prevention and Control years old and above is 45,650 in 2016 and the total - Address the aim of public health : to promote, to population is 275,260, what is the Swaroop's Index in protect and restore health 2016? EPIDEMIOLOGIST - person who studies epidemiology. Public Health Surveillance - the ongoing systematic collection, analysis and interpretation of health of health related-data needed for the planning,  COMMUNITY HEALTH NURSING NCM 113A Module 3: Health Statistics and Epidemiology implementation and evaluation of public health Biological practice; HCW may take an active or passive role Physical Chemical Philippine Integrated Disease Surveillance and Mechanical Response Nutritive 1. Notifiable Disease Reporting System (NDRS) 2. Host – is any organism that harbors and 2. Field Health Service Information System provide nourishment for another organism (FHSIS) Demographic characteristics 3. National Epidemiology Sentinel Surveillance General health status System (NESSS) Body defenses 4. Expanded Program on Immunization (EPI) State of immunity & immunological Surveillance System response 5. HIV-AIDS Registry Human behavior 3. Environment – the sum total of all external R.A. 11332 - "Mandatory Reporting of Notifiable conditions and influences that affect the life Diseases and Health Events in Public Health and development of an organism Concern Act" Physical – inanimate surroundings such as the geophysical conditions and Section 7 of RA 11332 provides that the President climate of the Republic of the Philippines shall declare a Biological – living things such as plants State of Public Health Emergency in the event of an and animal life (vectors) epidemic of national and/or international concern Socio-economic – economic which threatens national security in order to mobilize development, social disruptions governmental and nongovernmental agencies to respond to the threat. b. Iceberg Principle – describe a situation in which a large percentage Practical Application of Epidemiology of a problem is subclinical, unreported, or otherwise Assessment of the health system of the hidden from view. community Elucidation of the natural history of disease c. Web of Causation Determination of disease causation - shows the relationship between different multiple Prevention and control of disease factors that contribute to the cause of a disease Monitoring and evaluation of health intervention Provision of evidence for policy formulation 2. Natural History of Disease - Seeks to identify factors related to the course of a Concepts in Epidemiology disease once established in order to determine its duration and the probability of recovery, death or 1. Multiple Causation Theory specific complications. - Disease development does not rest on a single - Help the nurse and other people to implement cause but rather results from multiple factors. measures to prevent pathologic processes to progress. Models in Disease Causation Stages of Natural History of Disease a. Ecologic Triad (Triad of Epidemiology) (Leavall and Clark, 1968 ) – most helpful to the nurse because it highlights not only the host’s and agent’s roles in disease Pre-pathogenesis development but also regards the role of - the disease has not developed but factors that favor environment as important in disease causation. its occurrence are present. 1. Agent – is any element, substance, force Pathogenesis animate or inanimate which serve as a - disease has developed into: stimulus to initiate or perpetuate a disease 3 Substages of Pathogenesis process.  COMMUNITY HEALTH NURSING NCM 113A Module 3: Health Statistics and Epidemiology 1. Pre-symptomatic disease or early pathogenesis - a cause must precede a disease and the cause ~ individual has no symptoms that indicate the of a disease must be necessary and sufficient for presence of illness but in fact, pathogenic changes the occurrence of disease. have begun. b. Necessary cause 2. Discernible lesions - refers to the fact that the factor must be present – changes may be detectable through sophisticated for the disease to occur. laboratory tests, during this period, the early signs & symptoms of diseases are developing. c. Sufficient cause - indicates that if a factor is present, the disease 3. Advanced disease can occur, but the factor’s presence does not - anatomical or functional changes have produced always result in the disease occurrence. recognizable signs & symptoms. d. Risk 3. Levels of Prevention of Health Problems - probability of an unfavorable event, disease, - Prevention refers to identification of potential disability, defect or even death. problems so that the nurse can minimize or eradicate - must be identified and dealt with to prevent possible disability or deformity in a population at risk. diseases. 1. Primary Prevention e. Association - activities directed to the healthy population, - concurrence of 2 variables under investigation focusing on prevention of emergence of risk and are often associated with each other factors and removal or reduction of risk factors Factors Associated with Increased Risk of - strengthen host resistance; interrupt the chain Disease of infection - surveillance, quarantine, segregation, A. Predisposing factor – any characteristic of an isolation individual, a community or an environment that predisposes behavior or other conditions related to 2. Secondary Prevention health. - aims to identify and treat existing health problems at the earliest possible time. B. Enabling Factor - any characteristic of an - control or eradication of the health problem individual, group or the environment that facilitates or - screening, case finding, disease surveillance make possible a certain health behavior or other - prompt and appropriate treatment conditions affecting health. C. Reinforcing factor – any reward or punishment 3. Tertiary Prevention or any feedback following or anticipated as a - limits disability progression consequence of health behavior. - the nurse attempts to reduce the magnitude or severity of the residual effects of infectious PRINCIPLES IN EPIDEMIOLOGY diseases and non-infectious diseases. 1. No disease occurs by chance alone because each follows its own recognizable pattern of 4. Concept of Causality and Association occurrence. 2 Premises: 2. Health is a state of equilibrium, a delicate Disease does not occur at random. balance of many factors. Disease has identifiable CAUSAL and 3. Disease causation is complex. PREVENTIVE factors 4. Infection is not synonymous with disease. 5. Knowledge of the distribution of disease a. Cause of a disease overtime is valuable to the nurse in the - any event, condition, characteristic or community. combination of these factors that play an 6. An epidemic curve is merely a graphic display important role in producing the disease. of disease onsets overtime, hours, days or weeks.  COMMUNITY HEALTH NURSING NCM 113A Module 3: Health Statistics and Epidemiology Functions of the Nurse in Epidemiology Endemic 1. Maintain surveillance of the occurrence of - occurrence of disease that implies habitual notifiable diseases. presence of disease in a given geographic 2. Coordinate with other team members during an location outbreak. 3. Participate in case finding and collection of lab Hyperendemic specimen. - occurrence of disease that implies habitual presence of disease in a given geographic 4. Isolate cases of communicable diseases. location 5. Render or supervise nursing care. Sporadic 6. Perform and teach household members methods - disease occur every now and then affecting a of disinfection. small number of people relative to the population 7. Conduct health teachings. 8. Follow-up cases. Pandemic 9. Organize, coordinate, and conduct community - global occurrence of a disease affecting several health education campaign. countries or continent 10. Refer cases when necessary. 11. Coordinate with other concerned community Outbreak agencies. - The occurrence of disease in excess of what 12. Accomplish and keep records and reports and would normally be expected in a defined submit to proper office/agency. community geographical area or season (WHO) - also considered in a previously unknown disease Phases of Epidemiological Approach A. Descriptive Epidemiology Cluster - aims to describe the occurrence of health - refers to an aggregation of cases grouped in conditions in the community in terms of the place in time that are suspected to be greater attributes of the people, pattern of disease and than the number expected characteristics of the place when the disease appeared Determining characteristics of the community - concerned with disease distribution and and population: frequency - Case finding and screening activities 1. Herd Immunity - represents the immunity and susceptibility levels B. Analytical Epidemiology of the population - Attempts to identify the possible factors - occurs when a high percentage of the community associated with disease occurrence. is immune to a disease (through vaccination and/or prior illness), making the spread of this C. Interventional or Experimental Epidemiology disease from person to person unlikely. - aims to test effectiveness of intervention programs designed to prevent and control 2. Exposure or Contact Rate disease utilizing randomized controlled or - represents opportunities for progressive transfer clinical trials and field or community trials. or transmission of an infectious agent to a susceptible host D. Evaluation Epidemiology - depends on the frequency of contact and facility of - attempts to measure effectiveness of different transmission. health services and intervention programs 3. Chance - is the probability of contact between the Levels of Disease Occurrence (Accdg. to CDC) source of infection and the susceptible host Epidemic - occurs when the proportion of susceptible are high compared to the immunes; increase in disease incidence