Nursing 109

N109: Foundations in Nursing Practice Study Guide

7.6 Epidemiology and Comm icable Disease Epidemiology is the branch of medicine that deals with the study of the causes, distribution, and control of disease in populations. Various methods can be used to carry out epidemiological investigations, including surveillance and descriptive studies that can be used to study distribution, and analytical studies that are used to study determinants. Epidemiologists attempt to determine what factors are associated with diseases (risk factors), and what factors may protect people or animals against disease (protective factors). The science of epidemiology was first developed to discover and understand possible causes of contagious diseases like smallpox, typhoid, and polio among humans. It has expanded to include the study of factors associated with non-transmissible diseases, like cancer, and of poisonings caused by environmental agents. The strength of an epidemiological study depends on the number of cases and controls included in the study. The more individual cases that are included in the study, the more likely it is that a significant association will be found between the disease and a risk factor. Just as important is determining what behavioral, environmental, and health factors will actually be studied as possible risk or protective factors. If inappropriate factors are chosen, and the real factors are missed, the study will not provide any useful information. Communicable diseases are illnesses caused by microorganisms and transmitted from an infected person or animal to another person or animal. Endemic refers to the usual number of cases of a specific disease within an area or population. When the number of new cases of a communicable disease exceeds what is normally expected, it is termed an epidemic. When the epidemic becomes a worldwide problem, it is called a pandemic. The mortality rate is the number of deaths from all causes (or a specific disease) in a given population during a specific period of time. In contrast, the morbidity rate refers to the incidence of a disease ina population during a specified period of time, as in the number of people sick with a disease. 7.7 Factors Influencing Health in the Community Genetics In communities where there is a large population from specific ethnic groups, the nurse must be aware of the possibility of certain genetically acquired diseases. For example, in large populations from the Middle East, the astute nurse will be aware that thalassemia and hypertension are common in this group. The nurse must evaluate all individuals for genetic history that might predispose them to certain conditions or diseases. Gender Since women tend to outlive their spouses, they are often at increased risk for poor health outcomes, particularly if they are economically disadvantaged. Women of childbearing age are also at increased risk if they are poor because they are less likely to receive care before, during, and after pregnancy. Women in a community are often the primary caregivers. The community nurse should be aware of this role and should use this information to find formal and informal leaders in the community.

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