PH Exam 1

What are the goals and services of governmental public health agencies?

\-Prevent epidemics and spread of disease

\-Protect against environmental hazards

\-Prevent injuries

\-Promote and encourage healthy behaviors

\-Respond to disasters and assist communities in recovery

\-Ensure quality and accessibility of health services

What are the 10 essentials of public health practice?

\-monitor health

\-diagnose and investigate

\-inform, educate, empower

\-mobilize community partnerships

\-develop policies

\-enforce laws

\-link to/provide care

\-assure competent workforce

\-evaluate

What are the 3 core functions of public health practice?

\-assurance

\-assessment

\-policy development

What is the vision of public health in America?

healthy people in healthy communities

What is the mission of public health in america?

\-promote physical and mental health

\-prevent disease, injury, and disability

What are the public health core functions?

\-assessment

\-policy development

\-assurance

What is the assessment core function?

obtaining data that defines overall health of a population, and the groups within that population

What is the assurance core function?

Governmental PH’s oversight of effective health system. Including healthcare, and public health, even though the work itself, might be delegated 

What is the policy development core function?

Developing EBP recommendations and policy analysis to guide implementation and efforts to educate and mobilize community partnerships​

What are the aspects of the assessment core function?

\-monitor health status to identify and solve community health problems

\-diagnose and investigate health problems and hazards in the community

What are the aspects of the policy development core function?

\-inform, educate, and empower people about health issues

\-mobilize community partnerships to identify and solve health problems

\-develop policies and plans that support individual and community health

What are the aspects of the assurance core functions?

\-enforce laws and regulations that protect health and ensure safety

\-link people to needed personal health services and ensure provision of care when otherwise unavailable

\-ensure the provision of a competent public and personal healthcare workforce

\-evaluate effectiveness, accessibility, and quality of personal and population based services

\-research for new insights and solutions

What does monitoring health status to identify and solve community health problems essentially mean?

\-accurate diagnosis of the community’s health status​

\-identification of threats to health​

\-assessment of health service needs​

\-timely collection, analysis, and publication of information on access, utilization, costs, and outcomes of personal health services​

\-attention to the vital statistics and health status disparite groups​

\-collaboration to manage integrated information systems with private providers and health benefit plans

What does diagnose and investigate health problems and azards in the community essentially mean?

Basically case finding, identifying emerging health threats, and also rapid on-site screenings to identify cases of infectious disease in “nontraditional” healthcare settings

What does inform, educate, and empower people about health issues essentially mean?

\-Media communications and social marketing to “sell” healthy behaviors​

\-Tobacco cessation programs​

\-“This is your brain, this is your brain on drugs…”

What does mobilize community partnerships to identify and solve health problems essentially mean?

Convening and facilitating groups and associations to work toward a common goal

What does develop policies and plans that support individual and community health essentially mean?

leadership development at all levels of public health, community and state-level planning for health improvement, development of codes and regulations​

What does enforce laws and regulations that protect health and ensure safety essentially mean?

Full enforcement of sanitary codes, full protection of drinking water supply, timely follow-up of hazards, exposures, and timely review of new drug and biological applications

What does link people to needed personal health services and ensure provision of care when otherwise unavailable essentially mean?

Making sure there is a coordinated system of care for folks who otherwise wouldn’t have it

What does ensure the provision of a competent public and personal healthcare workforce essentially mean?

education and training for personnel, efficient licensure processes with regular verification and inspection, and adoption of quality improvement plans​

What does evaluate effectiveness, accessibility, and quality of personal and population based services essentially mean?

ongoing evaluation of health programs, based on analysis of health status and service utilization data

What are the benefits of public health practice?

\-dramatic increase in life expectancy

\-improved sanitation and control of infectious diseases

\-population based prevention programs

\-potential to prevent 70% of early deaths in US

\-enormous impact despite limited funding

What is public health nursing?

\-practice of promoting and protecting the health of populations using knowledge from nursing, social, and public health sciences​

\-population focused practice that emphasizes the promotion of health, the prevention of disease and disability, and the creation of conditions in which all people can be healthy.​

What is the definition of population/aggregate?

collection of individuals who have one or more personal or environmental characteristics in common

What is population focused practice?

\-Diagnoses, interventions, and treatments are carried out for population or subpopulation​

\-Population-level decision making is different​

\-Concerned with more than one subpopulation

What is individual focused practice?

Diagnoses, interventions, and treatments are carried out at individual client level

What are social determinants of health (SDOH)?

social conditions in which people live and work

What is patient/client centered care?

\-Patients and their families are integral to the healthcare team​

\-Monitoring health is the client’s responsibility

What are the two models of local?

home rule and local autonomy

What is the barriers to specializing in PHN?

\-Changing mindset that nursing is only at bedside​

\-Work structure and role socialization​

\-Few nurses receive graduate-level preparation in PHN concepts and strategies

What is epidemiology?

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

What is endemic?

The usual prevalence of a specific disease or infectious agent within a population

What is epidemic?

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

What is pandemic?

a worldwide epidemic

What is rates?

the primary measurement used to describe either the occurrence or the existence of a specific state of health or illness

What are common source outbreaks?

Characterized by exposure to a common, harmful substance (cholera at the water fountain)

What are propagated outbreaks?

Direct or indirect transmission of an infectious agent from an infected person to a susceptible host​ (influenza)

What is incubation?

Point where disease is “cooking.” Infectious, but not symptomatic

What is prodromal?

Sx, but not full blown illness “coming down with . . .”​

What are the aspects in the epidemiologic triangle?

\-host

\-agent

\-environment

_____ indices of the health of a community, region, or country include comparisons of general mortality rates and maternal infant rates.

rates

How do you calculate rates?

\# Events/Population at risk   X  base multiple of 10

What is adjusted rate?

statistical procedure that removes the effects of differences in the composition of a population, such as age, when comparing one with another

What is crude rate?

measurement of the occurrence of the health problem or condition being investigated in the entire population

What is incidence rate (number of new cases)?

measure of the probability that people without a certain condition will develop that condition over a period of time

What is prevalence rate (number of cases total)?

measures the number of people in a given population who have an existing condition at a given point in time​

What are the different factors that affect our definitions of health?

\-age

\-our expectations of self

\-sociocultural influences

\-previous experiences with health or disease

What is health?

a quality, an ability to adapt to change, or a resource to help cope with challenges and processes of daily living

What is well being?

a subjective perception of full functional ability as a human being

What are the Healthy People’s initiatives?

\-to increase quality and years of healthy life

\-to eliminate any barriers to accessing care, specifically through health disparities

What are the levels of prevention?

\-primary

\-secondary

\-tertiary

What is primary prevention?

maximizing health and wellness through strategies that are set in place before illness or injury is present

What is secondary prevention?

maximizing health and wellness through stragies that are set in place at the early and active chronic stages of pathogenesis of illness and injury

What is tertiary prevention?

maximizing health and wellness through strategies that are set in place at the palliation and end stage of disease and injury trajectories

What is promotion?

behavior that helps patients maintain or enhance their present level of health, increase well-being and actualize human health potential

What is screening?

presumptive identification of an unrecognized disease through tests, examinations, or other procedures which can be applied rapidly

What do screening tests do?

sort out apparently well persons who probably have a disease from those who probably do not

What is the importance of screening?

\-early detection

\-the human body is continually changing

Why is early detection important?

\-leads to early treatment

\-can lead to a decrease in morbidity and mortality

\-can break the chain of transmission and development of new cases

\-is often cost effective

_____ identifies asymptomatic people who may have a disease.

screening tests

_____ determines presence or absence of disease when patient shows signs or symptoms.

diagnostic tests

What are the characteristics of a good screening test?

simple, rapid, inexpensive, safe, available, acceptable

What does an assessment include?

\-family history

\-environmental factors

\-physical findings

\-knowledge and questions

What should a family history include?

*-*At least 3 generations​

\-Health status, medical Dx, age at Dx​

\-Age at and cause of death​

\-Pregnancy outcomes​

What are some red flags that can show up in a family history assessment?

\-stillbirths, miscarriages

\-common adult conditions at young ages

What are the parts of the planning stage?

\-review assessment and information needs

\-nursing diagnosis

What are nursing diagnoses for health promotion?

\-Readiness for enhanced self health management​

\-Ineffective health maintenance​

\-Ineffective self health management

What are the parts of the intervention stages?

\-patient education

\-genetic testing

\-genetic counseling referral if indicated

What do you do during patient education?

\-discuss risks

\-discuss factors that can be modified

What does genetic counseling aim to do?

\-Increase family’s understanding of a genetic condition​

\-Discuss options regarding disease management and further testing​

\-Help individual and family identify resources to cope with potential outcomes​

\-Reduce family’s anxiety​

\-Assists the health care provider who is often not trained in how to interpret family history/genetic testing​

What is the health belief model?

\-Developed to explain why some people who are free of disease would adopt actions to prevent illness, while others fail to do so

\-Model developed at a time when screenings were becoming readily available, and yet people would refuse to do them

What is the self efficacy and social cognitive theory?

\-Personal factors, the environment in which behavior is formed, and the behaviors themselves interact

\-Basically, self-efficacy, the belief that one has the ability to change one’s health habits greatly impact a person’s ability to adopt a behavior​

\-The greater the self-efficacy, the more likely a new behavior

What is the health promotion model?

a motivational source for change based on individual’s subjective value of the change

What is intrinsic benefits?

affects sustainability

What is extrinsic benefits?

more important initially

What are percieved barriers to health action?

\-Arouse motives of avoidance​

\-Serve as blocks to action​

\-Decrease commitment to plan of action

What is perceived self efficacy?

conviction person has that they can successfully carry out actions necessary​

What are the four sources of percieved self efficacy?

\-enactive mastery experiences- doing thing in the past​

\-vicarious experiences- seeing others do it​

\-verbal persuasion- encouragement​

\-physiologic and affective states​

What is situational influences?

\-Perception of available options​

\-Demand characteristics​

\-Aesthetic features of environment

What are interpersonal influences?

\-Expectation of significant others​

\-Individuals likely to undertake behavior that is socially reinforced

What is commitment to a plan of action?

\-Propels the individual into action unless a competing demand or preference interferes​

\-Intention to implement and a strategy for carrying it out​

Competing _____ is when individual has little control.

demands

Competing _____ is when individual has high degree of control.

preferences

What are some positive health outcomes?

\-improved health​

\-enhanced functional ability​

\-better quality of life

What are the stages of the behavior change model?

\-pre contemplation

\-contemplation

\-preparation

\-action

\-maintenance

\-relapse

What is the pre contemplation stage?

no intention on changing behavior

What is the contemplation stage?

aware a problem exists but with no commitment to action

What is the preparation stage?

intent on taking action to address the problem

What is the action stage?

active modification of behavior

What is the maintenance stage?

sustained change; new behavior replaces old

What is the relapse stage?

fall back into old patterns of behavior

What should you do to help in the maintenance stage?

\-Behavior must be sustained to promote wellness​

\-Assist patient in creating an environment that lends to habit forming (specific times/days, specific locations for eating, etc)​

\-Continue to check in with client long after goal is met.  (ex: ask about smoking every visit)

What is the ecological model?

\-Belief that all processes occurring within individual people and their environment should be viewed as interdependent​

\-Emphasize the unique developmental nature of variables that influence behaviors​

\-Use a multilayered understanding of influence on behaviors​

\-Test variables from each of the identified systems in the model to guide the assessment, development, implementation, and evaluation of targeted interventions

What is ontogenic system?

personal factors

What is microsystem?

relationship between women and environment

What is exosystem?

formal and informal social structures

What is macroculture?

values and beliefs of culture

What is the American Association of Occupational Health Nurses?

professional association of nurses working in a business setting, dedicated to the health and safety of workers, worker populations, and community groups

What is the National Institute of Occupational Safety and Health (NIOSH)?

the federal agency established to help ensure safe and healthy working conditions by conducting scientific research, gathering information, and providing education and training in occupational safety and health​

What is the Occupational Safety and Health Administration (OSHA)?

The federal agency that sets exposure standards and is responsible for enforcement of safety and health legislation​