NR-503 Epidemiology Final Exam Questions and Answers

Kleinman explanatory Model - Eliciting the patient's (explanatory) model gives the physician knowledge of the beliefs the patient holds about his illness, the personal and social meaning he attaches to his disorder, his expectations about what will happen to him and what the doctor will do, and his own therapeutic goals Cultural competence - Cultural competence is defined as "a dynamic, fluid, continuous process whereby an individual, system or health care agency find meaningful and useful care delivery strategies based on knowledge of the cultural heritage, beliefs, attitudes, and behavior of those to whom they render care" Cultural Awareness - :Self-examination of one's own prejudices and biases toward other cultures. An in-depth exploration of one's own cultural/ethnic background. Cultural humility - A lifelong commitment to self-evaluation and self-critiques, redressing the power of imbalances in the patient- physician dynamic, developing mutually. Beneficial relationships. Cultural Knowledge - Obtaining a sound educational foundation concerning the various worldviews of differences cultures. Obtaining knowledge regarding biological variations, disease and health conditions and variation in drug metabolism. Cultural Skill: - Ability to collect culturally relevant data regarding the client's health history and presenting problem. Ability to conduct culturally based physician assessments. Conducting these assessments in a culturally sensitive manner. Cultural Desire - Motivation of the healthcare provider to "want" to engage in the process of cultural competence, characteristics of compassion, authenticity, humility, openness, availability, and flexibility, commi tment and passion to caring, regardless of conflict. ethnicity - as "the aggregate of cultural practices, social influences, religious pursuits, and racial characteristics shaping the distinctive identity of community" Cultural competence in nursing consists of four principles. - Care is designed for the specific client. Care is based on the uniqueness of the person's culture and includes cultural norms and values. Care includes self-employment strategies to facilitate client decision making to improve health behaviors. Care is provided with sensitivity and is based on the cultural uniqueness of clients. NR-503 Epidemiology Final Exam Questions and Answers The APN may also use the Kleinman Explanatory Model of Illness (1978). Below are the questions that can be utilized. - What do you call your problem? What do you think caused your problem? Why do you think it started when it did? What does your sickness do to you? What do you fear most about your sickness? What are the chief problems your sickness has caused you? What kind of treatment do you think you should receive? What is the most important result you hope to receive from the treatment? According to Giger and Davidhizer (2000), although cultures differ, they all have the same basic organizing factors that must be assessed in order to provide care for culturally diverse patients. These factors include - communication (verbal and nonverbal); personal space; social organization; time perception; environmental control; and biological variations. The National Center for Cultural Competence (NCCC) provides national leadership and contributes to the body of knowledge on cultural and linguistic competency within systems and organizations. Major emphasis is placed on translating evidence into policy and practice for programs and personnel concerned with health and mental healthcare delivery, administration, education, and advocacy. - The NCCC uses four major approaches to fulfill its mission, including - Web-based technical assistance, (2) knowledge development and dissemination, (3) supporting a community of learners, and (4) collaboration and partnerships with diverse groups. These approaches entail the provision of training, technical assistance, and consultation and are intended to facilitate networking, linkages, and information exchange. The NCCC has particular expertise in developing instruments and conducting organizational self-assessment processes to advance cultural and linguistic competency. - Epidemiological Triad: - host, agent, environment Genetics is considered an agent in the epidemiological triad - Genetics - The study of individual genes and their impact on relatively rare single gene disorders Genomics - The study of all genes in the human genome as well as their interaction with other genes, the individual's environment, and the influence of cultural and psychosocial factors Genetic epidemiology - the link of epidemiology and genetics Absolute risk - is the probability of an event, such as illness, injury, or death Absolute risk - gives no indication of how its magnitude compares with others. The odds ratio - closely approximates the relative risk if the disease is rare. Odds ratio and the relative risk are used - to assess the strength of association between risk factor and outcome. Attrubutible risk - is used to make risk-based decisions for individuals. Population-attributable risk measures - are used to form public health decisions EGAPP: - Evaluation of Genomic Applications in Practice and Prevention GAPPNet - Genomic Applications in Practice and Prevention Network (established in 2009) is a collaborative initiative involving partners from across the public health sector working together to realize the promise of genomics in health care and disease prevention. GEDDI - Genetics Early Disease Detection Intervention project (GEDDI) (established in 2009) developed a model strategy for using clinical, genetic, and family history information to reduce the risk of disease, death, and disability in affected individuals, family members, and populations. HuGENet - Human Genome Epidemiology Network (HuGENet) (established in 1998) helps translate genetic research findings into opportunities for preventive medicines and public health by advancing the synthesis, interpretation, and dissemination of population-based data on human genetic variation in health and disease. HuGENet reviews are systematic, peer-reviewed synopses of the epidemiologic aspects of human genes, including prevalence of allelic variants in different populations, population-based information on disease risk, evidence for gene-environment interaction and quantitative data on genetic tests and services carried out according to specific guidelines. NHANES III - DC's Office of Public Health Genomics (established in 2002) formed a multidisciplinary working group with members from across CDC. It developed a proposal to measure the prevalence of selected genetic variants of public health significance in a representative sample of the U.S. population and to examine the association between the selected genetic variants and disease outcomes available in NHANES III data. The World Health Organization defines a pandemic - as a global epidemic that spreads to more than one continent (WHO, 2009). One of the more recent pandemics that you might be familiar with is the H1N1 influenza outbreak of 2009. Outbreak - the occurrence of disease within persons in excess of what would normally be expected in a clearly defined community, location, or time of year. An outbreak may only last for a matter of days or weeks, but may last for years Quarantine - the separation and restriction of the movement of people who were or are exposed to a contagious disease for a set period of time, to see whether they become ill Isolation - the separation of sick people with a contagious disease from those who are not ill Disaster epidemiology - "Disaster epidemiology is defined as the use of epidemiology to assess the short- and long-term adverse health effects of disasters and to predict consequences of future disasters. It brings together various topic areas of epidemiology including acute and communicable disease, environmental health, occupational health, chronic disease, injury, mental health, and behavioral health" Antigenic drift - is a term describing the changes that occur within virus's ribonucleic acid that changes the virus. Typically, these changes create seasonal changes or new strains of a virus WHO Pandemic Phases - Phase 1—None of the current viruses circulating in animals have been reported to cause infection in humans. Phase 2—An animal-based influenza virus is known to have caused infection in humans and is considered a potential pandemic threat. Phase 3—An animal- or human-animal-based virus has caused some clusters of cases in people, but has not caused human-to-human transmission that is significant enough to cause community-level outbreaks. Phase 4—Human-to-human transmission of an animal or human-animal virus is causing community outbreaks and sustained disease. This is a significant shift in risk and any country with such an outbreak should consult with WHO. Phase 5—There is human-to-human spread of the virus in at least two countries. This phase means that pandemic is imminent and that community action and implementation of planned mitigation procedures is needed. Phase 6—This is the pandemic phase, characterized by outbreaks in more than one WHO defined region in addition to all Phase 5 criteria (WHO, 2009) Phase 1 - None of the current viruses circulating in animals have been reported to cause infection in humans. Phase 2 - An animal-based influenza virus is known to have caused infection in humans and is considered a potential pandemic threat. Phase 3 - An animal- or human-animal-based virus has caused some clusters of cases in people, but has not caused human-to-human transmission that is significant enough to cause community-level outbreaks.