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Community Assessment

Community Assessment
  • Status
  • Structure
  • Process

Types of Community Assessment
1. Community Diagnosis
  • A process by which the nurse collects data about the community in order to identify factors which may influence the deaths and illnesses of the population, to formulate a community health nursing diagnosis and develop and implement community health nursing interventions and strategies.
2 Types:

Comprehensive Community Diagnosis  Problem-Oriented Community Diagnosis
  • aims to obtain general information about the community
  • type of assessment responds to a particular need

    Steps:

    Preparatory Phase
  1. site selection
  2. preparation of the community
  3. statement of the objectives
  4. determine the data to be collected
  5. identify methods and instruments for data collection
  6. finalize sampling design and methods
  7. make a timetable
    Implementation Phase
  1. data collection
  2. data organization/collation
  3. data presentation
  4. data analysis
  5. identification of health problems
  6. prioritization of health problems
  7. development of a health plan
  8. validation and feedback
    Evaluation Phase

Biostatistics
  • DEMOGRAPHY ­- study of population size, composition and spatial distribution as affected by births, deaths and migration.
  • Sources: Census – complete enumeration of the population
2 Ways of Assigning People
  1. De Jure - People were assigned to the place where assigned to the place they usually live regardless of where they are at the time of census.
  2. De Facto - People were assigned to the place where they are physically present at are at the time of census regardless, of their usual place of residence.
Components
  1. Population size
  2. Population composition
    • Age Distribution
    • Sex Ratio
    • Population Pyramid
    • Median age - age below which 50% of the population falls and above which 50% of the population falls. The lower the median age, the younger the population (high fertility, high death rates).
    • Age – Dependency Ratio - used as an index of age-induced economic drain on human resources
    • Other characteristics:
      • occupational groups
      • economic groups
      • educational attainment
      • ethnic group
  3. Population Distribution
    • Urban-Rural - shows the proportion of people living in urban compared to the rural areas
    • Crowding Index - indicates the ease by which a communicable disease can be transmitted from 1 host to another susceptible host.
    • Population Density - determines congestion of the place

Vital Statistics
  • The application of statistical measures to vital events (births, deaths and common illnesses) that is utilized to gauge the levels of health, illness and health services of a community.
Types of Vital Statistics

Fertility Rate

    1. Crude Birth Rate

        Total # of livebirths in a given calendar year                         X 1000  Estimated population as of July 1 of the same given year

    2. General Fertility Rate

        Total # of livebirths in a given calendar year                     X 1000                  Total number of reproductive age

Mortality Rate
    1. Crude Death Rate

       _Total # of death in a given calendar year_                        X 1000   Estimated population as of July 1 of the same calendar year

    2. Infant Mortality Rate
       Total # of death below 1 yr in a given calendar year             X 1000
      
Estimated population as of July 1 of the same calendar year

    3. Maternal Mortality Rate
        
        Total # of death among all maternal cases in a given calendar year         X 1000
              Estimated population as of July 1 of the same calendar year

Morbidity Rate
1. Prevalence Rate

        Total # of new & old cases in a given calendar year                     X 100
    
Estimated population as of July 1 of the same calendar year

2. Incidence Rate

        Total # of new cases in a given calendar year_                            X 100      Estimated population as of July 1 of the same calendar year

3. Attack Rate
        Total # of person who are exposed to the disease                        X 100
    Estimated population as of July 1 of the same calendar year


Epidemiology
  • the study of distribution of disease or physiologic condition among human population s and the factors affecting such distribution
  • the study of the occurrence and distribution of health conditions such as disease, death, deformities or disabilities on human populations
1. Patterns of disease occurrence
    Epidemic
  • A situation when there is a high incidence of new cases of a specific disease in excess of the expected.
  • when the proportion of the susceptible are high compared to the proportion of the immunes
    Epidemic potential
  • an area becomes vulnerable to a disease upsurge due to causal factors such as climatic changes, ecologic changes, or socio-economic changes
    Endemic
  • habitual presence of a disease in a given geographic location accounting for the low number of both immunes and susceptibles.E.g. Malaria is a disease endemic at Palawan. 
  • The causative factor of the disease is constantly available or present to the area.
    Sporadic
  • disease occurs every now and then affecting only a small number of people relative to the total population
  • intermittent
    Pandemic
  • global occurrence of a disease
    Steps in Epidemiological Investigation:
  1. Establish fact of presence of epidemic
  2. Establish time and space relationship of the disease
  3. Relate to characteristics of the group in the community
  4. Correlate all data obtained
2. Role of the Nurse
  • Case Finding
  • Health Teaching
  • Counseling
  • Follow up visit

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