Download Epidemiology NUR/408 Abstract Epidemiology is a science that

Epidemiology
NUR/408
Abstract
Epidemiology is a science that speaks of facts regarding various diseases, their nature, and
how they are transmitted from one to another. This helps in developing disease treatments.
The entire process is a long one but it is to ensure accuracy and correctness in detecting the
disease and in its treatment. The process is utilized to study a new type of disease and
when a previous disease is threatening the community again. One common disease
diagnosed on patients who are in their old age is CHF or the congestive heart failure.
Epidemiology is used to analyze the disease’s nature, its causes, and treatment.
Epidemiology
The World Health Organization (WHO) defines epidemiology as the study of the
allocation and determinants of health-oriented countries or events. These events include
diseases and the practical side of epidemiology is focused on how these diseases can be
controlled or prevented. There are different means on how to do an epidemiological search
and these are by surveillance and descriptive researches to evaluate allocation; and
analytical investigations to assess determinants (WHO, 2011).
In simple language, epidemiology is the study of diseases in both humans and
animals with the aim of discovering when, where and how they start. Epidemiology aims to
unlock the hidden facts of disease causing microorganisms and inform people on how they
can prevent themselves from being hosts to these microorganisms. Epidemiology can be
traced back from the time scientists and experts were trying to find a cure for polio and
smallpox (Cornell University, 1993). Before epidemiology was limited to transmissible
diseases but this is no longer true today. Even with the advent of epidemiology, it is still
difficult to find the cause of every type of disease. Epidemiology is limited to showing only
the factors that causes a particular disease but this field of science cannot directly correlate
these factors as actual causes. For instance, with epidemiology, a scientist would state that
those people who are habitual smokers are prone to lung cancer but they never released a
statement that smoking causes cancer (Cornell University, 1993).
Epidemiology includes particular procedures in pinpointing the causes of a definite
disease. Utilizing a proper procedure is essential in arriving at the right solution at the
shortest possible time. The first step would require a research of everything about the
disease, preparation of equipments, and briefing with the investigators. The second step is
to know if the disease has started to spread. The number of infected persons will determine
if there is an alarming rate of transmitted cases. By checking on the census records, the
investigators will be apprised with the disease’s rate of occurrences. After checking on
transmitted cases, the third step is to name the disease. Sometimes, the disease is still
unknown. In such a case, it will be necessary to at least determine its nature. The third
procedure also includes verification on clinical findings and laboratory procedures. The
fourth step is to define and identify the case wherein different sets of criteria are made to
be able to identify specific cases. A census of the possible infected individuals is also
prepared.
The fifth step involves characterizing the disease. In this procedure, it is necessary
that the investigators be accurate with their findings and evaluation. The data will be
summarized not only once but a couple of times to ensure accuracy. The summary will
include details on who has CHF, the length of time that they were infected with it, and
where they reside. The sixth procedure will be the hypothesis on the reason and process of
the spreading disease. The seventh procedure is the verification of the hypothesis to ensure
accuracy. Two methods of verification are available. These are hypothesis and factual
comparisons, and analytic epidemiology. One hypothesis that an investigator can come up
with is this statement: “persons below the age of 35 who experience high blood pressure
are prone to having CHF”. The eighth procedure is to finalize the hypothesis. If further
investigations will be necessary then it would have to be conducted. If analytical hypothesis
proves the hypothesis to be wrong, then, there could be a different means of transmission.
The ninth procedure aimed to promote preventive measures to avoid spreading the
disease. Measures to prevent the disease transmission shall start from the moment that it
was identified. One cannot absolutely escape having congestive heart failure but a lowsodium diet with minimal liquid will help in lowering the risk. The tenth procedure is to
inform the public. The formal means of disseminating information is through a
communication with local health authorities coupled with the hard copy data. The nature of
the disease shall be explained, the manner of transmitting it, and the preventive measures
are the topics that would have to be discussed. The accuracy of the information would be
vital because that would be the same information that the local authorities will let the
public know.
Communicable diseases are transmitted when there is an interaction between the
agents of infection, the host, and the elements of the environment (Stanhope & Lancaster,
2008). Agents are the bacteria, viruses, funguses, and parasites. The host is where these
agents find their home like animals or human. Everything beyond the host is the
environmental elements which aid in transmitting the agents between hosts.
There are two terms used to describe how a communicable disease is transmitted.
One is vertical transmission in which the disease is transmitted from the parent to the
child. Another is horizontal transmission in which the disease is transmitted from one
person to another. Horizontal transmission is effected through sexual intercourse or
through the air. Infection is the term for the growth of the infectious agent inside the host.
Once there is an infection, the host will have a disease. Disease is the term used when the
host displays infection signs.
There are various means through which a communicable disease can spread. There
are infectious agents which are airborne. Some live in bodily fluids, some are transmitted
through physical contact and some through sexual intercourse. Both animals and insects
can be carriers of infectious agents. The epidemiology triangle consists of the host, the
agent and the environment. The center of these three is the time necessary for the agent to
reproduce and transfer from one host to another (Stanhope & Lancaster, 2008).
Congenital heart failure or CHF is a heart disease characterized by an abnormal
cardiac function. The heart is unable to supply oxygen to the blood stream. In case the heart
is able to pump oxygenated blood, still it is not enough to sustain bodily requirements.
Failure of the ventricles to pump blood results to CHF. Causes of CHF are hypertension,
coronary artery disease, and mitral or aortic valvular dysfunction (American Heart
Association, 2010).
Once proven to have CHF, the patient will be subjected to a test where the physician
will determined which among the systolic or diastolic is weak. The treatment will vary
depending on which pressure is weak. There is systolic dysfunction when the ejection
fraction is below 40%. On the other hand, diastolic dysfunction occurs when the left
ventricle fails to fill blood properly due to lack of elasticity (Rasmussen & Renlund, 2006).
Diastolic dysfunction is common on patients experiencing hypertension.
The cure for CHF is both medical and non-medical. Patients who are prone to this
disease must be oriented with the symptoms like shortness of breath, increasing weight,
and incapability to do the usual activities. Patients seldom realize the importance of
medication. Sixty five percent of worsening conditions are due to noncompliance to
physician’s orders (American Heart Association, 2010). The patient shall undergo a no-salt
diet. Fluids are limited as well. Medication includes diuretics, ACE inhibitors, beta-blockers,
digoxin, and aspirin.
Patient with CHF are classed into four. Those whose symptoms are not evident and
act as normal people do belong to Class I. Patients with few symptoms and the heart’s
pumping of blood can still be considered as normal belong to Class II. Patients who are
comfortable while at rest but with little exertion belong to Class III. Those who display
symptoms like fatigue and dyspnea while at rest, belong to Class IV. It is not always
possible to prevent CHF. But those who are Class I patients are advised to use secondary
preventive measures.
Two kinds of epidemiology are the descriptive and the analytical. Descriptive
epidemiology involves gathering of information to arrive at a theoretical conclusion about
the disease. In analytical epidemiology, it is necessary to compare distinct groups to arrive
at points of similarities and differences. In studying CHF, descriptive epidemiology is used.
Discovering the causes of CHF will help in developing the means to cure it. Sodium was
proven to worsen the condition of CHF patients. Patients are advised to have a low sodium
diet.
The three levels of preventive measures for CHF are the primary, secondary, and
tertiary. Primary prevention deals with measures to absolutely prevent the person from
having the disease (Center for Disease Control, 2011). These measures include regular
exercise and maintaining a heart friendly diet.
Secondary prevention is being able to diagnose the disease as early as possible.
These measures are blood pressure and weight monitoring. The purpose of secondary
prevention is to treat the disease in the earliest time.
Tertiary prevention aims to prevent the disease from making further damages to the
body of the patient (Center for Disease Control, 2011). Lasix treatment falls under this
level. It aims to reduce the pain that the patient feels and slow down the disease to prevent
further complications.
Conclusion
Epidemiology may seem to be a complex scientific process with several steps to
follow. But the information that this field can provide is useful to many. Nurses has
information needs to properly perform their duties. CHF patients and caregivers are
benefitted as well. Every problem would require a solution and the solution will reveal
itself once the causes are discovered. The main goal of each individual is to prevent
catching a disease. However, it is a reality that there are no absolute preventive measures.
Treatment and slowing it down are the next possible solutions that medical science
can provide.
References
American Heart Association. (2010). Heart failure. Retrieved from
http://www.heart.org/HEARTORG/Conditions/HeartFailure
Center for Disease Control CDC. (2004). Steps of an Outbreak Investigation. Retrieved from
http://www.cdc.gov/excite/classroom/outbreak/steps.htm.
Center for Disease Control and Prevention. Retrieved June 9, 2011.
http://www.cdc.gov/excite/skincancer/mod13.htm.
Cornell University. (1993). Epidemiology. Retrieved from
http://pmep.cce.cornell.edu/profiles/extonet/TIB/epidemiology.html.
Fletcher, L., & Thomas, D. (2001). Clinical practice. Congestive heart failure: understanding
the pathophysiology and management. Journal of the American Academy of Nurse
Practitioners, 13(6), 249-257. Retrieved from CINAHL Plus with Full Text database.
Rasmusson, K., Hall, J., & Renlund, D. (2006). Heart failure epidemic: boiling to the surface.
Nurse Practitioner, 31(11), 12. Retrieved from CINAHL Plus with Full Text database.
Stanhope, M., & Lancaster, J. (2008). Public health nursing: Population-centered health care
in
the community (7th ed.). St. Louis: Mosby Elsevier.
World Health Organization. (2011). Health Topics: Epidemiology. Retrieved from
http://www.who.int/topics/epidemiology/en.