Tools Used in Community Diagnosis

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TOOLS USED IN COMMUNITYDIAGNOSIS

Cristina G. Juan


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Tools in Community Diagnosis

1.DEMOGRAPHY

- The study of the characteristics of human populations size, composition and

distribution in space.

-helps the nurse find reasons or rationale why or how a particular population or group

is influenced by a variety of factors resulting in vulnerability to diseases.SOURCES OF DEMOGRAPHIC DATA

Census official and periodic enumeration of population.

Two ways of assigning people when the census is being taken

a. de jure method done when people are assigned to the place where they usually

live regardless of where they are at the time of the census.

b. de facto method people are assigned to the place where they are physically

present at the time of the census regardless of their usual place of residence.

Sample survey

Registration system


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Components of Demography

POPULATION SIZE number of people in a given place at a giventime

Method of Measuring Population Size Determine increase in the popu lation resulting from excess of

birth compared to deaths.

Nutural increase = Number of births Number of deaths

(specified year) (specified year) (specified year)

Rate of Natural Increase = Crude Birth Rate Crude Death Rate

(specified year) (specified year) (specifiedyear)


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a. Determine the increase in the population using data obtained during two census periods.

Absolute increase per year measures the number of people that are added to the population peryear.

Absolute per year = Pt Po

T

where : Pt = population size at the later time

Po = population size at an earlier time

t = number of years between time o and time t

Relative increase is the actual difference between the two census counts expressed in percentrelative to the population size made during an earlier census.

Relative increase = Pt - Po

Po

where: Pt = population size at a later time

Po = population size at an earlier time


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2.POPULATION COMPOSITION described interms of its age and sex.

a. Sex Composition the sex ratio compares the

number of males to the number of femalesin the population.

Sex Ratio = number of males

Number of females

The sex ratio represents the number of malesfor every 100 female in the population.


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b. Age Composition population into two equal parts.

1. Median age

2. Dependency Ratio compares the number ofeconomically dependent (0-14 and 65 and above age

groups) with the economically productive group ( within15-64 age group) in the population. The dependency ratiorepresents the number of economically dependent forevery 100 economically productive.

c. Age and Sex Composition

- Can be described at the same time using a populationpyramid. It is a graphical

presentation of the age and sex composition of thepopulation.


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POPULATION DISTRIBUTION

Urban-Rural Distribution - illustrates the proportion of thepeople living in urban compared to the rural areas.

Crowding Index described by dividing the number of

persons in a household with the number of rooms used bythe for sleeping.

Population Density will determine how congested a placeis and has implications in terms of adequacy of basic healthservices present in the community.

Divide the number of people living in a given land area.


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2. VITAL STATISTICS

- are the information maintained by a

government, recording the birth and death ofindividuals within that government'sjurisdiction. These data are used by publichealth programs to evaluate how effective

their programs are.

- use to determine health status
http://en.wikipedia.org/wiki/Governmenthttp://en.wikipedia.org/wiki/Childbirthhttp://en.wikipedia.org/wiki/Deathhttp://en.wikipedia.org/wiki/Jurisdictionhttp://en.wikipedia.org/wiki/Public_healthhttp://en.wikipedia.org/wiki/Public_healthhttp://en.wikipedia.org/wiki/Public_healthhttp://en.wikipedia.org/wiki/Public_healthhttp://en.wikipedia.org/wiki/Jurisdictionhttp://en.wikipedia.org/wiki/Deathhttp://en.wikipedia.org/wiki/Childbirthhttp://en.wikipedia.org/wiki/Government


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3. EPIDEMIOLOGY

- the study of the occurrence and distribution ofhealth conditions such as disease, death,

deformities or disabilities on human populations.- also concerned with the study of probablefactors that influence the development of thesehealth conditions.

-used to analyze the different factors thatcontribute to disease development.


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USES OF EPIDEMIOLOGY (Morris

1. Study the history of the health population and the rise and fall ofdisease and changes n their character.

2. Diagnose the health of the community and the condition of people tomeasure the distribution and dimension of illness in terms of

incidence, prevalence, disability and mortality, to set healthproblems in perspective and to define their relative importance andto identify groups needing special attention.

3. Study the work of health services with a view of improving them.

4. Estimate the risk of disease, accident, defects and the chances ofavoiding them.

5. Identify syndromes by describing the distribution and association ofclinical phenomena in the population.

6. Complete the clinical picture of chronic disease and describe theirnatural history.

7. Search for cause of health and disease by comparing the experience

of groups that are clearly defined by their composition,inheritance, experience, behaviour and environments.


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EPIDEMIOLOGIC CONCEPTS AND

PRINCIPLES1. Multiple Causation Theory/Ecologic Concept of Disease- Disease development does not rest on a single cause

- Health condition results from a multitude of factors

2. Levels of prevention of health Problems

Models of Multiple Causation Theory

Wheel

Web Ecologic Triad (most helpful to the nurse)


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ENVIRONMENT

-sum total of all external

conditions and influences:

Physical, Biological,

Socio-economi

AGENT

-Any element, substance or

force, animate or inanimate,

presence or absence of

which may serve as stimulus

to initiate/ perpetuate a disease

process.

HOST

-any organism that harbors andnourishes another organism

-characteristics of host will affect

its susceptibility or resistance

The Ecologic Triad


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Web of Causation


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Wheels of Causation


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Disease factors in singular or plural (necessaryand/or sufficient) are required for diseaseoccurrence.

If "A" is "necessary", then disease will not occurwithout it, but "A" may require other factors tobe sufficient (example: TB). Several factorstogether may be sufficient for disease but no onefactor may be necessary in itself (example: CHD);

several sufficient wheels may exist for a disease. Wheel of causation illustrates how disease may

occur through the interplay of several causalfactors without any being necessary in itself.

TB again: One sufficient wheel might include: contact with a carrier low immunity and crowding; another wheel might include contact with a carri


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Wheel of Causation

TB again: One sufficient wheel might include:contact with a carrier, low immunity, andcrowding; another wheel might includecontact with a carrier, having AIDS, poorhygiene. Both wheels are sufficient toproduce disease, but factors differ. But for

TB, both wheels must have the TB organism,is a necessary factor for TB to occur.

TB again: One sufficient wheel might include: contact with a carrier, low immunity, and crowding; another wheel might include contact with a carri


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The three elements of the triad interact withone another in an attempt to maintain anequilibrium.

Any major change in any one of the factorsmay bring about a disturbance in theequilibrium provoking the appearance of a

health problem.


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LEVELS OF PREVENTION OF HEALTHPROBLEMS

Promoting health and preventing health problems

make up most of the nurses activity in thecommunity.

Prevention refers to identification of potentialproblems and further eradication orminimization of disability in a population-at-risk

to a NEGATIVE EXPOSURE FACTOR.


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PRIMARY PREVENTION

Directed to the healthy population.

Prevention of emergence of risk factors

Interventions before agent enters host .

Aims to strengthen host resistance,inactivate the agent, interrupt the chain.

Health Promotion activities: provision ofproper nutrition, safe water supply and wastedisposal system.


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SECONDARY PREVENTION

Aims to identify and treat existing health

problems at the earliest possible time. Interventions: screening, case finding,

disease surveillance, promt and appropriatetreatment.

Disease Prevention: health teaching on riskfactors and risk behaviours that contribute todevelopment of disease.


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TERTIARY PREVENTION

Limits disability progression

Nurse attempts to reduce magnitude orseverity of the residual effects.


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In explaining the interrelationship of factors that bring aboutcommunity health problems, epidemiological approach is being used,specifically DESCRIPTIVE EPIDEMIOLOGY.

DESCRIPTIVE EPIDEMIOLOGY

Aims to describe the occurrence of health conditions in the communityin terms of person, place and time characteristics.

Various existing patterns s aspects involved in descriptive epidemiologyinclude:

1. Observation and recording of existing patterns of occurrence of healthconditions.

2. Description of the condition as to person, place and timecharacteristics.

3. Analysis of the general pattern of occurrence.

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Tools Used in Community Diagnosis

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