Epidemiology and the

Nurse
 Epidemiology
• Epi (upon) & Demos (People)
– Descends among the People.
• Branch of Medical Science that deals with
the incidence, distribution, and control of
disease in population (Miriam Medical Dictionary)
• The sum of factors controlling the
presence or absence of disease or
pathogen.
 Other Definition of Epidemiology

- is the “Science which give firstly, a picture of occurrence,

distribution and types of the diseases of mankind its
distinct epochs of time and at various points of earth
surface.” (Hirsch)
- Field of medical science which is concerned with
relationship of the various factors and conditions which
determine the frequencies and distributions of an
infection process, a disease or a physiologic state in
human community. (Maxcy)
- Is the systematic, scientific study of distribution, pattern
and determinants of health, disease and condition
frequencies in population, for the purpose of promoting
wellness and preventive disease conditions. (Dizon, 1979)
 Aspect of Epidemiology
• Epidemiology as Descriptive Science
– It Collect Facts to describe the occurrence and distribution of
disease in population, and orients in terms of that variables of
person, time and place. It seek to analyze the various factors
pertaining to the agent, host and environment and interrelate
such factors into the natural history of disease and this
discover any gaps in the knowledge on the disease and its
control.
• Epidemiology as a Constructive Science
– It does not only describe disease occurrence, but seeks to
explain such occurrence; it does not only present the gaps in
the available knowledge on the disease, but more important it
seeks to construct new knowledge so as to fill in the gaps in
the natural history of the disease.
 The Descriptive & Constructive Aspect of Epidemiology
EPIDEMIOLOGY
Science Concerned with Factors and Condition which determine occurrence
and distribution of health, disease, defect, disability and death in population

Body of Existing Knowledge Method of Gaining new Knowledge

Descriptive – Analytic Epidemiology Constructive Epidemiology
ACTION
Collection of Information for Analysis Epidemiologic Investigations
1. General Factors influencing occurrence and Steps of the Epidemiologic Method
distribution of disease 1.Definition of problem&clarification of objectives
2. Description occurrence & distribution of 2. Critical Appraisal of existing information
disease 3. Formulation of Hypotheses
3. Natural History of Disease Verification of Hypotheses
5. Practical Application

To discover gaps in knowledge by:

1. Searching for causes of disease processes
1. Historical Study of disease occurrence
2. Observing the range, aptitude, and group behavior
2. Community diagnosis of health and disease
or clinical syndromes in population
3. Estimation of rise of morbidity and mortality
3.. Evaluate the effectiveness of preventive program

More Effective Preventive Medicine

 Graphical Explanation of Epidemiology
Epidemiology – Systematic Ultimate Goal: Promote Wellness
Epidemiological Process and prevent disease
Study of Disease and condition occurrence

I. Determine the Nature, Extent and Scope of the Problem

II. Formulate Tentative Hypothesis

III. Collect and Analyze further data to Test Hypothesis

IV. Plan for Control

V. Implementation of Control Plan

VI. Plan for Control

VII. Appropriate Reporting

VIII. Conduct Research

 Comparison of Nursing Process and Epidemiological Process
Nursing Process Epidemiological Process
Assessment - Data Collection to determine I. Determine the Nature, Extent and Scope of
nature of client problems the Problem.
A. Natural life History of Condition
B. Determinants influencing condition
1. Primary data (Essential agent)
a. Parasite/bacterium/virus
b. Nutritional
c. Psychosocial
2. Contributory Patterns
a. Agent
b. Host
c. Environment
C. Contribution Patterns
1. Person
2. Place
3. Time
D. Condition Frequencies
1. Prevalence
2. Incidence
3. Other Biostatistical Measurement
Nursing Process Epidemiological Process

Analyzing – Formulation of Nursing Diagnosis II. Formulate/ Develop tentative hypotheses.

III. Collect and analyze further data to test
hypotheses

Planning IV. Plan for Control

Implementation V. Implement Control Plan

Evaluation VI. Evaluation Control Plan

Revising or Terminating VII. Make Appropriate Report

Research VIII. Conduct Research

I. Determine the Nature, Extent and
Scope of the Problem.

A. Natural life History of Condition

 Person-Place-Time Relationship
Person – who is affected
Place – where is affected
Time – when affected
When monitoring incidence of infectious disease, relative frequency in time
and space are terms as:
Sporadic – There is intermittent occurrence of a few isolated and
unrelated cause in a given locality, seasonal/periodical
Endemic – There is continuous occurrence throughout the period of
time of usual number of cases in a given locality
Epidemic – the occurrence of unusual large number of cases in
relatively short period of time, most interesting for study because
the element of urgency is involved.
Pandemic – there is simultaneous occurrence of epidemics of the
same disease in several countries of international perspective.
Health education on the nature and occurrence of the
communicable disease and on personal hygiene, lessen the
primary care nurse duty.
 Epidemiological Triangle
Host – Agent – Environment Relationships

Agent – Animate or inanimate factor that must be

present or lacking for a disease or condition to
occur.
Host – Living species (human or other animals)
capable of being infected or affected by an agent
Environment – Everything external to a specific
agent and host, including humans and animals.
animals
 HOST

Epidemiological
Triangle

Agent Environment
 Leavell and Clark: Natural History of Disease

• Prepathogenesis – Exposure to
predisposing factor or stimuli which would
cause disequilibrium or disease

• Pathogenesis – host not able to overcome

the stimuli. There are changes in human
and the start of disease process.
 Three Phases of Prevention
1. Primary Prevention – accomplished in the Prepathogenesis
period of the natural history of disease. Design to promote general
optimum health or by specific protection of man against agents or
establishment of barriers against agents in the environment
a. Health Promotion
b. Specific Protection
2. Secondary prevention – it happened as soon as the disease
process is detectable early in pathogenesis.
a. Early Diagnosis and Prompt Treatment
1. Tertiary Prevention – Corrective therapy prevention that
accomplished as the pathogenesis progresses.
a. Disability Limitation
b. Rehabilitation
Natural History of Any Disease Process in Man

Prepathogenesis Period Pathogenesis Period

Before Man is Diseased The Course of the Disease in Man Death

Chronic State
Environment

Disability
Disease Human Discernible
Advanced
disease
Agent Host Early disease Convalescence

Early
Environmental Factors which pathogenesis Recovery
produce disease stimulus

Health Early Diagnosis

Specific
Promotion And Prompt Disability Rehabilitation
Protection
Primary Prevention Treatment Limitation
Secondary Prevention Tertiary Prevention
 Step 1:

Determine the Nature, Extent and

possible significance of the problem
 Step 2: Develop Tentative
hypotheses
A hypotheses defined for this purpose, as a
tentative theory or supposition
provisionally adopted to explain facts and
to guide in further investigation.
Step 3: Collect and Analyze Further
Data to Test Hypotheses
• Identify the group selected for attack by
the disease or problem under
investigation.Individual epidemiological
health histories should be done to classify
person according to their exposure to
suspected or causative agents.
 Step IV: Plan for Control
• When planning for control, it is essential to
identify preventive activities based on the
knowledge of the natural history of the
disease in question, which can be used to
control further spread of disease
occurrence.
 Chain of Infection
Chain of Infection

Transmission
Etiologic Agent Host

Pathogenecity Contact Individual Host Factor

Infection Dose Common Vehicle Non-specific Resistance
Resevoir Airborne Specific Immunity
Source Vector
 Pathogecity
Pathogecity - An ability of agent to cause disease.
(Virulence + Invasiveness)
a. Virulence – Severity of Infection
Virulence = Morbidity
Mortality
b. Invasiveness – Ability of organism to invade tissue.
(Influence by susceptibility of host.)
Infection Dose – No of organism necessary to
cause disease.
Reservoir – were the organism resides,
metabolizes and multiply.

Method of Transmission:
Contact Transmission
Common Vehicle Transmission
Airborne Transmission
Vector borne Transmission
 Duties and Responsibilities of
Epidemiological Nurse
1. Maintains surveillance of the occurrence of notifiable
disease.
2. Coordinates with other members of the health team during
disease outbreak
3. Participates in case findings and collection of laboratory
specimens.
4. Isolate cases of communicable disease
5. Renders nursing care, teaches and supervises giving of
care
6. Perform and teach household members method,
concurrent, and terminal disinfection.
 Duties and Responsibilities of
Epidemiological Nurse
7. Gives health teachings to prevent further
spreads of disease to individual and families.
8. Follow up cases and contacts.
9. Organizes, coordinates and conducts
community health education
campaign/meetings.
10. Refers cases when necessary
11. Coordinates with other concerned community
agencies.
12. Accomplishes and keeps records and reports
and submits to proper office or agency.