流行病学与社区护理课件

单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,流行病学与社区护理,流行病学与社区护理,1,definition,The study of the distribution and determinants of health-related states or events in specified populations, and the application of this study to control of health problems.,流行病学研究在人群中与健康有关状态和事件分布的决定因素，以及应用这些研究以维持和促进健康的问题。,definitionThe study of the dis,2,流行病学与社区护理课件,3,流行病学与社区护理课件,4,流行病学与社区护理课件,5,流行病学与社区护理课件,6,流行病学与社区护理课件,7,流行病学与社区护理课件,8,Significant milestones in the history of epidemiology,1942 - Official of Malarial Control,in War Areas,1946 - Communicable Disease,Center(CDC),1973 - Centers for Disease Control,Now - Centers for Disease Control,and Prevention,Significant milestones in the,9,Significant milestones in the history of epidemiology,1977 World Health Organization,（,WHO,）,Organization,s smallpox eradication campaign succeeds: last known case of smallpox in the world occurs,1990s U.S. Department of Health and Human Services Race and Health Initiative,Significant milestones in the,10,（三）现代发展期（,modern epidemiology,）,20,世纪四、五十年代至今。,主要特点,传染病 疾病和健康,调查分析 定性与定量相结合,宏观与微观相结合,三环节两因素 社会行为因素,分支学科不断涌现，应用越来越广,（三）现代发展期（modern epidemiology）,11,第一阶段,20,世纪,40,年代到,50,年代,创造慢性非传染性疾病的研究方法,Doll,和,Hill,吸烟与肺癌,Framingham,心血管病研究,Cornfield,相对危险度、比值比等,Maentel,和,Haenszel,分层分析法,传染性疾病方面,1954,年 脊髓灰质炎疫苗现场试验,第一阶段 Doll和Hill,12,第二阶段,20,世纪,60,年代到,80,年代,流行病学分析方法长足发展,Sackett 35,种潜在偏倚,Miettien,偏倚分类,Cornfield,第一个多变量模型,Last,第一本流行病学辞典,第二阶段 Sackett,13,第三阶段,20,世纪,90,年代至今,流行病学与其他学科交融,微观上 分子流行病学,宏观上 生态流行病学,随着信息化时代到来,循证医学,循证保健,第三阶段 微观上,14,流行病学研究的内容,描述与解决流行疫区的疾病状态,研究并描述疾病自然史的发展过程,了解地方特有流行病的形态及特殊流行现象的解释,提供公共卫生政策或卫生保健工作的计划设计参考及效果评价,流行病学研究的内容描述与解决流行疫区的疾病状态,15,流行病学研究方法,描述性流行病学研究,分析性流行病学研究,横断研究发,纵贯研究法,实验流行病学研究,理论流行病学研究,流行病学研究方法描述性流行病学研究,16,研究方法,观,察,法,实,验,法,数,理,法,描述流行病学,分析流行病学,横断面调查,监测,生态学研究,病例对照研究,队列研究,实验流行病学,临床试验,现场试验,社区干预项目,理论流行病学,产生假设,检验假设,验证假设,研究方法观实数描述流行病学 分析流行病学 横断面调查病例对照,17,流行病学在社区护理工作中的应用,流行病学在社区护理工作中的应用,18,社区护理的流行病学干预,首要任务：避免有害因素，预防疾病，维持提高健康水平,早期发现病例,促进患者早期接受治疗,提供家庭式的护理服务,预防流行病的发生,社区护理的流行病学干预首要任务：避免有害因素，预防疾病，维持,19,流行病学的基本原理,疾病与健康在人群中分布原理,疾病发病过程,人与环境关系,病因论,病因推断原则,疾病防治原则和策略：三级预防、疾病发展的数学模型等,流行病学的基本原理疾病与健康在人群中分布原理,20,Levels of preventive interventions,Primary prevention,Interventions to reduce the incidence of disease by promoting health and preventing disease process from developing,Secondary prevention,Includes programs designed to detect disease in the early stages, before signs and symptoms are clinically evident, to intervene with early diagnosis and treatment,Tertiary prevention,Provides treatments and other interventions directed toward persons with clinically apparent disease, with the aim of lessening the course of disease, reducing disability, or rehabilitating,Levels of preventive intervent,21,疾病防治原则和策略,一级预防,又称病因预防，主要是疾病尚未发生时针对致病因素（或危险因素）采取措施，也是预防疾病和消灭疾病的根本措施。,二级预防,又称,“,三早,”,预防，即早发现、早诊断、早治疗，是防止或减缓疾病发展采取的措施。,三级预防,又称临床预防。即防止伤残和促进功能恢复，提高生存质量，延长寿命，降低病死率。主要是对症治疗和康复治疗措施。,疾病防治原则和策略 一级预防 二级预防 三级预防,22,Examples related to cardiovascular disease,Primary prevention,Counsel clients about low-fat and regular physical exercise,Secondary prevention,Implement blood pressure and cholesterol screening, give treadmill stress test,Tertiary prevention,Provide cardiac rehabilitation, medication, surgery,Examples related to cardiovas,23,流行病学在社区护理实践中的应用,疾病的预防与健康促进,疾病监测,疾病病因及危险因素的研究,疾病的自然史,疾病预防的效果评价,流行病学在社区护理实践中的应用疾病的预防与健康促进,24,运用生命统计的方法指导社区护理工作,生命统计,vital statistics/biostatistics,是应用统计方法针对人口的生命事件（,vital events,）诸如出生、死亡、疾病、婚姻、平均寿命等作有系统的研究分析，从而发现卫生方面的问题，为制定卫生规划、政策、评价卫生服务状况，改进医疗卫生服务做参考，以减少疾病发生，减少不必要的死亡以及经济损失等。,运用生命统计的方法指导社区护理工作生命统计vital st,25,生命统计内容,出生统计,出生率,一般生育率,死亡统计,死亡率,粗死亡率,婚姻统计,结婚率,离婚率,疾病统计,发病率,流行率,社会增加率和自然增加率,社会增加率,自然增加率,人口密度,平均寿命,生命统计内容出生统计疾病统计,26,Practice application,You are a nurse at a local health department where Rob, a 46-year-old African American, comes for a routine blood pressure check. He mentions that his father recently died from prostate cancer and that he is worried about himself. Further assessment reveals that his father was diagnosed with prostate cancer when he was 52, and rob,s uncle, who is 56 years old, was recently diagnosed with prostate cancer. You know from Rob,s health history that Rob smokes a pack of cigarettes a day and eats fried food frequently.,Practice applicationYou are a,27,Which action would be your best choice?,A. Give Rob a digital rectal examination and prostate-specific antigen (PSA) test immediately to screen for prostate cancer.,B. Do not discuss or provide prostate cancer screening with Rob, because he is under 50 years old.,Which action would be your bes,28,Which action would be your best choice?,C. Advise Rob to be tested immediately for the prostate cancer gene because of his family history.,D. Inform Rob of the risks and benefits of prostate cancer testing, and of his increased personal risk of prostate cancer because of his family history, smoking, and dietary habits. Involve him in the decision-making process about prostate cancer screening.,Which action would be your bes,29,小结,流行病学定义及内涵,社区护理的流行病学干预的内容,三级预防及其主要内容,流行病学在社区护理实践中的应用,小结流行病学定义及内涵,30,结束语,谢谢大家聆听！,31,结束语谢谢大家聆听！31,