NSG-604 Chronic Disease Epidemiology Assignment Paper

NSG-604 Chronic Disease Epidemiology Assignment Paper

NSG-604 Chronic Disease Epidemiology Assignment Sample Paper

Chronic diseases such as diabetes have huge disease burden to the affected patients and their significant others. The impacts include loss of lives, productivity, decline in the quality of life, and increased are costs. Nurses, including DNP-prepared nurses are centrally placed in healthcare to assist the affected by chronic diseases overcome them. Accordingly, they explore evidence-based interventions that are associated with enhanced outcomes such as safety, quality, and efficiency. Care interventions such as interprofessional collaboration enable the adoption of patient-centered practices in the care process. Therefore, the purpose of this research paper is to explore the issue of diabetes mellitus and the application of health belief model in its management. The topics of focus include a description of the health belief model, analysis of diabetes mellitus, patient population that the model will be applied, application of the concepts of the model, and use of the model by a DNP-prepared nurse to improve quality of care.

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Health Belief Model

Health belief model is a common theory utilized in nursing practice to influence behavioral change. The model was developed in the 1950s for use in the design and implementation of prevention and prevention initiatives. The failure of a free tuberculosis program during this period gave rise to the model. The model largely aims at determining the behavior of human beings by examining their attitudes and perceptions towards a health problem or outcomes associated with intended actions (Jeffrey et al., 2019).

The health belief model asserts that a change in human behavior occurs when three ideas exist simultaneously. The first one is the perceived severity and susceptibility to a health problem. An understanding of one’s susceptibility and severity of a health problem drives them to embrace the desired behaviors (Saghafi-Asl et al., 2020). The second idea is perceived threat. A person is likely to change his or her behavior if they understand their vulnerability to a disease or negative outcomes associated with a condition. The last idea is the understanding of the perceived barriers and benefits, which stimulate one to embrace actions that aim at averting the effects of a disease or a health problem (Dadkhah Tehrani et al., 2019).

The health belief model is associated with some strengths that make it effective in promoting behavioral change in nursing. First, the model focuses on the cognitive aspect of behavioral change. It uses individual’s motivations and beliefs to influence behavioral change. It also transforms the factors within and outside the patient that influence one’s attitude and beliefs towards action. The other strength is that the model guides individuals to develop realistic actions for their behavioral change. Studies have shown the use of the model in conditions such as hypertension and obesity result in sustainable change since it uses the resources within the patient’s disposal (Saghafi-Asl et al., 2020). Therefore, it makes the model and effective theory for use in addressing the issue of diabetes mellitus in the community and nursing practice.

Selected Chronic Disease

The selected chronic disease is diabetes mellitus. According to the Centers for Disease Control and Prevention (CDC), diabetes mellitus is a chronic condition that affects body’s metabolism. It is characterized by hyperglycemia due to the lack of or inadequate insulin needed to move glucose across the cells. Diabetes is classifiable into several types that include type 1, 2, and gestational diabetes. Diabetes mellitus has several causes. One of them is genetics. Individuals born to families with a history of diabetes have an increased risk of developing the disease (Cole & Florez, 2020). The other factor is obesity. Obesity predisposes hyperinsulinemia, which causes diabetes. The additional causes include polycystic ovarian syndrome, giving birth to a macrosomia baby, Cushing’s disease, autoimmune diseases, sedentary lifestyles, unhealth diet, and increasing age (Glovaci et al., 2019).

Patients with diabetes mellitus present the hospital with several symptoms. They include polyuria, polydipsia, polyphagia, fatigue, weight loss, blurred vision, non-healing ulcers, paresthesia, and frequent urinary tract infections. The physical examination findings of a patient with diabetes mellitus vary. They include weight loss, impaired vision, non-healing ulcers, and passage of dilute urine. The additional findings include poor sensation, hyperglycemia, normal or dry skin, Kussmaul respiration, dry mucus membranes, and hypothermia in severe cases. The treatment for diabetes mellitus depends largely on the type of diabetes. For example, insulin is the primary treatment option in type I diabetes mellitus while diet, exercise, and oral hypoglycemics are used in type 2 diabetes. Lifestyle modifications such as weight loss and healthy diets are recommended for both types of diabetes mellitus. Insulin is used in uncontrolled type 2 diabetes mellitus (Padhi et al., 2020). The treatments are usually combined for optimum glycemic control.

Patient Population

The target population that the health belief model will be applied are prediabetic African Americans. The population will be obtained through diabetes screening done to patients that come to the clinic. Patients with family histories of diabetes mellitus, obese, overweight, or suffering from diabetes-related comorbidities will be selected. African Americans are the appropriate population because of some reasons. First, the existing statistics show that diabetes rate is high among individuals of ethnic minority groups, including African Americans as compared to American whites. They are also increasingly predisposed to poor outcomes in the treatment of diabetes (Sims et al., 2020). Social determinants of health have been identified to play a crucial role in increasing diabetes rate in this population. For example, factors such as poverty, low income, unemployment, and structural injustices make it difficult for people of African American backgrounds become vulnerable to diabetes and its associated complications. The application of health belief model to prediabetic patients can reverse disease progression (Turkson‐Ocran et al., 2020). The utilization of interventions such as health education and motivational interviewing are effective in encouraging the prediabetics to adopt healthy lifestyles and behaviors, hence, the promotion of their optimum health and wellbeing.

Application of the Six Concepts

HBM Concept	How the concept relates to the disease	Interventions to address the concept
Perceived susceptibility	Perceived susceptibility refers to the individual’s vulnerability to diabetes mellitus. The relationship with diabetes is that individual’s opinion on their risk of diabetes and its complications influences their behavioral change. If a prediabetic patient feels that he is at a risk of developing diabetes, then he is likely to embrace healthy lifestyles to reverse diabetes.	One of the interventions is health education. The prediabetics will be educated about the causes, risks, and prevention of diabetes. They will also be educated on the lifestyle and behavioral modifications to make and assisted in developing the desired plans (Saghafi-Asl et al., 2020).
Perceived severity	This refers to the individual’s susceptibility to a disease. A prediabetic may not understand the complications and challenges associated with diabetes. Increasing their awareness among them may stimulate positive change in lifestyle and behaviors.	The prediabetic patients will be educated about the health risks of diabetes mellitus. They are also educated on the strategies to live a healthy life. Increasing awareness will result in positive change in their lifestyle and behaviors, hence, reversing prediabetes and diabetes (Saghafi-Asl et al., 2020).
Perceived benefits	This refers to the benefits that the patients will get by changing their behaviors and lifestyle. The prediabetic patients are informed about the benefits of living a diabetes free lives.	Health education about the benefits of living a diabetes free life. This includes the elimination of health complications such as diabetic nephropathy, neuropathy, and wound, decline in the quality of life, and increased care costs (Jeffrey et al., 2019).
Perceived costs	This refers to the things that an individual must engage to achieve the desired health outcomes. The prediabetics have to change their lifestyles and behaviors for them to reverse the risks of developing diabetes.	Health education on the actions that the prediabetics have to embrace to prevent their risk of developing diabetes. This includes engaging in active physical activity, losing weight, eating healthy diets, and avoiding carbonated drinks (Azadi et al., 2021).
Cues to action	The reasons why a person realizes their risk of developing a disease. Triggers to behavioral change among the prediabetic patients are the cues to action.	Health education programs, community interventions for diabetes, and the media trigger behavioral change among the prediabetic patients (Dadkhah Tehrani et al., 2019).
Enabling or modifying factors	These are factors that support behavioral change.	Strategies such as linking the prediabetic patients with the existing social support groups, follow-up care, and giving them feedback on areas of improvement will contribute to the desired behavioral change (Wu et al., 2020).

Use of the Framework by a DNP-Prepared Nurse

A DNP-prepared nurse can impact the quality of care by utilizing health belief model. First, the nurse uses the model in assessing the needs of their patients. The health belief model enables nurses to assess the attitudes, beliefs, and values that influence the behaviors of their patients. The understanding informs the strategies that nurses implement to facilitate behavioral change. The DNP-prepared nurse also uses the model to understand the perceptions of patients towards risks and their behavior. For example, nurses base their nursing actions on the perception of prediabetic patients towards diabetes and their behaviors (Saghafi-Asl et al., 2020). The understanding helps them to develop care plans that influence the lifestyles and behaviors of their patients, hence, minimizing their risk of developing diabetes and other health problems.

The DNP-prepared nurses also utilize the health belief model to address issues that affect the realization of optimum outcomes in the treatment process. Accordingly, issues such as poor treatment adherence and adoption of preventive services influence the health of the public. The health belief model is an effective tool for addressing these issues in nursing practice (Jeffrey et al., 2019). The DNP-prepared nurse uses the model to understand the influencing factors such the patients’ perception of barriers, benefits, susceptibility, and benefits of embracing the prescribed interventions.

The DNP-prepared nurse also uses the health belief model to promote preventive behaviors among populations at a risk of developing conditions such as diabetes. The model helps nurses to achieve this outcome by addressing constructs that include self-efficacy of the patients in meeting their needs. For example, the use of the health belief model in the study by Azadi et al., (2021) resulted in enhanced adoption of preventive measures because there were increase in the cues to action and perceived benefits among the study participants. Therefore, DNP nurses can use the model to stimulate positive behaviors among the vulnerable and affected populations in their communities.

Conclusion

In summary, the health belief model is a crucial tool for promoting behavioral change. The model can be applied to reversing the risk of diabetes among prediabetics. The concepts are applicable to diabetes prevention strategies. The DNP-prepared nurse can apply the model to improve the quality of care given to diverse populations in their practice.

References

Azadi, N. A., Ziapour, A., Lebni, J. Y., Irandoost, S. F., Abbas, J., & Chaboksavar, F. (2021). The effect of education based on health belief model on promoting preventive behaviors of hypertensive disease in staff of the Iran University of Medical Sciences. Archives of Public Health, 79(1), 69. https://doi.org/10.1186/s13690-021-00594-4

Cole, J. B., & Florez, J. C. (2020). Genetics of diabetes mellitus and diabetes complications. Nature Reviews Nephrology, 16(7), Article 7. https://doi.org/10.1038/s41581-020-0278-5

Dadkhah Tehrani, B., Tavakoli, R., & Jazayeri, S. A. (2019). ​The Effect of an Educational Intervention Based on Health Belief Model on Nutritional Behaviors in Type 2 Diabetics. Military Caring Sciences Journal, 5(4), 303–311. https://doi.org/10.29252/mcs.5.4.303

Glovaci, D., Fan, W., & Wong, N. D. (2019). Epidemiology of Diabetes Mellitus and Cardiovascular Disease. Current Cardiology Reports, 21(4), 21. https://doi.org/10.1007/s11886-019-1107-y

Jeffrey, B., Bagala, M., Creighton, A., Leavey, T., Nicholls, S., Wood, C., Longman, J., Barker, J., & Pit, S. (2019). Mobile phone applications and their use in the self-management of Type 2 Diabetes Mellitus: A qualitative study among app users and non-app users. Diabetology & Metabolic Syndrome, 11(1), 84. https://doi.org/10.1186/s13098-019-0480-4

Padhi, S., Nayak, A. K., & Behera, A. (2020). Type II diabetes mellitus: A review on recent drug based therapeutics. Biomedicine & Pharmacotherapy, 131, 110708. https://doi.org/10.1016/j.biopha.2020.110708

Saghafi-Asl, M., Aliasgharzadeh, S., & Asghari-Jafarabadi, M. (2020). Factors influencing weight management behavior among college students: An application of the Health Belief Model. PLOS ONE, 15(2), e0228058. https://doi.org/10.1371/journal.pone.0228058

Sims, M., Glover, L. S. M., Gebreab, S. Y., & Spruill, T. M. (2020). Cumulative psychosocial factors are associated with cardiovascular disease risk factors and management among African Americans in the Jackson Heart Study. BMC Public Health, 20(1), 566. https://doi.org/10.1186/s12889-020-08573-0

Turkson‐Ocran, R. N., Nmezi, N. A., Botchway, M. O., Szanton, S. L., Golden, S. H., Cooper, L. A., & Commodore‐Mensah, Y. (2020). Comparison of Cardiovascular Disease Risk Factors Among African Immigrants and African Americans: An Analysis of the 2010 to 2016 National Health Interview Surveys. Journal of the American Heart Association, 9(5), e013220. https://doi.org/10.1161/JAHA.119.013220

Wu, S., Feng, X., & Sun, X. (2020). Development and evaluation of the health belief model scale for exercise. International Journal of Nursing Sciences, 7, S23–S30. https://doi.org/10.1016/j.ijnss.2020.07.006

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Module VIII: environmental health

Introduction

We interact with the environment continually, and these interactions affect the quality of our lives and the number of quality, healthy years we live. The World Health Organization (WHO) defines the relationship of health to the environment as being all the physical, chemical, and biological factors external to a person, and all the related behaviors (WHO, 2015). The Healthy People 2030 environmental health objectives include:

• Increase the proportion of people whose water supply meets Safe Drinking Water Act regulations
• Reduce exposure to arsenic
• Reduce exposure to lead
• Reduce exposure to mercury in children
• Reduce exposure to bisphenol A
• Reduce exposure to perchlorate
• Reduce diseases and deaths related to heat

Depending on the source, the United States makes up only 4% or 5% of the world’s population yet uses 24% or 25% of its energy—more than China, Japan, and India combined—and produces 22% to 28% of the world’s “carbon footprint.” These are huge issues when taken on a global scale.

As people live longer, the prevalence of chronic diseases with their pain and disability will continue to grow. On a smaller scale, what does this mean for healthcare providers and the development of chronic diseases?

bjectives

Upon completion of this module the student will be able to:

• discuss chronic disease epidemiology
• identify environmental health issues
• define the latency period
• distinguish between the terms idiopathic and cryptogenic.
• discuss the Precautionary Principle

Leading Causes of Death

The causes of diseases have changed over the last century when death was caused primarily by infections -influenza, pneumonia, tuberculosis, diarrhea, and enteritis. According to the Centers for Disease Control and Prevention (Heron, 2021) the leading causes of death in 2019 were:

1. Diseases of heart
2. Malignant neoplasms
3. Accidents (unintentional injuries)
4. Chronic lower respiratory diseases
5. Cerebrovascular diseases
6. Alzheimer disease
7. Diabetes mellitus
8. Nephritis, nephrotic syndrome and nephrosis
9. Influenza and pneumonia
10. Intentional self-harm (suicide)

Epidemiology involves studying the distribution, determinants, prevention, and control of these disorders. Chronic diseases develop slowly, and usually are less severe than acute conditions, but have a long duration. The latency period is the period of time before the disease occurs. Preventative interventions at this point may decrease the chances of development.

According to the CDC (2020) 6 in 10 adults have at least one chronic disease and 4 in 10 adults have two or more. Many chronic diseases are directly related to risk factors such as:

• Tobacco Use/Secondhand smoke
• Poor nutrition
• Lack of physical activity
• Alcohol abuse

Infectious agents such as tuberculosis, syphilis, polio, leprosy, and COVID-19, among others, can lead to chronic, debilitating conditions.

Social Determinants of Health

Social and environmental issues such as violence, acts of terrorism, and natural disasters predispose one to chronic illnesses. According to Merrill (2021) factors such as, poverty, fear, stress, economics, and crime also contribute to chronic health problems. Behavior changes, however, can help overcome some of these behavioral and social health issues.

Heredity and Chronic Problems

Diseases can be idiopathic (having genetic origins) in nature or cryptogenic (having non-generic origins). Many health problems have a genetic component; osteoporosis is one example. Although they may not be eliminated, one can do much to prevent them. Weight-bearing exercises are an excellent way to increase bone density and prevent osteoporosis.

Unfortunately, prevention is difficult to measure and may not be identifiable when it occurs. We all know that prevention works and that it must be the goal to improve the health of all populations.

Environmental Health, Epidemiology, and Nursing

“The basic principle of epidemiology is to clarify the relationship between environmental agents and human health” (Amiri, 2022, p. 45). Epidemiology supports the development of models that can predict hazards and their effect on humans. Nurse’s use epidemiologic data and population concepts in many ways. for example, in planning an intervention to decrease falls of elderly patients on a hospital unit, the characteristics of the unit and patients helps to identify any relationships that can be altered.

One Health is a CDC agency begun in 2009. It is focused on “…using a collaborative, multisectoral, and transdisciplinary approach — working at the local, regional, national, and global levels — with the goal of achieving optimal health outcomes recognizing the interconnection between people, animals, plants, and their shared environment” (CDC, 2022, p.1). Focus areas for One Health include zoonotic diseases, antimicrobial resistance, food safety, vector-borne diseases, environmental contamination, and other health threats shared by people, animals, and the environment.  This includes pandemic preparedness and response.

Precautionary Principle

The Precautionary Principle calls for “erring on the side of caution” if there are any doubts as to the safety of a new intervention or product. The American Nurses Association (ANA)’s Principles of Environmental Health for Nursing Practice include that nurses should practice in a way that does not harm the environment or human health. This requires consideration of how health policy and politics can balance ecological concerns with economic and social factors.

The Precautionary Principle developed from a consensus statement in 1998. The four central tenets include taking preventive action when uncertain, placing the burden of proof on those who are the proponents of an activity, exploring alternatives to harmful actions, and increasing the public’s involvement in decision-making.

Welcome to week

Readings

• Merrill: Chapter 11
• Environmental Health | Work Environment | ANA Enterprise (nursingworld.org)
• Environmental Health in Nursing, 2nd Edition (2022) can be found at the Alliance of Nurses for Healthy Environments at http://www.envirn.org
• One Health Basics | One Health | CDC
• Aronson, J. K. (2021). When I use a word . . . . The Precautionary Principle: a definition. BMJ : British Medical Journal (Online), 375  When I use a word . . . . The Precautionary Principle: a definition – ProQuest
• Chaudry, R. V. (2008). The precautionary principle, public health, and public health nursing. Public Health Nursing (Boston, Mass.), 25(3), 261-268. The Precautionary Principle, Public Health, and Public Health Nursing – Chaudry – 2008 – Public Health Nursing – Wiley Online Library (oclc.org)

Discussion

Module VIII
Discussion 1	Based on the readings from this module choose a disease, disability, or injury disorder you believe is being overlooked and discuss measures you would take to address this problem. Module VIII – Discussion 1
Assignment	Module VIII: Chronic Disease Epidemiology
	Post your initial response by Wednesday at 11:59 PM EST. Respond to two students by Saturday at 11:59 PM EST. The initial discussion post and discussion responses occur on three different calendar days of each electronic week. All responses should be a minimum of 300 words, scholarly written, APA formatted (with some exceptions due to limitations in the D2L editor), and referenced.  A minimum of 2 references are required (other than the course textbook). These are not the complete guidelines for participating in discussions. Please refer to the Grading Rubric for Online Discussion found in the Course Resources module. Special Guidance on APA formatting in Discussion Posts APA formatting is required in discussion posts with the following two exceptions (due to limitations with the text editor in LIVE):  double line space and indent 1/2 inch from the left margin. Discussion posts will NOT be evaluated on those two formatting requirements. All other APA formatting guidelines should be followed. For example, in-text citations must be formatted with the appropriate information and in the correct sequence (Author, year), reference list entries must include all appropriate information following  guidelines for capitalization, italics, and be in the correct sequence. Refer to the APA Publication Manual 7th ed. for each source type’s specific requirements. Please let your instructor know if you have any questions.