According to research, descriptive epidemiology studies are conducted utilizing the collection of events over a defined population base and by the use of denominator data to determine rates (Centers for Disease Control and Prevention, 2016). The most frequent information generated from these designs/studies are incidence rates for injuries/illnesses (Centers for Disease Control and Prevention, 2016). Curley and Vitale ( 2016) assert that “there are four types of descriptive studies: case reports, case series, cross-sectional studies, and correlation or ecologic studies”. A case report is a thorough description of disease prevalence; unusual features may propose new hypothesis regarding the cause or mechanism of the disease; case series are reports that involve the characteristics of a group of subjects who have the same disease or condition in common; cross-sectional studies examine the exposure and health status of individuals in one point in time and prevalence rates are compared among groups that have been exposed to the disease/illness; and lastly, correlation studies examine groups of people, who have common exposure to disease/illness and health outcomes ( BioMed Central, 2014) . The information/data utilized in descriptive studies are available and can be retrieved from the following sources: hospital records, census data, or vital statistical databases/records (BioMed Central, 2014). Population-based studies are an important component to nursing practice today. Historically there have been many nurses; who have made an impact by decreasing morbidity and mortality. Clara Barton and Florence Nightingale are two nurses who made a historical impact decreasing illness and disease. Clara Barton founded the Red Cross and cared for wounded soldiers during World War II, and Florence Nightingale, transformed a negative environment into a positive one; for wounded and ill soldiers during the Crimean war. The student DNP believes that, there is a relationship between descriptive epidemiology and nursing today. EBP has been implemented by utilizing descriptive methods of epidemiology.
Nursing Today and Descriptive Epidemiology
Descriptive epidemiology is a critical component in nursing today. It is imperative that nurses obtain the appropriate skills pertaining to disease surveillance; it is a critical component to public health and community-based nursing (Fayram & Anderko, 2013). The purpose for disease surveillance is to “predict, observe, and minimize the harm caused by outbreak, epidemic and pandemic situations” (Schaffer, Keller & Reckinger, 2015). The student DNP believes that, there is a correlation between descriptive epidemiology and nursing today. It plays an important role in nursing as a whole, by assisting the public health nurse in gathering valid and reliable data; in order to decrease morbidity and mortality among vulnerable populations. Otherwise stated, descriptive epidemiology assists public health nurses in developing a plan of change and applying it to the community; in order to create positive outcomes. This plan of change can be accomplished by utilizing the following: epidemiological and bio-statistical principles; epidemiological methods to plan, implement, and evaluate community health problems and applying epidemiological methods; in order to critically evaluate EBP, which is significantly used in public health decision-making (Ressing, Blettner & Klug, 2015).
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Contemporary Example of Descriptive Epidemiology in Public Health Nursing
A study conducted by Naito (2014) illustrates two descriptive epidemiology studies from Japan; regarding prevalence and incidence of illness. His study presented data on the prevalence of diabetes and distribution of HbA1c in Japan (Naito, 2014) . The prevalence of diabetes was projected by using data from a large-scale cohort study. Research sample consisted of registered populations between the ages of 46–75; which were recruited from ten different public health center (PHC); which were included in the initial survey. The age-standardized prevalence of diabetes in 55- to 74-year-old adults was 8.2% in the initial survey in the late 1990s and 10.6% at the five-year follow-up. Findings suggest a significant effort to decrease the number of individuals who progress to diabetes is required to stop the diabetes epidemic. The student DNP believes that the study conducted by Naito (2014), is a descriptive epidemiology example that can be applies to public health nursing. A cohort study method was used; which investigates individuals who are at risk such as diabetes.
Another study conducted by Naito (2014), presented data on the incidence of myelodysplastic syndromes (MDS) in Japan. According to research MDS are a diverse group of malignant clonal hematopoietic stem cell; these cells exist in the elderly, who present with persistent bone marrow failure and peripheral blood cytopenia (Naito, 2014). The author examined cancer registry data from the Monitoring of Cancer Incidence in Japan. According to Naito the registry was started in 2007 as a national project; in order to extract prefecture-wide cancer registry data (Naito, 2014). The results of the study presented that the age-adjusted incidence of MDS in Japan, was 1.6 cases per 100 000 for males and 0.8 cases for females in 2008. The student DNP believes that, the aforementioned rates are less than half of those in the United States among the elderly (Naito, 2014). The elderly are more prone to MDS; due to doctors not thoroughly evaluating them during the diagnosis phase. The student writer believes that, MDS needs to accurately be evaluated; it also requires evaluation of disease mortality, continued surveillance, and improvement in the quality of cancer registry data (Naito, 2014).
Components of Epidemiology for at-risk Populations
According to Ressing and colleagues, incidence and mortality are important frequency measures when utilizing cohort studies (2015). In addition, relative risk (RR), hazard ratio (HR), standardized incidence ratio (SIR), standardized mortality ratio (SMR), and odds ratio (OR) are important effect in measuring and calculating statistical data that has been gathered. In cross-sectional studies, the odds ration can be measured using statistical calculation (Ressing, Blettner & Klug, 2015). Lastly, in cross-sectional studies, prevalence is the most important frequency measure. All the aforementioned components are imperative when implementing epidemiology. Statistical measurements are substantial to research in order to produce data that is reliable and valid.
Cervical Cancer and At-Risk Population
The Human Papilloma virus is the main cause of cervical cancer. It is regard as a “sexually transmitted disease” which is largely carried by the males (Chando, Tiro, Harris, Kobrin, & Breen, 2013). A study carried out by Montealegre, Zhou, Amirian, Follen and Scheurer (2013) depict that cervical cancer is considerably higher among the women of Hispanic origin as compared to non-Hispanic ones. Montealegre et al. (2013) also discovered that the incidence of cervical cancer and the rate of death among the women of Hispanic origin were 10.9 for every 100, 000 and 2.9 deaths for every 100, 000 women. Data obtained from the study depict that Hispanic women have a higher risk of getting cervical cancer. Therefore, the research advocates for HPV vaccine as it can minimize cervical cancer discrepancies among Hispanic women (Thomas & Snell, 2013).
The Human Papilloma Virus (HPV) is projected to presently infect men aged 20 years and older. The rates range between 65% and 93% in highly prone populations. On the other hand, only 45% accounts for the populations that are less prone to this risk (Thomas & Snell, 2013). Existing data point out that HPV infections are most likely connected with 96–99% of cases of cervical cancers, 90–93% of anal cancers cases, 12–63% of oropharyngeal cancers cases, 36–40% of cases of penile cancers, 40% of cases of vaginal cancers, and 40–51% of cases of vulvar cancers (Thomas & Snell, 2013). Vaccinating boys and men aged nine and twenty-six years may thwart more than five million genital warts cases and 40,000 deaths related to cancer for the next century, whereas setting aside $25,700 per quality adjusted life year (Thomas & Snell, 2013).
A study conducted by Rogers (2010) illustrates that behavioral belief ideas reveal participant’s confidence in, the ease with, and acquaintance of conventional techniques of care such as teas and herbs. Also, it depicts their confidence in the efficiency of the traditional care such as the use of physicians, technology and medicine (Rogers, 2010). On normative belied ideas, participants perceived that community and family contacts supported them in the utilization of conventional techniques and that family upholds the enlisting of conventional techniques . Rogers (2010) further illustrate that Control belief ideas propose that conventional methods are reachable and inexpensive except that they actually are not. BAS scored pointed out that the majority of the participants (90.3%) held on to Hispanic traditions. It was only two participants (6.5%) who held on to non-Hispanic traditions whereas a bi-cultural score was represented by one participant (3.2%) (Rogers, 2010).
Analysis of Data
Descriptive Analysis
Descriptive analysis indicates the essential features of the collected data. This kind of analysis includes statistics like minimum, frequency, range and maximum. Also, it involves the use of central tendency measures like mode, mean , standard deviation and mean which depict how a study’s data looks like . Statistics assist in converting quantitative data to valuable information which is essential in the decision-making process. Statistics can be used in summarizing the study’s data, describing various connections, relationships and patterns. This study will be focused on the descriptive analysis in summarizing its data.
Data Structure
Data for the study would be collected from individuals. In this case, the data will be from the literature reviews depicting Hispanic women and the men affected by the Human Papilloma Virus. The information obtained from the individuals would be the variables. The research by Rogers (2010) used a sample of 31 adults dwelling in USA’s north-west urban area. These were recruited using various non-health community organizations .
Variables
Two kinds of variables exist namely categorical and numerical. For this study, the nominal variables will be the sex of the participants that is female/male and their race. Rogers’ (2010) research enlisted females who accounted for 87% of the study’s population. On the other hand, the numerical variables would consist of the number of individuals taking part in the study and their ages. Rogers’ (2010) research, similarly, used participants whose age ranged between 54 and 85 years.
Other descriptive aspects of the data that would be considered in this study include:
Median : It is the middle value obtained after arranging the data set in order. In case the values of the dataset are even, the median will be obtained by finding the average of these two numbers in the middle of the dataset. This measure of central tendency is vital when there is an outlier in the data set, and the distribution of the values is quite uneven.
Mode: It is the value that is regularly observed . This will be used to indicate the item that is popular in the dataset.
Range: It is the difference between the minimum and maximum values seen in the variable. The bigger the range, the more the values are distributed . In this study, range would illustrate the existing gap between the variables being tested . It would give a general picture of the gap . As depicted in the study done by Thomas and Snell (2013), the present data show that the uptake of HPV vaccine among boys only accounts for about 10 to 20% of the of the national population.
Frequency : It is the number of times a particular value emerges. B ased on this study’s data, the frequency of cervical cancer among the Hispanic women would be obtained and the result would be compared to the frequency at which cervical cancer affects the non-Hispanics. The final result would depict the population which is at a higher risk of cervical cancer. Apart from that, the mean age at which the Human Papilloma Virus affected men would be determined. This would be based on the data obtained from reviewing the literature. This information will illustrate the age at which one is at a higher risk of Human Papilloma Virus infection.
Standard Deviation: D epicted as the variance’s positive square root. It is the standard variation between the mean and the experimental values. The use of standard deviation will be important in illustrating dispersion in the data. It will further illustrate the extent to which dispersion of disease and various health-related conditions like cancer is spread among the Hispanics and non-Hispanics.
After the description of data, the transcription of data obtained from interviews will be done by a qualified transcriptionist. Analysis of qualitative data would be based on the organizational , conceptual and textual levels. Rogers (2010) indicates that to achieve this, the investigator will employ the use of ATLAS-ti (Rogers, 2010). Also, an interpretive technique will be employed to highlight the significance of the social perspective in which participants understood their environment and the manner in which their lives are affected by the experiences of illness and health.
Apart from that, descriptive data will be made on demographic and variables. Associations between the open-ended answers and variables will be investigated to find out whether there existed any personal discrepancies regarding health ideas based on the demographic features like age and sex (Rogers, 2010). In particular, the diverse levels of demographic features like younger age versus older age would be measured against similar open-ended answers to establish whether diverse demographic features were connected to specific open-ended answers (Rogers, 2010).
Health Promotion and Disease Prevention Obstacles and Interventions
There are several barriers to cervical cancer screening among Hispanic women, but according to research, few effective interventions exist (Smith, Wilson, Orians & Byrd, 2013). Health promotion and disease prevention obstacles that exist include language barriers, literacy level, culture, religious beliefs , poor health literacy and socioeconomic status. All these obstacles contribute to health disparities among the Hispanic population (Smith et al., 2013). Health promotion and disease prevention are a significant part to the quality of life and improved health . Interventions are imperative to public health as it is our ethical responsibility as nurses to educate the public to decrease morbidity and mortality (Smith et al., 2013).
Interventions that can be applied to the Hispanic population include the inclusion of major stakeholders particularly program administrators and deliverers, scheduling for translation and dissemination as they are fundamental components of a thriving intervention plan (Smith et al., 2013). Also, the provision of clear adaptation directions for plan deliverers, pertinent information for the administrators of the program and accessibility to the intervention plans through the internet would assist in enhancing the screening of cervical cancer among the Hispanic women and also others who have suffered from cervical cancer.
Another intervention strategy is advocacy. This focuses on the development of an individual’s capacity to personally take action . In their study, Schaffer et al., (2004) depict that public health nursing activities facilitated the accessibility to basic needs of life and health services for susceptible persons. Also, it promoted the availability of better healthcare by scheduling for transportation and appointments by the physician (Schaffer et al., 2004). Through this initiative, the sufficiency of life’s basic needs like food was guaranteed . Furthermore, the evaluation of susceptible adults and children, following referrals for neglected, abused or vulnerable adults and children, arranging for interpreters and providing crucial information needed in courts enhanced sufficiency (Schaffer et al., 2004).
Screening of individuals should also be encouraged. This enables the identification of persons with asymptomatic conditions or risky health factors (Schaffer et al., 2004). As indicated in study by Schaffer et al., (2004), PHN’s carried out different kinds of screening. Among the most done screening were for hypertension, nutrition, status of immunization, postpartum depression, body mass index, tuberculosis, increased levels of lead in the blood, hearing, anemia, vision and infant development and growth.
Conclusion
The student DNP believes that epidemiology is imperative to public health nursing. Vulnerable populations in the United Sates are at-risk in developing life-threatening diseases/illnesses. Evidence-based practice pertaining to epidemiology is the first step to making critical decisions that can save lives. Epidemiological techniques may be used for describing the needs of health in terms of particular diseases and their distribution. Despite the fact that commonness and incidence do not automatically link with the needs, both are vital in portraying the population’s predicaments concerning diseases. Some of the epidemiological researches may take a lot of time and end up being expensive. Available information in previously conducted studies may be used in informing the local requirements provided that a generalisability criterion is formulated . Customary health information sources may not be appropriate and accurate. However, the same sources may offer important explanations of healthcare and health in a distinct population. Lastly, preventative measures are essential to public health nursing; it assists in health promotion and disease prevention; in order to decrease morbidity and mortality. Nurses have the power to make a change and the empathy in wanting to make a change that can impact a whole population.
References
BioMed Central. (2014). Ethical considerations of universal vaccination against human papilloma virus. Retrieved from http://bmcmedethics.biomedcentral.com/articles/10.1186/1472-6939-15-29
Centers for Disease Control and Prevention. (2016). Principles of Epidemiology in Public Health Practice, Third Edition: An Introduction to Applied Epidemiology and Biostatistics. Retrieved from http://www.cdc.gov/ophss/csels/dsepd/ss1978/lesson6/section2.html
Chando, S., Tiro, J. A., Harris, T. R., Kobrin, S., & Breen, N. (2013). Effects of Socioeconomic Status and Health Care Access on Low Levels of Human Papillomavirus Vaccination Among Spanish-Speaking Hispanics in California. American Journal of Public Health , 103 (2), 270-272. doi:10.2105/AJPH.2012.300920
Curley, A. L., & Vitale, P. A. (2016). Population-based nursing: Concepts and competencies for advanced practice (2nd ed.). New York, NY: Springer Publishing Company. ISBN-13: 9780826196132
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Montealegre, J. R., Zhou, R., Amirian, E. S., Follen, M., & Scheurer, M. E. (2013). Nativity disparities in late-stage diagnosis and cause-specific survival among Hispanic women with invasive cervical cancer: an analysis of Surveillance, Epidemiology, and End Results data. Cancer Causes & Control , 24 (11), 1985-1994. doi:10.1007/s10552-013-0274-1
Naito, M. (2014). Utilization and Application of Public Health Data in Descriptive Epidemiology. Journal of Epidemiology , 24 (6), 435–436. http://doi.org/10.2188/jea.JEA2014082
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Rogers, A. T. (2010). Exploring health beliefs and care-seeking behaviors of older USA-dwelling Mexicans and Mexican-Americans. Ethnicity & Health , 15 (6), 581-599. doi:10.1080/13557858.2010.500018
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Smith, J. L., Wilson, K. M., Orians, C. E., & Byrd, T. L. (2014). AMIGAS: Building a Cervical Cancer Screening Intervention for Public Health Practice. Journal of Women's Health (15409996) , 22 (9), 718-723. doi:10.1089/jwh.2013.4467
Thomas, T. L., & Snell, S. (2013). Vaccinate boys with the HPV vaccine? Really?. Journal for Specialists in Pediatric Nursing , 18 (2), 165-169. doi:10.1111/jspn.12025
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