NR I503 IPopulation IHealth, IEpidemiology I& IStatistical IPrinciples IFinal IExam IStudy IGuide
Week 5:
I
In Week 5 you completed your Infectious Disease paper. Are you able to define and apply the
epidemiological triad and the HP2020 social determinants of health? How might you use those
in your Week 6 paper? The determinants of health, from social to environmental from policy to
individual behavior are critical elements to consider related to population health and the role of the
NP. Also, in Week 5, the Open Forum gave you opportunity to review culture, access to care, and
‘;
how provider attitudes impact quality of care provision. Did you take the self-assessment? Was it
informative? Social justice theory is connected to the entire NR503 course, and also to this module,
the Kleinman Explanatory Model. Had you heard of this before? Do you think the explanatory
model would be useful in trying to understand various group’s notions of health?
The 5W's of descriptive epidemiology:
What = health issue of concern
Who = person
Where = place
When = time
Why/how = causes, risk factors, modes of transmission
Weekly Objectives:
1. Discriminate populations at risk for development of chronic health conditions while associating
the role of the Advanced Practice Nurse in levels of promotion.
2. Compare and contrast variables that differentiate those categorized at being at risk for
marginalization of health care.
At the end of this week, can you answer/discuss the following: (Self-quiz)
1. How does culture influence the decisions a provider may make when selecting an
intervention?
2. Explain how culture impacts provider attitudes? Does it? How will you assess your own
attitudes about various cultures/races/groups?
3. Review the terms for this week and apply them to population health; for instance: cultural
competence, cultural awareness, norms, values, Kleinman Explanatory Model, socioeconomic
status, disparities, minorities, food dessert.
4. What are the social determinants of health? How does a provider integrate knowledge of
these social determinants of health into their practice? Why are they important?
5. Apply social justice theory to the provision of care; what does social justice mean when
applied to health care?
6. What data sources are used to assess determinants of health?
,Discriminate Ipopulations Iat Irisk Ifor Idevelopment Iof Ichronic Ihealth Iconditions
Iwhile Iassociating Ithe Irole Iof Ithe IAdvanced IPractice INurse IinIlevels Iof
Ipromotion.
Minorities Iand Ipeople Iwith Ilow Isocio-economic Iconditions Iare Iat Ihigher Irisk Ifor Ichronic Iillness.
IThe IAPN Ishould Ipractice Iwith Icultural Icompetence Iin Iorder Ito Iprovide Icare Ifor Ithese Ipatients. IAsking
Iquestions Iand Iresearching Ito Iknow Ihow Ieach Ipatient Iperceives Itheir Iillness Iand Ihow Ithey Iwould Ilike Ito
Itreat Iit.
Compare Iand Icontrast Ivariables Ithat Idifferentiate Ithose Icategorized Iat
Ibeing Iat Irisk Ifor Imarginalization Iof Ihealth Icare.
Variable Ithat Idifferentiate Ithose Icategorized Ias Ihigh-risk Ihealth Iliteracy, Icultural Ibarriers, IandIlow
IEnglish Iproficiency
1. How Idoes Iculture Iinfluence Ithe Idecisions Ia Iprovider Imay Imake Iwhen Iselecting Ian Iintervention?
The Ivery Iessence Iof Iwhat Ihealth Iand Idisease Idenotes Ican Ivary Ifrom Iculture Ito Iculture. ITherefore, Ithere Iis Ia Iwide
Ispectrum Iof Iwhat Iare Iconsidered Iappropriate Iinterventions, Iwhich Imay Inot Ibe Icompatible Iwith IWestern
Imedicine. IBased Ion Ithe Icultures' Iperceptions Iof Idisease Icausation, Isymptomatology, Iand Ipathology, Iappropriate
Iinterventions Imay Idiverge Ifrom IWestern Imedicine's Iapproach.
In Iorder Ito Iprovide Iappropriate Ihealthcare Iinterventions, Iculture Iand Iall Iits Ivariants Imust Ibe Iaddressed
I(communication, Ispace, Itime, Ienvironment, Ietc). IThe IAPN Imust Ibe Icognizant Iof Ihis Ior Iher Iown Icultural Ibeliefs
Iand Ithe Iattitudes I he/she Iinherently Ihas Iabout Iother Icultures.
Patients Iculture Imust Ibe Iaddressed Iwhen Iproviding Icare Ifor Ipatients. IGood Icommunication Ibetween
Iprovider Iand Ipatient Ibridges Ithe Igap Iand Iprovides Iculturally Icompetent Icare.
2. Explain Ihow Iculture Iimpacts Iprovider Iattitudes? I Does Iit? I How Iwill Iyou Iassess Iyour Iown
IattitudesIabout Ivarious Icultures/races/groups?
Differences Iin Iculture Ican Iimpact Iprovider Iattitudes. IAlthough Icultures Idiffer, Ithey Iall Ihave Ithe Isame Ibasic
Iorganizing Ifactors Ithat Imust Ibe Iassessed Iin Iorder Ito Iprovide Icare Ifor Iculturally Idiverse Ipatients. IThese Ifactors
Iinclude: Icommunication I(verbal Iand Inonverbal); Ipersonal Ispace; Isocial Iorganization; Itime Iperception;
Ienvironmental Icontrol; Iand Ibiological Ivariations.
Cultural Icompetency Itraining Iand Icultural Iawareness Ican Ihelp IAPNs Iassess Ihis/her Iown Iattitudes.
3. Review Ithe Iterms Ifor Ithis Iweek Iand Iapply Ithem Ito Ipopulation Ihealth; Ifor Iinstance: Icultural Icompetence,
Icultural Iawareness, Inorms, Ivalues, IKleinman IExplanatory IModel, Isocioeconomic Istatus, Idisparities,
Iminorities, Ifood Idessert.
Culture I– I"the Ipractices, Ibeliefs, Ivalues, Iand Inorms Iwhich Ican Ibe Ilearned Ior Ishared, Iand Iwhich Iguide Ithe
Iactions Iand Idecisions Iof Ieach Iperson Iin Ithe Igroup"
Cultural Icompetence I– Ia Idynamic, Ifluid, Icontinuous Iprocess Iwhereby Ian Iindividual, Isystem Ior Ihealth
Icare Iagency Ifind Imeaningful Iand Iuseful Icare Idelivery Istrategies Ibased Ion Iknowledge Iof Ithe Icultural
Iheritage, Ibeliefs, Iattitudes, Iand Ibehavior Iof Ithose Ito Iwhom Ithey Irender Icare.
, Cultural Iawareness I– ISelf-examination Iof Ione's Iown Iprejudices Iand Ibiases Itoward Iother Icultures. IAn
Iin-depth Iexploration Iof Ione's Iown Icultural/ethnic Ibackground.
Cultural Ihumility I– IA Ilifelong Icommitment Ito Iself-evaluation Iand Iself-critiques, Iredressing Ithe Ipower
Iof Iimbalances Iin Ithe Ipatient- Iphysician Idynamic, Ideveloping Imutually. IBeneficial Irelationships.
Cultural Iknowledge I– IObtaining Ia Isound Ieducational Ifoundation Iconcerning Ithe Ivarious Iworldviews Iof
Idifferences Icultures. IObtaining Iknowledge Iregarding Ibiological Ivariations, Idisease Iand Ihealth Iconditions
Iand Ivariation Iin Idrug Imetabolism.
Cultural Iskill I– IAbility Ito Icollect Iculturally Irelevant Idata Iregarding Ithe Iclient's Ihealth Ihistory Iand
Ipresenting Iproblem. IAbility Ito Iconduct Iculturally Ibased Iphysician Iassessments. IConducting Ithese
Iassessments Iin Ia Iculturally Isensitive Imanner.
Cultural Idesire I– IMotivation Iof Ithe Ihealthcare Iprovider Ito I"want" Ito Iengage Iin Ithe Iprocess Iof Icultural
Icompetence, Icharacteristics Iof Icompassion, Iauthenticity, Ihumility, Iopenness, Iavailability, Iand Iflexibility,
Icommi Itment Iand Ipassion Ito Icaring, Iregardless Iof Iconflict.
Norms I- Irefers Ito Iattitudes Iand Ibehaviors Ithat Iare Iconsidered Inormal, Itypical Ior Iaverage Iwithin Ithat
Igroup.
Values I- Iabstract Iconcepts Ithat Icertain Ikinds Iof Ibehaviors Iare Igood, Iright, Iethical, Imoral Iand Itherefore
Idesirable.
The Idifference Ibetween Ivalues Iand Inorms Iis Ithat Ithe Iformer Iare Iabstract Ithoughts Iwhile Ithe Ilatter
Iare Iexternal Iactions. IA Iculture's Ivalues Irelate Ito Icommonly Iheld Ibeliefs Iabout Iwhat Iis Iconsidered
Idesirable Iand Iproper, Iwhile Icultural Inorms Iare Ithe Iestablished Ibehaviors Ithat Ireflect Ithose Ivalues.
Kleinman IExplanatory IModel I– Isimilar Ito Ia Icultural Iassessment; Iproposes Ithat Iindividuals Iand Igroups
Ican Ihave Ivastly Idifferent Inotions Iof Ihealth Iand Idisease. IKleinman Iproposed Ithat Iinstead Iof Isimply Iasking
Ipatients, I“Where Idoes Iit Ihurt,” Ithe Iphysicians Ishould Ifocus Ion Ieliciting Ithe Ipatient’s Ianswers Ito I“Why,”
I“When,” I“How,” Iand I“What INext.”
Eliciting Ithe Ipatient’s I(explanatory) Imodel Igives Ithe Iphysician Iknowledge Iof Ithe Ibeliefs Ithe
Ipatient Iholds Iabout Ihis Iillness, Ithe Ipersonal Iand Isocial Imeaning Ihe Iattaches Ito Ihis Idisorder, Ihis
Iexpectations Iabout Iwhat Iwill Ihappen Ito Ihim Iand Iwhat Ithe Idoctor Iwill Ido, Iand Ihis Iown Itherapeutic
Igoals. IEliciting Ithe IPatient’s IExplanatory IModel Iof Iillness Ithrough Ia Iset Iof Itargeted Iquestions
Ishown Ibelow Iis Ian Iimportant Itool Ifor Ifacilitating Icross-cultural Icommunication, Iensuring Ipatient
Iunderstanding, Iand Iidentifying Iareas Iof Iconflict Ithat Iwill Ineed Ito Ibe Inegotiated.
• What Ido Iyou Icall Iyour Iproblem?
• What Ido Iyou Ithink Icaused Iyour Iproblem?
• Why Ido Iyou Ithink Iit Istarted Iwhen Iit Idid?
• What Idoes Iyour Isickness Ido Ito Iyou?
• What Ido Iyou Ifear Imost Iabout Iyour Isickness?
• What Iare Ithe Ichief Iproblems Iyour Isickness Ihas Icaused Iyou?
• What Ikind Iof Itreatment Ido Iyou Ithink Iyou Ishould Ireceive?
• What Iis Ithe Imost Iimportant Iresult Iyou Ihope Ito Ireceive Ifrom Ithe Itreatment?
Socioeconomic Istatus I– Ithe Isocial Istanding Ior Iclass Iof Ian Iindividual Ior Igroup. IIt Iis Ioften Imeasured Ias Ia
Icombination Iof Ieducation, Iincome Iand Ioccupation. IExaminations Iof Isocioeconomic Istatus Ioften Ireveal
Iinequities Iin Iaccess Ito Iresources, Iplus Iissues Irelated Ito Iprivilege, Ipower Iand Icontrol.
Week 5:
I
In Week 5 you completed your Infectious Disease paper. Are you able to define and apply the
epidemiological triad and the HP2020 social determinants of health? How might you use those
in your Week 6 paper? The determinants of health, from social to environmental from policy to
individual behavior are critical elements to consider related to population health and the role of the
NP. Also, in Week 5, the Open Forum gave you opportunity to review culture, access to care, and
‘;
how provider attitudes impact quality of care provision. Did you take the self-assessment? Was it
informative? Social justice theory is connected to the entire NR503 course, and also to this module,
the Kleinman Explanatory Model. Had you heard of this before? Do you think the explanatory
model would be useful in trying to understand various group’s notions of health?
The 5W's of descriptive epidemiology:
What = health issue of concern
Who = person
Where = place
When = time
Why/how = causes, risk factors, modes of transmission
Weekly Objectives:
1. Discriminate populations at risk for development of chronic health conditions while associating
the role of the Advanced Practice Nurse in levels of promotion.
2. Compare and contrast variables that differentiate those categorized at being at risk for
marginalization of health care.
At the end of this week, can you answer/discuss the following: (Self-quiz)
1. How does culture influence the decisions a provider may make when selecting an
intervention?
2. Explain how culture impacts provider attitudes? Does it? How will you assess your own
attitudes about various cultures/races/groups?
3. Review the terms for this week and apply them to population health; for instance: cultural
competence, cultural awareness, norms, values, Kleinman Explanatory Model, socioeconomic
status, disparities, minorities, food dessert.
4. What are the social determinants of health? How does a provider integrate knowledge of
these social determinants of health into their practice? Why are they important?
5. Apply social justice theory to the provision of care; what does social justice mean when
applied to health care?
6. What data sources are used to assess determinants of health?
,Discriminate Ipopulations Iat Irisk Ifor Idevelopment Iof Ichronic Ihealth Iconditions
Iwhile Iassociating Ithe Irole Iof Ithe IAdvanced IPractice INurse IinIlevels Iof
Ipromotion.
Minorities Iand Ipeople Iwith Ilow Isocio-economic Iconditions Iare Iat Ihigher Irisk Ifor Ichronic Iillness.
IThe IAPN Ishould Ipractice Iwith Icultural Icompetence Iin Iorder Ito Iprovide Icare Ifor Ithese Ipatients. IAsking
Iquestions Iand Iresearching Ito Iknow Ihow Ieach Ipatient Iperceives Itheir Iillness Iand Ihow Ithey Iwould Ilike Ito
Itreat Iit.
Compare Iand Icontrast Ivariables Ithat Idifferentiate Ithose Icategorized Iat
Ibeing Iat Irisk Ifor Imarginalization Iof Ihealth Icare.
Variable Ithat Idifferentiate Ithose Icategorized Ias Ihigh-risk Ihealth Iliteracy, Icultural Ibarriers, IandIlow
IEnglish Iproficiency
1. How Idoes Iculture Iinfluence Ithe Idecisions Ia Iprovider Imay Imake Iwhen Iselecting Ian Iintervention?
The Ivery Iessence Iof Iwhat Ihealth Iand Idisease Idenotes Ican Ivary Ifrom Iculture Ito Iculture. ITherefore, Ithere Iis Ia Iwide
Ispectrum Iof Iwhat Iare Iconsidered Iappropriate Iinterventions, Iwhich Imay Inot Ibe Icompatible Iwith IWestern
Imedicine. IBased Ion Ithe Icultures' Iperceptions Iof Idisease Icausation, Isymptomatology, Iand Ipathology, Iappropriate
Iinterventions Imay Idiverge Ifrom IWestern Imedicine's Iapproach.
In Iorder Ito Iprovide Iappropriate Ihealthcare Iinterventions, Iculture Iand Iall Iits Ivariants Imust Ibe Iaddressed
I(communication, Ispace, Itime, Ienvironment, Ietc). IThe IAPN Imust Ibe Icognizant Iof Ihis Ior Iher Iown Icultural Ibeliefs
Iand Ithe Iattitudes I he/she Iinherently Ihas Iabout Iother Icultures.
Patients Iculture Imust Ibe Iaddressed Iwhen Iproviding Icare Ifor Ipatients. IGood Icommunication Ibetween
Iprovider Iand Ipatient Ibridges Ithe Igap Iand Iprovides Iculturally Icompetent Icare.
2. Explain Ihow Iculture Iimpacts Iprovider Iattitudes? I Does Iit? I How Iwill Iyou Iassess Iyour Iown
IattitudesIabout Ivarious Icultures/races/groups?
Differences Iin Iculture Ican Iimpact Iprovider Iattitudes. IAlthough Icultures Idiffer, Ithey Iall Ihave Ithe Isame Ibasic
Iorganizing Ifactors Ithat Imust Ibe Iassessed Iin Iorder Ito Iprovide Icare Ifor Iculturally Idiverse Ipatients. IThese Ifactors
Iinclude: Icommunication I(verbal Iand Inonverbal); Ipersonal Ispace; Isocial Iorganization; Itime Iperception;
Ienvironmental Icontrol; Iand Ibiological Ivariations.
Cultural Icompetency Itraining Iand Icultural Iawareness Ican Ihelp IAPNs Iassess Ihis/her Iown Iattitudes.
3. Review Ithe Iterms Ifor Ithis Iweek Iand Iapply Ithem Ito Ipopulation Ihealth; Ifor Iinstance: Icultural Icompetence,
Icultural Iawareness, Inorms, Ivalues, IKleinman IExplanatory IModel, Isocioeconomic Istatus, Idisparities,
Iminorities, Ifood Idessert.
Culture I– I"the Ipractices, Ibeliefs, Ivalues, Iand Inorms Iwhich Ican Ibe Ilearned Ior Ishared, Iand Iwhich Iguide Ithe
Iactions Iand Idecisions Iof Ieach Iperson Iin Ithe Igroup"
Cultural Icompetence I– Ia Idynamic, Ifluid, Icontinuous Iprocess Iwhereby Ian Iindividual, Isystem Ior Ihealth
Icare Iagency Ifind Imeaningful Iand Iuseful Icare Idelivery Istrategies Ibased Ion Iknowledge Iof Ithe Icultural
Iheritage, Ibeliefs, Iattitudes, Iand Ibehavior Iof Ithose Ito Iwhom Ithey Irender Icare.
, Cultural Iawareness I– ISelf-examination Iof Ione's Iown Iprejudices Iand Ibiases Itoward Iother Icultures. IAn
Iin-depth Iexploration Iof Ione's Iown Icultural/ethnic Ibackground.
Cultural Ihumility I– IA Ilifelong Icommitment Ito Iself-evaluation Iand Iself-critiques, Iredressing Ithe Ipower
Iof Iimbalances Iin Ithe Ipatient- Iphysician Idynamic, Ideveloping Imutually. IBeneficial Irelationships.
Cultural Iknowledge I– IObtaining Ia Isound Ieducational Ifoundation Iconcerning Ithe Ivarious Iworldviews Iof
Idifferences Icultures. IObtaining Iknowledge Iregarding Ibiological Ivariations, Idisease Iand Ihealth Iconditions
Iand Ivariation Iin Idrug Imetabolism.
Cultural Iskill I– IAbility Ito Icollect Iculturally Irelevant Idata Iregarding Ithe Iclient's Ihealth Ihistory Iand
Ipresenting Iproblem. IAbility Ito Iconduct Iculturally Ibased Iphysician Iassessments. IConducting Ithese
Iassessments Iin Ia Iculturally Isensitive Imanner.
Cultural Idesire I– IMotivation Iof Ithe Ihealthcare Iprovider Ito I"want" Ito Iengage Iin Ithe Iprocess Iof Icultural
Icompetence, Icharacteristics Iof Icompassion, Iauthenticity, Ihumility, Iopenness, Iavailability, Iand Iflexibility,
Icommi Itment Iand Ipassion Ito Icaring, Iregardless Iof Iconflict.
Norms I- Irefers Ito Iattitudes Iand Ibehaviors Ithat Iare Iconsidered Inormal, Itypical Ior Iaverage Iwithin Ithat
Igroup.
Values I- Iabstract Iconcepts Ithat Icertain Ikinds Iof Ibehaviors Iare Igood, Iright, Iethical, Imoral Iand Itherefore
Idesirable.
The Idifference Ibetween Ivalues Iand Inorms Iis Ithat Ithe Iformer Iare Iabstract Ithoughts Iwhile Ithe Ilatter
Iare Iexternal Iactions. IA Iculture's Ivalues Irelate Ito Icommonly Iheld Ibeliefs Iabout Iwhat Iis Iconsidered
Idesirable Iand Iproper, Iwhile Icultural Inorms Iare Ithe Iestablished Ibehaviors Ithat Ireflect Ithose Ivalues.
Kleinman IExplanatory IModel I– Isimilar Ito Ia Icultural Iassessment; Iproposes Ithat Iindividuals Iand Igroups
Ican Ihave Ivastly Idifferent Inotions Iof Ihealth Iand Idisease. IKleinman Iproposed Ithat Iinstead Iof Isimply Iasking
Ipatients, I“Where Idoes Iit Ihurt,” Ithe Iphysicians Ishould Ifocus Ion Ieliciting Ithe Ipatient’s Ianswers Ito I“Why,”
I“When,” I“How,” Iand I“What INext.”
Eliciting Ithe Ipatient’s I(explanatory) Imodel Igives Ithe Iphysician Iknowledge Iof Ithe Ibeliefs Ithe
Ipatient Iholds Iabout Ihis Iillness, Ithe Ipersonal Iand Isocial Imeaning Ihe Iattaches Ito Ihis Idisorder, Ihis
Iexpectations Iabout Iwhat Iwill Ihappen Ito Ihim Iand Iwhat Ithe Idoctor Iwill Ido, Iand Ihis Iown Itherapeutic
Igoals. IEliciting Ithe IPatient’s IExplanatory IModel Iof Iillness Ithrough Ia Iset Iof Itargeted Iquestions
Ishown Ibelow Iis Ian Iimportant Itool Ifor Ifacilitating Icross-cultural Icommunication, Iensuring Ipatient
Iunderstanding, Iand Iidentifying Iareas Iof Iconflict Ithat Iwill Ineed Ito Ibe Inegotiated.
• What Ido Iyou Icall Iyour Iproblem?
• What Ido Iyou Ithink Icaused Iyour Iproblem?
• Why Ido Iyou Ithink Iit Istarted Iwhen Iit Idid?
• What Idoes Iyour Isickness Ido Ito Iyou?
• What Ido Iyou Ifear Imost Iabout Iyour Isickness?
• What Iare Ithe Ichief Iproblems Iyour Isickness Ihas Icaused Iyou?
• What Ikind Iof Itreatment Ido Iyou Ithink Iyou Ishould Ireceive?
• What Iis Ithe Imost Iimportant Iresult Iyou Ihope Ito Ireceive Ifrom Ithe Itreatment?
Socioeconomic Istatus I– Ithe Isocial Istanding Ior Iclass Iof Ian Iindividual Ior Igroup. IIt Iis Ioften Imeasured Ias Ia
Icombination Iof Ieducation, Iincome Iand Ioccupation. IExaminations Iof Isocioeconomic Istatus Ioften Ireveal
Iinequities Iin Iaccess Ito Iresources, Iplus Iissues Irelated Ito Iprivilege, Ipower Iand Icontrol.
