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Aplikasi Epidemiology

dalam Keperawatan

Sebagai dasar perencanaan


Intervensi keperawatan
Istianna Nurhidayati
Review Dasar Epidemiologi

 Epidemiologi
– Ilmu yg mempelajari kejadian suatu
penyakit yg menimpa sekelompok
penduduk
 Pendekata epidemiologi saat ini berupa:
– Agen penyebab, pejamu, lingkungan
 Faktor penyebab:
– Biologis, kimiawi, fisik
 Faktor penjamu:
– Umur, sex, suku, ekonomi, perkawinan,
perilaku hidup, genetik, gizi
 Faktor lingkungan
– Air, cuaca, sarana/prasarana, polusi dll
Variable Epidemiologi
 Metoda dan tehnik epidemiologi didesain
untuk mendeteksi adanya hubungan
causal antara suatu penyakit dan
karakteristik seseorang yang menderita
penyakit tsb atau antara penyakit
dengan suatu faktor yg ada dalam
lingkungan
 Perkembangan sekarang aplikasi
epidemiologi meluas; non infeksi
Variable waktu

 Mencatat kejadian menurut suatu kurun


waktu: jam, hari, tahun, musim, hari
besar, dll
Variable Orang
 Dikaitkan dengan ciri ciri yang mereka bawa
sejak lahir maupun yang didapat setelah
mereka lahir; sex, umur, ras, status
kekebalan, status perkawinan)
 Dikaitkan dengan kegiatan mereka: jenis
pekerjaan, permainan/hoby, pengalaman
agama, adat istiadat,
 Keadaan dimana dia tinggal; sosial ekonomi,
kondisi lingkungan
Variable Tempat

 Tempat area geografi, luas maupun


tingginya, alamat kotam negara, wilayah
dsb; rural -urban, jalan raya- jalan desa,
Tropis – sub tropis, dsb.
Peran Perawat Komunitas
Diantaranya:

 Care giver: Mulai pengakajian– evaluasi


– Epidemiologi --- tahap analisa data,

 Program planner
– Fokus pada faktor resiko ; lihat variabel
epidemiologi
– Pelajari Chain of causation or
multicausation
Peran Perawat Komunitas
Diantaranya:

 Primary role in investigation and identification of


factors not only in prevent illness but also promote
health.
 Developing policy and research initiate for public
health
 Researcher in nursing
 Evidence based in nursing study
– Example; Cancer program, injury prevention, etc…
See the end page
Levels of prevention

 Prevention during natural history stage


of disease
– Primary prevention
– Secondary prevention
– Tertiary prevention
Application in Epidemiology of
wellness
 Epidemiology move from communicable
disease to wellness at various level
 Improve method for health planning and health
policy analysis
 Epidemiology has develop more holistic model
 Wellness model now focused on approaches
that encompass aggregates
– Societal change - global economy
– Growing elderly - Communication revbolution
Epidemiology of wellness
– Technology development
– More Behavior development

• Effort at developing health policy


• Research initiatives for public health
Planning for wellness
intervention
 Learn from Natural history stage of a disease
or health condition
– Stage1. Susceptibility; Plan health practices
improve health system
– Stage2. Exposure; Community can learn about
health promoting behavior
– Stage3.Onset; Could trying out the beneficial
policies and activities
– Stage4. Culmination; Could be full adoption and a
higher level of well being for community
Aplication Injury Prevention
(Pejalan kaki dan bersepeda pada anak usia sekolah)
Sebagai Contoh Kasus Aplikasi Epidemiologi

 Problem Statement
– Adakah masalah dengan Kejadian pejalan
kaki dan bermotor?
– Seberapa besar masalah?
– Bagaimana mengungkapkan?
– Apakah kebiajakan transportasi baik?
– Lihat variable epidemiologi
• Waktu, orang, tempat
Epidemiology application to identify
Target population, Goals, and Issues to be
Addressed
 Primary objective: increase public
awareness of risks involved in certain
behavior.
 Target population: children What Year?
How About Parent ?
How about community? Whose Other?
Aplikasi epidemiologi dalam
Rancangan intervensi
 Berfocus pada Kelompok resiko
 Menggunakan pendekatan model
– Triad epidemiology; host, agent,
environment
– Determinant of health;
– Epidemiology of Wellness (more holistic)
Interventions That Have Been
Used
 Education
 Counselling
 Hospital Initiatives
 Community
 Environmental Modification
 Legislative Change
 Comprehensive Approach
Suggestions and Alternatives

 Education
 Engineering
 Enforcement
 Encouragement
Conclusion
 Develop health program planning based on
epidemiology studies;
 Intervention methods related to pedestrian
and bicycling activities for example; have
been varied and have targeted children,
parents, drivers, and communities as a whole,
sometimes singly and sometimes in
combination with one another
Conclusion

However, after careful review of


available literature, it is apparent that
the most effective intervention style to
date is a comprehensive,
multidimensional program with
education, engineering, enforcement,
and encouragement as its foundation.
Epidemiology in Nursing Practice
As a example.

 OrOutbreak of Acute Gastroenteritis in a Geriatric Long-Term–


Care Facility: Combined Application of Epidemiological and
Molecular Diagnostic Methods by; Arthur Marx, MD, MPH;

 Epidemiology of community- and nursing home-acquired


pneumonia in older adults by; Mark Loeb

 The epidemiologic approach to the study of clinical nursing


diagnoses by; Martha M. Brown R.N., Ph.D.
 DLL