Chickenpox, Its Epidemiology And Nursing Role Free Writing Sample

Introduction

Some communicable diseases can quickly spread through a community without proper prevention and health care. Community health nurses can help stop this from happening by researching and analyzing data and keeping the community educated. One of these communicable diseases is chickenpox, the highly contagious nature of which can affect various groups of people and rapidly disperse through the community. This paper describes the nature of chickenpox and its development in the epidemiologic triangle, explores the roles of the community health nurse and national agencies in the prevention, treatment, and awareness of chickenpox in society.

Disease Description

Chickenpox, otherwise known as varicella, is a communicable disease caused by the varicella-zoster virus (Centers for Disease Control and Prevention, 2017). It is most notably characterized by the itchy rashes, which then turn into fluid-filled blisters that appear first on the stomach, chest, or face and then spread to the rest of the body. Other symptoms may include fever, headache, nausea, malaise, loss of appetite, and tiredness.

These symptoms usually occur before the rashes, which appear after one or two days of infection. After six to ten days, blisters turn into scabs and start falling off. This disease is extremely contagious, as it spreads by direct and indirect ways of transmission through touching or inhaling the virus, which is contained in the blisters’ liquid or coughs and sneezes of an infected individual. The portal of entry for chickenpox is the respiratory system. Affected individuals remain contagious throughout the development of the disease until the formation of scabs.

Although most cases of chickenpox are not severe, some people may encounter a number of complications. There are groups of people that are at a higher risk for complications than others. These groups include infants and adults, pregnant women, and individuals with a weakened immune system, such as patients on various medications and people with HIV, AIDS, or cancer. Complications can range from mild to serious.

Such complications include bleeding, pneumonia, bacterial skin infections, and encephalitis. According to Chowdhury et al. (2014), some individuals may encounter rather serious complications, which have to be treated by a medical professional. For example, one young adult infected by chickenpox developed a urinary tract infection, encephalitis, septicemia, and disseminated intravascular coagulation (Chowdhury et al., 2014).

Another study by Amalnath, Karthikeyan, Thammishetti, Subrahmanyam, and Surendran (2016) shows that individuals with chickenpox can suffer from serious neurological complications, such as cerebellitis, cortical venous thrombosis, and arterial stroke. Pregnant women, who are infected with chickenpox, may additionally affect the unborn child, which can result in it being born with congenital varicella syndrome and limb abnormalities.

The primary way of dealing with chickenpox is vaccination. It prevents most patients from getting infected. Vaccinated patients that get infected don’t usually develop a severe case of chickenpox. If a person does not show any signs of complications, the disease can be treated at home after a consultation with a health professional. Some ways of treatment include antiviral medications, symptom-relieving lotions and balms, and non-aspirin fever-reducing medications (Centers for Disease Control and Prevention, 2017).

In the case of complications, infected individuals should receive professional medical treatment. According to the National Center for Health Statistics, the incidence, morbidity, mortality, and prevalence of this disease are continuously declining due to vaccination (Centers for Disease Control and Prevention, 2017).

Health Determinants

The determinants of health are factors that impact a person’s well-being. They include social status, economic environment, education, physical environment, individual characteristics, genetics, behavior, and habits of a person. Every one of these factors can affect the development of chickenpox. For example, the physical environment of an individual with unsafe water or contaminated air, as well as an unhealthy workplace, can result in a faster spread of the disease.

Because chickenpox is highly contagious, the environment of healthy and infected people plays a significant role in the disease’s development. Poorer conditions and the inability to get vaccinated lead to fast contamination. Moreover, if individuals that have complications cannot receive proper treatment at the hospital, they are more likely to not only spread the disease but also to suffer more negative outcomes. Personal habits and behavior also impact the overall health of individuals. For example, proper hygiene is crucial for both infected and uninfected persons.

Epidemiologic Triangle

The epidemiologic triangle is a three-corner model that shows the process of disease spreading. This model includes an agent, a host, and an environment. The agent is something that causes a disease. In this case, the cause of chickenpox is a virus called the varicella-zoster virus. This virus spreads through the infected cells. The host is an organism that spreads the disease. For chickenpox, most hosts are represented by infected individuals and the fluids of the blisters that can be transmitted through air or direct contact. The hosts can be affected differently by this disease because of some personal characteristics.

For example, adults that are infected with chickenpox may encounter more complications than infected children. The environment is the last corner of the epidemiologic triangle. It encompasses the external conditions and surroundings of the host that cause the disease to be transmitted. This virus is spread through direct or indirect contact with an infected person. It can also survive for a short amount of time to be transmitted through some contaminated items, such as clothes of an infected person.

Role of the Community Health Nurse

The spread of chickenpox can be stopped or evaded with preventative measures, such as vaccination. Therefore, medical professionals that are responsible for educating the public and collecting necessary data to predict an outbreak play a significant role in the health of the community. One of these professionals is a community health nurse whose objectives include monitoring and interacting with community members to prevent health issues before they spread through the entire community.

In the case of chickenpox, it is important for community health nurses to collect and analyze the data about individuals, who were or were not vaccinated. Looking at the most common causes of infected patients can also provide some insight into the demographic situation of the community, which may allow the nurses to inform certain groups of patients to take precautions. Analyzing the most frequent complications can help community health nurses to identify possible connections or influences that are present in the community. The promotion of proper hygiene, vaccination, and overall disease awareness can also become one of the nurses’ goals. If treated right and timely, chickenpox can be a disease that does not significantly challenge the community’s health.

National Agency

Chickenpox is caused by a virus that can also result in a person getting other types of diseases. One of them is shingles, which can be developed separately or as a continuation of smallpox. Post-herpetic neuralgia is another infection that can appear because of this virus. All of the diseases that are caused by the varicella-zoster virus can cause a lot of pain to infected individuals. The National Shingles Foundation is an organization that focuses on the issues connected to the varicella-zoster virus.

This foundation is non-profit. Its primary activities include building community awareness and raising funds to research the virus, various aspects of the diseases, and their effect on human organisms (National Organization for Rare Disorders, 2017). The foundation focuses on research to prevent the virus from appearing and spreading in the first place rather than analyzing the effects of the epidemics.

Moreover, the National Shingles Foundation provides interested individuals with information about the causes, symptoms, complications, and treatment of varicella-zoster virus-related diseases. However, it does not offer medical advice or assistance, although the website has some information about preventative measures, treatments, and psychosocial interventions (National Organization for Rare Disorders, 2017).

Conclusion

Chickenpox is a highly contagious communicable disease caused by the varicella-zoster virus. Its main symptoms are rashes and blisters that appear on the skin of infected patients after one to two days of nausea, fever, and tiredness. The disease enters the body through the respiratory tract and can be transmitted through air or direct contact with the infected individual’s blisters. Some affected persons can encounter a number of complications that range from bleeding and bacterial skin infections to encephalitis, cerebellitis, and arterial stroke. Infants, adults, pregnant women, and people with weakened immune systems are at a higher risk of developing complications.

Chickenpox can be controlled and prevented by means of vaccination. The role of a community health nurse in the treatment of chickenpox is to spread awareness to the community and collect data connected to the disease. Giving necessary information to individuals is also the primary goal of the National Shingles Foundation.

References

Amalnath, D., Karthikeyan, A., Thammishetti, V., Subrahmanyam, D. K. S., & Surendran, D. (2016). Neurological complications due to chicken pox in adults: A retrospective study of 20 patients. Annals of Indian Academy of Neurology, 19(1), 161.

Centers for Disease Control and Prevention. (2017). Chickenpox. Web.

Chowdhury, M. K., Siddique, A. A., Haque, M. M., Ali, S., Biswas, S., Biswas, P. K., & Ahasan, H. N. (2014). Life threatening complications of chicken pox in a young adult. Journal of Medicine, 15(1), 55-57.

National Organization for Rare Disorders. (2017). National Shingles Foundation. Web.

Divorce Impact On Child-Rearing Styles

The impact of divorce or separation on child-rearing styles can be different, depending on various factors such as sex, age, education level, relationships with the child, and social background. For example, more highly educated fathers who are divorced are more likely to have an authoritative parenting style (Bastaits, Ponnet, Van Peer, & Mortelmans, 2014). The authors also point out that girls of divorced fathers are more likely to have a parent with an uninvolved rearing style because fathers identify more with their sons than daughters (Bastaits et al., 2014). Furthermore, divorced parents are more likely to have different rearing styles; if a mother has an authoritative parenting style, a father is more likely to have a permissive parenting style.

Both authoritative and attached rearing styles have a direct impact on a child’s identity development (Tsuji, 2017). Alami, Khosravan, Moghadam, Pakravan, and Hosseni (2014) found that there was a positive correlation between an authoritative style and adolescents’ self-esteem both in two-parent and single-parent families.

It should be noted that widowed mothers had a particular parenting style that was characterized as sentimental and focused on self-ignorance, sacrifice, and extensive child care (Alami et al., 2014). Such parenting displayed a high level of support and a low level of control and aligned with the characteristics of a similar parenting style known as supportive parenting.

Parental stress related to a conflict with his or her spouse or divorce can also significantly influence the rearing style of a parent. Single parents who express signs of anxiety or depression are more likely to develop anxious rearing styles that will also evoke anxious behaviors in their child (Platt, Williams, & Ginsburg, 2016). It is important to remember that if a divorced parent is able to support friendly relationships with their former spouse, it is more likely that their parenting style will be more efficient, and the child will not be involved in the parental conflict (Amato, 2014).

Additional attention should be paid to the parenting style of nonresident fathers. Nonresident fathers can display an authoritative style of parenting that will be efficient for the child due to shorter lengths of meetings and the general greater distance of parenting of a nonresident father. However, divorce or separation can also lead to a more aggravated parenting style of mothers (Karre & Mounts, 2012).

Since separation or divorce can lead to serious stress or depressive symptoms in parents, it is also possible to assume that the rearing style might change from authoritative to uninvolved, from attached to low-support parenting. A low level of conflict with an ex-spouse can also encourage the parent to have a more sensitive parenting style than if a conflict between former spouses is present.

At the same time, both mothers and fathers can develop excessive authoritarian parenting style during or after the divorce proceedings due to high-stress levels or alienation from their child. An authoritative parenting style is not a negative factor per se because it can influence the child positively. However, if the child-parent relationships are complicated with issues triggered by a divorce (parental stress, depression, anxiety, possible substance abuse, or worsened mental health), an authoritative style can become too excessive, and, thus, ineffective or even harmful.

It is less likely that a divorce or separation will influence the rearing styles positively; however, if divorced parents are able to maintain friendly relationships, their rearing styles might be more supportive and attentive to the needs and demands of their child.

References

Alami, A., Khosravan, S., Moghadam, L. S., Pakravan, F., & Hosseni, F. (2014). Adolescents’ self-esteem in single and two-parent families. International Journal of Community Based Nursing and Midwifery, 2(2), 69-76.

Amato, P. R. (2014). The consequences of divorce for adults and children: An update. Drustvena Istrazivanja, 23(1), 5-25.

Bastaits, K., Ponnet, K., Van Peer, C., & Mortelmans, D. (2014). The parenting styles of divorced fathers and their predictors. Journal of Social and Personal Relationships, 32(5), 557-579.

Karre, J. K., & Mounts, N. S. (2012). Nonresident fathers’ parenting style and the adjustment of late-adolescent boys. Journal of Family Issues, 33(12), 1642-1657.

Platt, R., Williams, S. R., & Ginsburg, G. S. (2016). Stressful life events and child anxiety: Examining parent and child mediators. Child Psychiatry & Human Development, 47(1), 23-34.

Tsuji, B.H. (2017). Human development. Class notes in PSYC1002R, Carleton University.

Computerized Provider Order Entry And Clinical Decision Support

In his discussion of Computerized Provider Order Entry (CPOE) and Clinical Decision Support (CDS), Dr. Smith demonstrates their importance by considering their advantages in comparison to handwritten orders. For instance, he shows that CPOE has the potential of reducing the time required to communicate order information and the mistakes that can occur in the process. Moreover, CPOE has the advantage of being compatible with CDS, which offers multiple opportunities for even faster and more error-free ordering, for example, through order sentences and alerts. Thus, the benefits of CPOE adoption are apparent.

Dr. Smith also mentions the barriers to CDS and CPOE effectiveness, including human error, the lack of training, and various issues in implementation that prevent the adoption from being successful. For instance, Dr. Smith considers alert fatigue, which has indeed been shown to have negative effects on patient outcomes (Carspecken, Sharek, Longhurst, & Pageler, 2013). Carspecken et al. (2013) also show that meaningful changes in the alert system can improve the situation, which illustrates the difference between successful adoption and unfinished implementation.

The adoption of CDS and CPOE is bound to have an impact on public health (PH) since the two can be regarded as an element of the healthcare “factory” (fast, efficient, automatized care) that Shillingstad describes. This fact has been proven, for example, by Krive, Shoolin, and Zink (2015) who demonstrate that CDS and CPOE adoption can result in reduced mortality in pneumonia patients. Similarly, the literature review by Dixon, Gamache, and Grannis (2013) indicates that CPOE-related improvements in communication between clinicians are crucial for PH outcomes. Thus, when considering a PH informatics project, I would suggest one related to the adoption of CDS-assisted CPOE at a hospital.

The phase of designing the adoption is very extensive. Among other things, it needs to take into account major aspects of CDS and CPOE work, including an evaluation of the product and determination of specific cases of its employment (Smith, 2013). Moreover, it needs to predict and plan to overcome or prevent possible barriers and risks. Budgeting is also a major concern of this phase as well as organizational investigation. Thus, the design phase involves data collection and analysis, the results of which are employed for intervention planning.

The process of implementation introduces new considerations, including the issue of stakeholder involvement. The leadership of the organization includes key stakeholders (Smith, 2013), and engaging them is a priority. However, the engagement of the co-workers who are interested in the project can be carried out with the aim of collecting data and showing the extent of the concern to the leaders, which should, in turn, make them more willing to cooperate. Other implementation concerns follow engagement, and they include training, process and performance management, change resistance management, continuous identification of barriers and issues and their resolution, and so on.

While technically local, the project would significantly improve the quality of care at the hospital, which would result in PH outcomes. Moreover, the project would have direct consequences for the employees: as the Medicare Access and CHIP Reauthorization Act of 2015 promotes performance- and outcome-based reimbursement (Hirsch et al., 2015), healthcare specialists will benefit from the improved outcomes of CDS and CPOE that are adopted right (Krive et al., 2015; Smith, 2013). The correct adoption is the aim of the proposed project, which makes it valuable from multiple perspectives.

References

Carspecken, C., Sharek, P., Longhurst, C., & Pageler, N. (2013). A clinical case of electronic health record drug alert fatigue: Consequences for patient outcome. PEDIATRICS, 131(6), 1970-1973. Web.

Dixon, B., Gamache, R., & Grannis, S. (2013). Towards public health decision support: a systematic review of bidirectional communication approaches. Journal of the American Medical Informatics Association, 20(3), 577-583. Web.

Hirsch, J., Harvey, H., Barr, R., Donovan, W., Duszak, R., & Nicola, G., … Manchikanti, L. (2015). Sustainable growth rate repealed, MACRA revealed: Historical context and analysis of recent changes in Medicare physician payment methodologies. American Journal of Neuroradiology, 37(2), 210-214.

Krive, J., Shoolin, J., & Zink, S. (2015). Effectiveness of evidence-based pneumonia CPOE order sets measured by health outcomes. Online Journal Of Public Health Informatics, 7(2), 1-15.

Smith, P. (2013). Making computerized provider order entry work. London, UK: Springer London.

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