Describe one biomedical theory or model frequently used in health care and provide your rational for how it relates to improved patient outcomes.
The theory of web of causation, developed by MacMahon and Pugh, identifies that many disease processes evolve from a culmination of many factors (as cited in McEwen, 2014). The example provided Friedmans adapted web of causation related to cardiac disease is an excellent example (as cited in McEwen, 2014). Viewing the web of causation for coronary artery disease, we can predict the modifiable risk factors that lead to death of cardiac tissue. These modifiable risk factors are the concepts within the framework that can be studied in order to identify appropriate interventions. Studying each concept within the web of causation can yield more information about the disease process and information about how much each concept contributes to the disease (Merril & Timmereck, 2006). This idea is demonstrated by Tilling, Sterne, & Szklo (2002) who studied relationships between cardiovascular risk factorsspecifically smoking, diabetes, basic metabolic
index, and use of anti-hypertensive medication. Tilling et al.(2002) identified that the timing of exposure to smoking, diabetes, and anti-hypertensive medications impacts mortality rates related to cardiovascular disease and added to knowledge surrounding cardiovascular disease. Tilling et. al. (2002) also identified there are many ways to look at all of the concepts and study the relationships between the concepts. For example, Tilling et al. (2002) identified that the results from their study showed that each additional year of smoking a person added to their baseline, reduced life expectancy of that person by 2 months while a study by Mark and Robins had demonstrated quitting smoking increased life expectancy by 50% (as cited in Tilling et al., 2002).
Identifying the impact of each concept on the disease provides healthcare providers to consider how best to initiate preventative strategies. The National Heart, Lung, and Blood Institute (NHLBI) focuses prevention strategies on the risk factors that can be modified to improve high blood cholesterol, high blood pressure, diabetes, weight, smoking, diet, stress and lack of physical activity (NIH, 2011). Within the Vital Statistics of the United States that in 2006, 81.1 million people had some form of cardiovascular disease and 74.5 million people had hypertension (as cited in NHLBI, 2014). This is a large part of why the NHLBI and the American Association place much effort and emphasis on maintaining a healthy blood pressure. Finally, clinical guidelines are created to promote health patient outcomes. This is demonstrated by the American Society of Hypertension and the International Society of Hypertensions publication of guidelines for the
management of hypertesntion (Weber et al., 2014).
Describe one biomedical theory or model that is utilized in your specific practice area. Provide at least two examples related to its application.
My previous clinical practice has been, and continues to be, impacted by the web of causation and cardiovascular disease. The cardiovascular critical care unit has education aimed at reducing peoples risk for developing cardiovascular disease and decreasing risk of heart disease. Events and screenings in the health system include topics of nutrition, diabetes education, and exercise (Susquehanna Health System, 2015). In addition, there are patient education protocols in place for patients diagnosed under specific disease titles. If a patient is diagnosed with a myocardial infarction, they are categorized, and a process is followed to educate the patient. It is like using an algorithm. If a patient is assessed to have a high salt and high fat diet, a nutrition consult is placed and the nurse begins to assess factors that impact the patients diet that may be modified. The hospital also follows tracking guidelines set forth by the center for
disease control to track cardiovascular disease (CDC, 2014).
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