Sakit kepala adalah gejala umum dari tumor otak, tapi biasanya disertai dengan gejala lain. Sakit kepala pada tumor otak memiliki karakteristik sendiri yang membedakannya dengan sakit kepala pada umumnya. (foto: Republika.co.id)
Sakit kepala adalah gejala umum dari tumor otak, tapi biasanya disertai dengan gejala lain. Sakit kepala pada tumor otak memiliki karakteristik sendiri yang membedakannya dengan sakit kepala pada umumnya. (foto: Republika.co.id)
Anak-anak yang terkena paparan terapi radiasi sebelum usia lima tahun diketahui memiliki risiko untuk terkena tumor pada otak atau sistem saraf pusatnya beberapa tahun kemudian. Data itu diperoleh dari penelitian terhadap anak-anak yang bertahan hidup dari kanker semasa kanak-kanak. Jenis tumor saraf yang sering ditemui pada anak-anak yaitu gliomas dan meningiomas, yang umumnya ditemukan pada otak dan juga bagian lainnya.
Sekitar 1% dari total penderita kanker usia anak-anak yang mampu bertahan dalam selang waktu bertahun-tahun diketahui akan terkena tumor pada sistem sarafnya jika mereka terkena radiasi. Risiko tertinggi untuk terkena kanker kedua kalinya (kanker pada sistem saraf) untuk anak-anak yang menjalani terapi radiasi pada usia sangat muda memiliki kemungkinan untuk berkembang menjadi kanker otak di kemudian hari.
Sebuah penelitian yang melibatkan 14.361 penderita kanker pada usia anak-anak yang bertahan setelah lima tahun terbebaskan dari kanker, 116 anak di antaranya beberapa tahun kemudian menderita kanker saraf. Sebanyak 40 orang di antaranya menderita gliomas berselang sembilan tahun setelah bebas dari kanker pertama di usia anak-anak dan 66 di antaranya menderita kanker meningiomas selang 17 tahun setelah dinyatakan sembuh dari kanker pertama pada usia anak-anak.
Penyembuhan dengan cara radiasi diketahui memang memiliki risiko hingga enam kali lipat untuk menyebabkan terjadinya glioma dan sepuluh kali lipat untuk terkena meningioma. Risiko terkena kanker pada saraf akan semakin meningkat seiring dengan meningkatnya dosis radiasi yang digunakan untuk terapi penyembuhan dari kanker pertama yang dideritanya.
Namun, para peneliti menyimpulkan bahwa perlu adanya pengamatan lebih lanjut bagi anak-anak yang mampu bertahan dari kanker di usia muda terutama yang menjalani terapi radiasi untuk menjadi petunjuk atau deteksi dini terhadap jenis kanker yang akan menyerang selanjutnya.
Kanker otak terjadi karena adanya pertumbuhan sel otak yang tidak normal. Kanker otak dapat terjadi pada anak-anak dan orang dewasa, namun angka kejadian kanker otak pada keduanya relatif jarang. Tumor otak dapat dikelompokkan menjadi malignan (kanker) atau jinak (non kanker). Kanker cenderung lebih agresif dibanding tumor, namun keduanya sangat serius dan dapat berakibat fatal. Untuk tujuan pengetahuan, artikel ini hanya terkait dengan keganasan tumor otak pada dewasa saja.
Ada lebih dari 140 jenis tumor otak yang dapat terbentuk di otak. Tumor otak dapat diklasifikasikan menjadi primer dan metastasis, tergantung di mana munculnya tumor di tubuh. Tumor otak primer berasal dari otak dan jarang terjadi penyebaran keluar otak. Tumor metastasis berasal dari bagian tubuh lain dan menyebar ke otak melalui darah atau jaringan limfatik. Beberapa jenis kanker yang dapat menyebar ke otak adalah kanker payudara, kanker ginjal, melanoma dan kanker kulit.
Penyebab Kanker Otak
Kita tidak mengetahui secara pasti apa penyebab tumor otak, namun beberapa penelitian menunjukkan ada beberapa faktor resiko yang berperan dalam perkembangannya. Faktor resiko tersebut adalah:
Riwayat keluarga yang memiliki gangguan genetik seperti neurofibromatosis, tuberous sclerosis, penyakit Von Hippel-Lindau dan sindrom Li-Fraumeni.
Sistem pertahanan tubuh dan rentan (berhubungan dengan limfoma sistem saraf pusat dan orang yang terinfeksi AIDS)
Ada beberapa penyebab dan faktor resiko yang tidak terbukti dalam penelitian. Telpon selular dan konsumsi aspartam merupakan 2 hal yang sangat kontroversi yang dipercaya oleh beberapa orang dapat menyebabkan kanker otak.
Gejala Tumor Otak
Gejala tumor otak sangat tergantung pada lokasi dan ukuran tumor. Tingkat keparahan gejala yang muncul tidak menggambarkan ukuran tumor yang ada, karena tumor yang ukurannya kecil juga bisa mengakibatkan gejala yang berat juga.
Sakit kepala adalah gejala umum dari tumor otak, tapi biasanya disertai dengan gejala lain. Sakit kepala pada tumor otak memiliki karakteristik sendiri yang membedakannya dengan sakit kepala pada umumnya. Berbeda dengan apa yang orang percaya saat ini, sakit kepada bukanlah merupakan gejala awal yang dialami, sebenarnya merupakan ketegangan atau kelemahan otot yang sering terjadi pada gejala awal tumor otak.
Gejala tumor otak lainnya meliputi:
mual dan / atau muntah
gangguan pendengaran dan penglihatan
masalah dengan memori
lambat dalam proses berfikir
lemah pada satu sisi tubuh
kelelahan atau peningkatan frekuensi tidur
Perubahan kepribadian
Bagaimana Mendiagnosis Kanker Otak
Jika dokter mencurigai adanya tumor otak, salah satu langkah pertama untuk mendapatkan diagnosis yang akurat adalah melalui Magnetic Resonance Imaging (MRI). Tes pencitraan memberikan gambaran yang luar biasa dari otak dan hal ini sering satu-satunya tes yang dibutuhkan untuk mengidentifikasi kemungkinan adanya tumor otak. Dalam beberapa kasus, dapat digunakan CT scan. PET scan, yang membantu dokter melihat aktivitas otak, dapat membantu mendiagnosa kanker otak primer namun penggunaannya lebih pada kondisi metastasis.
Pada akhirnya, biopsy adalah yang digunakan untuk menentukan keganasan dan jenis tumor otak. Jika tumor telah terdiagnosa dengan MRI dan jenis kanker tersebut memiliki sifat bermetastasis, maka biopsi mungkin tidak diperlukan. Namun, dengan jenis kanker yang tidak sering menyebar ke otak, biopsi merupakan alat diagnostik yang vital. Tumor otak primer adalah yang paling sering memerlukan biopsi.
Biopsi otak dapat dilakukan selama masa operasi. Jaringan sampel dapat diperiksa di ruang operasi, yang memungkinkan ahli bedah untuk membuat keputusan tentang apakah akan melanjutkan dengan pembedahan atau tidak. Evaluasi lebih luas dari spesimen tumor juga akan dilakukan oleh ahli patologi. Mungkin diperlukan waktu beberapa hari untuk mengetahui hasilnya.
Dalam beberapa kasus, biopsi tertutup, juga disebut biopsi stereotactic, dilakukan bila tumor terletak di wilayah otak yang sulit dijangkau. Ini adalah jenis biopsy yang paling tidak invasif, tetapi tidak memiliki risiko.
Pengobatan Tumor Otak
Tumor otak diterapi oleh sekelompok dokter yang professional dalam beberapa hal mereka merupakan sebuah tim yang terdiri dari berbagai macam spesialisasi. Tim ini terdiri dari seorang ahli bedah saraf, ahli onkologi medis atau neuro-onkologi, onkologi radiasi, dan ahli patologi. Selain para dokter, biasanya perawat juga ikut berperan serta dalam tim ini.
Jenis tumor, lokasi, dan kelas akan menentukan rencana pengobatan. Perawatan kuratif adalah memungkin pada beberapa tumor, sedangkan memperlambat pertumbuhan atau hanya menghilangkan gejala-gejala yang parah mungkin juga merupakan tujuan pengobatan lainnya. Sayangnya, pada beberapa jenis tumor otak tidak ada program pengobatan yang direkomendasikan.
Pendekatan operasi dalam pengobatan tumor otak termasuk reseksi tumor (penghapusan lengkap) atau debulking (menghapus sebanyak mungkin). Dalam beberapa kasus, pembedahan mungkin merupakan satu-satunya metode pengobatan yang diperlukan, tetapi untuk kasus yang lain mungkin membutuhkan metode perawatan yang berbeda, seperti terapi radiasi. Pada banyak jenis kanker kombinasi antar operasi dan radiasi merupakan hal yang umum dilakukan. Ada beberapa jenis terapi radiasi digunakan untuk mengobati tumor otak. Sekali lagi, jenis tumor, kelas, dan lokasi adalah faktor kunci dalam menentukan jenis terapi yang terbaik.
Namun terapi radiasi juga memiliki risiko. Hal ini dapat merusak bagian dari otak, menyebabkan penurunan kognitif, seperti hilangnya memori dan kesulitan berkonsentrasi. Pembengkakan dapat menjadi efek samping, tetapi dapat dikontrol dengan kortikosteroid. Nekrosis radiasi juga bisa merupakan efek samping dari radiasi. Dalam istilah sederhana, ini adalah pembentukan jaringan otak iradiasi yang telah mati dan berkembang menjadi massa. Pembedahan mungkin diperlukan untuk mengangkat jaringan yang mati.
Kemoterapi dapat digunakan pada beberapa tumor yang diketahui dapat merespon kemoterapi dengan baik, seperti limfoma SSP, glioma, atau medullablastomas. Beberapa tumor stadium tinggi merespon dengan baik, tetapi tidak semua. Jadi, kemoterapi bisa diberikan pada pasien dengan tumor yang peka terhadap kemoterapi.
Terapi obat target seperti Avastin lebih tepat daripada beberapa obat kemoterapi dan sering pula efek samping yang dihasilkan lebih sedikit. Mekanisme kerja obat Avastin adalah dengan memotong pasokan darah ke tumor, mencegah pertumbuhan dan menyusutkan massa tumor. Tidak semua orang merespon Avastin, dan hal lain yang harus menjadi perhatian juga bahwa biaya pengobatan dengan pobat ini cukup mahal. (fn/dc/tk) www.suaramedia.com
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Public Health Nursing
Gale Encyclopedia of Public Health:
Public Health Nursing
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Home > Library > Health > Public Health Encyclopedia
Public health nursing is a specialized form of registered nursing that combines nursing and public health principles. According to the American Public Health Association, the primary focus of public health nursing is improving the health of the community as a whole rather than just that of an individual or family. Public health nursing is sometimes called a type of community health nursing. Some experts use the terms "public health nursing" and "community health nursing" interchangeably.
History
Public health nursing traces its roots to England where, in 1859, Florence Nightingale assisted in organizing district public health nursing. Each nurse was assigned a specific geographic area of London and was responsible for the health of the people living in that neighborhood. This type of organization finds its echo today in many public health departments, where public health nurses organize their work by groups of census tracts called districts and the nurse is known as the district public health nurse.
In the United States, modern public health nursing was defined by pioneering nurse Lillian Wald in the late 1800s. She established the Henry Street Settlement in New York City, where nurses lived in the neighborhoods where they worked. In the beginning, public health nursing was primarily concerned with taking care of the sick poor in their homes. Lillian Wald came to the realization that sickness found in the home had its origin in larger societal problems. She set about directing nursing efforts toward employment, sanitation, recreation, and education. It was Lillian Wald who coined the term "public health nurse." Hospital-based schools of nursing which granted nursing diplomas provided the educational preparation for nurses at this time.
In the early part of the twentieth century, Visiting Nurses Associations were formed to continue the tradition of providing care for the sick in their homes, which eventually became known as home health nursing. Public health nursing began to be practiced in both voluntary agencies such as the American Red Cross, and governmental agencies, such as local county and city health departments. Serving the needs of the poor remained a key aspect of public health nursing. In the mid twentieth century, care shifted from the home to the clinic, where nurses worked in well baby and immunization clinics for the uninsured and were active in controlling communicable diseases such as tuberculosis.
In the latter part of the twentieth century, nursing education began to move out of hospitalbased programs and into community colleges and universities. Educational preparation for public health nurses varies widely in the United States with some jurisdictions requiring a bachelor's degree in nursing and others accepting a hospital diploma or associate degree from a community college. A bachelor's degree in nursing is considered a minimum requirement for public health nursing practice by many nursing professionals and professional nursing organizations. A bachelor's degree in nursing is thought to provide the background in social science and public health science such as epidemiology and environmental health that a public health nurse needs. Increasingly, public health nurses are enrolling in advanced degree programs in public health, community health nursing, and other public health specialties.
The Role of the Public Health Nurse
Ideally, the work of public health nurses is defined as "primary prevention," which means preventing disease, injury, disability and premature death. Public health nurses work as a team with other public health professionals such as environmental health specialists, health educators, epidemiologists, public health physicians, and nutritionists. As members of this team, they work with local communities to assess and prioritize the major health problems and work on a plan to alleviate or eliminate these problems and the conditions that contribute to their development.
Public health nurses are able to assist individuals and families to take action to improve their health status. Often this takes the form of teaching about healthy lifestyle choices in the home, in the workplace, and in community settings. Public health nurses assist people in applying improved health behavior choices to their everyday lives. Examples of personal behaviors that can contribute to health problems are tobacco use, improper diet, lack of physical exercise, unsafe sexual practices, and driving while intoxicated.
Public health nurses also recognize that the community and environment in which people live can affect their ability to make healthy lifestyle choices and can affect whether or not such choices exist at all. Thus, public health nurses may spend a significant portion of their time on ensuring healthy living conditions in the neighborhoods where they work and on improving the health status of the entire community, not just that of individuals. Examples of community issues on which the public health nurse may work are reducing tobacco sales to minors, fluoridation of drinking water, identifying and reducing workplace hazards, immunization of all children against communicable diseases, and reducing the risk of drowning through community education, pool safety, and construction regulation.
Public health nurses are found in a variety of settings, including schools and the workplace. Public health nurses who assist workers at the job site are called occupational health nurses. Some nurses work in local government health departments as general practice nurses in neighborhoods. In some health departments, the community intervention role of public health nurses is not well established and their work is confined to home visits and clinic work. Their primary role is that of case manager and they have a varied caseload of individuals and families whom they assist with illness-oriented concerns, such as communicable diseases and health problems of mothers and children. Sometimes, these case manager public health nurses specialize in one area, such as follow up of cases of lead poisoning or sudden infant death syndrome. Much of the funding for public health work has been fragmented, coming to local government jurisdictions from state and federal sources for a specific problem or intervention only. As a consequence, public health nursing in many settings has become more specialized and even more concentrated on caring for individuals and families, usually in the home.
Many public health nursing experts feel that this emphasis on caring for people with a disease or condition has hindered public health nurses from being full participants in public health and has diverted public health nursing away from its prevention role. Some in public health nursing would even argue that, as a result, the practice of public health nursing has lost its way and needs to refocus on the true mission of public health: to look at the health problems of a community as a whole and work with the community in alleviating those problems. They would argue that there is the mistaken perception of public health nurses as providers of personal care only. The challenge for public health nurses in the future is to apply the nursing process (assessment, diagnosis, planning, implementation, and evaluation of interventions) to improve health, not just of individuals, but also with larger segments of the population in partnership with the community.
Trends and Future Directions
The practice of public health nursing has been greatly affected by sources of funding. Much of the past focus on clinic work and personal health care for the indigent and uninsured has been driven by the need to limit nursing work to what was reimbursable by a third party, such as Medicaid in the United States. Many public health nurses practice in local health departments, which are seen as the providers of last resort for care of the sick poor and the uninsured. County hospital care and out patient services have taken much of the public health funding and attention away from the primary goal of public health, that is, improving the health of the entire community. However, this is gradually changing, with a major shift in the 1990s to health plans (managed care) and the movement of Medicaid populations, in most states, into managed care programs. This has made caring for sick low-income people more financially viable for the private sector. Consequently, local health departments and their public health nursing staff have been encouraged to shift their activities back toward the primary mission of public health, which is to work on the causes of health problems and to prevent them.
(SEE ALSO: Barrier Nursing; Nurse; Practice of Public Health)
Bibliography
American Public Health Association Public Health Nursing Section (1996). The Definition and Role of Public Health Nursing. Washington, DC: Author.
Anderson, E. T., and McFarlane, J. (1996). Community as Partner: Theory and Practice in Nursing, revised edition. Philadelphia, PA: Lippincott.
Buhler-Wilkerson, K. (1993). "Bringing Care to the People: Lillian Wald's Legacy to Public Health Nursing." American Journal of Public Health 83(December):1778–1786.
Clark, M. J. (1996). Nursing in the Community, revised edition. Stanford, CT: Appleton and Lange.
Helvie, C. O. (1998). Advanced Practice Nursing in the Community. Thousand Oaks, CA: Sage Publications.
Keller, L. O.; Strohschein, S.; Lia-Hoagberg, B.; and Schaffer, M. (1998). "Population-Based Public Health Nursing Interventions: A Model from Practice." Public Health Nursing 15(June):207–215.
Kosidlak, J. G. (1999). "The Development and Implementation of a Population-Based Intervention Model for Public Health Nursing Practice." Public Health Nursing 16(October):311–320.
National Association of County Health Officials (1993). Core Public Health Functions. July.
Stanhope, M., and Lancaster, J. (2000). Community and Public Health Nursing, revised edition. St. Louis, MO: Mosby.
— KATHLEEN N. SMITH
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Public Health Nursing
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Home > Library > Health > Public Health Encyclopedia
Public health nursing is a specialized form of registered nursing that combines nursing and public health principles. According to the American Public Health Association, the primary focus of public health nursing is improving the health of the community as a whole rather than just that of an individual or family. Public health nursing is sometimes called a type of community health nursing. Some experts use the terms "public health nursing" and "community health nursing" interchangeably.
History
Public health nursing traces its roots to England where, in 1859, Florence Nightingale assisted in organizing district public health nursing. Each nurse was assigned a specific geographic area of London and was responsible for the health of the people living in that neighborhood. This type of organization finds its echo today in many public health departments, where public health nurses organize their work by groups of census tracts called districts and the nurse is known as the district public health nurse.
In the United States, modern public health nursing was defined by pioneering nurse Lillian Wald in the late 1800s. She established the Henry Street Settlement in New York City, where nurses lived in the neighborhoods where they worked. In the beginning, public health nursing was primarily concerned with taking care of the sick poor in their homes. Lillian Wald came to the realization that sickness found in the home had its origin in larger societal problems. She set about directing nursing efforts toward employment, sanitation, recreation, and education. It was Lillian Wald who coined the term "public health nurse." Hospital-based schools of nursing which granted nursing diplomas provided the educational preparation for nurses at this time.
In the early part of the twentieth century, Visiting Nurses Associations were formed to continue the tradition of providing care for the sick in their homes, which eventually became known as home health nursing. Public health nursing began to be practiced in both voluntary agencies such as the American Red Cross, and governmental agencies, such as local county and city health departments. Serving the needs of the poor remained a key aspect of public health nursing. In the mid twentieth century, care shifted from the home to the clinic, where nurses worked in well baby and immunization clinics for the uninsured and were active in controlling communicable diseases such as tuberculosis.
In the latter part of the twentieth century, nursing education began to move out of hospitalbased programs and into community colleges and universities. Educational preparation for public health nurses varies widely in the United States with some jurisdictions requiring a bachelor's degree in nursing and others accepting a hospital diploma or associate degree from a community college. A bachelor's degree in nursing is considered a minimum requirement for public health nursing practice by many nursing professionals and professional nursing organizations. A bachelor's degree in nursing is thought to provide the background in social science and public health science such as epidemiology and environmental health that a public health nurse needs. Increasingly, public health nurses are enrolling in advanced degree programs in public health, community health nursing, and other public health specialties.
The Role of the Public Health Nurse
Ideally, the work of public health nurses is defined as "primary prevention," which means preventing disease, injury, disability and premature death. Public health nurses work as a team with other public health professionals such as environmental health specialists, health educators, epidemiologists, public health physicians, and nutritionists. As members of this team, they work with local communities to assess and prioritize the major health problems and work on a plan to alleviate or eliminate these problems and the conditions that contribute to their development.
Public health nurses are able to assist individuals and families to take action to improve their health status. Often this takes the form of teaching about healthy lifestyle choices in the home, in the workplace, and in community settings. Public health nurses assist people in applying improved health behavior choices to their everyday lives. Examples of personal behaviors that can contribute to health problems are tobacco use, improper diet, lack of physical exercise, unsafe sexual practices, and driving while intoxicated.
Public health nurses also recognize that the community and environment in which people live can affect their ability to make healthy lifestyle choices and can affect whether or not such choices exist at all. Thus, public health nurses may spend a significant portion of their time on ensuring healthy living conditions in the neighborhoods where they work and on improving the health status of the entire community, not just that of individuals. Examples of community issues on which the public health nurse may work are reducing tobacco sales to minors, fluoridation of drinking water, identifying and reducing workplace hazards, immunization of all children against communicable diseases, and reducing the risk of drowning through community education, pool safety, and construction regulation.
Public health nurses are found in a variety of settings, including schools and the workplace. Public health nurses who assist workers at the job site are called occupational health nurses. Some nurses work in local government health departments as general practice nurses in neighborhoods. In some health departments, the community intervention role of public health nurses is not well established and their work is confined to home visits and clinic work. Their primary role is that of case manager and they have a varied caseload of individuals and families whom they assist with illness-oriented concerns, such as communicable diseases and health problems of mothers and children. Sometimes, these case manager public health nurses specialize in one area, such as follow up of cases of lead poisoning or sudden infant death syndrome. Much of the funding for public health work has been fragmented, coming to local government jurisdictions from state and federal sources for a specific problem or intervention only. As a consequence, public health nursing in many settings has become more specialized and even more concentrated on caring for individuals and families, usually in the home.
Many public health nursing experts feel that this emphasis on caring for people with a disease or condition has hindered public health nurses from being full participants in public health and has diverted public health nursing away from its prevention role. Some in public health nursing would even argue that, as a result, the practice of public health nursing has lost its way and needs to refocus on the true mission of public health: to look at the health problems of a community as a whole and work with the community in alleviating those problems. They would argue that there is the mistaken perception of public health nurses as providers of personal care only. The challenge for public health nurses in the future is to apply the nursing process (assessment, diagnosis, planning, implementation, and evaluation of interventions) to improve health, not just of individuals, but also with larger segments of the population in partnership with the community.
Trends and Future Directions
The practice of public health nursing has been greatly affected by sources of funding. Much of the past focus on clinic work and personal health care for the indigent and uninsured has been driven by the need to limit nursing work to what was reimbursable by a third party, such as Medicaid in the United States. Many public health nurses practice in local health departments, which are seen as the providers of last resort for care of the sick poor and the uninsured. County hospital care and out patient services have taken much of the public health funding and attention away from the primary goal of public health, that is, improving the health of the entire community. However, this is gradually changing, with a major shift in the 1990s to health plans (managed care) and the movement of Medicaid populations, in most states, into managed care programs. This has made caring for sick low-income people more financially viable for the private sector. Consequently, local health departments and their public health nursing staff have been encouraged to shift their activities back toward the primary mission of public health, which is to work on the causes of health problems and to prevent them.
(SEE ALSO: Barrier Nursing; Nurse; Practice of Public Health)
Bibliography
American Public Health Association Public Health Nursing Section (1996). The Definition and Role of Public Health Nursing. Washington, DC: Author.
Anderson, E. T., and McFarlane, J. (1996). Community as Partner: Theory and Practice in Nursing, revised edition. Philadelphia, PA: Lippincott.
Buhler-Wilkerson, K. (1993). "Bringing Care to the People: Lillian Wald's Legacy to Public Health Nursing." American Journal of Public Health 83(December):1778–1786.
Clark, M. J. (1996). Nursing in the Community, revised edition. Stanford, CT: Appleton and Lange.
Helvie, C. O. (1998). Advanced Practice Nursing in the Community. Thousand Oaks, CA: Sage Publications.
Keller, L. O.; Strohschein, S.; Lia-Hoagberg, B.; and Schaffer, M. (1998). "Population-Based Public Health Nursing Interventions: A Model from Practice." Public Health Nursing 15(June):207–215.
Kosidlak, J. G. (1999). "The Development and Implementation of a Population-Based Intervention Model for Public Health Nursing Practice." Public Health Nursing 16(October):311–320.
National Association of County Health Officials (1993). Core Public Health Functions. July.
Stanhope, M., and Lancaster, J. (2000). Community and Public Health Nursing, revised edition. St. Louis, MO: Mosby.
— KATHLEEN N. SMITH
Home of Wiki & Reference Answers, the world’s leading Q&A siteReference Answers
English▼
Enter question or phrase...
Search: All sources Community Q&A Reference topics
Browse: Unanswered questions | New questions | New answers | Reference library
Related Videos:
Public Health Nursing
Top
The Importance of Measuring Medical Outcomes
Skilled Nursing Homes
Learn about Nursing Homes, Naturopathy and Nutritional Information
Home Dialysis Equipment 101
View more Health videos
Related topics:
Nurse
Lillian D. Wald (American sociologist & physician)
Lexington: Health Care (city, Kentucky)
Related answers:
Future employment for public health nursing? Read answer...
How much does Public HealtH nURSING gets paid a day? Read answer...
What are the Nursing role and responsibility of public health nurse? Read answer...
Help us answer these:
What is a Public Health Nursing?
Family health on public health nursing?
Where can Public Health Nursing done?
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$copyright.smallImage.alttext Gale Encyclopedia of Public Health. Encyclopedia of Public Health. Copyright © 2002 by The Gale Group, Inc. All rights reserved. Read more
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