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Health Outcome: Level of Measurement

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Health Outcome: Level of Measurement

Epidemiologic data is crucial in modern healthcare practice as it underpins the evidence-

based decisions and development of nursing practice in various health domains. Analyzing

epidemic data according to the level of measurement used, nominal, ordinal, and ratio/interval,

this paper explores its effects on healthcare strategies and nursing roles. Epidemic data,

therefore, offers more refined information concerning population genetics of chronic illnesses

and the effectiveness of preventive measures. Examining Muntner et al. 's hypertension control

trends review and the WHO's global hypertension report, the paper illustrates how evidence-

based practices allow nurses to meet specific patient needs, fuel systemic reforms, and effect

parity in global health.

Nominal Level

Brief Description of the Variable

The health outcome of interest is “Hypertension Awareness.” This variable touches on

community awareness of hypertension or high blood pressure. It is measured at the nominal

level, categorizing individuals into two distinct groups: the hypertensive participants and those

with and without knowledge of their hypertensive status. Hypertension knowledge is an essential

area of concern in public health as it determines the effective management of the condition.

People with hypertension knowledge are likely to change their behaviour and take actions,

including medication compliance, as well as consulting their physicians for early treatment and

control. On the other hand, patients with the same disease but with no knowledge of it have a

high risk of developing other conditions such as heart disease, stroke, and kidney failure.

Measurement of the Variable

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Hypertension awareness is assessed either using cross-sectional questionnaires or face-to-

face interviews. An example of the question format is: “Do you know you have hypertension or

high blood pressure?” The responses include ‘Yes’ or ‘No’ The question format is simple,

straightforward and binary to eliminate confusion or ambiguity. The surveys or interviews can be

conducted at clinics and community health fairs or through phone or online resources. It is,

therefore, essential to focus on ensuring that the developed question is straightforward so that

participants with different literacy levels provide valid responses. However, surveyors may also

give the respondents a brief description of hypertension to ensure that they understand what the

term encompasses. This measure could be made more reliable by comparing the findings from

the self-report method with the available medical records; this is not only sometimes done in

such community settings.

Recording the Measurement

Therefore, hypertension awareness measurement should be recorded in a binary form.

Every individual's reaction is recorded on a scale of 1 as "To an extent, I am aware" or 0 as "I am

not aware". This is because this binary coding makes it easier to enter and analyze. Further, data

on age, gender and ethnicity can be collected to identify customer segments that are aware of the

brand. This data should be recorded using forms or electronic means that can record this

information efficiently and securely (World Health Organization, 2023). Data entry and input

must be precise and error-free, and data checks or verification can be performed routinely.

Descriptive Statistics

To describe the variable of hypertension awareness, the following descriptive statistics should be

used:
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1. Frequency Distribution: The number and percentage of individuals who know and do

not know about their hypertension condition should be determined. This, in turn, explains

the percentage of the population that understands the specific condition.

2. Cross-tabulation: If demographic variables are collected, Chi-square tests can compare

hypertension awareness by age, gender and ethnicity. This makes it easier to determine if

there are any differences in awareness among different subgroups.

Graphical Description

Hypertension Awareness by Ethnicity

250

200
No of people

150

100

50

0
White Black Hispanic other
ethnic Group

Aware Not Aware Column1

Ordinal Level

Brief Description of the Variable

The dependent variable of interest is "Depression Severity." This is a measure of the level

of depression of people in a joint practice setting. It is measured on the ordinal level where the
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variable has a meaningful arrangement, but the differences from one value level to the other are

unequal. The severity of depression is usually grouped into levels like "None," "Mild,"

"Moderate," "Severe," and "Very Severe." Classifying it provides a continuum of the condition,

which can help in evaluating the extent of depression and its effect on people's functioning.

Depression intensity is an essential indicator of health because depression influences physical

health, interpersonal relations, and overall quality of life.

Measurement of the Variable

The degree of depression is usually assessed through structured tools or questionnaires

like the Patient Health Questionnaire-9 (PHQ-9). The PHQ-9 includes nine questions to measure

the intensity of depressive symptoms experienced during the last two weeks. Each question is

rated on a 0-3 scale, where 0 represents "Not at all," 1 "Several days," 2 "More than half the

days," and 3 "Nearly every day."

The scores for each item are summed up, and the final score ranges from 0 to a maximum of 27.

Based on the total score, depression severity is categorized as follows:

 0-4: None

 5-9: Mild

 10-14: Moderate

 15-19: Moderately Severe

 20-27: Severe

This categorization allows healthcare providers to determine the appropriate level of intervention

needed for each individual.

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Recording the Measurement

To facilitate the analysis and comparison of depression severity, it was proposed that it

should be measured in a structured manner. Each participant's total PHQ-9 score and severity

category should also be recorded. For instance, if a participant obtained a total score of 12, they

would be categorized as having "Moderate" depression. Further, other demographic data like

age, gender and economic status, among others, can be captured to assess differences in

depression levels among population subgroups. Information can be gathered through EHR,

survey databases, paper-based forms or any other means depending on the facility and available

instruments.

Descriptive Statistics

To describe the variable of depression severity, the following descriptive statistics should be

used:

1. Frequency Distribution: The count and the percentage of people in each severity level

(none, mild, moderate, moderately severe, severe) must be determined. This gives a clear

insight into the proportions of the population with different disease severity levels.

2. Cross-tabulation: The correlation between depression severity and demographic data

such as age, sex, and SES may also be compared using cross-tabulations. This aids in

categorizing to determine if there is any variation in the severity of depression among

different groups.

Graphical Display
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Percentage Distribution of Depression Sever-

ity

None
12% 10% Mild
Moderate
Moderate Severe
18%
severe
36%

24%

Interval/Ration Level

Brief Description of the Variable

The health outcome of interest is "Blood Glucose Levels. " This element focuses on the

amount of sugar in the blood and is significant for people with diabetes or at high risk of

developing the condition. Blood glucose concentrations are expressed in the interval or ratio

level because they have equal intervals between corresponding values and an actual zero point

(no glucose). Self-monitoring is crucial in diabetes and helps evaluate the patient's general

condition. Hyperglycemia can be an aspect of insulin deficiency or insulin resistance, and

hypoglycemia can cause symptoms like dizziness, confusion, unconsciousness, etc.

Measurement of the Variable

Glycosylated haemoglobin reflects blood glucose levels, usually from a finger stick

procedure using a glucometer and a venous blood sample for laboratory analysis. They offer spot
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checking and are ideal for use at homes or any clinical environment as they give quick results.

Blood tests are more precise and can include other values such as fasting blood glucose or

HbA1c, the average blood glucose level for 2-3 months.

Recording the Measurement

The measurement of blood glucose levels is in terms of milligrams per deciliter of blood

milligrams per deciliter (mg/dL) or millimoles per litre (mmol/L). All measurements indicate the

glucose content in the blood at the time of sampling. It is also advisable to record data with

certain background information, including date, time of the day, for instance, fasting or

postprandial state and other conditions like medication intake or meal consumption. For

example, a glucose level of 120 mg/dL measured before breakfast should be written as "120

mg/dL, fasting." Using forms or electronic templates for documentation or via the EHR can help

maintain consistency, provide ready access to the data, and be helpful when comparing

measurements taken over time.

Descriptive Statistics

To describe the variable of blood glucose levels, the following descriptive statistics should be

used:

1. Mean and Standard Deviation: These statistics give information about where it is

typical or usual and how spread out or dispersed the values are from the mean, which in

this case represents the average glucose level.

2. Median and Interquartile Range (IQR): The median expresses the central point of the

data, and the IQR represents how much the middle 50% of data deviates from the

median. These statistics are valuable for summarising basic ERT measures of central
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tendency and variability of blood glucose data, where outliers could influence the

outcome variable.

Graphic Display

Percentage Distribution of Blood Glucose

Levels
11%

37%
21%

32%

Normal (70-100 mg/dL) Pre-Diabetes (101-130 mg/dL)

Mild Diabetes (131-160 mg/dL) Moderate Diabetes(161-200 mg/dL)
Severe Diabetes (>200 mg/dL)

Epidemiologic Data-Articles

The present article by Muntner et al. focuses on analyzing control rates among US adults

with hypertension between 1999-2000 and 2017-2018. They show trends in proportion with

controlled BP by specific earlier and later years, positive changes, and recent negative trends. BP

control 'improved' from 31. The private sector increased from 8% in 1999-2000 to a peak of 53.

It increased to 8% in 2013-2014 and then reduced to 43 per cent. This data shows the ever-

evolving nature of hypertension control endeavours and the differential impact of intervention

programs at different phases. This data type is relevant to healthcare policymakers and nursing
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leaders making decisions. They help implement resource allocations, including money for

hypertension awareness and prevention public health campaigns, availability of health facilities,

and interventions to enhance medication compliance among high-risk populations. The findings

can inform the nurses' development of hypertension action plans, with significant highlights

regarding healthcare check-ups and medication compliance.

The findings also add knowledge and faith to nursing by demonstrating the needed and

complex approach to managing hypertension. Nurses are involved in patient education, BP

monitoring and advocating for their patients to adopt healthy lifestyles and access healthcare

services. Epidemiology helps the nurse make policy changes that will promote preventable

health and equal distribution of health among the population. On the other hand, the "Global

Report on Hypertension" released by the World Health Organization gives a more general view

of the global burden of hypertension. Thus, strengthening the focus on hypertension as one of the

significant trends in global cardiovascular disease risk requires concerted efforts on the

international level.

In conclusion, epidemic data cross-sectional between nominal, ordinal, and ratio/interval

levels has revolutionised practice and healthcare decisions. Research analysis does not merely

assist in developing individual patient treatment and prevention plans but also helps inform

public policy changes that eradicate inequalities in healthcare access. In the course of disease

surveillance, disease incidence, and the assessment of treatment outcomes, nurses are essential in

implementing epidemiological findings as interventions that contribute to improving individual

and population health status. Further, integrating practical data analysis into future healthcare

policies will be crucial, and the progress that will be made in the future will be sustainable.
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References

Muntner, P., Hardy, S. T., Fine, L. J., Jaeger, B. C., Wozniak, G., Levitan, E. B., & Colantonio,

L. D. (2020). Trends in blood pressure control among US adults with

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hypertension, 1999-2000 to 2017-2018. Jama, 324(12), 1190-1200.

https://jamanetwork.com/journals/jama/article-abstract/2770254

World Health Organization. (2023). Global report on hypertension: the race against a silent

killer. World Health Organization. https://books.google.com/books?

hl=en&lr=&id=KaIOEQAAQBAJ&oi=fnd&pg=PR5&dq=The+World+Health+O

rganization%27s+(WHO)

+2023+Global+Report+on+Hypertension&ots=AlbrlELjNE&sig=WCf1r6BWdk

RJGx0NQg3GNluYZCg