The model of web of causation dates back to 1960, when it was developed to represent different pathways that point on a genesis of a health problem or a disease, giving rise to defined causative risk factors. The model has been used in community health and nursing to explain diseases and disabilities caused by multiple factors and identify possible points for preventive interventions in community health problems. This research paper introduces the conceptual nursing model of the web of causation and uses a community aggregate of children below 18 years diagnosed with type 1 and type 2 diabetes to discuss conceptual nursing web of causation.
Medicineamigo (2007) defines web of causation as a medical term used to represent a complex group of subjects and relationships that can contribute to occurrence and spread of a disease. The model of web of causation shows that diseases are not distributed randomly in any group but isolation of how they are distributed requires one to study several factors. This implies that there are multiple and heterogeneous causes of any disease, symptom or health condition, collectively forming a web of causation. Clark (2008) argues that the model of the web of causation represents pathway factors that point to a genesis of a health problem and gives rise to or mitigate more precisely defined causative risk factors. Based on this model, one can increase the chances of controlling a disease or a health condition by breaking more links within the web of potential factors in the model. The model offers a solution in conceptualizing health problems that have multi- factoral etiologies such as diabetes.
Historical Development of Model of Web of Causation
MacMahon, Pugh, and Ipsen (1960) came up with the model of web of causation; whereby it was used explain the occurrence of icterus for a group of patients who were receiving treatment for syphilis.
This was followed by a more sophisticated but generalized web of causation that Stallones came up with in 1966. The purpose of his web of causation was to to describe the interrelationships among the 3 main types of cardiovascular disease. After some further research, Friedman developed a web of causation that was more detailed in 1980. His model was based on causation for the classic heart attack. This development marked the beginning for mapping what is today known concerning the etiology of heart diseases. The model of web of causation has continued to gain popularity since its discovery in 1960 and has proved useful in identifying possible factors for preventive interventions in community health.
How Concepts Relate Within the Model of Web of Causation
Duncan (2007) points out how the model of web of causation emphasizes on agents in explaining causes of diseases, while providing multifactoral causes that traverse various pathways, mirroring reality. In this model, the disease or a health condition is not only seen to be having different causes, but each one of these individual causes is viewed as a consequence that came from the multiple causes, of which each is an effect resultanting to multiple causes. This web is built using arrows of causation, with each arrow of causation implying that the element at the arrow source is somehow an individual cause of the element at that particular point of the arrow. Using type 1 and type 2 diabetes in children under 18 as an example, the disease can be as a result of new potential risk factor within the neighborhood or a variable in the web of causation representing a toxic environment that leads to diabetes or a variable representing lack of health care for possible underlying causes of diabetes such as high blood pressure or obesity, or having genetic predisposition that leads to diabetes (At Health 2005).
Model Application to Nursing Process
The model of web of causation can be used in nursing process to explain diseases and disabilities caused by multiple factors such as hepatitis and diabetes, which can be explained using complex relationship in the disease agent, host and environment; integrating factors such as genetic factors, environmental factors and race among others (At Health, 2005).
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American Diabetes Association (2000) highlights the importance of the model of web of causation in monitoring of diabetes in children and adolescents to avoid further complications resulting from the disease. This can be achieved when families work together with health care providers to help set a childâ€™s target for blood glucose levels and develop a personal diabetes plan for healthy meals, regular exercise and oral medication.
Duncan (2007) explains how the model can be applied in nursing to address health related threats and conditions such as the problem of teenage pregnancy, which is attributed to complex interaction between several causative and contributing factors such as ignorance, peer pressure and lack of contraceptives among others.
Applications Model of Web of Causation to Community Health Problems
According to Clark (2008), the model of web of causation is applied in enhancing the understanding of non-communicable diseases. The model has further been used in identifying possible points for preventive interventions in community health problems. Based on this model, prevention of obesity can be used as an intervention measure to protect the target population from being infected with type 2 diabetes.
Duncan (2007) explains the importance of the model of web of causation in summarizing community health information for presentation, communication and analysis. He points out the importance of the model in study of distribution of health outcomes in a given population through interpretation of epidemiological relationships.
Importance Of Community Partnership In Community Health Projects
Community partnership in community health projects brings collaborative efforts to improve health through sharing of resources, combining talents and enhancing opportunities to achieve positive health outcomes (World Health Organization, 2002).
According to World Health Organization (2002), involving communities in community health projects is a sign of giving up control and concern about who contributes to success of the partnership. This empowers people to creatively develop skills and build competencies and capacities because better and more sustainable decisions are made by involving communities in decision making. Furthermore, community participation in health projects is a way of extending the democratic process by opening up governance and redressing inequality in power for organizations involved. This offers new opportunities for creative thinking and innovative planning of health projects.
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Partnership with community in community health project implementation creates dedicated staff in project implementation as communities positively identify with the projects. This ensures ownership and sustainability of the projects, provides a source of information, knowledge as well as experience and eliminates deficiencies in the society, while empowering members to put emphasis on problem solving (WHO, 2002).
The model of web of causation is an important model that has been used in community health to represent different pathways that point on a genesis of a health problem or a disease, giving rise to defined causative risk factors. It has proved to be a viable model in addressing health problems that have multifactoral causes like the type 1 and type 2 diabetes. Lasting solutions in addressing community health problems can be achieved by involving people at community level in decision making and participation in community health projects.
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