Sumandeep Nursing College

An Assignment
on
Medical Surgical Nursing

Submitted to:- Sonal Patel Submitted by:- Sunita Kumari

Submission Date:- 19th November, 2019

Historical Development of Medical Surgical
Nursing:-
In the history of Indian medicine begins from 3000 BC. In the Indus valley civilizations we can
see the drainage and we will understand that they have given importance to health and hygiene.

In 2000 BC the RIGVEDA marks the beginning of Indian system of medicine. The conditions
like fever, cough, constipation, diarrhea, dropsy abscesses, seizures, skin diseases including
leprosy were treated from that time. The herbs were used for the treatment.

In 272 BC king Ashoka built number of hospitals. He had given his emphasis on the prevention
of the diseases. Doctors, Nurses and the Midwifes were also available in that time. Nalanda and
Thaxaxila were the two famous medical schools.

In 100 B C, the surgical field was the well known by surgeons Sushruta and Charaka. Especially
two types of operation at those times were outstanding, Removal of the gall bladder stone and
the plastic surgery of the nose.

Nursing in India:
In the beginning the nursing was hindered by many difficulties like the cast system among the
Hindus, the Pardha system among the Muslims and the low status of the women. In the
beginning period the nurse has a servant image so no one was ready for nursing. The military
nursing was the earliest type of the nursing in 1664 the British east India company helped to start
a hospital for soldiers in madras (St. George HOSPITAL). The company appointed staff was
served in the hospital. In 1854 the government sanctioned training school for the midwives. 1864
Miss Florence Nightingale starts the efforts to reform the hospitals. St. Stephens Hospital Delhi –
1864 - First to train Indian girls as nurses. . In 1871 the government, general hospital of madras
took a plan to train the nurses. The nurses from the England were the in charge of the training
and the students were those who previously received there diploma in midwifery. 1905 – T.N.A.I
established. 1926 – Madras state formed the first registration council .1946 – First four year
Basic Bachelor degree program established in R.A.K. The attitude towards the nursing begins to
change and the nursing begin to see as a profession. The Indian Nursing Council was passed by
ordinance on December 31, 1947. The council was constituted in 1949. The development of
Nursing in India was greatly influenced by the Christian missionaries, World War, British rule
and by the International agencies such as the World Health Organization UNICEF, the Red
Cross, UNSAID etc.. In 1970 the WHO recognized nursing as a profession. Nursing today
provides an ever widening scope of opportunity for service.
Current Status of Health and Disease burden in
India:
The India State-level Disease Burden Initiative was launched in October 2015 to address this
crucial knowledge gap with support from the Ministry of Health and Family Welfare of the
Government of India. This is a collaborative effort between the Indian Council of Medical
Research, Public Health Foundation of India, Institute for Health Metrics and Evaluation, and
experts and stakeholders from about 100 institutions across India. The work of this Initiative is
overseen by an Advisory Board consisting of eminent policymakers and involves extensive
engagement of 14 domain expert groups with the estimation process.

The report describes the distribution and trends of diseases and risk factors for every state of
India from 1990 to 2016.

Methods and data

The estimates were produced as part of the Global Burden of Disease Study 2016. The analytical
methods of this study have been standardised over two decades of scientific work, which has
been reported in over 16,000 peer-reviewed publications, making it the most widely used
approach globally for disease burden estimation. These methods enable standardised
comparisons of health loss caused by different diseases and risk factors, between geographic
units, sexes, and age groups, and over time in a unified framework. The key metric used for this
comparison is disability-adjusted life years (DALYs), which is the sum of the number of years of
life lost due to premature death and a weighted measure of the years lived with disability due to a
disease or injury. The use of DALYs to track disease burden is recommended by India’s National
Health Policy of 2017.

Through an elaborate process, all data sources and inputs available to estimate disease burden in
every state and union territory of India were identified. These included censuses, vital
registration, Sample Registration System, large-scale national household surveys, other
population-level surveys and cohort studies, disease surveillance data, disease programme-level
data, administrative records of health services, disease registries, and a wide range of other
studies conducted across India. Data were included in the analysis if they met quality and
inclusion criteria.
 Health status improving, but major inequalities between states
 Life expectancy at birth improved in India from 59.7 years in 1990 to 70.3 years in 2016 for
females, and from 58.3 years to 66.9 years for males. There were, however, continuing
inequalities between states, with a range of 66.8 years in Uttar Pradesh to 78.7 years in Kerala
for females, and from 63.6 years in Assam to 73.8 years in Kerala for males in 2016.
 The per person disease burden measured as DALYs rate dropped by 36% from 1990 to 2016 in
India, after adjusting for the changes in the population age structure during this period. But there
was an almost two-fold difference in this disease burden rate between the states in 2016, with
Assam, Uttar Pradesh, and Chhattisgarh having the highest rates, and Kerala and Goa the lowest
rates

Disease profile in India:-

 48% to 75% for non-communicable diseases
 14% to 43% for infectious and associated diseases, and
 9% to 14% for injuries.

Infectious and associated diseases reducing, but still high in many states
 The burden of most infectious and associated diseases reduced in India from 1990 to 2016, but
five of the ten individual leading causes of disease burden in India in 2016 still belonged to this
group: diarrhoeal diseases, lower respiratory infections, iron-deficiency anaemia, preterm birth
complications, and tuberculosis.
 The proportion of total disease burden caused by infectious and associated diseases was highest
among children, which contributed to the disproportionately higher overall disease burden
suffered by the under-5 years age group.

 For India as whole, the disease burden or DALY rate for diarrhoeal diseases, iron-deficiency
anaemia, and tuberculosis was 2.5 to 3.5 times higher than the average globally for other
geographies at a similar level of development, indicating that this burden can be brought down
substantially.
Rising burden of non-communicable diseases in India
 The contribution of most of the major non-communicable disease groups to the total
disease burden has increased all over India since 1990, including cardiovascular diseases,
diabetes, chronic respiratory diseases, mental health and neurological disorders, cancers,
musculoskeletal disorders, and chronic kidney disease.
 Among the leading non-communicable diseases, the largest disease burden or DALY rate
increase from 1990 to 2016 was observed for diabetes, at 80%, and ischaemic heart
disease, at 34%.
 In 2016, three of the five leading individual causes of disease burden in India were non-
communicable, with ischaemic heart disease and chronic obstructive pulmonary disease
as the top two causes and stroke as the fifth leading cause.
 The range of disease burden or DALY rate among the states in 2016 was 9 fold for
ischaemic heart disease, 4 fold for chronic obstructive pulmonary disease, and 6 fold for
stroke, and 4 fold for diabetes across India.
 While ischaemic heart disease and diabetes generally had higher DALY rates in states
that are at a more advanced epidemiological transition stage toward non-communicable
diseases, the DALY rates of chronic obstructive pulmonary disease were generally higher
in the EAG states that are at a relatively less advanced epidemiological transition stage.

Current Concept of Health:

Health is individually defined by each person. On a personal level, individuals define health
according to – how they feel – absence or presence of symptoms of illness – and ability to carry
out activities WHO refers health as situation that may exist in some individuals but not in
everyone all the time, it is not usually observed in a groups of human beings and in communities.
Nobody is qualified as completely healthy, i.e., perfect biological, psychological and social
functioning all the time. That is, if we accept the WHO definition, we are all sick.

1. Health as a human right.

 Citizens have the right to health insurance, guaranteeing them accessible medical care
and free use of medical services under conditions and order.
 Health care for citizens is funded by the state budget, employers, personal and collective
insurance payments and other sources under conditions and order, stipulated by law.
 The state promotes citizens health and encourages the development of sport and tourism.
 No single person can be subjected unwillingly to treatment and sanitary measures, except
for the cases foreseen in law
 The state exercises control over all treatment facilities, as well as the production of
medications, bioactive substances and medical equipment and over trade with them.”

2. Social dimension of health includes the level of social skills one possesses, social
functioning and the ability to see oneself as a member of a larger society. It states that
harmony and integration within and between each individuals and other members of the
society. It also refers to the ability to make and maintain relationships with other people
or communities.

3. Spiritual dimension of health includes integrity, principle and ethics, the

purpose of life, commitment to some higher being, belief in the concepts that are not
subject to “state of art” explanation. It is intangible “something” that transcends
physiology and psychology. Spiritual health is connected with religious beliefs and
practices. It also deals with personal creeds, principles of behavior and ways of achieving
peace of mind and being at peace with oneself.

4. Concept of disease
The oxford English Dictionary defines disease as “ a condition of the body or some part
or organ of the body in which its functions are disturbed or deranged”.

Webster defines disease as “a condition in which body health is impaired, a departure

from a state of health, an alteration of the human body interrupting the performance of
vital functions”.

The simplest definition is that disease is just the opposite of health: i.e. any deviation
from normal functioning or state of complete physical or mental well-being.

5. Standard of living
Income and occupation, standards of housing, sanitation and nutrition, the level of
provision of health, educational, recreational and other services all be used individually
as measures of socioeconomic status, and collectively as an index of the standard of
living.
6. Level of living

Health is affected by and is affecting the level of living. It consists of certain objective
components : food consumption, education, occupation and working conditions, housing,
social security, clothing, recreation and leisure human rights.

7. Quality of life
A composite subjective measure of physical, mental and social wellbeing as perceived
by each individual or by group .Quality of life of individuals e.g. happiness, satisfaction
and gratification as it is expressed in such life concerns as health, marriage, family work,
financial situation, educational opportunities, self-esteem, creativity, belongingness, and
trust in others.

8. Responsibility for health

International responsibility, national responsibility, State responsibility: constitutional

rights. Community responsibility: health care for the people to the health care by the
people. Individual responsibility: self care for maintaining his own health, adoption of
healthy life style