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47 terms

Community Health Nursing Quiz 1

Community Health Nursing. Spring 2012. Dr Susan Lombardo, Dr Michelle Eaton.
STUDY
PLAY
Community
Group of people sharing something, interacting with one another. May exhibit commitment with one another and may share geographic boundary. E.g., a NORC, a school, NYU students.
Population
Group of people having at least one thing in common and who may or may not interact with one another. E.g., night-shift workers, children with CF.
Community-focused nursing
Delivery of nursing care to improve health of an entire community - bigger picture, deals with prevention and population at systems level.
Community-based nursing
Nursing care provided outside of acute care setting. Care for families, individuals within a community. At individual, "hands on" level. Does not require public health background.
Population-focused care
Interventions for health promotion, disease prevention to shape a community's overall health status.
Public health nursing
Promotion and protection of health of populations using knowledge from nursing, social and public health sciences. Population-focused; goals: promotion of health and prevention of disability and disease by creating conditions in which people can be healthy.
Acute Care
Provider control
Predictable routine
Hospital policy
Resources available
Collaboration and consultation
Controlled PT compliance
Standardized care
Community Health Nursing
Familiar and comfortable environment for PT
Routine more determined by PT
Diverse resources
Autonomy, choice in HC decisions for PT by PT
Health
"extent to which an individual or group is able on the one hand, to realize aspirations and satisfy needs; and on the other hand, to change or cope with the environment." WHO
Eudaimonistic Model
HOLISTIC
UPSTREAM
Greek origins. R/t Maslow's hierarchy of needs.
MOST HOLISTIC
Health = actualization/realization of complete fulfillment and development. Illness impedes/prevents self-actualization.
Aim to redirect thinking away from mechanistic view toward holistic view.
HOLISM, UNITY, INDIVIDUALITY
Adaptive Model
ABLE TO ADAPT
Medicine beyond treatment of disease: from writings of Dubos.
Health means ability to adapt to a changing environment. Disease is failure to adapt.
How flexible is someone in a changing environment?
Role-performance Model
ABLE TO DO JOB
Medical sociology, work of Parsons.
Person is healthy if they can perform their job.
Shapes health policies of military, industry.
Limited since one person may have many roles.
Clinical Model
MOST LIMITING
DOWNSTREAM
Health extreme = absence of S/S of disease/disability as IDed by medical science
This model = downstream pattern of thinking rather than upstream which is holistic.
Levels of Care
Individual - downstream
Family
Community
Population - upstream
Public health wheel
For selling health messages
R/t epidemiology
Levels of Prevention
Primary
Secondary
Tertiary
Primary Prevention
PREVENTION
Stay well and avoid problem
Reduction of risk factors before occurrence of disease condition/injury
E.g., exercise, brushing teeth, condoms, immunizations, nutrition.
Secondary Prevention
PREVENTION/MAINTENANCE
SCREENINGS/EARLY DX
Early detection of potential for disease/condition or existence of such while asymptomatic.
E.g., screening programs - Pap smears, mammograms, colonoscopy.
Tertiary Prevention
RESTORATIVE
Treatment of existing or symptomatic disease to prevent/delay progress.
Treatment after Dx, e.g, cardiac/stroke rehab.
Healthy People 2020
New topic areas:
adolescent health, blood, dementias inc. AD, early/mid childhood, genomics, global health, HAIs, health related QoL and well being, LGBT health, older adults, preparedness, sleep, social determinants.
"Prevention Agenda for the Nation"
Public Health Nursing
Promoting, protecting health of populations using knowledge from nursing, social and public health sciences. Population focused.
Public Health Nursing Goals
Promotion of health and prevention of disease and disability for all through creation of conditions in which people can be healthy.
Assurance
Ensuring healthy populations
Appropriate and accessible services for all
Healthful physical environment
Stable ecosystem
Strong, supportive, non exploitive membership
Extensive participation in decision making
Members' basic needs provided for.
Access to resources and opportunities for interaction
Sustainable vital economy
Maintain connectedness with cultural and biological heritages
Provide governance structures that promote health.
Community health work
unstructured, "bigger picture", community is both client and partner, work at every level but especially advocate for primary level with population focus.
Newest Vital Sign
Health literacy test: being able to read food labels.
Nursing Process in the community
ADPIE:
Assessment
Diagnosis (written in different format for the community)
Planning
Implementation
Evaluation
Community Assessment
Population assessment
Primary informants
Gaining entry (Kauffman's 5 phases)
Kauffman's Five Phases
IBSBC
Impressing
Behaving - building rapport
Swapping - sharing information
Belonging - becoming part of the group
Chilling out - near end of relationship, beginning longer term partnership with the community.
Collecting data
IOSFCW
7 methods
Informant interviews
Observation
Secondary analysis of existing data
Focus groups
Community forums
Windshield surveys
Community Diagnosis
Risk of X
Among X group/population
Planning and Prioritization Phase
Priorities established (set by community members)
Goals and objectives IDed
Community focused interventions
Implementation Phase
Action phase
Role of community health nurse
Social change, community action
Evaluation
formative - changes made during process
summative - at end, related to outcomes
Health education
"The pedagogy of the oppressed"
Community empowerment (WHO)
Community as partner model (Betty Neuman)
Community as Partner
Community core
8 interacting community subsystems
Community stressors/boundaries
Normal line of defense LOD = status quo
Flexible line of defense - protection vs stressors
Lines of resistance LOR - strengths, resources, coping mechanisms
Health Education
Planned learning experiences based on sound theories to provide individuals, groups, communities opportunity to learn info and skills to make quality health decisions
Health Education Goals
Help individuals, groups, communities achieve, by own actions/initiative, optimal health
Facilitate voluntary actions to promote health
Empowerment
Advocacy
Self-efficacy
Steps in Teaching/Learning Process
ADDIE
Assessment
Development of outcomes
Development of teaching plan
Implementation of teaching plan
Evaluation of outcomes (did it work?)
Facilitate learning
Stimulate senses
Active learning
Comfortable
Learner's readiness?
Relevant information
Repetition
Learning should be positive
Start simple, go to complex
Generalize and pace appropriately
Transtheoretical Model
Most common learning theory
Stages of Change
Precontemplation - resistance; don't see problem
Contemplation - know there's a problem and thinking about it
Preparation - decision making; prepared for action, e.g., cutting down on cigarettes.
Action - modifies behavior/environment to overcome problem. Takes lots of time and energy. W/D S/S now.
Maintenance - constant work to avoid relapse.
Transtheoretical Model: Stages of Change
PCPAM
Precontemplation
Contemplation
Preparation
Action
Maintenance
Nature of learning
CAP = B F D
Cognitive Domain
Affective Domain
Psychomotor Domain
Cognitive Domain
BRAIN
memory, recognition, understanding, application, problem solving.
Affective Domain
FEELINGS
attitudes, values:appreciates, chooses, accepts - role play, talk to s.o., feelings.
Psychomotor Domain
DEMONSTRATE
Hands on manipulation, "teach back"
performance of skills requiring coordination and motor skills.
Planning health education
Establish outcomes - measurable
Mutual goal setting with community as client
Educational objectives
Cognitive
Affective
Psychomotor