NURS 288 Quiz 1 Flashcards
(67 cards)
1
Q
Definition of a community
A
A group of people, whether together geographically, or within settings, or by shared interest; whatever tit is, there is a common bond
2
Q
Definition of a population
A
Is usually a larger, a more diverse group of people, often (but not always) within a particular geographic locality
3
Q
Definition of Community Health Nursing
A
nursing practise specializing in promoting the health of individuals, families, communities, and populations, and promoting an environment that supports health
4
Q
What are Community Health Nurses?
A
Registered nurses who work where people live, work learn, worship, and play, to promote health
5
Q
What do community health nurses do?
A
- partner with individuals, families, groups, communities, systems, and populations and work with the community members to determine and address their priorities
- focus on the needs of the population
- specialize in promoting health and preventing illness
- have concern for social justice
- emphasize capacity building
6
Q
What is the CHN practise?
A
- work to promote health at various levels
- promote, protect, or restore health and prevent illness
- advocate for patients
7
Q
What are the CHN roles?
A
Public Health Nurse, Home Health Nurse, Occupational Health Nurse, Primary Care Nurse, Street Nurse, Parish Nurse, Forensic Nurse, Outpost/rural Nurse, Military Nurse, Telehealth Nurse, Community Mental Health Nurse, Health Educator
8
Q
What is health?
A
Social, physical, and mental wellbeing
9
Q
Top Ten Approach to Understanding Health
A
- Don’t smoke
- Eat a balanced diet
- Be physically active
- Limit stress
- Get 7-8 hours good sleep in 24 hours
- Wear sun protection
- Practise safe sex
- If you drink alcohol, do so in moderation
- Drive safely, wear a seatbelt and respect speed limits
- Get a regular checkup including routine screening
10
Q
Biomedical model of health
A
- focuses on physical and biological aspects of disease, illness, and disability
- focus on diagnosis, treatment, and cure
- return to pre illness state
- Advantages: advances in technology, extended life expectancy, improved quality of life
- Disadvantages: relies on professionals and technology, costly, narrow view of health, not every condition is treatable
11
Q
Social model of health
A
- address the broader influences of health (social, cultural, environmental, and economic factors)
- reduce social inequities
- empowers individuals and communities
- access to proper healthcare
- inter-sectoral collaboration
- advantages: prevention of disease through education and access to health care, costs less, community approach
- disadvantages: not all diseases can be prevented, lifestyle change is very difficult, population may not be motivated to change
12
Q
Determinants of health
A
- income and social status (income is top determinant)
- social support networks
- education
- employment and working conditions
- social environments
- physical environment
- personal health practices and coping skills
- healthy child development
-culture - gender
- biologic and genetic endowment
- health services
13
Q
Social Determinants Ten Tips for Better Health
A
- Don’t be poor. If you can, stop. If you can’t try not to be poor for long
- Don’t have poor parents
- Own a car
- Don’t work in a stressful, low-paid, manual job
- Don’t live in damp, low quality housing
- Be able to afford to go on a foreign holiday and sunbathe
- Practise not losing your job and don’t become unemployed
- Take up all benefits you are entitled to, if you are unemployed, retired, or sick or disabled
- Don’t live next to a busy major road or near a polluting factory
- Learn how to fill in the complex housing benefit/asylum application before you become homeless or destitute
14
Q
Holistic definition of health
A
includes physical, psychological, social, spiritual, cultural, and developmental
15
Q
WHO (1948) definition of health
A
a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity
16
Q
CHNC (2011) definition of health
A
a dynamic process of physical, mental, spiritual, and social well-being and as a resource for everyday life that is influenced by circumstances, beliefs, and determinants of health
17
Q
What does “well-being” refer to?
A
quality of life
18
Q
What does individual well-being include?
A
factors such as personal values, relationships, work, health, and one’s financial stability
19
Q
What does societal well-being include?
A
collective well-being of people and the quality of interactions between and among people and social institutions (eg. health care systems, educational system, etc)
20
Q
What is Primary Data
A
Information from direct sources; observation, key informant interview, focus group intervieww
21
Q
What is Secondary Data
A
data that collects and stores data from various sources; vital statistics
22
Q
What is a windshield survey?
A
- observational technique used to assess a community
- use all of your senses to capture the essence of the community
- look for strengths and challenges in the community
- get to know the community and all its aspects
- ask questions
- use a checklist to help (dig deeper than the checklist)
23
Q
What is SWOT
A
Strengths, Weaknesses, Observations, Threats
24
Q
Lalonde Report (1974)
A
- formally recognized health beyond the absence of disease in health policy
- less focus on healthcare services
- human biology, life-style, environment, and healthcare organization
- new ways of thinking about health
- looked at how the broader social environments affected health
- created blame fro victims because lifestyle affects health
- brought international attention to international people
25
Declaration of Alma-Ata (1978)
- social factors affect health as well
- people need to take active roles in health
- health is a state of complete physical, mental, and social wellbeing, and not merely the absence of disease
- health is a fundamental human right
- worldwide social goal
- needs inter-sectoral collaboration
- 10 declarations focused on action
- needs of the population
- root causes of ill health
- challenging status quo (of just treatment)
- move beyond biomedical health
- social justice, equity, public participation, appropriate technology, inter-sectoral collaboration
26
Epp Framework for Health Promotion (1986)
- Achieving health for all
- health challenges
- health promotion mechanisms
- implementation strategies
27
Health Challenges
- Reducing equities/reducing disparities
- increasing prevention (preventing occurrence of injuries, increase or continue prevention)
- enhancing coping (how people cope with every day life, chronic disease, stressors; social networks; individual, social, and societal coping)
28
Health Promotion mechanisms
process of enabling people to increase control over their life circumstances to improve their health
- self care
- mutual aid
- healthy environment
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Implementation Strategies
- fostering public participation
- strengthening community health services
- coordinating public policy
30
Ottawa Charter for Health Promotion (1986)
- Enable, mediate, activate
- strengthen community action (engage people taking active role in health)
- develop personal skills (self-care; coping skills)
- create supportive environment (social and political)
- reorient health services (prevention: appropriate and accessible)
- build healthy public policy (across all sectors)
31
Population Health Promotion Model
- What? (Determinants)
- Who? (Level of Action)
- How? (Action Strategies)
- Why? (Foundations
32
Upstream thinking
- focuses on prevention
- looks at root causes of health
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Downstream thinking
- acute care
- treating health issues after they have shown up
34
Primordial Prevention
- eliminate risk factors before they even happen
- improve sanitation; handwashing
- education and awareness and legislation (seatbelts)
- reducing pollution
- iodized salt
- policies
35
Primary prevention
- prevent, delay, or reduce the impact of specific risk factors, thereby trying to reduce occurrence of diseases or injury
- can be done across all populations, but can also be done with groups that are high risk, or more vulnerable to disease or injury
- vaccinations
- cancer awareness
- promoting sunscreen
- key difference is that primordial is for everyone, but primary can be large groups, but can be specific
- healthy living programs for specific people
36
Secondary prevention
- detecting and managing disease
- cancer screening
- HIV screening of immigration applicants
- trigger prompt healthcare services
- regular doctor visits
- medication
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Tertiary prevention
- disease or injury has happened
- goal is to reduce impact for the long term
- preventing complications or ling term negative consequences
- cardiac rehab
- rehabilitation processes
38
Primary Health Care
- an approach to health and wellbeing
- 5 principles
- came with the alma at a
- central philosophical foundational approach in achieving health
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PHC principles
- Accessibility
- public participation
- health promotion
- appropriate technology
- Intersectional collaboration
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PHC Essential Elements
- Education about health problems and prevention
- promotion of food security
- adequate supply of safe water and basic sanitation
- maternal and child health and reproductive health
- immunization
- prevention and control of disease and injury
- accessible and appropriate health care
- essentail pharmacotherapeutics
41
Primary Health Care vs primary care
- primary care: part of notion of different levels of healthcare services; first point of contact to healthcare system; family physician/NP
- Primary Health Care: philosophical approach to achieving healthcare
42
What is health?
- resource for daily living
- sustain quality of life
- people live with different abilities
- how do we best support people within their strengths and abilities to live a healthy lifestyle
43
The Nursing Process
- Assessment and analysis, nursing diagnosis, plan, implement, evaluate
- used in all nursing focuses
- transfer to any practise setting
- is a systematic approach
- follow the order
44
Key concepts to the CasP model
- health
- community
- client
- environment
- sectors
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Health (CasP)
- resource for everyday living
- holistic means of understanding one's wellness
- physically, spiritually, emotionally
- finding a way to live with a good quality of life despite different abilities and capacities
- broader social and physical factors that influence your health
- biomedical still important
46
Community (CasP)
- can include geographic boundaries, but not limited to that
- common bond between people (ethnicity, cultural practises, language, shared experiences
- ex. sports teams, religion, geographic
- dynamic aspect on what a community is
- diversity and inclusivity
47
client (CasP)
- much broader than the individual or patient
- think of your setting
- person/individual, family, community, population
48
Environment (CasP)
- anything that's external to the person
- social, political, physical environment (policy decisions trickle-down into the day-to-day lives of people in the community
49
Sectors (CasP)
- subsystems in society
- things that make a society and a population live in their day-to-day
- think about health from a public and community lens
- health is not business of health sector alone, needs inter-sectoral collaboration
- inter-sectoral action and collaboration
- working across sectors
- "health in all"
50
Canadian Community as Partner (CasP) Model
- Originally from the US; adapted to Canadian version by Dr. Vollman
-alignment with nursing process
- systematic approach
- continuously monitor and evaluate our interventions
- evaluation is important in all our work
- must be baked into intervention from beginning
- speaks to need to continuously monitor how things are going and to shift and adjust as needed
- see how public funds are being used
51
Assessment (CasP)
- getting data from key informants and putting everything on the table and getting all the information you can
- the process of collecting data (information) to understand the characteristics of the community as well as:
- health and social disparities
- health and social inequities
- protective factors (strengths)
- stressors (putting strain on community members or community as a whole)
- sub-systems (mini systems within society that make thins function; business, education, health, social programs, legal
- DOH: different factors that have been recognized through health research, as factors that influence health; DOH and social determinants of health are different (social are the factors usually found in the social context, can be influenced
52
CasP model assessment wheel
- components that you want to find information on as part of assessment
- people: central to this, main interest
- sub-systems that influence the lives of individuals, population as a whole
53
Social Demographic Data
- age
- sex
- gender
- ethnicity
- culture, language
- religion
- income
- legal status (citizen, permanent resident, refugee)
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population health data (indicators)
- mortality
- morbidity
- birth rates
- QOL indicators
55
CasP Assessment Wheel: subsystems
- physical environment
- education
- safety and transportation
- politics and gov't
- health and social services
- communication infrastructure and processes
- business and economics
- recreation and leisure
- still disparities in these areas that people still work with
56
data collected about communities
- affordable and stable housing
- people-centered design of neighbourhoods
- accessible and appropriate education system
- thriving and inclusive economy
- access to healthy foods
- access to appropriate transportation
- safe, inclusive public spaces
- Clean, safe, and inclusive environments
- safe appropriate infrastructure
57
principles of conducting a community assessment
- engagements, participation, and collaboration
- building relationship with the community and its members
- intersectional work
- team development
- the people themselves know what people want
58
Where to start assessment
- workplan
- process and scope of the assessment
- collect the information and analyze
- document, communicate, and share results of assessments
- defining roles on the team
- defining timelines (what's feasible, what's needed, what can we do in certain timeline, what's doable, funding timeline
59
CasP methods
- what data?
- community characteristics
- population health data
- depends on context and scope
- sources of data
- sources of data
- primary source: you directly collect or generate
- secondary: information that other people/organization/gov't departments have collected and reported on already
- data: what constitutes evidence (proves a point, can be objective, lived experiences, systematically collected)
- critically look at sources/information for credibility (who collected it, sponsors, arms length agencies)
60
Primary sources of data
- windshield survey: physical environment, characteristics
- key informant interview: lived experiences of living in the community, gathering new data
- focus group: discussion of focused topics based on other sources of data; already have data, and want to know
- community forum/town halls: sharing information and gathering feedback, widely share information about a topic and gather feedback
- questionnaire: demographic data, opinions, satisfaction, etc. (individual level)
- survey: population wide data collection
61
Secondary data sources
- have been collected, analyzed, and synthesized
- health ministries
- Stats canada: social demographic information
- population health reports: population health indicators
- historical documents/key informants: history of a community (can be primary)
62
Key informant
- individual interviews with people who live in or live out of the community
- someone who has in-depth insight to the lives and experiences of people living in the community
- has relationships with the community and its members
- can be someone who serves community but lives outside of geographic boundaries
- ex. social workers, religious leaders, head of community association, program coordinators, councillors, law enforcement, etc.)
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Focus group
- sources of data are analyzed and synthesized and require additional insights
- 6-12 people
- facilitator present with question guide (focused questions)
- group responses are dynamic and people's responses build on one another
-
64
Questionnaire
- normally at the individual level
- demographic data, opinions, satisfaction, measuring concepts
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survey
- normally at the population level
- wide data collection
- census data, Canadian community health survey
66
analysis of assessment data
- begins when done collecting data
- examine/analyze data for:
- health patterns
- patterns of strengths and/or weaknesses
- areas of disparities
- identifying determinants related to such disparities (are there areas of inequities?)
67
developing nursing diagnoses
- identify target population in the community
- actual or potential challenge or strength that the CHN can mitigate, support, or strengthen
- characteristics or evidence of the challenge or strength
- can be around strengths and how to support them
