Week 6 Flashcards
(145 cards)
1
Q
define: theory
A
- presents a systemic way of understanding events or situation
- a set of concepts, definitions, and propositions that explain or predict these events or situations by illustrating the relationships between variables
2
Q
theories that are not as highly developed or that have not been as vigorously tested are referred to as…
A
- conceptual models or frameworks
3
Q
theory, research, and practice are ______. what does this mean?
A
- reciprocal
= theory provides roots that anchor both practice and research in the nursing discipline - practice and research in diverse settings contribute to development of new theories
4
Q
theory assists practitioners, decision makers, educators, and researchers to… (3)
A
- explain what they experience
- inform their actions and decisions
- articulate possible outcomes
5
Q
for CHNs, theories may…
A
- guide practice in situation where rigorous research-based evidence is not available
6
Q
theories can support understanding of…
A
- why things are the way they are
7
Q
nursing theories are integrated with…
A
- theories developed in public health, and the social sciences to guide the practice, research, and education of CHNs
8
Q
what are important foundations for understanding theory and how it can be used (3)
A
- core concepts
- patterns of knowing
- different levels of theoretical knowledge in nursing
9
Q
what are key public health concepts (6)
A
- social justice
- population health
- epidemiology
- health promotion and prevention
- ethics
- commitment to community and health equity
10
Q
what are community health nursing concepts (7)
A
- health equity
- DOH
- capacity building
- strengths-based approach
- caring
- cultural safety
- collaboration
11
Q
health equity is achieved when…
A
- all people have the opportunity to reach their full health potential regardless of age, race, ethnicity, gender, or social class
12
Q
what are the theoretical foundations of CHN?
A
- florence nightingale –> impact of enviro on healing
- virginia henderson –> basic needs
- intersectionality (layered impacts)
- ecological systems theory
- calgary family assessment model
- health promotion model
- neuman’s system model
- population health promotion model
- self-care deficit model (Orem)
13
Q
nursing theories focusing on illness in clinical settings are..
A
- not always easily adapted to practice of community health nursing
14
Q
Theories specifically about CHN are…
A
- lacking
15
Q
in 1987, Schultz argued that nursing tends to represent…
A
- individual problems as isolated events rather than a pattern of responses in a community
16
Q
what are more recent developments for nursing theory
A
- nursing theories being adapted specifically to CHN
- new conceptual frameworks specific to community health w emphasis on health promotion and prevention
17
Q
describe the perspectives of First Nation, Metis, and Inuit people r/t community health nursing theory and practice
A
- their perspectives are not well represented due to little acknowledgment of the colonial roots
- they did not explicitly draw on Indigenous perspectives and may have been the resuklt of few FNMI nurses as community health nursing scholars, researchers, and leaders
18
Q
2-eyes seeing and two-row campom demonstrate…
A
- both traditional Indigenous knowledge and Western scientific understanding
19
Q
diagram on first nations perspective on health and wellness model
A
20
Q
the CHNC model of the most important types of theoretical foundations to the discipline includes:
A
- CHN metaparadigm
- philosophies encompassing CHN ethics and values
- broad theoretical perspectives
- conceptual models and frameworks (various health prmotion models, intervention wheels)
- grand, middle range, and practice (or substantive) theories
21
Q
describe the area of change in health promotion theories and models that focus on individuals
A
- theories that explain health behavior and behavior change by focusing on the individual
22
Q
what are theories or models that connect to health promotion theories and models for individuals (3)
A
- theory of planned behavior (TPB)
- transtheoretical (stages of change) model
- health belief model (HBM)
23
Q
what assumption is made with the theory of planned behavior
A
- the intention to act is the most immediate determinant of behavior
ex. if your intention is not to smoke to improve your health, you are more likely not to smoke
24
Q
theory of planned behavior diagram
A
25
what assumption is made with the transtheoretical (stages of change) model
- behavior change is a process, not an event
- individuals have varying levels of readiness to change
26
transtheoretical model (stages of change)
27
what are the stages in the stages of change model (6)
- precontemplation
- contemplation
- determination
- action
- relapse
- maintenance
28
describe the precontemplation stage of stages of change model
- no intention of changing behavior
- imp to build awareness & give info
29
describe the contemplation stage of stages of change model (5)
- aware a problem exists
- no commitment to action
- assess pros and cons
- reduce perceived conc
- increase pros
30
describe the determination stage of stages of change model
- intent upon taking action
- commit & make a plan
31
describe the action stage of stages of change model (2)
- implement and revise plan
- design strategies to mitigate risk of relapse
32
describe the relapse stage of stages of change model (2)
- offer support & mngmt
- expected
33
describe the maintenance stage of stages of change model
- integrate change into lifestyle
- how to maintain this change
ex. taking BP 2x/day rather
34
describe the health belief model
- the focus is on motivation to change/engage in health promotion behavior
- looks at ones perception about changing a behavior (does somebody actually perceive that they're at risk??)
35
the health belief model addresses... (3)
- the individual's perceptions of the threat posed by a health problem,
- the benefits of avoiding the threat
- factors influencing the decision to act (barriers, cues, self-efficacy)
36
the health belief model
37
HBM is used when we....
- screen individuals
- screening program gives cues to act
38
describe the area of change in health promotion theories and models that focus on communities
- theories that explain change in communities and organizations
- community action for health
39
what theories are connected to health promotion theories and models for communities (2)
- diffusion of innovation
- community mobilization/community organization
40
describe the theory: diffusion of innovation
- how new ideas (practices, programs) are adopted by communities
- focuses on diff categories of adopters based on time it takes to adopt innovation
41
diffusion of innovation diagram
42
what are the different categories of adopters in the diffusion of innovation theory (5)
- innovators
- early adopters
- early majority
- late majority
- laggards
43
describe: innovators
- open to risks and first to try new ideas
44
describe: early adopters (2)
- opinion leaders
- embrace change
45
describe: early majority
- take time to make decisions
- adopt new innovations before the average person
- need evidence that it works before adopting
46
describe: late majority
- more resistant to change but responsive to peer pressure
- skeptical of change and will only adopt an innovation after it’s been generally accepted and adopted by the majority of the population
47
describe: laggards (3)
- highly resistant to change
- hard to reach
- wait for a mainstream inventioned
- last to make the changeover
48
what are variables effecting rate of adoption of innovations
- relative advantage
- compatability
- complexity, simplicity
- flexibility
- trialability
- observability
- cost-efficiency
49
describe how relative advantage effects the rate of adoption of innovations
- the degree to which an innovation is perceived as better than the idea it supersedes
50
describe how compatability effects the rate of adoption of innovations
- the degree to which an innovation is perceived as being consistent with existing values, past experiences, and needs of potential adopters
51
describe how complexity/simplicity effects the rate of adoption of innovations
- the degree to which an innovation is perceived as difficult to understand and use
52
describe how flexibility effects the rate of adoption of innovations
- the degree to which an innovation is perceived as being easily accessed and modified for use
53
describe how trialability effects the rate of adoption of innovations
- the degree to which an innovation may be experimented with on a limited basis
54
describe how observability effects the rate of adoption of innovations
- the degree to which the results of an innovation are visible to others
55
describe how cost efficiency effects the rate of adoption of innovations
- the degree to which the innovation is cost effective, especially compared to alternatives
56
what is the first law of public health
- the right choice must be the easy choice
57
community mobilization/organization includes... (3)
1. social planning
2. community development
3. social action
58
describe social planning r/t community mobilization/organization (3)
- stresses problem solving
- often relies on expert practitioners
- task oriented
59
describe community development r/t community mobilization/organization (4)
- aim is to develop group identity & cohesion
- focus on building capacity
- community members identify issues
- process oriented
60
describe social action r/t community mobilization/organization (3)
- goal is to increase community's capacity to solve problems and to make concrete changes that redress social injustice
- task and process oriented
61
community mobilization/organization
62
community organization practice requires a...
- capacity building approach, rather than a deficiency orientation approach
63
what is the role of the CHN in community organization practice
- external champion = must take lead of the community
64
community organization practice requires...
- maximum participation of community members in decisions related to program planning, implementation, or needed policy change
65
with community organization practice, without some lvl of ________, health promotion strategies will not be effective long-term
empowerment
66
what are common elements in community mobilization/organization (6)
- empowerment
- community capacity
- participation
- relevance
- issue selection
- critical consciousness
67
describe empowerment r/t community mobilization/organization
- a social action process thru which people gain mastery over their lives and their communities
68
describe community capacity r/t community mobilization/organization
- characteristics of a community that affect its ability to identify, mobilize around, and address problems
69
describe participation r/t community mobilization/organization (2)
- engagement of community members as equal partners
- never do for others what they can do for themselves
70
describe relevance r/t community mobilization/organization
- community organizing that "starts where the people are"
71
describe relevance r/t community mobilization/organization
- community organizing that "starts where the people are"
72
describe issue selection r/t community mobilization/organization
- identifying immediate, specific, and realizable targets for change that unify and build community strength
73
describe critical consciousness r/t community mobilization/organization
- awareness of social, political, and economic forces that contribute to social problems
74
define: healthy public policy
- policies outside the health sector that promote health of individuals/communities by:
--> making it easier for people to adopt health practices
--> making it harder for people to adopt unhealthy practices
--> creating healthy physical and social enviro
75
what is the area of change for health promotion theories & models that focus on change in public policy
- theories that explain the development and implementation of healthy public policy
76
what health promotion theories/models promote change in public policy (3)
- milio's framework
- weiss's framework
- health impact assessment (HIA)
77
describe milio's framework (3)
- stages and influences of development and implementation of healthy public policy
- coined term "healthy public policy"
- identified non-linear stages of, and influences on, HPP development & implementation
78
describe weiss's framework
- evidence used in a variety of ways to lead, justify, support development of healthy public policy
79
describe the health impact assessment
- assess potential health impacts of proposed policy, and potential inequitable distribution of impacts
80
weiss's model of policy development focuses on... (5)
- knowledge driven
- problem solving
- interactive
- political
- tactical
81
describe the "knowledge driven" component of weiss's model
- new research knowledge rapidly accepted into policy development
82
describe the "problem solving" component of weiss's model
- mechanisms during decision making process related to HPP development include collection and consideration of evidence
83
describe the "interactive" component of weiss's model (2)
- evidence is collected from variety of sources
- knowledge from research & social pressures, experience, and political situation
84
describe the "political" component of weiss's model
- evidence is used to justify a predetermined position
85
describe the "tactical" component of weiss's model (3)
- preferable data is used
- evidence used to support an unpopular decision or to explain and avoid an unpopular decision
- unsubstantiated research findings are used to delay decision making
86
describe the area of change for health promotion theories and models that focus on systems
- theories that have a system lvl focus and explore that relationships between individuals and communities, and between sociocultural and environmental factors that affect health
- often referred to ecological models
87
what theories/models focus on systems
- population health promotion model
- precede-proceed planning model
88
population health promotion model
89
precede-proceed model
90
what are some HP strategies that focused on changing behavior in the behavioral/lifestyle approach (4)
- health education (individual, group)
- health communication
- social marketing
- regulatory measures
91
HP strategies focused on changing behaviors
92
what are the 4 P's of marketing
- product
- price
- place
- promotion
93
describe the use of marking principles
- can be used to advance a social cause, idea, and promote change in social behaviors
94
what is the goal of social marketing (2)
- to encourage health promoting behaviors
- to eliminate or significantly reduce behaviors that negatively impact a population's health
ex. bell let's talk day, MADD
95
the six essential benchmarks considered the best strategic application of the "marketing mix" consists of...
- the 4 P's of product, prize, place, and promotion
96
what are other Ps of marketing (2)
- policy change
- people
97
interventions that only use the promotion P are...
- social advertising, not social marketing
98
health promotion strategies focused on changing the community, enviro, or policy are influenced by...
community, policy, ecological lvl change theories :
- ottawa charter strategies
- empowering strategies
99
what are the 5 ottawa charter strategies
- building healthy public policy
- creating supportive enviro
- reorienting health services
- developing personal skills
- strengthening community action
100
define: health promotion
- the process of enabling people to increase control over, and to improve, their health
101
define: empowerment
- an active, involved process where people, groups, and communities move toward increased individual and community control, political efficacy, improved quality of community life, and social justice
- more group oriented
102
large body of evidence suggests that.. (4)
- individuals and communities lacking control over their destiny have poor health outcomes
- being poor is associated w a stress-induced response in IQ
- powerlessness leads to poor health outcomes (may not be a matter of absolute powerlessness)
- being lower in the power/status hierarchy can contribute to poorer health choices
103
what are powerlessness risk factors (70
- living in poverty
- lower in hierarchy
- high demand psychological & physical needs
- low control (perceived and actual)
- chronic stress
- lack of social support
- lack of resources
104
powerlessness
105
what are some empowerment strategies (5)
- political action
- coalition advocacy
- community organization development
- personal care/empowerment
- small group development
106
what are some empowerment strategies for CHNs
- CHN standard #5 --> capacity building
107
what is the continuum of empowering strategies (5)
- personal empowerment
- small group development
- community organization
- coalition advocacy
- political action
108
describe personal empowerment
- goal of direct service is to provide individuals w the knowledge and skills to enhance their competence and confidence to deal w life's challenges
ex. health teachings, prenatal classes, connecting people w resources
109
describe small group developmengt
- individuals need opportunties to overcome isolation and to discover that they arent alone in their problems
- organizing people around the issues that are unique to the group
ex. parenting support groups
110
describe community organization empowerment-
- community organizing involves local actions whereby people organize around issues or problems that are larger than group members own immediate concerns
- may be an extension of small group work
- often called commuity
ex. tenderlion project, harm reduction groups
111
describe coalition advocacy
- taking a position on an issue and initiating actions in a deliberate attempt to influence public or private policy
- lobbying is done by several groups that temporarily come together to advocate a policy change
- CHNs may be involved as representatives of their agencies
112
describe political action empowerment
- individual CHNs are less likely to be involved at this lvl as part of their work, in part due to inherent conflicts of interest, being bound by employer's parameters, etc.
- professional nursing associations are often involved at this level
ex. CHNs volunteering at a pop-up consumption site
113
empowerment continuum
114
describe the improtance of activism, research, and advocacy
- important for research and action to seek partnership w and promote the health of individuals and communities
- advocacy is a social justice issue and a mandatory component of public health and CN
- nursing practice within communities will create more opportunities for nursing practice focused on health promotion and different forms of advocacy and activism
115
activism as a public health intervention has been used to.. (4)
- effect change for people living in poverty
- changes for child labour
- fight for women's right to vote
- distirbute birth control info to women
116
summarize theory-informed practice in CHN r/t clients
- examine the client within the community, as well as nurse-client interactions & the role of CHNs as community advocates
117
summarize theory-informed practice in CHN r/t indigenoys peoples
- first nations perspective on health & wellness model is used to guide care and decolonize and redesign health programs for FN
118
summarize theory-informed practice in CHN r/t people experiencing social and health inequities
- interweaving of multiple SDoH offers a more inclusive look at factors that cause oppression
119
summarize theory-informed practice in CHN r/t the health system
- theories help to broaden scope of effective and considerate care beyond treating illness in a clinical context
120
summarize theory-informed practice in CHN r/t nursing profession
- theory can refine, guide, and develop the practice of CHNs
121
summarize theory-informed practice in CHN r/t policy
- critical social theory support nurses to collab w other sectors to influence public policy and address the sturctural and systemic DOH
122
summarize theory-informed practice in CHN r/t reserach
- theory informs research, which produces the evidence used to guide the practice of CHNs in education, admin, and practitioner roles
123
single interventions do not work. the future of behavior change and health promotion consists of 3 core components
1. a behavior change approach
2. a strong policy framework that creates a supportive enviro
3. the empowerment of people to gain more control over making healthy lifestyle choices
124
define: health education
- one strategy for implementing health promotion and disease prevention programs
- provides learning experiences on health topics tailored for their traget population
125
health education includes...
- the health benefits/threats they face
- providing tools to build capacity and support behavior change in an appropriate setting
126
what is the target of health education
- individual people
127
what is the goal of health education
- changing the behavior of individual people
128
what are the forms health education takes
- lectures
- presentations
- courses
- seminars
- posters
- videos
- webinars
- classes
- workshops
129
what is the evaluation of health education
- asking participants if their behavior changed
130
what are the primary features of health education(2)
- providing info
- presuading people to change their enviro
131
what is the role of policy in health education
- policy does not generally play a role in health education
132
what are examples of health education
- teaching a patient how to eat better
- running a weight loss group for obese pts
- trying to convince your pt why smoking is bad for COPD
- encouraging your pt to exercise a little everyday
133
define: health promotion
- the process of enabling control over, and to improve their health
134
health promotion involves...
- public policy that addresses health determinants
135
what is the target of health promotion
- policies that influence health, either directly or indirectly
136
what is the goal of health promotion
- healthy public policy, to improve the health of the population
137
what forms does health promotion take
- policy development to support the health of population
138
what is the evaluation of health promotion
- statistics collected from the population to assess the value of policies and programs
139
what is the primary feature of health promotion
- impacting social, economic, and political factors to improve population health
140
what is the role of policy in health promotion
- policies should foster health and wellbeing in the population
- healthy public policy is a key component of population health promotion
141
what are examples of health promotion
- reduce inequalities in income and wealth
- create safe, supportive enviros in schools, workplaces, and community
- ensure that individuals and families have access to the resources they need to sustain a healthy lifestyle
- protect people and the earth from toxic pollution, resource depletion, and systemic global efforts
- focus health promotion practice more on implementing policies that create healthy living conditions and less on policies that influence personal lifestyle behavior's
142
more differences on health education vs promotion
143
144
145
