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7th Semester > 402 Exam 3 > Flashcards

402 Exam 3 Flashcards

1
Q

is a group of people that share something in common, such as geographic location, interests, or values

A
  1. Community-
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2
Q

is a population or group of individuals who share common personal or environmental characteristics

A
  1. Aggregate-
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3
Q

when the nursing focus is on the collective or common good of the population, instead of on individual health.

Nurse may work with individuals, families, other interacting groups, aggregates, or institutions; the resulting changes are intended to affect the entire community

A
  1. Community as client-
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4
Q

seeks healthful change for the whole community’s benefit

A

Population-centered practice-

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5
Q

includes assessment, assurance, and policy development

A

Core public health functions-

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6
Q

means doing the greatest good for the greatest number of people

A

Utilitarianism-

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7
Q

means treating people fairly, and distributing resources and burdens equitably among the members of the society

A

Distributive justice-

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8
Q

means ensuring that vulnerable groups are included in equitable distribution of resources

A

Social Justice-

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9
Q
  • is reflected in the health behaviors and subsequent outcomes of its residents and also by the ability of the community as a system to support healthy individuals
A

Community health

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10
Q

views individuals as having dynamic interactions with social and environmental features of communities, for example social networks, organizations like schools and businesses, media, government policies, and natural and built environments

A

Socio-ecological model-

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11
Q

is an example of community partnership for assessment

A

Mobilizing for Action through Planning and Partnerships (MAPP)-

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12
Q

are formal partnerships in which individuals and organizations serve in defined capacities such as steering communities, advisory committees, and work groups

A

Coalitions-

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13
Q

is the antithesis of the partnership approach most valued in nurse-community partnerships, in which all partners are actively involved in and share power in assessing, planning, and implementing needed community changes

A

Passive participation-

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14
Q

involvement of the community or its representatives in healthy change

A

Active participation-

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15
Q

an essential concept for nurses to know and use, as are the concepts of community, community as client, and community health

A

Partnership-

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16
Q

refer to formal or informal community leaders who create opportunities for nurses to meet diverse members of the community

A

Gatekeepers-

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17
Q

are not professional or licensed health care providers but are community members from diverse backgrounds who receive training to do health outreach work

A
  1. Community health workers-
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18
Q

are collected directly through interaction with community members, which may include community leaders or interested stakeholders

A
  1. Primary data-
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19
Q
  • are obtained through existing reports on the community including census, vital stats, and numerical reports (morbidity, mortality info) or information from reference books
A
  1. Secondary data
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20
Q

include 8 major domains: analytic and assessment skills, policy development/program planning skills, communication skills, cultural competency skills, community dimensions of practice skills, public health science skills, financial management and planning skills, and leadership and systems thinking skills

A
  1. Public Health Nursing Competencies-
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21
Q

are numerical measures of health outcomes, such as morbidity and mortality, as well as determinants of health and population characteristics

A
  1. Health indicators-
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22
Q

anyone with a personal or occupational interest or concern in a community’s life

A
  1. Stakeholders-
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23
Q

refers to the deliberate sharing in the life of a community, for example, participating in a local fair or festival or attending a political or social event

A
  1. Participant observation-
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24
Q

can be identified through formal or informal channels in the community. They do not have to hold any formal titles but are generally viewed as leaders in the community

A
  1. Key informants-
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25
Q

is similar to an interview, in that it collects data mainly through asking open-ended questions to participants but to a small group rather than an individual

A
  1. Focus group-
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26
Q

also called photo elicitation, is a community assessment technique in which community members take photos to represent a topic or theme about community health

A
  1. Photovoice-
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27
Q

is a set of software and technology that can create maps electronically

A
  1. Geographic information systems (GIS)-
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28
Q
  • model based on nursing process and theories, and emphasizes the dynamic nature of community systems as integral to the health of residents
A
  1. Community-as-partner
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29
Q

are a method of simple observation, provide quick overview of a community and can be used along with photographs and interviews to get a general overall sense of the community

A
  1. Windshield surveys-
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30
Q

identifies ages, genders, martial information, births and infant deaths, race or ethnicity, and density of the population and assemble the information into a table

A
  1. Demographic data-
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31
Q

One of two Standardized classification systems to accommodate nursing diagnosis

A
  1. North American Nursing Diagnosis Association (NANDA)-
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32
Q

was developed by visiting nurses and expands beyond the physiological domain and includes environmental, psychosocial, and health-related behaviors domains

A
  1. Omaha system-
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33
Q

Community Health: Has three common characteristics:

A

status
structure
process dimension

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34
Q

: (outcome)—most well-known and accepted approach.

A

Status

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35
Q

Three parts of status:

A

biological, emotional, and social.

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36
Q

morbidity/mortality, life expectancy, risk factors.

A

Biological—

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37
Q

consumer satisfaction & mental health indexes.

A

Emotional—

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38
Q

can be measured by crime rates, functional levels.

A

Social part of health status

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39
Q

Services & resources—patterns of use of services, provider to client ratio. Examples include number of hospital beds, number of ER visits at a certain hospital. Demographics is another useful index when looking at community structure.

A

Structural

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40
Q

effective community functioning or problem solving.

A

Process dimension:

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41
Q

a process by which parts of a community (organizations, groups, aggregates) “are able to collaborate effectively in identifying the problems and needs of the community; can achieve a working consensus on goals and priorities; can agree on ways and means to implement the agreed-on goals; and can collaborate effectively in the required actions (Cottrell, 1979, p 197).

A

Community competence

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42
Q

(which includes all of the three concepts listed above): the meeting of collective needs by identifying problems and managing behaviors within the community itself and between the community and the larger society.

A

Community health definition:

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43
Q

Ability to respond effectively to changing dynamics
Ability to meet needs of its members
This indicates productive functioning

A

Healthy Community

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44
Q

Recognizes the need to work collectively, in community partnerships, to bring about the changes that are necessary to fulfill this vision

A

Healthy People 2020

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45
Q

Healthy People 2020 provides the foundation for a national health promotion and disease-prevention strategy built on two goals:

A
  1. Increasing the “quality and years of healthy
    life”
  2. Eliminating “health disparities”
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46
Q

a movement that helps community members bring about positive health changes. Each community will have its own perspective on critical health qualities—community’s definition of health may differ from the community health nurse’s!

A

Healthy Cities and Healthy Communities:

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47
Q

important to get community “buy-in” when intervening in the community! Lay community members, especially the community leaders, possess credibility and skills that most health professionals lack. MAPP (Mobilizing for Action through Planning and Partnerships) is one example of community partnerships.

A

Community Partnerships:

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48
Q

obtain usable information (existing data) about the community and its health. Gathering/compiling existing information, generating missing data. These are then analyzed and the results show any problems (predictive factors) with community health and what the community abilities are (protective factors).

A

Data collection and interpretation:

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49
Q

obtaining that data which already exists—things readily available such as BRFSS, vital statistics, etc. Such data usually describes the demographics of a community!

A

Data gathering:

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50
Q

: filling in the blanks by interviewing members of the community (key informants, focus groups, etc.); completing windshield surveys (see next slide)

A

Data generation

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51
Q

such as the Community Wheel on the next slide! Great tools for structuring your assessment (enables maximum focus), especially for online assessments such as the ones we will be doing!

A

Assessment guides:

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52
Q

viewed as community leaders; formal and informal

A

Key Informants –

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53
Q

asking open-ended questions to a small group within the community as opposed to the larger community

A

Focus groups –

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54
Q

– sharing in the life of the community

A

Participant observation

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55
Q

simple observation from a vehicle

A

Windshield surveys-

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56
Q

Community Assessment: The 7 A’s

A 
Awareness
Access
Availability
Affordability
Acceptability
Appropriateness
Adequacy
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57
Q

Used to help clarify the problems prioritized

Is an important first step to planning

A

Nursing Diagnosis

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58
Q

North American Nursing Diagnosis Association (NANDA) – outlines the nursing diagnosis process by identifying:

A

The problem or potential problem

Relation to factors, stressors, or health issues

Supports data that documents the problem

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59
Q

Involves analyzing and establishing priorities of the problems identified thru the nursing diagnosis

A

program planning

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60
Q

: nurse gathers & analyzes facts, then implements programs

A

Change agent

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61
Q

nurse is enabler-catalyst, teacher of problem-solving skills, activist advocate

A

Change partner:

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62
Q

People in the community are influential; they have the power to veto or approve new ideas and others in the community generally seek them out for advice about new ideas

A

lay advisors

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63
Q

Measures the success of the program and determines community satisfaction with the outcome

Begins in the planning stage—goals and measurable objectives are created

A

Evaluation

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64
Q

ideas about the world that a person believes to be true; these beliefs are rooted in societal values.

A
  1. Personal beliefs—
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65
Q

—are the beliefs and perspectives that a society values.

A
  1. Cultural attitudes
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66
Q

—(views) are a way to communicate thoughts and attitudes through literature, film, art, television, newspapers, and the internet.

A
  1. Media discourses
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67
Q

refers to having insufficient financial resources to meet basic living expenses.

A
  1. Poverty—
68
Q

issued by the U.S. Bureau of the Census and are used primarily for statistical purposes

A
  1. Poverty threshold guidelines—
69
Q

AKA the cost of living index. It is a measure of the average change over time in the prices paid by households for a fixed market basket of consumer goods and services, including housing; electricity; food; clothing; fuels; doctor, dentist, and drug charges; transportation; and other goods and services that people buy for day-to-day living.

A
  1. Consumer price index (CPI)—
70
Q

persons whose income is above the federal poverty guidelines but still inadequate.

A
  1. Near poor—
71
Q

individuals and families who remain poor for long periods and whose poverty is multigenerational.

A
  1. Persistent Poverty—
72
Q

geographically defined areas of high poverty, characterized by run-down housing, high unemployment rates, and poorer health outcomes.

A
  1. Neighborhood Poverty—
73
Q

people whose lives are generally marked by hardship and struggle. For them, homelessness is often transient or episodic. They may have brief stays in shelters

A
  1. Crisis poverty—
74
Q

goal was to replace large state psychiatric hospitals with community-based treatment centers.

A
  1. Deinstitutionalization—
75
Q

have greater risk taking behaviors, poorer health status, and decreased access to health care than do teens in the general population.

A
  1. Homeless children—
76
Q

provided funding for outpatient health services; however, the monies for these services were not large, and many needs go unmet.

A
  1. Stewart B. McKinney Homeless Assistance Act of 1987—
77
Q

coordinates and directs federal homeless activities.

A
  1. Interagency Council on the Homeless (ICH)—
78
Q

are an important stopgagp during a crisis.

A
  1. Emergency shelters—
79
Q

is typically reserved for vulnerable homeless population groups, such as persons with physical and mental disabilities, women and children who are victims of abuse, and those recovering from alcohol and drug users.

A
  1. Supportive housing—
80
Q

if available would be accessible through vouchers or after a homeless person has stabilized, and had access to employment income or SSI.

A
  1. Low-income housing—
81
Q

, established in the seventeenth century, said that persons who were born within the boundaries of the community should be given assistance by that community.

A

Elizabethan Poor laws

82
Q

Needy travelers from another community would not be helped and were sent back to their original community where they would be helped by their own people.

A

Elizabethan Poor laws

83
Q

: the beliefs and perspectives that a society values

Perspectives about individual responsibility for health and well-being are influenced by prevailing cultural attitudes.

A

cultural attitudes

84
Q

a way to communicate thoughts and attitudes through literature, film, art, television, newspapers and the Internet

A

Media discourses:

85
Q

Media images of persons on welfare influence, and are influenced by cultural attitudes and values. Poor persons may be cast as lazy or shiftless.

A

Media discourses:

86
Q

Poverty level in 2008 was $____ for a family of four and $_____ for a family of three

A

$21,200 and $17,600

87
Q

Poverty has _____, _____, and _______ consequences.

A

physical, psychological, and spiritual

88
Q

Poverty rate for children is ___% higher than any other age group

A

18

89
Q

Poverty among _____ ______ and _____ children is three times greater than that of white, non-Hispanic children.

A

African-American and Hispanic

90
Q

risk for children and poverty

A

Lack of adequate nutrition and brain development

Maternal substance abuse or depression

Exposure to environmental toxins

Trauma and abuse

Poor quality daily care

91
Q

Older Adults and Poverty

A

High prevalence rates for chronic illness and chronic illness complications, general morbidity, poor dental health, and overall mortality

92
Q

Poverty affects both ____ and ____ communities.

A

urban and rural

93
Q

More likely to be victims of crime, substance abuse, racial discrimination, and police brutality

Less access to health care

Poor housing conditions

A

poverty

94
Q

Poverty can lead to ______

A

homelessness

95
Q

lack of a fixed, regular, and adequate night-time residence

A

homelessness

96
Q

Two prominent ways to determine number of people who are homeless:

A

Point-in-time counts

period prevalence counts

97
Q

counting the # of persons which are homeless on a given day or during a given week

A

Point-in-time counts:

98
Q

the number of people homeless over a given period of time

A

Period prevalence counts:

99
Q

Transient or episodic homelessness marked by hardship and struggle; may be due to a lack of employment, education, obsolete job skills, divorce or domestic violence

A

Crisis poverty:

100
Q

homeless persons who may have mental or physical disabilities, alcohol problems, drug abuse, chronic health problems, and a lack of family support and money

A

Persistent poverty:

101
Q

who defined poverty

A

Stewart B. McKinney Homeless Assistance Act of 1987

102
Q

Two trends largely responsible for growth in homelessness over the past 20 to 25 years:

A

Shortage of affordable rental housing

Increase in poverty

103
Q

Why Are People Homeless?

A

Deinstitutionalization of chronically mentally ill individuals

104
Q

Lack of affordable housing has led to:

A

Overcrowding
Substandard housing
Increased homelessness

105
Q

Homelessness and At-Risk Populations

A

Homeless pregnant women
Homeless children
Homeless adolescents
Homeless older adults

106
Q

Provided small amount of funding for outpatient health services; also gave homeless children same access to education as permanently housed children

A

Stewart B. McKinney Homeless Assistance Act of 1987:

107
Q

responsible for coordinating and directing federal homeless activities; HUD funds housing programs

A

Interagency Council on Homeless (ICH):

108
Q

Primary Prevention:

A

affordable housing, effective job training, preventive health services & counseling services

109
Q

Secondary Prevention:

A

targets person on the verge of becoming homeless

110
Q

Tertiary prevention

A

homelessness includes comprehensive case management, physical and mental health services, emergency shelter housing, needle exchange programs, and drug and alcohol treatment

111
Q

an individual whose primary work in the past 24 months has been
in the agricultural field as a temporary
worker on a seasonal basis

A

Migrant farmworker:,

112
Q

Cyclic worker in the agricultural field who DOES NOT migrate

A

Seasonal farmworker:

113
Q

Leave home annually traveling throughout the country seeking employment

A

migrant lifestyle

114
Q

Uncertainty regarding work and housing

Faces isolation in new communities

A

migrant lifestyle

115
Q

average pay for a migrant worker

A

7.25/hr; less than 10,000 a year

116
Q

the migrant worker spends an average of ___ weeks/year unemployed

A

10

117
Q

Three migratory streams of migrant workers

A

eastern
midwestern
western

118
Q

eastern originated in?

A

florida

119
Q

midwestern originating in?

A

texas

120
Q

western originating in?

A

california

121
Q

52% of farmworker housing is crowded

More than half lacked showers & laundry machines, or both

1/3 of migrant workers used more than

30% of their total income to pay for housing

A

Housing Assistance Council

122
Q

migrant lifestyle has a high risk for:

A

chronic disease
poor dental health
mental health problems
higher rates for certain diseases
high levels of work injuries and chemical exposures
detrimental physical and social environments for children

123
Q

migrant lifestyle has an increased risk for what diseases?

A

TB
anemia
DM
HTN

124
Q

provided funds for primary & supplemental health services for migrant workers and their families

A

Migrant Health Act (1962):

125
Q

serve migrant workers across the country; less than 20% of all migrant workers receive services at these centers

A

Migrant health centers:

126
Q

Factors that limit adequate provision of health services:

A 
Lack of knowledge about services
Inability to afford care
Availability of services
Transportation
Hours of service
Mobility and tracking
Discrimination
Documentation
Language barrier
Cultural aspects of health care
127
Q

_____ ___ ranks as one of the most dangerous industries in the United States

A

Agricultural work

128
Q

Has highest fatality rate for foreign-born workers

A

Agricultural work

129
Q

Occupational health risks:

A

Injuries

Exposure to chemicals (pesticides)

Inadequate surveillance system denoting the extent of an injury

Physical demands

130
Q

: insufficient food (especially when children are in the home); can cause adults to borrow money, decrease variety of foods, feed children first, and eat less as a means of coping with not having enough to eat

A

Food insecurity

131
Q

examples of Mental health

A

Stress

Depression

Anxiety (especially females)

132
Q

Children and Youth migrant lifestyle

A 
malnutritiion
infectious disease
dental caries
inadequate immunization status
pesticide exposure
injuries
overcrowding and poor housing conditions
disruption of their social and school lives increases problems with anxiety
adolescent farmworkers
133
Q

Federal law does not protect children from?

A

overworking or from the time of day they work outside of school.

134
Q

Nurse is considered an _______ figure who should respect the individual, be able to relate to the individual, and maintain the individual’s dignity

A

authority

135
Q

Nurse should try to ______ that the patient understands what the nurse is telling him/her

A

validate

136
Q

_____ patients may not seek health professional care first.

A

Mexican

137
Q

Mexican patients will instead consult with who for health problems?

A

family
friends
folk healers

138
Q

_____ is significant component of a Mexican individual’s health care and social support system

A

Family

139
Q

who is the caretaker in mexican culture?

decision maker?

A

female caretaker

male decision maker

140
Q

May be more willing to follow advice from ????? than the advice of the health professional

A

another Mexican individual with a similar health problem

141
Q

____ may be considered a gift from God

A

Health

142
Q

is one who can continue to work and maintain one’s daily activities independent of symptoms or diagnosed diseases.

A

A healthy person

143
Q

Four common folk illnesses

A

mal de ojo (evil eye)
susto (fright)
empacho (indigestion)
caida de mollera (fallen fontanel)

144
Q

mal de ojo

A

evil eye

145
Q

susto

A

fright

146
Q

empacho

A

indigestion

147
Q

cada de mollera

A

fallen fontanel

148
Q

The more common healers are the

A

curanderos, herbalistas, and espiritualistas

149
Q

most commonly used herbs

A 
chamomile (manzanilla)
peppermint (yerba buena)
aloe vera
nopales (cactus)
epazote
150
Q

Health promotion and disease prevention may be difficult concepts for migrant workers to embrace because of:

A

Their beliefs regarding disease causality

Their irregular and episodic contact with the health care system

Their lower educational level

151
Q
  • provide education
A

Primary Intervention–

152
Q
  • screenings provided for prevention of diseases
A

Secondary Intervention–

153
Q

rehabilitation and treatment provided

A

Tertiary Intervention—

154
Q

before this, care of the sick in small communities was provided by informal social support systems

A

red cross rural nursing service (1912)

155
Q

problems in rural communities for generations

A 
maldistribution of health professionals
poverty
limited access to services
ignorance
social isolation
156
Q

a subjective concept.

is often defined in terms of the geographic location and population density or it may be described in terms of the distance from or the time needed to commute to an urban center

A

rural

157
Q

 Differences in_____ vs. ____ less significant now

A

rural versus urban

158
Q

 Rural and urban residencies not opposing lifestyles 

Must be seen on a wider range

• Remote farm to village to small town to larger town or city to large metropolitan area with a core inner city.

A

rural-urban continuum

159
Q

 Collective term for metro and micro areas

A

 Core-based statistical area

160
Q

 Core urban area of 50,000 or more

A

 Metropolitan area

161
Q

Urban core of at least 10,000 but less than 50,000

About 60% of the total non-metro population

A

 Micropolitan area

162
Q

 No urban core, but on average 14,000 residents

A

 Non-core area

163
Q

 Core urban area of 50,000 or more

A

 Metropolitan area

164
Q

population characteristics for rural areas

A 
more whites
higher younger (under 18 y/o)
older adults (over 65 y/o)
more likely to be married
more likely to be widowed
more likely to be poorer
fewer formal education years
unerinsured/uninsured
165
Q

some equate the idea of rural with __________

A

farm residency

166
Q

and equate the idea of urban with _______

A

non-farm residency

167
Q

a physician or nurse practitioner who provides services to residents who live in surrounding counties

A

health professional shortage area (HPSA)

7th Semester (14 decks)

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