402 Exam 3 Flashcards
1
Q
is a group of people that share something in common, such as geographic location, interests, or values
A
- Community-
2
Q
is a population or group of individuals who share common personal or environmental characteristics
A
- Aggregate-
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
- Community as client-
4
Q
seeks healthful change for the whole community’s benefit
A
Population-centered practice-
5
Q
includes assessment, assurance, and policy development
A
Core public health functions-
6
Q
means doing the greatest good for the greatest number of people
A
Utilitarianism-
7
Q
means treating people fairly, and distributing resources and burdens equitably among the members of the society
A
Distributive justice-
8
Q
means ensuring that vulnerable groups are included in equitable distribution of resources
A
Social Justice-
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
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-
11
Q
is an example of community partnership for assessment
A
Mobilizing for Action through Planning and Partnerships (MAPP)-
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-
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-
14
Q
involvement of the community or its representatives in healthy change
A
Active participation-
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-
16
Q
refer to formal or informal community leaders who create opportunities for nurses to meet diverse members of the community
A
Gatekeepers-
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
- Community health workers-
18
Q
are collected directly through interaction with community members, which may include community leaders or interested stakeholders
A
- Primary data-
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
- Secondary data
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
- Public Health Nursing Competencies-
21
Q
are numerical measures of health outcomes, such as morbidity and mortality, as well as determinants of health and population characteristics
A
- Health indicators-
22
Q
anyone with a personal or occupational interest or concern in a community’s life
A
- Stakeholders-
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
- Participant observation-
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
- Key informants-
25
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
1. Focus group-
26
also called photo elicitation, is a community assessment technique in which community members take photos to represent a topic or theme about community health
1. Photovoice-
27
is a set of software and technology that can create maps electronically
1. Geographic information systems (GIS)-
28
- model based on nursing process and theories, and emphasizes the dynamic nature of community systems as integral to the health of residents
1. Community-as-partner
29
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
1. Windshield surveys-
30
identifies ages, genders, martial information, births and infant deaths, race or ethnicity, and density of the population and assemble the information into a table
1. Demographic data-
31
One of two Standardized classification systems to accommodate nursing diagnosis
1. North American Nursing Diagnosis Association (NANDA)-
32
was developed by visiting nurses and expands beyond the physiological domain and includes environmental, psychosocial, and health-related behaviors domains
1. Omaha system-
33
Community Health: Has three common characteristics:
status
structure
process dimension
34
: (outcome)—most well-known and accepted approach.
Status
35
Three parts of status:
biological, emotional, and social.
36
morbidity/mortality, life expectancy, risk factors.
Biological—
37
consumer satisfaction & mental health indexes.
Emotional—
38
can be measured by crime rates, functional levels.
Social part of health status
39
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.
Structural
40
effective community functioning or problem solving.
Process dimension:
41
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).
Community competence
42
(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.
Community health definition:
43
Ability to respond effectively to changing dynamics
Ability to meet needs of its members
This indicates productive functioning
Healthy Community
44
Recognizes the need to work collectively, in community partnerships, to bring about the changes that are necessary to fulfill this vision
Healthy People 2020
45
Healthy People 2020 provides the foundation for a national health promotion and disease-prevention strategy built on two goals:
1. Increasing the “quality and years of healthy
life”
2. Eliminating “health disparities”
46
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!
Healthy Cities and Healthy Communities:
47
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.
Community Partnerships:
48
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).
Data collection and interpretation:
49
obtaining that data which already exists—things readily available such as BRFSS, vital statistics, etc. Such data usually describes the demographics of a community!
Data gathering:
50
: filling in the blanks by interviewing members of the community (key informants, focus groups, etc.); completing windshield surveys (see next slide)
Data generation
51
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!
Assessment guides:
52
viewed as community leaders; formal and informal
Key Informants –
53
asking open-ended questions to a small group within the community as opposed to the larger community
Focus groups –
54
– sharing in the life of the community
Participant observation
55
simple observation from a vehicle
Windshield surveys-
56
Community Assessment: The 7 A’s
```
Awareness
Access
Availability
Affordability
Acceptability
Appropriateness
Adequacy
```
57
Used to help clarify the problems prioritized
| Is an important first step to planning
Nursing Diagnosis
58
North American Nursing Diagnosis Association (NANDA) – outlines the nursing diagnosis process by identifying:
The problem or potential problem
Relation to factors, stressors, or health issues
Supports data that documents the problem
59
Involves analyzing and establishing priorities of the problems identified thru the nursing diagnosis
program planning
60
: nurse gathers & analyzes facts, then implements programs
Change agent
61
nurse is enabler-catalyst, teacher of problem-solving skills, activist advocate
Change partner:
62
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
lay advisors
63
Measures the success of the program and determines community satisfaction with the outcome
Begins in the planning stage—goals and measurable objectives are created
Evaluation
64
ideas about the world that a person believes to be true; these beliefs are rooted in societal values.
1. Personal beliefs—
65
—are the beliefs and perspectives that a society values.
1. Cultural attitudes
66
—(views) are a way to communicate thoughts and attitudes through literature, film, art, television, newspapers, and the internet.
1. Media discourses
67
refers to having insufficient financial resources to meet basic living expenses.
1. Poverty—
68
issued by the U.S. Bureau of the Census and are used primarily for statistical purposes
1. Poverty threshold guidelines—
69
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.
1. Consumer price index (CPI)—
70
persons whose income is above the federal poverty guidelines but still inadequate.
1. Near poor—
71
individuals and families who remain poor for long periods and whose poverty is multigenerational.
1. Persistent Poverty—
72
geographically defined areas of high poverty, characterized by run-down housing, high unemployment rates, and poorer health outcomes.
1. Neighborhood Poverty—
73
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
1. Crisis poverty—
74
goal was to replace large state psychiatric hospitals with community-based treatment centers.
1. Deinstitutionalization—
75
have greater risk taking behaviors, poorer health status, and decreased access to health care than do teens in the general population.
1. Homeless children—
76
provided funding for outpatient health services; however, the monies for these services were not large, and many needs go unmet.
1. Stewart B. McKinney Homeless Assistance Act of 1987—
77
coordinates and directs federal homeless activities.
1. Interagency Council on the Homeless (ICH)—
78
are an important stopgagp during a crisis.
1. Emergency shelters—
79
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.
1. Supportive housing—
80
if available would be accessible through vouchers or after a homeless person has stabilized, and had access to employment income or SSI.
1. Low-income housing—
81
, established in the seventeenth century, said that persons who were born within the boundaries of the community should be given assistance by that community.
Elizabethan Poor laws
82
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.
Elizabethan Poor laws
83
: the beliefs and perspectives that a society values
Perspectives about individual responsibility for health and well-being are influenced by prevailing cultural attitudes.
cultural attitudes
84
a way to communicate thoughts and attitudes through literature, film, art, television, newspapers and the Internet
Media discourses:
85
Media images of persons on welfare influence, and are influenced by cultural attitudes and values. Poor persons may be cast as lazy or shiftless.
Media discourses:
86
Poverty level in 2008 was $____ for a family of four and $_____ for a family of three
$21,200 and $17,600
87
Poverty has _____, _____, and _______ consequences.
physical, psychological, and spiritual
88
Poverty rate for children is ___% higher than any other age group
18
89
Poverty among _____ ______ and _____ children is three times greater than that of white, non-Hispanic children.
African-American and Hispanic
90
risk for children and poverty
Lack of adequate nutrition and brain development
**Maternal substance abuse or depression**
Exposure to environmental toxins
Trauma and abuse
Poor quality daily care
91
Older Adults and Poverty
High prevalence rates for chronic illness and chronic illness complications, general morbidity, poor dental health, and overall mortality
92
Poverty affects both ____ and ____ communities.
urban and rural
93
**More likely to be victims of crime, substance abuse, racial discrimination, and police brutality**
Less access to health care
Poor housing conditions
poverty
94
Poverty can lead to ______
homelessness
95
lack of a fixed, regular, and adequate night-time residence
homelessness
96
Two prominent ways to determine number of people who are homeless:
Point-in-time counts
period prevalence counts
97
counting the # of persons which are homeless on a given day or during a given week
Point-in-time counts:
98
the number of people homeless over a given period of time
Period prevalence counts:
99
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
Crisis poverty:
100
homeless persons who may have mental or physical disabilities, alcohol problems, drug abuse, chronic health problems, and a lack of family support and money
Persistent poverty:
101
who defined poverty
Stewart B. McKinney Homeless Assistance Act of 1987
102
Two trends largely responsible for growth in homelessness over the past 20 to 25 years:
Shortage of affordable rental housing
Increase in poverty
103
Why Are People Homeless?
Deinstitutionalization of chronically mentally ill individuals
104
Lack of affordable housing has led to:
Overcrowding
Substandard housing
Increased homelessness
105
Homelessness and At-Risk Populations
Homeless pregnant women
Homeless children
Homeless adolescents
Homeless older adults
106
Provided small amount of funding for outpatient health services; also gave homeless children same access to education as permanently housed children
Stewart B. McKinney Homeless Assistance Act of 1987:
107
responsible for coordinating and directing federal homeless activities; HUD funds housing programs
Interagency Council on Homeless (ICH):
108
Primary Prevention:
affordable housing, effective job training, preventive health services & counseling services
109
Secondary Prevention:
targets person on the verge of becoming homeless
110
Tertiary prevention
homelessness includes comprehensive case management, physical and mental health services, emergency shelter housing, needle exchange programs, and drug and alcohol treatment
111
an individual whose primary work in the past 24 months has been
in the agricultural field as a temporary
worker on a seasonal basis
Migrant farmworker:,
112
Cyclic worker in the agricultural field who DOES NOT migrate
Seasonal farmworker:
113
Leave home annually traveling throughout the country seeking employment
migrant lifestyle
114
Uncertainty regarding work and housing
Faces isolation in new communities
migrant lifestyle
115
average pay for a migrant worker
7.25/hr; less than 10,000 a year
116
the migrant worker spends an average of ___ weeks/year unemployed
10
117
Three migratory streams of migrant workers
eastern
midwestern
western
118
eastern originated in?
florida
119
midwestern originating in?
texas
120
western originating in?
california
121
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
Housing Assistance Council
122
migrant lifestyle has a high risk for:
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
migrant lifestyle has an increased risk for what diseases?
TB
anemia
DM
HTN
124
provided funds for primary & supplemental health services for migrant workers and their families
Migrant Health Act (1962):
125
serve migrant workers across the country; less than 20% of all migrant workers receive services at these centers
Migrant health centers:
126
Factors that limit adequate provision of health services:
```
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
_____ ___ ranks as one of the most dangerous industries in the United States
Agricultural work
128
Has highest fatality rate for foreign-born workers
Agricultural work
129
Occupational health risks:
Injuries
Exposure to chemicals (pesticides)
Inadequate surveillance system denoting the extent of an injury
Physical demands
130
: 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
Food insecurity
131
examples of Mental health
Stress
Depression
Anxiety (especially females)
132
Children and Youth migrant lifestyle
```
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
Federal law does not protect children from?
overworking or from the time of day they work outside of school.
134
Nurse is considered an _______ figure who should respect the individual, be able to relate to the individual, and maintain the individual’s dignity
authority
135
Nurse should try to ______ that the patient understands what the nurse is telling him/her
validate
136
_____ patients may not seek health professional care first.
Mexican
137
Mexican patients will instead consult with who for health problems?
family
friends
folk healers
138
_____ is significant component of a Mexican individual’s health care and social support system
Family
139
who is the caretaker in mexican culture?
decision maker?
female caretaker
male decision maker
140
May be more willing to follow advice from ????? than the advice of the health professional
another Mexican individual with a similar health problem
141
____ may be considered a gift from God
Health
142
is one who can continue to work and maintain one’s daily activities independent of symptoms or diagnosed diseases.
A healthy person
143
Four common folk illnesses
mal de ojo (evil eye)
susto (fright)
empacho (indigestion)
caida de mollera (fallen fontanel)
144
mal de ojo
evil eye
145
susto
fright
146
empacho
indigestion
147
cada de mollera
fallen fontanel
148
The more common healers are the
curanderos, herbalistas, and espiritualistas
149
most commonly used herbs
```
chamomile (manzanilla)
peppermint (yerba buena)
aloe vera
nopales (cactus)
epazote
```
150
Health promotion and disease prevention may be difficult concepts for migrant workers to embrace because of:
Their beliefs regarding disease causality
Their irregular and episodic contact with the health care system
Their lower educational level
151
- provide education
Primary Intervention--
152
- screenings provided for prevention of diseases
Secondary Intervention--
153
rehabilitation and treatment provided
Tertiary Intervention---
154
before this, care of the sick in small communities was provided by informal social support systems
red cross rural nursing service (1912)
155
problems in rural communities for generations
```
maldistribution of health professionals
poverty
limited access to services
ignorance
social isolation
```
156
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
rural
157
Differences in_____ vs. ____ less significant now
rural versus urban
158
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.
rural-urban continuum
159
Collective term for metro and micro areas
Core-based statistical area
160
Core urban area of 50,000 or more
Metropolitan area
161
Urban core of at least 10,000 but less than 50,000
About 60% of the total non-metro population
Micropolitan area
162
No urban core, but on average 14,000 residents
Non-core area
163
Core urban area of 50,000 or more
Metropolitan area
164
population characteristics for rural areas
```
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
some equate the idea of rural with __________
farm residency
166
and equate the idea of urban with _______
non-farm residency
167
a physician or nurse practitioner who provides services to residents who live in surrounding counties
health professional shortage area (HPSA)
