chapter 1

Question 1

a process of enabling people to increase control over and to improve their health. enabling people to increase control over and improve their health transcends ‘healthy lifestyle’ or ‘health choices’ and focuses on the personal and social resources that are available, accessible and so forth

Answer 1

Health promotion

Question 2

the emphasis on personal and social resources moves us into the idea of ______

Answer 2

community

Question 3

community as _________________: the environment within which a person lives; structural and geographic

Answer 3

Context

Question 4

community as _________________: as a result of the public health movement we assess the health of the community through epidemiology (disease patterns, risk factors). assessment strategies include size, population groups, culture spatial characteristics, boundaries, history, schools, resources, socioeconomic data and so forth

Answer 4

client

Question 5

the branch of medicine which deals with the incidence, distribution, and possible control of diseases and other factors relating to health (disease patterns, risk factors)

Answer 5

Epidemiology

Question 6

community as __________________ ______________: this asks the question what are the relational aspects of community inclusive of the power relations? the political elements that define how health is viewed and resources are part of the assessment and planning. the shift in thinking is away from ‘blame the individual’ to look at how health disparity is a result of societal issues of poverty, racism, colonial practices, economic and political decisions, governmentally

Answer 6

relational experience

Question 7

the __________________ (1932) recommended that the number of nurses in Canada should be immediately doubled as well as recommendations for University standards of education and support of public health nursing as a nursing speciality

Answer 7

Weir Report

Question 8

CHNs must continue to be strong policy advocates and increasingly focus their practice on the ______________________ such as evidence linking poor health to societal inequities (i.e.: homelessness, addiction, poverty, and injustice)

Answer 8

SDOH

Question 9

CHNs advocate for the provision of ____________________ and provide sociopolitical leadership for the development of the heath system and global health in their practice

Answer 9

primary health care

Question 10

_________________________: from New France, they established “essential health care and carried out work in homes, hospitals and communities”. this early work is emulated in CHN practice today through the focus on determinants of health, community outreach and advocacy

Answer 10

Duchesse d’Aiguillon sisters

Question 11

origins of CHN encompassed broad focus on _______________ and concerns for vulnerable populations access to housing, food and the essentials of life

Answer 11

SDOH

Question 12

poverty, poor ______________ and self care and social unrest due to capitalism, immigration and urbanization shaped CHN and the public health system

Answer 12

health

Question 13

______________ groups and individual ______________ played a vital role in the development of community health services for the rural and poorer communities and immigrant woman in Canada in the late 19th century and early 20th centuries

Answer 13

women

woman

Question 14

t or f
the early practice of community health nursing was characterized by considerable overlap between what we now identify as distinct public health nursing roles and distinct or home visiting nursing roles

Answer 14

true

Question 15

______________ emerged in the early 20th century when civic departments of health established health education and preventative programs to combat communicable diseases, infant mortality and morbidity in school aged children. nurses were seen as ideal professionals to deliver these programs because of medical knowledge and ability to interact with women and children in private homes and in public school settings

Answer 15

PHN

Question 16

the first PHN’s were responsible for?

Answer 16

TB control
child hygiene programs
school inspection programs

Question 17

with regards to public health nursing, the Scope of health education and prevention of illness has grown to include: 
o \_\_\_\_\_\_\_\_\_\_\_\_ health 
o Control of \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ diseases 
o Preschool health 
o \_\_\_\_\_\_\_\_\_\_\_\_\_\_ education

Answer 17

mental
venereal
prenatal

Question 18

____________ nursing: nurses providing services in the most remote geographic locations, serving settlers and aboriginal communities

Answer 18

outpost

Question 19

Weir was commissioned to undertake a review of nursing education across the country and make recommendations. The report describes the types of ________________ nursing roles, activities, salaries, and numbers of nurses who were practicing public health nursing at the time. One of Weirs many recommendations is that in the immediate health interests of Canadians, as well as in their future economic interests, the number of public health nurses in Canada should at least be _____________ within the next 5 or 10 years. The report also contains recommendations for university standards of _____________ and support of public health nursing as a nursing __________

Answer 19

community
doubled
education
speciality

Question 20

in the mid 20th century, increased _______________ responsibility for healthcare of Canadians had a significant impact on PHN

Answer 20

government

Question 21

in the mid 20th century there was a general shift from traditional programs (child health, immunization, communicable disease control) to programs focusing on reduction of morbidity and mortality from _____________ illness and ____________

Answer 21

chronic

injury

Question 22

1970’s: higher cost = patients discharged earlier from hospital and required longer more complex follow-up care in community. These individuals were often unable to obtain bedside nursing care in their homes during their convalescence. No publically insured programs for home care services existed until 1974. The ___________ realized that participation in publically insured home care programs provided an opportunity to both consolidate and strengthen its organization. It commissioned a national report which recommended that Canada’s oldest and most experienced visiting nursing organization be given the mandate to deliver publically insured home care programs. Today the __________ continues to function by offering a mix of services shaped by local circumstances with a particular focus on creating programs to respond to unmet needs among specific segments of the population

Answer 22

Victoria Order Nurses

VON

Question 23

in the mid 20th century, mantra of governments was and still is, replace the hospital based care with _community health services and home care. Publically funded home care programs had resulted in some growth in the number of nurses working in community settings. The number of PHNs did not increase and their mandate has continued to emphasize health promotion_of, _________________ disease control, health child development, prevention of ___________ illness and identification of other factors that cause morbidity and morality in the population

• infrastructure for communicable disease control was hit hard and the loss of capacity/capability to monitor, identify and follow up on communicable diseases has been identified as one of the major reasons for the resurgence of old (_________) and new diseases: ___________, ___________, _____________
• deinstitutionalization of patients from acute care and psychiatric institutions has resulted in the need for innovative and comprehensive community based healthcare programs and systems. Nursing leadership for the development of essential programs to meet client ___________ has become more important than ever

Answer 23

communicable
chronic

TB
AIDS
SARS
H1N1

needs

Question 24

Harnessing skills and knowledge of CHN is essential to achieving health ___________
-CHN’s have provided leadership for advancing the understanding and integration of primary healthcare principles in the system. The CNA submitted an influential brief titled putting health into health care to the federal government to review its health system. This was the CNAs nation wide lobbying effort to endorse __________________ and health____________

Answer 24

equity
primary health care
promotion

Question 25

Canadian Leadership in evolution of health promotion via: (these 2 sparked a public health movement that focused the understanding of health and its determinants as value based processed and identified broach health promotion strategies that remain foundational to community health nursing practice and to nursing education)
o 1974: _________________
o 1986: _____________________________

Answer 25

Lalonde report

ottawa charter for health promotion

Question 26

1987: formation of the ____________________________________________
o has since evolved to become: Community Health Nurses of Canada (CHNC). They have a vision for developing strategic organizational partnerships, advancing the practice of community health nursing and refining the role and standards of practice
o the CHNC has a mandate to advance the practice of community health nursing through role _______________, the development of ______________ and _____________ development and_______________. It has also developed a professional practice model for Canadian community health nursing, specifying _________ standards as benchmarks of excellence that define the practice of a RN in the specialty area of community health nursing

Answer 26

community health nurses association of Canada

definition
standards
theory
research
7

Question 27

2002: _______________________________: “Building on Values: the future of healthcare in Canada”. This continues to be recognized as a visionary document with recommendations for shifting resources and policy in the direction of primary health care_, home__ healthcare and health __promotion with _nurses_____ as key players in the transformation of systems and services
o Recommending shifting in resources and policy in primary health care, home healthcare and health promotion

Answer 27

Romanow Commissions report

Question 28

CHNs of today must assume a strong policy advocacy role to ensure that essential nursing care and services are accessible to _________________

Answer 28

communities

Question 29

PHNs must increasingly focus their practice on the ____________ and examine the evidence pointing to the causes of poor health that are rooted in societal ______________ and how marginalized populations experience homelessness, addiction, poverty and injustice. This may be hard to achieve in hierarchical organizational structures where there may be barriers to nurses voicing concerns and taking political action for change

Answer 29

SDOH

inequities

Question 30

Today there is a strong legacy of CHNs outreach, care, and advocacy to address the social and living conditions of those most ________________ members of society

Answer 30

vulnerable

Question 31

It is significant that the early practice of community health nursing was generalist in nature, consisting of a comprehensive range of services including __________ healthcare and health _____________. Nursing roles became differentiated and specialized over time in response to ___________,______________ and _____________ forces including the expanding knowledge of society

Answer 31

home 
promotion
social
economic
political

Question 32

Today, the competencies and role descriptions for _____________ health, ____________ health, community ____________ health and ______________l health are distinct forms of CHN in Canada. CHNs must also be equipped with knowledge about ____________ health, ______________ disaster preparedness and____________ health

Answer 32

public
home
mental health
occupational

aboriginal
emergency
global

Question 33

It is easy to recognize how the early practice of nurses was focused on promoting the health of ________________, ________________, _______________ and ________________ and included the prevention of infectious diseases. These nurses worked in partnership with woman’s groups and the communities they served to develop essential services, address the SDOH and advocate for marginalized and vulnerable people

Answer 33

individuals
families
populations
communities

Question 34

discuss how increased government responsibility for the healthcare of Canadians had an impact on public health nursing

Answer 34

programs were expanded between 1940-1970

shift in focus from child health immunization and communicable disease control to a focus on decreasing mobility and mortality from chronic diseases and injuries

increased demands on time for the early postpartum discharge home visiting program

Question 35

____________ analysis reveals to us the shifting definitions of community as a result of the way that health is/was conceptualized.

Answer 35

historical

Question 36

who would a visiting nurse most likely work with in the early 1900s in Canada?

• families who could afford to pay
• poor and destitute families
• the community
• school children

Answer 36

poor and destitute

Question 37

which community health nursing speciality emerged in the early 20th century Canada to combat communicable disease, infant mortality and childhood morbidity?

• visiting nursing
• district nursing
• private duty nursing
• public health nursing

Answer 37

public health nursing