chapter 1 Flashcards
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
Health promotion
the emphasis on personal and social resources moves us into the idea of ______
community
community as _________________: the environment within which a person lives; structural and geographic
Context
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
client
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)
Epidemiology
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
relational experience
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
Weir Report
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)
SDOH
CHNs advocate for the provision of ____________________ and provide sociopolitical leadership for the development of the heath system and global health in their practice
primary health care
_________________________: 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
Duchesse d’Aiguillon sisters
origins of CHN encompassed broad focus on _______________ and concerns for vulnerable populations access to housing, food and the essentials of life
SDOH
poverty, poor ______________ and self care and social unrest due to capitalism, immigration and urbanization shaped CHN and the public health system
health
______________ 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
women
woman
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
true
______________ 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
PHN
the first PHN’s were responsible for?
TB control
child hygiene programs
school inspection programs
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
mental
venereal
prenatal
____________ nursing: nurses providing services in the most remote geographic locations, serving settlers and aboriginal communities
outpost
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 __________
community
doubled
education
speciality
in the mid 20th century, increased _______________ responsibility for healthcare of Canadians had a significant impact on PHN
government
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 ____________
chronic
injury
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
Victoria Order Nurses
VON
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
communicable
chronic
TB
AIDS
SARS
H1N1
needs
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____________
equity
primary health care
promotion
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: _____________________________
Lalonde report
ottawa charter for health promotion
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
community health nurses association of Canada
definition standards theory research 7
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
Romanow Commissions report
CHNs of today must assume a strong policy advocacy role to ensure that essential nursing care and services are accessible to _________________
communities
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
SDOH
inequities
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
vulnerable
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
home promotion social economic political
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
public
home
mental health
occupational
aboriginal
emergency
global
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
individuals
families
populations
communities
discuss how increased government responsibility for the healthcare of Canadians had an impact on public health nursing
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
____________ analysis reveals to us the shifting definitions of community as a result of the way that health is/was conceptualized.
historical
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
poor and destitute
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
public health nursing
