CHAPTER 4 Flashcards
This refers to the collection of data in the community which serve as a guide in determining the actual and potential health problems.
Community Assessment
It is a quantitative and qualitative description of the health of citizens and the factors which influence their health. It identifies problems, proposes areas for improvement and stimulates action.
Community Diagnosis
This is an official count or survey of a population, typically recording various details of individuals.
Census
These are the formal and informal community leaders or persons of position and influence, such as leaders in local government schools and businesses.
Key Informants
It refers to a process by which community members gain an understanding of the health, concerns, and health care systems of the community by identifying, collecting, analyzing, disseminating information on community assets, strengths, resources, and needs
Community Assessment
Primarily, it involves the collection of data which is mainly dependent on the objectives of the assessment
Community Assessment
In general, who desires to collect data on the three categories of the community health determinants such as people, place and social system.
community health nurse
In Collecting Primary Data, what are the tools that are commonly used for the conduct of community assessment.
- Observation
- Survey
- Informant Review
- Community Forus
- Focus Group
This may be done through an ocular or windshield survey, either by driving or riding a vehicle or walking through it.
Observation
This gives the community health nurse the opportunity to observe the people as well as to take note of the environmental conditions and existing facilities.
Observation
This may be necessary when there is no available when there is no available information about the community or specific population group to be studied.
Survey
According to Mauret & Smith (2009), it is made up of a series of questions for systematic collection of information from a sample of individuals or families in a community which may be written or oral.
Survey
It is appropriate for determining attitudes, knowledge, behaviors and perception of health and health services. Likewise, it is also used by the nurse in identifying patterns of utilization of health services
Survey
This denotes to a purposeful talks with either key informants or ordinary members of the community.
Informant Review
The interview may be structured where the nurse will direct the talk based on an interview guide, or it may be unstructured where the informant guides the talk.
It provides the nurse valuable information on community perceptions about the health and health care.
Informant Review
The interview may be structured where the nurse will direct the talk based on an interview guide, or it may be unstructured where the informant guides the talk.
This refers to an open meeting of members of the community
Community Forum
It does not only give the nurse information on community perceptions on needs, health and health care, but it also an effective tool in providing the people with medium for expressing their views and developing their capacity to influence decision makers.
Community Forum
It may be used as a venue for informing people about secondary data, for data validation and for getting feedback from the community people themselves about the gathered data previously.
Community Forum
This method is effective in the assessment of health needs of a specific groups in the community
Focus Group
A good example is a focus group of teenage mothers.
These are of the particular importance to the community health nurse, since they are sources of fertility and mortality data.
The birth and death registries
What R.A was enacted in 1930, established the civil registry in the Philippines that requires the registration of vital events like births, marriages and deaths.
R. A. 3753
otherwise known as the Civil Registration Law
what R.A assigned the function of civil registration to local governments and mandated the appointment of Local (municipal/city) Civil Registrars.
R.A. 7160
known as the Local Government
What Executive Order No. specifies that the Field Health Service Information System (FHSIS) as the official recording and reporting system of the Department of Health and used by the NSCB to generate health statistics.
Executive Order No. 352
Office of the President, Republic of the Philippines
It is a tool in monitoring health status of the population at the different levels. Thus, it serves as basis for priority setting by local governments, planning and decision making at barangay, municipality, district, provincial as well as national levels.
Field Health Service Information System (FHSIS)
It is used for monitoring and evaluating health program implementation. Detection of unusual occurrence of diseases is being facilitated. And it also provides a standardized, facility-level database for more in-depth studies
Field Health Service Information System (FHSIS)
It refers a listing of persons with specific type of disease in a defined population
Disease registry
The data or information that are collected through disease registries serve as basis for monitoring, decision making and management of program (DOH,2011)
It refers to the periodic governmental enumeration of the population.
census
What provides for a national census of the population and other related data in the Philippines for every 10 years.
The Batas Pambansa Blg. 72
It provides statistical information and services to the public.
The Philippine Statistical System (PSS)
It is the policy-making and coordination body of the PSS, where the NSO, now the PSA (Philippine Statistics Authority), is the PSS arm that generates general purpose statistics such as population, employment, prices, and family income/expenditures
National Statistical Coordination Board (NSCB)
It is the process of determining the health status of the community and the factors responsible for it.
Community diagnosis
The term is applied both to the process of determination and to its findings.
It is the quantitative and qualitative description of the health of citizens and the factors that influence their health.
Community diagnosis
Community Diagnosis allows identification of problems and areas of improvement, thereby stimulating action.
Depending on the context and the purpose of the presentation, community data may be presented what:
- as text
- in tables
- in pictorial for (maps and graphs).
It can be used to show differences or similarities across geographic areas
Maps
In divergence, numeric data are usually more clearly presented through tables and graphs or charts.
Graphs for presenting community data:
- Bar Graph
- Line Graph
- Pie Chart
- Scatter plot or diagram
Type of graph:
This is used to compare values across different categories of data.
For example, a population pyramid is made up to two horizontal bar graphs representing the age structure of the male and female population.
Bar Graph
Type of graph:
This is utilize to have a visual image of trends in data over time or age.
For example, the trend of the total fertility rate or average number of children per woman in the Philippines from 2000-2020.
Line Graph
Type of graph:
This is commonly use in showing percentage distribution or composition of a variable, such as population or households.
Pie Chart
Type of graph:
It is an effective tool in highlighting the value of a group in relation to the whole population. However, it can only illustrate only a small number of categories, usually not more than six.
For example, it may be used to visually present the percentage distribution of households based on environmental variables, such as water source method of refuse, and excreta disposal.
Pie Chart
Type of graph:
This is made to show the correlation between two variables. The values of both variables in subjects are plotted in a graph with an x-axis and a y-axis.
For example, it may be done to show a positive correlation between body mass index and waist circumference among women aged 20 years and above.
Scatter plot or diagram
Types of Community Diagnosis:
- Traditional Research
- Participatory Action Research (PAR)
Type of Community Diagnosis:
A method of research that follows a systematic or scientific procedure in which a question is asked and a hypothesis is proposed in which it is either proved or disproved.
Traditional Research
Type of Community Diagnosis:
This is related to the investigation or experimentation aimed at the discovery and interpretation of facts or revision of accepted theories or laws in the light of new facts.
Traditional Research
Type of Community Diagnosis:
An approach to research that aims at promoting change among the participants.
Members of the group being studied participate as partners in all phases of the research, including design, data collection, analysis and dissemination.
Participatory Action Research (PAR)
Decision making Emphasis:
- Top-down
- Expert/Nurse-driven process
- Much premium is placed on the data and output
Traditional Research OR Approach COPAR
Traditional Research Approach
Decision making Emphasis:
- Bottom-up
- Community-driven process
- Premium is placed on the process
Traditional Research OR Approach COPAR
COPAR
Roles:
- Nurse as researcher: the community members are subjects or objects of research, usually respondents of the research instrument.
- Data analysis is done by the nurse, and then presented to the community.
Traditional Research OR Approach COPAR
Traditional Research Approach
Roles:
- Community members as researchers: the nurse is a facilitator and recorder
- Data analysis is done collectively by the community.
Traditional Research OR Approach COPAR
COPAR
Methodology:
Research tools and methodologies are predetermined/prepackaged by the nurse-organizer
Traditional Research OR Approach COPAR
Traditional Research Approach
Methodology:
Research tools and methodologies are identified and developed by the community.
Traditional Research OR Approach COPAR
COPAR
Output:
Upon completion, the study is packaged, submitted to the agency, and published. Recommendations are made by the researcher based on findings of the study.
Traditional Research OR Approach COPAR
Traditional Research Approach
Output:
Conclusions and recommendations are made by the community. These will lead to agreed community actions/projects. The whole research cycle continues until it becomes part of community life, leading towards community development. Community members formulate the recommendations.
Traditional Research OR Approach COPAR
COPAR
The different schemes in stating community diagnosis:
- NANDA.
- Shuster and Goeppinger
- The Omaha System
Scheme in stating community diagnosis:
This focused more on individual but in the recent versions, it has included diagnoses in the community level.
NANDA
Scheme in stating community diagnosis:
It proposed a practical adaptation of a format of nursing diagnoses for population groups.
Shuster and Goeppinger
Scheme in stating community diagnosis:
A comprehensive and research-based classification system for client problems that exists in the public domain.
The Omaha System
Components of the classification system:
* Problem classification scheme (client assessment)
* Intervention scheme
* Problem rating scale for outcomes
It consists of three components that offer a relational, reliable, and valid structure and set of terms that can link clinical data to demographic, financial, administrative, and staffing data.
The Omaha System
The three components include;
1. Problem Classification Scheme
2. Intervention Scheme
3. Problem Rating Scale for Outcomes
Component of The Omaha System:
Organize assessment (needs and strengths) for individuals, families, and communities
Problem Classification Scheme
Component of The Omaha System:
Organize multidisciplinary practitioners’ care plans and the services they deliver
Intervention Scheme
Component of The Omaha System:
Evaluate individual, family, or community change over time
Evaluate individual, family, or community change over time
Component of The Omaha System:
This serves as a guide in collecting, classifying, analyzing, documenting and communicating health-related needs and strengths.
Problem Classification Scheme
Problem Classification Scheme:
First and most general level of classification is composed of 4 domains:
- Environmental
- Psychosocial
- Physiological
- Health-related behaviors
Problem Classification Scheme:
Second level consists of problems or areas of concern under the 4 domains:
- Environmental domain (material resources and physical surroundings both inside and outside the living area, neighborhood, and broader community)
- Psychosocial domain (patterns of behavior, emotion, communication, relationships, and development)
- Physiological domain (functions and processes that maintain life)
- Health-related behaviors domain (patterns of activity that maintain or promote wellness, promote recovery, and decrease the risk of disease)
Problem Classification Scheme:
What level presents the problem or area of concern classified according to 2 sets of qualifiers
Third level
Problem Classification Scheme:
What level is made up of clusters of signs and symptoms that describe the actual problems
Fourth level
and most specific
It is designed to describe and communicate multidisciplinary practice, practice that is intended to prevent illness, improve or restore health, decrease deterioration, and/or provide comfort before death.
Intervention Scheme
Activities designed to provide information and materials, encourage action and responsibility for self-care and coping, and assist the individual/family/community to make decisions and solve problems.
Teaching, Guidance, and Counseling
Technical activities such as wound care, specimen collection, resistive exercises, and medication prescriptions that are designed to prevent, decrease, or alleviate signs and symptoms of the individual/family/community.
Treatments and Procedures
This is a method to evaluate client progress throughout the period of service. It consists of three five-point, Likert-type scales to measure the entire range of severity for the concepts of Knowledge, Behavior, and Status
Problem Rating Scale for Outcomes
Activities such as coordination, advocacy, and referral that facilitate service delivery, improve communication among health and human service providers, promote assertiveness, and guide the individual/family/community toward use of appropriate resources.
Case Management
Activities such as detection, measurement, critical analysis, and monitoring intended to identify the individual/family/community’s status in relation to a given condition or phenomenon
Surveillance
It is a logical process of decision making to determine which of the identified health concerns requires more immediate consideration (priority setting) and what actions may be undertaken to achieve goals and objectives.
Planning
This step provides the nurse and the health team with a logical means of establishing priority among the identified health concerns.
Priority Setting
________ is defined as what the client knows, ________ as what the client does, and ________ as the number and severity of the client’s signs and symptoms or predicament
- Knowledge
- Behavior
- Status
considerations in IDENTIFYING THE COMMUNITY HEALTH NURSING PROBLEMS
- Health Status Problems
- Health Resources Problems
- Health-Related Problems
This is described in terms of increased or decreased morbidity, mortality, fertility or reduced capability for wellness
Health Status Problems
This is described in terms of lack or absence of manpower, money, materials or institutions necessary to solve health problems
Health Resources Problems
This is described in terms of existence of social, economic, environmental and political factors that aggravate the illness-inducing situations in the community
Health-Related Problems
PRIORITY SETTING:
problems are classified as health status, health resources or health-related problems
Nature of the condition/problem presented
PRIORITY SETTING:
refers to the severity of the problem which can be measured in terms of the proportion of the population affected by the problem
Modifiability of the problem
PRIORITY SETTING:
refers to the perception of the population or the community as they are affected by the problem and their readiness to act on the problem
Social concern
PRIORITY SETTING:
refers to the probability of controlling or reducing the effects posed by the problem
Modifiability of the problem
It is a process of participation through which people, groups, and organizations work together to achieve desired results.
Collaboration
These are the desired outcomes at the end of interventions, whereas objectives are the short-term changes in the community that are observed as the health team and the community work towards the attainment of goals.
Goals
It is a collaborative relationship between willing entities formed to address shared objectives.
community partnership
It accomplish shared vision, achieve positive outcomes for the audiences they serve, and build an interdependent system to address issues and opportunities.
Collaboration
Its aim is to get people to work together in order to address problems or concerns that affect them.
partnership and collaboration
It gives people the opportunity to learn skills in group relationship, interpersonal relations, critical analysis and most important of all, decision-making process in the context of democratic leadership.
partnership and collaboration
It is one way the nurse can promote active community participation.
Advocacy work
The nurse helps the people attain optimal degree of independence in decision-making in asserting their rights to a safe and better community.
This is the phase of the planning cycle that determines whether the program is relevant, effective, efficient and adequate
It is concerned with finding out the specific input, process and output/outcome indicators of the program stating the criteria and standards of each. This exercise is called evaluation.
Designing and Implementing Evaluation Plan
refers to an organized process of overseeing and checking the activities undertaken in a project, to ascertain whether it is capable of achieving the planned results or not.
Monitoring
the process by which we judge the worth or value of something. This is a scientific process that gauges the success of the project or program in meeting the objectives
Evaluation
Evaluation involves two processes:
1. observation
2. measurement.
Two approaches of evaluating a program:
- Qualitative methods of evaluation
- Quantitative methods
approaches of evaluating a program:
determine the meaning and experience of the program for the people involved; and interprets the effects that may be observed.
Qualitative methods of evaluation
approaches of evaluating a program:
measure and score changes occurring as a result of the program.
Quantitative methods
Aspects of a program to be evaluated:
- Process evaluation
- mpact evaluation
- Outcome evaluation
Aspects of a program to be evaluated:
measures the activities of the program, its quality and who is reaching out
Process evaluation
Aspects of a program to be evaluated:
measures the immediate effects of the program and determines whether the objectives of the program were met
Impact evaluation
Aspects of a program to be evaluated:
measures the long-term effects of the program and determines if it meets the goal of the program
Outcome evaluation
5 Types of Evaluation
- Formative
- Summative
- Process
- Outcomes
- Impact
Type of Evaluation:
Definition
* Evaluates a program during development in order to make early improvements
* Helps to refine or improve a program
Uses
* When starting a new program
* To assist in the early phases of program development
Examples
How well is the program being delivered?
What strategies can we use to improve this program?
Formative
Type of Evaluation:
Definition
* Provides information on program effectiveness
* Is conducted after the completion of the program design
Uses
* To help decide whether to continue, end, or expand a program
Examples
Should funding continue for this program?
Should service expand to other after-school programs in the community?
Summative
Type of Evaluation:
Definition
* Focuses on program implementation
* Determines whether specific program strategies were implemented as planned
Uses
* To determine why an established program has changed over time
* To address inefficiencies in program delivery
* To accurately portray program operations to outside parties (e.g., for replication elsewhere)
Examples
Did your program meet its goals for participant recruitment?
Did participants receive the specified number of service hours?
Process
Type of Evaluation:
Definition
* Focuses on the changes in comprehension, attitudes, behaviors, and practices that result from program activities
* Can include both short- and long-term results
Uses
* To decide whether an activity affected participants’ outcomes
* To establish and measure clear benefits of the program
Examples
Did your participants report the expected changes after completing a program cycle?
What are the short- or long-term results observed among (or reported by) participants?
Outcomes
Type of Evaluation:
Definition
* Focuses on long-term, sustained changes as a result of program activities, both positive and negative and intended and unintended
Uses
* To influence policy
* To see impact in longitudinal studies with comparison groups
Examples
What changes in your program participants’ behaviors are attributable to your program?
What effects would program participants miss out on without this program?
Impact
