Community Health Nursing Theories Flashcards
Nightingale’s Theory of Environment Health Belief Model
NIGHTINGALE’S THEORY OF ENVIRONMENT:
+ Focuses on relationship between an individual’s environment and their health.
+ Focus is on PREVENTATIVE CARE (washing hands, clean environment).
HEALTH BELIEF MODEL:
+ Purpose is to predict or explain health behaviors.
+ Emphasizes change at the individual level
+ Assumes a person’s primary motivation in taking positive health actions is to AVOID GETTING A DISEASE.
LIKELIHOOD OF TAKING ACTION IS BASED ON:
+ Modifying variables (age, gender, race, economy, education)
+ Perceived severity and susceptibility of getting the disease
+ Perceived benefits vs barriers of taking action
+ Cues to action (i.e. adviser of doctor, media campaigns)
** Who is the client in Community Health Nursing?
Community-Based Nursing vs. Community Oriented Nursing
The COMMUNITY OR POPULATION is the “client” in community health nursing.
COMMUNITY-BASED NURSING: Is focused on ILLNESS CARE (acute or chronic conditions) for INDIVIDUALS AND FAMILIES. Examples: Home Health nurse doing wound care, School nurse administering epilepsy-pen.
COMMUNITY-ORIENTED NURSING: is focused on improving the collective health of the COMMUNITY. Examples: health education and promotion, disease prevention activities. NO Illness care! Community-orie ted nursing=public health nursing.
** Community Health Nursing vs. Public Health Nursing
COMMUNITY HEALTH NURSING: delivers health care services to INDIVIDUALS, FAMILIES, AND GROUPS. Includes community-based nursing (illness care for individuals and families) AND community-oriented nursing (community-focused care, with an emphasis on education and disease prevention).
PUBLIC HEALTH NURSING: Disease prevention and health promotion of COMMUNITIES AND POPULATIONS. They are not providing direct care to individuals! Public health nursing=community-oriented nursing.
** Ethical Principles in Community Health Nursing
RESPECT FOR AUTONOMY: Respect a patient’s rights to self-determination.
NON-MALEFICIENCE: Do no harm.
BENEFICIENCE: Do what is best (i.e. maximize benefits).
DISTRIBUTIVE JUSTICE: Fair allocation of resources in community.
What is Epidemiology?
Components of the Epidemiology Triangle
EPIDEMIOLOGY: Study of spread, transmission, and incidence of disease/injury.
COMPONENTS OF EPIDEMIOLOGY TRIANGLE:
+ AGENT: What is causing the disease (ex: bacteria, toxin, noise)
+ HOST: Human/animal being affected by the disease
+ ENVIRONMENT: Physical environment (water/food supply, geography). Social environment (access to health care, work condition, poverty).
Incidence vs. Prevalence
INCIDENCE: Number of NEW cases of disease/injury in a population during a specified time period of time.
PREVALENCE: Number of ALL cases (new and pre-existing) of disease/injury in a population during a specified period of time.
Community Health Education: Obstacles, Learning Styles
What is Healthy People 2020?
COMMUNITY HEALTH EDUCATION
+ OBSTACLES: Age, culture, literacy, language barriers, lack of access, lack of motivation.
+ LEARNING STYLES: VISUAL (videos, presentations), AUDITORY (vernal lectures, discussions), TACTILE-KINESTHETIC (hands-on, return demonstration).
HEALTHY PEOPLE 2020: includes national health goals based on major risks to health and illness of U.S. population (examples: Diabetes, Cancer, Older Adults, LGBT health). See website for complete list.
** Primary vs. Secondary vs. Tertiary Prevention
PRIMARY PREVENTION: PREVENTS INITIAL OCCURRENCE of disease.
+ Examples: education, immunizations, prenatal classes.
SECONDARY PREVENTION: Focuses on EARLY DETECTION of disease, limiting severity of disease.
+ Examples: screenings disease surveillance, control of outbreaks.
TERTIARY PREVENTION: Maximize recovery AFTER and injury/illness.
+ Examples: rehabilitation, PT/OT, support groups.
What is acculturation?
What is ethnocentrism?
Components of Cultural assessment
Use of Interpreter
ACCULTURATION: Adopting the traits of a different culture.
ETHNOCENTRISM: The belief that one’s own culture is superior to all others. View world from their own cultural viewpoint.
CULTURE ASSESSMENT: Ask about patient’s ethnic background, religious preference, family structure, food patterns, and health practices. Incorporate patient preferences into care whenever possible.
INTERPRETER: Use of family members is NOT recommended, interpreters need to have knowledge of health terminology. Patient teaching materials should be available in their primary language.
Environmental Risks (3 main risks) Environmental Assessment Questions
ENVIRONMENTAL RISKS:
+ TOXINS (examples: lead, pesticides, asbestos, radon)
+ AIR POLLUTION (examples: carbon monoxide, tobacco smoke, lead)
+ WATER POLLUTION (examples: waste produces, chemical runoff from soil)
ENVIRONMENTAL ASSESSMENT QUESTIONS:
+ Condition of housing. Remodeling activities?
+ Water heater temperature less than 120 DEGREES FARENHEIT?
+ Occupation (including exposure to chemicals, toxins)?
+ Tobacco smoke present in home?
+ Quality of drinking water?
Lead Exposure key points
PRE-1978 HOUSING AT RISK FOR LEAD-BASED PAINT!
+ Screen children 6 months -5 years for blood lead levels
+ Avoid playing in soil right outside home
+ Wet mop floors (vs. vacuuming floors)
+ Use wet sanding technique (vs. dry sanding)
+ Make sure children get enough iron and calcium in diet, as this decreases absorption of lead in the body.
+ Use cold water (vs. hot water) because lead dissolves more quickly in hot water.
Medicare: Who is eligible? Parts A, B, C, D
Medicaid: Who is eligible?
MEDICARE ELIGIBILITY:
+ Older than 65 years
+ Receiving disability for at least 2 years
+ Diagnosed with Amyotrophic Lateral Sclerosis (ALS) or End-stage Renal disease (ESRD) and receiving dialysis.
PART A: Inpatient hospital, limited SNF, home health care
PART B: Outpatient care, diagnostic services, PT/OT
PART C: Combines Part A and B, provided through private insurance
PART D: Prescription drug coverage (D is for Drug)
MEDICAID ELIGIBILITY: Those with low socioeconomic status and no other insurance, based on household size and income.
Responsibilities of:
+ State Department of Health
+ State Board of Nursing
+ Local Health Department
STATE DEPARTMENT OF HEALTH: manages WIC program, CHIP, Medicaid program. Reports notifiable communicable disease to CDC (voluntary).
STATE BOARD OF NURSING: Licenses LPNs and RNs, oversees state schools of nursing, develops state’s nurse practice act.
LOCAL HEALTH DEPARTMENT: Meets health needs of community. Reports notifiable communicable diseases to State Department of Health.
Parts of a Community Assessment:
+ People
+ Environment
PEOPLE:
+ Demographics
+ Biological factors (race, age, gender, health/disease status)
+ Social factors (education, income, crime rate)
+ Cultural factors (history, religion, customs)
ENVIRONMENT
+ Physical factors (geography, housing, location of health care services)
_ Environmental factors (climate, pollutants, topography).
Types of data collection in Community Nursing
INFORMANT INTERVIEWS: direct conversations with member of community.
COMMUNITY FORUM: public meeting (participation challenges).
SECONDARY DATA: review existing data available (statistics, health records).
PARTICIPANT OBSERVATION: observe community activities.
WINDSHIED SURVEY: literally drive through community and make observations.
FOCUS GROUPS: meet with representative sample of community.
SURVEYS: written format (expensive, low response rate)