Exam 1 - Week 2 Flashcards
Who are people and the relationships that emerge among them as they develop and use in common some agencies and institutions and physical environment:
a community
What is a group, population or cluse of people at least one common characteristic, such as geographic location, occupation, ethnicity or housing condition?
community
What is the main difference between CAP and the nursing process?
CAP model is more linear than cyclical with evaluation feeding back into assessment, reformulating nursing diagnosis and so on.
Both the CAP and nursing process include the same steps, but what does the CAP model do with analysis?
makes analysis of data a step onto itself rather than part of assessment.
What are 3 other outstanding aspects of the CAP model?
- the assessment wheel
- a population rather than an individual as the client and recipient of care
- the defining of community health nursing interventions as one of the 3 levels of prevention.
What happens during a community assessment?
- Getting to know and understand the community (the people, their relationships with agencies, organizations, institutions, and the physical environment)
- PHNs learn about people and the relationships they have with the various subsystems of the community which can be agencies, organizations and institutions as well as the physical environment.
During a community assessment, what do nurses identify and clarify? THIS IS THE PURPOSE
- identify strengths (resources & protective factors)
2. clarify stressors (needs, problems, concerns & risk factors
Who is a community assessment done with?
with the community members and other providers as partners throughout the process
What is data gathering?
- collecting or compiling of pre-exiting information may be quantitative like demographics and crime statistics or qualitative like information on resources or the environment.
- Often these data have been collected for reasons other than community assessment and requires secondary analysis of the data.
What is data generation?
- the collecting of new information
- is usually qualitative in nature
- It includes observations about the people and the community as well as investigating knowledge, beliefs, values and perceptions.
What are the sources of data gathering?
- Maps
- Organizations’ records and reports
- Meeting minutes
- Community resources manuals, brochures and flyers
- Grant applications
- Newspapers and newsletters
- Census data & vital statistics
What are the 5 data generation methods?
- key informant interviews
- participant observation
- windshield survey
- written surveys
- focus groups
Who is represented in the core of the CAP wheel?
the people of the community
What are the 8 categories of services and resources surrounding the people making up the community?
subsystems
What data should be collected on the core of the CAP wheel?
- demographics (age, sex, race ethnicity)
- health indicators
- culture and religion
- health beliefs and practices
- values
What are 2 potential problems with race and ethnicity?
- most population –based data on race and ethnicity is gathered from self reports, so people are categorized into the racial and ethnic groups that they identify with.
- racial and ethnic categories are not collected uniformly.
What does the physical environment of the CAP include?
- Includes the community’s boundaries, age, condition and type of housing, buildings and lots, sins of community vitality and decline
- Location of the community, size, population density, layout, a general overview of what Is in the community.
- Geography of the community.
When is a physical environment assessment best generated?
during a windshield survey
What does health services include?
acute care, urgent care, outpatient clinics, long term care care, home health and hospice, mental health, preventative, rehabilitation and alternative or complimentary health services.
What does social services include?
programs that provide food, shelter, clothing, counseling, advocacy, case management, and assistance with daily living.
What does economic include?
financial statistics about the people who live there:
- income level
- poverty rates
- occupations and employments rates
- information about the businesses in the community.
What does safety and transportation include?
- Protective services
1. Fire & police
2. Disaster planning - Crime & other hazards
- Transportation
1. Private
2. Public
3. Road/sidewalk conditions
4. Bikeways
What does politics and government include?
- includes:
1. include data about elected representatives in the area
2. voting
3. political activity
4. political boundaries - Residential groups such as neighborhood and homeowners associations, and any other body that makes rules that impact community members.
What is the easiest way to gather info on politics and government?
The easiest way to gather this much of this data from online maps although quite a bit of real political flavor of some communities is generated through windshield survey and interviews.
What does communication include?
includes learning about how information is accessed and shared in the community and looks at the availability and use of:
- Radio & TV
- Newspapers, newsletters, & flyers
- Billboards & bulletin boards
- Languages used
- -> and specifically the percentage of the population that does not speak and understand English very well although this data could also easily fit in demographics or the education subsystem. - Internet access & use
How is communication information generated?
windshield survey and interviews and gathered from the census and sometimes from agency records.
What does education include?
Includes:
- Educational status
- Schools & colleges
- Libraries
- Child care centers
- Ed & literacy programs
What else does education include?
The education subsystem usually includes both the educational level of the community, such as the percent of HS and college grads as well as the percent of those with less than an 8th grade education.
- It also includes data about educational resources in the community, such as schools, libraries and childcare centers.
- The educational status in terms of years of school completed is available for CTs through the census.
- Like health and social service resources, educational resources are usually found by WS and interviews with supporting information from the Internet.
What does recreation include?
Includes
- Parks and playgrounds
- Paths and trails
- Gyms/recreation centers
- Theaters, bowling alleys, video game parlors
- Shopping malls
- Spectator sports
Why do we do a community assessment?
To identify factors (both positive and negative) that impinge on the health of the people to develop strategies for health promotion.
What does the medical model exclude that the nursing model include?
The medical model excludes health promotion and the holistic focus that is central to nursing.
What used to be the community-as-client model?
Community-as-Partner Model
In the community-as-partner Model what are the people?
A population or an aggregate.
In the community-as-partner Model what is the environment?
Thought of as community a network of people and their surroundings.
In the community-as-partner Model what is the health?
A resource for everyday life, not the objective of living. It is a positive concept emphasizing social and personal resources, as well as physical capacities.
In the community-as-partner Model what is nursing?
Prevention
What kind of prevention is aimed at reducing possible encounters with stressors or strengthening the lines of defense?
primary prevention
What is an example of primary prevention?
sunscreen to prevent skin cancer; immunizations
What kind prevention occurs after a stressor crosses the line of defense and causes a reaction, and it is aimed at early detection to prevent further damage?
secondary prevention
What is an example of secondary prevention?
breast self-exam
What kind of prevention aims to maintain and restore a more-or-less health state?
tertiary prevention
What is an example of tertiary prevention?
rehabilitation, meditation
What are the 2 central factors in the community-as-partner model?
- Focus on the community
2. Nursing process
What does the core of the community-as-partner model represent?
Core of the assessment wheel represents the people who make up the community.
What does the solid line in the community-as-partner model involve?
The level of health the community has reached over time
What is the broken line, or the flexible line of defense, represent in the community-as-partner model?
Buffer zone representing a dynamic level of health resulting from a temporary response to stressors.
What are the lines of resistance in the community-as-partner model?
Internal mechanisms that act to defend against stressors.
What are the stressors or stars in the community-as-partner model?
Tension-producing stimuli that have the potential of causing disequilibrium
What do stressors + lines of resistance equal?
the degree of reaction
What is the degree of reaction?
the amount of disequilibrium or disruption that results from stressors impinging on the community’s lines of defense
What do you want to first identify in a community assessment?
identify the community – a community is the sum of its subsystems
What 3 parts is the community assessment broken down into?
- The community core
- The community subsystems
- Perceptions
How do you inspect the physical environment subsystem in the community-as-partner model? (hint: 3 things)
- All sense
- Windshield survey
- Walk through community
How do you auscultate the physical environment subsystem in the community-as-partner model?
Listen to community sounds/residents
How do you take the vital signs of the physical environment in the community-as-partner model?
i. Observe climate, terrain, natural boundaries, and resources
ii. Life signs such as notices of community meetings; density
How do you do a systems review of the physical environment in the community-as-partner model?
i. Observe social systems, including housing, businesses, churches, and hangouts
How do lab studies within physical environment in the community-as-partner model?
- Almanac; census data
2. Chamber of commerce planning studies and surveys
What is 1 way to classify health and social services?
to differentiate between facilities located outside of the community (extra community) and those within the community (intracommunity).
What are examples of extra community or intracommunity health services?
- Hospitals and clinics, home health care, extended care facilities, public health services, emergency care.
What are examples of extra community or intracommunity social services?
- Extracommunity or intracommunity facilities counseling and support, clothing, food, shelter, and special needs.
What does economics entail in the community assessment?
a. The goods and services available to the community.
b. The costs and benefits of improving patterns of resource allocation.
How do extracommunity factors affect the economics?
local economy
How do intracommunity factors affect the economics?
impinge on all other subsystems.
What is the unemployment rate a key indicator of in the labor force in the community assessment?
of the economic health of the community
What is the labor force composed of?
The labor force of a community is composed of people aged 16 years and above
What 3 things are involved in the safety and transportation portion of the community assessment?
- Protection services
- Fire protection
- Police protection
What are the two types of communication assessed in a community assessment?
- formal
2. informal
Where does formal communication originate?
outside of the community
What are examples of formal communication?
- Newspaper
- radio and television
- postal service
- telephone status
Where does informal communication originate?
Always originates and is disseminated within the community.
What are examples of informal communication?
i. Bulletin boards; posters; flyers; church, civic, and school newspapers
ii. Word of mouth; mail; radio and television
How can the education of a community be summarized in a community assessment? using what?
census data
What does the census list?
lists the number of residents attending schools, years of schooling completed, and percentage of residents who speak English.
Where is the info supplemented in the census?
from schools, colleges, and libraries as well.
What requires a thorough assessment in the education assessment?
primary and secondary schools.
