Final Exam - Weeks 6 -12 Flashcards
Health Education Programs
Encourages positive informed changes in lifestyle behaviour
Empowers people by voluntarily changing actions to improve their health status
Prevents disease and disability
Support social and political actions to promote health and quality of life in families and communities
Learning Principles of Health Education
Use methods that stimulate a variety of senses
Involve the person actively in the process
Create a comfortable learning environment
Assess readiness of the learner
Provide relevant information i.e. does it meet the learner’s needs? Interests?
Teaching Strategies of Health Education
lecture, discussion, demonstration and practice, simulation, gaming, role-playing
Evaluation of teaching
written/oral testing, demonstrations, self-reports, self monitoring, post-program questionnaires/surveys, verbal/non verbal feedback
RNAO Best Practice Guidelines on Client-Centred Learning
Clients have the right to accessible information, tools and supports to actively participate in their own care
People create their own understandings by integrating their previous experiences /knowledge with new learning to deepen understanding
Learning is social and involves many (friends, family, professionals, community, etc. )
LEARNS Model (RNAO)
Describes the interactions between nurses and clients
Evidence based
Can be used in any setting
Focuses on adults over age 18
Does not require fluency in health literacy
LEARNS Model Acronym
L - listen to the client
E - establish a therapeutic relationship
A - Adope intentional approach to every learning encounter
R - reinforce health literacy
N - Name new knowledge via teach back
S - Strengthen self-management via links to community
Health Literacy definition
Defined as the ability to:
access
understand
evaluate
and communicate information as a way to promote, maintain and improve health
Social Learning theory
Bandura’s Self-efficacy Model
Self-efficacy refers to the belief that one is capable of performing a certain behaviour needed to influence one’s own health
Health Belief Model
An individual’s perceived state of health or risk of disease will influence the probability of making an appropriate plan of action
Developed to explain why individuals do or do not act in relation to their health
Considers the individuals:
1. Perceived susceptibility
2. Perceived severity
3. Perceived benefits
4. Perceived barriers
Clients are most likely to change behaviours when they value their health and the perceived benefits
transtheoretical Model of Change
pre-contemplation
contemplation
planning or preparing
action
maintenance
relapse
Digital Health
Access to the internet for health information is not equitable
Individuals with low income, limited education, living on Indigenous reserves or in rural and remote areas, and who are members of minority ethnic groups or recent immigrants may have limited access to the internet
Digital Divide
Digital Divide – refers to internet users and non-users resulting in information “haves” and “have-nots”
Occupational Health
The promotion and maintenance of the highest degree of physical, mental and social well-being of workers in all occupations (WHO, 1995)
Prevention/protection of risks, injury and disease caused by working conditions
Placing and maintaining workers in an occupational environment adapted to their physiological and psychological capabilities
Occupational health nursing
Occupational Health Nurses (OHNs) apply the practice of nursing in the workplace to specific populations of workers
OHNs are often part of a team
OHNs are the frontline health care and emergency responders
First aid; policy planning and prevention
Environmental factors in the workplace
chemical factors
physical factors
biological factors
psychological factors
ergonomic factors
Environmental Health the History
Link between health and environment has underpinned nursing practice since Nightingale (1859) stressed the importance of:
- good ventilation
- pure water
- efficient drainage
- cleanliness
- light
Modifying the environment promotes the reparative process
Environment can also stimulate, promote and sustain disease
Environmental Health Risks
Environmental threats:
- Climate change
- Pollution
- Resource depletion
- Marine degradation
- Population growth
25% of the global burden of disease is related to environmental risks
Children, older adults, Indigenous communities are vulnerable to environmental health inequities
Social Trends (environment)
Increasing urbanization and displacement of people = food and housing insecurity
Climate change has forced migration:
impact on Canada’s Indigenous communities
compounds colonization = loss of connection to the land, loss of identity, culture health and livelihood
Environmental Injustice
Pollution related – unsafe water
Indigenous persons most affected
Unsafe drinking water
Fishing –contamination of traditional foods
Occupational roles
- Neurotoxicants – pesticides impact brain development, prenatal exposure
- Cosmetic sector –fumes from cosmetic products –endocrine disruptors
Autism, sex organ anomalies in males
Occupational carcinogens
- arsenic, asbestos, benzene, cadmium, formaldehyde
- Asbestos accounts for 40% deaths 2o to occupational carcinogens
The Role of the CHN (environment)
Work for social and ecological justice
An ethical imperative to preserve the environment for future generations – join interdisciplinary lobby groups
Need to curb pollution, reduce greenhouse gases
Start by reflecting “ What can I do today?”
Salutogenic effects of nature
Health-enhancing environments
Promotes:
- psychosocial well-being
- decrease CV mortality rates
- decreased cancer rates
“Shinrin-yoku” - making contact with and taking in the atmosphere of the forest (bathing in the forest)
MIOB Framework
recognize (warning signs, risk factors)
respond (SNCit conversation, risk assessment, safety planning, monitoring)
refer (policy, local expert, internal team)
report
What is Domestic Violence?
Domestic violence is any form of physical, sexual, emotional or psychological abuse, including financial control, stalking and harassment. It occurs between opposite- or same-sex intimate partners, who may or may not be married, common law, or living together. It can also continue to happen after a
a relationship has ended.
Patterns of Abusive Behaviour
Physical: slapping, choking, punching, threats
Sexual: threats, force used for sexual acts
Verbal: making degrading comments
Emotional: humiliation, inducing fear, threats to
children, pets
Economic: stealing/controlling money/possessions
Spiritual: using beliefs to manipulate / control
Stalking: persistent, unwanted following or watching,
use of electronic devices to monitor
Origins of understanding of domestic violence
Forty years of research
Initially understood as violence that only
happened to women
Referred to as battering, woman abuse,
coercive control, intimate partner violence,
intimate terrorism
Domestic Violence – 3 Types
Situational couple violence
most common / arguments escalate to violence
Coercive control
abusive partner controls and coerces
pattern of behaviour
Violent Resistance
victim of coercive control fights back
Coercive control / Woman Abuse
Highest risk cases (DVDRC)
Most serious injuries (Stats Can)
More likely to be reported to police (Stats Can)
Women almost exclusively victims of sexual
assault in relationships (Stats Can)
More likely to fear for their lives (Stats Can)
Domestic Violence Death Review
Committee 2012 Report
229 cases resulted in 328 deaths since 2002
Perpetrators:
- women (3%)
- men (97%)
Victims:
- 29 children (11%)
- 212 women (80%)
- 23 men (9%)
45% of cases are homicide - suicides
How Common is Domestic Violence at Work?
One third (33.6%) had experienced DV in their
lifetime
Female, transgender, and Aboriginal respondents,
those with disabilities, or a sexual orientation
other than heterosexual had higher rates
Rates consistent with other large Canadian
surveys
Pillars of the Canada Health Act
Federal funding continues for the provincial health insurance plans, provided the five criteria are met.
Health care must be:
Publicly administered
Comprehensive
Universal
Portable
Accessible
The Canada Health Act
Benefits
Ensures that Canadians have access to to health care regardless of their ability to pay or where they live
Defines health care as a right
Upholds values of social justice and equity
Drawbacks:
Covers only essential medical and hospital services – what are they??
Health promotion, disease and injury prevention, health protection, home health care not emphasized (i.e., cost may not be covered by shared prov/federal cost sharing)
Primary Health Care (PHC)
promotes healthy lifestyles as a pathway to disease and injury prevention
provides continuing care of chronic conditions and recognizes the importance of the broad determinants of health.
Involves a broad range of health-care providers (CIHI, 2006)
Primary Care
service at the entry of the healthcare system
“responsible for coordinating the care of patients and integrating their care with the rest of the health system by enabling access to other healthcare providers and services”
Principles of Primary Health Care (5)
- Accessibility
Healthcare universally available regardless of geography - Public participation
Clients are actively encouraged to participate in decision-making for their own health and needs - Health promotion
Includes the spectrum from health enhancement to disease prevention - Appropriate technology
Appropriate modes of care are available - Intersectional cooperation
Need collaboration between national and local health goals, public policies, and planning of services
Primary Health Care Reform
Move towards a more integrated system to provide full spectrum of healthcare services at a community/neighbourhood level- upstream approach
Community Health Centers
Family Health Teams (FHTs)
Public health vs. home health
Public Health: services depend largely on provincial (or municipal) governance and delivery structures
Funding and infrastructure being eroded
Home Health: MHLTC funds homecare (HCCSS)
Medical, nursing, social & therapeutic treatment/assistance and ADL support
Fastest growing nursing care sector in Canada
Public Health Agency of Canada
Main Government of Canada agency responsible for public health in Canada
Led by Chief Public Health Officer – Dr. Theresa Tam
Mission is to protect the health of Canadians
Goal is to strengthen Canada’s capacity to protect and improve the health of Canadians and to help reduce pressures on the health-care system
Home Care Costs
No legislative mechanism to fund = a wide variation in services across Canada
All provinces offer basic home care services however:
- Variation in access to and variety of homecare services
- Individuals may have to copay or pay entirely for services they need
- There is significant inequity in funding of home care across Canada
Policy
A principle or protocol to guide decisions and achieve rational outcomes
A definite course or method of action selected from among alternatives and in light of given conditions to guide and determine present and future decisions (Merriam-Webster, 2013)
Health Policy
Building healthy public policy involves advocacy for any health, income, environmental or social policy that:
fosters greater equity
creates a setting for health
increases options/resources for health (Stamler & Yiu, 2012)
policy development can be regarded as an act of social justice
Steps to Health policy development
describe the problem
access readiness for policy development
develop goals, objectives, policy options
identify decision markers & influencers
Build support for a policy
write/revise policy
implement the policy
evaluate/monitor the policy
Policy, Politics and Power
CHNs work in a variety of settings where resources are finite
Policy: guides the work of CHNS and occurs within a political context
Politics: “is the use of relationship and power” to encourage stakeholders to influence policy and the allocation of scarce resources
Power is “ the ability to act so as to achieve a goal”
Health inequities occur…
When there is bad policies and politics
Despite our universal health care system there are still barriers to access for many i.e. immigrants, refugees , Indigenous peoples
This has resulted from poor social policies and programs, unfair economic conditions and bad politics
