Midterm 1 - Weeks 1-5 Flashcards
What is Health Promotion
Enabling or empowering people to increase control over, and improve their health
To reach a state of complete physical, mental and social well-being, an individual or group must be able to identify and realize aspirations to satisfy needs, and to change or cope with the environment.
Health is, therefore, seen as a resource for every-day life, not the object of living
Characteristics of Family
The Vanier Institute of the Family (2018) define family as “any combination of two or more person who are bound together over time by ties of mutual consent, birth, adoption and/or placement”
“…unique and whomever the person defines as being family. They can include, but are not limited to, parents, children, siblings, neighbors, and significant people in the community”
Wright and Leahey (2013) state “the family is who they say they are”
Functions of Family
Physical maintenance and care of members
Addition of new members through procreation or adoption
Socialization of children and social control of members
Production, consumption, distribution of goods and services – basic economic unit
Affective nurturance — love
Characteristics of Family: Form
Way family is composed or structured
Characteristics of Family: Structure
Characteristics and demographics of individuals that make up the family
Defines the roles and positions the individuals
Characteristics of Family: Function
behaviours and activities used to maintain the family unit and meets family and individual needs
Trends in Canadian families
Married couples (66%) are the dominant family structure (2017)
51.1% of couples have children; 48.9% of couples are without children
Baby busters ( born between 1965-1976) contribute to increasing number of couples without children
Multigenerational households were the fastest growing households between 2001-2016
Large cohort of aging baby boomers
Families are smaller
Number of households has increased
Percentage of one person households has increased from 7% in 1951 to 28% in 2016
More women live alone than any other age group
What is the impact of the low fertility rate which is below the expected population replacement rate ?
is not enough people to take care of the elderly
less income taxes being paid
What is Family Health Nursing?
A provision of care where the nurse uses nursing processes to assist the family and its members in achieving the highest potential health through coping and adapting to various health and illness situations
First Level: Family as context
the individual is main nursing focus and the family is secondary
Second Level: Family as sum of its parts
focus on individual family members as separate entities (divorced couples, context is the family, but multiple clients)
Third Level: Family subsystems as client
focus on dyads and triads
Fourth Level: Family as client
focus on the entire family
care for the individual, the family and society simultaneously
Fifth Level: Family as a component of society (family is the client, society is the context)
family is one of society’s basic institutions
What is a Community
Concept of community as a collection of people who interact with one another and whose common interests or characteristics form the basis for a sense of unity or belonging
A group of people with a common characteristic or interest living in together or in a particular area within a larger society
An interacting population of various kinds of individuals in a common location
A social group of any size whose members reside in a specific locality, share government and often have a common cultural and historical heritage
Examples of some communities:
Citizens of a town
Group of farmers
Prison community
Tiny village in Labrador
Members of Mothers Against Drunk Driving (MADD)
Professional nurses
Community as client of care:
The unit of care is the entire community. The nurse can concentrate on both the community and the family simultaneously, but the community is the main focus
Community as context for care:
The family is the focus of care. Families live within community contexts- creating and defining the communities within which they interact impacts family health
What is Community/Public Health Nursing
Focuses on increasing health of individuals and the community at-large
Focuses on determinants of health (e.g., socioeconomic, and physical environment, education, culture, biological endowment and more)
primary prevention
reduces the impact of existing risk factors for a potential problem and thus reduces the occurrence of disease
secondary prevention
screening, detection and early treatment
tertiary prevention
reduces the impact of long-term disease and disability
targets both the clinical and outcome stages of a disease. It is implemented in symptomatic patients and aims to reduce the severity of the disease
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”
Primary care is where the care takes place
Public Health (PHN)
provide health promotion, disease and injury prevention, health protection and surveillance, population health assessment and emergency preparedness
link individual & family health experiences into the population health framework
Work within public health agencies mandated under provincial and territorial legislation
Home Health (HHN)
Provide chronic disease management, curative care, health promotion and education, rehab care, palliative care, social support and maintenance,
focus on clients & families
practice in homes, schools or workplace and integrates health promotion, teaching & counseling with provision of care
Why Study Family/Community Health Nursing?
Earlier discharges from hospital means that family caregivers are continuing treatments in the home setting (Patrick & Edmunds, 2004)
80% of health care is provided by non-professionals including family members.\
Health is a way of living or behaving that is readily communicated within such institutions as the family
Community Nursing Theories
Theory provides roots that anchor both practice and research in the nursing discipline
There has been a lack of theory development in the CHN field
As a result, broad theoretical perspectives, conceptual models, frameworks, and Indigenous perspectives must be considered
The CHN metaparadigm: person, environment, health, nursing AND social justice
Medical model discourse
(Absence of disease) sees achieving/maintaining health as a mechanistic, technical process
Behavioral/lifestyle model discourse
Focus on lifestyle changes, behavioral risk factors
Socio-environmental model of health
Dynamic process of interrelation between systems, including living conditions, lifestyle, environment, and more sees achieving/maintaining health not just as result of MD care
what is the concern with the behavioural model
victim blaming
Socio-Environmental Approach to Health Promotion
Focuses on underlying (root) causes
Social and economic inequities (e.g., poverty, social exclusion)
Acts to reduce inequities
Promoting social justice
Advocating for common good
Acting for social change
Eliminating victim blaming
Ottawa Health Charter- Five health promotion strategies
- Build healthy public policy- Involves advocacy for any health, income, environmental, or social policy that fosters greater equity or increases resources for health.
- Create supportive environments- Involves generating living, working, and playing conditions that are safe, stimulating, satisfying and enjoyable and protect the environment.
- Strengthen community action- Involves supporting those activities that encourage community members to participate and take action on issues that affect their health.
- Develop personal skills- Involves supporting personal development through the provision of information such as health education, to increase options available to people to exercise more control over their own health.
- Reorient health services- Involves moving beyond health sector’s responsibility for providing clinical and curative services in a health promotion direction that is sensitive to the needs of the community.
Risk Factors
behavior patterns which tend to lead to poor health. They are modifiable through strategies that create behavior change.
Have control
Risk Conditions
circumstances over which people have little control that can affect health status and are often a result of public policy. They are modified through collective action and social reform.
Health Equity
Health equity is a social justice goal focused on pursuing the highest possible standard of health and healthcare for all people, and taking into account broad social, political, and economic influences and access to care.
People’s daily experiences and their access to [health] services intersect in ways that are highly dependent on their sex/gender, ethno-cultural heritage, socioeconomic status or class, sexual orientation, religion, ability, nationality and other fluid intersections.
Health Inequities Examples
“There are a number of social factors that influence whether Indigenous peoples access health services.
Indigenous peoples do not have access to adequate pain medications because physicians are reluctant to provide Indigenous patients with pain medications due to common perceptions of addiction.
Indigenous peoples also have barriers accessing a family physician because physicians are reluctant to take on new patients with complex health needs.”
Indigenous peoples have more complex healthcare needs as many lack resources, educational reasons, environment etc
Physicians are reluctant because it is simpler for them to just take on patients with simple problems like ear infections not someone with an ear infection along with diabetes, high blood pressure etc
Equipping for Equity
The EQUIP model for equity in health care includes three key dimensions:
1. Trauma and Violence Informed Care
2. Harm reduction
3. Culturally Safe Care
Upstream
Upstream Approach looks like… primary prevention
Downstream
Downstream Approach looks like… secondary and tertiary prevention
Mental Health
The capacity to think, feel and act in ways that enhance the enjoyment of and ability to face life’s challenges
A positive sense of well-being that respects the importance of culture, equity, social justice, interconnections and personal dignity
Mental Illness
Refers to a group of diagnosable conditions
Some combination of altered thinking, mood, behavior or will that can be linked with distress and impaired functioning
Canadian Trends- Mental health/illness
1 in 5 Canadians will experience a MI
1 in 4 Seniors has a MI
1 in 7 children and youth have a mental illness
LARGEST group affected is between ages 10-29 years
Mental illness is disproportionately represented in the homeless population (one third have serious MI)
Suicide
One of the leading causes of death in Canadian youth
Mortality is 4x higher in men; hospitalizations higher for women but this trend is changing
Youth suicide – high risk groups include Indigenous youth; youth whose parents have a MI; students experiencing stress, anxiety and depression
A client reports that they want to “end it.” How would you respond?
- Acknowledge their feelings
- How long has this been going on for
- Previous suicide attempts
Risk Factors for Mental Illness
Genetics and Heredity – biomedical model
Root causes can be viewed through a systemic lens ie. people who live with chronic oppression, poverty, domestic violence
People who have experienced complex traumatic situations ie. Indigenous intergenerational trauma & colonization
Ageism, racism, sexism, etc.
Target Groups to End Stigma
- Youth
- Healthcare Providers
- Media
- Workforce
Recovery Model
Challenges the status quo that living with MI leads to a diminished life
Recovery is a personal process where some people may live with symptoms in recovery and others look to being symptom free
both experience more control and optimism about recovery
Persons are central in planning their own care
Recovery actions plans are concerned with support and self-help
Maternal Health/Women’s Health
Maternal health refers to the health of women before conception, during pregnancy, childbirth, and the postpartum period (perinatal period)
Encompasses family planning, preconception, prenatal and postnatal care
Canada is a leader in maternal child health care globally
Still barriers remain- disparities in access to care
Maternal Health- Immigrant and Refugee Women
Inadequate social support and poverty
Experience negative mental health outcomes in perinatal and postnatal period
Maternal Health - Indigenous Women
have high incidence of adolescent pregnancy, high and low birth weight babies, pregnancy-associated diabetes, and poorer nutrition
Colonization and medical model have resulted in birth experiences that remove Indigenous women from their community, isolating women without social support
Maternal Health Risks and Challenges
Maternal Behavior
- maternal education level; teenage mothers; older mothers
- Breastfeeding widely accepted as best nutrition for an infant, but many women still face discrimination
Lack of social support and life stress
- Lack of housing, nutrition, etc.
- Linked to adverse birth outcomes: preterm/ Low birth weight babies; large for gestational age; fetal mortality
Lack of income
- Canadian Public Health Policy- 50-week maternity and paternal benefit
- However, benefit is only a maximum of 55% of a woman’s salary, to a maximum of $573/week (Government of Canada, 2020)
- Infant outcomes poorer in low-income neighborhoods and in indigenous communities (increased morbidity and mortality)
