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NURS350 - Community Health > Midterm > Flashcards

Midterm Flashcards

1
Q

What were the main contributions to nursing in the 18th century?

A

The beginning of modern hospitals created by religious orders focusing on SDOH, community outreach and advocacy regarding access to health care.

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2
Q

What can the earliest forms of healthcare practices in Canada relate to?

A

Indigenous health and healing.

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3
Q

What does the British North America Act (1867) entail?

A

Made limited provisions for the establishment and maintenance of health care system. Federal government was responsible for taxes, laws, quarantine, and establishment of marine hospitals. All other healthcare responsibilities were that of the province.

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4
Q

What were the major focuses in the 18th and 19th century?

A

Poverty, immigration, epidemics (cholera, typhoid)

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5
Q

The first school of Nursing was created in where (1874)?

A

St. Catherines, Ontario

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6
Q

What occurred for health departments in the 19th century?

A

Provinces started health departments

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7
Q

The VON was established in 1897 and did what?

A

Responded to local needs. Deliver wide range of CHNing services.

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8
Q

What was the VON concerned with?

A

Communicable diseases, infant mortality and childhood morbidity.

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9
Q

When was nursing seen as three distinct sectors? What were these sectors?

A

Late 19th and early 20th century. Hospital, private-duty, and public health/home-visiting nurses.

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10
Q

In the early 20th century, PHNing evolved from specialties of TB nursing and school nursing to what?

A

Focus on reducing infant mortality.

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11
Q

What were the two first PHNing specialties?

A

TB and school nursing.

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12
Q

In 1920, the Red Cross gave funding to what?

A

Red Cross certificate programs. PHN education. To further education regarding maternal child programs, communicable diseases, school health and social welfare.

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13
Q

What does the Weir (1932) report entail?

A

Recommendations about doubling the number of PHN and creating university standards of education and supports of PHN as a nursing specialty

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14
Q

After WW2 what sort of changes happened to health care?

A

Provinces took over PH programs and obstetrics was now in hospital.

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15
Q

The Ottawa Charter (1986) discusses what?

A

Focused understanding of health and determinants as value-based processes and identified broad health promotion strategies, PHC, and population health

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16
Q

The Declaration of Alma Ata (1978) discussed what?

A

Declared primary health care as the guiding vision for achieving health for all people.

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17
Q

The Medical Care Act (1966) discussed what?

A

Covering part of costs for physicians outside of hospitals

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18
Q

The formation of the CHNAC in 1987 had what kind of vision?

A

Develop strategic organizational partnerships, advancing the practice of CHN, and refining the role and the standards of practice

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19
Q

In 2002 the Romanow Report came out. What was discussed in this report?

A

Shift resources and policy in the direction of primary health care, HHC, and HP, with nurses as key players in the transformation of the systems and services

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20
Q

What is the definition of public health?

A

Organized efforts to society to keep people healthy and prevent injury, illness and premature death.

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21
Q

What are the 8 competencies of a PHN (PAPPDCLP)?

A

1) PH and nursing science
2) assessment and analysis
3) policy and program planning, implementation and evaluation
4) partnerships, collaboration and advocacy
5) diversity and inclusiveness
6) communication
7) leadership
8) professional responsibility and accountability

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22
Q

What are 6 PHNing roles (HEHPHD)?

A

1) HP
2) emergency preparedness and disaster response
3) health surveillance
4) population health assessment
5) health protection
6) disease and injury prevention

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23
Q

What is primary prevention? Give one example.

A

Eliminate all modifiable risk factors to prevent illness or disease from ever happening. Immunizations.

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24
Q

What is secondary prevention? Give one example.

A

The disease process is suspended before symptoms occur. Mammograms/prostate exams.

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25
Q

What is tertiary prevention? Give one example.

A

Impairment or disability from the disease process is halted. Providing treatment, education, self-management strategies to support individuals with communicable diseases.

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26
Q

The title CHN most often refers to nurses working where?

A

Northern, rural, and remote areas. Generalist role.

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27
Q

What is political and social advocacy?

A

To not just accept conditions that contribute to marginalization and inequities but to change them

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28
Q

What is primary health care?

A

The vision. Principle-based comprehensive approach seeking to improve the health of populations across the contiuum of birth to death

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29
Q

What is primary care?

A

Delivery of community-based health care services. Point-of-care service that offers wrap around service to client.

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30
Q

What does the critical social theory entail?

A

It considers multiple social and economic forces that result in power differentials in society.

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31
Q

What does the feminist theory entail?

A

It focuses on role of sexism and oppression in creating inequities

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32
Q

What does the intersectionality theory entail?

A

It considers multiple oppressive factors at play. Focuses on many “isms” like racism, sexism etc and the compounding effect of the overlap of them.

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33
Q

What does the post-colonial theory entail?

A

Considers the role of race and history in creating inequities (like Aboriginals and the IRS etc)

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34
Q

What does the complexity science theory entail? What are the 5 central concepts? Broad theoretical perspective

A

The success of an action is dependent on the context, just because it worked in one situation does not mean it will work in another. Might need to alter actions to make it work for a different community. Interconnectedness, bon-linerarity, self-organization, emergence and co-evolution.

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35
Q

What Carper’s four identified patterns of knowing?

A

Aesthetic knowing, personal knowing, ethical knowing, and empirical knowing

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36
Q

What are examples of some nursing philosophies?

A

Florence Nightingale, Virginia Henderson, Watson

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37
Q

What are the five principles to PHC (HAAPI)?

A

1) Health promotion
2) Access
3) Appropriate technology
4) Public participation
5) Intersectoral collaboration

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38
Q

What are the key points of the critical caring theory (Falk-Rafael) [TLESBB]? Middle range theory

A

Seven carative HP processes that reflect core of PHN. Uses broad definition of client to encompass communities/pop. Process of T/L, creation of supportive and sustainable enviro, social justice, building capacity, and honouring local belief systems.

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39
Q

What are the key points of the strengths based theory (Gottileb)?

A

Incorporate positives-things that work well while dealing with problems. Oriented to individual, family and community levels of intervention.

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40
Q

Relational inquiry key points (Hartrick Diane and Varcoe)

A

Relational practice focuses on the way personal, interpersonal, and contextual elements shape experiences/situations. Capacities and socioenvironmental limitations influence health and illness experience.

41
Q

Sociopolitical knowing?

A

Society’s knowledge of nursing and vice versa. Find intersections between health-related interests of the public and nursing and become involved in these interests.

42
Q

Emancipatory knowing?

A

Recognize social/political inequities and injustice and piece together complex elements of experience and context to change a situation to improve people’s lives.

43
Q

What does the population HP model tell us?

A

Explains relationship between population and HP. It shows how a pop health approach can be implemented through action on all determinants of health

44
Q

What 12 different types of CHN are there?

A

1) PHN 2) forensic nursing 3) parish nursing 4) military nursing 5) outpost nurse/CHN 6) HHN 7) Occupational health nurse 8) mental health nurse 9) PHCNP 10) nurse entrepreneur 11) Telehealth 12) street nurse

45
Q

What does it mean by focusing on “health equity and social justice?”

A

It is a standard for CHN to be politically competent and to use political and social advocacy to accept the conditions that contribute to marginalization and inequities and change them.

46
Q

What is social justice?

A

Fair distribution of society’s benefits, responsibilities, and their consequences

47
Q

What are the 10 attributes of social justice (PEACH JEEP D)?

A

1) poverty reduction 2) equity 3) advocacy 4) capacity building 5) human rights 6) just institutions 7) enabling environments 8) ethical practice 9) partnerships 10) democracy and civil rights

48
Q

What are the 4 ethical principles for PH interventions?

A

1) harm principle 2) least resistive or coercive means 3) reciprocity 4) transparency

49
Q

What does “empowerment” mean when discussed as community empowerment?

A

Refers to the process of enabling communities to increase control over their lives

50
Q

What is the definition of oppression?

A

Prolonged cruel or unjust treatment or control

51
Q

What is epidemiology?

A

The study of occurrence and distribution of health-related states or events in specified populations.

52
Q

What did Dr. John Snow notice in regards to epidemiology?

A

The apparent relationship between the number of cholera deaths in various neighbourhoods and the source of the drinking water.

53
Q

In regards to epidemiology, what was Flo convinced of?

A

The effect of the environment on disease and death.

54
Q

Modern CHN use epidemologic models and processes for what?

A

To determine and test appropriate interventions.

55
Q

What are the components of the epidemiologic triangle?

A

Host, environment, agent.

56
Q

Define association

A

Occurs when there is REASONABLE EVIDENCE that a connection exists between a stressor or environmental factor and a disease or health challenge

57
Q

Define causation

A

When a relationship or association has been CONFIRMED beyond doubt. Definite cause-and-effect.

58
Q

What is the difference between a cause and risk factor?

A

Cause can be things like poverty, education etc. that are shown to influence health. Risk factors can be environmental, lifestyle, psychosocial and biological.

59
Q

What is “risk”?

A

The probability that healthy people exposed to a specific “risk” will acquire a specific disease

60
Q

Why is it important for CHNs to know association/causation/risk factors/cause?

A

To know their target population so they can engage in nursing interventions where most needed (people who are most likely to develop unhealthy behaviours that potentially affect their health)

61
Q

What are the 7 causation criteria? Give 1 example for each.

A

1) biologic plausibility - consistent with medical knowledge that is known
2) experimental replication - several studies by different scientists produce similar results
3) dose-response - the more exposed the sicker you get
4) specificity - cause is linked to a specific disease (that certain bacteria caused the diarrhea)
5) strength of association - sufficient exposure = bring on disease
6) temporal relationship - exposure to a necessary stressor to get disease (like contaminated water or food)
7) consistency - all who eat contaminated food gets sick

62
Q

What is screening?

A

Investigating for signs of disease when NO SYMPTOMS are present

63
Q

What is surveillance?

A

Collecting data by CONSTANTLY MONITORING and reporting of disease to assess patterns and identify events that don’t fit pattern

64
Q

What is validity?

A

If the test measures what you want it to measure

65
Q

What is reliability?

A

Results are consistent over time and populations

66
Q

What is point prevalence?

A

Describes the situation only for a particular point in time (ex. do you currently smoke?)

67
Q

What is period prevalence?

A

Describes the situation only for a period of time (ex. have you smoked within the past 3 months?)

68
Q

What is incidence rate?

A

Number of NEW cases of a given disease in a population in a given time

69
Q

What is prevalence rate?

A

Number of people with a given disease in given population at one point in time

70
Q

What is relative risk?

A

Compares risk for a particular disease between two populations: one exposed to stressor and one not exposed

71
Q

If the resulting number of relative risk is >1.0… what does that mean?

A

The risk in the exposed group is HIGHER than the risk in unexposed group and the conclusion is that the exposure is a risk factor of the disease

72
Q

What is the odds ratio? what is it the estimate of?

A

the prevalence of a disease in a given population over a given period of time. relative risk factor

73
Q

What does it mean if the odds ratio is near 1?

A

No association between the disease and the exposure in the studied population

74
Q

What does it mean if the risk ratio is near 1?

A

exposed and unexposed people were equally likely to develop the disease

75
Q

Crude mortality rate?

A

Compare number of deaths from a specific cause within ENTIRE population

76
Q

Specific mortality rate?

A

compare number of deaths from a specific cause in a particular SUBGROUP

77
Q

Proportional mortality rates?

A

number of deaths from a specific cause in a given pop for a particular time period. can be used to stratify crude mortality rates

78
Q

What is one of the primary tenets of PHC?

A

Increase the reach of HCP into the community. Doing so will improve the health of all Canadians and foster their active participation in their health.

79
Q

What group contributed to social and healthcare services in smaller communities? Why?

A

Women volunteers because there weren’t enough CHN.

80
Q

Which program was taken over by the health department as part of the process of consolidating all public health programs?

A

School health programs

81
Q

Early school-based initiatives involved which activity?

A

Medical inspection of children followed by home health visits

82
Q

How did the reduction in government spending in the 1980 and 1990s affect CHN?

A

Reduced nursing positions

83
Q

What was the significance of the Public Health Agency Act?

A

Confirmed the agency as a legal entity and appointed a chief public health officer

84
Q

When were the responsibilities for health and social welfare matters delegated to the provinces?

A

After the Canadian confederation

85
Q

What are three broad theoretical perspectives?

A

Critical social theory (focuses on power differentials), intersectionality theory (focuses on intersections and overlap of factors oppressing health), complexity science theory (actions must be changed dependent on different contexts)

86
Q

Which document received international attention helping to stimulate the WHO to converse a meeting of member countries to address health disparities between dev and un-dev countries?

A

The Lalonde Report

87
Q

What is discussed in the Lalonde Report?

A

Drew attention to the inequalities in healthcare status between high and low income countries. Community participation at all levels is required and whenever possible people should use local resources to promote health.

88
Q

Who was the first order of nurses in Canada providing access to health care, food, shelter, and education to the most vulnerable?

A

The Grey Nuns

89
Q

Why were public health programs a limited success in rural and isolated areas?

A

Because there was a greater need for home care and midwifery

90
Q

Clinical practice, research, administration and education are known as what?

A

Domains of practice for CHNing

91
Q

What are Carper’s four identified ways of knowing?`

A

Aesthetic, personal, ethical, and empirical.

92
Q

What does the social ecological theory entail?

A

Assess interplay among community and the social, institutional, and cultural context of people-environment relations

93
Q

Why is Orem’s self-care deficit in nursing theory applicable to CHNing practice?

A

because the underlying self-care philosophy in has been embraced by nursing practice

94
Q

What is Orem’s Self-care Deficit Theory of Nursing?

A

Facilitate client-nurse relationship to preserve integrity of human beings though self-care actions. Strategies directed at controlling, maintaining, and motivating actions toward self-care.

95
Q

CHN often use theories from where?

A

Other disciplines

96
Q

What do complexity science, intersectionality, and critical social theories have in common?

A

Complexity and intersectionality in that there may be overlapping influences. Intersectionality and critical social theory place equity issues in foreground.

97
Q

What do complexity science, intersectionality and critical social theory have that are different from each other?

A

Intersectionality focuses on “isms” - racism and classism and compounding effects of these. Complexity science considers characteristics of changing relationships (needing to change actions/interventions depending on context), and critical social focuses on power differentials fro social and economic forces and how they result in inequities.

98
Q

What does the Population Health Promotion Model most closely reflect?

A

Socio-environmental perspective.

99
Q

What are the 8 elements of PHC to the Canadian context?

A
  1. Education about health problems and prevention techniques
  2. Promotion of food supply and proper nutrition
  3. Adequate supply of safe water and basic sanitation
  4. Maternal and child healthcare, including family planning
  5. Immunization against major infectious diseases
  6. Prevention/control of locally endemic diseases
  7. Appropriate treatment of diseases and injuries using the PHC principle of appropriate technology
  8. Provision of essential drugs

NURS350 - Community Health (1 decks)

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