shit Flashcards
What 7 activities can community health be considered as?
o Education concerning prevailing health problems and the methods of preventing and controlling them
o Promotion of food supply and proper nutrition
o Provision of an adequate supply of safe water and basic sanitation
o Provision of maternal and child healthcare; including
o Immunisation against the major infectious diseases
o Appropriate control of locally endemic diseases
o Provision of essential drugs
What did the nightingale model focus on?
when was it introduced to Australia?
sanitation
hygiene
client education
benevolent support of the client
1868
When did community nursing start in Australia?
1885 with the start of the Melbourne district nursing service
What model will the community nurse use for post acute and subacute?
Disease - Recovery
What does primary health care focus on?
Early intervention to prevent exacerbation
Health education, disease prevention and health promotion focus
What is the psychological approach?
considers the multiple effect and interrelatedness of social and environmental factors as they determine health
o Addresses issues, locates the most effective way to encourage healthy behaviour within the individual, the person and their environment and within levels of government (policies, resources)
What is the social gradient?
Effect of relative and absolute income on an individual’s health
o ‘poor’ people have poor health outcomes and visa versa
What is the social gradient influenced by?
♣ Social status and position
♣ Emotional environment in early childhood
♣ Psychosocial disadvantage
♣ Levels of access to services
♣ Comparative vs complete lack of resources
♣ The capacity for power and control of one’s situation
♣ Opportunities for social inclusion and participation
What is the primary care of a person?
the initial medical care given has an illness focus
What are the 4 A’s of primary health care?
Accessible, Affordable, Acceptable and Available
What does a community health nurse do?
- work using a primary health care focus of health promotion and disease prevention
- target at risk groups
- health promotion, education, screening, early detection
- work in community health care nursing, organisation, institutions eg prison nursing, infant and child welfare nursing, drug and alcohol, mental health
What does a community based nurse do?
♣ Hospital in the home ♣ Rehabilitation nursing ♣ Royal flying doctor service ♣ Palliative care nursing ♣ Home based chemotherapy ♣ home dialysis
Aims to provide healthcare, disease management and care coordination to individuals and localised groups across the lifespan; aiming to promote health, prevent complications, manage conditions and enable self-care within a community context
observes client in personal environment
What are the values of a primary health care approach?
- Equity
- Social Justice
- Empowerment
- Self-determination
- Culturally appropriate services
What are the social determinants of health?
name 4
Represent the conditions in which people live and work, which affects personal ability to be healthy
- Social Gradient
- Stress
- Early life – developmental stages, childhood illness…
- Social exclusion – racism, discrimination, stigmatisation, hostility, unemployment
- Work/Unemployment
- Social support
- Addiction
- Food
- Transport
Approaches to primary health care
explain the social model of health
this approach attempts to address the broader influences on health (social, cultural, environmental and economic factors) rather than disease and injury.
It is a community approach to prevent diseases and illnesses with the focus on policies, education and health promotion
Approaches to primary health care
explain public health
focus on health of entire population and includes disease surveillance and prevention, health education, sanitation and environmental safety
Approaches to primary health care
explain community health
seeks to identify the health needs of community and develop program to meet needs through empowering of people to promote prevention
Approaches to primary health care
explain web of causion
allows an epidemiologist to map the interrelationships among factors that contribute to the development and/or prevention of a particular health condition. It identifies the influence of multiple direct and indirect factors on the development of specific health conditions
Approaches to primary health care
explain the new public health movement?
challenges the prevailing focus on finding a cure and argues for a focus on anticipating and preventing health problems
Approaches to primary health care
explain the epidemiological triad
the traditional model of infectious disease causation and has three factors; an agent (a perpetrator), the host (the at-risk population), and the environment which work together to contribute to disease
What are the components of the community assessment wheel and the core subsystems
- community in the middle
- physical environment
- education
- safety and transportation
- politics and government
- health and social services
- communication
- economics
- recreation
The community assessment wheel and the core subsystems
Explain the community core
- The core of the community is its people, history, values characteristics and beliefs
- Describes the people and boundaries of your community
The community assessment wheel and the core subsystems
Explain the subsystem of the physical envionment
- The physical assessment of a community is accomplished through careful observation using all the senses. Take a walk and/or drive through the community and see what you notice.
- Includes the boundaries of the community, climate, housing, water and air quality, and solid waste disposal
The community assessment wheel and the core subsystems
Explain the subsystem of education
- The general education status describes the adequacy of education for the needs of the community
- Institutions, vocational skill needs
The community assessment wheel and the core subsystems
Explain the subsystem of safety and transport
- Describes how the population moves in, out and within the boundaries, as well as safety issues for the population
- Includes protective services (fire, police and sanitation) and private and public transport
The community assessment wheel and the core subsystems
Explain the subsystem of politics and government
- Control, guidance, rules and regulations are the cornerstones of a civilised community. These components bring structure, coordinated organisation, economic balance and safety to a community
- Sources of funding, leadership, organising structure
The community assessment wheel and the core subsystems
Explain the subsystem of health and social sciences
• Contains largest amount of data that health professionals desire. • Health services o Physical o Spiritual o Mental • Social services o Economic o Housing o Support groups • Consider the structure (what types of services) and the process (how accessible)
The community assessment wheel and the core subsystems
Explain the subsystem of communication
- May be formal or informal. Formal communication including newspaper, radio, and television often originates outside the community. Informal communication (such as those conversations occurring over coffee in churches and restaurants) almost always originates and is disseminated within the community
- Patterns of communication and efficacy
The community assessment wheel and the core subsystems
Explain the subsystem of economics
- The goods and services in the community as well as economic data
- May include household income levels, major employers, and rate of employment
The community assessment wheel and the core subsystems
Explain the subsystem of recreation
- Provide activities to help the members of a community maintain or increase their mental, social and physical health needs
- Sites of recreation, acceptability to wide array of ages, unmet needs
Describe the community as a partner model
- The partnership approach provides a framework for planning health promotion programs with local communities
- Help guide public health nurses in their practice
- Underlying philosophy is primary health care with an emphasis on community empowerment
- A systems perspective that gives direction to types of community systems that need to be assessed
Explain the differences of the biomedical model and the social model in reference to:
their focus
Biomed model:
- acute treatment of individuals
- clinical services, health education, immunisation
social model:
- societal focus - living and working conditions that affect health
- public health infrastructure and legislation, social services, community action, equity/access issues
Explain the differences of the biomedical model and the social model in reference to:
Key indicators of illness
Biomed model:
- individual pathology
- hereditary factors, sex, age
- risk taking factors
Social model:
- social inequity
- social groups, class, race, age, ethnicity, gender, occupation, unemployment
- risk-imposing factors
Explain the differences of the biomedical model and the social model in reference to:
Goals
Biomed:
- cure disease, limit disability and reduce risk factors to prevent disease in individuals
social model:
- prevention of illness and reduction of health inequities to aim for equality of health outcomes
Explain the differences of the biomedical model and the social model in reference to:
Benefits
Biomed:
- adressess disease and disability of individuals
Social model:
- addresses social determinants of health and illness
Explain the differences of the biomedical model and the social model in reference to:
Causes of illness
Biomed model:
- gene defecits and micro-organisms (viruses, bacteria)
- trauma
- behaviour/lifestyle
Social model:
- political economic factors
- employment and education factors
- cultural and structural factors
Explain the differences of the biomedical model and the social model in reference to:
Interventions
Biomed model:
- surgery and pharmaceuticals
- behaviour modification
- health education and immunisaiton
Social Model:
- Public policy
- State intervention to alleviate health and social inequities
- community participation, advocacy and political lobbying
What are the critisisms of the Biomedical model?
Disease focus - lack of preventative measures
ignores the complexity of health and illness
fails to take into account social origins of health and illness
medical opinions can reniforce victim-blaming
What are the critisisms of the social model?
equity goal leads to unfeasible expectations of change
over emphasis on harmful side effects of biomedicine
solutions are complex and difficult to implement in the sort term
Prior to technological developments such as the microscope enabling the discovery of micro-organisms, people believed that disease was the result of
a. Retribution for being a bad person
b. Maisma, which is bad or foul air
c. Exposure from bathing to often
d. Sloth from not working hard enough
b. Maisma, which is bad or foul air
Equity means
a. People who have the greatest needs receive the most assistance
b. All people are treated exactly the same
c. People who have a good income will get the best service
d. Making sure those who complain the loudest get taken care of first
a. People who have the greatest needs receive the most assistance
What is the social gradient?
a. The line that separates the rich and the poor
b. An indication of how popular a person is
c. An imaginary inclined line representing on a continuum the relationship between income and health status
d. A line that shows the wealthier a person is the more friends they have
c. An imaginary inclined line representing on a continuum the relationship between income and health status
The role of a community health nurse focuses on
a. Providing clinical care to maintain health and prevent the onset, progress or complications from disease
b. Health promotion and disease prevention activities aimed at groups
c. Chatting to members of the community regularly
d. Visiting people in their homes to see if the needs to go to hospital
b. Health promotion and disease prevention activities aimed at groups
The role of a community based nurse focuses on
a. Providing clinical care to maintain health and prevent the onset, progress or complications from disease
b. Visiting people in their homes to see if they need to go to hospital
c. Working with local governments to plan healthy environments
d. Chatting to members of the community regularly
a. Providing clinical care to maintain health and prevent the onset, progress or complications from disease
Which of these roles would NOT be done by a community nurse?
a. Working at the blood bank for the Red Cross
b. Working in a public health unit
c. Working as a district nurse from a rural hospital
d. Working as a school nurse at the local secondary school
a. Working at the blood bank for the Red Cross
What is meant by scope of practice?
a. The nurses check the environment for signs of danger before they do any work
b. The nurses can undertake any kind of work they are asked to perform
c. That nurses can experiment with ideas they think work in the care of their clients
d. That nurses must work within the boundaries of what they have been educated, authorised and deemed competent to perform
d. That nurses must work within the boundaries of what they have been educated, authorised and deemed competent to perform
What is a nurse practitioner?
a. A student nurse who is still practicing new skills and knowledge
b. A registered nurse who has recently graduated and is practicing skills and knowledge to consolidate their professional practice
c. A registered nurse who has undertaken advanced education and is authorised to request appropriate tests, medications and manage of their client in a specialised area of healthcare
d. A registered nurse who works in a GP or medical specialists practice
c. A registered nurse who has undertaken advanced education and is authorised to request appropriate tests, medications and manage of their client in a specialised area of healthcare
What is a nurse specialist?
a. A nurse who works in a GP or medical specialists practice
b. A nurse who has high level skills and knowledge in a specific area of nursing, or a defined population or health related activity
c. A nurse who is really interested in a particular area or type of nursing
d. A nurse who is recognised by their peers as being an excellent colleague
b. A nurse who has high level skills and knowledge in a specific area of nursing, or a defined population or health related activity
What does it mean to work in an advanced practice role?
a. This is a nursing role where there is greater complexity, usually requiring further education, experience, competence development, clinical leadership and more autonomy with clinical judgement
b. This is a role which involves lobbying governments to recognise the need to broaden the scope of practice for nurses and advance the practice of the nursing profession
c. This refers to any nurse who has been doing the same job for more than 5 years
d. This is a nursing role which involves planning in advance the type of care a client might need
a. This is a nursing role where there is greater complexity, usually requiring further education, experience, competence development, clinical leadership and more autonomy with clinical judgement
Why are good client assessments important in community nursing practice?
a. As community nurses frequently work alone, there is no one else who will check that they haven’t missed anything
b. As the client is not in hospital there is not a lot of equipment close by if the nurse needs to do anything specific for the client
c. Colleagues who also see the client might need to know if there any risks when seeing the client, such as aggressive dogs, firearms in the house or domestic violence issues
d. A good client assessment enables the signs of complications to be detected early, so that the intervention and referrals can occur as quickly as possible
d. A good client assessment enables the signs of complications to be detected early, so that the intervention and referrals can occur as quickly as possible
The arrangement where different health professionals work together as a team and take on overlapping professional action is called
a. Multidisciplinary practice
b. Collegial practice
c. Interdisciplinary practice
d. Transdisciplinary practice
d. Transdisciplinary practice
Which of the following proposed financial arrangements may contribute to shaping future community practice?
a. Financial incentives to treat people in community based primary care services rather than hospitals
b. Individualised funding where consumers will take a more active role in selecting the services they wish to receive
c. Government proposals for a more integrated model of health funding
d. All of the above
d. All of the above
Shorter hospital stays and early discharge practices has meant that community based nurses
a. Have to work harder
b. Need to understand treatment protocols, processes and how a range of devices work because of greater technological care in the home
c. Losing practical skills due to the change in environment and practice setting
d. All of the above
b. Need to understand treatment protocols, processes and how a range of devices work because of greater technological care in the home
Evidence based practice for community nurses means
a. Information used is current and the appropriate research has proved that it is the best way to practice
b. Doing things the way they have always been done
c. Providing care for the client in the way the clients wants it to be done
d. Following the instructions given in the discharge plan
a. Information used is current and the appropriate research has proved that it is the best way to practice
Health coaching is
a. Getting people more active and involved in sports
b. Taking a tram approach in managing a person’s health care
c. Assisting the client to better manage their chronic health issue using education and promoting healthy behavioural changes
d. Teaching carers how to best look after the person in their care
c. Assisting the client to better manage their chronic health issue using education and promoting healthy behavioural changes
What does the term ‘carer’ mean?
a. Any person who is concerned about the wellbeing of another
b. A person employed to provide assistance and support to a person with health issues
c. A health specialist responsible for organising the care provided for a person with health issues
d. An unpaid worker, often a family member, who looks after another person with a health problem for which they require assistance and support
d. An unpaid worker, often a family member, who looks after another person with a health problem for which they require assistance and support
What is meant by the term ‘worker’?
a. Any health care professional who is not a doctor, nurse or pharmacist
b. A person employed to provide assistance and support to a person with health issues and is not bound by any professional regulations
c. A health specialist responsible for coordinating the work involved in providing care for a person with health issues
d. An unpaid workers, often a family member, who looks after another person with a health problem for which they require assistance and support
b. A person employed to provide assistance and support to a person with health issues and is not bound by any professional regulations
What historical challenges for rural nurses still exist to this day?
a. Difficulties in recruitment
b. The blurring of personal and professional boundaries
c. Lack of privacy
d. All of the above
d. All of the above
What is the definition of ADVANCE PRACTICE ROLE
– A nursing role that is characterised by greater complexity
What is the definition of MIASMA
– Means polluted and is used to describe noxious, foul-smelling forms of bad air
explain the qualities of a community assessment
- reflect the aim of the planned initiatives
- composition of community, community resources, key people in community, the strengths, weaknesses, opportunities and threats to community
- include epidemiological and demographic data, stakeholder information, information from service providers and service user reports
- A needs analysis may need to be completed to identify felt, normative, expressed and comparative needs in the community
Community Definition:
A group of people with diverse characteristics who are linked by social ties, share common perspectives and engage in joint action in geographical locations or settings
explain how to build a community profile
- understanding of a population, including its morbidity and mortality trends, community infrastructure and referral pathways
- Community profile assists nurse to establish baseline data to inform policy, planning and practice
- Step 1 is to use pre-existing knowledge to describe the community Step 2 is to research and gather information about community
Describe the nurse’s role in providing education to individuals and communities
- Is to provide capacity building and empowerment opportunities to the community and its people
- The aim of education is to assist people to make informed choices about lifestyle decisions, to take control of and participate in health and lifestyle decisions
What is the Adult Learning Theory?
a tool to assist nurses to provide education to adults that reflects their health needs and learning styles
- Theory assists the nurse to empower people through education
- Assumes adults are self-directed learners who are motivated to learn, are problem focused, bring valuable life experience to the education process and are able to collaborate in setting education and evaluation goals.
What is health literacy?
cognitive and social skills which determine motivation and ability of individuals to gain access to, understand and use information in ways to promote and maintain good health
Activities that optimise health by reducing societal inequity, promoting actions that are predicted to increase positive health impacts and reducing actions that have negative health impacts are classified as
a. Health education
b. Health promotion
c. Community development
d. Capacity building
b. Health promotion
Evaluating and establishing a defined population’s resources, strengths and assests, and needs and issues, and then partnering with the community to plan, locate and provide services to meet identified needs is known as
a. A community needs assessment
b. Public health assessment
c. Community profiling
d. Community development
a. A community needs assessment
Inappropriate responses from health professionals may result from unhelpful negative stereotyping
a. A comparative need assessment is used
b. They have preconceived ideas about the community they are working with
c. The profile of a whole community is applied to an individual
d. Normative need assessment is applied
c. The profile of a whole community is applied to an individual
- A need defined by an expert is referred to as
a. A felt need
b. Comparative need
c. Normative need
d. Expressed need
c. Normative need
A need identified by the community or services within the community as what they want is a
a. Felt need
b. Comparative need
c. Normative need
d. Expressed need
a. Felt need
Why should a community needs assessment be done?
a. To justify the existence of an organisation or program
b. To ensure sound public policy and to develop appropriate health promotion programs
c. To assess the need for nurses in particular community
d. All of the options listed
b. To ensure sound public policy and to develop appropriate health promotion programs
The sociocultural determinants that impact on health and wellbeing cannot be identified using
a. Qualitative data collection
b. Consultations with community members or community service providers
c. Epidemiological data of the distribution and determinants of disease
d. A community needs assessment
c. Epidemiological data of the distribution and determinants of disease
Establishing the makeup of the community, how things work in the community, what resources the community has at its disposal and who are they key stakeholders in the community is included in
a. A community needs assessment
b. Program planning
c. Developing public policy
d. All of the above
a. A community needs assessment
A simple and quick framework that can be used to identify the strengths, weaknesses, opportunities and threats of a situations refers to
a. A SWOT analysis
b. Community needs assessment
c. Community profile
d. A swift analysis
a. A SWOT analysis
Equity and access and health literacy impact upon
a. Health care provision
b. Health service funding
c. Health education
d. Health statistics
c. Health education
Language spoken, educational level, economic circumstances, employment and family and community membership are
a. Issues that need to be overcome when working with clients
b. Social determinants identified by a community needs assessment
c. Health limiting factors
d. Client characteristics accommodated for quality health education
d. Client characteristics accommodated for quality health education
Readiness to learn may be affected by
a. Motivation
b. Physical and psychological capacity
c. The environment
d. All of the options listed
d. All of the options listed
What type of environmental factors may affect the learning of participants?
a. Temperature of a room, noise, ventilation and lighting
b. Timing of the education and transportation to the venue where it is being held
c. The choice of font, its size and colour in printed materials
d. The provision of breaks and refreshments
a. Temperature of a room, noise, ventilation and lighting
Accessing, utilising and understanding health information demonstrates
a. Educational achievement
b. Professionalism
c. Health literacy
d. Sound public health policy
c. Health literacy
Planning, resourcing, implementation and evaluation are
a. The process required to develop health literacy
b. The steps required in undertaking health education
c. The stages of group formation
d. The steps involve in developing public health policy
b. The steps required in undertaking health education
Printed material is most common resource used in health education sessions, these need to be
a. As detailed as possible and use the correct medical terminology
b. Colourful at attract the reader’s attention
c. Provided in the everyday language of the reader with clear illustrations
d. Provide only enough detail to ensure the reader will enlist the services of a healthcare professional
c. Provided in the everyday language of the reader with clear illustrations
A group with fixed specific goal or purpose is known as
a. A supportive/therapeutic group
b. A teaching group
c. A social group
d. A task / action group
d. A task / action group
A group which aims to assist individual growth and problem solving is referred to as
a. A supportive / therapeutic group
b. A teaching group
c. A social group
d. A task/action group
a. A supportive / therapeutic group
Closed groups
a. Have no structure
b. Require membership to be static, or if members leave it decline as no new members are added
c. Are usually run by volunteers
d. Allow movement of membership, with new member joining all the time and old members leaving when they wish to
b. Require membership to be static, or if members leave it decline as no new members are added
What are the two usual elements of health promotion?
a. Overcoming current health issues and revering the effects of these
b. Applying strategies to prevent the development of health issues and overcoming current health issues
c. Overcoming current health issues and improving health literacy
d. Applying strategies to prevent the development of health issues and promoting positive health behaviours
b. Applying strategies to prevent the development of health issues and overcoming current health issues
Explain Social Inclusion
– assumes that each person needs to have access to particular resources and structures within society to have health, achieve successfully in life and participate fully in society
Explain Social Exclusion
– is the outcome of multiple deprivations (unemployment, discrimination, inadequate skills, low incomes, poor housing, high crime, family breakdown) that prevent individuals or groups from participating fully in the economic, social and political life of the society in which they live.
What is Social Capital and the 3 types?
- Social Capital concerns the extent of trust, reciprocity and mutual cooperation that are available to individuals and communities
- Community nurses who employ a social capital approach to working with their communities, seek to build lasting, cohesive and cooperative bonds between all stakeholders
bonding
bridging
linking
3 types of social capital
Explain bonding social capital
occurs within tightly connected groups such as families, groups that share a common purpose or social identity, where one can gain strong emotional and social support. This SC helps people get by
3 types of social capital
Explain Bridging social capital
happens between individuals that are not part of the same group but share a sense of respect and reciprocity. This SC helps people get ahead
3 types of social capital
Explain Linking social capital
occurs between individuals and organisations in a more vertical manner. There is usually a formal power differential in these – relationship between lecturer and student. This SC helps people get ahead
What is Social Capacity?
The ability to produce an enabling environment that fosters open and inclusive relationships between people that are characterised by qualities such as trust, cooperation, justice and equity, from which a cohesive, relational and tolerant society can develop.
What is globalisation
a process that marks the diffusion of commodities, ideas and economic activity around the world
What is the impact of globalisation on health?
• People traveling around the world contributes to the distribution of disease and disease transmission rates and consequently to the management of diseases
• Increased movement of goods, services, trade, investment, money, knowledge, ideas, technology, culture and people between countries to create a more borderless world
• Poverty in developed countries is decreasing and the global health initiative to eradicate it is working
• Examples:
o The advertising and marketing of tobacco, fast food and consumer goods known to be associated with disease, death and lifestyle disorders
o The spread or threat of spread of epidemic and pandemic infections diseases such as TB, H1N1-swine and H5N1-avian influenza, HIV/AIDS, the plague, continue to be a concern with the movement of people, hosts and vector organisms
o The increase in modern technology to enable a rapid response to pandemic emergencies and health conditions
What are the 8 Millennium development goals?
o Eradicate extreme poverty and hunger
o Achieve universal primary education
o Promote gender equality and empower women
o Reduce child mortality
o Improve maternal health
o Combat HIV/AIDS, malaria and other diseases
o Ensure environmental sustainability
o Develop a global partnership for development
What are the four levels of community engagement?
o 1. Provide information to individuals or community about decisions and activities underway. Involves use of factsheets, websites, information kits
o 2. To consult with individuals and community and get feedback on activities. Involves communication in the form of focused groups, comments and surveys
o 3. Involvement by working with community to explore issues. Involves working groups, committees and workshops involving community members
o 4. Collaborate and engage so the community can define their own goals and contribute to decision making to address a collective health issue
What are the 2 components of medicare?
federal and state funded Australian Healthcare Agreements for public hospital services
National Medical Benefits Scheme.
Where does funding for health come from ?
medicare
not for profit organisations
regional health services
contracts with public hospitals
What is the Integrated Community Care for Older People (ICCOP) program and what are some of the benefits of this program?
- for older people with chronic conditions
- goal is to promote self care and reduce escalation of condition
- risk assess
- promote early intervention
- designed to link clients to their community
- helping keep them in their own home