Test 1 Flashcards
Does community health nursing have its own standards of practice?
Yes
What are the 8 standards of practice for community health nursing?
- Health promotion
- Prevention and health protection
- Health maintenance, restoration, and palliation
- Professional relationships
- Capacity building
- Health equity
- Evidence informed practice
- Professional responsibility & accountability
What are the two most common types of community health nurses?
Public health nurse and home health nurse
What is the primary focus of a public health nurse?
Promoting, protecting, and preserving health
Match the following with either public health nurse or home health nurse
A) Work in a variety of settings to meet the health needs of specific populations and communities
B) Work in a variety of settings to deliver nursing care to individuals and families
A = PHN
B = HHN
What is the primary focus of a home health nurse?
prevention, health restoration, health maintenance, & palliation
Match the following with either public health or home health nurse
A) integrate health promotion, teaching, and counselling with care
B) link to individual & family health into the population health framework and link population health to families & individuals
A = HHN
B = PHN
What lens/angle are PHNs? How about HHNs?
PHNs begin with a wide angle/broad lens and then narrow into a smaller scope, whereas HHNs are the opposite - small scope to broad
Why is nursing diagnosis removed from the community health nursing process?
No diagnosis because PHN do not take a deficit approach, as they focus on the capacity and strengths of the community
What are the five values and principles of a community health nurse?
Caring, principles of primary health care, multiple ways of knowing, individual & community partnerships, and empowerment
Define the health promotion CHN standard. What large event is it linked with?
the process of enabling people to increase control over, and to improve their health
The Ottawa Charter
What is meant by primary health care when defined in the values and principles of a community health nurse?
Universal access to services, SDOH, active participation of individuals/communities in health decisions
Define the prevention and health protection standard. Provide some examples
actions implemented in accordance with government legislation and nursing standards to minimize the occurrence of disease or injuries and their consequences
Surveillance, harm reduction, disaster management/planning, immunization
Define the health maintenance, restoration, and palliation standard
maintain maximum function, improve health, and support life transitions including acute, chronic, or terminal illness and end of life
Define the professional relationships standard
work with others to establish, build, and nurture professional and therapeutic relationships. These relationships include optimizing participation, and self-determination of the client
Define the capacity building standard
Partner with the client to promote capacity. The focus is to recognize barriers to health and to mobilize and build on existing strengths
Define the health equity standard
recognize the impacts of the determinants of health and incorporate actions into their practice such as advocating for healthy public policy. The focus is to advance health equity at an individual and societal level
Define the evidence informed practice standard
use best evidence to guide nursing practice and support clients in making informed decisions
Define the evidence informed practice standard
use best evidence to guide nursing practice and support clients in making informed decisions
Define the professional responsibility and accountability standard
community health nurses demonstrate responsibility and accountability as a fundamental component of their professional and autonomous practice
What five sections make-up the meta paradigm of community health nursing? What part is in the middle?
nursing, health, social justice, person, and environment
social justice is in the middle
What is the WHOs definition of health? What year is it from?
A state of complete physical, mental, and social wellbeing, and not merely the absence of disease or infirmity - 1986
How does the Community Health Nurses of Canada define health?
CHNs view health as a dynamic process of physical, mental, spiritual, and social well-being. Health includes self determination, realization of hopes and needs, and a sense of connection to the community. CHNs consider health as a resource for everyday life that is influenced by circumstances, beliefs and the determinants of health
Define the biomedical definition of health, 3 proposed causes of health problems, and principal strategies to address health problems
- a perception that health is the absence of diseases, conditions, and disorders
- hypertension, family history, hypercholesterolemia
- pharmaceutical treatment
Define the behavioural definition of health, 5 proposed causes of health problems, and principal strategies to address health problems
- A perception that health is the product of behaviours and habits, is the individual’s responsibility, and is the result of lifestyle choices
- lifestyle, smoking, high fat diet, low PA, high stress
- health education on low salt/cholesterol diet, health education on PA importance, and stress reduction
Define the socioenvironmental definition of health, 3 proposed causes of health problems, and principal strategies to address health problems
- A perception that health arises from the social determinants of health and is a resource for every day living
- living conditions, working conditions, and poverty
- advocacy, policy change
What are the four dimensions of the medicine wheel?
physical, emotional, mental, and spiritual
What four broad categories can the SDOH be lumped into?
Biology, environment, lifestyle, and health organization
Categorize the 12 SDOH into biology, environment, lifestyle, and healthcare organization
Biology - biological/genetic endowment, healthy childhood development
Environment - income & social status, social support networks, education and literacy, employment/working conditions, social environment, physical environment, culture, gender
Lifestyle - personal health practices and coping
Healthcare organization - health services
What was the first report to challenge the biomedical model and in what year?
Lalonde Report in 1974
What are the five principles of the Ottawa Charter?
Developing individual skills, creating supportive environments, strengthening community action, reorienting health services, building healthy public policy
What are the five basic prereqs for health, as outlined by the Ottawa Charter?
peace, shelter, education, food, and income
What are the five sections of the SEM? Define each one and provide one example
Individual - individual attitudes, beliefs, knowledge, and behaviors (i.e., values)
Interpersonal - relationships including those with family, friends, co-workers, support groups, social and cultural networks (i.e., culture, family)
Organizational - schools, health care systems, businesses, government and community-based organizations (i.e., hospitals, schools)
Community - neighbourhoods, cities, and countries (i.e., grocery store)
Society - Federal, state, and local policy, systems, and environmental levels (i.e., policy, government)
Describe how the population health promotion model is structured
Strategies for action, SDOH, and levels of action
It tells us WHO (through the SEM), WHAT needs to be addressed (DOH), and HOW we address it (Ottawa Charter)
What is the public health promotion model based on?
The PHPM is based on an ecologic perspective that acknowledges health as a product of interdependence between people and ecosystems. Based on this point of view, individuals are not solely responsible for their actions; environments influence the way people view the world and the choices they make. “Making the healthiest choice the easiest choice”
“Making the healthiest choice the easiest choice” is related to which model?
Population health promotion model
What did the Ottawa Charter aim to do by 2000?
Health for all by moving away from a western biomedical model to an individual focused lens
What is the goal of health promotion?
Empowerment - clients have the resources and power to control the factors that influence their health
What does developing personal skills for empowerment enable an individual to do?
Lifelong learning, preparation for life stages, and coping with chronic illness/injury
What is the RNs role in developing personal skills and empowerment?
Facilitate development of personal skills in school, home, work, and community settings - build capacity of clients
What is the 5th standard of capacity building in the community health nurse standard of practice?
Community health nurses partner with clients to promote capacity - the focus is to recognize barriers to health and mobilize and build on existing strengths
What five actions can nurses take to support the 5th standard of capacity building in the CHNSOP?
a. Uses an asset approach and facilitates action to support Jakarta declaration
b. Enhances client’s ability to recognize their strength, their challenges, causal factors and resources available that impact their health
c. Assists client to make informed decisions in determining their health goals and priorities for action
d. Uses capacity building strategies such as mutual goal setting, visioning, and facilitation in planning for action
f. Support the client to build their capacity to advocate for themselves.
Why is individual empowerment not enough to achieve healthier communities?
The meaning of individual empowerment has been “shaped within neo-colonial contexts that privilege western identity and biomedically oriented belief and knowledge systems – including Indigenous peoples”
What is the difference between health education and community health promotion?
Health education aims at reduces individual risky behaviours and has high rates of recidivism
Community health promotion focuses on accessing community assets and resources to create conditions for health for all
What are the internal and external empowerment terrains?
Internal - the more subjective or psychological elements of empowerment (i.e., strong self identity)
External - The more outwardly orientated material elements and relational aspects of empowerment (i.e., horsing and income)
Neither is independent of the other *
How do Indigenous approaches to health differ from Western ones?
Indigenous approaches to health are distinct from Western constructions in that they place emphasis on wholeness, connection, balance, harmony, and growth.
- They are holistic in nature and philosophy
Define health literacy
The skills to enable access, understanding and use of information for health
The ability to access, comprehend, evaluate and communicate information as a way to promote, maintain and improve health in a variety of setting across the life-course
What is the Indigenous perspective on literacy?
The rainbow approach - where seven ways of knowing represent a colour
It recognizes that spirit, heart, mind, and body equally contribute to a life of balance and nurtures them all
What principle does having poor health literacy effect? Why?
Empowerment because to gain mastery or be empowered, people must be able to predict, control and participate in their environments
_____ is a stronger predictor of an individual’s health status than income, employment status, education level, and racial or ethnic group
Health literacy
What are the five levels of literacy outlined by OECD?
1 - very poor literacy skills
2 - a capacity to deal only with simple, clear material involving uncomplicated tasks
3 - adequate to cope with the demands of everyday life and work in an advanced society
4/5 - strong skills
How does higher literacy rates benefit society?
Those with higher literacy contribute more to the society through higher income, less risky behaviours, and improved health adherence
What value is at the core of developing personal skills?
Individual empowerment
How does cultural and economic globalization affect individual empowerment?
it influences the way people see and feel about themselves (identity) and shapes power relations for opportunities for individual empowerment
What concept has been shaped within neo-colonial contexts that privilege Western identities and biomedical oriented beliefs? How?
Individual empowerment - it views an individual as being a discrete entity and the development of individual skills as being separate from the environment
The following statement defines what concept? A participatory empowering equity focused process - one that regards community participation as being essential to every stage of health promoting actions as well as one that leverages community assets and knowledge to create the necessary conditions for health
Community health promotion
How does empowerment differ in Indigenous perspectives?
Empowerment is generally much more a collective phenomenon within which the individual is metaphysically indistinct from extended family, ancestors, land, and historical tribal context
What three groups in Canada have the lowest literacy rates?
Indigenous, Francophone, and immigrant
Define material deprivation
lack of access to environmental capacities conducive to health, including the alignment of communities’ realities and cultural values with rules, norms, and conventions on which institutions and public policies are based
Define relative deprivation
relative access to environmental capacities (i.e., employment, income, social segregation)
Broadly define the empowerment terrain
the elements that exist both within and outside of individuals whose dynamic interaction constitutes an individual’s or community’s capacity to exercise control over health and well-being
Define internal empowerment terrain
refers to more subjective or psychological elements of empowerment (i.e., consciousness, identity, and culture)
Define the external empowerment terrain
colonization, economic globalization, cultural globalization, and physical and economic resources to which one may have access (i.e., social structures, discourses, community networks, strategic partnerships)
List the five components highlighted by the Canadian commission to move toward healthier environments
- ending prejudice and oppression
- creating a new vision of environmental choice
- fostering technology for assessing our environment
- accommodating diversity through participation
- becoming world experts in intersectional action in the design of healthy environments
What two basic principles does the Sundsvall Statement suggest are needed to achieve health for all? Describe both
Equity - Priority in creating supportive environments for health based on clear resource allocation based on priority
Public action - The interdependence of all living beings and manage all natural resources effectively, specifically considering indigenous individuals and the future generations
What four key action strategies were identified at the Sundsvall Statement to create supportive environments at the community level? What are they similar to?
- Strengthen advocacy through community action, particularly through groups run by women
- Enable communities and individuals to take control over their health and environment through education and empowerment
- Build alliances for health and supportive environments
- Mediate between conflicting interests in society
These reflect the Ottawa Charter action strategies (i.e., advocacy, enable, mediate)
What populations living in what regions have detectable levels of contaminants like lead and mercury in their body tissues due to waste?
Those living near manufacturing and processing plants or in remote areas
Food, air, or water, which has the lowest transmission of pollutants/contaminants? Which is the highest?
Water is lowest and food is highest
When attempting to improve the overall health of a population and environment, where is the best place to start?
Think in terms of specific setting in which people interact (i.e., schools, work) and to look at the environmental influences within that setting in order to develop strategies that are feasible, focused, evaluable, and effective
What was the 3rd international health promotion conference and what year was it?
Sundsvall Statement in 1991
What six factors make up the ecological perspective model? What is in the middle?
Individual in the middle & politics, physical, sociocultural, biological, economic
What did the Lalonde Report suggest and what groups did they separate the SDOH into?
Argues that health is not achievable from just health services, but also environment, lifestyle, and biology
Four sections - Health services, environment, lifestyle, and biology
What was the key focus of the Future We Want?
Poverty eradication through promoting sustainable patterns of consumption and production
In addition, focused on reducing inequalities, raising basic standards of living, and equitable social inclusion
What are the four strategies for action highlighted by the Canadian commission for supportive environments?
- Political vision and leadership in all 5 action components
- Scientific and social research and industrial incentive to produce materials that are cleaner, less risky, and less damaging
- public education about environmental effects on health
- legislative review and reexamination of policies to ensure that individuals control their environments
