Week 1 - Introduction to Families & Communities Flashcards
Health Promotion (WHO) Definition:
Enabling or empowering people to increase control over, and improve their health
- Ideally improve it as a result
- 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
Define SDoH:
The conditions in which people are born, grow, live, work and age. These circumstances are shaped by the distribution of money, power and resources at global, national and local levels
Why is SDoH ikmportantfor community health nurses?
Important for community health nurses because the social determinants of health are responsible for a number of inequities in Canada that affect the health of individuals and marginalized populations
What are the most significant SDoH?
1) Social; and
2) Economic Conditions
Which social determinant has the most significant influence on health?
Income
What are a few characteristics of family?
1) Within nursing family is defined quite broadly
- It is more than just individuals who are related to one another through blood rather it’s people who are bound together either through consent birth adoption or placement
family is also very subjective and unique to individuals so they get to decide who their family is
2) Family can be made up of an individual/their parents an individual and their roommates their friends ….whoever they say
- Text states the family is who the person states their family members are
How does The Vanier Institute of the Family (2018) define family?
The RNAO?
Wright & Leahy?
1) “any combination of two or more person who are bound together over time by ties of mutual consent, birth, adoption and/or placement”
2) “…unique and whomever the person defines as being family. They can include, but are not limited to, parents, children, siblings, neighbours, and significant people in the community”
3) “the family is who they say they are”
How has family changed over time?
- Historically we always had traditional heterosexual nuclear family ….
- Now in the media we’re seeing different representations and that traditional definition is being challenged and reshaped
What are the (5) functions of a “healthy” family?
1) Physical maintenance and care of members
2) Addition of new members through procreation or adoption
3) Socialization of children and social control of members
4) Production, consumption, distribution of goods and services
5) Affective nurturance — love
What are the (3) characteristics of family? Describe each.
1) Form:
- Way family is composed or structured or functions
- Ex. Nuclear, extended family, blended LGBTQ family
2) Structure
- Characteristics and demographics of individuals that make up the family
- Defines the roles and positions the individuals
3) Function
- Behaviours and activities used to maintain the family unit and meets family and individual needs
Healthy vs. Dysfunctional family?
Healthy
- Respect
- Autonomy
- Etc.
Dysfunctional
- Lack of problem-solving skills
- Lack of resources
- etc.
What is the dominant family structure?
Married couples
How do couples with children and without children compare?
About 1:1 ratio
What contributes to increasing number of couples without children?
Baby busters
What is the fastest growing household type?
Multigenerational
What is comprised of the aging population?
Baby boomers
How has the size of families changed over time?
Smaller
Why has the number of households increased?
Families are continually getting smaller but the number of households has actually increased as more and more people are living alone
Do male or females typically live alone?
Females
What is the WHO definition of family health?
…the relative functioning of the family as the primary social agent in the promotion of health and well-being
What are (5) characteristics of family health?
1) Negotiation skills in navigating interdependence
2) Communication
3) Respectful of feelings/beliefs/autonomy
4) Encourages responsibility
5) Demonstrates closeness/warmth
Define family health nursing:
- What does it use?
- Why is it important?
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
- Use the nursing process to help families achieve their highest potential for health
- Family health promotion is an important aspect of this nursing care so we want to empower families to use a strengths based care approach
How can care be provided for families in (5) different ways?
First Level: Family as context
- The individual is main nursing focus, and the family is secondary
- Ex. Depression counselling
Second Level: Family as sum of its parts
- Focus on individual and family members as separate entities
Third Level: Family subsystems as client
- Focus on dyads and triads (2 or 3 members)
- Ex. Mom and baby
Fourth Level: Family as client
- Focus on the entire family
- Care for the individual, the family and society simultaneously
- Ex. Parent of a child who received a cancer diagnosis – the family experiences this together
Fifth Level: Family as a component of society
- Family is one of society’s basic institutions
- Ex. Public health focus
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
Give examples of a community:
- Citizens of a town
- Group of farmers
- Prison community
- Tiny village in Labrador
- Members of Mothers Against Drug Driving (MADD)
- Professional nurses
Describe 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
Describe community as context of 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
- Ex. Overcrowding of homeless shelter with daughter of immunosuppressed disease
What is community/public health?
- 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)
What are the three levels of prevention in public health?
1) Primary prevention reduces the impact of existing risk factors for a potential problem and thus reduces the occurrence of disease
- Ex. Vaccines, nutritional education
2) Secondary prevention provides screening, detection and early treatment
- Ex. Screening early PAP’s
3) Tertiary prevention reduces the impact of long-term disease and disability
- Ex. Chronic disease but minimize effects – HIV care, counselling for PTSD
Briefly describe the history of community health nursing:
1) First seen in indigenous communities when healing practices for conducted to meet the needs of the communities
2) Grey nuns arose and they were a religious order /advocated for social justice and health inequities and helped improve access to health services food shelter education
3) The Victorian Order of Nurses was established in 1897 /still around today and it remains a not for profit nursing agency it provides community based care
- Would supply in-home nursing for poor to provide affordable nursing care
4) 1940-1970- focus on medical model and expanding programs
5) 1970s- rising hospital costs + shift away from hospital stay to community through early discharge (sooner bc less $)
6) 1980s down-sizing of hospitals with continued community-based services
Both historically and currently nurses have:
embraced role as advocate for individual, family and community health
fostered empowerment with individuals, families and communities
embraced health-promoting practice built on notion of empowerment
engaged a strengths-based approach to health-promoting practice
What is the Canadian community health nursing standards of practice?
References for reading
Be familiar
Recognize standards of practice in community health nursing
Why is the Canadian community health nursing standards of practice important? (6)
1) Define scope and depth of CHN (community health nurse) practice
2) Establish criteria and expectations for acceptable practice and safe ethical care
3) Provide criteria for measuring performance
4) Support the ongoing development of CHN
5) Promote CHN as a specialty and provide a foundation for certification as a clinical specialty with Canadian 6) Nurses Association
Inspire excellence in and commitment to CHN practice
Set a benchmark for new community health nurses
Today, CHNs are RNs, RPNs and NPs who:
- Work with people where they live, work, learn, worship and play to promote health
- CHNs provide a continuum of care from health promotion and protection and prevention of illness, to treatment, restorative and palliative care
- Provide care to populations who experience health inequities and disparities i.e, Indigenous peoples, LGBTQ2S, newcomers and refugees, etc.
Empowerment is the capacity of choice
What is the difference between PHC and PC?
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” (Kingston-Riechers et al., 2010, p. 6).
Give an example of PHC and PC?
Ex. Newly diagnosed with diabetes’s
1) PC
- Physician
- Diagnosis
- Insulin $$$
- Referral
- Follow up
PHC
- Physician and team (i.e. dietician, diabetes nurse specialist)
- Identify they cannot afford insulin
- Refer to social worker to manage costs
- Having all these people involved, contributes to better management
- Less complications
- Less costly to healthcare system
Describe a PHN vs. HHN:
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 (Allen & Warner, 1996)
