Week 2 - Introduction to Health Promotion & Caring Flashcards
What are community nursing theories?
Theory provides roots that anchor both practice and research in the nursing discipline
- Socioecological model
What results from the lack of theory in CHN field?
As a result, broad theoretical perspectives, conceptual models, frameworks, and Indigenous perspectives must be considered
- Lack of representation of indigenous perspectives
What is the CHN metaparadigm?
The CHN metaparadigm: person, environment, health, nursing AND social justice
What are the three difference health discourses?
1) Medical Model
- Absence of disease
- Mechanistic health
- Technical process
2) Behavioural/Lifestyle Model
- Lifestyle changes
- Behavioural risk factors
- Often victim blaming
3) Socio-environmental Model
- 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 does the Socio-Environmental Approach to Health Promotion focus on? Reduce?
Focus on - Underlying root causes
- Social and economic inequities (e.g., poverty, social exclusion)
Reduce - Inequalities by:
- Promoting social justice
- Advocating for common good
- Acting for social change
- Eliminating victim blaming
Health promotion based on 5 strategies outlined in the Ottawa charter:
Five health promotion strategies
1)
Build healthy public policy- Involves advocacy for any health, income, environmental, or social policy that fosters greater equity or increases resources for health.
2) Create supportive environments- Involves generating living, working, and playing conditions that are safe, stimulating, satisfying and enjoyable and protect the environment.
3) Strengthen community action- Involves supporting those activities that encourage community members to participate and take action on issues that affect their health.
4) Develop personal skills- Involves supporting personal development through the provision of information such as health education, in order to increase options available to people to exercise more control over their own health.
5) 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.
Define population health:
“… the health of a population, as measured by health-status indicators and as influenced by social, economic, and physical environments; personal health practices; individual capacity and coping skills; human biology; early childhood development; and health services.” (Federal, Provincial and Territorial Advisory Committee on Population Health, 1999, p.7)
What is population health measured by?
Population health measured by specific indicators/influenced by different determinants of health ..biology, personal health practices
Explain the difference between risk factors and risk conditions?
Risk Factors
…behaviour patterns which tend to lead to poor health. They are modifiable through strategies that create behaviour change.
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.
Explain health equity vs. health equality?
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.
Difference between health equity and health equality
- Health equality makes sure everyone gets the same thing
- Health equity ensures fair and just distribution taking into account socially determined circumstances
What is the EQUIP model?
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
Explain mental health vs. mental illness:
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
Describe a few trends in mental illness:
1 in 5 Canadians will experience a mental illness
1 in 4 Seniors has a mental illness
LARGEST group affected is between ages 10-29 years
1 in 7 children and youth have a mental illness
Mental illness is disproportionately represented in the homeless population (one third have serious mental illness)
Describe a few trends in regard to 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 mental illness; students experiencing stress, anxiety and depression
What are examples of risk factors?
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.
Name the 4 target groups to end stigma:
- Youth
- Healthcare Providers
- Media
- Workforce
What is the recovery model?
Recovery model is considered best practice
- Subjective process – clients are given control and are central to planning their care/develop own recovery action plans
Challenges the status quo that living with mental illness 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
Describe resources for mental health from a historical perspective:
There were asylums which became overcrowded, poorly staffed
Hospitals in 1960 where people were discharged before ready
Describe present resources for mental health services:
- Resources currently inadequate (For example- hallway psychiatry)
- Bias towards institutional care and funding + inadequate community resources
- Services lacking in remote and rural areas
- Housing inadequate
- Stigma and discrimination continue to be a barrier to accessing resources
Define maternal 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
Material Health:
- Immigrant/Refugee
- Indigenous
Immigrant/Refugee:
- Experience negative mental health outcomes in perinatal and postnatal period
- Inadequate social support and poverty
Indigenous:
- 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:
- 3 risks/challenges
1) Maternal Behaviour
maternal education level; teenage mothers; older mothers
- Breastfeeding widely accepted as best nutrition for an infant but many women still face discrimination
2) 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
3) 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 neighbourhoods and in Indigenous communities ( increased morbidity and mortality)
What is the relational approach to maternal child health promotion?
Recognizes strengths of women and children
- Screening tools must “not replace conversation” to understand the context of women’s lives
- CHNs inquire about what is significant to women and children
- Do not assume role of expert
- Work together to address inequities and conditions that marginalize women and children
- Facilitate access to services and programs that enhance health of women and children
What is important to consider for child health? (4)
Importance of Relationships
- Secure, stable attachments contribute to safety and security (infant bonding)
Nutrition
- Critical in early years –breastfeeding for up to two years or longer; introduce foods at 6 months
- Concern with obesity
Physical Activity
- Concern re. sedentary lifestyles and link to childhood obesity
Injuries
- Immigrant children age 0-4 at greater risk of unintentional injuries than Canadian counterparts
- Playground equipment, bicycling, tobogganing, swimming , trampolines
