Week 3 - Use of Assessment & Tools Flashcards
What are the 2 approaches to defining rural?
The technical approach relies on locators or geographic regions and includes four different types of communities:
1) Not isolated communities have Rd access and are within 90 kilometres of physician services
2) semi isolated communities also have Rd access but they are greater than 90 kilometres to physician services
3) isolated communities do not have Rd access but they do however have good telephone service and scheduled air transportation flights
4) remote communities are very isolated meaning that they have no access to flights or roads and have minimal access to telephone
How does the social approach define rural?
The social approach defines rural based on features and services that are normally associated with larger population sizes
- For example having different stores or restaurants in the community
- Socio economic context of rural communities can also impact the health of its members
- Many rural and remote community communities contain resources associated with industries such as oil mining gas or agriculture
Examples of these industries can impact the health of community members due to their net negative effects on air quality and water quality
- Rural and remote communities might also rely on their natural resource base to sustain economic viability and if these resources become depleted they must find alternative means for the economy
- Lastly access to employment opportunities that offer an actual reasonable living wage can be limited in rural and remote areas
Describe some rural statistics:
- 5 million Ontarians or 19% of the province’s population.
- Of this population 1.4 million live in areas under 10,000 in population
30% of Ontario Indigenous population reside in non-urban settings and growing
Projection- decline in youth and young adults and increases in people 45-64 years and > 65 years
- Decline of young people’s 2ndary nature of rural and remote communities and the lack of opportunities they present
- Many seek employment and education opportunities elsewhere
On average, there are half as many nurses per 100 000 people in rural Canada compared to urban Canada
- Rural and remote RNs often have less education due to limited access to continuing education
Approximately 19% of the provinces population actually lives in areas that are considered rural or remote
- Indigenous people farmers and people working in the oil and gas industry make up a large portion of this population
What are Health Inequities in Rural and Remote Communities? (4)
Concerning health inequities that exist in rural and remote communities include:
- access to healthcare
- access to technology
- water quality
- food insecurity
What is true about the care provided to indigenous communities?
There’s a lack of access to culturally competent care
- Indigenous communities are usually primarily served by non indigenous individuals
- Access to technology can be limited
- Internet connectivity – can’t use telehealth or electronic health records
- Water quality can be poor
Describe health variations among rural, remove, and indigenous people:
- Increased rates of low income and individuals with less than secondary education
- Increased rates of smoking and obesity
- Life expectancy at birth lower in Indigenous communities
- Higher mortality risks r/t circulatory disease, injuries, suicide, respiratory disease, and diabetes
- Experience social exclusion
- Childbirth has become medicalized as women in indigenous communities are often taken away from their communities during the birthing process
What is family health nursing?
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
When assessing a family (4)…
1) Use strength-based nursing assessments
- Strengths and thoughts are subjective (what one person considers a strength another person may think it is not a strength)
2) Create a rapport
- Therapeutic relationship (alliance)
3) Gather info using exploratory strategies and previous reports
4) Remember to check your own personal thoughts, feelings, beliefs, biases, etc.
What are 4 family assessment tools?
McGill Model (Gottleib & Gottleib, 2007)
Genogram
Ecomap
Spiralling Process (Gottlieb & Feeley, 2006)
Describe the McGill Model of Nursing:
1) All families possess capabilities or the health potential (strengths, motivation, resources) that serve as the basis for health promotion behavior.
2) The degree to which a family engages in health-related problem-solving and goal attainment, reflects the process of family health promotion.
3) The outcomes of health promotion are competence in health behaviour and improved health status.
Describe venogram:
Focuses on family structure through composition, health history and relationships
Genograms / assessment tool that provided visualization of a family /
- Diagram focuses on the structure of the family / composition & health history and relationships
Example: Helpful in discovering the roots of problems related to either intergenerational health or social problem
Describe ecomap:
Focuses on family within the context of their community
The ecomap illustrates the connection nature and degree of the relationships between a family and the larger community
- Focuses on the family within the context of their community
Example
- Family who have a couple children and outside main circle can see relationships within community
- Strengths of relationship depicted by type of line
Describe the spiralling process:
Phase 1: Exploring or getting to know
- Nurses need to continuously look for strengths/concerns
Phase 2: Zeroing In
- Identifying specific, workable goals and then prioritizing them
- Zero in by sorting out issues working with the family to develop and prioritize different goals /the nurse collaborates with the family to identify what they would like to see happen and which goals are the most important and achievable for them
Phase 3: Working out
- Putting the plan into action
- the goals are decided upon so a plan of action is then formulated and actually put into place in this phase strategies are tried out and alternatives are considered
Phase 4: Reviewing
- Appreciating strengths, resources and how they are feeling
- help families assess whether their goals were met /the actions that were taken are reviewed
What is the community health needs assessment?
A dynamic ongoing process undertaken to identify the strengths and needs of the community, enable the community wide establishment of priorities and facilitate collaborative action planning directed at improving community health status and quality of life.
- When nurses work with communities review health needs /ask questions re: issues community facing/ community strengths /their needs /resources could be allocated to improve health and reduce the inequities within community/ what could be done to improve this community’s quality of life ?
- Nurses then work with communities to develop short and longer term plans /help communities define and solve problems/ set priority/ develop awareness and explore sources of support and help initiate Community Action
What are the (3) community health assessment models?
Three different models/nurses conduct community health assessment:
1) Community as a partner model
2) Community capacity model
3) Community health promotion model
* Some of these models overlap with each other
