Wk 9- Community Development, Advocacy, Ethics, Assessment, Planning, Implementation, Analysis Flashcards
Community (WHO, 1998).
A specific group of people often living in a defined geographic; area, who share common culture, values, and norms and are arranged in a social structure according to relationships which the community has developed over a period of time (WHO ‘98)
3 Dimensions of community.
PEOPLE (defined by age, sex, SES, edu., occupation, etc), PLACE (geography and time), FUNCTION (aims and activities of the community or people in it)
Function of Community.
- space, infrastructure for housing, schools, social services etc.
- employment, income, economics
- security
- participation, socialization
- linkage with other community systems
Community function is demonstrated in what diagram?
community assessment wheel
Healthy community.
A healthy community is one where people, organizations and local institutions work together to improve the social, economic and environmental conditions that make people healthy – the determinants of health
- continually creates and IMPROVES its physical and social ENVIRONMENTS
- EXPANDS the community RESOURCES
- mutually SUPPORTIVE for max. potential
Community Development.
- community identifies concerns
- build capacity for change
- engaging community in work to improve the health of the community
- work with ppl, mobilize resources, develop plan to address problem that has been collectively identified
A healthy community is one where people, organizations and local institutions work together to improve the social, economic and environmental conditions that make people healthy – the determinants of health
- individual activity involvement
2. collective activity involvement
Community development results in…
- individual capacity building
- collective capacity building
- Improved health status of the community or target pop
Factors that facilitate community development.
Community Mapping
Community Mapping.
taking inventory of (MAPPING ASSETS) assets in a particular community
- these represent COMMUNITY CAPACITY
- Always BEGIN WITH STRENGTHS
Community capacity building.
- identify and work with community strengths to PROMOTE POSITIVE VIEW of COMMUNITY
- STRENGTHEN community
- form STRONG FOUNDATION of support through PARTNERSHIP and COLLABORATION
Empowerment.
- DISCOVERING own STRENGTHS
- able to STATE their HELATH REQUIREMENTS and be involved in and TAKE CHARGE of the strategies necessary to achieve IMPROVED HEALHT
- ACTIVE INVOLVEMENT PROCESS
- move toward increased individual and community CONTROL, improved QOL and SOCIAL JUSTICE
- involves participation, choice, support, negotiation and advocacy
- Results from COLLECTIVE AND INDIVIDUAL ACTION to influence and manage the effects of the DoH
How does CHN empower communities?
inclusion and engagements strategies
Inclusion and engagement strategies by CHN to Empower communities.
- process involving CITIZENS at various levels of PARTICIPATION based on INTERPERSONAL COMMUNICATION and TRUST and COMMON UNDERSTANDING and PURPOSE
- experience a SENSE OF BELONGING through involvement and feeling comfortable ACTIVELY PARTICIPATING in decisions which AFFECT HEALTH
How we develop a sense inclusion and engagement…
- involvement in social networks and supports
- assisting in forming groups/private/public sector participation to identify to tackle health priorities (COALITION BUILDING and ADVOCACY)
- Joining a community organization to take action on a community issue
- engaging in advocacy for change
- engaging in political action
Sustainability.
- maintenance and continuation of established community programs
- intent of sustainable is to heave the capacity to continue addressing the problem and to evolve strategies to math how the problem is changing
Examples of sustainability.
Sustainability at the policy level occurs when a policy is established and enforcement strategies are used
Establishment of a recreational space and strategies developed to continue managing it on the financial and operational level
Advocacy.
“Advocacy means acting on behalf of another person, speaking for person who cannot speak for themselves, or intervening to ensure that views are heard” (P&P)
Health Advocacy.
“the processes by which the actions of individuals or groups attempt to bring about social and /or organizational change on behalf of a particular health goal, program, interest or pop.”
Community Advocacy.
the process of TAKING ACTION, MOBILIZING COMMUNITIES to raise AWARENESS, CHANGE OPINIONS and INFLUENCE DECISIONS that affect them (Vollman, 2012)
The application of information and resources to effect systemic change that shapes the way people live in community (Christoffel, 2000)
CNA advices all nurses advocate for clients by…
- PROTECTING THE CLIENTS RIGHT TO CHOICE BY PROVIDING INFORMATION
(protecting the right to dignity and minimizing suffering, promote health and social conditions) - OBTAINING INFORMED CONSENT FOR ALL NURSING CARE (protect p&c, follow policy)
- RESPECT CLIENTS DECISIONS (Advocating for the client’s expressed or written wishes, nurse as a communication bridge btw health team and pt)
CHNC state main role of CHN is to ___
ADVOCATE for changes in the community and for individuals or groups in order to promote health and well being
CHNs need to…
- use SUPPORTIVE and EMPOWERING strategies to move individuals and communities toward max. AUTONOMY
- support clients to develop SKILSS necessary TO ADVOCATE for themselves
- need to SUPPORT communities efforts to CHANGE POLICIES to improve HEALTH
Community Advocacy consists of organized efforts and actions to:
- HIGHLIGHT CRITICAL ISSUES that have been ignored and submerged
- INFLUENCE PUBLIC ATTITUDES and decision makers in communities and government
- Support and implement LAWS and PUBLIC POLICY that PROMOTE HEALTH
Goal of advocacy.
improve community health as defined by the members of the community rather than as defined by the professional
Advocacy requires…
- strong AWARENESS of the CONTEXT
- UNDERSTAND the INFLUENCE of the POWER AND POLITICS
- Development of PARTNERSHIPS between CHNs, other professionals and community members to ENHANCE COMMUNITY SELF DETERMINATION
What do you need to change before you can empower?
attitudes and behaviours
Empower through…
advocacy, social planning, social action and consciousness raising
Empowerment is demonstrated by…
Individuals, groups, communities are able to STATE their HEALTH REQUIREMENTS and be INVOLVED in and take charge of the STRATEGIES necessary to IMPROVE HEALTH
What 3 things influence one another and summarize advocacy and empowerment
advocacy, empowerment, quality of health in the community
Barriers to advocacy.
- Person does not see himself as an activist
- Process takes too long, don’t have the time
- Too challenging to change peoples ideas, attitudes
- Feel there is a lack of knowledge of how to do advocacy work, do not know where to begin
- Feel it will not make a difference
- May impact their job
How do CHNs advocate.
- ASSIT AND INVOLVE THE COMMUNITY TO PROBLEM SOLVE
(Engage the community) - COMMUNICATE/DISSEMINATE THE ISSUE (community participates)
- INCORPORATE POLITICAL STRATEGIES
Benefits of advocacy.
Advocacy in nursing adds a level of humanity when dealing with the client.
Advocacy raises the voice of the person who cannot speak for themselves and ensures their views are heard
Advocacy benefits the client by protecting their right to choice and making an informed decision.
Protects client’s right to dignity by advocating for good health and social conditions so that a person can live and die with dignity.
Potential negative consequences of advocacy.
- become dependent on nurse
- nurse might be ‘caught in the middle’
- nurse and pt moral differences
- nurse might face disinterest and apathy of the involved parties which might even question the motivation of the nurse
- creates frustration and discord (lack of agreement)
How can the CHN advocate through
1. Assist and involve the community in the problem.
Encourage active participation of community members to:
a. Identify issue
b. Develop goals & strategies to address the issue
c. Evaluate outcomes
d. Create a time line for project
How can the CHN advocate through
2. Communication/disseminate the issue.
a. SPEAK TO community organizations, businesses, schools, politicians in the community
b. Have COMMUNITY GATHERINGS, town hall meeting
c. Form COALITIONS in the community to ADDRESS HEALTH R/T ISSUES
d. USE MEDIA (web, news, etc.)
e. BULLETIN BOARDS (church, community, recreation centres, grocery stores etc)
F. WRITE LETTERS to campaign to government officials and news papers
G. LOBBY together to raise awareness
Disseminate
broadcast a message
How can the CHN advocate through 3. Incorporate political strategies.
a. Organize a group of citizens have meetings with municipal government (City Hall)
b. Provide the facts, research to defend current issue
c. Write articles, research, publish
d. Have people tell stories
e. Join coalitions who have a similar cause
f. Vote: get out an vote and encourage others to vote
g. Electioneering
h. Lobbying
i. Serve on a provincial/community board
j. Assume strategic positions in professional organizations, government and become involved in policy development (RNAO, CHNC, Interest groups of RNAO or organizations in communities
Lobbying.
contact your representative by phone, email, letter about a specific issue, or piece of legislation, meet with representative , build an ongoing relationship with representative
Electioneering.
Support or become a candidate (running for political office)
Ethics.
- include a body of knowledge about moral life; referee to values, norms, moral principles, virtues, and traditions that guide human conduct
Ethics address:
- How we behave
- What actions should I perform
- What kind of person I should be
- What are my obligations to myself and my fellow humans
Nursing Ethics.
- Examines ethical issues in health and health care through the lens of nursing practice and nursing theory
- Several nursing documents articulate the central ethical values and concepts used in all areas of nursing practice, including CHN
Everyday ethics.
How nurses attend to ethics in carrying out their daily interactions including how they approach their practice and reflect on their ethical commitment to the people they serve.
When do ethical dilemmas arise?
when 2 possible actions can be used in a situation; equally compelling (choosing one means that somethings else is relinquished or let go)
Process of ethical decision making.
focusing on the orderly process of how ethical decisions are made; consider ethical principles, client values and abilities, professional obligations; decisions are made using a FRAMEWORK