Title NCM 113 - PRELIMS ✅

NCM 113 BY TONS and MADS WEEK 2 LEC: COMMUNITY HEALTH NURSING: DEFINITION,FEATURES & MODELS KEY CHN CONCEPTS VIDEO Video Transcript of KEY CHN CONCEPTS Public health nursing ● synthesis of public health and nursing practice. COMMUNITY HEALTH NURSING ● Synthesis of nursing practice and public health practice applied to promoting and preserving the health of population ● scope of nursing practice making use of the nursing process ● Clients: individuals, population groups or aggregates The Role of the Community Health Nurses ● To assist in transition of Philippine healthcare system from disease-oriented system to health-oriented system Practical Implications of Community Health Nursing ● Represents a profession that responds to all categories of demands of the people ● Opportunity for nurses to learn & develop partnership skills with all stakeholders and key actors in their communities. COMMUNITY SCENARIOS Both need community health nursing to intervene in its problem, to promote and preserve wellness 1. Downside scenario - Problems: psychological, physical, socioeconomic and emotional 2. Wellness State DISTINGUISHING FEATURES OF CHN I. Population-Focused A. To move beyond providing direct care to individuals and families B. Concentration is placed on specific groups of people and focuses on health promotion and disease prevention regardless of geographical location C. Employs ongoing data collection for assessment and management D. Would not have exclusive interests in assessing the individual or family's health. E. Ex: if a nurse is attending to an individual, she will not only assess that patient but transcends beyond (always minding of the groups) II. Levels of Clientele A. The Individual B. The Family C. The group / aggregate - the whole population III. Framework for Practice / INTERVENTION WHEEL A. Framework for CHN & PHN B. Contains 3 important elements 1. Population based 2. 3 levels of practice: a) Individual/ family focus practice b) Community focus practice c) Systems focus practice 3. Identifies and defines 17 public health interventions C. Gearing towards case finding and other concerns in the community 17 PUBLIC HEALTH INTERVENTIONS AND DEFINITIONS PUBLIC HEALTH INTERVENTION DEFINITION Surveillance Describes & monitors health events through ongoing & systematic collection, analysis, interpretation of health data for purpose of planning, implementing, & evaluating public health interventions Disease and other health event investigation Systematically gathers and analyzes data regarding threats to health of populations, ascertains source of threat, identifies cases and others at risk, and determines control measures Outreach Locates populations of interest or populations at risk and provides information about nature of the concern, what can be done about it, and how services can be obtained Screening Identifies individuals with unrecognized health risk factors or asymptomatic disease conditions, Case finding Locates individuals and families with identified risk factors and connects them with resources Referral and follow-up Assists individuals, families, groups, organizations, and/or communities to identify and access necessary resources to prevent or resolve problems or concerns Case management Optimizes self-care capabilities of individuals and families and the capacity of systems and communities to coordinate and provide services Delegated functions Carries out direct care tasks under the authority of a health care practitioner as allowed by law Health teaching Communicates facts, ideas, and skills that change knowledge, attitudes, values, beliefs, behaviors, and practices of individuals, families, systems, and/or communities Counseling Establishes an interpersonal relationship with a community, system, and family or individual, with intention of increasing or enhancing capacity for self-care and coping Consultation Seeks information and generates optional solutions to perceived problems or issues through interactive problem solving with community system and family or individual Collaboration Commits two or more persons or organizations to achieve a common goal through enhancing capacity of one or more members to promote & protect health Coalition building Promotes & develops alliances among organizations or constituencies for a common purpose Community organizing Helps community groups to identify common problems or goals, mobilize resources, and develop and implement strategies for realizing goals they collectively have set Advocacy Pleads someone’s cause or acts on someone’s 1
NCM 113 BY TONS and MADS behalf, with a focus on developing community, system, and individual or family’s capacity to plead their own cause or act on their own behalf Social marketing Utilizes commercial marketing principles & technologies for programs designed to influence knowledge, attitudes, values, beliefs, behaviors, and practices of the population of interest Policy development and enforcement Places health issues on decision makers’ agendas, acquires plan of resolution, & determines needed resources, resulting in laws, rules, regulations, ordinances, and policies. Policy enforcement compels others to comply with laws, rules, regulations, ordinances, and policies IV. The Prepayment Mechanism A. Community health nursing services are free at point of care because public health services are provided by government agencies. These services are prepaid by general population through taxes B. Provides for the means to "socialize" health services. NURSING THEORIES AND THEORISTS Nursing experts continuously looking for ways to improve nursing practice; this gives birth to nursing theories with goal to improve nursing practice I. Health Belief Model A. The model evolved from the premise that the world of the perceiver determines action B. The HBM may effectively promote behavioral change by altering patients’ perspectives, but it does not acknowledge the health professional’s responsibility to reduce or ameliorate health care barriers. C. Assumes a person's primary motivation of Positive health action to avoid getting a disease, likelihood of getting disease and it considers before prior to having this behavior D. Depicts complex multi-dimensional factors with with which people interact as they work to achieve optimum health E. Variables: All of these play a role whether a person take positive action to avoid getting a disease or not (Variables affect the likelihood of taking recommended preventive health action which is the end point of this health belief model) 1. Modifying factors a) Demographic Variables (1) Age (2) Race (3) Gender (4) Ethnicity b) Socio Psychological Variables c) Perceived Threat of Disease “X” d) Cues to Action: served as a venues and increase likelihood for one to take positive health actions (1) Mass media campaigns (2) Advice from others (3) Reminder postcard from physician / dentist (4) Illness of family member or friend (5) Newspaper or magazine article 2. Individual perceptions - Person evaluates if barrier is high compared to benefit of certain action a) Perceived susceptibility to Disease “X” b) Perceived Seriousness (Severity) of Disease “X” 3. Likelihood of Action a) Perceived benefits of preventive action MINUS Perceived barriers to preventive action II. NANCY MILIO’s FRAMEWORK FOR PREVENTION A. Includes set of propositions to provide frame of reference for proposed strategies to improve healthful behavior by placing personal choice making in context of societal option setting B. Outlined relationship between individual's ability to have healthy behavior and society's ability to provide accessible & affirming options for healthy choices. C. Preventive behavior or individual choice related to health promotion or health damaging behavior are influenced by socio-economic status, culture, educational status, and accessibility of health options like health insurance coverage. D. Source and funds of insurance influences choice of health services and health expert E. If any alteration of pattern is noted (increase in degree of smoking) and becomes difficult to maintain and modify -- this cause for policy making mandates (example: creation of anti-tobacco policy) F. Addressing chronic or persistent health problem is challenging; clients are aware of cause and effect but reluctant to make lifestyle change to prevent or reverse condition -- once these clients are given new information or resources, these can attract attention and direct changes in behavior in promotion of health G. Milio used these propositions to move the focus of attention upstream by challenging the notion that a main determinant for unhealthy behavior choice is lack of knowledge. H. She said that government and institutional policies set the range of health options, so community health nursing needs to examine a community’s level of health and attempt to influence a community’s health through public policy. I. She noted that the range of available health choices is critical in shaping a society’s overall health status. J. Milio believed that national-level policy making was the best way to favorably impact the health of most Americans rather than concentrating efforts on imparting information in an effort to change individual patterns of behavior. K. health deficits often result from an imbalance between a population’s health needs and its health sustaining resources. She stated that the diseases associated with excess (e.g., obesity and alcoholism) afflict affluent societies and that the diseases resulting from inadequate or unsafe food, shelter, and water afflict the poor. Within this context, the poor in affluent societies may experience the least desirable combination of factors. 2