NSG 411 1st EditionExam # 1 Study GuideChapter 1 – Foundations of CH nursing – 12 questions- Health promotion vs disease preventionDisease prevention begins with a threat to health--a disease or environmental hazard--and seeks to protect as many people as possible from the harmful consequences of that threat. Health promotion begins with people who are basically healthy and seeks the development of community and individual measures which can help them to develop lifestyles that can maintain and enhance their state of well being.- Levels of preventionPrimary- points out occurrence of health problem; vaccinations, encouraging elderly to install safety barsSecondary- Detects and Treats existing disease or impairment in early stageTertiary- Reduce the severity of a health problem to its lowest possible level- Community vs populationCommunities and populations are both types of aggregates (mass or grouping of distinct individuals who are considered as a whole)A population is made up of people who do not necessarily interact with one another anddo not necessarily share a sense of belonging to that group; directly contrasting a community- Types of communities-Geographic: city, town, and neighborhoods-Common-Interest: a collection of people (even if widely scattered geographically) can have an interest or goal, which binds them together; nursing organization, church in a large area- Solution: a group of people who came together to solve a problem that affects all of them Evolution of CH/PH Nursing – 4 questions- Nursing leadersFlorence Nightingale--“The ultimate object is to nurse all sick at home” - Changed to a cleaner environment for soldiers, an improved survival rateDorothea Dix-Advocated for those with mental illnessFrancis Root- First official public health nurse; served people living in poverty, provided care to the sick and taught hygeine- Helped start American Red CrossLillian Wald and Mary Brewster- Henry Street Settlement: focuses on health and the social environment, advocate forschool nursesMary Breckenridge- Frontier Nursing Service - Growth of industrial nursing- Stages or “eras” of CH/PH nursing (Early home health, etc)- Home care nursing- District nursing - Public Health Nursing - Era of community-based nursing: community-based clinics, work sites and schools, mental health and substance abuse programs, home health and hospice- Societal influencesPublic Health and the role of the CH nurse – 9 questions- PH core functions and essential servicesAssessment- system collection, analysis, and dissemination of data Policy development- development of strategies, programs, rules, and regulations to prevent and/or address identified health needsAssurance- activities that ensure that public health services are delivered- Roles of the CH nurseClinician- holistic, wellness focused, broad skill baseEducator- diverse audience, self acquired knowledge via technologyAdvocate- Help people gain greater independence, increase health system responsiveness and relevanceManager- planning, organizing, evaluating, case managementCollaboratorLeader- change agent, community planning, visionaryResearcher- Relationships among interventions, core functions, and essential servicesChapter 15 Community as Client – 14 questions- Dimensions of community- Status/people: comprised of morbidity and mortality data identifying the physical, emotional, and social determinants of health; looks at the specific health of the people- Structure: services and resources- Process: how community works OR- Physical location: boundaries, location of health services, geographic features, climate, flora and fauna, human made environment- Population: size, density, composition rate of growth or decline, cultural differences, mobility, poverty level, education level, unemployed, median age, health status, environmental health status- Social system: health, family, economic system, educational, religious, welfare, political, recreational, legal, communication system- Types of community assessment-Familiarization: studying data already available in the community, and gathering a certain amount of first hand data to gain working knowledge of the community-Problem-oriented: begins with a single problem and assesses the community in terms of that problem-Community subsystem: focuses on a single dimension of he community life (ex. churches role in community)-Comprehensive: seeks to discover all relevant community health information; may use key informants; expensive and time consuming-Community assets: strengths and capacities of a community rather than its problems using three levels 1. Specific skills 2. Local citizen organizations (ex. libraries, voluntary agencies)3. Local institutions outside of the community- Characteristics of the nursing process in community healthDeliberative- purposefully systematic, collecting data to inform other steps of nursing processAdaptable- flexible/subject to changeCyclical- steps are repeated over and overClient focusedInteractive- relationship based Need oriented- anticipate client needs and prevent problemsForming partnerships and building coalitionsTheories and models – 10 questions- Nursing theoriesPender- health promotion; looks at and studies thought processes that influence people to make healthy decisionsRoy- adaptation; how individuals/groups change from stress/the environment (ex. community destroyed from tornado, what resources will they use to overcome and rebuild)Salmon- ecological approach; examines biological/environmental/ structural factors- Models of behavior change-Health belief model:Concepts- Perceived susceptibility, perceived severity, perceived benefits, perceived barriersFocuses on how people see their own situation (barriers to healthcare and importance)-Transtheoretical Model (Stage of change):1) Precontemplation: no intent to change2) Contemplation: think about making change in next 6 months3) Preparation: make plans in the next 30 days4) Action: implement and continue with for 6 months5) Maintenance: change is 6 months old and part of life-Ecological Model:Looks at ALL factors that influence people’s behaviors- Practice modelsMinnesota Intervention WheelLos Angeles County PHN Practice model: The model depicts three interwoven circles that show the three levels of population-based practice: individual and family, community and systems. The circles are nested within the overalllabel of population-based practice,