Week 1: 1-20, 42-60, 267-282 (1,3,16)
Family- unique and whomever the person defines as family. They include parents, children,
siblings, neighbours, and people in the community (RNAO). It is also any combination of two or
more persons who are bound together over time by ties of mutual consent, birth, and/or
adoption (Vanier Institute).
Family health- the relative functioning of the family as the primary social agent in the promotion
of health and well being (WHO). The individual and cooperative processes to dynamically
engage one another and their diverse environments over the life course.
Functions of the family- physical care of members, addition of new members, socialization of
children, distribution and consumption of goods and services, and love.
Characteristics of health families- negotiation skills, communication, respect, encouraging,
responsibility, demonstrates closeness, and diversity of culture.
Family health nursing- a process providing for the health needs of a family that are within the
scope of nursing practice. Family as context: traditional focus of nursing, the family is
considered the background. Family as client: the unit of care is the entire family, focus on the
individual and the family, the family is the foreground and individuals are the background.
Community- a group of people with a common characteristic living together or in a particular
area within a larger society. They are an interacting population, with various kinds of individuals
in a common area, it can be of any size, perceives itself as distinct from the larger society.
Community health- focuses on increasing health of individuals and the community, focus on
determinants of health, includes primary (reduce risks), secondary (screening and early
treatment) and tertiary (maintaining health) prevention.
Community health nurse (CNH)- registered nurses who work in the community with individuals,
families, communities and populations, these settings include homes, schools, workplaces,
street, shelter, churches, and health centers. They provide health promotion, protection and
prevention of illness.
Home health nurse (HHN)- focus on prevention, restoring health and maintenance, focus on
clients and families, practice in homes, schools, or workplaces, involves health promotion and
Public health nurse (PHN)- health promotion, illness prevention and population health, link
individuals and families to the population health and vice versa, practiced in diverse settings
such as health centers, schools and streets.
Family & community health- family can be source of support and influence, so nurses realize
that improving the health of the families will also improve the health of the community. THINK
LOCALLY, ACT GLOBALLY. Week 2: 76-88, 89-108 (5,6)
Health- a process, state, objective, subjective, a resource or a social issue. Understanding
health as a nurse will impact how we engage in health promotion and care practices.
Discourse- a paternal way of speaking of something for some purpose, implicit messages in
discourse may shape power relationships. Medical model discourse: the absence of disease,
seen as a technical process. Behavioural/lifestyle discourse: focus on lifestyle changes and risk
factors. Systems discourse: socioenvironmental model, the interrelation between systems.
Discourses are still present today in varying degrees depending on the area of health.
Risk factors vs. conditions- factors are behaviour patterns that tend to lead to poor health but
can be modified by behaviour changes. Conditions are circumstances that people have little
control over that can affect health status, often a result of public policy, can be modified through
Ottawa charter- 5 key areas of health promotion: build healthy public policy, create supportive
environments, strengthen community action, develop personal skills, reorient health services.
The 3 health promotion strategies: enable, mediate and advocate. 3 wings originate from the
circle in the middle and the one breaks through the circle.
Population health promotion strategies- combines the Ottawa charter, the social determinants of
health and potential interventions.
Primary care vs. primary health care- illness oriented vs. wellness oriented, diagnosis/treatment
of health vs. health promotion/disease prevention, leads to secondary/tertiary care vs.
supportive/rehab services, provider directed vs. partnership oriented.
Principles of primary health care- accessibility, public participation, health promotion,
appropriate technology, intersectional cooperation.
Week 3: 213-235, 267-282 (13,16) SB-104-127, 313-349
Ways of knowing- empirical, ethical, aesthetic, personal and emancipatory
Why use models and tools- assessment tools help focus on a specific element, you can collect
data using critical inquiry, the assessment becomes more organized, you can use multiple ways
Strengths based approach- discovering the person (family/community) you are caring for, not
with a hammer and a chisel, but through presence, interpersonal skills and assessment tools
Family assessment tools- developmental model of health and nursing (situation responsive
nursing, health potential and readiness to change), Calgary assessment model (family structure,
development and function), genogram (family structure thru health history and relationships),
spiralling process (4 phases of working with the families), and ecomap (family within context of
the community). Health situations- life events that individuals and families learn to be healthy from. Such
situations include chronic disease, acute illness, financial insufficiency, family violence,
catastrophic events, community development.
Characteristics of a healthy community- clean and safe environment, social justice, access to
food/water/shelter/income/work/recreation, health services available, member participation,
government commitment, and development of healthy public policies.
Community- three main components include people (culture and gender issues), place
(geography, history, culture) and functions (activities of the community). The components are
independent and mutually reliable. These components would be considered in a comprehensive
Community assessment tools- community-as-partner model (community and nursing
processes), community capacity model (strengthen individuals and the community an d
implement health promotion for a positive outcome over time), community health promotion
model (assess the degree of 4 health fields and the SDOH) and windshield survey
(environmental scan as one piece of data).
Community-as-partner model- based on Newman’s systems model, interest in the community
system and its related environment, based on primary health care, the core represents the
people who make up the community, the environment is divided into subsystems (education,
safety, government, recreation) and the line around the community represents the normal
line of defence.
The assessment team- team effort that brings people together, it takes full participation of the
community members at all stages (first is capacity), it requires interpersonal skills from a diverse
Getting to know community- physical entry involves legitimacy and parameters, and
psychological entry involves rapport, trust and credibility.
Reasons for community health assessments- developing short and long term plans, strengths
and weaknesses, solving community problems, setting priorities, develop community
awareness, stimulate community action and open up the community to public values and
Practice Standards- standard 4 (professional relationships) and standard 5 (building capacity)
are primary in community and family assessment.
Week 4: 61-75 (4) *see group work handout*
Social justice- fair distribution of society’s benefits, responsibilities, and consequences, it
focuses on the relation of one social group to others in the society. Social justice is the
foundation of public health. We need to commit to address these disadvantages that limits
others well-being. Attributes of social justice include: equity, human rights, civil rights, capacity
building, just institutions, poverty reduction and ethical practice. 3 features of social justice- power, view persons as unique, connected and interdependent
(vulnerable and unequal power) and ethical dilemmas and ethics.