NURS 2215 Chapter Notes - Chapter 4, 7, 8, 13: Independent Community And Health Concern, Community Mobilization, Needs Assessment

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Class 2: Guided Questions for Readings
Stamler, Yiu, & Dosani (2015): Chapter 13 - Community Nursing Process (pp. 246 – 266)
1. List four different reasons why community health nurses engage in community assessments.
1) Environmental scan
2) Needs assessment
3) Problem investigation
4) Resource evaluation
2. List and describe 5 different components of a community assessment.
1) Community History and Perception- Understanding the past allows the CHN to build on
existing strengths and avoid repeating the same failures
2) Population- The core of community is people. A population is a diverse group of people or
aggregates residing within the boundaries of a community.
3) Boundaries- the boundary of the community refers to where the target population lives, works,
plays, and learns.
4) Environments- Physical, chemical, biological, social, and psychosocial factors in the
environment contribute to our quality of life.
5) Socioeconomic Environments- The interaction between social and economic conditions of the
community affects the health and well-being of individuals and populations.
6) Income and Social Status-
7) Employment and working conditions- Unemployment, underemployment, economic instability,
and stressful or unsafe working conditions significantly affect not only people's physical,
mental, and social health and general well being, but their families, friends, and communities.
8) Social Supports and networks
9) Diversity and social inclusion- Healthy communities embrace harmony, safety, and diversity as
the social norm.
10)Recreation- Recreation provides a form of socialization and a means for healthy physical and
mental activity for people outside of their family, school, and work life.
11)Education and healthy child development
12)Culture and religion
13)Health and social services
14)Transportation
15)Communication
16)Governments and politics
17)Law and safety
3. What is population health?
Population health is an approach to health that aims to improve the health of the entire
population and to reduce health inequities among population groups... it acts upon the broad
range of factors and conditions that have a strong influence on our health.
4. What is a risk?
Risk refers to the probability or likelihood that healthy persons exposed to a specific factor will
acquire specific disease. These specific factors, called risk factors, can be environmental,
lifestyle, and psychosocial factors (e..g., sources of exposure, cultural practices, patterns of
behavior, local concerns, direct impact from the service delivery system), or biological factors
(e.g., age, sex, or genetic, makeup).
5. What is risk assessment?
Identify and target clients who are most likely to contract a particular disease or develop
unhealthy behaviors, and assess attributes that affect or potentially affect their health.
6. What are the components of a community health nursing diagnosis?
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Specific aggregate or target group
Actual or potential unhealthy or healthy response/situation that a nurse can change
Etiology or cause for the unhealthy or healthy response/situation
Characteristics (i.e., signs and symptoms) or evidence that describes the response or
situation.
7. Why is it important to take a community participatory approach?
A community participatory approach is a key to community planning. Through dialogue
with stakeholders and community members during the process, the community decides
what makes a need become a priority, who is to take the action, what the action will be,
and when and how it is to be done.
8. What is community development?
Community development is the process of involving a community in the identification and
strengthening those aspects of daily life, culture life, and political life which support health.
This might include support for political action to change total environment and strengthen
resources for healthy living.
9. What is community mobilization?
Community mobilization is the process to bring on the change usually starts with one or a
few individuals at a grassroots level, taking collective action to generate solutions to
common problems, and it eventually involves the larger community.
10.What are the steps for community program evaluation?
1. Determining what needs to be evaluated based on the evaluation criteria
2. Engaging stakeholders throughout the process
3. Determining the appropriate methods of measurement
4. Developing data collection instruments, budget, and timeline for evaluation
5. Collecting and analyzing data
6. Reporting and disseminating the results
7. Making decisions for action
Stamler, Yiu, & Dosani (2015): Chapter 8 - Health Promotion (pp. 139 – 152; 155 – 156; 160 – 169)
1. What is the importance of the Lalonde Report?
An important component of the declaration was the statement that health, "is a
fundamental human right and that the attainment of the highest possible level of health is a
most important worldwide social goal whose realization requires the action of many other
social and economic sectors in addition to the health sector.
2. What is the health belief model and when would you use it?
The health belief model is a common model used to promote health, with its origins dating
back to social theory research completed by Rosenstock. The health belief model that
arose from this area of research suggests there is a greater probability of people making
healthy choices if they believe that
othey have a high risk of getting the disease,
othe consequences of the disease are serious
otaking action to minimize the risk will benefit them, and that
othere are relatively few obstacles or challenges to making the behaviour or lifestyle
change,
othey are prompted or reminded to perform the behaviors, and
othey believe they can execute the behaviour (self-efficacy)
o
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3. Why is it important to understand our values, beliefs, and attitudes when practicing in the
community?
Nursing values, beliefs, and attitudes affect practice behavior. Values, beliefs, and
assumptions lie beneath our foundation of evidence-based decision making, research
evaluation, and experiential learning in the base of the PHPM. Values are enduring beliefs
or attitudes about the worth of a person, object, idea, or action; sometimes these are
unconsciously held.
4. What is the difference between taking a collaborative partnership approach and traditional
hierarchical relationships?
Collaborative and partnership approaches are effective community-development and
relationship-building strategies employed by CHNs. The focus is on developing
relationships with others as a means of partnering effectively with them to address health
promotion strategies for their identified health challenges or concerns.
Traditional hierarchical relationships tend to be more authoritative, paternalistic, unilaterally
top-down, "power-over" approaches that arise from a "treatment mentality" toward nursing
practice-a perspective that suggests the healthcare professional is the expert with the
knowledge and power to treat and cure disease, and the role of the client or patient is to
comply with the professional's plan. This value is muck like a parent-child relationship
where the parent knows best.
5. Why is it important to take a strengths-based approach when working in community health
nursing practice?
Resilience or strengths-based approaches are those that focus on strengths of a group,
rather than on deficits, and build upon those to create health promotion initiatives. It is a
way to engage people in co-creating a healthier future by first focusing on what they are
doing well, what works well, and what their strengths are, and then building upon these
strengths to create a healthier future.
Resilience creating, appreciative, strengths-based approaches are health promoting
approaches to nursing practice, which can move policies and programs toward more
socially just practices congruent with community health nursing values.
Stamler, Yiu, & Dosani (2015): Chapter 7 - Theoretical Foundations of Community Health Nursing (pp. 115 –
121)
1. Compare and contrast the Canadian Community as Partner Model with the Population Health
Promotion Model.
Canadian Community as Partner Model -
oThis conceptual model depicts the community as a dynamic system that interacts with its
environment and moves iteratively through the phases of community assessment, analysis,
diagnosis, planning, intervention, and evaluation. It sees interventions as primary,
secondary, or tertiary preventive levels, and is consistent with the broad determinants of
health.
oEg- an example from practice is a local community demand for birth control services for
teens, and the subsequent involvement of CHNs with teens and community partners to
establish accessible and welcoming clinic services.
Population Health Promotion Model-
oThis widely used Canadian model demonstrates the link between population health and
health promotion at various levels of action. The model is used to identify specific
actions as well as demonstrate how to combine various actions to create a
comprehensive action strategy. Attention is directed to individual, family, and
community levels.
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