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BEJOC, JOYCEE MORE BSN2 B9 Community Health Nursing 1 - STUDENT ACTIVITY SHEET Lecture...

BEJOC, JOYCEE MORE BSN2 B9 Community Health Nursing 1 - STUDENT ACTIVITY SHEET Lecture BS NURSING / SECOND YEAR Session # 1 LESSON TITLE: Orientation / Nursing Core Values as a Materials: Community Health Nurse. Filipino Culture, values and Pen, paper, index card, book, and class List practices in relation to Health Care of Individual and Family. Global and National Health Situations Reference: LEARNING OUTCOMES: Famorca, Z. U., Nies, M. A., & McEwen, M. At the end of the lesson, the nursing student can: (2013). Nursing Care of the Community. 1. Demonstrate caring as the core of nursing, love of God, Elsevier Gezondheidszorg. love of country and love of people in serving the community; Community Health Nursing Services in the 2. Enumerate the role and responsibilities of a community Department of Health Philippines (2000). health nurse; 3. Exemplify love for country in the service of the Filipinos Community Health Nursing. 9th Edition. and family; National League of Government Nurses, Inc. 4. Customize nursing interventions based on Philippine Culture and values; and, 1. Discuss appropriate the global and national health situation and actions holistically and comprehensively. SUBJECT ORIENTATION (15 minutes) Your classroom instructor for this subject Community Health Nursing 1 - Lecture, is JENIKA KIRSTYN M. JARLATA. Listed below are the additional information vital in orientation: MAIN LESSON (20 minutes) The instructor should discuss the following topics. Instruct students to take down notes. Definition of Terms Community  Are social structures that exhibits and create norms and values that establish social institution (WHO) Health  A state of complete physical, mental and social being and not merely the absence of disease or infirmity (WHO) Community Health  Extends the realm of public health to include organized health efforts at the community level through both government and private sectors Community Health Nursing  “The utilization of the nursing process in the different levels of clientele-individuals, families, population groups and communities, concerned with the promotion of health, prevention of disease and disability and rehabilitation.” (Maglaya, et al)  Goal: “To raise the level of citizenry by helping communities and families to cope with the discontinuities in and threats to health in such a way as to maximize their potential for high-level wellness” (Nisce, et al)  Special field of nursing that combines the skills of nursing, public health and some phases of social assistance and functions as part of the total public health program for the promotion of health, the improvement of the conditions in the social and physical environment, rehabilitation of illness and disability (WHO Expert Committee of Nursing)  A learned practice discipline with the ultimate goal of contributing as individuals and in collaboration with others to the promotion of the client’s optimum level of functioning thru’ teaching and delivery of care (Jacobson)  A service rendered by a professional nurse to IFCs, population groups in health centers, clinics, school’s workplace for the promotion of health, prevention of illness, care of the sick at home and rehabilitation (DR. Ruth B. Freeman) Role and Responsibilities of Community Health Nurse “The main focus of community health nurse is health promotion.” 1. Programmer/Planner  Identifies the needs and concerns of individuals, groups, families, and the community  Formulates health plans, especially in the absence of a community physician  Interprets and implements nursing plans and programs  Assists other health team members in implementing health programs in the setting 2. Health Educator/Trainer/ Counsellor  Acts as resource speaker on health and health-related services  Advocate health programs in the community through dissemination of IEC or Information Education and Communication materials  Conducts advocacy educations concerning premarital, breastfeeding, and immunization counselling  Organizes orientation/ training of concerned groups like pregnant mothers  Identifies and interprets training needs of health team members and formulate appropriate training program for them  Conducts and facilitates necessary training or educational orientation to other health team members in the community “The recipient of care of community public health nursing practice is extended not only to the individual but also to benefit the whole family and community.” 3. Community Organizer  Promotes self- reliance of community and emphasizes their involvement and participation in planning, organizing, implementing and evaluating of health services  Initiates and implements community development activities 4. Coordinator of services  Coordinate’s health services with concerned individuals and families through the community health team members, government organizations and non- government organizations  Coordinate’s nursing plans and programs with other health programs “Community health nurses are generalists in terms of their practice through life’s continuum.” 5. Provider of Nursing Care  Renders direct care to various clients with different needs, may it be at home, in school, clinics or work settings  Involves the family in the care of the sick or dependent individual, i.e., sick child “Continuity of care with the client, family or and the community extends for a longer time involving individuals of all ages and health needs” 6. Health Monitor  Monitors and detects the presence of health concerns in the community through contacts or home visits.  Utilizes various effective data gathering techniques in keeping an eye on the health status of all recipients of care.  Records and reports health status and presence of health problems in the community “The nature of nursing practice in the community needs the knowledge of biological and social sciences, ecology, clinical nursing, and community organizing, for it to be effective.” 7. Researcher  Follows a systematic process of monitoring the health status of the community through the conduct of surveys and home visits  Conducts researches concerning the health of the community  Coordinates with government and non- government organizations in the conduct and implementation of studies 8. Statistician  Records data systematically and ensures its validity through accurate and complete data gathering  Reports prepared reports to concerned organizations i.e. government organization for immediate necessary plans or programs  Consolidates and reviews reports efficiently.  Analyzes and interprets consolidated data for monitoring the development in the health matters of the whole community “This field of nursing practice utilizes a dynamic process (assessment, planning, implementation, and evaluation) in the provision of continuous care until termination is implicit.” 9. Change Agent  Promotes and motivates change in the community in their health practices and lifestyle behaviors for them to promote and maintain good health, be knowledgeable and has the initiative in accessing health services  Inculcates self- reliance to brought about development and improvement in the community Core Values of a Community Health Nurse 1. Integrity (honesty and willingness to do what is right) Skills attribute to integrity  Care Comes First – Communication is key. Listen to others, and provide information and advice clearly so every patient can understand. Make well-informed decisions that are best for the patient. Do not accept gifts for preferential treatment.  Confidentiality- states that anything said to nurses and other health-care providers by their patients must be held in the strictest confidence.  Veracity- requires nurses to be truthful. Truth is fundamental to building a trusting relationship.  Accountability- linked to fidelity and means accepting responsibility for one’s actions. Nurses are accountable to their patients and to their colleagues.  Respect Dignity – Protect patient privacy. Never give client information to an unauthorized person, and preserve anonymity when citing patient cases in coursework, research, or other public documents.  Honesty and Integrity – Do not plagiarize coursework or professional assessments. Compile an accurate CV to reflect your education and work experience. Always aspire to the highest levels of personal and professional conduct.  Uphold reputation – be aware that all actions—even outside of work—may have consequences. 2. Professionalism Skills attribute to professionalism  High Standards of Care – Be punctual. Acknowledge when a situation is beyond your professional scope. Don’t be afraid to ask for help.   Leadership – A sought-after attribute, leadership is founded on excellent communication skills, attention to detail, respect, and resourcefulness. Professionals commonly build leadership skills as they move on to more senior roles in which they can guide others to provide higher levels of care. 3. Competence  Conflict resolution – This involves a professional’s ability to de-escalate a problem. It requires the nurse to consider the needs of everyone involved in the conflict, while communicating possible solutions with respect.  Ethical thinking – This skill enables nurses to make value-based judgments that align with professional standards and moral codes, prioritizing the needs of patients and colleagues ahead of their own.  Adaptability – This demonstrates the capacity to combine new information with education, experience, and professional guidelines to re-evaluate a situation and make changes that lead to more effective solutions. 4. Commitment  Fidelity- a promise that the individual will fulfill all commitments made to himself or herself and to others.  Accountability- linked to fidelity and means accepting responsibility for one’s actions. Nurses are accountable to their patients and to their colleagues. 5. Openness  We want our community to have confidence in their local health services.  We foster greater confidence and cooperation through open communication.  Our performance is open to public scrutiny through patient and employee surveys.  We welcome and use feedback as a tool to do better.  We encourage those around us to speak up and voice their ideas as well as their concerns by making it clear that speaking up is worthwhile and valued.  We communicate clearly and with integrity. 6. Teamwork  Collaboration -working with others and being able to communicate and cooperate is crucial to developing an efficient work environment that places patient needs at the forefront  Cooperate with team members and respect their contributions. Always treat everyone with respect.  Team Leader – excellent communication skills leadership skills as they move on to more senior roles in which they can guide others to provide higher levels of care. 7. Patriotism  National pride is the feeling of love, devotion and sense of attachment to a homeland and alliance with other citizens who share the same sentiment. Filipino Culture, Values and Practices in relation to Health Care of Individual and Family. Culture is socially transmitted behavior, patterns, rules of conduct, arts, values, beliefs, custom, rituals, lifeways, and products of existence that guide the worldwide and decision making. Madeleine Leininger recognized the need to focus on culture in nursing as she predicted that nursing and health care would become global. The major concepts of Leininger’s Theory is cultural diversity and goal of nursing is to provide patient with culturally specific nursing care. Key component of the nursing assessment process in order to plan in a manner that is sensitive and respectful of the individual needs of the client /significant others Cultural considerations  An individual may not necessary identify strongly with the specific group just because he/she was born into it.  An individual may identify with more than one group.  Client may choose to practice selected custom of a group while not honoring others.  How a client identifies with a culture, ethnic group, or religion may affect his/her health practices and care up to the end of life.  Rituals tend to become most important to individuals at times of significant life transitions  When ethical dilemmas arise, the leader of the spiritual or cultural group might be consulted. Assessment  Does the client identify strongly with a specific group or groups?  What are the beliefs, customs, practices and rules that are most important to the client?  How can the health care team support the client and plan of care that will address these needs? Are there special wishes/needs?  Is the client part of a community, congregation, or extended family structure? Does this play an important part in his/her life?  How do the identified culture(s) influence feelings about health and care? It is important to assess areas related to the situation (e.g., for a client newly diagnosed with AIDS? What gives the client’s life meaning? What does pain mean to this client? Selected examples of diverse cultures that might influence health care practices 1. Jehovah’s Witness  Urge members to refuse blood transfusion 2. Seventh-day Adventist  Prohibit consumption of pork, shellfish, alcohol, coffee and tea. 3. Hindus  Prohibit consumption of beef (all meat and alcohol are avoided by the most devout).  Food is eaten with right hand (regarded as clean) 4. Muslims  Prohibit consumption of pork and pork products and alcohol. Consumption of blood is forbidden; therefore, all meat and poultry ate cooked to well done.  Bread is required with each meal (a gift from God)  Food is eaten with the right hand (regarded as clean)  Beverages are not consumed until after the meal (some believe it unhealthy to eat and drink at the same time). Some Muslims do not mix hot and cold foods at the same time.  Fasting as the start of a remedy: prophet Mohammad said” stomach is the house of every disease”  High concern for ingredients in mouthwash, non-home- prepared food, medication (gelatin capsule derived from pig, insulin, etc.)  Special daily prayer times ✔ Need basin of water to wash before praying ✔ Bed or chair facing Mecca ✔ Read or listen to the Qur’an  Death is God’s will and foreordained. The worldly life is preparation for eternal life.  Death rituals ✔ Body washed three times by Muslim of the same gender and wrapped in white ✔ Buried as soon as possible in brick-or cement grave with the body facing Mecca (no cremation and typically no autopsy) 5. Roman Catholic  Anointing of the sick (last rites) for the seriously Ill. This sacrament of healing discusses God’s grace and brings physical and spiritual strength  attending mass  praying the rosary and novena  expressing devotion to saints and the Virgin Mother  receiving the sacraments and holy communion  reconciliation  anointing the sick  observing religious holidays and rituals   going on pilgrimages Health Beliefs and Behaviors: Health Behaviors Response to Illness  Filipino older adults tend to cope with illness with the help of family and friends, and by faith in God.  Complete cure or even the slightest improvement in a malady or illness is viewed as a miracle.  Filipino families greatly influence patients’ decisions about health care.  Patients subjugate personal needs and tend to go along with the demands of a more authoritative family figure in order to maintain group harmony.  They may even resort to utilizing traditional home remedies such as alternative or complimentary means of treatment.  They may discuss their concern with a trusted family member, friend, spiritual counselor or healer (Yeo, 1998).  Seek medical advice from family members or friends who are health professionals is also a common practice among Filipino older adults and their family members, especially if severe somatic symptoms arise (Anderson, 1983). Responses to Mental Illness Indigenous traits common among elderly Filipino Americans when faced with illness related to mental conditions:  Devastating shame (Hiya)  Sensitivity to criticism (Amor Propio) Coping Styles Coping styles common among elderly Filipino Americans in times of illness or crisis include:  Patience and Endurance (Tiyaga): the ability to tolerate uncertain situations  Flexibility (Lakas ng Loob): being respectful and honest with oneself  Humor (Tatawanan ang p\Problema): the capacity to laugh at oneself in times of adversity  Fatalistic Resignation (Bahala Na): the view that illness and suffering are the unavoidable and predestined will of God, in which the patient, family members and even the physician should not interfere  Conceding to the wishes of the collective (Pakikisama) to maintain group harmony Cultural Values  Smooth Interpersonal Relationships are a core value for every Filipino community  They involve a shared identity, engagement on an equal basis with others  Give importance to the individual versus agencies or institutions. This cultural characteristic is also known as “Personalism.”  The high value placed on sensitivity and regard for others, respect and concern, understanding, helping out, and consideration for others’ limitations, often creates discord with American tendencies toward openness and frankness (Agoncillo & Guerrero, 1987; Enriquez, 1994).  Perceptions regarding physician preferences dictate who will provide care and how much trust is given. Two main concepts determine the interaction between a Filipino and a health care provider: 1. “One of Us” (Hindi ibang Tao) versus 2. “Not one of Us” (Ibang Tao) Health providers who are respectful, amenable and willing to accommodate the patient’s needs are considered to be Hindi ibang Tao. If the provider is considered Ibang Tao, Filipino Americans will be reluctant to express their feelings and emotions. They will designate a family member to mediate or advocate on their behalf while responding politely to the provider at a formal and superficial level. The concept “Not one of Us” involves The concept “One of Us” includes: civility (Pakikitungo) mutual trust/rapport (Pakikipagpalagayan ng loob) mixing (Pakikisalamuha) getting involved (Pakikisangkot) joining/participating (Pakikilahok) oneness/full trust (Pakiisa) adjusting (Pakikisama) (Pasco, 2004; Enriquez, 1994; Pe Pua, 1990). Family and Filial Responsibility  Children are taught to show affection for older family members and respect for older adults and authority.  Seek the advice of and accept the decisions of their older adults.  They are obligated to care for older adults and aging parents, and maintain group harmony, loyalty, and emotional ties with parents and other family members across the life span (Chao & Tseng, 2002; Mc Bride, 2006; Miranda, Mc Bride & Anderson, 2000; Superio, 1993). Spiritual Life and Religiosity  Religion is deeply embedded in and intertwined with Filipino culture. It is central to people’s lives and enables them to face life’s challenges and adversities with strength and optimism (Tompar-Tiu & Sustento- Seneriches, 1995).  Filipino use spirituality and religion as part of their coping practice, especially when dealing with illness. Global and National Health Situations. With the huge national debt, widespread poverty, high birth rate and growing population, the task of creating a healthy population in the Philippines as a prerequisite to national development lies in the hand of health sector. The department of health must undertake bold initiatives in health care services through innovate approaches 50 Facts: Global health situation and trends 1955-2025 Population Global Rural/Urban Birth /Death Age /employment Population Areas 2.8billion in 1955 In 1955, 68% of Every day in 1997, 1. Today's population is made up of 613 5.8 billion now the global about 365 000 million children under 5; 1.7 billion population lived in babies were born, children and adolescents aged 5-19; It will increase by rural areas and and about 140 000 3.1 billion adults aged 20-64;and 390 nearly 80 million 32% in urban people died, million over 65. people a year to areas. 2. The proportion of older people requiring reach about 8 In 1995 the ratio Giving a natural support from adults of working age will billion by the year was 55% rural and increase of about increase from 10.5% in 1955 and 2025. 45% urban; 220 000 people a 12.3% in 1995 to 17.2% in 2025 day. 3. In 1955, there were 12 people aged by 2025 it will be over 65 for every 100 aged under 20. 41% rural and By 1995, the old/young ratio was 59% urban. 16/100; by 2025 it will be 31/100. 4. The proportion of young people under 20 years will fall from 40% now to 32% of the total population by 2025, despite reaching 2.6 billion - an actual increase of 252 million. 5. The number of people aged over 65 will rise from 390 million now to 800 million by 2025 - reaching 10% of the total population. 6. By 2025, increases of up to 300% of the older population are expected in many developing countries, especially in Latin America and Asia. 7. Globally, the population of children under 5 will grow by just 0.25% annually between 1995-2025, while the population over 65 years will grow by 2.6%. 8. The average number of babies per woman of child-bearing age was 5.0 in 1955, falling to 2.9 in 1995 and reaching 2.3 in 2025. While only 3 countries were below the population replacement level of 2.1  babies in 1955, there will be 102 such countries by 2025. Life expectancy  Average life expectancy at birth in 1955 was just 48 years; in 1995 it was 65 years; in 2025 it will reach 73 years.  By the year 2025, it is expected that no country will have a life expectancy of less than 50 years.  More than 50 million people live today in countries with a life expectancy of less than 45 years.  Over 5 billion people in 120 countries today have life expectancy of more than 60 years.  About 300 million people live in 16 countries where life expectancy actually decreased between 1975-1995.  Many thousands of people born this year will live through the 21st century and see the advent of the 22nd century. For example, while there were only 200 centenarians in France in 1950, by the year 2050, the number is projected to reach 150 000 - a 750-fold increase in 100 years. Age Structure of Deaths  In 1955, 40% of all deaths were among children under 5 years, 10% were in 5–19-year-olds, 28% were among adults aged 20-64, and 21% were among the over-65s.  In 1995, only 21% of all deaths were among the under-5s, 7% among those 5-19, 29% among those 20-64, and 43% among the over-65s.  By 2025, 8% of all deaths will be in the under-5s, 3% among 5–19-year-olds, 27% among 20-64 year-olds and 63% among the over-65s. Leading causes of Global deaths In 1997, of a global total of 52.2 million deaths  17.3 million were due to infectious and parasitic diseases; ✔ acute lower respiratory infections ✔ chronic obstructive pulmonary disease ✔ tuberculosis ✔ diarrhea ✔ HIV/AIDS ✔ malaria  15.3 million were due to circulatory diseases; ✔ coronary heart disease ✔ cerebrovascular disease ✔ other heart diseases ✔ million were due to cancer; ✔ Lung ✔ Stomach ✔ Colon and rectum ✔ Liver ✔ breast  3.6 million Were due to perinatal conditions. Health of infants and small children  Spectacular progress in reducing under 5 mortality achieved in the last few decades is projected to continue. There were about 10 million such deaths in 1997 compared to 21 million in 1955.  The infant mortality rate per 1000 live births was 148 in 1955; 59 in 1995; and is projected to be 29 in 2025. The under-5 mortality rates per 1000 live births for the same years are 210, 78 and 37 respectively.  By 2025 there will still be 5 million deaths among children under five - 97% of them in the developing world, and most of them due to infectious diseases such as pneumonia and diarrhoea, combined with malnutrition.  There are still 24 million low-birthweight babies born every year. They are more likely to die early, and those who survive may suffer illness, stunted growth or even problems into adult life.  In 1995, 27% (168 million) of all children under 5 were underweight. Mortality rates are 5 times higher among severely underweight children than those of normal weight.  About 50% of deaths among children under 5 are associated with malnutrition.  At least two million a year of the under-five deaths could be prevented by existing vaccines. Most of the rest are preventable by other means. Health of older children and adolescents  One of the biggest 21st century hazards to children will be the continuing spread of HIV/AIDS. In 1997, 590 000 children age under 15 became infected with HIV. The disease could reverse some of the major gains in child health in the last 50 years.  The transition from childhood to adulthood will be marked for many in the coming years by such potentially deadly "rites of passage" as violence, delinquency, drugs, alcohol, motor accidents and sexual hazards such as HIV and other sexually transmitted diseases. Those growing up in poor urban areas are more likelly to be most at risk.  The number of young women aged 15-19 will increase from 251 million in 1995 to 307 million in 2025.  In 1995, young women aged 15-19 gave birth to 17 million babies. Because of population increase, that number is expected to drop only to 16 million in 2025. Pregnancy and childbirth in adolescence pose higher risks for both mother and child. Health of adults  Infectious diseases will still dominate in developing countries. As the economies of these countries grow, noncommunicable diseases will become more prevalent. This will be due largely to the adoption of "western" lifestyles and their accompanying risk factors - smoking, high-fat diet, obesity and lack of exercise.  In developed countries, non-communicable diseases will remain dominant. Heart disease and stroke have declined as causes of death in recent decades, while death rates from some cancers have risen.  About 1.8 million adults died of AIDS in 1997 and the annual death toll is likely to continue to rise for some years.  Diabetes cases in adults will more than double globally from 143 million in 1997 to 300 million by 2025 largely because of dietary and other lifestyle factors.  Cancer will remain one of the leading causes of death worldwide. Only one-third of all cancers can be cured by earlier detection combined with effective treatment.  By 2025 the risk of cancer will continue to increase in developing countries, with stable if not declining rates in industrialized countries.  Cases and deaths of lung cancer and colorectal cancer will increase, largely due to smoking and unhealthy diet respectively. Lung cancer deaths among women will rise in virtually all industrialized countries, but stomach cancer will become less common generally, mainly because of improved food conservation, dietary changes and declining related infection.  Cervical cancer is expected to decrease further in industrialized countries due to screening. The incidence is almost four times greater in the developing world. The possible advent of a vaccine would greatly benefit both the developed and developing countries.  Liver cancer will decrease because of the results of current and future immunization against the hepatitis B virus in many countries.  In general, more than 15 million adults aged 20-64 are dying every year. Most of these deaths are premature and preventable.  Among the premature deaths are those of 585 000 young women who die each year in pregnancy or childbirth. Most of these deaths are preventable. Where women have many pregnancies the risk of related death over the course of a lifetime is compounded. While the risk in Europe is just one in 1 400, in Asia it is one in 65, and in Africa, one in 16.  Health of older people  Cancer and heart disease are more related to the 70-75 age group than any other; people over 75 become more prone to impairments of hearing, vision, mobility and mental function.  Over 80% of circulatory disease deaths occur in people over 65. Worldwide, circulatory disease is the leading cause of death and disability in people over 65 years.  Data from France and the United States show breast cancer on average deprives women of at least 10 years of life expectancy, while prostate cancer reduces male average life expectancy by only one year.  The risk of developing dementia rises steeply with age in people over 60 years. Women are more likely to suffer than men because of their greater longevity. CASELET: As a nurse, you have been assigned to a community health clinic in a rural village. The community is composed of close-knit families that are deeply rooted in their culture, values, and practices. It is your task as a community health nurse to provide culturally sensitive care and address the global and national health situations affecting individuals and families. ACTIVITY: 1. Discuss how you would uphold nursing core values while navigating the unique cultural beliefs and practices of this particular community. 2. Outline the strategies you would employ to promote health awareness and education while addressing the current global and national health challenges. ANSWER 1. Keeping the Core Values of Nursing: - Dignity and Autonomy Respect: Acquaint yourself with the cultural beliefs of the community and show respect for them while enabling patients to make informed decisions about their treatment. - Empathy and Compassion: Foster a culture of mutual respect and understanding by supporting local customs and practices. This will help to establish a foundation of trust. -Integrity and Ethical Practice: Strike a balance between cultural customs and moral medical principles, facing disagreements head-on and resolving them in a civil manner. - Dedication to Excellence: Stay up to date on the customs and culture of the community and modify your care to suit their needs while upholding the highest standards of professionalism. 2. Strategies for Promoting Health Awareness and Education: - Involve Community Leaders: To successfully spread health messages and win over the community, collaborate with local leaders. - Provide Relevant Materials: Produce health education materials in formats that are acceptable for the local language and culture. - Host Workshops: Plan interactive talks on significant health issues while taking into account regional customs and traditions. - Address Global challenges Locally: Describe how the village is impacted by national and international health challenges and provide helpful guidance. - Gather Feedback: Seek community feedback on health education initiatives on a regular basis and make any adjustments to strategy. CHECK FOR UNDERSTANDING (20 minutes) You will answer and rationalize this by yourself. This will be recorded as your quiz. One (1) point will be given to correct answer and another one (1) point for the correct ratio. Superimpositions or erasures in you answer/ratio is not allowed. You are given 20 minutes for this activity: Multiple Choice 1. Filipino nurses are very religious people, there is a deep faith in God that is reflected in the expression of “bahala na” (it is up to God or leave it to God”.) Which cultural attitude still exist at present the” bahala” system. A. Incorrectly equated with an expression of fatalism and a passive acceptance of or resignation to fate. B. May also apply to acceptance of illness or malady. C. Operates psychologically to elevate one’s courage and conviction to persist in the face of adversity and improve D. All of the above ANSWER: ____D____ RATIO: This is sometimes mistakenly understood to be a manifestation of fatalism and a passive surrender to destiny. Bahala na can also refer to accepting a disease or condition. While bahala na is a sign of accepting one's own limitations and the way of things, it also has a psychological effect of boosting one's bravery and conviction to persevere in the face of hardship and change one's circumstances (Okamura & Agbayani, 1991). 2. An American nurse tries to speak with a Korean client who cannot understand the English language. To effectively communicate to a client with a different language, which of the following should the nurse implement? A. Have an interpreter to translate. B. Speak slowly. C. Speak loudly and closely to the client. D. Speak to the client and family together. ANSWER: ___A_____ RATIO: The best way to communicate with a customer who doesn't comprehend what is being said is to use an interpreter. An interpreter can guarantee that the client's queries and concerns are appropriately understood and taken care of in addition to accurately communicating medical facts. Speaking too softly, too loudly, or too near may not break down the language barrier and instead cause miscommunication or annoyance. If the client's family does not speak English, talking to them alone could not resolve the language barrier. An interpreter offers the linguistic proficiency required to close the communication gap. 3. A nurse is caring for a Chinese client who is hospitalized due to pneumonia. Based on their culture, which of the following is believed to be the cause of the illness? A. An illness is cast by an enemy. B. An illness is a result of punishment for sins. C. An illness may be attributed to overexertion. D. An illness may be given by someone who did not want it. ANSWER: ___C_____ RATIO: In traditional Chinese culture, external causes like stress, exposure to the environment, or overexertion are commonly blamed for illnesses like pneumonia, as well as imbalances in the body's "qi" (energy). It is thought that sickness might result from the body's defenses being weakened by prolonged physical or mental stress. While some cultures may explain sickness away as spiritual or external factors, the idea that health is impacted by overexertion is consistent with traditional Chinese medical knowledge. As a result, option C captures a typical Chinese cultural perspective on health and sickness. 4. Which of the following food items would be appropriate for a Seventh Day Adventist to be followed? A. Shrimp and mussels. B. Beef and pork. C. Tuna and salmon. D. Cheese and milk. ANSWER: ___C_____ RATIO: For religious and health-related reasons, Seventh-Day Adventists often consume a vegetarian diet and abstain from certain meats, such as pig and shellfish. However, if fish satisfies biblical dietary requirements and is deemed clean, some Seventh-Day Adventists may eat seafood. Salmon and tuna are suitable options for someone adhering to the Seventh-Day Adventist diet as they meet these criteria. Due to dietary limitations, Seventh-Day Adventists often avoid the foods listed in options A, B, and D. 5. When assessing a patient from a different culture, what is the most important area to consider? A. Religious beliefs B. Language spoken C. Health Practices D. Social Organizations ANSWER: ___B_____ RATIO: The language spoken is the most important factor to take into account when evaluating a patient from a foreign culture since good communication is essential to giving the patient correct and appropriate care. Comprehending the patient and effectively communicating with them are crucial for determining their healthcare requirements, elucidating proposed treatments, and guaranteeing informed consent. In order to provide patients with effective and courteous treatment, language is the main obstacle that has to be overcome, even though social groups, health practices, and religious convictions are all significant components of cultural evaluation. 6. Identification of health risk in the community is a step-in formulating community health diagnosis. Which of the following methods should be done by the public nurse to best facilitate the identification of health risk threatening this community? A. Review vital statistics available B. Study health center records and reports C. Assess community health resources and industries available D. Familiarize with prevalent lifestyle of the people within the community ANSWER: __D______ RATIO: It is essential to comprehend the common lifestyle of a community in order to detect health hazards in that area. Assessing their daily routines, food, level of physical activity, and other lifestyle elements that may have an impact on health outcomes is part of this. Acquainting yourself with these facets will enable you to recognize community-specific risk factors and modify health treatments appropriately. Vital data, health center records, and resource assessments are valuable, but they offer a broad picture and could miss certain lifestyle-related hazards that are particular to the customs and culture of the community. 7. You are the new public health nurse. To obtain 100% population count of the community, you should need to do a: A. One to one interview B. Survey C. Sampling of the population D. Census ANSWER: __D____ RATIO: The process of getting a precise and comprehensive count of every person living in a community is called a census. To ensure a 100% count, it entails gathering data from every member of the population. Although surveys and sampling are helpful in obtaining information from a portion of the population, they cannot give an accurate count. Even if they are thorough, one-on-one interviews are impractical for getting a complete population census. 8. In order to raise people’s awareness on cancer prevention, the following danger signs of cancer need to be disseminated. A. Unexplained anemia and weight loss B. All these groups C. Indigestion and nagging cough D. Change in normal bowel habits and unusual bleeding or discharge ANSWER: ____B____ RATIO: Increasing public knowledge of cancer prevention entails educating people about the many warning indicators of cancer, such as: -Loss of weight and unexplained anemia may be signs of cancer or internal hemorrhage. A persistent cough and indigestion might be signs of an underlying malignancy, such as one that affects the lungs or digestive system. -Unusual bleeding or discharge together with changes in regular bowel habits: These signs and symptoms may point to malignancies of the reproductive or digestive systems. -For the purpose of early cancer detection, each of these indicators is significant. Consequently, the most thorough strategy is to incorporate each of these symptom categories into awareness campaigns so that the public is educated. 9. In the year 1995, 27% of all children under 5 were underweight and about 50% of deaths among children under 5 are associated with: A. Malnutrition B. Diarrhea C. Denque D. Malaria ANSWER: ____A____ RATIO: A major contributing cause to the high death rate among children under five in 1995 was malnutrition. Numerous additional health problems, such as an increased vulnerability to infections, malaria, and diarrhea, are frequently the result of malnutrition. Malnutrition is a major factor that exacerbates diarrhea, dengue fever, and malaria, which are all serious health issues that lead to high rates of death in young children. 10. What government agency is responsible to undertake initiatives in health care services through innovative approaches? A. Department of Science and Technology B. Department of Local Government C. Department of Health D. Department of Education ANSWER: _____C___ RATIO: In many nations, the Department of Health (DOH) is the government organization in charge of managing and carrying out health care programs and services. This entails creating and supporting cutting-edge strategies to manage health initiatives, enhance public health, and handle medical emergencies. The DOH has a major concentration on health care services, unlike the Department of Science and Technology, the Department of Local Government, which oversees local government activities, and the Department of Education, which addresses educational matters. RATIONALIZATION ACTIVITY (THIS WILL BE DONE DURING THE FACE TO FACE INTERACTION) The instructor will now rationalize the answers to the students. You can now ask questions and debate among yourselves. Write the correct answer and correct/additional ratio in the space provided. 1. ANSWER: ________ RATIO:_______________________________________________________________________________________ _____________________________________________________________________________________________ _____________________________________________________________________ 2. ANSWER: ________ RATIO:_______________________________________________________________________________________ _____________________________________________________________________________________________ _____________________________________________________________________ 3. ANSWER: ________ RATIO:_______________________________________________________________________________________ _____________________________________________________________________________________________ _____________________________________________________________________ 4. ANSWER: ________ RATIO:_______________________________________________________________________________________ _____________________________________________________________________________________________ _____________________________________________________________________ 5. ANSWER: ________ RATIO:_______________________________________________________________________________________ _____________________________________________________________________________________________ _____________________________________________________________________ 6. ANSWER: ________ RATIO:_______________________________________________________________________________________ _____________________________________________________________________________________________ _____________________________________________________________________ 7. ANSWER: ________ RATIO:_______________________________________________________________________________________ _____________________________________________________________________________________________ _____________________________________________________________________ 8. ANSWER: ________ RATIO:_______________________________________________________________________________________ _____________________________________________________________________________________________ _____________________________________________________________________ 9. ANSWER: ________ RATIO:_______________________________________________________________________________________ _____________________________________________________________________________________________ _____________________________________________________________________ 10. ANSWER: ________ RATIO:_______________________________________________________________________________________ _____________________________________________________________________________________________ _____________________________________________________________________ LESSON WRAP-UP (5 minutes) Teacher directs the student to mark (encircle) their place in the work tracker which is simply a visual to help students track how much work they have accomplished and how much work there is left to do. This tracker will be part of the student activity sheet. You are done with the session! Let’s track your progress. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 AL Activity: CAT: 3-2-1 Instructions: 1. As an exit ticket at the end of the class period 2. Record three things you learned from the lesson. 3. Next, two things that you found interesting and that you’d like to learn more about. 4. Then, record one question you still have about the lesson. Three things you learned: 1. __________________________________________________________________________________ 2. __________________________________________________________________________________ 3. __________________________________________________________________________________ Two things that you’d like to learn more about: 1. __________________________________________________________________________________ 2. __________________________________________________________________________________ One question you still have: 1.___________________________________________________________________________________