Community Health Nursing Lecture Notes PDF

1 | NCM 113n LECTURE- PRELIM Rizza G. Francisco, RN, MN DEFINITION OF COMMUNITY Educator HEALTH NURSING  Provides essential health education to individuals, families, and  Combines pr...

1 | NCM 113n LECTURE- PRELIM Rizza G. Francisco, RN, MN DEFINITION OF COMMUNITY Educator HEALTH NURSING  Provides essential health education to individuals, families, and  Combines primary healthcare with communities nursing practice  Involves teaching about disease  Promotion and Protection of the prevention, health promotion, and health of the community healthy lifestyle choices through  Deals with health promotion, workshops, counseling sessions, Disease prevention, and health and community programs maintenance within the context of a  Tailors educational materials and community methods to meet the cultural and  As a specialty field of nursing literacy needs of the community,  Focuses on the health individuals, ensuring that healh messages are families, groups and entire accessible and effective. populations in the community  Education is a cornerstone of CHN  Involves the assessment, planning, practice as it empowers communities implementation, and evaluation of to take control of their health. health strategies aimed at promoting and protecting the health of Provider of Care communities  Delivers direct nursing care to  Works towards the prevention of individuals and groups within the disease and the maintenance of community health across the lifespan  Includes clinical services, such as  Considers the impact of social, immunizations, wound care, and environmental, and economic factors health screenings on population health.  More comprehensive care management for chronic diseases Roles and Responsibilities  Provides care in non-traditional  Health advocate settings , such as community  Educator centers, schools, and homes  Provider of care  Ensures that care is accessible to  Researcher those who need it most  Integral to maintaining and improving Health Advocate the health of the community.  Represents the needs and concerns of the community, especially Researcher vulnerable and underserved  Systematical gathering of data, populations analyzing health trends, and  Involves identifying barriers to conducting research to improve health, such as lack of access, community health outcomes community mobilization, and direct  May include participating in intervention epidemiological studies, evaluating  Also includes empowering the effectiveness of community individuals and communities to make health programs, and contributing to informed health decisions, thereby the evidence base for best practices promoting health equity and social in public health nursing justice.  Integrates research into practice Ms. A୨ৎ 2 | NCM 113n LECTURE- PRELIM Rizza G. Francisco, RN, MN  CHNs help to develop innovative within and between communities, solutions to health challenges and often influenced by factors such as ensure that interventions are socioeconomic statues, race, and grounded in scientific evidence geographic location  Advocating for vulnerable Collaboration and Interdisciplinary populations Approach  Ensuring access to necessary health services Partnership with other sectors  Designing interventions that target  Partnerships with various sectors – the root causes of inequities, such as education, social services, local poverty, education, and access to government, and non-government healthcare organizations (NGOs) to address the broad determinants of health Health Policy and Advocacy  Leverage resources, expertise, and  Central to the role of CHNs influence to design and implement  Advocates for policies that address comprehensive health programs that social determinants of health, address the diverse needs of the improve access to care, and ensure community health equity  Essential for creating sustainable  Lobbying for changes in local or health interventions that go beyond national health policies the healthcare system  Participating in public health  Include elements such as housing, campaigns education, and economic  Working with policymakers to design development, which all impact and implement health programs community health.  Can help shape the healthcare environment to better meet the Interdisciplinary Approach needs of their communities  Collaboration among healthcare professionals from various Global and Local Perspectives disciplines, including medicine,  Global health perspectives – social work, public health, nutrition, understanding international health and environmental health trends, challenges such as  Ensures that complex health issues pandemics, and the impact of global are addressed comprehensively, policies on local health considering the multifaceted nature  Local perspectives – focus on the of health determinants specific health needs, cultural  To develop and implement health context, and resources of a interventions that are holistic, community covering physical, social, and  Design interventions that are locally emotional aspects of health relevant while also being informed by  Enhances the quality of care and global best practices and standards outcomes by incorporating diverse perspectives and expertise Addressing Health Inequities  Health inequities – unfair, avoidable differences in health status seen Ms. A୨ৎ 3 | NCM 113n LECTURE- PRELIM Rizza G. Francisco, RN, MN KEY ASPECTS OF CHN PRACTICE Epidemiological Approach  To study the distribution an HOLISTIC APPROACH determinants of health-related states or events in specific populations Comprehensive Care  To identify risk factors for disease,  Considers the physical, emotional, track health trends, and develop social, economic, and environment targeted interventions to prevent factors that affect a person’s health illness and promote health  Involves addressing the multiple needs of individuals and populations, HEALTH PROMOTION AND DISEASE rather than focusing solely on PREVENTION treating specific illnesses or conditions Educational Programs  Development and delivery of Preventive Care educational programs  A fundamental component of CHN  To increase awareness about health  Involves proactive measures issues, encourage healthy  To prevent illness and promote behaviors, and empower health communities to take control of their  Immunizations, health education, health. and early detection screenings  Delivered through workshops,  Prevent health problems before they seminars, and community outreach arise Screening and Vaccination COMMUNITY – BASED SETTINGS  Involves screening and vaccination programs Accessibility  Help detect health issues early and  Accessible to all members of the prevent the spread of infectious community diseases  Those who might face barriers to  Organize and administer these accessing traditional healthcare programs to protect the health of the settings, such as hospitals or clinics community  Critical for promoting equity in healthcare COMMUNITY ASSESSMENT AND POPULATION HEALTH FOCUS PLANNING Health of the Population Needs Assessment  Focus on improving the health of  Systematically collecting data to entire populations, rather than just understand the health needs and individual patients resources of a community  Involves assessing and addressing  To identify health priorities, gaps in the health needs of specific groups – services, and areas for improvement children, the elderly, or underserved  The first step in the community communities health planning process  The best possible health outcomes  Based on the needs assessment for the community as a whole Ms. A୨ৎ 4 | NCM 113n LECTURE- PRELIM Rizza G. Francisco, RN, MN  Program planning to develop CULTURAL COMPETENCE strategies and interventions that address the identified health needs Respect for Diversity  Program evaluation – an ongoing  Practice cultural competence – process that measures the respecting the diverse culture effectiveness of these interventions backgrounds of the communities and informs future planning efforts they serve  Understanding cultural beliefs, ADVOCACY AND POLICY practices, and values and integrating DEVELOPMENT this understanding into healthcare delivery Health Advocacy  Tailoring health interventions to meet  Health needs of individuals and the specific cultural needs of the communities, particularly vulnerable population populations  Ensure that health services are  Involves speaking up for those who accepted and effective within may not have a voice, influencing different cultural contexts public policy, and working to create environments that support health EMPOWERMENT AND SELF-CARE Policy Influence Empowering Communities  Shaping health policies at local,  Equipping communities with the state, and national levels knowledge, skills, and resources  Participating in policy development they need to take control of their  Ensure that policies are informed by health the realities of community health  Encourages active participation in and address the needs of the health decisions and promotes self- population reliance INTERDISCIPLINARY Self-Care Education COLLABORATION  To maintain their health and manage chronic conditions Team-Based Approach  A key component of health  Include professionals from various promotion and disease prevention fields such as medicine, social work, public health and education RESEARCH AND EVIDENCE –  Ensures comprehensive care and BASED PRACTICE allows for the integration of diverse perspective in addressing community Data – Driven Approaches health issues  Use data – driven approaches  Using research findings, public Resource Integration health data, and clinical evidence to  Coordinate resources from different guide decision-making and ensure sectors and discipline to provide that interventions are based on the holistic care and address the multiple best available evidence determinants of health  Maximizes the impact of community health interventions Ms. A୨ৎ 5 | NCM 113n LECTURE- PRELIM Rizza G. Francisco, RN, MN Continuous Learning ENVIRONMENT HEALTH  Stay current with the latest research  Addresses the impact of and best practices in community environmental factors on health health  Ensures that CHNs can provide GLOBAL HEALTH PERSPECTIVES high-quality care and adapt to  Health issues that transcend national changing health needs boundaries PUBLIC HEALTH FOUNDATIONS HEALTH POLICY AND ADMINISTRATION CORE FUNCTIONS  Development and management of  Assessment public health systems  Policy Development  Assurance INTERDISCIPLINARY APPROACH  Collaboration among healthcare DETERMINANTS OF HEALTH professionals from various  Influence the health of individuals disciplines to address complex public and populations health issues PREVENTION AND HEALTH RESEARCH AND EVIDENCE – PROMOTION BASED PRACTICE  Key strategies in public health  Essential for advancing public health  Reduces the burden of disease and community health nursing  Improves quality of life EPIDEMIOLOGY THEORETICAL MODELS AND  Distribution and determinants of APPROACHES health-related events in populations HEALTH BELIEF MODEL  One of the most widely used HEALTH EQUITY AND SOCIAL frameworks JUSTICE  Susceptible to a health problem, the  Everyone has the opportunity to problem has serious consequences, attain their highest level of health taking a specific action would reduce  Focuses on the fair distribution of their susceptibility or severity, and resources and opportunities the benefits of taking the action outweigh the barriers  Components: perceived COMMUNITY ENGAGEMENT AND susceptibility, perceived severity, PARTICIPATION perceived benefits, perceived barriers, cues to action, and self-  Actively involving community efficacy members in planning, implementation, and evaluation of  To predict and explain health health programs behaviors by understanding how individuals beliefs influence decisions Ms. A୨ৎ 6 | NCM 113n LECTURE- PRELIM Rizza G. Francisco, RN, MN  Evaluation of an individual’s  To empower communities to address perceptions across the different their own health issues through self- components, which then guide the efficacy and collective action. development of interventions  Include identifying community issues, building community capacity, SOCIAL ECOLOGICAL MODEL facilitating community-led initiatives,  Interplay between individual, and evaluating outcomes. interpersonal, organizational, community, and societal factors in MILIO’S FRAMEWORK FOR influencing health behaviors PREVENTION  Concentric circles representing the different levels of influence, from  The relationship between individual individual to societal health behaviors and the availability  Understand how various levels of of health-promoting resources in the influence interact to affect health community. outcomes.  Behavior is influenced by societal  Considers the following levels: norms and resource availability individual, interpersonal,  To identify and address barriers to organizational, community, and healthy behaviors at the community policy/society level.  Assessing community resources, TRANSTHEORETICAL MODEL identifying health needs, and  stages individuals go through in implementing policy changes to making a behavior change: Pre- increase access to health-promoting contemplation, Contemplation, resources Preparation, Action, Maintenance, and Termination  Cyclical, recognizing that individuals OREM’S SELF-CARE DEFICIT can relapse and re-enter earlier NURSING THEORY stages.  Individuals can take care of  Behavior change by matching themselves to the extent of their interventions to the individual's ability, and nursing care is required current stage of change when there is a self-care deficit  Stages include Pre-contemplation,  Self-care, self-care deficit, and Contemplation, Preparation, Action, nursing systems and Maintenance.  To guide nursing interventions that support patients in meeting their self- COMMUNITY EMPOWERMENT care needs MODEL  Communities to gain control over PENDER’S HEALTH PROMOTION their health by increasing their social, MODEL political, and economic power.  How individual characteristics and  involves active community experiences influence health- participation, critical awareness, and promoting behaviors. collective action  Individual characteristics, behavior specific cognitions, and behavioral outcomes Ms. A୨ৎ 7 | NCM 113n LECTURE- PRELIM Rizza G. Francisco, RN, MN  Promote health by enhancing THE OTTAWA CHARACTER FOR individuals’ motivation to engage in HEALTH PROMOTION health promoting behaviors  For health and strategies to promote health on a global scale. LEININGER’S THEORY OF CULTURE  To guide health promotion efforts at CARE DIVERSITY AND the individual, community, and policy UNIVERSALITY levels  Importance of culturally congruent care in nursing. SYSTEMS THINKING  Understanding cultural beliefs, values, and practices to provide care  Examines the complex that is meaningful and beneficial to interrelationships within healthcare patients systems.  To address complex health issues by PUBLIC HEALTH INTERVENTION considering the broader context and MODEL interactions within the system  Framework for public health SYNDEMICS THEORY interventions that address health issues at the population level.  Interaction of multiple diseases or  Assessment, planning, health conditions that exacerbate implementation, and evaluation one another within a population phases  Co-occurring health issues and socio-environmental factors. DIFFUSION OF INNOVATIONS HEALTH IMPACT ASSESSMENT THEORY  New ideas, practices, or products  Evaluate the potential health effects spread within a society or from one of a policy, program, or project society to another before it is implemented.  To promote the adoption of health  Health considerations are innovations by understanding how incorporated into decision-making they spread within communities processes across various sectors LOGIC MODEL COMMUNITY-BASED  A planning tool used to PARTICIPATORY RESEARCH conceptualize a program’s inputs, activities, outputs, and outcomes.  Equal partnership between  Depicted as a flowchart linking researchers and community resources, activities, outputs, and members, co-creating research outcomes agendas, data collection, and dissemination Ms. A୨ৎ 8 | NCM 113n LECTURE- PRELIM Rizza G. Francisco, RN, MN ASSET-BASED COMMUNITY This action is an example of which of DEVELOPMENT the following competencies? A. Clinical skills  Empower communities by B. Policy development recognizing and utilizing their own C. Program evaluation assets to create sustainable change D. Leadership and advocacy CORE COMPETENCIES AND ROLES 6. What is a key component of effective 1. A CHNurse is conducting home visits communication for a CHNurse to manage a patient with leading a health education hypertension. Which of the following workshop? is the most critical aspect of this A. Using complex medical terms care? B. Speaking in a loud voice A. Prescribing medication C. Avoiding questions from B. Educating the patient on diet and participants exercise C. Monitoring blood pressure 7. Which of the following best regularly exemplifies inter-professional collaboration in community health 2. When providing care to a diverse nursing? population, which of the following A. Working alone to solve health best demonstrates cultural issues competence? B. Coordinating with a nutritionist A. Assuming all patients have the and social worker for a same health community plan B. Tailoring care based on C. Ignoring input from other cultural preferences professionals C. Ignoring cultural differences D. Speaking only in English 8. When developing a smoking cessation program, what should the 3. A CHNurse is organizing a CHNurse do first? vaccination campaign. What is the A. Implement the program primary goal of this activity? immediately A. Treating existing diseases B. Evaluate the program's success B. Preventing the spread of C. Ignore evidence-based infectious diseases approaches C. Promoting health equity D. Identify the target population D. Providing free healthcare 9. A CHNurse is involved in creating 4. What is the first step a CHNurse public health policies. What is their should take when conducting a primary role? community assessment? A. Writing laws A. Analyzing health outcomes B. Implementing local policies B. Gathering data on community C. Ignoring policy changes health D. Contributing expertise to C. Implementing interventions health policy creation 5. A CHNurse is advocating for free school meals in low-income areas. Ms. A୨ৎ 9 | NCM 113n LECTURE- PRELIM Rizza G. Francisco, RN, MN 10. Which of the following actions by a MEASUREMENT OF HEALTH CHNurse best demonstrates EVENTS adherence to ethical principles?  Quantification - calculating rates,  Providing care without consent ratios, and proportions to understand  Ensuring informed consent is the impact of diseases in a obtained population.  Making decisions without patient  Validity and Reliability - input measurement tools that ensure the accuracy and consistency of BASIC PRINCIPLES OF epidemiological data. EPIDEMIOLOGY EPIDEMIOLOGY EPIDEMIOLOGICAL STUDY DESIGNS  the cornerstone of public health  Descriptive Studies - time, place  distribution and determinants of and person health and diseases within  Analytical Studies - risk factors and populations causes  patterns of illness, health risks, and  Experimental Studies effectiveness health behaviors among different of interventions population groups CAUSALITY ASSESSMENT DISEASE DISTRIBUTION  Criteria for Causation - cause and-  Incidence - the number of new effect relationship (risk factor and cases of a disease that occur in a health outcome) specific period  Hypothesis Testing  Prevalence - the total number of cases, both new and existing, at a NATURAL HISTORY AND SPECTRUM particular point in time OF DISEASE  burden of disease  Patterns and Trends - distribution  Disease Progression - course from of diseases over time and across onset to resolution or chronicity different populations  Clinical vs. Sub-clinical Disease  predicting future outbreaks and for Sub-clinical disease (without visible planning public health symptoms) DETERMINANTS OF HEALTH AND SCREENING AND SURVEILLANCE DISEASE  Screening Programs - to detect  Risk Factors - increase the diseases in their early stages among likelihood of developing a disease asymptomatic populations  smoking or poor diet, are identified  Surveillance Systems - and quantified to target preventive continuously monitor health events in efforts populations  Protective Factors - decrease the EPIDEMIOLOGY AND PUBLIC risk of disease and promote health HEALTH POLICY  regular physical activity and a balanced diet  Informing Policy and Practice Ms. A୨ৎ 10 | N C M 1 1 3 n L E C T U R E - P R E L I M Rizza G. Francisco, RN, MN  Health Program Planning and GLOBAL HEALTH EPIDEMIOLOGY Evaluation  International Health Issues  Collaborative Research and Action EPIDEMIOLOGY AND HEALTH EQUITY USE OF TECHNOLOGY IN EPIDEMIOLOGY  Disparities in Health  Equity-Focused Interventions  Data Analytics and Software  Geographic Information Systems (GIS) ETHICAL CONSIDERATIONS IN EPIDEMIOLOGY LIFELONG LEARNING IN  Informed Consent and Confidentiality EPIDEMIOLOGY  Beneficence and Non-maleficence  Continuing Education  Adapting to Emerging Challenges CRITICAL EVALUATION OF EPIDEMIOLOGICAL DATA  Data Interpretation - accurate STATISTICS IN EPIDEMIOLOGY interpretation is essential for drawing Data Collection and Management valid conclusions about health trends and risk factors.  Surveys and Sampling - primary tool  Critical Appraisal - quality and for data collection in epidemiology applicability  Data Quality - free from bias, complete, accurate, and timely APPLICATION TO DISEASE Measures of Disease Frequency PREVENTION AND HEALTH PROMOTION  Incidence: number of new cases of a disease that occur in a specific  Primary Prevention: before disease period among a population at risk. occurs (vaccination, health  Prevalence: total number of existing education) (old and new) cases of a disease at  Secondary Prevention - early a particular point in time or over a detection and treatment of diseases period. to prevent progression (regular health screenings) Measures of Association  Tertiary Prevention - managing and  Relative Risk (RR): strength of the reducing the impact of chronic association between an exposure diseases (rehabilitation and ongoing and an outcome - exposed group care) and unexposed group. OUTBREAK INVESTIGATION AND  Odds Ratio (OR): compares the RESPONSE odds of exposure in cases to the odds of exposure in controls  Identifying Outbreaks unusual patterns or clusters of health events Statistical Testing  Containment Strategies - to control  Hypothesis Testing: testing an and prevent the spread assumption P-values and Confidence Intervals: Ms. A୨ৎ 11 | N C M 1 1 3 n L E C T U R E - P R E L I M Rizza G. Francisco, RN, MN  P-values the probability of observing  identify patterns, trends, and the data if the null hypothesis is true; anomalies Confidence intervals - a range of  a rising incidence of lifestyle related values within which the parameter is diseases in urban areas expected to lie with a certain level of  crucial for early intervention and confidence resource allocation Analysis of Epidemiological Data Program Planning and Evaluation  Descriptive Analysis: mean, median, mode, and standard deviation.  to determine the health needs of a  Analytical Analysis: examine community relationships between variables,  measuring outcomes against set such as regression analysis. objectives to determine their impact Modeling and Predictive Analysis Policy Development and Advocacy  Regression Analysis: relationship between a dependent variable and  ensures that interventions are independent variables; linear and targeted and effective logistic regression.  helps determine their effectiveness  Predictive Models: to predict future in achieving public health goals outcomes based on current and historical data Resource Allocation Evaluating Causality  allocating resources to areas with  Bradford Hill Criteria: strength, the greatest need consistency, specificity, temporality,  helps determine the best use of biological gradient, plausibility, limited resources by comparing the coherence, experiment, and analogy costs and benefits of different health  Controlling for Confounding: a third interventions variable influences both the exposure and the outcome Disease Prevention and Health Screening and Diagnostic Test Promotion Evaluation  Risk Assessment  Sensitivity and Specificity  Educating communities about health  Predictive Values risks Survival Analysis Epidemiological Research  Life Tables  Kaplan-Meier Analysis  Study Design and Analysis  Causality Determination APPLICATION IN COMMUNITY SETTING Screening and Early Detection  effectiveness of screening programs Health Assessment and Surveillance  Determining Screening Thresholds Ms. A୨ৎ 12 | N C M 1 1 3 n L E C T U R E - P R E L I M Rizza G. Francisco, RN, MN  Health policy and planning  Community engagement and feedback Community Engagement and  Ethical and privacy considerations Education  presenting health data in an COMMUNITY HEALTH ASSESSMENT accessible format  using infographics Data Collection  providing communities with the  Quantitative Data - disease information they need to make prevalence, mortality rates, informed health decisions vaccination coverage, or the number of healthcare facilities; Surveys, Health Records Health Disparity Analysis  Qualitative Data - FGDs; In-depth Interviews  To identify disparities helps target interventions where they are most Health Needs Identification needed.  analyzing the collected data to  To address specific disparities that determine the most pressing health they are effective and respectful of issues in the community local traditions  Trend Analysis  Community Prioritization Quality Improvement Resource Assessment  Performance Measurement  availability, accessibility, and  Benchmarking adequacy of resources  Resource Mapping Collaborative Research and  Capacity Assessment Partnerships Community Engagement  combining data from different sectors  involving community members in the to understand health issues assessment, planning, and  public-private partnerships implementation of health interventions  Community Forums SURVEILLANCE AND MONITORING  Partnerships with Local OF COMMUNITY HEALTH Organizations  Continuous Data Collection Health Profile Development  Disease surveillance  Compiling all the collected data and  Risk factors surveillance insights into a comprehensive  Use of technology and data systems document  Community health assessment  Provides a clear picture of the  Epidemiological investigations community’s health status, needs,  Public health reporting and and available resources. notification  Data Synthesis  Evaluation of public health  Report Writing interventions Ms. A୨ৎ