411 Exam 2 Objectives

cdunbar4's version from 2017-05-20 00:28

Chapters 15-17

Question Answer
How is community defined? (p394)open social system characterized by ppl in a place who have common goals over time. Includes a place and groups or aggregates.
How are groups & aggregates considered different types of populations? (p10 & p394) ???both "population group" & "aggregate" are synonyms for population. An aggregate are any number of individuals who shares at least 1 common characteristic
Factors to consider in assessing the health of a community. p401 Box 15-41. Boundaries or parameters (people, place, social interaction)
2. Goals via sources of data (geopolitical & phenomenological)
3. Physical (demographics, physical features that influence behavior of comm.) & Psychosocial (SES, religion) characteristics
4. ID suprasystem
5. ID which external influences are resources or demands
6. Internal Functions (ID resources & demands w/in community that influence health)
Identify sources of data regarding communities p408Personal observation; local sources (library, newspaper); key informants; focus groups; published community surveys; national census data
How does a community/PHN achieve assessment of communities? 412-413interviews, meetings, assessments via different approaches (comprehensive needs approach; problem-oriented; familiarization; single pop.).
How does a community/PHN analyze the assessment data of communities?By considering community assets, major problems, major health-related problems, current and proposed community action for problem resolution, and the community's pattern of action involving past problems.
Principles that assist a nurse in developing an effective plan. (p. 432 Steps of Planning)1. Assessment 2. Diagnosis 3. Validation 4. Prioritization of needs 5. Identification of the target population 6. Identification of the planning group 7. Establishment of the program goal 8. Identification of possible solutions 9. Matching solutions with at-risk aggregates 10. Identification of resources 11. Selection of the best intervention strategy 12. Delineation of expected outcomes 13. Delineation of the intervention work plan 14. Planning for program evaluation
Examples of community nursing diagnoses p 434Impaired home maintenance and impaired social interaction
How are priorities determine in health planning with communities? p435Based on seriousness of problem, desires/concerns of community time, cost & availability of resources
Target population p435the group or aggregate in which change is desired as a result of a program or intervention
Common types of interventions typically planned by community/public health nurses p441Health ed. programs
Screening programs
establishing services
policy setting & implementation
increasing community self-help & competence
increasing power among disenfranchised individuals
Strategies for implementation plans p443Single action (plans implemented only 1 time for a specific purpose)
Phasing (over a period of time, large programs with lots of resources)
Collaboration of networks
Coalitions (temporary union for a common purpose)
Steps in Evaluation p. 450-51(Two parts: measurement & interpretation) 1. Plan evaluation 2. Collect Evaluation Data 3. Analyze Data 4. Report Evaluation 5. Implement Results
Questions that can be answered by evaluation p452 Tbl 17-1Outcome attainment: Did change occur?
Appropriateness: What intended outcomes occurred?
Adequacy: Were some people not served?
Efficiency/Cost-effectiveness: What resources were used?
Benefit-cost analysis process: Do the benefits justify the use of resources? How many people were reached?
Outcomes that are indicators of the effectiveness of nursing interventions within communitiesKnowledge; behaviors, skills; emotional well-being; health status; presence of health care system services & components; satisfaction or acceptance regarding program interventions; presence of policy; altered rel. with physical env't.
Compare evaluation of nursing care with communities with the evaluation of care with families & individuals p459?Each human in a community has their own needs, desires & self-expression. Social interaction with multiple humans is complex & must continuously be evaluated & revised since population changes in numbers, health status health risks, health needs, assets and interests.
How is evaluation used to modify nursing care with communities? p459 ??Community/PHN occurs w/in a physical, political, economic, cultural & social contexts and a change in any one of these results in changes in all other aspects of the community system. FORMATIVE evaluation helps modify ALL steps of the nursing process.

Chapter 20

Question Answer
Describe three domains of learningcognitive (intellectual), psychomotor (motor skills), and affective (attitudes & emotions). *All three are usually necessary to incorporate a new health behavior into the learner's life.
Steps and principles that guide community health education p521Physical environment: convenient location, size of room, chairs, equipment, lighting, temperature
Educational env't: communications & rapport, support, participation, clarifying, sharing; diversity; experience, valuing of life's knowledge, personalization
Models that help explain health-related behaviorsHealth-belief model; health promotion model; primary health care model.
How does group purpose, member interaction, cohesion, conflict & leadership affect group effectiveness??? (could not find this in chapter 20, need to look in Arnold & Boggs)
Describe how nurses can work with groups to promote the health of individuals & communities? p510PHN frequently implements education programs for groups of learners. Nurse must assessment learner's readiness beforehand and construct health education lesson plans.
Main steps of the educational processcreate behavioral objectives (cognitive, psychomotor, affective) deciding what content/activities will get the learner to the desired outcome and then evaluate the outcome.
Select content catered to what the target group of learners are, what they need to know and any constraints involved.
select teaching strategies suitable to size, composition, learning abilities of group
select evaluation strategies both outcome evaluation and teacher evaluation.
Why is it so important to evaluate the educational product? p514Not only is it required for community/PHN's to adhere to via ANA Scope and Standard's but it also leads to the development of new data for community planning.
Difference b/t promoting health and preventing illness (from my brain)promoting health such as primary prevention includes awareness measures and education. Preventing illness might be secondary or tertiary measures to prevent further disease or harm.
Responsibilities of PHN in health promotion and prevention of illness in communities(1) identification of unmet needs; (2) advocacy and referral to ensure access to health and social services; (3) teaching, especially for health promotion and prevention; (4) screening and case finding; (5) environmental management; (6) collaboration and coordination; and (7) political action to advocate for adequate standards of living and health care services and resources.
Patient education vs. health educationpatient ed. is normally used to describe a series of planned teaching-learning activities designed for individuals, families or groups who have identified alteration in health. Nurse uses systematic approach catered to learning needs of patient & implements plan for changed behavior.
Health education focuses on health promotion & disease prevention.
Difference is that health education is directed toward individuals or populations who are NOT experiencing an acute alteration in health.
How does a PHN identify health education needs?Four classifications; a real need (based on a deficiency that actually exists); an educational need (one that can be met by an educational experience); a real educational need (specific skills, knowledge); a felt need (important to learner)
What kind of impact does the community env't and culture have on learning needs?cultural barriers such as language or physical barriers such as hearing or learning problems, background noise, good lighting, appropriate seating.
Identify teaching strategies the nurse should use with the identified target group for educationLecture with a presentation; use examples; discussion (affective domain); role modeling; positive reinforcement; demonstration and guided practice; simulation; support groups (good for behavioral change; contracting; stress-reduction exercises; computer-assisted instruction; and team teaching.
How does the nurse determine what kind of educational aids (print, audiovisual, internet materials) should be used for learners?assess healthy literacy for appropriate readability level. Content: should be accurate, up to date, organized with resources for more info.; Format: type & size (need to be bigger font with easy print?); Printed materials: select materials appropriate for diverse ethnic & cultural groups
Explain how nurse knows whether the teaching strategies have been effectiveFeedback form from learners.
Identify the community resources available to enhance health education (where would you find the materials that you can recommend to your learners?)the nurse's own agency; distributors of educational materials; catalogues; community agencies; phone book; internet; library.

Terms at the beginning of each chapter

Question Answer
Asset models of community assessmentstress the positive abilities and capacities of communities to identify their own health problems and plan solutions
Census tracta type of human-made boundary (map) for the purpose of reporting demographic data
Communityan open social system that is characterized by people in a place who have common goals over time. The term is applicable to a variety of situationsCommunity capacity
Community competence is based on 8 variablescommitment, self and other awareness and clarity of situation definitions, articulateness, communication, conflict containment and accommodation, participation, management of relations with the larger society,
Community resiliencythe ability of a community to use its assets and resources to adapt to adversity and improve its capacity
Geopolitical communityspatial designation—a geographical or geopolitical area or place.
Groupconsists of two or more people engaged in an interdependent relationship that includes repeated face-to-face communication.
Healthy community (according to Jean Watson)a holistic community, one which is able to integrate social and personal resources and capacities to attain or maintain health for its members
Phenomenological communitythe members' feeling of belong- ing or sense of membership, rather than geographical or political boundaries. Relational rather than a spatial designation.
Populationcollection of individuals who share one or more personal or environmental characteristics, the most common of which is geographical location
Population “at risk”vulnerable aggregates & risky behavior. Groups may exist within a geopolitical community who do not have a disease or a condition but do have personal or social conditions that make their ability to deal with disease or disability less.
Target populationpopulation involved in which change is desired
Formative evaluationongoing data is collected; occurs through- out the nursing process but before evaluation of the out- comes of care
Outcome measuresevaluation of outcomes
Summative evaluationinvolves measurement of community responses to nursing care and interpretation of the degree to which planned goals were met
andragogyteaching-learning style of adults
pedragogyteaching-learning style of children
behavioral objectivesare statements of what the learner achieves, not statements of the teacher's activities.

Highlights from lecture handout