Week 2:

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Week 2

• Community Health Nursing
• Role Dimensions

2
Defining Community Health Nursing

• ANA (1986) Standards of Community Health Nursing
• promotes and preserves the health of populations
  by integrating knowledge of nursing and public
  health. The practice is comprehensive and
  general, not limited to age or group. It is
  continual not episodic and the dominant
  responsibility is to the population as a whole...

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Attributes of CH Nursing

• Making it a unique field of practice
• Health Orientation
• Population Focus
• Autonomy
• Continuity Intimacy
• Collaboration
• Interactivity
• Accountability
• Variability

4
Roles and Functions

• Roles can be categorized on basis of their
  orientation
• client oriented
• involves direct provision of client services
• caregiver
• educator
• counselor
• referral resource
• role model
• advocate
• primary care provider

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Roles and Functions

• Delivery-oriented roles
• designed to enhance the operation of the health
  care system
• co-ordinator
• collaborator
• liaison

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Roles and Functions

• Population Oriented roles
• roles that are exclusively group oriented
• case finder
• leader
• change agent
• community care agent
• researcher

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Health Education Role

• The purpose of health education is to assist
  clients in making appropriate health-related
  decisions
• about personal health behaviors
• about use of available health resources
• about societal health issues

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General Principles of Learning

• The Learner
• learns best what is perceived to be most relevant
• motivation enhances learning
• people learn in different ways

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General Principles of Learning

• Learning situation
• The context of the learning situation influences
  the learning

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General Principles of Learning

• Presentation of Content to enhance learning
• relevance of content
• individualization of presentation
• multiple modes of presenting
• focusing learners attention participation
• content presented first is learned
• logical organization
• simple to complex
• associate new content with previous

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General Principles of Learning

• Reinforcement and retention
• repetition enhances learning
• positive reinforcement is most effective
• prompt and accurate feedback
• recency of learning influences retention
• application of information in several contexts

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Assessing the Learner

• Identify the target audience based on
• level of need
• resources available
• probability of success

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Assessing the Learner

• What characteristics of the learners influence
  the learning situation?
• Biophysical Dimension
• What is the age of the learners?
• What learning needs arise from the age and
  developmental level of learners?
• How will developmental level affect the ability
  to learn?
• How does it affect teaching strategies and
  methods?

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Assessing the Learner

• What characteristics of the learners influence
  the learning situation?
• Psychological Dimension
• Is the learner aware of need for education?
• What is learners motivation?
• What will motivate the learner?
• Do learners attitudes enhance or detract from
  learning?
• Will stress or anxiety interfere with learning?

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Assessing the Learner

• What characteristics of the learners influence
  the learning situation?
• Social Dimension
• How do peers influence the situation?
• What is education level of learners?
• How does this influence teaching strategies and
  content?
• What is primary language?
• What are cultural beliefs that may influence?
• What facets of social situation influence
  process?

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Assessing the Learner

• What characteristics of the learners influence
  the learning situation?
• Behavioral Dimension
• What health behaviors create need for education?
• Dietary practices
• sexual activity
• rest/exercise

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Assessing the Learner

• What characteristics of the learners influence
  the learning situation?
• Health System Dimension
• Do health care recommendations give a rise to the
  need for education
• Does learner need help with use of services
• Do elements of care regimen influence learning
• Does learner attitude to health services
  influence ability to learn

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Diagnostic Reasoning

• How will you analyze data?
• Look at it with a multifaceted lens
• client quality of life, problems, priorities
• epidemiologic perspective
• predisposing, reinforcing and enabling factors
• resources availability and capability for health
  education

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Planning Health Education

• Establish priorities
• Consider client behaviors and relative effects
• What benefits will be achieved by change
• What is the ease with which specific behaviors
  can be changed?

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Planning Health Education

• Identify goals
• What is broad purpose of lesson?
• What is the level of prevention to be addressed?
• Primary Prevention
• Secondary Prevention
• Tertiary Prevention

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Primary Prevention

• Designed to promote the health of the population
  and prevent specific illnesses. It involves
  education programs of any kind designed to
  promote overall health
• parenting classes
• immunization
• exercuse program for elderly

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Secondary Prevention

• Identifying and resolving existing health
  problems in members of a community or target
  group
• screening programs or the preliminary examination
  or testing of a person to determine whether has
  the condition or needs further testing
• mass immunization during an epidemic

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Tertiary Prevention

• Designed to prevent complications of identified
  problems or prevent recurrence or consequences of
  a problem
• program to maintain immunity levels after
  epidemic is under control

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Planning

• Learning objectives
• statements of specific behaviors
• process and outcome objectives
• both nurse and client are actors
• process- what nurse will do
• outcome-what client will do

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Planning

• Outcome objectives
• Classified according to learning domain and in
  hierarchy
• cognitive - intellectual skills
• affective- attitudes and values
• psychomotor- physical manipulative skills
• perceptual- learning to perceive and extract
  information from stimuli

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Planning

• Selecting content
• Selecting teaching strategies
• consider total learning
• foster learner participation
• content complexity means more activities
• simple to complex
• use audiovisuals

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Planning

• What teaching strategies have you used?
• case study
• computer assisted
• demonstration
• discussion
• lecture
• media
• readings
• role play

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Planning

• Evaluation
• Criteria to evaluate self arises from process
  objectives
• Were you prepared?
• Were you flexible?
• Was audience interested?
• Were strategies appropriate?
• What would you change?

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Planning

• Evaluation
• Criteria to evaluate client arises from outcome
  objectives
• Formative
• Summative

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Implementation

• Speak the clients language
• Be specific
• Keep it short
• Focus learners attention
• Promote learner participation
• Restate and reinforce important points

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Research Areas