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The Community as a Client: Assessment and Diagnosis

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Title: The Community as a Client: Assessment and Diagnosis


1
The Community asa Client Assessment
andDiagnosis
2
  • Community health nurses work with clients at
    several levels
  • as individuals,
  • families,
  • groups,
  • subpopulations,
  • populations,
  • and communities.

3
  • First, the community directly influences the
    health of individuals, families, groups,
    subpopulations, and populations who are a part of
    it
  • Second, provision of most health services occurs
    at the community level. Community agencies help
    develop specific health programs and disseminate
    health information to many types of groups and
    populations

4
Myths Perpetuated by anIndividualistic Focus
  • Location Myth
  • Skills Myth
  • Client Myth

5
a community
  • (1) a location,
  • (2) a population, and
  • (3) a social system
  • (Lynd, 1939)

6
Community Profile Inventory Location Perspective
  • Community Boundaries
  • Location of Health Services
  • Geographic Features
  • Climate
  • Flora and Fauna
  • Human-Made Environment
  • Population

7
Community Profile Inventory Population
Perspective
  • Size
  • Density
  • Composition
  • Rate of Growth or Decline
  • Cultural Characteristics
  • Social Class and Educational Level
  • Mobility

8
Community Profile Inventory Social System
Perspective
  • Health system
  • Family system
  • Economic system
  • Educational system
  • Religious system
  • Welfare system
  • Political system
  • Recreational system
  • Legal system
  • Communication system

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10
Three factors in particular affect community
dynamics
  • (1) citizen participation in community health
    programs,
  • (2) the power and decision-making structure, and
  • (3) collaborative efforts of the community (Lynd,
    1939).

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TYPES OF COMMUNITY NEEDSASSESSMENT
  • Familiarization or Windshield Survey (involves
    studying data already available on a community,
    and gathering a certain amount of firsthand data,
    to gain a working knowledge of the community)
  • Problem-Oriented Assessment
  • Community Subsystem Assessment
  • Comprehensive Assessment
  • Community Assets Assessment (which focuses on the
    strengths and capacities of a community rather
    than its problems)

13
Community Assets Assessment
  • (1) specific skills, talents, interests, and
    experiences of individual community members
  • (2) local citizen associations and organizations
    and
  • (3) local institutions

14
COMMUNITY ASSESSMENTMETHODS
15
Surveys
  • 1. Planning Phase
  • a. Determine what information is needed and why.
  • b. Determine precise data to be collected.
  • c. Select population to be surveyed (eg,
    individuals, a household, a city block).
  • d. Select survey method or instrument to be used
    (eg, interviews, telephone calls,
    questionnaires).
  • e. Determine sampling size (eg, a percentage of
    the total population in question).
  • 2. Data Collection Phase
  • a. Identify and train data collectors (eg,
    interviewers).
  • b. Pretest and adjust instrument.
  • c. Supervise actual collection, including plans
    for nonresponses or refusals.
  • 3. Data Analysis and Presentation Phase
  • a. Organize data for tabulation and analysis.
  • b. Apply appropriate statistical methods.
  • c. Determine relationships and significance of
    analysis.
  • d. Report results, including implications,
    recommendations, and next steps needed provide
    feedback to the population surveyed through a
    community forum (discussed later).

16
Descriptive Epidemiologic Studies
  • examines the amount and distribution of a disease
    or health condition in a population
  • by person (Who is affected?),
  • by place (Where does the condition occur?),
  • and by time (When do the cases occur?)

17
Community Forums or Town HallMeetings
  • is a qualitative assessment method designed to
    obtain community opinions

18
Focus Groups
  • First, there is only a small group of
    articipants, usually 5 to 15 people
  • Usually the group meets for 1 to 3 hours, and
    there may be a series of meetings.
  • Major advantages of focus groups are their
    efficiency and low cost, similar to the community
    forum or town hall meeting format.

19
SOURCES OF COMMUNITY DATA
  • Primary and Secondary Sources
  • International Sources
  • National Sources
  • State Sources
  • Local Sources

20
DATA ANALYSIS AND DIAGNOSIS
21
The Process of Analysis
  • (1) data can be rechecked by the community
    assessment team,
  • (2) data can be rechecked by others,
  • (3) subjective and objective data can be
    compared, or
  • (4) community members can consider the findings
    and verify them.

22
Community Diagnosis Formation
23
WHAT IS A HEALTHYCOMMUNITY?
  • 1. Collaborate effectively in identifying
    community needs and problems
  • 2. Achieve a working consensus on goals and
    priorities
  • 3. Agree on ways and means to implement the
    agreed-upon goals
  • 4. Collaborate effectively to take the required
    actions

24
Planning, Intervention, andEvaluation of Health
Care inCommunities
25
Three characteristics support the use of the
nursingprocess in community health nursing.
  • the nursing process is a problem-solving process
    that addresses community health problems at
    every aggregate level with the goalsof preventing
    illness and promoting public health.
  • It is a management process that requires
    situational analysis, decision-making, planning,
    organization, direction and control of services,
    and outcome evaluation
  • it is a process for implementing changes that
    improve the function of various health-related
    systems and the ways that people behave within
    those systems.

26
  • Interacting With the Community
  • Need for Communication

27
Forming Partnerships and BuildingCoalitions
  • Partnerships are agreements between people (and
    agencies) that support a joint purpose.
  • A coalition is an alliance of individuals or
    groups that work together to influence outcomes
    of a specific problem (Green, Daniel, Novick,
    2001)

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30
Types of Evaluations
  • Structure-Process Evaluation
  • Outcomes Evaluation

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33
The end
  • Thank you !
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