Community Health Exam 2
Describe how a nurse can successfully teach clients with special learning needs
Keep in mind the following special learning needs when tailoring education for the client(s). -cultural or language differences -hearing impairments -developmental delays -memory losses -visual perception distortions -problems with fine or gross motor skills -distracting personality characteristics -demonstrations of stress or emotions
Discuss factors that influence vulnerability and increase the risk for suboptimal health
Low income, difficulty accessing healthcare or uninsured/underinsured, poor self-esteem, young or advanced age, chronic stress, environmental factors, presence of communicable disease, racial and ethnic minority status, disparities for minority groups that differ across each population.
The PRECEDE or PROCEED Models
stands for predisposing, reinforcing, and enabling constructs in educational/ecological diagnosis and evaluation.
Culture
the beliefs, values, and behaviors that are shared by members of a society and provide a template or "road map" for living.
Holistic view of health
the world is viewed as seeking harmonious balance; imbalance of natural forces can create chaos and disease. For an individual to be healthy, all facets of an individual's nature- physical, mental, emotional and spiritual- must be in balance.
Discuss the methods to conduct a thorough family health assessment
use genograms or ecomaps, focus on the family as a total unit, ask goal-directed questions, collect data over time, combine quantitative with qualitative data, exercise professional data.
Effective and culturally competent care involves:
(1) avoiding ethnocentric attitudes, (2) bridging cultural differences, (3) developing knowledge and skill in serving multicultural clients, and (4) placing client's responses to care within the context of their lives.
What are the transcultural nursing principles
(1) develop cultural self-awareness, (2) cultivate cultural sensitivity, (3) assess the client group's culture, (4) show respect and patience while learning about other cultures, (5) examine culturally derived health practices
Nurses develop teaching plans that focus on the three levels of prevention depending on the clients' needs. The following are examples of the levels of prevention in health education/promotion
-Primary prevention 1. teaching importance of immunization with subsequent immunization clinic 2. health education on safe driving for adolescents -Secondary prevention 1. BP screening & teaching its importance to older adults 2. Screening for hypercholesterolemia & teaching how to lower cholesterol in diet -Tertiary prevention 1. Teach home safety to a person who is newly diagnosed with epilepsy 2. Teach a person who has epilepsy about the importance of medication use
Characteristics of culture
1. Learned from others 2. Integrated system of customs and traits 3. Shared 4. Mostly tacit 5. Dynamic
There are 6 principles for effecting positive change in your client (individual/family/community)
1. Participation - involve the client in all aspects of the planned change process Fosters collaboration, reduces resistance, removes obstacles 2. Resistance to change - expect the client(s) to resist change WHY? change effects status quo, threatens safety & security, existing misconceptions 3. Proper timing - make sure it is the right change with the right client at the right time and with the right resources 4. Interdependence - the proposed change will impact many people not only the person who is preparing to change 5. Flexibility - nurses must always adapt and be flexible to changing circumstances Think of alternative strategies/plans ahead of the planned change process 6. Self-understanding - nurses must define their role and ensure others understand their role Understand your values/motives & personality traits to be most effective in the planned change process
steps of affective learning
1. Receptive - client listens to information 2. Responsive - client discusses information, seeks out more information, or discusses information 3. Valuing - client accepts, appreciates, and commits to health education/promotion 4. Internal consistency - client understands health education/promotion and accepts responsibility for it 5. Adoption - client incorporates new health education into lifestyle
steps of cognitive learning
1. Remember - nurse provides information 2. Understand - nurse explains information 3. Apply - nurse suggests how to use learning 4. Analyze - nurse demonstrates and encourages analysis 5. Evaluate - nurse facilitates evaluation 6. Create - client formulates own plan
Discuss the stages of change
1. Unfreezing (when desire for change develops) 2. Changing (when new ideas are accepted and tired out) 3. Refreezing (when the change is integrated and stabilized into practice)
steps of psychomotor learning
1. client must be capable 2. client must have image of how to perform skill 3. client must practice skill
Health Belief Model
Addresses the relationship between a person's beliefs and behaviors and is useful in explaining the actions and behaviors taken by people to prevent illness and injury.
Cultural preservation
Assisting the client to maintain traditional values and practices
Transtheoretical or Stages Model of Behavior Change
Behavior change is a process that occurs in distinct stages: Precontemplation Contemplation Preparation Action Maintenance Termination
What is included in the cultural assessment?
Ethnic/racial background, language and communication patterns, cultural values and norms, biocultural factors, religious beliefs and practices, health belief and practices.
Give examples of different types of family compositions
Families experiencing divorce, remarriage, and blending, single-parent families, families headed by an adolescent parent or parents, LGBTQ families, families with older adults, and foster families.
Pender's Health Promotion Model
Focuses on promoting health and managing stress. Three general areas of concern to health-promoting behavior: individual characteristics and experiences are seen to interact with behavior-specific cognitions and affect to influence specific behavioral outcomes.
Describe the role of the community health nurse in client empowerment
Having a client centered approach, developing a trusting relationship, employing advocacy, being a teacher and role model, capacity building through encouraging and supporting of clients work toward attaining health goals.
What are the four health teaching models?
Health Belief Model Pender's Health Promotion Model Transtheoretical/Stages of Change Model PRECEDE/PROCEED Model
social determinants of health
The conditions in which people are born, grow, live, work, and age, shaped by the distribution of money, power, and resources at global, national, and local levels
Discuss traits associated with healthy family functioning
a facilitative process of interaction exists among family members, individual member development is enhanced, role relationships are structured effectively, active attempts are made to cope with problems, there is a healthy home environment and lifestyle, regular links with the broader community are established.
Cultural competence
a skill the nurse develops in learning to respect individual dignity and preferences, as well as acknowledging cultural differences
Cultural brokering
advocating, mediating, negotiating, and intervening between the client's culture and health care culture on behalf of the client
The different health care practices in the world community
biomedical, magicoreligious, holistic
biomedical view of health
defines diseases objectively, in accordance with the presence of recognized symptoms, and believes that the healthy body can be restored through scientifically based medical treatment
Health problems of migrant workers
dental disease, tuberculosis, chronic conditions, mental health concerns like stress and anxiety, leukemia, iron deficiency anemia, stomach, uterine and cervical cancers, lack of prenatal care, higher infant mortality rates, STI's, HIV/AIDS, pesticide exposure.
health disparities
differences in the quantity of disease, burden of disease, and other adverse health conditions present in different groups.
outline family development tasks
establishing a mutually satisfying relationship, adjusting to pregnancy and parenthood, fitting into kin network, adapting to critical needs of children at all stages, fitting into the community, balancing freedom with responsibility, releasing young adults into work, adjusting to retirement.
magicoreligious view of health
focuses on control of health and illness by supernatural forces. Diseases are thought to originate from intrusion of a malevolent spirit, and supernatural forces are in control.
psychomotor domain of learning
learning by performing a skill
Cognitive Domain of Learning
learning by understanding the meaning and relationships of information provided
affective domain of learning
learning through emotion or feeling
Cultural diversity
or cultural plurality: refers to the coexistence of a variety of cultural patterns within a geographic area. This diversity can occur both between and within countries and communities. Cultural diversity within communities has unique advantages and challenges. Language barriers and misunderstanding of cultural values can occur, whereas cultural practices, celebrations, and food traditions can enrich the community.
Issues in migrant health
pesticide exposure, food insecurity, inconsistent income, poor and unsanitary working and housing conditions, exposure to environmental pesticides in agricultural settings, less access to healthcare, inability to afford care, reduced availability of services, language barriers and cultural aspects of healthcare, discrimination, and immigration status (fear of being deployed if seeking services).
Transcultural nursing
providing culturally sensitive nursing service to people of an ethnic or racial background different from the nurse's