1 NUR 4636C Community Partnered Care Fall 1999 Health: A Community View Regina L. Payne, EdD, RN,...

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NUR 4636C Community Partnered CareNUR 4636C Community Partnered CareFall 1999Fall 1999

Health: A Community ViewHealth: A Community View

Regina L. Payne, EdD, RN, CWOCN

Anne Nolan, MS, RN, FRCNA

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How do we define health?

Depends on who is defining it & why defining it

And on the unit of analysis: individual, family, community, aggregate, population Are there common characteristics of health regardless of who or why defining it & unit of analysis?

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Definitions of Health Personal 80 year old female caretaker of husband Relative Surgeon Mexican migrant farm laborer Director of Nursing County Health

Department School health nurse

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Definitions WHO, 1986: …extent to which an individual or group …realize aspirations and satisfy needs … change or cope with the environment. … Health … resource for everyday life … not object of living … positive concept … social and personal … physical capacities.” DON: Health is the extent to which an individual or group is able, on the one hand, to realize expectations and satisfy needs, and, on the other hand, to change or cope with the environment (WHO, 1984, p.3).

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Definition & Focus of Public Health & Community Health What is Public Health?

Definition: How is Public Health different from Private Health?

Focus: Health promotion/education & disease prevention Examples of PH Health Promotion/Education

Activities? PH Disease Prevention Activities?

Primary Prevention Secondary Prevention Tertiary Prevention

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Focus of Public Health & Community Health

Focus of Public Health versus Focus of Nonpublic Health

National Level:

Local level:

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Focus of Public Health & Community Health Focus of Public Health COMMUNICABLE DISEASE CONTROL (Prevention?)

Examples: HEALTH EDUCATION (Level of Prevention?)

Examples:EARLY DIAGNOSIS of DISEASE (Level of Prevention?

Examples:SOCIAL PROGRAMMING (Level of Prevention?)

Examples:

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Focus of Public Health & Community Health Functions of Public Health

ASSESSMENT: WHAT IS THE HEALTH STATUS OF THE POPULATION?

Proxy Measure: Disease ASSURANCE: IS CARE AVAILABLE?

Uninsured Children Accidental Deaths

POLICY DEVELOPMENT: LOCAL, STATE, & FEDERAL

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Focus of Public Health & Community Health Focus of Community Health

Health of local communities organized through partnerships between pubic tax supported & private agencies: American Heart Assoc, American Cancer Society, hospitals, schools, HDs, United Way agencies, universities

Examples of partnerships you have been involved in which focused on the health of a community

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Public Health and Community Health Nursing How would you define and ‘level’ each of the following? Community Family Individual Aggregate Population Group Neighborhood

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Population Based and Aggregate Based Care Population: Large collection individuals with common personal or environmental characteristic(s):Give examples:

Geographic locale: Special interest: Other characteristics:Subpopulations-Special groups within populations:

High risk infants under 1 year age Unmarried adolescent mothers Grade Schoolers (5-11 year olds)

Population Based Care: Define: CHN Role: Specialist? Generalist? Where would this person work with populations?

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Population Based and Aggregate Based Care Aggregate: Group of individuals (smaller than population) with common personal or environmental characteristic(s): Example:

Geographic locale: Special interest: Other characteristics:Other aggregate groups:

High risk infants under 1 year age: Hispanic, RCMA Unmarried adolescent mothers: Lee County HD Grade Schoolers (5-11 year olds): Rural Lee County

Aggregate Based Care: Define: CHN Role: Specialist? Generalist? Where would this person work?

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Public Health and Community Health Nursing Public Health Nursing & Community Health

Nursing How does PHN differ from CHN? What are the defining characteristics of

each? What is their focus of practice for each? What are their goals? What education and titles do nurses hold

in each sphere?

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Preventionistic Approach

Marie is an 8 year old Haitian girl at San Carlos Park Grade School. You are the school nurse who has found that Marie has the following needs: Understands little English; family speaks no EnglishScored at 60th percentile for age/weight on growth chartHas head lice, dental caries, & poor hygiene

Identify short term goals & primary, secondary, and tertiary level coventions for Marie

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Thinking UpstreamThinking Upstream

Microscopic vs Macroscopic Approaches Microscopic Approach to Health Care

Focus: Disease Causation: Coventions:

Macroscopic Approach to Health Care Focus: Disease Causation: Coventions:

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Thinking UpstreamThinking Upstream

Models for Public Health Planning Individual Focus: Thinking Downstream Orem: Self Care Deficit Theory Health Belief Model Societal Focus: Thinking Upstream Milio’s Framework for Prevention Critical Social Theory

Identify one health problem of a population in FGCU service region. Formulate coventions using downstream/upstream approaches. How are these analogous to microscopic/macroscopic approaches and individual/societal foci?

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Historical Factors: Historical Factors: Community Health in ContextCommunity Health in Context

Identify one highlight of historical significance in public health for class discussion (Text, Chapter 2)

Why did you select this event? Is there a counterpart event today?

1 NUR 4636C Community Partnered Care Fall 1999 Health: A Community View Regina L. Payne, EdD, RN,...

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