Theories and Models in Community Health Nursing

MZC 1© 2005 by Lippincott Williams & Wilkins

WELCOME


THEORIES AND MODELS OF COMMUNITY HEALTH NURSING


All professional disciplines are based on a unique body of knowledge that is expressed through conceptual models and theories that guide practice. The hallmark of professional nursing is theory – based nursing. Community oriented nursing practice blends nursing and public health theory into a population-focused practice to promote and preserve the health of communities.

Introduction


Definition

“Theory is a set of interrelated concepts or hypothesis that seeks to explain or predict phenomena.”“Model is a description or analogy used as a pattern to enhance our understanding of something that is known.”


Essential Characteristics of Nursing Service to Populations

Community oriented, population focusedCommunity orientation is a process that is actively shaped by the unique experiences, knowledge, concerns, values, beliefs, and culture of a given communityPopulation focus implies that a nurse uses population-based skills such as epidemiology, research in community assessment, and community organizing as the basis for interventions


Theories and models of Community Nursing Process

Nightingale’s Theory of EnvironmentOrem’s Self Care ModelNeuman’s Health Care System’s ModelRoger’s Model Of The Science Of Unitary ManParser’s Human Becoming Theory Pender’s Health Promotion ModelRoy’s Adaptation Model


Theories and models of Community Nursing Process

Milio’s Framework For PreventionSalmon White’s Construct For Public Health NursingMinnesota Wheel The Public Health Interventions ModelOmaha System ModelBlock and Josten’s Ethical Theory Of Population Focused NursingCanadian Model For Community


Nightingale’s Theory of Environment

Focused on preventive care for populationsNightingale used observations to validate her hypothesis

Poor environmental conditions are bad for healthGood environmental conditions reduce disease

Others have added social services and health care in addition to environment


Orem’s Self-Care Model

Communities can be considered to have a collective set of self-care actions and requirements that affect the well-being of the total groupSelf-care deficit: demand exceeds client abilities related to

Universal requirementsDevelopmental requirementsHealth deviation requirements

Nursing care supports client


Neuman’s Health Care Systems Model


Rogers’ Model of the Science of Unitary ManBased on systems theoryWhole is greater than the sum of the partsThree principles:

1. Life proceeds in one direction along a rhythmic spiral

2. Energy fields follow a certain wave pattern and organization

3. Human and environmental energy fields interact simultaneously and mutually, leading to completeness and unity


PENDER’S MODEL


Parse’s Human Becoming TheoryOriginally “Man-living-health” theoryThree themes:

1. Meaning2. Rythmicity3. Transcendence


PARSE’S MODEL


Pender’s Health Promotion Model


Roy’s Adaptation Model


Milio’s Framework for Prevention

Premise: Behavioral patterns of populations are a result of habitual patterns and limited choicesChallenged “lack of knowledge” conceptProposed that government and institutional choices set the range of options for aggregate and individual choices


Salmon White’s Construct for Public Health Nursing

Categories of nursing interventionsEducation directed toward voluntary change in the attitudes and behavior of the subjectsEngineering directed at managing risk-related variablesEnforcement directed at mandatory regulation to achieve better health

Interventions target determinants in four categories: human/biologic, environmental, medical/technologic/organizational, and social


Minnesota Wheel – the Public Health Interventions Model


Omaha System Model


Block and Josten’s Ethical Theory Of

Population Focused Nursing

Three essential elements of populationfocused nursing

An obligation to populationThe primacy of preventionCentrality of relationship - based care.

The first two are from public health and the third element from nursing.


Canadian Model For Community

Basis for the Canadian Community Health Nursing Practice Model

The values and beliefs of Community Health Nurses

The community health nursing process


Canadian Model For Community


Application of Eight Tenets of PHN to CHN

1. Use a comprehensive and systematic process2. Work in partnership with the people3. Focus on primary prevention4. Promote a healthful environment5. Target all who might benefit6. Give priority to community needs7. Promote optimum allocation of resources8. Collaborate with others in the community


Social Issues Influencing CHN Care

Communication technologyGenetic engineeringGlobal economyMigrationTerrorism and bioterrorismClimate changes

Theories and Models in Community Health Nursing

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