Week 2:

• Community Health Nursing – Role Dimensions

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...

Attributes of CH Nursing

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

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

Roles and Functions

– Delivery-oriented roles • designed to enhance the operation of the health care

system– co-ordinator

– collaborator

– liaison

Roles and Functions

– Population Oriented roles • roles that are exclusively group oriented

– case finder

– leader

– change agent

– community care agent

– researcher

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

General Principles of Learning

• The Learner– learns best what is perceived to be most

relevant– motivation enhances learning– people learn in different ways

General Principles of Learning

• Learning situation– The context of the learning situation influences

the learning

General Principles of Learning

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

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

Assessing the Learner

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

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?

Assessing the Learner

• What characteristics of the learners influence the learning situation?– Psychological Dimension

• Is the learner aware of need for education?

• What is learner’s motivation?

• What will motivate the learner?

• Do learner’s attitudes enhance or detract from learning?

• Will stress or anxiety interfere with learning?

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?

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

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

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

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?

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

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

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

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

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

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

Planning

• Selecting content

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

Planning

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

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?

Planning

• Evaluation– Criteria to evaluate client arises from outcome

objectives• Formative

• Summative

Implementation

• Speak the client’s language

• Be specific

• Keep it short

• Focus learner’s attention

• Promote learner participation

• Restate and reinforce important points

Research Areas

Bloom'sTaxonomy

Preventionlevels

Referral

OutcomeObjectives

Learningevaluation

Teaching/learningtheories

Standards forCH Nursing