1. Delmar Learning Copyright © 2003 Delmar Learning, a Thomson Learning company Chapter 9 Environmental Perspectives

2. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 9 Environmental Perspectives Environment Person-environment interrelationship Environmental health

3. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 9 Environmental Health “Those aspects of human health, disease, and injury that are determined or influenced by factors in the environment.” (WHO, 1974)

4. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 9 Determinants of Health Interrelationship between environmental and human health 25% of illness is caused by poor environmental quality

5. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 9 Environmental Concerns by Setting Homes and families  Exposure to environmental pollutants  Lower income families at greater risk

6. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 9 Environmental Concerns by Setting (cont.) Workplaces  Exposure to toxic chemicals  Work-related injuries & deaths  Job stress

7. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 9 Environmental Concerns by Setting (cont.) Local communities and cities  Chemical, physical, biological, or psychological hazards

8. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 9 Environmental Concerns by Setting (cont.) National and International  Ecological balance  Bioterrorism  Chemical terrorism

9. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 9 Environmental Justice “The fair treatment and meaningful involvement of all people regardless of race, ethnicity, income, national origin or educational level with respect to the development of environmental laws, regulations, and policies.” (Environmental Protection Agency, 1995, p. 2)

10. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 9 The Role of the Community Health Nurse in Environmental Health Interrelationship between individuals and the environment Environmental health hazard assessment Refer conditions with suspected environmental etiologies Advocacy, ethics and risk communication Legislation and regulation

11. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 9 Person-Environment Theories Einstein’s theory Systems perspectives

12. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 9 Nursing theories Martha Rogers  Humans and their environment are inseparable Margaret Newman’s Theory of Expanding Consciousness

13. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 9 Conceptual Framework for Assessing Environments Dimensions of environment  Physical  Organizational  Social  Human aggregate  Internal

14. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 9 Physical Dimension Physical hazards Chemical hazards Biological hazards

15. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 9 Organizational Dimension Structural and functional effectiveness

16. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 9 Social Dimension Attitudes of various groups and cultures

17. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 9 Human Aggregate Dimension Characteristics of people within a specific environment

18. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 9 Internal Dimension Biological, psychological, and spiritual attributes of a person

19. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 9 Dimensions of Environment Internal Environment  Social  Organizational  Physical  Human Aggregate

20. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 9 Human Responses to the Environment Individual Family Community Societal

21. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 9 Creating a Caring Environment Safety Respect Nurturance Order Beauty

22. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 9 Characteristics of a Respectful Environment The client identifies the problem. The nurse plays a supportive role. Problems are opportunities. The nurse acknowledges the client’s ability to take advantage of the opportunity. The nurse cannot independently solve the problem.

23. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 9 Application of the Nursing Process to Environment Assessment Planning Interventions Evaluation

24. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 9 Assessment Exposure history Visual inspection Risk assessment Patterns of co-morbidity Sentinel events Nursing Diagnosis

25. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 9 Planning Establish health outcomes for individuals, families, and communities

26. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 9 Interventions Education Advocacy Referrals Case management

27. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 9 Evaluation Consider health outcomes Evaluate hazard abatement