1. Chapter 23
Community Care

2. Elements of a Community
Group of individuals who have characteristics in common:
Share relationships
Share a common culture
Share a common locality
Have the capacity to act collectively over a period of time
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3. Types of Communities Rural Villages Group Homes Women’s Shelters
Schools/Classrooms
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4. Types of Communities Social Clubs Urban Neighborhoods
Members of Immigrant and Refugee Groups
Community Groups, Religious Groups
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5. Frameworks for Delivery of Community Care
Critical Social Theory
Citizen Ladder of Participation
Ecological Framework
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6. Critical Social Theory Framework
Goal is to liberate people from health-damaging environmental conditions.
The nurse asks critical questions to assess and respond to the health issue.
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7. The Citizen Ladder of Participation Framework
Informing
Consultation
Partnership
Delegated Power
Citizen Control
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8. Ecological Framework
Health is both an individual and a societal responsibility.
The nurse seeks to understand the structural barriers to health promotion and illness prevention behaviors.
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9. Nursing Roles in Community Health Care
Educator
Advocate
Consultant
Direct Care Provider
Social Marketer
Facilitator
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10. Selected Settings for Community- Based Health Care
Schools
Neighborhood/Community Centers
Twenty-Four Hour Health Lines (Telehealth)
Migrant Clinic Health Services
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11. Selected Settings for Community-Based Health Care
Rural Community Health Services
Correctional Health Nursing
Occupation/Environmental Health Nursing
Public Health Care Services
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12. Settings for Partnerships with Community Health Care Nursing
Homeless Care
Parish Nursing
International Partnerships
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13. Nursing Process in Community Health Care
The goal of community health nurses is the preservation and improvement of the health of populations and communities worldwide.
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

14. Assessment Comprehensive Assessment of a Group Gender, age, ethnicity
Socioeconomic status
Education levels and literacy rates
Existing support services and resources
Other programs accessible to the group
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15. Nursing Diagnosis
Formulated in terms of health promotion and illness prevention for populations.
The OMAHA system identifies physical factors and external health factors important to community health.
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

16. Planning Gain acceptance and establish rapport.
Determine the main focus or priority for the client.
Identify number of people affected by the problem.
Determine severity of the issue/problem.
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

17. Planning Determine group’s motivation to address the issue/problem.
Consider nurse’s ability to influence the issue/problem.
Consider skills, time, and/or resource constraints.
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.

18. Implementation Identify need for policy changes.
Identify need for social changes.
Implement interventions to accomplish this mission.
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19. Evaluation of Community Care
Healthy People 2010
National standards and objectives published by the American Public Health Association (APHA)
Addresses the health needs of communities
Copyright 2004 by Delmar Learning, a division of Thomson Learning, Inc.