1. Week 2:
Community Health Nursing
Role Dimensions

2. 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...

3. Attributes of CH Nursing
Making it a unique field of practice:
Health Orientation
Population Focus
Autonomy
Continuity & Intimacy
Collaboration
Interactivity
Accountability
Variability
Health Orientation - emphasis on health promotion and disease prevention rather than illness cure
Population - emphasis on health of population groups (aggregatesa0 rether than individuals
Autonomy- greater control over health care decisions by nurse and client
Continuity - care is provided on continuing comprehensive basis rather than episodic
Intimacy- greater awareness of reality of client lives and situations
Collaboration- Interaction between nurse and client as equals
Interactivity- awareness of interaction of variety of factors & health
Accountability- to society for health of general population
Variability- wide array of clients in different settings & backgrounds

4. 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

5. Roles and Functions Delivery-oriented roles
designed to enhance the operation of the health care system
co-ordinator
collaborator
liaison

6. Roles and Functions Population Oriented roles
roles that are exclusively group oriented
case finder
leader
change agent
community care agent
researcher

7. 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

8. General Principles of Learning
The Learner
learns best what is perceived to be most relevant
motivation enhances learning
people learn in different ways

9. General Principles of Learning
Learning situation
The context of the learning situation influences the learning

10. 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

11. 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

12. Assessing the Learner Identify the target audience based on
level of need
resources available
probability of success

13. 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?

14. 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?

15. 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?

16. 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

17. 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

18. 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

19. 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?

20. 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

21. 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

22. 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

23. 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

24. 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

25. 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

26. Planning Selecting content Selecting teaching strategies
consider total learning
foster learner participation
content complexity means more activities
simple to complex
use audiovisuals

27. Planning What teaching strategies have you used? case study
computer assisted
demonstration
discussion
lecture
media
readings
role play

28. 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?

29. Planning
Evaluation
Criteria to evaluate client arises from outcome objectives
Formative
Summative

30. Implementation Speak the client’s language Be specific Keep it short
Focus learner’s attention
Promote learner participation
Restate and reinforce important points

31. Research Areas