Start by reading and following these instructions:
Note that in this course, due to the nature of the assignments, you are permitted to use first person, such as: "I, Me", in all assignments and discussion posts.
1. Quickly skim the questions or assignment below and the assignment rubric to help you focus.
2. Read the required chapter(s) of the textbook and any additional recommended resources. Some answers may require you to do additional research on the Internet or in other reference sources. Choose your sources carefully.
3. Consider the course discussions so far and any insights gained from it.
4. Create your Assignment submission and be sure to cite your sources if needed, use APA style as required, and check your spelling.
Three-part APA Paper…. ALL papers require strict APA formatting with title page, introductory paragraph to tell the reader what will be covered and the purpose of the paper, discussion on the assignment(s), APA headings, a conclusion paragraph to sum up the highlights of the paper, and a references page with references listed for every in text citation. Note that headings in APA do not include articles such as "Part 1" , "Module 2", or the name of the course. Headings/titles are to reflect the topic that is being covered.
Part 1: Reflect on how those experiences from the Discussion Post impact your nursing practice now?
Part 2: Discuss what ageing biases you have witnessed &/or perpetrated.
Part 3: Create a community education plan to address ageing bias.
The assignment should be written in an APA-formatted essay. The essay should be at least 1500 words in length and include at least two scholarly sources other than provided materials.
Mental Health of America. (2011). Position Statement 35: Aging well: Wellness and psychosocial treatment for the emotional and cognitive challenges of aging. Retrieved from http://www.mentalhealthamerica.net/positions/aging-well
Discussion post question mentioned in part 1:
Answer the following questions honestly (safe space).
I have been blessed to live in one of the most diversified city like Chicago. I come across patients of different ages, cultures, race, gender and those living in different situations. As a nurse, I have never let these factors weigh in on how I care for these individuals. Regardless of who it is and where they come from, I try to my best ability to care for my them the best I can without being biased. If I have ever been biased, it’s probably against my own kind and it’s mostly because of their attitude towards me knowing that I am the same ethnic background as them. I am of Indian ethnicity and “our kind” tend to be very difficult as patients. But regardless of the request and difficulties they put forth, I try my best to remain unbiased. Knowing that I am Indian, they become very inquisitive about my personal life and will ask many questions. This is something I find uncomfortable being that I am somewhat of a private person about my personal life. Depending on which part of India you are from, they also tend to be very candid, not realizing that their comments may be hurtful or even offensive.
As I mentioned earlier, I am of Indian native. I was born and raised in India until the age of 7 so I had the privilege of living with my grandparents. Majority of the families follow an extended family pattern consisting of parents, children and grandparents. Our culture puts great emphasis on values, especially those pertaining to respecting the old age. The elderly or old age are seen as a source of knowledge, being able to give valuable advice and share greater wisdom. Certain areas in India, respect is shown to elders by touching their feet when you greet them. Respect for the elderly is something that is expected within families, as well as the community and in society. I remember that I was not allowed to raise my voice or talk back to my grandparents or any other adults for that matters. Adult children, particularly sons are expected to provide care for the aging adults at home. This includes taking care of all their needs, even monetary. Concepts of old age homes have only emerged in recent years as there is a rise in adult children going overseas and both husband and wife being in the workforce.
POPULATION AND COMMUNITY HEALTH
Mary Jo Clark
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Library of Congress Cataloging-in-Publication Data Clark, Mary Jo Dummer, author. [Community health nursing] Population and Community Health Nursing / Mary Jo Clark. — Sixth edition. p. ; cm. Preceded by: Community health nursing / Mary Jo Clark. 5th edition. 2008. Includes bibliographical references and index. ISBN 978-0-13-385959-1 ISBN 0-13-385959-2 I. Title. [DNLM: 1. Community Health Nursing. 2. Nursing Process. WY 106] RT98 610.73’43—dc23 2014024175
ISBN-10: 0-13-385959-2 ISBN-13: 978-0-13-385959-1
10 9 8 7 6 5 4 3 2 1
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Mary Jo Clark, PhD, RN, PHN, has been practicing and teaching population health nursing for 50 years. After completing her BSN degree at the University of San Francisco, she received her in- troduction to global population health nursing as a U.S. Peace Corps Volunteer in Vita, India, a ru- ral town with a population of about 3,000. Returning to the United States, Dr. Clark employed her cross-cultural expertise as a Public Health Nurse in the Los Angeles County Department of Health Services. In 1973, she became a pediatric nurse practitioner, and later began teaching population health nursing at East Tennessee State University. She completed a master’s degree as a com- munity health clinical nurse specialist at Texas Women’s University and a PhD in nursing at the University of Texas at Austin. Moving with her army nurse husband to Augusta, Georgia, she taught graduate and undergraduate population health at the Medical College of Georgia. For the past 29 years, Dr. Clark has taught at baccalaureate, master’s, and doctoral levels at the University of San Diego, Hahn School of Nursing and Health Science. In addition to her full-time teaching and writing, Dr. Clark has maintained an active population health nursing practice. She is well known in the population health nursing field and has provided consultation and made presentations across the country and overseas. Her many and varied experiences in population health nursing in the United States and abroad form the core of the material presented in this book.
About the Author
This book is lovingly dedicated to Phil the elder, Phil the younger, and Heather, who are the wind beneath my wings, and to my fellow population health nurses and faculty across the country and around the globe. Little by little we are improving the health status of the world’s population.
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Reviewers Our heartfelt thanks go to our colleagues from schools of nursing across the country and others who have given time generously to help create this exciting new edition of our text. These individuals helped us plan and shape our book and resources by reviewing chapters, art, design and more. Population and Community Health Nursing has reaped the benefit of your collective knowledge and experience as nurses and teachers, and we have improved the materials due to your efforts, suggestions, objections, endorsements and inspira- tion. Among those who gave their time to help us are the following:
Dr. Sue Bhati, PhD,FNP-BC,NP-C,MSN,RN Northern Virginia Community College Springfield, Virginia Terese Blakeslee, MSN, RN, Ed University of Wisconsin Oshkosh, Wisconsin Anne Watson Bongiorno, Ph.D., APHN-BC, CNE SUNY Plattsburgh Plattsburgh, New York Angeline Bushy, PhD, RN, FAAN, PHC University of Central Florida Daytona Beach, Florida Kim Clevenger, EdDc, MSN, RN, BC Morehead State University Morehead, Kentucky Angela Cox, RN, MS Ball State University—School of Nursing Muncie, Indiana Mary P. Curtis, RN, PhD, ANP-BC, PHCNS-BC Barnes-Jewish College, Goldfarb School of Nursing St. Louis, Missouri Pamela Davis, MSN, RN, ANP, CPHQ Northern Kentucky University Highland Heights, Kentucky Julia K. Donegan, MS, APHN-BC, RN The Ohio State University—College of Nursing Columbus, Ohio Charlene Douglas, PhD, MPH, RN George Mason University Fairfax, Georgia Janice Edelstein, RN, EdD University of Wisconsin Oshkosh, Wisconsin Susan England, PhD, RN Texas State University Round Rock, Texas Melissa Garno, EdD, RN Georgia Southern University—School of Nursing Statesboro, Georgia Camille Groom, RN,MS Miami-Dade College School of Nursing Miami, Florida
Tammy Haley, PhD, CRNP University of Pittsburgh at Bradford Bradford, Pennsylvania Linda James, MSc, RN Sam Houston State University Huntsville, Texas Nancy Jones, MSN, RN Kent State University Kent, Ohio Toshua Kennedy, MSN/MPH, BSN, ADN The University of South Carolina Upstate Greenville, South Carolina Nancy Laplante, PhD, RN Neumann University Aston, Pennsylvania Sherry Lovan, PhD, RN Western Kentucky University Bowling Green, Kentucky Paula McNiel, DNP, RN, APHN-BC University of Wisconsin Oshkosh—College of Nursing Oshkosh, Wisconsin Richard Ralls, RN, BSN Florida International University Miami, Florida Kate Shade, PhD, RN Samuel Merritt University Oakland, California Ashley Shroyer, MSN, RN, CNE Fairmont State University Fairmont, West Virginia Virginia Teel, DHSc, RN Georgia Southern University Statesboro, Georgia Anne Watson Bongiorno, Ph.D., APHN-BC, CNE SUNY Plattsburgh Plattsburgh, New York Kim White, PhD, MS, CNS-BC Southern Illinois University Edwardsville—School of Nursing Edwardsville, Illinois
Lisa Rae Dummer, Transgender Law Center San Francisco, California
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This book represents the lessons learned and the prog-ress made in more than 100 years of population health nursing in the United States. The year 1993 marked the 100th anniversary of the founding of the Henry Street Settlement, the acknowledged beginning of modern American population health nursing. Since then, the work of population health nurses and others has led to better health for individuals, families, and population groups. In this book, I have tried to dis- till the wisdom of early pioneers and present-day practitioners to guide and direct future generations toward nursing excellence.
Locally, nationally, and globally, society is in greater need of population health nursing services than at any time since our be- ginning. Although expected longevity has increased significantly in the last century, quality of life has not kept pace for a large por- tion of the world’s population. Previously controlled communi- cable diseases are resurfacing, and new diseases are emerging to threaten the public’s health. Malnutrition is a fact of life for many people. Chronic physical and emotional diseases are taking their toll on the lives of large numbers of people. Substance abuse and violence are rampant, and more and more frequently, environ- mental conditions do not support health. All of these are problems that population health nurses can and do help to solve.
Population health nurses must have the depth and breadth of knowledge that allows them to work independently and in conjunction with clients and others to improve the health of the world’s populations. In part, this improvement occurs through care provided to individuals and families, but it must also occur on a larger scale through care provided to communi- ties and population groups. Population and Community Health Nursing, Sixth Edition, provides population health nurses with the knowledge needed to intervene at these levels. This knowl- edge is theoretically and scientifically sound, yet practical and applicable to society’s changing demands.
Nursing Excellence Through Advocacy Like prior editions, this edition focuses on the central facet of population health nursing—advocating for the health of the public. The theoretical concept of advocacy is introduced in Chapter 1 and is based on qualitative research by the author that examines the process of advocacy as it is performed by population health nurses. Practical application of the concept occurs in each of the subsequent chapters.
Advocacy Then and Advocacy Now The Advocacy Then and Advocacy Now vignettes that open each chapter showcase the efforts of population health nurses,
other health professionals, and members of the lay public to advocate for the health of populations. Some of the Advocacy Now vignettes were contributed by population health nurses and are gratefully acknowledged. Other vignettes celebrate the past and present contributions of population health nurses and others to promoting health and addressing health needs in the United States and the world. We offer our appreciation to these contributors for their heartfelt descriptions of nursing in the population and for their generosity in permitting us to tell their stories. The Advocacy Now vignette that opens Chapter 2 de- scribes the work of Susie Walking Bear Yellowtail, the first Na- tive American registered nurse and an exemplary population health nurse advocate. The other stories, past and present, are equally inspiring for the population health nurses of today and those in the ages to come.
Population and Community Health Nursing, Sixth Edition, provides students with a strong, balanced foundation for pop- ulation health nursing practice. The book is designed to help students first achieve excellence in the classroom through the many features and exercises that accompany the narrative. The additional tools and supplemental information will help stu- dents succeed at applying those concepts in clinical settings with families, communities, and population groups, with the ultimate goal of preparing nurse generalists who will exhibit nursing excellence in any setting.
The underlying intent of this book is to convey to nurs- ing students at the beginning of the 21st century the excite- ment and challenge of providing nursing care to populations. As we begin a new era of population health nursing, I believe that well-educated population health nurses can provide a fo- cal point for resolution of the global health problems presented throughout the book. Early population health nurses changed the face of society; we can be a strong force in molding the so- ciety of the future by striving for nursing excellence through advocacy.
Organization This textbook is designed to present general principles of population health nursing and to assist students to apply those principles in practice. It is organized in five units. The first three units address general concepts and strategies of popula- tion health nursing practice, and the last two examine the ap- plication of those concepts to specific populations, settings, and population health problems.
UNIT I sets the stage for practice by describing popula- tion health nursing and the context in which it occurs. Read- ers are introduced to population health nursing as an area of
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specialized practice and to its emphasis on advocacy for the health of individuals, families, and population groups. The attributes and features that make population health nursing unique, standards for practice, and typical roles and func- tions of population health nurses are addressed. Then, the concept of populations as recipients of nursing care and the historical and theoretical underpinnings and development of population health nursing are presented followed by a discus- sion of epidemiology as a core content area for population health care.
A unique feature of this book is the consistent use of the Population Health Nursing model to structure the discussion of principles of practice. The model is introduced in Chapter 1. Further Information about other theoretical models that may be useful in population health nursing practice is provided in ancillary materials found at www.nursing.pearsonhighered .com. Other relevant models dealing with epidemiology, family nursing, health promotion, and so on, are included in specific chapters.
The population health nursing (PHN) model is used as the organizing framework for most of the chapters in the book, providing students with a systematic approach to determining factors that influence health and relevant strategies designed to promote health, prevent illness and injury, resolve existing health problems, and restore health in individuals, families, communities, and populations. The consistent use of the PHN model permits students to readily identify commonalities and differences among processes, populations, settings, and health problems.
UNIT II examines influences on population health and ad- dresses environmental, cultural, economic, healthcare delivery system, and global influences on population health. Knowledge of the influence of these factors on population health leads to the application of specific strategies to improve population health addressed in UNIT III. Strategies addressed include po- litical, empowerment, health promotion and health education, case management, and home visiting approaches to population health nursing as a specialized area of practice. Other aspects of population health nursing practice (e.g., community engage- ment, referral, delegation, social marketing, group dynamics, and leadership) are integrated into these and other chapters as appropriate.
UNIT Iv addresses health care provided to special popu- lation groups. In each chapter, students are assisted to apply principles of care to individuals and families, as well as to these populations as aggregates. For example, Chapter 16 emphasizes population health nursing care for children and adolescents as population groups, as well as strategies for improving the health of individual children and adolescents. Similar approaches are taken to other population groups in the unit: families, com- munities, men, women, the elderly, the GLBT population, and people experiencing poverty and homelessness.
UNIT Iv also addresses population health nursing in spe- cialized settings such as the school, work, correctional, and di- saster settings. For example, Chapter 22 examines the role of the
population health nurse in school settings, whereas Chapter 23 addresses employee health in the work setting. In each chapter in the unit, students are guided in the use of the nursing pro- cess and application of the PHN model in the special practice setting. Consideration is given to factors influencing determi- nants of health in each setting, and population health nursing interventions related to health promotion, illness and injury prevention, resolution of existing health problems, and health restoration are discussed.
UNIT v focuses on population health nursing practice re- lated to the control of common population health problems such as communicable diseases, chronic physical and men- tal health conditions, substance abuse, and societal violence. Again, students are assisted to apply the nursing process and the PHN model to identify factors contributing to problems in each of these areas and in designing nursing interventions at each of the four levels of health care. Consideration is given to the care of individuals and families with these problems as well as to resolving common health problems at the population level.
How to use this book to foster success in POPULATION HEALTH advocacy
The various features in the sixth edition of Population and Community Health Nursing provide tools to help you succeed in the classroom and in practice. They offer opportunities to apply the principles presented in the book in real and virtual practice settings, promoting your ability to be an advocate for health at multiple levels.
Learning Outcomes Learning outcomes at the beginning of each chapter help you to focus on the outcomes expected of you in relation to your knowledge and application of principles of population health nursing. They highlight the important content for each chapter and assist you in applying the PHN model to specific circum- stances and settings.
Key Terms The list of key terms at the beginning of each chapter alerts you to significant concepts to be addressed in the chapter, concepts with which an effective population health nurse needs to be fa- miliar. At the point of definition within the chapter, each term is set in boldface type.
Healthy People 2020: Objectives for Population Health These boxes present relevant objectives from Healthy People 2020 to familiarize you with these important population health goals. You also learn about the current status of objectives here
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and sources of further information on the objectives on the Nursing Portal for students at www.nursing.pearsonhighered .com.
Focused Assessments These boxes present a series of questions that assist you in conducting health assessments focused on a particular client, specific population groups, or particular aspects of care. They are framed in the context of determinants of health included in the PHN model and help you to tailor your nursing assessment to the specific needs of the client population, setting, or health problem addressed in the chapter.
Global Perspectives This feature presents an international view of population health nursing practice, examining issues that affect health throughout the world. The feature also addresses differences in population health nursing as practiced outside the United States and highlights global solutions to health problems facing mankind.
Evidence-Based Practice These boxes discuss the evidence base (and sometimes the lack of evidence) that underlies specific aspects of population health nursing practice. They also pose questions that stimulate think- ing about the development or critical review of the evidence base for practice.
Client Education These boxes identify important content for educating clients and the public regarding particular health issues and topics, equipping you for successful clinical encounters as you begin your career.
Highlights A feature intended to aid your review of content from the chap- ter; these bulleted summaries of main points or special foci ap- pear periodically in the text.
Case Studies Each chapter concludes with a case study designed to assist you to apply the principles addressed in the chapter to the real world of population health nursing practice. Many of the case studies foster application of the PHN model in clinical prac- tice with individual, families, and/or population groups. Each case study is followed by questions designed to promote critical thinking in practice.
References References contained in each chapter present an up-to-date pic- ture of principles and concepts related to the topic presented. References provide a balanced view of population health nurs- ing, exploring a variety of issues from several perspectives, and
provide a wide range of supplemental materials, including re- search reports, for the interested reader.
Additional Student Resources A variety of supplemental information and assessment tools are provided on the Nursing Portal for students at www.nursing .pearsonhighered.com. The site includes the following features:
• Testing Your Understanding: This feature assists you in evaluating your comprehension of concepts and principles presented in each chapter and assessing your achievement of the chapter learning outcomes. Questions are open-ended to facilitate thought and discussion.
• Clinical Reasoning Questions: Additional short answer questions are provided to assist readers in applying content from the chapters and to promote clinical reasoning. These questions maintain a balance between application of prac- tice concepts to individuals/families and population groups.
• Exam Review Questions: Multiple-choice review questions are provided for each chapter to assist readers in evaluating their comprehension of chapter content.
• Assessment Guidelines: The Nursing Portal for students also contains a wide variety of assessment tools and guide- lines to assess the health needs of individuals, families, and population groups in a variety of settings. Formerly included in a separate companion text, these tools and guidelines are made available to assist you with the practical aspects of as- sessing the health needs of various populations as well as in- dividual clients and their families. Most of the guidelines are organized around the elements of the PHN model, making it even easier to apply the model to a variety of client popu- lations, settings, and population health issues. Tools range from comprehensive assessment and intervention guides for care of specific population groups (e.g., children and ado- lescents, prisoners) or in specific settings (e.g., schools) to more specialized assessments (e.g., fall risk assessment in the elderly or client suitability for case management services). The tools and guidelines can be downloaded for immediate use in practice.
• Cultural Considerations: Relevant cultural considerations are provided for each chapter of the book to assist you in developing expertise in caring for a wide variety of culturally and ethnically diverse populations.
• Further Information: For some chapters, the Nursing Portal for students contains additional information related to chap- ter topics that may be of interest to readers. As noted earlier, additional information about other theoretical models for population health nursing is provided in this feature. Simi- larly, detailed cultural information tables are provided for a wide variety of cultural groups, including ethnic groups, healthcare professionals, and the dominant U.S. culture.
• Resource Exchange: This section of the Nursing Portal for students provides resources for further information on a va- riety of topics addressed in the book.
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Instructor Resources • Test Bank: An electronic test generator with questions for
each chapter is available for instructors to download from the Instructor Resource Center via the Nursing Portal.
• Instructor’s Resource Manual: This guide, available in the Instructor Resource Center, provides a wealth of helpful in- formation for planning learning opportunities for students.
Included are learning objectives that provide instructors with student goals for each chapter. Suggested classroom ac- tivities promote student participation in learning and help bring community health nursing practice to life.
• Lecture Note PowerPoints: PowerPoint slides for each chapter are available to instructors in the Instructor Re- source Center to help convey key points to students in class and facilitate discussion.
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Unit 1 Population Health Nursing: An Overview 1
Chapter 1 Population Health and Nursing 2 Defining Populations as a Focus for Care 3 Defining Population Health 4 Population Health Practice 5
Core Public Health Functions 5 Essential Public Health Services 5
Objectives for Population Health 6 Nursing and Population Health: Labeling the Specialty 10 Population Health Nursing as Advocacy 10
Defining Advocacy 10 Advocacy by Population Health Nurses 11 The Advocacy Process 11 Population Health Nursing Functions in the Advocacy Role 12
Population Health Nursing Standards and Competencies 13 Population Health Nursing Education 14 A Population Health Nursing Model 14
Determinants of Population Health 15 Population Health Nursing Interventions 20 Levels of Health Care 24
Chapter 2 Population Health Nursing: Yesterday, Today, and Tomorrow 29
Historical Roots 31 The Influence of Christianity 32
The Early Christian Church 32 The Middle Ages 32
Other Religious Influences 33 The European Renaissance 33 A New World 33
The Colonial Period 33 Early Public Health Efforts 34
The Industrial Revolution 34 Nursing in War 37 District Nursing in England 37 Visiting Nurses in America and the World 38 Nursing and the Settlement Houses 38 Expanding the Focus on Prevention 39 Standardizing Practice 42 Educating Population Health Nurses 42 Federal Involvement in Health Care 44
The Latter Half of the 20th Century 45 The Present and Beyond 47
Chapter 3 Epidemiology and Population Health Nursing 53
Basic Epidemiologic Concepts 55 Causality 56 Risk 57 Rates of Occurrence 58
The Epidemiologic Process 60 Defining the Condition 60 Determining the Natural History of the Condition 60 Identifying Strategic Points of Control 61 Designing, Implementing, and Evaluating Control Strategies 62
Epidemiologic Investigation 62 Descriptive Epidemiology 62 Analytic Epidemiology 63 Experimental Epidemiology 63
Epidemiologic Models 64 The Epidemiologic Triad Model 64 The Web of Causation Model 67 Determinants-of-Health Models 67
Unit 2 Influences on Population Health 71 Chapter 4 Environmental Influences on Population
Health 72 Environment and Health 73 Components of the Human Environment 78
The Natural Environment 78 The Built Environment 85 The Social Environment 87 Interactions Among Environmental Components 90
Population Health Nursing and Environmental Influences on Health 91
Assessing Environmental Health Influences 91 Planning to Address Environmental Health Issues 94 Evaluating Environmental Health Measures 98
Chapter 5 Cultural Influences on Population Health 102
Basic Concepts Related to Culture and Health 104 Culture and Health 106
Ethnic/Societal Culture and Health 107 Biomedical Culture and Health 107
Ethnic Diversity in the United States 108
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Assessing Cultural Influences on Health and Health Care 109 Principles of Cultural Assessment 109 Obtaining Cultural Information 109
Cultural Assessment Data 111 Biological Determinants 111 Psychological Determinants 113 Environmental Determinants 115 Sociocultural Determinants 116 Behavioral Determinants 126 Health System Determinants 127
Planning Culturally Congruent Care and Delivery Systems 135 Cultural Competence 136
Evaluating Cultural Competence 140
Chapter 6 Economic Influences on Population Health 144
Economics and Health—The Interrelationships 146 Soci
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