MZC 1© 2005 by Lippincott Williams & Wilkins
WELCOME
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THEORIES AND MODELS OF COMMUNITY HEALTH NURSING
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All professional disciplines are based on a unique body of knowledge that is expressed through conceptual models and theories that guide practice. The hallmark of professional nursing is theory – based nursing. Community oriented nursing practice blends nursing and public health theory into a population-focused practice to promote and preserve the health of communities.
Introduction
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Definition
“Theory is a set of interrelated concepts or hypothesis that seeks to explain or predict phenomena.”“Model is a description or analogy used as a pattern to enhance our understanding of something that is known.”
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Essential Characteristics of Nursing Service to Populations
Community oriented, population focusedCommunity orientation is a process that is actively shaped by the unique experiences, knowledge, concerns, values, beliefs, and culture of a given communityPopulation focus implies that a nurse uses population-based skills such as epidemiology, research in community assessment, and community organizing as the basis for interventions
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Theories and models of Community Nursing Process
Nightingale’s Theory of EnvironmentOrem’s Self Care ModelNeuman’s Health Care System’s ModelRoger’s Model Of The Science Of Unitary ManParser’s Human Becoming Theory Pender’s Health Promotion ModelRoy’s Adaptation Model
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Theories and models of Community Nursing Process
Milio’s Framework For PreventionSalmon White’s Construct For Public Health NursingMinnesota Wheel The Public Health Interventions ModelOmaha System ModelBlock and Josten’s Ethical Theory Of Population Focused NursingCanadian Model For Community
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Nightingale’s Theory of Environment
Focused on preventive care for populationsNightingale used observations to validate her hypothesis
Poor environmental conditions are bad for healthGood environmental conditions reduce disease
Others have added social services and health care in addition to environment
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Orem’s Self-Care Model
Communities can be considered to have a collective set of self-care actions and requirements that affect the well-being of the total groupSelf-care deficit: demand exceeds client abilities related to
Universal requirementsDevelopmental requirementsHealth deviation requirements
Nursing care supports client
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Neuman’s Health Care Systems Model
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Rogers’ Model of the Science of Unitary ManBased on systems theoryWhole is greater than the sum of the partsThree principles:
1. Life proceeds in one direction along a rhythmic spiral
2. Energy fields follow a certain wave pattern and organization
3. Human and environmental energy fields interact simultaneously and mutually, leading to completeness and unity
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PENDER’S MODEL
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Parse’s Human Becoming TheoryOriginally “Man-living-health” theoryThree themes:
1. Meaning2. Rythmicity3. Transcendence
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PARSE’S MODEL
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Pender’s Health Promotion Model
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Roy’s Adaptation Model
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Milio’s Framework for Prevention
Premise: Behavioral patterns of populations are a result of habitual patterns and limited choicesChallenged “lack of knowledge” conceptProposed that government and institutional choices set the range of options for aggregate and individual choices
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Salmon White’s Construct for Public Health Nursing
Categories of nursing interventionsEducation directed toward voluntary change in the attitudes and behavior of the subjectsEngineering directed at managing risk-related variablesEnforcement directed at mandatory regulation to achieve better health
Interventions target determinants in four categories: human/biologic, environmental, medical/technologic/organizational, and social
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Minnesota Wheel – the Public Health Interventions Model
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Omaha System Model
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Block and Josten’s Ethical Theory Of
Population Focused Nursing
Three essential elements of populationfocused nursing
An obligation to populationThe primacy of preventionCentrality of relationship - based care.
The first two are from public health and the third element from nursing.
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Canadian Model For Community
Basis for the Canadian Community Health Nursing Practice Model
The values and beliefs of Community Health Nurses
The community health nursing process
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Canadian Model For Community
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Application of Eight Tenets of PHN to CHN
1. Use a comprehensive and systematic process2. Work in partnership with the people3. Focus on primary prevention4. Promote a healthful environment5. Target all who might benefit6. Give priority to community needs7. Promote optimum allocation of resources8. Collaborate with others in the community
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Social Issues Influencing CHN Care
Communication technologyGenetic engineeringGlobal economyMigrationTerrorism and bioterrorismClimate changes
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