Primary Health Care and Public Health: Foundations of Universal Health Systems

The aim of this review is to advocate for more integrated and universally accessible health systems, built on a foundation of primary health care and public health. The perspective outlined identified health systems as the frame of reference, clarified terminology and examined complementary perspectives on health. It explored the prospects for universal and integrated health systems from a global perspective, the role of healthy public policy in achieving population health and the value of the social-ecological model in guiding how best to align the components of an integrated health service. The importance of an ethical private sector in partnership with the public sector is recognized. Most health systems around the world, still heavily focused on illness, are doing relatively little to optimize health and minimize illness burdens, especially for vulnerable groups. This failure to improve the underlying conditions for health is compounded by insufficient allocation of resources to address priority needs with equity (universality, accessibility and affordability). Finally, public health and primary health care are the cornerstones of sustainable health systems, and this should be reflected in the health policies and professional education systems of all nations wishing to achieve a health system that is effective, equitable, efficient and affordable.Key Words: Health systems, Primary health care, Public health, Universality, Program integration, Social-ecological model, Professional education, Policy, Planning, Human resources     

Changing Health Behavior of Community Health Clients

Fifty-two women over the age of 70 participated in a study to investigate the use of an individualized music protocol to promote sleep onset and maintenance. They were recruited from the practices of physicians and nurse practitioners, and met the inclusion and exclusion criteria of the International Classification of Sleep Disorders (1990), and the Diagnostic and Statistical Manual of Mental Disorders (1994). Results indicated that the use of music decreased time to sleep onset and the number of nighttime awakenings. Consequently, it increased satisfaction with sleep. Nurses may wish to recommend the use of music at bedtime to older women with insomnia.     

Reflections: Berea Health Ministry Rural Health Clinic

The challenges are many. Perhaps some of the greatest ones are: 1) teaching self-management of ones personal health, 2) keeping appointments, 3) call ins for refills of medications without seeing a provider, and 4) the need for dental health care for adult and seniors to mention a few.     

Population Health Surveillance Practice of Public Health Nurses

ABSTRACT Objective: To report the population health surveillance functions of public health nurses and to describe factors that impede these functions.
Design and Sample: An interpretive qualitative study was conducted in Public Health Service areas in Eastern Canada. Participants were public health nurses ( n =55) with an average of 14.5 years of pertinent work experience.
Measures: Semistructured face-to-face, telephone interviews, and focus groups were conducted, transcribed, coded, and analyzed.
Results: The nurses in this study used ecosocial population health surveillance functions that included multilevel societal influences on health. Extensive interprofessional and intersectoral networks were foundational to their surveillance work, allowing them to monitor what was occurring in the community and transfer this knowledge into various systems to contribute toward improved health outcomes. However, the nurses did not acknowledge the significance of their population health surveillance work, and documentation structures did not support these surveillance functions.
Conclusion: New surveillance methods and documentation structures that reflect an ecosocial surveillance approach are needed that are more consistent with public health nurses' population-focused practice.     

Public Health Nursing Education for Primary Health Care

This article examines several issues relevant to the education of nurses for roles in primary health care. The basic premises of education for community-based public health practice are put forth. The World Health Organization's seven key principles for primary health care and their cur-ricular implications for various levels of nursing programs are discussed. Examples are given of nursing education programs in which aspects of primary health care are used; finally, the continuing education needs of nurses are explored.     

Measuring Occupational Health Nurses'' Counseling on Health Promotion

Abstract The purpose of the study was to validate an instrument that measures health counseling practices of occupational health nurses. The measure, the health habits counseling questionnaire (HHCQ), was derived from a model of physician counseling practices. The health habits included smoking, alcohol, weight management, and exercise. Safety at work was added for this random sample of California occupational health nurses. Reliability was comparable to original findings for a random sample of physicians drawn from the roster of a western medical society. The validity of the hypothesized global constructs of aggressiveness and indications was not supported. Physicians in the normative sample were more likely to use primary prevention as an indication for counseling. Overall, occupational health nurses and medical society physician members were similar on many aspects of their counseling, although some significant differences did exist.