Community assessment: a church community and the parish nurse

In central Massachusetts a large urban parish asked the University of Massachusetts, Amherst School of Nursing to conduct a community assessment for the church and newly employed parish nurse. The aims of the assessment were: to determine the health status of parishioners, identify their perceived health needs and perceived barriers in meeting those needs, and to assist the church and parish nurse in developing a health program for their faith community. Findings of the assessment are based on questionnaire and focus group data. Four hundred and twenty-one questionnaires were completed, and six focus groups were held to validate the data. Results showed most parishioners felt they were in good health (93%), believed faith and spiritual beliefs were important in maintaining health and well-being (91%), and thought that the church should play a role in helping parishioners meet their health needs (70%). In addition, focus group discussions revealed a need for respite care for primary caretakers of the ill and elderly, and health education programs for their teen and elderly populations. In conclusion, parishioners were positive and articulated support of the parish nurse and activities designed to address the physical, emotional, and spiritual needs of their community.     

Deaf community analysis for health education priorities

Deaf persons' access to health-related information is limited by barriers to spoken or written language: they cannot overhear information; they have limited access to television, radio, and other channels for public information; and the average reading level of Deaf adults is at a 3rd to 4th grade level. However, literature searches revealed no published reports of community analysis focusing specifically on health education priorities for Deaf communities. A seven-step community analysis was conducted to learn the health education priorities in Arizona Deaf communities and to inform development of culturally relevant health education interventions in Deaf communities. The word "Deaf" is capitalized to reflect the cultural perspective of the Deaf community. A 14-member Deaf Health Committee collected data using multimethods that included review of state census data, review of national health priorities, key informant interviews, discussions with key community groups, a mail survey (n = 20), and semistructured interviews conducted in sign language with 111 Deaf adults. The community diagnosis with highest priority for health education was vulnerability to cardiovascular disease (CVD). Following completion of the community analysis, a heart-health education intervention (The Deaf Heart Health Intervention) was developed using a train-the-trainer, community health worker model. If this model proves to be effective in addressing vulnerability to CVD, then a similar protocol could be employed to address other health concerns identified in the Deaf community analysis.     

社区护士健康评估能力培养存在问题及对策

作为护理程序的第一步,健康评估是护士尤其是社区护士应该掌握的最基础、最重要的专业知识技能之一。本文就中国社区护士培养现状及注重培养健康评估能力的必要性进行了分析,并提出提高社区护士健康评估能力的相应对策。     

Identifying older people in need using action research

An ageing population has implications for community-based health promotion and disease prevention. There is concern about older people who do not fit into existing programmes and services yet need minimal support to maintain independence. A study was designed to develop approaches to gain access to this hard to reach population, assess needs and design and test interventions to integrate them into the community. The study, informed by theories of health promotion and social support, used action research methods. Participant observation documented in field notes, together with case notes and clinical assessments, provided a rich source of qualitative and quantitative data. This article discusses the needs assessment. Over a 3-year period, public health nurses linked with community groups in a predominantly francophone, urban community to identify the target group. Key characteristics of the target group included limitations with instrumental activities of daily living and low levels of social support combined with stressful life situations that challenged adaptation. Three patterns of inadequate support were identified.     

Nurses' lived experience of peacebuilding

Nursing has a unique opportunity to address issues of structural violence that contribute to poor health outcomes. Models for designing nursing care relative to the social determinants of health can be adapted from the discipline of peace studies and the phenomenon of peacebuilding. The aim of this qualitative study was to describe the lived experience of peacebuilding from the perspective of community or public health nurses. Interviews were conducted with eight participants. Attributes of the peacebuilder included fostering human relationships that value the inherent worth and dignity of others, nurturing a character of humility and moral courage, and contemplating the personal cost of engaging in prolonged processes of peacebuilding. Practices of peacebuilding included mediating conflict through multilayered processes, accompanying others to places of empowerment, and utilizing interdisciplinary teaching and learning to build capacity for change. Increasing an understanding of the lived experience of peacebuilding by nurses is relevant to nursing research, theory, and practice, and adds to a broader understanding of peacebuilding.     

‘Health equity through action on the social determinants of health’: taking up the challenge in nursing

REUTTER L and KUSHNER KE. Nursing Inquiry 2010; 17 : 269–280
‘Health equity through action on the social determinants of health’: taking up the challenge in nursing Reducing health inequities is a priority issue in Canada and worldwide. In this paper, we argue that nursing has a clear mandate to ensure access to health and health‐care by providing sensitive empowering care to those experiencing inequities and working to change underlying social conditions that result in and perpetuate health inequities. We identify key dimensions of the concept of health (in)equities and identify recommendations to reduce inequities advanced in key global and Canadian documents. Using these documents as context, we advocate a ‘critical caring approach’ that will assist nurses to understand the social, political, economic and historical context of health inequities and to tackle these inequities through policy advocacy. Numerous societal barriers as well as constraints within the nursing profession must be acknowledged and addressed. We offer recommendations related to nursing practice, education and research to move forward the agenda of reducing health inequities through action on the social determinants of health.     

三甲医院-社区卫生服务中心-居民心肺复苏培训效果

目的 利用基层健康教育平台,研究三甲医院-社区卫生服务中心-社区居民心肺复苏培训模式的效果及可行性。方法 选取2020年9月至2021年9月参加健康教育的社区居民500例,三甲医院急救经验丰富的人员定期指导、考核我中心医护人员的心肺复苏技能,进而对社区居民开展心肺复苏培训,采取PPT讲解、模拟人操作、健康教育讲座、微信或微课等多种培训方式相结合的形式,培训前后完成两次调查问卷及考核试题,分析培训效果。结果 社区居民的心肺复苏意愿、心肺复苏相关知识的掌握情况均较培训前显著提高,差异有统计学意义(P均<0.05)。结论 三甲医院-社区卫生服务中心-社区居民心肺复苏培训模式效果显著,有待进一步推广,以提高院外心脏骤停抢救成功率。     

A participatory assessment of environmental health concerns in an Ojibwa community

This research employed a participatory approach to explore environmental health (EH) concerns among Lac Courte Oreilles (LCO) Ojibwa Indians in Sawyer County, Wisconsin. The project was grounded in a broad ecological conceptualization of EH and in principles of health promotion and community participation. Community participation was accomplished through a steering committee that consisted of the primary author and LCO College faculty and community members. The selected assessment methodology was a self-administered survey mailed to LCO members in Sawyer County. Concern for environmental issues was high in this tribal community, especially for future generations. Concern was higher among older members and tribal members living on rather than off the reservation. Local environmental issues of concern were motorized water vehicles, effects from global warming, aging septic systems on waterways, unsafe driving, and contaminated lakes/streams. The LCO community can use survey results to inform further data needs and program development.     

Perspectives on certification of community health workers: A statewide mixed-methods assessment in Nebraska

Objectives

While the Community Health Worker (CHW) workforce in the United States has been growing, so far only 19 states certify CHWs. This study sought to identify perspectives on CHW certification among stakeholders in Nebraska, a state that has not established official certification for CHWs yet.

Design

A concurrent triangulation mixed methods design.

Sample

Study data came from a survey of 142 CHWs in Nebraska and interviews with 8 key informants employing CHWs conducted in 2019.

Methods

Logistic regression was used to identify significant factors associated with favoring CHW certification, supplemented by thematic analysis of qualitative data from CHWs and key informants.

Results

The majority (84%) of CHWs were in favor of a statewide CHW certification in Nebraska, citing community benefits, workforce validation, and standardization of knowledge as the main reasons. Participant characteristics associated with favoring CHW certification included younger age, racial minority, foreign born, education lower than bachelor's degree, volunteering as a CHW, and employed for less than 5 years as a CHW. Key informants employing CHWs were divided in whether Nebraska should develop a state certification program.

Conclusions

While most CHWs in Nebraska wanted to have a statewide certification program, employers of CHWs were less sure of the need for certification.     

Science Cafés: Engaging Scientists and Community through Health and Science Dialogue

Engagement of the community through informal dialogue with researchers and physicians around health and science topics is an important avenue to build understanding and affect health and science literacy. Science Cafés are one model for this casual interchange; however the impact of this approach remains under researched. The Community Engagement Key Function of the Clinical and Translational Science Institute of Southeast Wisconsin hosted a series of Science Cafés in which topics were collaboratively decided upon by input from the community. Topics ranged from Personalized Medicine to Alzheimer''s and Dementia to BioMedical Innovation. A systematic evaluation of the impact of Science Cafés on attendees'' self‐confidence related to five health and scientific literacy concepts showed statistically significant increases across all items (Mean differences between mean retrospective pre‐scores and post‐scores, one tailed, paired samples t‐test, n = 141, p < .0001 for all items). The internal consistency of the five health and scientific literacy items was excellent (n = 126, α = 0.87). Thematic analysis of attendees'' comments provides more nuance about positive experience and suggestions for possible improvements. The evaluation provides important evidence supporting the effectiveness of brief, casual dialogue as a way to increase the public''s self‐rated confidence in health and science topics.     

对社区血脂异常居民护理干预的方法与效果

目的 探讨社区血脂异常居民的护理干预方法与效果.方法 将在体检中心体检的血脂异常人群分为实验组和对照组,对照组采取常规健康教育,实验组在此基础上进行6个月的护理干预,给于健康指导、心理辅导及鼓励同伴之间互相支持.干预前及干预后6个月两组分别填写简易应对方式问卷和社会支持评定量表.结果 经过6个月的护理干预,实验组积极应...     

Comparison of user assessed needs for care between psychiatric inpatients and supported community residents

The aim of the present study was to compare user assessed needs for care for psychiatric patients in inpatient settings with that of residents in supported community residences. The Camberwell Assessment of Need was administered to 75 patients and residents in different housing settings. Residents in supported community settings had more needs for care (8.1), than patients in inpatient settings (5.8), partly because of differences in duration of illness. A greater proportion of those living in supported community residences reported needs in the areas of psychotic symptoms, accommodation, food, daytime activities, sexual expression and looking after the home. There were no differences in numbers of unmet needs. Relatives and friends provided emotional and social support predominantly in the areas of company and psychological distress. In conclusion, living in supported community residences does not imply more unmet needs, or less adequate response to needs from services, despite a greater number of needs being reported. In some areas of need, relatives and friends play an important role in the provision of support.     

Association of Community Health Nursing Educators', 2020 evidence-based project priorities: A national blueprint for unifying research and evidence-based practice priorities

The Association of Community Health Nursing Educators (ACHNE) Research Committee Subcommittee on Evidence-Based Practice (EBP) presents a paper on the state of translation of science into public health nursing education practice. The paper builds from the integrative research review completed by the ACHNE Research Priorities Subcommittee (McElroy et al., Public Health Nursing, 2020) offering updated research priorities and a Research in Action model. Four EBP Project Priorities were established using the Johns Hopkins EBP Model guided by Dang and Dearholt's (Johns Hopkins nursing evidence-based practice: Model and guidelines, 2018) 19-step process. The EBP Project Priorities emphasize the need for EBP projects to align ACHNE strategic plans and research priorities. The authors recommend that the Research in Action model guide deliberate unification of both the Research and EBP Project Priorities. Standards and criteria for essential effort unifying collaborative effort between PhD and Doctorate in Nursing Practice scholars, coordination of research efforts, and innovative practice partnerships is provided.     

Embedding Socio-Behavioral Frameworks in Community Rehabilitation: Evaluation of a Service Change Program

Background: Paradigms which emphasize the social determinants of health and client self-management, and approaches which promote health behavior change, are rarely operationalized within rehabilitation settings. The aim of this study was to investigate the processes required for this model of care change within an existing allied health community rehabilitation service. Methods: The service change program consisted of training elements in the areas of the social determinants of health, client self-management and health behavior change techniques as well as associated operational changes to reflect this paradigm shift. Results: The training packages implemented appear to have improved staff knowledge and skills within these socio-behavioral areas. Clinicians self-reported improvement with client care; however, these changes were not reflected in the chart audit. Conclusions: Clinician training is required to build both knowledge and skills in the areas of the social determinants of health, client self-management and health behavior change principles. In addition, clinicians should be equipped with frameworks to assist with operationalizing these principles.