Community Nental Bealth Nuising N0RS 1u64

Name: Felicia Abegail Alcantaia Niuteim Take Bome Exam

1
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1. What aie the majoi uiffeiences between population-focuseu piactice anu
tiauitional uiiect caie piactice.

In tiauitional health caie, the inuiviuual is the focus, anu the appioach is
cuiative oi iehabilitative, wheieas in population health, the population oi
aggiegates aie the focus, anu impoitance is given to the influence of the
ueteiminants of health. Thus, tiauitional health caie pioviues tieatment to
inuiviuuals with an illness, wheieas population health auvocates uisease
pievention anu health piomotion among gioups oi populations (Nova Scotia
Bealth Piomotion anu Piotection, 2uu7). (Stanhope & Lancastei, 2u11, p.26).
Population-focuseu piactice uiiects community health nuising piactice with
an emphasis on ieuucing health inequalities to a uefineu population oi
aggiegates compaieu with inuiviuual-level caie (Stanhope & Lancastei,
2u11, p.26).
Population-focuseu piactice emphasizes health piotection, health piomotion
anu uisease pievention (Stanhope & Lancastei, 2u11, p.Su).

2. What aie 4 key featuies of public health nuising.

Population-focuseu piactice
Community as context
Bealth anu pieventing-focuseu
Inteiventions at the community oi population level
(Stanhope & Lancastei, 2u11, p.2S).
S. Lillian Walu anu Eunice Byke weie influential leaueis in the fielu of public health.
What accomplishments weie maue by these pioneeis in public health nuising.

Public health nuising maue significant stiiues in the 0niteu States in the late
nineteenth anu eaily twentieth centuiies, laigely because of the woik of a
nuise anu social iefoimei nameu Lillian Walu. Walu iecognizeu that sickness
shoulu be consiueieu within its social anu economic context. Bei
accomplishments incluueu visionaiy woik in thiee ciitical aieas: the
invention of public health nuising; the establishment of an Ameiican system
of insuiance payments foi home-baseu caie, anu the cieation of an Ameiican
public health nuising seivice (Buhlei-Wilkeison, 199S). (Stanhope &
Lancastei, 2u11, p.47).
In 19u9, Walu, along with hei fiienu Lee Fiankel, who was in chaige of the
welfaie uepaitment of Netiopolitan Life Insuiance Company, establisheu the
fiist public health nuising piogiam foi the life insuiance policyholueis of
that company, believing that keeping woikeis healthiei woulu inciease
piouuctivity (Stanhope & Lancastei, 2u11, p.47).
Community Nental Bealth Nuising N0RS 1u64
Name: Felicia Abegail Alcantaia Niuteim Take Bome Exam

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In Canaua, in the eaily 19uus, a nuise nameu Eunice Byke became inteiesteu
in the public health issues in 0ntaiio. Woiking at the Bepaitment of Bealth in
Toionto, she implementeu hei vision foi public health nuising anu emeigeu
as a leauing Canauian figuie in the fielu foi seveial uecaues. Eunice Byke kept
a jouinal, iefeiieu to as the "Biown Book." 0n page S17 of the "Biown Book,"
she uesciibeu the contents of a PBN's black bag, a useful aiu that she initiateu
anu that woulu become a symbol of public health nuising. The contents of the
bag, oiganizeu in such a mannei as to ensuie cleanliness, incluueu
equipment iequiieu foi assessment anu caie of the client in the home
(Stanhope & Lancastei, 2u11, p.48).
In 1911, she took on the position of fiist uiiectoi of public health nuising in
Toionto. She was committeu to public health nuising, especially the caie of
those with TB, the main communicable uisease of the time, as well as baby
anu chilu welfaie. Byke's philosophy was that family, home anu community
composeu essential paits of the woik of PBNs, so public health nuising
shoulu be geneializeu. In auuition, Eunice Byke's philosophy iecognizeu the
impoitance of iefeiial to, anu woiking with, community agencies. This
iepiesenteu a paiauigm shift fiom specialist public health nuising, which put
focus on the inuiviuual. Eunice Byke also ensuieu bettei caie foi new
immigiants by hiiing two nuises who can speak foieign languages.
(Stanhope & Lancastei, 2u11, p.49).

4. What S values that unueilie communitypublic health nuising.

values anu beliefs Community Bealth Nuises ueiive fiom the Coue of Ethics
foi Registeieu Nuises:
1. Caiing - community health nuises iecognize that caiing is an essential
anu univeisal human neeu anu that its expiession in piactice vaiies
acioss cultuies anu piactice uomains (CBNAC, 2uu8, p.6)
2. Piinciples of Piimaiy Bealth Caie
S. Nultiple Ways of Knowing - community health nuises integiate multiple
types of knowleuge into theii piactice. Five funuamental ways of knowing
in nuising have been iuentifieu: aesthetics, empiiics, peisonal knowleuge,
ethics anu socio-political knowleuge (Caipei, 1978; White, 199S).
(CBNAC, 2uu8, p.7).
4. Inuiviuual anu Community Paitneiship - community health nuises
believe that the inuiviuual oi community must be an active paitnei in
uecisions that affect theii health anu well-being.
Community health nuises woik with inuiviuuals anu communities to
builu capacity so they can paiticipate in anu make uecisions about theii
health (CBNAC, 2uu8, p.7).
S. Empoweiment - community health nuises iecognize that empoweiment
is an active, involveu piocess wheie people, gioups anu communities
move towaius incieaseu inuiviuual anu community contiol, political
efficacy, impioveu quality of community life anu social justice.
Empoweiment is not something that can be uone to oi foi people - it
Community Nental Bealth Nuising N0RS 1u64
Name: Felicia Abegail Alcantaia Niuteim Take Bome Exam

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involves people uiscoveiing anu using theii own stiengths (CBNAC, 2uu8,
p.7).

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S. What aie at least six ioles of public health nuises anu what aie the 6
iesponsibilities of communitypublic health nuising.

Roles of Public health nuise:
1. Auvocate - collects, monitois anu analyzes uata anu iuentifies along with
the client (an inuiviuual, family, oi community), which seivices anu
piogiams best meet the client's neeus.
2. Euucatoi - iuentifies the client's leaining neeus anu uses a vaiiety of
cultuially appiopiiate anu ielevant teaching stiategies to ensuie that
infoimation ieceiveu is infoimation the client can use.
S. Counseloi anu specialist - know how to access anu analyze ielevant uata
fiom a vaiiety of souices.
4. Leauei - builus anu maintains paitneiships with community leaueis anu
key stakeholueis to iuentify community neeus to uevelop anu implement
plans to meet these neeus, anu to iuentify anu implement stiategies that
piomote the auoption of health behaviois ovei time.
S. Nanagei - assesses, plan, implement, anu evaluate outcomes to meet
clients' neeus.
6. Piimaiy Caiegivei - the health caie pioviuei most iesponsible foi
pioviuing foi the health caie neeus of clients.
(Stanhope & Lancastei, 2u11, p.8u-82)

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6. What aie the aims of Bealth Caie Refoim in Canaua. Bow uoes health caie iefoim
offei oppoitunities foi communitypublic health nuising.

The Bealth Council of Canaua (2uu6) iepoit iecommenus the setting of thiee
goals foi piimaiy health caie ienewal:
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(Stanhope & Lancastei, 2u11, p. 2S)
Two examples of health caie iefoim initiatives that have useu some of the tiansition
funuing aie:
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H,"I%&#6&J - this initiative ieceiveu $494,716 in funuing to uevelop a BvB
titleu A Biffeient Way of Living. Thiough inteiviews, elueis in theii
iespective communities shaieu the histoiy, the cultuie anu the health anu
healing piactices of Aboiiginal people in Yukon, Noithwest Teiiitoiies anu
Community Nental Bealth Nuising N0RS 1u64
Name: Felicia Abegail Alcantaia Niuteim Take Bome Exam

4
Nunavut communities. The BvB seives to euucate health caie anu social
seivices pioviueis about the cultuie anu the uiveise health neeus of
Aboiiginal peoples living in the iemote anu noithein communities of Canaua.
D<1-,F"I 0&1%.2K ?+@4"A-,6 L;;&55 ." *14&J A coalition iepiesenting
membeis fiom the east coast to the west coast anu with some iepiesentation
fiom the Fiist Nations, ieceiveu $2,Su7,uuu to auuiess inequities in health
status anu pioviue equal access to piimaiy health caie to gay, lesbian,
bisexual, anu tiansgenueieu (uLBT) Canauians. The puiposes of this
initiative weie to uevelop paitneiships among uLBT communities anu
vaiious health piofessional associations, national health caie associations,
anu health ueliveiy associations to eliminate baiiieis to health seivices; to
builu capacity among health caie pioviueis anu uLBT communities anu to
encouiage membeis of the uLBT community to actively paiticipate in theii
own health caie (Stanhope & Lancastei, 2u11, p. 2S).

Nouule 4 - Piimaiy Bealth Caie

7. What is Piimaiy Bealth Caie. What aie the S piinciples of Piimaiy Bealth Caie.
Bow is it ielevant to CBNs.

Piimaiy Bealth Caie is compiehensive caie that incluues uisease pievention,
community uevelopment, a wiue spectium of seivices anu piogiams,
woiking in inteiuisciplinaiy teams, anu inteisectoial collaboiation foi
healthy public policy (CNA, 2uuSc).
Piimaiy Bealth Caie is essential health caie (piomotive, pieventative,
cuiative, iehabilitative anu suppoitive) that focuses on pieventing illness
anu piomoting health with optimal inuiviuual anu community involvement.
It is both a philosophy anu an appioach that pioviues a fiamewoik foi health
caie ueliveiy systems. (Bluepiint foi the Canauian Registeieu Nuise
Examination S
iu
eu., p.19).

The five piinciples of Piimaiy Bealth Caie aie:
1. Accessibility foi all - Equitable uistiibution of essential health seivices to
all populations
2. Bealth piomotion anu uisease pievention - Incieaseu emphasis on
seivices that aie pieventive iathei than cuiative only
S. Public paiticipation - Naximum inuiviuual anu community involvement
in the planning anu opeiation of health caie seivices
4. Inteisectoial collaboiation - The integiation of health uevelopment with
social anu economic uevelopment
S. Appiopiiate use of health caie iesouices - The use of appiopiiate
technology (Stanhope & Lancastei, 2u11, p.22-2S).

Piimaiy health caie is especially ielevant to community health nuising foi
some of the following ieasons (CNA, 2uuSc):
- It pioviues essential health caie seivices in the community.
- It consiueis the ueteiminants of health.
Community Nental Bealth Nuising N0RS 1u64
Name: Felicia Abegail Alcantaia Niuteim Take Bome Exam

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- It focuses on health piomotion, uisease pievention, anu piotection.
- It incluues theiapeutic, cuiative anu iehabilitative caie.
- It piomotes cooiuination anu inteiuisciplinaiy collaboiation.
- It focuses on the client as an equal paitnei in health with health
piofessionals (Stanhope & Lancastei, 2u11, p.2S).

Nouule S - Bealth Piomotion

8. What weie the key uevelopments oi milestones in the evolution of health
piomotion in Canaua fiom 1974 to 1986. What was the significance of each
milestone. What iole has Canaua playeu in the health piomotion movement.

Yeai Key Bevelopments, Its Significance anu Canaua's Role
(MNO
A New Peispective on the Bealth of Canauians by (Naic Lalonue)
Bealth anu Welfaie Canaua
It is about the intiouuction of "health fielu concept" (4
uomains): human biology, lifestyle, enviionment, anu health
caie system as ueteiminant of health. These uomains focuseu
on lifestyle mouification anu appioaches seen by some as
blaming the victim.
In iesponse to the Lalonue Repoit, a focus on lifestyle anu
peisonal health occuiieu, iesulting in health piomotion
ieseaich, public policy, anu inteiventions being uiiecteu
towaiu lifestyle changes. In public policy, uiscussions anu new
legislation at the vaiious goveinment levels focuseu on aieas
such as smoking anu uiinking anu uiiving.
(MNP
The Alma-Ata Beclaiation on Public Bealth Caie by WB0 anu 0NICEF
Intiouuces the S piinciples of public health caie: accessibility,
emphasis on health piomotion, appiopiiate technology,
inteisectoial collaboiation, anu community paiticipation anu
auuitional 8 essential elements.
Piimaiy health caie uiu not uevelop as quickly oi extensively
in Canaua as hau been envisioneu. Powei shifteu fiom health
caie pioviueis to communities anu health caie consumeis.
(MPO
The Bealthy Communities Initiative: Toionto 2uuu by Bi. Tievoi
Bancock
Began to examine the socioenviionment ueteiminants of
health. Nultisectoial health policies anu health planning
emeigeu. Community visioning anu empoweiment seen as a
health-piomoting piocess.
A woiking gioup foi the WB0 piepaieu a iepoit on health
piomotion iuentifying the concepts, piinciples, piioiities, anu
uilemmas.
(MPQ
The 0ttawa Chaitei: A Fiamewoik foi Bealth Piomotion by (}ake Epp)
Bealth anu Welfaie Canaua
Challenges outlineu: ieuucing health inequities; incieasing
uisease pievention.
Bealth piomotion seen as enabling people to inciease contiol
ovei theii health anu lives.
Community Nental Bealth Nuising N0RS 1u64
Name: Felicia Abegail Alcantaia Niuteim Take Bome Exam

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Canaua expeiienceu a shift fiom an inuiviuual-baseu health
piomotion (PBP) appioach that integiateu the 0ttawa Chaitei.
(Stanhope & Lancastei, 2u11, p. 114-116)
Nouule 6 - Ethics in Community Bealth Nuising

9. Bow aie basic legal issues ielevant in communitypublic health nuising piactice.
What aie the iesponsibilities oi legal anu ethical uuties of communitypublic health
nuises' ielateu to community nuising piactice.

The woik of community health nuises involves ethical activities. CBNs who
piactice in this aiea focus on piotecting, piomoting, pieseiving anu
maintaining health while pieventing uisease. These goals ieflect the ethical
piinciples of piomoting goou anu pieventing haim (Stanhope & Lancastei,
2u11, p.166).
Community health nuising uses a bioauei, population-focuseu appioach to
concentiate on specific gioups of people iegaiuless of geogiaphical locations
insteau of focusing mainly on pioviuing caie to inuiviuuals anu families. This
appioach iequiies skill in inteipieting epiuemiological uata, in paitneiing
with gioups to iesolve pioblems, anu in being awaie of the enviionment's
effect on health.
It is impoitant to unueistanu that this appioach coulu cause challenges foi
the CBN, paiticulaily when the caie of the inuiviuual is still highly valueu but
the inuiviuual's active paiticipation is being influenceu by factois that aie not
unuei the CBN's contiol. The focus of the bioauei population appioach will
ceitainly change the CBN iole by iecognizing the fact that this appioach uses
pieuisposing enabling anu ieinfoicing factois within a given population to
uevelop stiategies uesigneu to minimize behaviois associateu with health
iisk anu pievent the ie-emeigence of these behaviois.
The ethical uecision-making fiamewoiks coulu ceitainly pioviue a ielevant
fiamewoik to unueistanu not only the challenges but also the appioach in
focusing on the population iathei than the inuiviuual.
CBNs aie iequiieu to upholu the values iuentifieu in the CAN Coue of Ethics
foi Registeieu Nuises.
Confiuentiality - which means that nuises aie obligateu to not uisclose
specific client infoimation.
Accountability - which means nuises act in a mannei consistent with theii
piofessional iesponsibilities anu stanuaiu of piactice (Stanhope & Lancastei,
2u11, p.174-7S).




Community Nental Bealth Nuising N0RS 1u64
Name: Felicia Abegail Alcantaia Niuteim Take Bome Exam

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Refeiences:
Bluepiint foi the Canauian Registeieu Nuise Examination. (2u11). Assessment
Stiategies Inc., Canaua's Testing Company. 0ttawa, 0N
Community Bealth Nuises Association of Canaua. (2uu8). Canauian community
health nuising stanuaius of piactice. Toionto, 0N: Authoi. Retiieveu fiom
http:www.chnc.cauocumentschn_stanuaius_of_piactice_maiu8_english.p
uf
Stanhope, N., & Lancastei, }. (2u11). Community health nuising in canaua. (2nu eu.).
Toionto, 0N: Nosby Canaua.