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Community/Public Health Nursing
Promoting the Health of Populations
SIXTH EDITION
Mary A. Nies, PhD, RN, FAAN, FAAHB Dean and Professor School of Nursing, Joint Appointment MPH Program, Division of Health Sciences, Idaho State University, Pocatello, Idaho
Melanie McEwen, PhD, RN, CNE, ANEF Associate Professor, University of Texas Health Science Center at Houston, School of Nursing, Houston, Texas
Table of Contents
Cover image
Title page
Copyright
Dedication
Author Biographies
Contributors
Reviewers
Preface Unit 1. Introduction to Community Health Nursing
Chapter 1. Health: A Community View
Definitions of Health and Community
Determinants of Health and Disease
Indicators of Health and Illness
Definition and Focus of Public Health and Community Health
Preventive Approach to Health
Definition and Focus of Public Health Nursing, Community Health Nursing, and Community-Based Nursing
Population-Focused Practice and Community/Public Health Nursing Interventions
Community Health Nursing, Managed Care, and Health Reform
Learning Activities
Chapter 2. Historical Factors: Community Health Nursing in Context
Evolution of Health in Western Populations
Advent of Modern Health Care
Consequences for the Health of Aggregates
Social Changes and Community Health Nursing
Challenges for Community and Public Health Nursing
Summary
Learning Activities
Chapter 3. Thinking Upstream: Nursing Theories and Population- Focused Nursing Practice
Thinking Upstream: Examining the Root Causes of Poor Health
Historical Perspectives on Nursing Theory
How Theory Provides Direction to Nursing
Microscopic Versus Macroscopic Approaches to the Conceptualization of Community Health Problems
Assessing a Theory’s Scope in Relation to Community Health Nursing
Review of Theoretical Approaches
Healthy People 2020
Summary
Learning Activities
Chapter 4. Health Promotion and Risk Reduction
Health Promotion and Community Health Nursing
Determinants Of Health
Theories in Health Promotion
Risk and Health
The Relationship of Risk to Health and Health Promotion Activities
Summary
Learning Activities
Unit 2. The Art and Science of Community Health Nursing
Chapter 5. Epidemiology
Use of Epidemiology in Disease Control and Prevention
Calculation of Rates
Concept of Risk
Use of Epidemiology in Disease Prevention
Use of Epidemiology in Health Services
Epidemiological Methods
Summary
Learning Activities
Chapter 6. Community Assessment
The Nature of Community
Healthy Communities
Assessing the Community: Sources of Data
Needs Assessment
Diagnosing Health Problems
Summary
Learning Activities
Chapter 7. Community Health Planning, Implementation, and Evaluation
Overview of Health Planning
Health Planning Model
Health Planning Projects
Health Planning Federal Legislation
Nursing Implications
Summary
Learning Activities
Chapter 8. Community Health Education
Connecting with Everyday Realities
Health Education in the Community
Learning Theories, Principles, and Health Education Models
The Nurse’s Role in Health Education
Enhancing Communication
Framework for Developing Health Communications
Health Education Resources
Social Media
Summary
Learning Activities
Chapter 9. Case Management
Overview of Case Management
Origins of Case Management
Purpose of Case Management
Utilization Review and Managed Care
Trends that Influence Case Management
Education and Preparation for Case Managers
Case Manager Services
Case Manager Roles and Characteristics
Case Identification
The Referral Process
Application of Case Management in Community Health
Research in Case Management
International Case Management
Summary
Learning Activities
Unit 3. Factors that Influence the Health of the Community
Chapter 10. Policy, Politics, Legislation, and Community Health Nursing
Overview: Nurses’ Historical and Current Activity in Health Care Policy
Definitions
A Major Paradigm Shift
Structure of the Government of the United States
Overview of Health Policy
Major Legislative Actions and the Health Care System
Public Policy: Blueprint for Governance
The Effective Use of Nurses: A Policy Issue
Nurses’ Roles in Political Activities
Health Care Reform and Restructuring of the Health Care Industry
Nurses and Leadership in Health Policy Development
Summary
Learning Activities
Chapter 11. The Health Care System
Overview: The Health Care System
Components of the Health Care System
Quality Care
Critical Issues in Health Care Delivery
Future of Public Health and the Health Care System
Summary
Learning Activities
Chapter 12. Economics of Health Care
Factors Influencing Health Care Costs
Public Financing of Health Care
Philanthropic Financing of Health Care
Health Care Insurance Plans
Cost Containment
Trends in Health Financing
Health Care Financing Reform
Roles Of the Community Health Nurse in the Economics of Health Care
Best Care at Lower Cost
Summary
Learning Activities
Chapter 13. Cultural Diversity and Community Health Nursing
Cultural Diversity
Transcultural Perspectives on Community Health Nursing
Population Trends
Cultural Perspectives and Healthy People 2020
Transcultural Nursing
Overview of Culture
Culture and Socioeconomic Factors
Culture and Nutrition
Culture and Religion
Culture and Aging
Cross-Cultural Communication
Health-Related Beliefs and Practices
Management of Health Problems: A Cultural Perspective
Management of Health Problems in Culturally Diverse Populations
Role of the Community Health Nurse in Improving Health for Culturally Diverse People
Resources for Minority Health
Summary
Learning Activities
Chapter 14. Environmental Health
A Critical Theory Approach to Environmental Health
Areas of Environmental Health
Effects of Environmental Hazards
Efforts to Control Environmental Health Problems
Emerging Issues in Environment Health
Approaching Environmental Health at the Population Level
Critical Environmental Health Nursing Practice
Summary
Learning Activities
Chapter 15. Health in the Global Community
Population Characteristics
Environmental Factors
Patterns of Health and Disease
International Agencies and Organizations
International Health Care Delivery Systems
Research in International Health
Health Initiatives Taking Place Throughout the World
Summary
Learning Activities
Unit 4. Aggregates in the Community
Chapter 16. Child and Adolescent Health
Issues of Pregnancy and Infancy
Childhood Health Issues
Adolescent Health Issues
Factors Affecting Child and Adolescent Health
Strategies to Improve Child and Adolescent Health
Public Health Programs Targeted to Children and Adolescents
Sharing Responsibility for Improving Child and Adolescent Health
Legal and Ethical Issues in Child and Adolescent Health
Summary
Learning Activities
Chapter 17. Women’s Health
Major Indicators of Health
Social Factors Affecting Women’s Health
Health Promotion Strategies for Women
Major Legislation Affecting Women’s Health
Health and Social Services to Promote the Health of Women
Levels of Prevention and Women’s Health
Roles of the Community Health Nurse
Research in Women’s Health
Summary
Learning Activities
Chapter 18. Men’s Health
Men’s Health Status
Use of Medical Care
Theories that Explain Men’s Health
Factors that Impede Men’s Health
Men’s Health Care Needs
Primary Preventive Measures
Secondary Preventive Measures
Tertiary Preventive Measures
Summary
Learning Activities
Chapter 19. Senior Health
Concept of Aging
Theories of Aging
Demographic Characteristics
Psychosocial Issues
Physiological Changes
Wellness and Health Promotion
Common Health Concerns
Additional Health Concerns
Elder Safety and Security Needs
Psychosocial Disorders
Spirituality
End-of-Life Issues
Summary
Learning Activities
Chapter 20. Family Health
Understanding Family Nursing
The Changing Family
Approaches to Meeting the Health Needs of Families
Approaches to Family Health
Assessment Tools
Family Health Assessment
Extending Family Health Intervention to Larger Aggregates and Social Action
Applying the Nursing Process
Summary
Learning Activities
Unit 5. Vulnerable Populations
Chapter 21. Populations Affected by Disabilities
Self-Assessment: Responses to Disability
Definitions and Models for Disability
A Historical Context for Disability
Characteristics of Disability
Disability and Public Policy
Costs Associated with Disability
Healthy People 2020 and The Health Needs of People with Disabilities
The Experience of Disability
Strategies for the Community Health Nurse in Caring for People with Disabilities
Ethical Issues for People Affected by Disabilities
Summary
Learning Activities
Chapter 22. Homeless Populations
Definitions, Prevalence, and Demographic Characteristics of Homelessness
Factors that Contribute to Homelessness
Health and Homeless Populations
Health Status of Homeless Population
Community Public Health Nursing: Care of Homeless Populations
Summary
Learning Activities
Chapter 23. Rural and Migrant Health
Rural United States
Rural
Rural Health Disparities: Context and Composition
Specific Rural Aggregates
Application of Relevant Theories and “Thinking Upstream” Concepts to Rural Health
Rural Health Care Delivery System
Community-Based Care
Legislation and Programs Affecting Rural Public Health
Rural Community Health Nursing
Rural Health Research
New Models of Health Care Delivery for Rural Areas
Summary
Learning Activities
Chapter 24. Populations Affected by Mental Illness
Overview and History of Community Mental Health: 1960 to the Present Day
HEALTHY PEOPLE 2020: Mental Health and Mental Disorders
Factors Influencing Mental Health
Mental Disorders Encountered in Community Settings
Identification and Management of Mental Disorders
Community-Based Mental Health Care
Role of the Community Mental Health Nurse
Summary
Learning Activities
Unit 6. Population Health Problems
Chapter 25. Communicable Disease
Communicable Disease and Healthy People 2020
Principles of Infection and Infectious Disease Occurrence
Chain of Transmission
Breaking the Chain of Transmission
Public Health Control of Infectious Diseases
Vaccines and Infectious Disease Prevention
Vaccine Needs for Special Groups
Healthy People 2020 Focus on Immunization and Infectious Diseases
Healthy People 2020 Focus on Sexually Transmitted Diseases
Healthy People 2020 Focus on HIV/AIDS
Prevention of Communicable Diseases
Summary
Learning Activities
Chapter 26. Substance Abuse
Etiology of Substance Abuse
Historical Overview of Alcohol and Illicit Drug Use
Prevalence, Incidence, and Trends
Adolescent Substance Abuse
Conceptualizations of Substance Abuse
Sociocultural and Political Aspects of Substance Abuse
Course of Substance-Related Problems
Legal and Ethical Concerns Related to Substance Abuse
Modes of Intervention
Social Network Involvement
Vulnerable Aggregates
Nursing Perspective on Substance Abuse
Summary
Learning Activities
Chapter 27. Violence
Overview of Violence
History of Violence
Interpersonal Violence
Community Violence
Factors Influencing Violence
Violence from a Public Health Perspective
Prevention of Violence
Summary
Learning Activities
Chapter 28. Natural and Man-Made Disasters
Disaster Definitions
Types of Disasters
Characteristics of Disasters
Disaster Management
Disaster Management Stages
Summary
Learning Activities
Unit 7. Community Health Settings
Chapter 29. School Health
History of School Health
School Health Services
School Nursing Practice
School-Based Health Centers
Future Issues Affecting the School Nurse
Summary
Learning Activities
Chapter 30. Occupational Health
Evolution of Occupational Health Nursing
Demographic Trends and Access Issues Related to Occupational Health Care
Occupational Health Nursing Practice and Professionalism
Occupational Health and Prevention Strategies
Skills and Competencies of the Occupational Health Nurse
Impact of Federal Legislation on Occupational Health
Legal Issues in Occupational Health
Multidisciplinary Teamwork
Summary
Learning Activities
Chapter 31. Forensic and Correctional Nursing
Subspecialties of Forensic Nursing
Correctional Nursing
Health Issues in Prison Populations
Mental Health Issues in Correctional Settings
Education and Forensic Nursing
Summary
Learning Activities
Chapter 32. Faith Community Nursing
Faith Communities: Role in Health and Wellness
Foundations of Faith Community Nursing
Roles or Functions of the Faith Community Nurse
Education of the Faith Community Nurse
The Faith Community Nurse and Spirituality
Issues in Faith Community Nurse Practice
Summary
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