theoretical foundations of community health nursing practice

8/18/2019 Theoretical Foundations of Community Health Nursing Practice

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Theoretical foundations ofcommunity health nursing

practice


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“A systematic vision of reality; a set ofinterrelated concepts that is useful forprediction and control” (woods andcatanzaro, 1988, p58!

“A conceptual system or framewor"invented for some purpose; and as the

purpose varies, so too must the structureand comple#ity of the system” ($ic"o% and

&ames, 198, p'19!

Denition of Theory


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eneral systems theory )ocial learnin* theory +he health elief model

-ilio.s /ramewor" for 0revention 0ender.s ealth promotion model +he transtheoretical model 0recede20roceed -odel

Theoretical approaches


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Applicale to individuals, families, *roupsand communities

3iewed as an open system, the client isviewed as a set of interactin* elements

+he individual is set of several dimensions

+he family and the *roup are sets ofinterrelated individuals

General systems theory


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+his concept is particularly useful whenanalyzin* interrelationships of the elementswithin the client, as well as those of theclient and the environment

General systems theory


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4s ased on the elief that learnin* ta"esplace in a social conte#t

4t is anchored on the fact that persons arethin"in* ein*s with self2re*ulatorycapacities, capale of ma"in* decisions andactin* accordin* to e#pected conseuences

of their ehavior

Social Learning theory


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+he environment a%ects learnin*, utlearnin* outcomes depend on the learner.sindividual characteristics

Social Learning theory


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0rovides the asis for much of the practice ofhealth education and health promotion today

6as developed y a *roup of social

psycholo*ists to e#plain why the pulic failed toparticipate in screenin* for tuerculosis(ochaum and associates 1958!

7sed to e#plain ehavior chan*e andmaintenance of ehavior chan*e and to *uidehealth promotion interventions

The Health Belief Model


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omponents 0erceived susceptiility 0erceived severity

0erceived ene:ts 0erceived arriers ues to action )elf2ecacy

The Health Belief Model


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0rovides a complement to the


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-ilio used these propositions to move thefocus of attention upstream in an attempt tocreate a framewor" for initiatin* upstreampolicies

Milio’s framework forpreention


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0ropositions 0opulation health de:cits. result from

deprivation or e#cess of critical health resources

uence choices



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4ndividual choices relate to healthpromotion or health dama*in* ehaviorsare in>uenced y e%ort to ma#imize valuedresources

Alteration in patterns of ehavior resultin*from decision ma"in* of a si*ni:cant

numer of people in a population can resultin social chan*e



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6ithout concurrent availaility ofalternative health2promotin* options forinvestment of personal resources, healtheducation will e lar*ely ine%ective inchan*in* ehavior patterns



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?#plores many iophysical factors thatin>uence individuals to pursue health promotionactivities

$epicts the comple# multidimensional factorswith which people interact as they wor" toachieve optimum health

ontains seven variales related to healthehaviors as well as individual characteristicsthat may in>uence a ehavioral outcome

!ender’s Health promotionmodel


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)even variales related to health ehaviors 0erceived ene:ts of action 0erceived arriers to action

0erceived self2ecacy Activity2related a%ect ommitment to a plan of action 4nterpersonal in>uences )ituational in>uences

!ender’s Health promotionmodel


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4s ased on the assumption that ehaviorchan*e ta"es place over time, pro*ressin*throu*h a seuence of sta*es

Assumes that each of the sta*es is othstale and open to chan*e'

=ne may stop in one sta*e, pro*ress to thene#t sta*e, or return to previous sta*e

Transtheoretical Model


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)ta*es of chan*e 0recontemplation ontemplation

0reparation Action -aintenance

$ecisional alance 0ros ons

Transtheoretical Model


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$eveloped y $r' @awrence 6 ' reen andcollea*ues

0rovides a model for communityassessment, health education plannin*, andevaluation'

0??$? )tands for !redisposin*, "einforcin*, and #nalin*

$onstructs in #Ducational dia*nosis and#valuation, is used for community dia*nosis

!"#$#D#%!"&$#D# Model


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0=?$? stands for !olicy, "e*ulatory, and &r*anizational

$onstructs in educational and#nvironmental D#velopment

4t is a model for implementin* andevaluatin* health pro*rams ased on

0??$?

!"#$#D#%!"&$#D# Model


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0redisposin* factors refer to people.scharacteristics that motivate them towardhealth2related ehavior

?nalin* factors refer to conditions in peopleand the environment that facilitate or impedehealth2related ehavior

einforcin* factors refer to feedac" *iven ysupport persons or *roups resultin* from theperformance of the health2related ehavior

!"#$#D#%!"&$#D# Model

theoretical foundations of community health nursing practice

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