Theoretical Foundations of Community Health Nursing Practice

A comprehensive set of practice-oriented flashcards covering key theories and models in the theoretical foundations of community health nursing practice, including General Systems Theory, Social Learning Theory, Health Belief Model, Milio’s Framework, Pender’s Health Promotion Model, Transtheoretical Model, and the Precede-Proceed Model.

What is the purpose of nursing theories in community/public health nursing?

To guide practice and improve nursing practice, including public health.

How is a theory differently described from a full terrain, according to a nurse theorist analogy?

A theory is like a map of a territory; it highlights important parts for its purpose rather than providing the full terrain.

Who is considered the first nurse to formulate a conceptual foundation for nursing practice?

Florence Nightingale.

Name some theorists who began to include community perspectives in their definitions of health since 1980.

Dorothy Johnson, Sister Callista Roy, Imogene King, Betty Neuman, and Jean Watson.

In General Systems Theory, how is the client viewed?

As an open system—an interacting set that exchanges energy, matter, or information with the environment.

What dimensions compose an individual in General Systems Theory?

Physical, psychological, social, and spiritual—interdependent and interrelated.

How are families, groups, and communities related in the open systems view?

The family is a set of interrelated individuals; the geographic community is a set of families; a suprasystem (e.g., the community) contains these subsystems.

Why is a home visit useful in open systems analysis?

It provides data to analyze the family as a system and its relation to the environment.

What constitutes the family environment in this model?

The family home, the community and its institutions; interpersonal relationships; physical environmental conditions; inputs of matter, energy, and information.

What are inputs, throughput, outputs, and feedback in open systems?

Inputs are resources; throughput is processing; outputs are products; feedback is environmental information used to adjust functioning.

What is a suprasystem?

A larger system that contains subsystems, such as the community containing families.

What are the basic structures of a family found in open systems?

Boundaries, environment, inputs, outputs, processing (throughput), feedback, subsystems.

What is Social Learning Theory primarily based on?

Learning occurs in a social context, people learn from one another, and modeling is important; individuals have self-regulatory capacities.

How can a nurse apply Social Learning Theory in practice?

By serving as a live model, giving detailed verbal instructions, and using print or multimedia health education.

What are the four learning processes in Social Learning Theory?

Attention, retention, reproduction, and motivation.

What does the Health Belief Model aim to explain?

Why people participate or do not participate in health screening; disease avoidance is a major determinant.

List the constructs of the Health Belief Model.

Perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, and self-efficacy.

What does Perceived Susceptibility mean?

One's belief regarding the chance of getting a given condition.

What does Perceived Severity mean?

One's belief regarding the seriousness of a given condition.

What does Perceived Benefits mean?

One's belief that an advised action will reduce risk or seriousness of a condition.

What does Perceived Barriers mean?

One's belief regarding tangible and psychological costs of an advised action.

What are Cues to Action?

Strategies or environmental conditions that activate readiness to take action.

What is Self-Efficacy in the Health Belief Model?

One's confidence in one's ability to take the action to reduce health risks.

What does Milio’s Framework for Prevention add to health behavior theories?

An upstream perspective that includes economic, political, and environmental determinants and broader societal context.

What did Nancy Milio believe about national-level health policy?

Policy making at the national level is best for favorably impacting health across populations.

State Milio’s Propositions 1–3.

1) Population health results from deprivation or excess of critical health resources; 2) Behaviors reflect limited options and beliefs; 3) Organizational decisions/policies dictate many options and influence choices.

State Milio’s Propositions 4–6.

4) Individual choices are influenced by maximizing valued resources; 5) Widespread changes can lead to social change; 6) Without alternative health-promoting options, health education alone is ineffective.

What is the key difference between Milio and the Health Belief Model?

Milio includes economic, political, and environmental determinants; HBM focuses on individual perceptions and disease avoidance.

What is Pender’s Health Promotion Model about?

Explores biopsychosocial factors influencing pursuit of health promotion; multi-dimensional with seven variables; threat is not used as a motivator.

List the seven variables in Pender’s Health Promotion Model.

1) Prior related behaviors; 2) Personal factors; 3) Behavior-specific cognition and affect (perceived benefits, perceived barriers, perceived self-efficacy); 4) Activity-related affect; 5) Interpersonal influences; 6) Situational influences; 7) Health-promoting behavior.

What is the Transtheoretical Model and its basic assumption?

A model that combines several theories; assumes behavior change occurs over time through stages that are stable yet open to change.

What are the stages of change in the Transtheoretical Model?

Precontemplation, Contemplation, Preparation, Action, Maintenance.

What is Decisional Balance in the Transtheoretical Model?

Pros and Cons.

What is the Precede-Proceed Model and who developed it?

A model for community assessment, health education planning, and evaluation developed by Dr. Lawrence W. Green and colleagues.

What does PRECEDE stand for?

Predisposing, Reinforcing, and Enabling Constructs in Educational Diagnosis and Evaluation.

What does PROCEED stand for?

Policy, Regulatory, and Organizational Constructs in Educational and Environmental Development.

What are Predisposing factors in PRECEDE?

People’s characteristics that motivate them toward health-related behavior.

What are Enabling factors in PRECEDE?

Conditions in people and the environment that facilitate or impede health-related behavior.

What are Reinforcing factors in PRECEDE?

Feedback from supporters or groups resulting from performing the health-related behavior.