NSCH 111 Study Unit 6: Health Education in the Community

Health Education in the Community

6.3: Nursing Process and Dimensions Model

  • Applies to health education.
  • Compiled by Mrs. Petro Benadé.

Learning Outcomes

  • Understand and apply the nursing process and the dimensions model of community health nursing in health education.

Needs Assessment

  • A planned process that identifies the needs of an individual or group. (Clark, 2008: 264)

Target Group

  • The individuals to whom an intervention program is aimed at and that would benefit from the intervention (Clark, 1999:146).
    • E.g., The Syferfontein community consisting of women, men, and children.

Planning (as related to health education)

  • Planning in the context of health education involves making decisions regarding:
    • What topic to address
    • What problems to attack
    • Where to direct time and resources (Butler, 2001, p.259 as cited by Clark, 2008:267)

Goals

  • The broad purpose of the health education encounter (Clark, 2008:267)

Objectives

  • The specific outcomes that need to be achieved as a result of a health education program (Clark, 2008:268)

Steps in the Health Education Process: Dimensions Model

  • Use the Nursing Process and the Dimensions Model to design the health education:
    • Use the Dimensions of Health to assess:
      • The audience
      • Their health education needs
      • The learning environment (Clark, 2008)
  • Diagnose their learning needs
  • Use the Dimensions of Healthcare to:
    • Plan
    • Implement
    • Evaluate
  • Use the Dimensions of Nursing during the whole process (Clark, 2008)

Assessment

  • Assessment of the audience, their health education needs, and the learning environment using the dimensions of health in the dimensions model (Clark, 2008:264-267+272) (Clark, 1999:172-175)

Assessing Health Education Needs

  • Assessment of the health education needs according to the 6 dimensions of health:
    • Biophysical considerations
    • Psychological considerations
    • Physical environmental considerations
    • Socio-cultural considerations
    • Behavioral considerations
    • Health system considerations
    • SELF STUDY!!! (Clark, 2008:264 + 266-268) GEFOKUSDE ASSESSERING NB! Bladsy 268

Dimensions of Health

Biophysical Considerations

  • Age composition of the target audience
  • Learning needs arising from age and developmental level of audience
  • Effect of developmental level of audience on ability to learn or teaching strategies
  • Effect of physical health problems in the population on the need for health education or hindrance of learning (Clark, 2008:73; 268)

Psychological Considerations

  • Awareness of the target population of the need for health education
  • Level of motivation to learn
  • Effect of population attitudes toward health and health behaviors on learning ability
  • Levels of stress or anxiety of target audience interfering with learning (Clark, 2008:73; 268)

Physical Environmental Considerations

  • Conditions in the physical environment giving rise to health education needs
  • Effects of the environment on learning (Clark, 2008:73; 268)

Sociocultural Considerations

  • Effects of learners’ peers on motivation to learn
  • Current education level of learners
  • Prior exposure to health information
  • Primary language spoken by the target audience
  • Cultural beliefs and practices influencing learning
  • Influence of occupations of group members on need for health education
  • Factors in the social situation influencing health education
  • Effect of these facets on the health education situation (Clark, 2008:73; 268)

Behavioral Considerations

  • Common health behaviors in the population that give rise to the need for health education (Clark, 2008:73; 268)

Health System Considerations

  • Emphasis of health education by local healthcare providers
  • Access to healthcare services/education
  • Need for education regarding the use of healthcare services
  • Need for health education caused by healthcare recommendations
  • Influence of elements of the healthcare regimen on learning abilities (e.g., medications)
  • Influence of attitudes toward healthcare services and providers on the ability to learn (Clark, 2008:73; 268)

Diagnostic Reasoning in Health Education

  • Example of a diagnosis
    • "Need for education regarding effective modes of discipline appropriate to child’s age due to limited knowledge of child development, poor parental role models, and poor stress management skills." (Clark, 1999:175)

Planning Health-Education Programs

  • Prioritizing learning needs
  • Developing goals and objectives
  • Selecting and sequencing content
  • Selecting teaching strategies
  • Preparation of materials
  • Planning evaluation (Clark, 1999:176-180)
  • Also, see for self-study:
    • Language and literacy in health education
    • The internet in health education (Clark, 2008:267-270)
    • Using media in health education and health promotion (Clark, 2015:270-272)

Prioritizing Learning Needs

  • Determine the risk factors in the population and the benefits if they can be changed.
  • Decide which risk factor must get attention first.
  • In community nursing, the first decision may be health education that addresses the most important problem. (Clark, 2008:267)
  • Community members can help determine priorities. (Clark, 2015:271)

Developing Goals and Objectives

  • The broad goal of the health education encounter is specified
    • Program goals
      • Purpose of the whole health education program
        • E.g., Prevention of obesity in school-aged children
    • Educational goals
      • Learning outcomes that are expected for the audience
        • E.g., Parents need to obtain more knowledge regarding child nutrition (Clark, 2008:267-268)

Objectives

  • Specific outcomes that need to be achieved as a result of the health education program

    • Program objective
      • The incidence (number of new cases) of childhood obesity will drop by 50% in 2 years
    • Educational objective
      • Parents can indicate the number of servings of each food group needed by school-aged children on the food guide pyramid (Clark, 2008:268)

  • Objectives need to be stated in measurable terms to determine if the expected outcomes have been reached.

  • Outcomes need to be specific in order for them to be evaluated.

    • E.g., A drop of 50% in the incidence of childhood obesity, including a timeframe of 2 years, for expected achievement. (Clark, 2008:268)

Selecting and Sequencing Content

  • The nurse usually has a greater knowledge of a specific topic.
  • Need to select and organize content to fit the client’s needs.
  • New learning must be based on previous learning.
  • Sequenced from:
    • Simple to complex
    • Most important to least important
    • Familiar to less familiar (Clark, 1999:178)

Selecting Teaching Strategies

  • Characteristics of the audience
  • Content and objectives
  • Program budget
  • Time available
  • Cultural appropriateness
  • Environment (Clark, 2008:268)

Preparation of Material

  • Needs to be appropriate for the audience.
    • E.g., For a group of young children, a coloring book might be more effective than a “PowerPoint Presentation” (Clark, 1999:178)
  • Take language and literacy into account
    • Self-study: (Clark, 2008:270, Table 11-5)

Planning Evaluation

  • Plan for the development of criteria to measure the effectiveness of the health education session, e.g., evaluation.
  • Evaluation is done to determine if the audience did learn something.
    • E.g., asking questions. (Clarke, 1999:179)

Implementation of the Health-Education Session

  • Speak in the patients’ language
  • Do not use difficult medical terms
  • Keep message short
  • Key points
  • Verbal headings
  • Repetition (Clark, 1999:180)
  • Communication clear
  • Relevant information
  • Structured information (VPGR 111, PGCE, Study guide, 2014:22)

Implementation

  • Focus event
    • Gain attention of the audience
    • Focus attention on the material to be presented
    • E.g., slides child abuse
  • Presentation of content
    • Lesson presented as planned
    • Formative checks
    • Client participation e.g., group discussion, role-playing, etc. (Clark, 1999:180)
  • Summary of the session
    • Reinforces pertinent points
    • Recaps and highlights the major concepts covered
    • Synthesizes content in a few major themes (Clark, 1999:180)

Evaluating Health Promotion Programs

  • Diagnostic evaluation
    • Accuracy of needs assessment is assessed
  • Formative evaluation
    • The way the program was carried out is examined
  • Summative evaluation
    • The focus may be on the program outcome, impact, or both (Clarke, 2008:271)

Self Study

  • Plan a health education program for a rural community
    • (Clark, 2015: 280-281)
    • (Clark, 2008: 272-273))
    • (Clark, 1999:181-182)
    • (NSFP 111 Section B: Community Health)
    • Health Education PowerPoint 2020)

Elements of a Community Health Education Program

  • Assessment:
    • Biophysical factors
    • Psychological factors
    • Physical environmental factors
    • Sociocultural factors
    • Behavioral factors
    • Health system factors
  • Purpose/Goal
  • Levels of prevention
  • Objectives
  • Content
  • Teaching strategies/materials
  • Evaluation (Clark, 2008:272-273)

Scenario

  • The community of Syferfontein lives on a farm.
  • There is no tap water and no toilets.
  • The community consists of women, men, and children.
  • The men work on the farm, and the women stay at home to look after the children.
  • The only place available to give health education is a small room with a few chairs.
  • During winter, it is very cold, and during summer, it is very hot in the room.
  • The refuse lies around the houses, and there are no vegetable gardens.
  • The community members live far from town, and they are very poor.

Assignment

  • Assess the health education needs of the community according to the six dimensions of health.
  • Formulate an educational diagnosis.
  • Plan a health education program for the Syferfontein community.
  • Implement a health education program for the Syferfontein community.
  • Evaluate your health education program.

Reference List

  • Clark, M.J. 1999. Nursing in the community: Dimensions of community health nursing. 3rd edition. Stamford, Connecticut: Appleton & Lange.
  • Clark, M.J. 2008. Community Health Nursing: advocacy for population health. 5th ed. New Jersey: Pearson Education
  • Clark, M.J. 2015. Population and Community Health Nursing. 6th ed. New Jersey: Pearson Education.
  • Watson, M.J. 2014. Community Nursing Science Processes. Potchefstroom: NWU, Potchefstroom Campus. (Study guide VPGR 111).