Community as Partner : Theory and Practice in Nursing

Preface                                                                                                                                                         xi
Contributors to the Second Edition                                                                                                    xiii
Contributors to the First Edition                                                                                                          xiv
Reviewers—Australia and New Zealand                                                                                            xv
Acknowledgements                                                                                                                                 xvii
PART I THEORETICAL FOUNDATIONS OF WORKING WITH COMMUNITY AS PARTNER                                            1

Chapter 1 Primary healthcare .......................................................................................................                         .3
Introduction                                                                                                                                                   4
Globalisation                                                                                                                                                 5
Factors directly affecting health                                                                                                                     7
Primary healthcare                                                                                                                                        14
Where are we today?                                                                                                                                                   24
Summary                                                                                                                                                      26
Web resources                                                                                                                                              26
References                                                                                                                                                    27

Chapter 2 Epidemiology, demography and community health .......................................                    31
Introduction                                                                                                                                                  32
Epidemiology                                                                                                                                               32
Demography                                                                                                                                                 33
Levels of prevention in community health practice                                                                                       33
Descriptive measures of health                                                                                                                      34
Analytical measures of health                                                                                                                       39
Criteria for determining causation                                                                                                                 44
Sources of community health data                                                                                                                45
Screening for health conditions                                                                                                                    47
Epidemiological approaches to community health research                                                                          49
Summary                                                                                                                                                      53
Web resources                                                                                                                                              54
References                                                                                                                                                    55

Chapter 3 The Australian healthcare system ..........................................................................      . ..........56
Introduction                                                                                                                                                  57
The health and social care system                                                                                                                                57
The Australian Disability Strategy                                                                                                                 62
Primary healthcare services                                                                                                                           63
Healthcare facilities                                                                                                                                      65
The health status of Australians                                                                                                                    68
Critique of the Australian healthcare system                                                                                                 69
Summary                                                                                                                                                      69
Web resources                                                                                                                                                             70
References                                                                                                                                                                   71

Chapter 4 The New Zealand healthcare system ............................................................... ......           ..... 73
Introduction                                                                                                                                                  74
The health and disability system                                                                                                                   74
The structure of the New Zealand health and disability sector                                                                      76
Primary health organisations and the ‘Better, Sooner, More Convenient’ initiative                                       77
Mental health strategy                                                                                                                                   81
The New Zealand Disability Strategy                                                                                                            81
Complementary and alternative medicine                                                                                                     81
PHARMAC                                                                                                                                                   82
The health status of New Zealanders                                                                                                            83
Critique of the health system                                                                                                                        83
Summary                                                                                                                                                      84
Web resources                                                                                                                                              84
References                                                                                                                                                    85

Chapter 5 Ethics and advocacy in community health nursing                                                            87
Introduction                                                                                                                                                                 88
What is ethics?                                                                                                                                              88
Essential principles in healthcare ethics                                                                                                        90
Applying the principles to the code of ethics for nurses in Australia                                                                           95
Applying the principles of the code of ethics for nurses in New Zealand                                                                    96
Ethical dilemmas in community health                                                                                                         97
Summary                                                                                                                                                      98
Web resources                                                                                                                                              99
References                                                                                                                                                    99
Further reading                                                                                                                                             100

Chapter 6 Building healthy and healing communities ...............................................................        ....101
Introduction                                                                                                                                                  102
Applying social ecology to community health                                                                                              102
Perspectives on community health partnerships                                                                                            103
Community participation                                                                                                                              104
Healing in the community                                                                                                                             106
Developing right-relationships                                                                                                                      107
Supporting communities to make change                                                                                                      109
Participatory research                                                                                                                                   110
Research projects using a social ecological framework                                                                                                112
Summary                                                                                                                                                      114
Web resources                                                                                                                                              114
References                                                                                                                                                    114

Chapter 7 Culturally competent partnerships with communities                                                        117
Introduction                                                                                                                                                  118
Cultural safety                                                                                                                                              119
Cultural competence                                                                                                                                     119
Diversity, ethnicity and culture                                                                                                                     121
Culture, health, illness and nursing                                                                                                               122
Cultural healthcare systems                                                                                                                          123
Decision making                                                                                                                                           125
Cultural awareness exercises                                                                                                                        126
Becoming culturally competent                                                                                                                    127
Summary                                                                                                                                                      128
Web resources                                                                                                                                              128
References                                                                                                                                                    129
Further reading                                                                                                                                             131

Chapter 8 Health policy for healthy communities and cities                                                                132
Introduction                                                                                                                                                  133
World conferences on health promotion and healthy public policy                                                              133
Health promotion                                                                                                                                          135
Healthy public policy                                                                                                                                   136
Healthy communities and cities                                                                                                                    139
The social determinants of health                                                                                                                 145
Opportunities for community nursing                                                                                                           148
Summary                                                                                                                                                      149
Web resources                                                                                                                                              149
References                                                                                                                                                    150

PART II THE PROCESS OF COMMUNITY AS PARTNER                                                                                                       155

Chapter 9 Models to guide practice .................................................................................................      160
Introduction                                                                                                                                                                 161
Models of nursing                                                                                                                                                        161
Models of health promotion and community partnership                                                                                            163
Summary                                                                                                                                                                     169
Web resources                                                                                                                                                             170
References                                                                                                                                                                   170

Chapter 10 Community assessment .................................................................................................     172
Introduction                                                                                                                                                                 173
Community assessment                                                                                                                                               173
The Learning about the Community on Foot Survey                                                                                                   175
The model of environmental scanning                                                                                                                         180
Community Assessment: Leichhardt Women’s Community Health Centre                                                                  185
Summary                                                                                                                                                                     187
Web resources                                                                                                                                                             188
References                                                                                                                                                                   188
Further reading                                                                                                                                                            189

Chapter 11 Analysing data collected during a community assessment ................................... .....  190
Introduction                                                                                                                                                                 191
Undertaking a community analysis                                                                                                                              191
Quantitative data analysis                                                                                                                                            191
Qualitative data analysis                                                                                                                                              194
Community analysis: Leichhardt Women’s Community Health Centre                                                                       195
Reporting on community assessments and data analysis                                                                               211
Constructing an analytical matrix: community as partner and the environmental scan                                  212
Summary                                                                                                                                                                     214
Web resources                                                                                                                                                             214
References                                                                                                                                                                   214

Chapter 12 Planning a community health program..................................................................... .       216
Introduction                                                                                                                                                                 217
Change theory                                                                                                                                                             217
Planning for community health programs                                                                                                                    219
Components of a community health action plan                                                                                                          220
Planning: Leichhardt Women’s Community Health Centre                                                                                          222
Partnerships between people concerned with primary healthcare                                                                                222
Recording the community health program plan in a concise and retrievable form                                                       225
Assessing the resources needed to accomplish the plan                                                                                               225
Summary                                                                                                                                                                     225
Web resources                                                                                                                                                             226
References                                                                                                                                                                   226

Chapter 13 Implementing a community health program  .................................................. ..........       227
Introduction                                                                                                                                                                 228
Transition to action                                                                                                                                                      228
Turning the plan into action: Leichhardt Women’s Community Health Centre                                                            229
Community participation: Working with health professionals                                                                                      230
Sustainability                                                                                                                                                               232
Summary                                                                                                                                                                     233
Web resources                                                                                                                                                             233
References                                                                                                                                                                   233

Chapter 14 Evaluating a community health program ...................................................................       235
Introduction                                                                                                                                                                 236
Types of evaluation                                                                                                                                                     236
Evaluation strategies                                                                                                                                                    239
Methods of data collection and generation                                                                                                                  239
Evaluation strategy: Leichhardt Women’s Community Health Centre                                                                          239
Evaluation strategy: Leichhardt Women’s Community Health Centre                                                                          243
Cost-benefit and cost-effectiveness analyses                                                                                                               245
Summary                                                                                                                                                                     246
Web resources                                                                                                                                                             247
References                                                                                                                                                                   247
Further reading                                                                                                                                                            247

PART III STRATEGIES FOR HEALTH PROMOTION                                                                                                            249

Chapter 15 Promoting health in children ..................................................................................   ...      251
Introduction                                                                                                                                                                 252
Early childhood                                                                                                                                                           252
School-age childhood                                                                                                                                                  257
Adolescent health promotion programs                                                                                                                       261
Summary                                                                                                                                                                     264
Web resources                                                                                                                                                             264
References                                                                                                                                                                   265

Chapter 16 Promoting healthy partnerships in the workplace ...................................................   .    269
Introduction                                                                                                                                                                 270
Changing workplace                                                                                                                                                    270
Health-promoting partnerships in workplaces                                                                                                              271
Health-promoting workplace                                                                                                                                       274
Occupational health and safety                                                                                                                                    274
Health promotion activities in the workplace                                                                                                               276
Planning a health promotion program                                                                                                                          278
Using stages of change in health promotion programs                                                                                  280
Program implementation                                                                                                                                              281
Program evaluation                                                                                                                                                      282
Tips for maintaining a health promotion program                                                                                                        283
Case management in the workplace                                                                                                                             283
Summary                                                                                                                                                                     284
Web resources                                                                                                                                                             285
References                                                                                                                                                                   285

Chapter 17 Promoting healthy partnerships with older people ......................................................   288
Introduction                                                                                                                                                                 289
Health status                                                                                                                                                                289
Aged care planning                                                                                                                                                      290
Access to healthcare                                                                                                                                                    291
Safety in the community and home                                                                                                                             292
Mental health and mental wellness                                                                                                                              297
Health promotion for older people                                                                                                                              297
Promoting wellness in older people                                                                                                                             299
Summary                                                                                                                                                                     300
Web resources                                                                                                                                                             300
References                                                                                                                                                                   301
Further reading                                                                                                                                                            302

Chapter 18 Promoting healthy partnerships with people with chronic conditions ................ .... ..303
Introduction                                                                                                                                                                 304
Characteristics of chronic health conditions                                                                                                                305
Health perception, chronic health conditions and self-management                                                                            307
Implementation of health promotion strategies                                                                                                            308
Research culture in community nursing                                                                                                                       312
Summary                                                                                                                                                                     312
Web resources                                                                                                                                                             313
References                                                                                                                                                                   313

Chapter 19 Promoting healthy partnerships with Indigenous communities of Australia
and New Zealand .......                                                                                                                               316
Denise Wilson
Introduction                                                                                                                                                                 317
Indigenous peoples                                                                                                                                                      318
Indigenous health status                                                                                                                                               318
Determinants of Indigenous health                                                                                                                              321
Working with Indigenous communities                                                                                                                        324
Promoting health in Indigenous communities                                                                                                              326
Strategies for working effectively with Indigenous communities                                                                  333
Summary                                                                                                                                                                     336
Web resources                                                                                                                                                             336
References                                                                                                                                                                   337
Further reading                                                                                                                                                            339

Chapter 20 Mental health promotion ...............................................................................................      341
Anthony J. O’Brien
Introduction                                                                                                                                                                 342
Mental health                                                                                                                                                               342
Mental health promotion                                                                                                                                              344
Individual and social factors associated with mental health                                                                                         347
Mental illness                                                                                                                                                               349
Mental health promotion policy                                                                                                                                   350
Opportunities for community nurses                                                                                                                           352
Summary                                                                                                                                                                     353
Web resources                                                                                                                                                             354
References                                                                                                                                                                   354

Chapter 21 Promoting healthy partnerships with refugees and immigrants ......... .......................   357
Introduction                                                                                                                                                                 358
Migrants and refugees                                                                                                                                                  358
Promoting health in migrant and refugee communities                                                                                                363
Community nurses and refugees health promotion programs                                                                                      368
Summary                                                                                                                                                                     369
Web resources                                                                                                                                                             369
References                                                                                                                                                                   370
Further reading                                                                                                                                                            371

Chapter 22 Promoting healthy partnerships with rural populations                                              .   372
Introduction                                                                                                                                                                 373
Rurality                                                                                                                                                                        373
Nursing in rural communities                                                                                                                                       374
Building partnerships in rural communities                                                                                                                  378
Summary                                                                                                                                                                     382
Web resources                                                                                                                                                             383
References                                                                                                                                                                   383
Further reading                                                                                                                                                            385

Appendix: Key health policies                                                                                                                 386
Index                                                                                                                                                                           399