Role of community health nursing and community partnerships as they apply to the participating family’s community – Assignment 1 Solution

This article discusses the Role of community health nursing and community partnerships as they apply to the participating family’s community.

Instructions

Part I

Using the data from your family and community assessments, create a plan in which you: 

• Analyze the role of community/public health nursing and community partnerships as they apply to the participating family’s community.
• Analyze the influence of social determinants of health, such as culture and access to resources, in the participating family’s community.
• Compare epidemiological data for the participating family’s community to state-level data.
• Select 1 Healthy People 2020 Leading Health Indicator (LHI) topic that relates to your participating family’s community and the identified problem that you developed in Week 2. Based on your selected LHI topic:
• Identify at least 3 nursing interventions for the identified problem.
• List health partnerships that assist in implementing the interventions to support improved health outcomes for the family.

Format your assignment as one of the following: 

• 700- to 1,050-word paper

Part II

Create a Health Education Action Plan. The plan will identify community health resources that support improved health outcomes for your selected family/community. Include: 

• Goal(s)
• Planned action (interventions)
• Needed resources (community resources)
• Timeframe for evaluation (projected expectation for evaluating initial outcomes of action plan)

Implement theHealth Education Action Plan with your selected family.

Write a 250- to 500-word summary of the implementation/teaching process, family response to action plan, and expectation for family compliance and improved health outcomes.  (USE INFO FROM FAMILY ASSESSMENT ATTACHED. ACTION PLAN CAN BE MADE UP ACCORDING TO FAMILY NEEDS AND LOCAL RESOURCES IN RICHMOND, VA)

Cite at least 1 peer-reviewed and 1 evidence-based reference.

Include APA-formatted citations and a references page. 

Exception for presentations: Include a slide with APA-formatted references. 

Note: Remove all personally identifying information such as the family members’ names. Refer to family members by initials only. 

Format Part II of your assignment as one of the following: 

• 8- to 10-slide presentation

Solution

Part I

Role of community health nursing and community partnerships as they apply to the participating family’s community.

Community/public health and community partnerships play crucial roles in preventing and managing family health issues to achieve comfort and wellbeing. In J.R. and Y.M.’s case, the community/public health and community partnership can play two crucial roles, counseling and creating a supportive environment.

Community health nursing, in essence, creates integrated programs that monitor, forecast, and react to public health issues in particular populations. Individuals and families who are part of vulnerable populations or high-risk groups, such as the participating family, can benefit from health education, clinical services, and family medicine through these initiatives.

Furthermore, community partnerships and nursing initiatives develop programs targeted at assessing and evaluating appropriate healthcare to guarantee that individuals are aware of the availability and usage of these programs and services.

In J.R. and Y.M.’s case, public health nursing can come in handy in providing counseling against alcohol and substance abuse (Nies & McEwen, 2019), which is the primary reason for the family issues. Alcohol and drug addiction are significant public healthcare issues in the U.S. that require effective mitigation initiatives. Community nurses have the capability and training to provide appropriate counseling therapies against dangerous alcoholism and substance abuse (Nies & McEwen, 2019; Haron et al., 2019).

Equally, community nursing and health partnerships such as peer groups can play a crucial role in encouraging alcohol abuse and smoking cessation in this family. Community partner groups can also play a role in counseling against infidelity concerns for the family, providing cessation mechanisms and counseling against adverse consequences.  

Lastly, nurses have the training to respond to A.R’s speech impairment and ADHD condition through targeted therapy and referral for specialized care.

Furthermore, community health nurses bridge the gap between epidemiologic studies and therapeutic comprehension of health and sickness as they manifest in human livelihoods (Swanson et al., 2020). The monitoring and surveillance of lifestyle illness patterns in communities is an example of this critical linkage.

In this regard, nurses can work with this family to establish appropriate physical activity and nutrition plans to mitigate against potential health issues associated with sedentary lifestyles and unhealthy eating habits such as diabetes, hypertension, cardiovascular diseases, and cancers. This comprehension is turned into action for the benefit of the family.

Emerging trends that may jeopardize the family’s health care, such as full-time employment, can lead to a lack of physical exercise, are identified, and relevant interventions are developed, integrated, and executed to enhance wellbeing.

Analyze the influence of social determinants of health, such as culture and access to resources, in the participating family’s community.

Various facets of social health determinants influence a family’s health status and trajectory. In the case of the community, the conditions that can favor social health determinants are minimal. Taking culture and access to resources, the family resides in a dynamic community with supportive households and access to resources.

However, studies have shown that Hispanic families have disproportionately affected by obesity and diabetes due to societal and health inequalities. Poor nutrition, sedentary lifestyle, and drug and alcohol abuse are factors, as are biological processes such as circadian rhythm disturbance, cytokine activation, and inflammatory processes (Velasco-Mondragon et al., 2016).

However, the participating family has adequate access to resources and health care. The significant social health determinants for the participating family include alcohol and substance abuse and sedentary lifestyle, primarily associated with the Hispanic community.

Compare epidemiological data for the participating family’s community to state-level data.

According to the City-Data.com. (n.d.), Richmond compares to Virginia state in terms of epidemiological data as discussed herein. Richmond’s cost of living index, 94.1, is slightly higher than the national index, 100, as of March 2019. The unemployment rate in Richmond stood at 6.6% against 4.6% for the whole state. 18.9% of Richmond’s residents have an income below the poverty level against 9.9% for the whole state.

Earthquake and tornado activity is slightly higher than the state level. Drinking water stations have been accused of quality issues, including supplying water contaminated with lead, copper, coliform, E.coli, and monitoring violations. Inequality in the education index stands at 13.4 against an average rate of 12.1 for the whole state.

Furthermore, the number of groceries stands at 3.60 / 10,000 compared to 2.03 / 10,000 people for the whole state. The adult obesity rate stands at 29% against 26.7% for the entire state. The low-income preschool obesity rate of 15% is comparatively lower compared to 18% for the whole state. The healthy diet rate is slightly lower at 48% compared to 50.2% for the entire state.

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The average BMI level stands at 29.3% against s statewide level of 28.7%. 87.1% of Richmond resistant consume alcohol against a statewide percentage of 89.3%. The percentage of overweight people in Richmond equal that of Virginia at 33.7%. Average hours of sleeping are 6.7 against a statewide rate average of 6.8. The General health condition of Richmond residents is slightly lower at 54% compared to an average of 56.7% for the whole state.

Healthy People 2020 Leading Health Indicator (LHI)

The Healthy People 2020 LHI relating to the participating family’s community, and the problem identified in week two is substance abuse, particularly cigarette smoking (HealthyPeople.gov, 2020). Although the United States has reached low rates of substance abuse in recent years, the use of behavioural and psychotic-altering substances continue to have a significant impact on the health of people, families, and communities across the country. Substance addiction is linked to several biological, social, ecological, cognitive, and genetic variables. Relational, familial, and community factors, including infidelity and trust issues, all significantly affect substance misuse.

Identify at least three nursing interventions for the identified problem.

Substance-addicted individuals have a low tolerance for stressors and limited coping skills. The specific nursing interventions for substance abuse include: 

1. Pharmacotherapy: Pharmacotherapy involves the use of medications to help drug addicts achieve remain sober. Medications include antidepressants such as olanzapine and dopamine that reduce psychotic symptoms of drug addiction (Imkome, 2018). These drugs have demonstrated effectiveness in decreasing drug addiction symptoms during cessation.  
2. Psychosocial therapies: Psychosocial therapies aid pharmacotherapy and psychoeducation interventions to ease addiction symptoms (Imkome, 2018). They also improve the quality of life, enhances social functions, reduces relapse, increases medication adherence. Psychosocial therapies include cognitive-behavioural therapies and other in-person counselling therapies for families and affected individuals.
3. Group interventions: Group intervention modalities are similar to psychosocial therapies. However, group intervention involves collective and structured behavioural and social skills education and training on mitigation measures for substance use cessation. Positively, group interactions for drug addiction can change social attitudes and behaviours and are generally cost-effective (Imkome, 2018).  Individual group members motivate each other to carry daily living and commit to stopping drug abuse. 

Health partnerships for substance abuse cessation

Most organizations, including private, non-profit, and governmental organizations, have come u together to support mitigation interventions to manage drug addiction. These partnerships include (NASADAD, n.d.):

1. Alcohol Addiction Center
2. American Addiction Centers
3. Center on Addiction and the Family
4. Drug & Alcohol Information Center
5. National Institute on Drug Abuse
6. Community Anti-Drug Coalitions of America (CADCA)
7. Center for the Application of Prevention Technologies
8. Centres for Disease Control Tobacco Information and Prevention Source Page
9. Center for Substance Abuse Prevention (CSAP)
10. National Institute on Alcohol Abuse and Alcoholism

Part II

Health Education Action Plan.

A family unit is an unrivalled participant in preserving health and avoiding public health diseases since members support and nurture each other through the different phases of life. Goals:

1. To create and closely-knit and functional family environment.
2. To improve family cooperation and communication.
3. To improve family understanding and management of relationship issues.

Planned Action:

• Behavioural counselling: Behavioral therapy such as Cognitive Behavioral Therapy (CBT) will aid in the modification of the client’s behaviour and attitudes about alcohol and drug use, develop healthy life skills, and support integration of pharmaceutical intervention (NIDA, 2019). CBT assists patients in recognizing, avoiding, and dealing with circumstances in which they are most prone to take drugs and alcohol.
• Pharmacotherapy: Bupropion 150 mg orally daily for three days. Increase the dosage to 150 mg every 12 hours, depending on the client’s response. Continue treatment for seven to twelve weeks. Acamprosate 666 mg PO TID. Bupropion is an FDA approved prescription medication for nicotine addiction (NIDA, 2019). Acamprosate is an FDA approved drug for severe alcohol addiction. Acamprosate alleviates long-term withdrawal symptoms such as sleeplessness, anxiety, agitation, and dysphoria (NIDA, 2019).
• Establish a periodical evaluation, assessment and treatment of any comorbid psychological issues, including depression and anxiety.
• Establish a follow-up routine until healthcare goals are achieved.

Needed Resources:

• Psychotherapist for CBT
• Financial support for medication.
• Rehabilitation Centers
• Speech and language services/ A speech-language pathologist

Timeframe for Evaluation:

• Five – Twelve weeks

Implementation Process:

• Establish therapist and family roles during the entire engagement period.
• Inform the family of the time, day, location, duration, frequency and the number of weekly counselling sessions.
• Advise both J.R. and Y.M. of possible changes in counselling sessions, assessments, and solutions.
• Discuss with the family the importance of the established nursing intervention.
• Discuss with the patient about the confidentiality of sessions’ contents, keep and respond to discussion contents between themselves.
• Inform J.R. and Y.M. that any arising issues at the end of the session should be addressed in the subsequent session.
• Encourage sharing of thoughts and feelings without confrontations, fights, or viciousness during therapy sessions.
• At the end of the therapy session, refer the family to medical aid services, speech and language services for their child, and rehabilitation centres for further guidance.
• Continue the process on a weekly basis and seek partnership with community health services whenever necessary.

Family Response Action Plan

• Both J.R. and Y.M. should demonstrate their wiliness to cooperate and discuss relevant issues affecting their relationship.
• Both J.R. and Y.M. should demonstrate their willingness to admit they are wrong and compromise their desires for the unity of the family.
• Both J.R. and Y.M. should demonstrate patience with each other, i.e., avoiding interruption of the other.
• Y.M. should demonstrate understanding and willingness to adhere to the pharmacological interventions and routine clinical visits.
• Both J.R. and Y.M. to take charge in taking A.R. to the referred speech-language pathologist.

The Expectation for Family Compliance:

• Both J.R. and Y.M. to avail themselves for therapy sessions in time.
• Both J.R. and Y.M. to communicate with reason cancellation/postponement of counselling sessions.
• Both J.R. and Y.M. to contribute their thoughts, perspectives, and prospects comprehensively.

Improved Health Outcomes:

• To achieve an alcohol and substance abuse independence
• To gain information, skills, and mindsets that will allow you to enjoy the benefits of maintaining a healthy lifestyle.
• To encourage J.R. to take responsibility for his drug usage and connect it to his own and family’s behaviours.

References

Haron, Y., Honovich, M., Rahmani, S., Madjar, B., Shahar, L., & Feder‐Bubis, P. (2019). Public health nurses’ activities at a time of specialization in nursing—A national study. Public Health Nursing, 36(1), 79-86. https://doi.org/10.1111/phn.12578

Imkome, E. U. (2018). Nursing Care for Persons with Drug Addiction. Drug Addiction, 49. https://doi.10.5772/intechopen.73334  

Nies, M. A., & McEwen, M. (2019). Community/public health nursing: Promoting the health of populations (7th ed.). Elsevier

Swanson, M., Wong, S. T., Martin‐Misener, R., & Browne, A. J. (2020). The role of registered nurses in primary care and public health collaboration: a scoping review. Nursing Open, 7(4), 1197-1207.  https://doi.org/10.1002/nop2.496

The National Association of State Alcohol and Drug Abuse Directors (NASADAD). (n.d.). National prevention resources. Retrieved 25 June, from https://nasadad.org/prevention-resources/

Velasco-Mondragon, E., Jimenez, A., Palladino-Davis, A. G., Davis, D., & Escamilla-Cejudo, J. A. (2016). Hispanic health in the USA: a scoping review of the literature. Public health reviews, 37(1), 1-27. https://doi.org/10.1186/s40985-016-0043-2

HealthyPeople.gov. (2020). Substance Abuse. Retrieved 25 June, from https://www.healthypeople.gov/2020/leading-health-indicators/2020-lhi-topics/Substance-Abuse

City-Data.com. (n.d.). Richmond, Virginia. Retrieved 25 June, from http://www.city-data.com/city/Richmond-Virginia.html

National Institute on Drug Addiction (NIDA). (2019). Treatment Approaches for Drug Addiction Drug Facts. Available at https://www.drugabuse.gov/publications/drugfacts/treatment-approaches-drug-addiction  (Accessed 26 June 2021)

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