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Community/Public Health Nursing
SEVENTH EDITION
2
Table of Contents
Cover image
Title page
Copyright
Dedication
Acknowledgments
Contributors
Preface
Unit 1. Introduction to Community Health Nursing
Definition and Focus of Public Health Nursing, Community Health Nursing, and Community-
Based Nursing
Summary
Evolve Website
3
Advent of Modern Health Care
Summary
Evolve Website
Summary
Evolve Website
Determinants of Health
Summary
Evolve Website
5. Epidemiology
Calculation of Rates
Concept of Risk
4
Use of Epidemiology in Disease Prevention
Epidemiological Methods
Summary
Learning Activities
6. Community Assessment
Healthy Communities
Needs Assessment
Summary
Evolve Website
Nursing Implications
Summary
Evolve Website
Enhancing Communication
5
Social Media
Summary
Evolve Website
9. Case Management
Case Identification
Summary
Evolve Website
Definitions
Summary
6
Evolve Website
Summary
Evolve Website
Cost Containment
Summary
Evolve Website
Cultural Diversity
Population Trends
Transcultural Nursing
Overview of Culture
7
Culture and Aging
Cross-Cultural Communication
Role of the Community Health Nurse in Improving Health for Culturally Diverse People
Summary
Evolve Website
Summary
Evolve Website
Population Characteristics
Environmental Factors
Summary
Evolve Website
8
Issues of Pregnancy and Infancy
Summary
Evolve Website
Life Expectancy
Summary
Evolve Website
9
Summary
Evolve Website
Concept of Aging
Theories of Aging
Demographic Characteristics
Psychosocial Issues
Physiological Changes
Psychosocial Disorders
Spirituality
End-of-Life Issues
Summary
Evolve Website
Assessment Tools
Summary
Evolve Website
10
21. Populations Affected by Disabilities
Prevalence of Disability
Summary
Evolve Website
Summary
Evolve Website
Summary
Evolve Website
Rural Health
11
Specific Rural Aggregates
Community-Based Care
Evolve Website
Overview and History of Community Mental Health: 1960 to the Present Day
Summary
Evolve Website
Chain of Transmission
12
Summary
Evolve Website
Modes of Intervention
Vulnerable Aggregates
Summary
Evolve Website
28. Violence
Overview of Violence
History of Violence
Interpersonal Violence
Community Violence
Prevention of Violence
Summary
Evolve Website
Disaster Definitions
Types of Disasters
13
Characteristics of Disasters
Disaster Management
Recovery Stage
Summary
Evolve Website
Summary
Evolve Website
Multidisciplinary Teamwork
Summary
Evolve Website
Correctional Nursing
14
Mental Health Issues in Correctional Settings
Summary
Evolve Website
Summary
Evolve Website
OASIS
Summary
Evolve Website
Index
IBC
15
16
Copyright
No part of this publication may be reproduced or transmitted in any form or by any means,
electronic or mechanical, including photocopying, recording, or any information storage and
retrieval system, without permission in writing from the publisher. Details on how to seek
permission, further information about the Publisher’s permissions policies and our arrangements
with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency,
can be found at our website: www.elsevier.com/permissions.
This book and the individual contributions contained in it are protected under copyright by the
Publisher (other than as may be noted herein).
Notices
Knowledge and best practice in this field are constantly changing. As new research and experience
broaden our understanding, changes in research methods, professional practices, or medical
treatment may become necessary.
Practitioners and researchers must always rely on their own experience and knowledge in
evaluating and using any information, methods, compounds, or experiments described herein. In
using such information or methods they should be mindful of their own safety and the safety of
others, including parties for whom they have a professional responsibility.
With respect to any drug or pharmaceutical products identified, readers are advised to check the
most current information provided (i) on procedures featured or (ii) by the manufacturer of each
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To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors,
assume any liability for any injury and/or damage to persons or property as a matter of products
liability, negligence or otherwise, or from any use or operation of any methods, products,
instructions, or ideas contained in the material herein.
Previous editions copyrighted 2015, 2011, 2007, 2001, 1997, and 1993.
17
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18
Dedication
To Phil Yankovich, my husband, companion, and best friend, whose love, caring, and true support
are always there for me. He provides me with the energy I need to pursue my dreams.
To Kara Nies Yankovich, my daughter, for whom I wish a happy and healthy life. Her energy, joy,
and enthusiasm for life give so much to me.
To Earl (who passed away October 15, 2017, at the age of 92) and Lois Nies, my parents, for their
never-ending encouragement and lifelong support. They helped me develop a foundation for
creative thinking, new ideas, and spirited debate.
Mary A. Nies
To my husband, Scott McEwen, whose love, support, inspiration, and encouragement have been
my foundation for more than 40 years. I can’t wait to see what happens next!
Melanie McEwen
19
About the Author
Mary A. Nies
Mary A. Nies, PhD, RN, FAAN, FAAHB, is the Director of Nursing Research and Professor
College of Nursing, Joint Appointment MPH Program, Kasiska Division of Health Sciences, Idaho
State University. Dr. Nies received her diploma from the Bellin School of Nursing in Green Bay,
Wisconsin; her BSN from the University of Wisconsin, Madison; her MSN from Loyola University,
Chicago; and her PhD in Public Health Nursing, Health Services, and Health Promotion Research at
20
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embraces every subject with the clearness and facility of one
prepared by previous study to comprehend and explain it. So perfect
is his analysis, that he extracts the whole matter, the kernel of
inquiry, unbroken, clean, and entire. In this process, such are the
instinctive neatness and precision of his mind, that no superfluous
thought, or even word, ever presents itself, and still he says every
thing that seems appropriate to the subject. This perfect exemption
from needless incumbrance of matter or ornament, is in some
degree the effect of an aversion to the labor of thinking. So great a
mind, perhaps, like large bodies in the physical world, is with
difficulty set in motion. That this is the case with Mr. Marshall's, is
manifest, from his mode of entering on an argument, both in
conversation and in public debate. It is difficult to rouse his faculties:
he begins with reluctance, hesitation, and vacancy of eye: presently,
his articulation becomes less broken, his eye more fixed, until, finally,
his voice is full, clear, and rapid, his manner bold, and his whole face
lighted up, with the mingled fires of genius and passion: and he
pours forth the unbroken stream of eloquence, in a current deep,
majestic, smooth and strong. He reminds one of some great bird,
which flounders and flounces on the earth for a while, before it
acquires impetus to sustain its soaring flight."
EMILIA HARRINGTON.
AMERICAN IN ENGLAND.
Very rarely have we seen any thing of the kind superior to the
"American in England." The interest begins with the beginning of the
book, and abides with us, unabated, to the end. From the scenes in
the Yankee harbor, to the departure of the traveller from England, his
arrival in France, and installment among the comforts of the Hotel
Quillacq, all is terse, nervous, brilliant and original. The review of the
ship's company, in the initial chapter of the book is exceedingly
entertaining. The last character thus introduced is so peculiarly
sketched that we must copy what the author says about him. It will
serve to exemplify some of our own prior remarks.
There are some few niaiseries in the work before us, which, although
insufficient to affect its character as a whole, yet constitute a weak
point in what otherwise is beautiful, and cause us to regret sincerely,
the accidents which have admitted them. We may mention, in
especial, the too frequent introduction of the monosyllable "how," in
such sentences as "they told how"—"it was related how"—"I was
informed how," &c. Mr. Slidell will find, upon self-scrutiny, that he has
fallen into this habit through the sin of imitation. The Lieutenant, too,
suffers his work to savor far too strongly of the ship, and lets slip him
no opportunity of thrusting upon the public attention the fact of his
particular vocation—insisting, indeed, upon this matter with a
pertinacity even ludicrous—a pertinacity which will be exemplified in
the following passage:
'If I were,' in this sentence, is not English—but there are few persons
who will believe that "if" does not in all instances require the
subjunctive. In the words "a small iron rod which served as a parapet
to protect me from falling off the precipice over which I hung, and
against which I was forced," &c. let us say nothing of the injudicious
use of the word parapet as applied to a small iron rod. Passing over
this, it is evident, that the second relative pronoun "which," has for its
antecedent, in strict syntactical arrangement, the same noun as the
first relative pronoun "which"—that is to say, it has the word
"precipice" for its antecedent. The sentence would thus imply that
Mr. Slidell was forced against the precipice. But the actual meaning
(at which we arrive by guessing) is, that Mr. Slidell was forced
against the iron rod. In the words "I was forced with a pressure
proportioned to the circumstances of my being compressed into a
space," &c. let us again be indulgent, and say as little as possible of
the tautology in "pressure" and "compressed." But we ask where are
the circumstances spoken of? There is only one circumstance—the
circumstance of being compressed. In the conclusion of the passage
where the Lieutenant speaks of "a seat having doubtless been
contrived to accommodate five men, and there being no greater
anatomical mistake than to suppose there would be more room
because four of them were women," it is quite unnecessary to point
out the "bull egregious"—a bull which could have been readily
avoided by the simple substitute of "persons" for "men."
CONTI.
Conti the Discarded: with Other Tales and Fancies. By Henry F.
Chorley. 2 vols. New York: Published by Harper and Brothers.
Mr. Chorley has hitherto written nothing of any great length. His
name, however, is familiar to all readers of English Annuals, and in
whatever we have seen from his pen, evidences of a rare genius
have been perceptible. In Conti, and in the "Other Tales and
Fancies" which accompany it, these evidences are more distinct,
more brilliant, and more openly developed. Neither are these pieces
wanting in a noble, and, to us, a most thrillingly interesting purpose.
In saying that our whole heart is with the author—that the deepest,
and we trust, the purest emotions are enkindled within us by his
chivalric and magnanimous design—we present but a feeble picture
of our individual feelings as influenced by the perusal of Conti. We
repeat it—our whole heart is with the author. When shall the artist
assume his proper situation in society—in a society of thinking
beings? How long shall he be enslaved? How long shall mind
succumb to the grossest materiality? How long shall the veriest
vermin of the Earth, who crawl around the altar of Mammon, be more
esteemed of men than they, the gifted ministers to those exalted
emotions which link us with the mysteries of Heaven? To our own
query we may venture a reply. Not long. Not long will such rank
injustice be committed or permitted. A spirit is already abroad at war
with it. And in every billow of the unceasing sea of Change—and in
every breath, however gentle, of the wide atmosphere of Revolution
encircling us, is that spirit steadily yet irresistibly at work.
"Who has not looked," says Mr. Chorley in his Preface, "with painful
interest on the unreckoned-up account of misunderstanding and
suspicion which exists between the World and the Artist? Who has
not grieved to see the former willing to degrade Art into a mere
plaything—to be enjoyed without respect, and then cast aside—
instead of receiving her high works as among the most humanizing
blessings ever vouchsafed to man by a beneficent Creator? Who
has not suffered shame in observing the Artist bring his own calling
into contempt by coarsely regarding it as a mere engine of money
getting, or holding it up to reproach by making it the excuse for such
eccentricities or grave errors as separate him from the rest of
society?"
That genius should not and indeed cannot be bound down to the
vulgar common-places of existence, is a maxim which, however true,
has been too often repeated; and there have appeared on earth
enough spirits of the loftiest and most brilliant order who have
worthily taken their part in life as useful citizens, affectionate
husbands, faithful friends, to deprive of their excuse all such as hold,
that to despise and alienate the world is the inevitable and painfully
glorious destiny of the highly gifted.
Very few of our readers, it may be, are acquainted with a particular
class of works which has long exercised a very powerful influence on
the private habits and character, as well as on the literature of the
Germans. We speak of the Art Novels—the Kunstromanen—books
written not so much in immediate defence, or in illustration, as in
personification of individual portions of the Fine Arts—books which,
in the guise of Romance, labor to the sole end of reasoning men into
admiration and study of the beautiful, by a tissue of bizarre fiction,
partly allegorical, and partly metaphysical. In Germany alone could
so mad—or perhaps so profound—an idea have originated. From
the statement of Mr. Chorley, we find that his original intention was to
attempt something in the style of the Kunstromanen, with such
modifications as might seem called for by the peculiar spirit of the
British national tastes and literature. "It occurred to me, however,"
says he, "that the very speculations and reveries which appeared to
myself so delicious and significant, might be rejected by the rest of
the world as fantastic and overstrained." Mr. C. could never have
persevered in a scheme so radically erroneous for more than a
dozen pages; and neither the world nor himself will have cause to
regret that he thought proper to abandon the Art Novels, and
embody his fine powers and lofty design in so stirring and so efficient
a series of paintings as may be found in the present volumes.
"But the boy, whose mind was full of other matters, and who,
having wandered away in the morning, before the delirium
became so violent, had no idea of his mother's imminent
danger, broke from them without catching the meaning of their
words, and forced his way up stairs, towards the great drawing
room, the folding doors of which were swinging open.
The other pieces in the volumes of Mr. Chorley are, Margaret Sterne,
or The Organist's Journey—an Essay on the Popular Love of Music
—Rossini's Otello—The Imaginative Instrumental Writers, Haydn,
Beethoven, &c.—The Village Beauty's Wedding—Handel's Messiah
—and A few words upon National Music—all of which papers evince
literary powers of a high order, an intimate acquaintance with the
science of music, and a lofty and passionate devotion to its interests.
NOBLE DEEDS OF WOMAN.
These are two neat little volumes devoted to a theme of rich interest.
From the Preface, or rather from the date and place of date of the
Preface, we may form a guess that the work was originally published
in London, and that the present edition is merely a reprint. There is
nothing in the title-page or in the body of the book indicative of its
derivation. But be the "Noble Deeds of Woman" English or
American, we recommend them heartily to public attention.
During the late war between the Turks and the Greeks, some
American ladies, touched by the hardships and sufferings of the
latter people, presented them with a ship containing money, and
various articles of wearing apparel, wrought by their own hands;
an offering which, under their forlorn situation, must have been
highly acceptable to the unfortunate Greeks.
"Sisters and friends, our hearts bleed for you. Deprived of your
protectors by the fortune of war, and continually in fear of evils
worse than death, our prayers are with you, in all your
wanderings, your wants and your griefs. In this vessel (which
may God send in safety to your shores) you will receive a
portion of that bounty wherewith He hath blessed us. The poor
among us have given according to their ability, and our little
children have cheerfully aided, that some of you and your
children might have bread to eat, and raiment to put on. Could
you but behold the faces of our little ones brighten, and their
eyes sparkle with joy, while they give up their holidays, that they
might work with their needles for Greece; could you see those
females who earn a subsistence by labor, gladly casting their
mite into our treasury, and taking hours from their repose that an
additional garment might be furnished for you; could you witness
the active spirit that pervades all classes of our community, it
would cheer for a moment the darkness and misery of your lot.
"We are inhabitants of a part of one of the smallest of the United
States, and our donations must therefore, of necessity, be more
limited than those from the larger and more wealthy cities; yet
such as we have, we give in the name of our dear Saviour, with
our blessings and our prayers.
"LYDIA H. SIGOURNEY,
BULWER'S RIENZI.