Chapter 2 Flashcards

1
Q

the Canadian constitution requires provinces to provide comparable levels of __________________ for comparable _________________

A

public service

taxation

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2
Q

the federal government encourages ________________ by contributing money and giving conditions under which that money is received

A

equalization

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3
Q

Canada health act passes in ____________ and reinforces 5 central points across provincial healthcare systems. state them

A

1984

publicly administered
comprehensive
universal
portable
accessible
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4
Q

Canada has a national, universal health insurance program, with the first policy implemented at the provincial level in Saskatchewan, where in 1947 Tommy Douglas introduced legislation to institute _______________, or publicly funded ________________, in that province…it was not until 10 years later in 1957 that similar legislation, the hospital insurance and diagnostic services act (HIDS) was passed by the government of Canada

A

medicare

healthcare

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5
Q

because provincial and territorial wealth varies, the federal governments involvement has been necessary to ______________ services across provinces and territories. Since 1957 the federal government has done that in 2 ways: first by contributing _____________ (in effect, transferring money from weather to poorer provinces and territories) and by stipulating specific ________________ the provinces and territories must meet in order to receive the money

A

equalize
money
conditions

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6
Q

in 1983 the Canada health act supported and lobbied fro by Canadian nurses associated established criteria and conditions in respect of insured health services and extended health care services provided under provincial law that must be met before a full cash contribution may be made: five central points- name them

A
publicly administered
comprehensive
universal
portable
accessible
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7
Q

federal: the public health agency of Canada was established in 2004 to strengthen __________________ in the country as a response to the ____________ crisis

A

public health

SARS

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8
Q

the PHAC concentrates the resources necessary to advance public health _______________ and _______________

A

nationally

internationally

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9
Q

_______________ and _________________ also have plans and committees to deal with disease prevention and health promotion

A

provinces

territories

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10
Q

hile there are differences in organization and delivery, each province and territory provides ___________________, __________________ and _________________ services

A

primary health care
public health
home care

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11
Q

the ________________________ was established in September 2004 to strengthen public health in Canada

A

public health agency of Canada (PHAC)

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12
Q

the PHAC brings together scientists, researchers, policy makers, and public health professionals including doctors and nurses and epidemiologists. they are committed to the well being of ____________ and the Canadian population as a _______________

A

communities

whole

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13
Q

____________________ is defined as accessible, acceptable, affordable health care and encompasses the determinants of health and their influence on health and well being

A

primary health care

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14
Q

primary care providers include?

A
physicians
nurses
dentists
pharmacists
dieticians
midwives
optometrists
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15
Q

________________ refers to services accessed at the first point of contact with the health system

A

primary care

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16
Q

most Canadians access _________________ through a GP who is reimbursed on a fee for service basis

A

primary care

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17
Q

while the largest group of primary care providers in Canada is ____________, other primary care providers include?

A
physicians
nurses
nurse practitioners
dentists
chiropractors
pharmacists
dieticians
midwives
optometrists
public health nurses
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18
Q

___________________ augments medicare by ensuring that health promotion, illness and injury prevention and health protection services are among the essential health services that are universally accessible to individuals and families

A

public health

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19
Q

public health infrastructure has been eroded in recent decades as a result of increased _______________ and decreased ______________

A

complexity

funding

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20
Q

home care

A

________________ is defined as a wide range of health services delivered at home and throughout the community to recovering, disabled, chronically, or terminally ill persons in need of medical, nursing, social or therapeutic treatment and or assistance with the essential activities of daily living

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21
Q

a vital part of Canadian health care, every jurisdiction offers publicly funded _______________ to its constituents

A

home care

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22
Q

a central strategy for all CHNs is developing _____________ and community _____________

A

leadership

influence

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23
Q

attributes that support community and public health nursing practice include: ____________________ practice; _________________ culture; and ______________ policy

A

management
organizational
government

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24
Q

creating and articulating a clear purpose and vision is critical and to do that effectively, nurses/CHNs must be ale to see the long _________, incorporating multiple aspects of the broader environment, communities, _____________ environment and the larger health and social systems

A

view

political

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25
Q

1947: Saskatchewan gets _______________ under Tommy Douglas

A

medicare

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26
Q

summarize 2/4 federal initiatives in the development of health promotion and give one rational for each the illustrates their importance on an international level

A

Lalonde report (1974): acknowledged the limitations of the funded medical/treatment system. presented a vision for health promotion. identified 4 determinants of health, with an emphasis on lifestyle and environment. led to a global reconceptualization of health promotion

Epp report (1986): expanded the definition of health promotion, incorporated some of the tenets of primary health care and emphasized social/environmental/political dimensions of health. formed the basis for the Ottawa charter of health promotion

Ottawa charter of health promotion (1986): international document identifying the prerequisites for health, strategies for promoting health, and outcomes of the strategies. acknowledges that caring for ones self and others is conducive to health. identifies caring, holism, and ecology as essential concepts in health promotion

Population health template and population health promotion model (2001 and 1996): resources developed to put population health and health promotion into action. used nationally and internationally in program planning, community development and resource allocation.

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27
Q

Population health template and population health promotion model (2001 and 1996)

A

resources developed to put population health and health promotion into action. used nationally and internationally in program planning, community development and resource allocation.

28
Q

international document identifying the prerequisites for health, strategies for promoting health, and outcomes of the strategies. acknowledges that caring for ones self and others is conducive to health. identifies caring, holism, and ecology as essential concepts in health promotion

A

Ottawa charter of health promotion (1986)

29
Q

epp report

A

expanded the definition of health promotion, incorporated some of the tenets of primary health care and emphasized social/environmental/political dimensions of health. formed the basis for the Ottawa charter of health promotion

30
Q

Lalonde report (1974)

A

acknowledged the limitations of the funded medical/treatment system. presented a vision for health promotion. identified 4 determinants of health, with an emphasis on lifestyle and environment. led to a global reconceptualization of health promotion

31
Q

discuss three Canadian values that are reflected in the current medicare system

A

social justice: all members of society ,including the most vulnerable, are entitled to free health care in Canada

equity: all Canadians are viewed equally and without discrimination in terms of universal health care coverage
community: all members of society contribute through taxation to provide everyone in the community with access to health care regardless of ability to pay

32
Q

1947: Medicare:
- first policy of public healthcare implemented in _________________________
- Tommy Douglas (‘father of Medicare’) and Cooperative Commonwealth Federation
- Not until 10 years later in 1957 that similar legislation, the _______________________________________________________(HIDS) was passed by the government of Canada which provided for the federal governments payment of half the costs of insurance plans if key criteria were met

A

Saskatchewan

hospital insurance and diagnostic services act

33
Q

Current: national,____________________ health insurance program

A

universal

34
Q

Canada Health Act:

  • Federal funding was provided as long as provincial health insurance plans met the 5 criteria:
    1. ) ______________ administered (accountable to the public)
  1. ) ___________________ (must cover necessary in-hospital, medical and surgical-dental services)
  2. ) _____________ (available to all)
  3. ) _______________ (available after a max of 3 months of residency, and no extra charge for care out of province)
  4. ) _______________ (no user fees HCP must be reimbursed adequately)
A
publicly 
comprehensive 
universal 
portable 
Accessible
35
Q

the Canada health act has ensured that Canadians have access to healthcare regardless of their ability to__________ and where they___________!!

A

pay

live

36
Q

the Canada health act Reflects the values of ________________,____________ and________________. It is held up as a symbol of the values that represent Canada. It articulates a social contract that defines healthcare as a basic ______________

A

social justice
equity
community
right

37
Q

Health_______________,_______________ of disease and injury, health _______________ and home health were not emphasized in the Canada health act
-These services were left unprotected by federal legislation; therefore each______________ determines what is covered to what extent

A

promotion
prevention
protection

province

38
Q

2006: CNA spoke up and stated that health_____________, funding to address_________________ of health and support for control of ____________ costs were as important as wait times and fears about financial sustainability

A

promotional
determinants
drug

39
Q

today public health systems in Canada continue to be confronted by ideologies that favor __________________, _______________________ and ______________ outcomes which tend to overshadow health promotion and prevention values, strategies and activities

A

efficiency
effectiveness
short term

40
Q

____________________:a process of enabling people to increase control over and to improve their health. Enabling people to increase control over and improve their health transcends ‘healthy lifestyle’ or ‘health choices’ and focuses on the personal and social resources that are available, accessible and so forth

A

health promotion

41
Q

Effective chronic disease prevention and management will require broad policy options, including amending the ___________________________; promoting interdisciplinary_________________ and supporting further integration of public health,_______________ and other sectors of the healthcare system. _______________ care and community______________ health services are areas that need to be strengthened within the Canada health act

A
Canada health act
teamwork
homecare
palliative
mental
42
Q

1974 Lalonde Report
-presented a vision for health promotion services as critical component of Canada’s health care services
-identified 4 determinants of health:
_________________
____________________
__________________
_________________
-this was the first acknowledgement that health was influenced by social, economic, environmental conditions (where people lived, worked and played)
the Lalonde report was considered revolutionary by the global community and led to a reconceptualization of health _______________

A
environment
human biology
lifestyle
healthcare system 
promotion
43
Q

1986: Epp Framework: Achieving health for all which is a framework for health promotion
- expanded on _____________ definition of health promotion
- incorporated: primary health care and emphasized the role of broad social, environmental and political determinants of health
- the document concluded with a slander of strategies that focus on _______________ responsibility for health or blaming the victim while ignoring the social and economic determinants
- formed the basis for the _____________________

A

Lalondes
individual
ottawa charter

44
Q

1986: The Ottawa Charter
- emerged from the first international conference on health promotional hosted in Ottawa
- identified ________________ for health, strategies for promoting health and outcomes of those strategies
- this marked a dramatic shift in health promotion
- determinants identified: peace, shelter, income, and food = broader view of health, focused on _____________________ factors rather than providing illness care and identifying risk factors, it switched to an inclusive approach that also focused on socioenvironmental factors
- caring for ones self and others is conductive to health
- _______________, _________________ and ecology are essential concepts in health promotion

A

pre-requisites
socioeconomic
caring
holism

45
Q

governments have a responsibility for the health of their people and equity in health is an expression of _________________

A

social justice

46
Q

primary health care

A

________________________= accessible, acceptable, affordable healthcare

  • Other tenets of PHC include: basis in research, continuum of services from promotive to rehabilitative, identification of health education, proper nutrition, disease prevention and control, and maternal and child health care as minimum services
  • recognizes importance of interdisciplinary approaches for success
  • emphasis on community participation and empowerment
  • encompasses the determinants of health and their influence on health and well-being
  • CHN’s have participated in primary health care and are well prepared to play a leadership role
47
Q

____________________ reform began at a national level and sought to move toward an integrated systems approach which would more broadly provide the full spectrum of health services in communities or neighborhoods. It was envisioned that health promotional and disease and injury prevention services would be enhanced as the focus shifted “upstream” with the implementation of primary health care

A

primary care

48
Q

public health ensures:
-health_______________,_____________ and injury prevention, and health _______________ services are among the affordable, acceptable and essential health services that are “universally accessible to individuals that live in the community”

A

promotion
illness
protection

49
Q

severe problems in public health in Canada include: disparities among _______________ and regions, severely inadequate and decreasing _______________, critical human resource issues, development of public health policies without consideration of relevant ____________

A

provinces
funding
data

50
Q

funding of public health services depends largely on ______________ governance and delivery structures

A

provincial

51
Q

standards for public health are inconsistently developed across_______________. The development of standards has been influenced by many factors, including legislation, mandates, leadership and history

A

canada

52
Q

problem: as care shifts to the home, they shift beyond the boundaries of public _________________. All of the provinces offer a package of basic services, but there are significant provincial variations in the degree to which services are publically funded vs privately funded and this results in significant inequity in accessing publicly funded home care across different regions of the country

A

insurance

53
Q

Community health nursing is in a______________ position today

The undervaluing mirrors the diminished funding and resources of previous decades

there is relative_____________ of CHNs

A

vulnerable

invisibility

54
Q

there is visible decline in community health nursing _____________

key issues that have been identified include: need for stronger discipline specific communities of practice and more opportunities to meet with peers to discuss and solve professional issues; substantial concern regarding leadership within health units and management skills at the senior management level; lack of career paths and opportunities for advancement

the areas most cited as needing attention were organizational culture, a sense of being _____________ and appreciated, the quality of leadership, the quality of supervision and management and access to ongoing education and training

A

leadership

valued

55
Q

CHNs must be able to see the long view and be able to articulate a clear _________________ and vision in order to incorporate multiple aspects of the communities, the political environment and the larger health and social systems

A

purpose

56
Q

• The following attributes of nurse leaders contribute to effectiveness:
o ______________________ and listening skills
o Resilience, persistence and hardiness
o Comfort with ambiguity, uncertainty and _________________
o Willingness to take _______________
o Working from a foundational moral ________________
o Confidence in own values and ________________
o Self confidence, self awareness, social awareness
o ___________________
o Cultivation of professional and personal _____________

A

communication

complexity

risks

framework

beliefs

knowledge

supports

57
Q

Within the context of community health nursing practice, important organizational supports that positively influence practice include a work culture that:
o Values the unique and combined contribution of _________
o Deliberately establishes _______________ and mentoring plans
o Has a clear vision engendering __________________
o Has stable ______________ and access to necessary resources to accomplish work

A

staff
leadership
commitment
funding

58
Q

Collaborative leadership at a national level will be strengthened by developing intersectoral relationships, promoting community health solutions across sectors and addressing the wider _________________________

__________________ is consistently identified as contributing to leadership developmen

A

determinants of health

mentoring

59
Q

numerous reports at the provincial and federal levels have recommended reforms to the healthcare system (_________________________, which made 47 recommendations for both the immediate future and the next 20 years)

A

Romanow commission report

60
Q

demands on limited ____________ health and ________________ health care nursing services have challenged the community health system

A

home

primary

61
Q

CHNs practice at the intersection of public policy and private lives and are thus in a position to include political advocacy and efforts to influence healthy ______________ _____________ in their practice

A

public policy

62
Q

CHNs are well positioned and morally obligated to act and provide

A

leadership

63
Q

______________: a resource for everyday life encompassing social and personal resources as well as physical capacities.

A

health

64
Q

The emphasis on personal and social resources moves us into the idea of_________________

A

community

65
Q

_______________________ is defined as: Equitable access to health and health services, public participation, appropriate technology, intersectional collaboration, and reorientation of the health care system to promotion of health and prevention of disease and injury.

A

primary health care

66
Q

in the early 20th Century, health departments were dissolved after a local emergency was over. which statement below characterizes the social attitude of the era?

  • public health was the responsibility of doctors
  • visiting nurses were responsible for community health
  • the state was not responsible for health care
  • women should not be working outside of the family
A

the state was not responsible for health care

67
Q

what was the primary reason for the establishment of school health programs?

  • prevent ill children from becoming dependent citizens
  • promote the health of all children
  • provide food for children who lived in poverty
  • treat sick children so they could work and contribute to the family income
A

promote health of all children