Gender-Appropriate Care for Men Community Health Nurses
Order ID 53563633773 Type Essay Writer Level Masters Style APA Sources/References 4 Perfect Number of Pages to Order 5-10 Pages Description/Paper Instructions
Gender-Appropriate Care for Men Community Health Nurses
Gender-Appropriate Care for Men Community health nurses are in an ideal position to address the health needs of men at individual, family, and community levels. The community health nurse may promote self-care in male members of the family, facilitate men’s health by addressing needed changes at the family level, buttress women’s roles as caregivers of the family’s health, and bring about change that influences policies that affect men at the community level.
Planning gender-appropriate care for males is outlined in the following case study, which is an application of the nursing process at the individual, family, and aggregate levels initiated in a home visit, and applies the previous discussions about the levels of prevention, roles of the community health nurse, research, and men’s health.
Application of the nursing process to aggregates is facilitated by the use of systems theory, in which the nurse identifies the system and subsystems involved. The nurse may use a deductive or an inductive approach. A deductive approach would involve carrying out a community assessment and identifying an area or areas, such as a program needed by the community. Planning, implementation, and evaluation of the program would be carried out at the family or group level. An inductive approach would involve entering the community system through a person or client via a referral about a problem or concern. Assessment of the individual would be followed by identification of those groups to which the client belongs, such as family and community, and assessment of those groups.
Beth Lockwood, a community health nursing student at a health department, received a referral from the high school nurse to visit the Connors family to assess Richard Connors’ mental health status. Richard was a 16-year-old sophomore whose academic work in school had declined rapidly after the premature death of his 46-year-old father. The father had died of a myocardial infarction, which he had while cleaning the garage with Richard one evening after school. Richard and the neighbors failed to revive Mr. Connors, and Richard carries feelings of guilt. Household members include Mrs. Connors, age 44 years, and Richard’s sister Yvonne, age 12 years.
Assessment
The referral to assess the Connors family called for an inductive approach to assessment. Beth used a deductive approach later, when her experience with the Connors family piqued her concern about the status of men’s health in her community. Beth assessed Richard, his mother, and his sister as household members of the family. However, she could not stop with the immediate family; she had to continue to identify the other groups within the community to which each individual family member belonged. Viewing the community as a system and focusing on systems and subsystems helped Beth organize the data she collected during assessment. Knowing that “the whole is greater than the sum of its parts,” Beth prepared for her visit by reviewing adolescent theories of development and family theory. Beyond individual assessment, she noted factors related to the development of sex role–related behavior that may influence health. Examples of assessment areas include the following:
Family Configuration, Traditional or Nontraditional
Sex role–related behavior of parents, including work patterns in and out of the home, division of household labor, and decision-making patterns
Patterns of parenting: mothering, fathering, and substitute father figure(s)
Ability of male children to disclose feelings to family members and others
Degree of assertiveness in female children
Ability of family members to give emotional and physical support during crises and no crises
Ability of family members to trade off role-related behavior during crises and no crises
Risk-taking health behaviors
Processing of stress and grief
Communal lifestyle patterns that place the individual or family at risk (e.g., lack of exercise, poor diet, smoking, and drinking)
Family history of death and illness
Health care–taking patterns of family members
Preventive health behaviors
Leisure activities
Assessment of other groups includes neighborhood and other peer groups, school environments, sports, and church and civic activities.
Diagnosis
Through induction, the nurse makes a diagnosis for each individual and each system component, including family and the community. The following are examples of diagnoses.
Individual
Loss of interest or involvement in an activity related to conflicting stages of grief process secondary to premature death of father (Richard)
Expressed dissatisfaction with parenting role related to feelings of helplessness and sadness secondary to premature death of husband (Mrs. Connors)
Risk of interpersonal conflict resulting from prolonged, unrelieved family stress secondary to premature death of father (Yvonne)
Family
Decreased ability to communicate related to family stress secondary to premature death of father
Risk of family crisis related to disequilibrium
Community
Inadequate systematic programs for linking families in crisis to community resources
Inadequate systematic programs for populations at risk of premature death related to inadequate planning among community systems
Planning
Planning involves contracting and mutual goal setting and is an outcome of mutually derived assessment and diagnosis. A contract with the family alone is shortsighted and may provide little community benefit over time. The following are examples of other aggregates with which a contract may be established:
The school subsystem that does not provide ongoing counseling but will meet periodically with family members to evaluate pupil progression
The school subsystem that provides physical education in football, basketball, and baseball (i.e., nonaerobic, nonlife time sports) but offers extramural aerobic, lifetime sports such as swimming, tennis, golf, and track after school hours
The American Red Cross, which does not offer cardiovascular pulmonary resuscitation (CPR) courses on evenings or weekends but offers to consider doing so for a defined minimum-size community
Mutual goal setting requires collaboration regarding long- and short-term goals. Again, mutually defined needs and diagnoses are important to this process. Regardless of the diagnosis, each individual in the family and the subsystem must participate in development of a care plan. The following are examples of goals
Individual
Long-Term Goal
Individual family members will be able to trade off role-related behavior.
Short-Term Goal
Individual family members will express feelings related to abandonment and loss.
Family
Long-Term Goal
The family will exhibit an increased ability to handle crisis, as evidenced by ability to discuss roles and interdependencies.
Short-Term Goal
The family will identify specific ways to recognize and use support services.
Community
Long-Term Goal
Systematic programs, with ongoing program evaluation, will be established for populations at risk of premature death from coronary heart disease, as evidenced by local planning bodies. Short-Term Goals
Information is disseminated to individuals, families, groups, and planning bodies in the community about the incidence of coronary heart disease.
Existing programs are identified that address coronary heart disease.
Existing programs are coordinated to bridge gaps and avoid duplication of effort.
Intervention
The nurse, family, and other aggregates carry out interventions contracted during the planning phase to meet the mutually derived goals. Most important, the nurse empowers the family and community to develop the networks and linkages necessary to care for themselves.
Individual
Individual counseling regarding loss and grief may be beneficial to each family member, but options may need to be explored and referrals may need to be reevaluated for members of the rural family. Education regarding preventive measures that combat risk factors for heart disease include those aimed at individual family members and those that address areas such as diet, exercise, smoking, alcohol use, and stress management.
Family
Examples of interventions with the family include counseling, education, and referral aimed at family self-care promotion. For example, Beth’s interventions with the Connors family depended on the family’s ability to solve problems, investigate community resources, and create linkages between the family and resources. Periodic family conferences at school and more inclusive family therapy may enable the family to work through the death of Mr. Connors; this process results in the development of new roles and the communication necessary to maintain family equilibrium. Education regarding preventive measures to combat risk factors for heart disease may need discussion at the family and individual levels (e.g., diet, exercise, smoking, alcohol use, and stress management).
Community
The nurse must also carry out interventions with other aggregates. These may involve activities such as educating, facilitating program expansion, and tailoring programs to meet community needs. Intervention at the aggregate level calls for group and community work. The nurse carries out interventions at this level in several ways (e.g., by communicating community statistics from a community analysis, relating anecdotes from families served, or linking family experience to program needs by acting as an advocate and bringing family members to board meetings or hearings on community health issues).
Education regarding preventive measures to combat risk factors for heart disease also includes those interventions aimed at the community. A rationale for the development of lifetime aerobic sports is needed not only by Richard but also by school districts. Exploration of options with the school nurse and review of the school district health education curriculum would be beneficial. A community assessment of heart disease awareness, including determination of the availability of resources such as emergency response and CPR courses, is an aggregate intervention. Taking the outcome of the assessment in the form of statistics and the anonymous anecdotal story of the Connors family to planning bodies in the community is also intervention at the aggregate level. Creative programs other communities used (e.g., teaching CPR within the school system) should be investigated and proposed.
Evaluation
Evaluation is multidimensional and ongoing. Using a systems approach to evaluation, the nurse evaluates each component of the system, from individual family member to family and community, in terms of goal achievement. Evaluation consists of noting degrees of equilibrium established, extent of change, how the system handles change, whether the system is open or closed, and patterns of networking. Ongoing evaluation includes noting referrals and follow-up of the individual, the family, and other aggregates in resource use.
Individual
Use of resources such as support groups by the individual family member may be noted. These resources may include a teen support group, a women’s support group, support groups for those experiencing the loss of a spouse or other family member, reentry programs for women at a local junior college or university, and Parents Without Partners.
Family
Evaluation of the Connors family would include follow-up of their use of support services specifically for the family, such as counseling options for the family as a unit. Evaluation would also focus on the family’s ability to handle crises in the future.
Community
Aggregate evaluation would focus on the community. For example, to what extent do school programs encourage sports options that promote lifetime aerobic activities and prevent premature death from heart disease? Are programs systematically planned in the community for populations that are at risk of premature death from heart disease?
Levels of Prevention
Society’s expectations of men and women are in transition. Application of levels of prevention by the community health nurse must consider men’s health status, men’s socialization, men’s use of health care services, men’s primary needs for prevention and health promotion, and the role of women as caregivers in family health.
Primary
Men are more likely to engage in risk-taking behavior than women and are less likely to engage in preventive behaviors; therefore, primary prevention must be marketed specifically to men. Examples of primary prevention for the Connors family are applied at the following individual, family, and community levels.
Individual
Assessment, teaching, and referral related to diet and exercise behaviors
Assist individual family members in dealing with grief from the loss of the father and husband.
Family
Assist family in dealing with grief and assuming alternative roles.
Community
Assist the community in dealing with loss of a fully functioning family by providing grief support services that include males or target males and females.
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