《社区护理》教学大纲
课程名称：社区护理 (Community Health Nursing)
课程编码：212017
学 ; ; ; 分：2分
总 学 时：32学时，其中，理论学时：24学时；实验学时：8学时
适应专业：护理学
先修课程：人体解剖学、生理学、病理学、药理学、护理学导论、护理学基础、内科护理学执 笔 人：衡艳林
一、课程的性质、目的与任务
《社区护理》是一门护理学专业的学科专业课。社区护理作为护理专业的一个分支学科和一门新兴学科逐渐发展起来。社区护士在社区卫生服务中承担重要的任务，要求她们要为社区人群提供生理、心理、社会全方位、连续性、以预防为主方向的服务。本课程的主要任务是通过《社区护理学》的教学，为学生奠定良好的社区护理专业知识和技术，使学生具备以个人、家庭、社区为中心的护理知识和技能，以及在社区应该如何进行可及性、综合性和持续性的整体护理基本能力。明确社区护理的性质、任务，认识到新形势下社区护理的重要性，培养应用型的社区护理人才。
二、教学基本要求
根据护理学专业的培养目标，教学中要求重点掌握社区护理的基本理论、基本知识和基本技能，将所学知识运用到社区实践中，为社区人群提供优质服务。
1.从现代医学模式和护理模式出发，使学生掌握社区护理的基本概念和方法。
2.学习运用社区护理理论知识和护理操作基本技能，以社区护理程序的工作理论，开展以家庭、群体和社区护理工作。
3.理解社区护士的角色和素质要求；熟悉社区护理常用的工作方法实施技能。
4.了解社区护理工作与临床护理工作的不同之处，我国社区护理的发展现状。
三、教学内容与学时分配
第一章 ;社区与社区护理 （2学时）
本章的重点和难点：掌握社区的基本概念
第一节 ;社区卫生服务概述
第二节 ;社区护理概述
第三节 ; 社区护理发展史与发展现状
第二章 ;社区护理工作方法 （2学时）
本章的重点和难点：社区工作方法的类型和特点及应用；健康教育的相关理论
第一节 ; 社区护理的常用工作方法 ;
第二节 ; 社区护理程序
第三节 ; 社区健康教育
第四节 ; 家庭访视和居家护理
第三章 ; 社区健康护理 （4学时）
本章的重点和难点：掌握社区健康档案的管理
第一节 ; 社区健康护理
第二节 ; 社区健康档案的管理与应用
第三节 ; 社区环境与健康
第四节 ; 社区传染病的防治
第五节 ; 社区灾害性事件
第四章 ; 家庭健康护理 （4学时）
本章的重点和难点：社区护士在家庭健康护理中的职责和作用；家庭健康护理理论
第一节 ; 家庭的概念；家庭类型；家庭结构和功能
第二节 ; 家庭生活周期和家庭面临的发展任务
第三节 ; 家庭健康护理的特点和工作内容
第四节 ; 社区护士在家庭健康护理中的职责和作用
第五节 ; 家庭护理相关理论：家庭系统理论、家庭压力应对理论
第六节 ; 护理程序在社区家庭护理中的应用
第五章 社区儿童青少年健康保健与护理 （2学时）
本章的重点和难点：儿童和青少年常见病的预防、护理和保健指导
第一节 ; 概述
第二节 ; 儿童和青少年生长发育特征、检测与评价
第三节 ; 新生儿家庭访视
第四节 ; 儿童计划免疫与预防接种
第五节 ; 各年龄期儿童与青少年保健指导
第六节 ; 托幼机构儿童卫生保健的工作要求和卫生保健管理
第六章 ; 社区妇女健康保健与护理 （2学时）
本章的重点和难点：妇女特殊时期的保健护理。
第一节 ; 妇女保健的概述
第二节 ; 妇女特殊时期的保健护理
第三节 ; 常见疾病及保健护理
第七章 ;亚健康人与中年人的健康保健与护理 （2学时）
本章的重点和难点：亚健康的概念和保健指导
第一节 ; 亚健康的概述
第二节 ; 亚健康人的保健指导
第三节 ; 中年人的保健指导
第八章 ; 社区老年人健康保健与护理（2学时）
本章的重点和难点：老年人的特点；老年人常见的社会心理健康问题与保健指导
第一节 ; 老年人健康保健概述
第二节 ; 国内外（美国、日本）老年人的健康保健措施
第四节 ; 联合国老年人保健原则
第五节 ; 老年人的保健指导
第六节 ; 老年人常见的社会心理健康问题和预防
第九章 社区慢性病病人健康保健与护理 （2学时）
本章的重点和难点：社区慢性病的特点和慢性病病人的自我护理模式；社区慢性病的综合管理措施
第一节 ; 慢性病的概述
第二节 ; 社区慢性病的综合管理
第三节 ; 慢性病自我管理
第四节 ; 慢性疾病居家护理的应用
第十章 社区残疾人和精神障碍者的康复护理 （2学时）
本章的重点和难点：社区康复护理工作常用的方法；社区残疾人康复护理评定；社区精神障碍患者的社区管理
第一节 ; 社区康复护理概述
第二节 ; 护理程序在残疾人康复护理中的应用
第三节 ; 社区康复对象常用日常生活活动训练的技术
第四节 ; 社区精神障碍者的康复护理
四、实验
1. 实验的目的与任务
《社区护理》是护理学的一个重要组成部分，也是一门实践性很强的专业课程。通过该课程的实验、实践教学，加强学生对社区常见问题判断能力的培养，巩固和加深学生的理论知识，提高社区护理实践能力，为培养能胜任社区护理工作人才打下良好的基础。
2. 教学基本要求
;老师在指导实践时，善于启发和诱导学生，指导学生如何应用评判性思维。学生在进行模拟实践或现场的实验时，教师要调动学生的主动参与意识，加强团队合作精神和能力的培养和训练。同时及时发现学生在实验课堂中存在的思维方法问题以及对知识理解等方面的问题，给予指出和纠正。
3. 实验项目与类型
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演示 |
验证 |
设计 |
综合 |
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选做 |
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社区健康教育活动设计 |
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社区健康教育实践 |
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社区家庭访视 |
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社区护理综合实践 |
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4. 实验教学内容及学时分配 ;
实验一 ; 社区健康教育活动设计（2学时）（1）目的要求
通过分组进行的社区健康教育活动方案的设计使学生加强团队合作意识，掌握社区健康教育活动的准备过程和社区健康教育的常用方法。
（2）掌握要点
掌握社区健康教育活动的准备过程和社区健康教育的常用方法。
（3）实验内容
分工合作完成社区不同人群健康教育活动设计书；设计与设计书相适应的健康教育宣传卡及其它相应的教学工具。
实验二 ; 社区健康教育实践 （2学时）（1）目的要求
通过将各组健康教育活动设计的现场或模拟现场进行实践，使学生掌握健康教育的基本方法；并通过学生互评，总结经验教训，寻找共同存在的问题，提高沟通交流能力。
（2）掌握要点
掌握健康教育的基本方法。
（3）实验内容
健康教育设计和健康教育实施。
实验三 ; 社区家庭访视 （2学时）
（1）目的要求
通过指导学生进入社区家庭进行家庭访视，使学生克服进入家庭进行家庭访视和家庭护理的心理障碍；学习家庭访视的程序和方法，并了解家庭访视记录的内容。完成一份家庭访视报告。
（2）掌握要点
掌握家庭访视的程序和方法。
（3）实验内容
访视前准备；家庭访视活动；家庭访视报告书写。
实验四 ; 社区护理综合实践 （2学时）（1）目的要求
通过参观社区卫生服务中心（站），使学生社区卫生服务中心（站）的设施和仪器设备有一个感性认识，了解社区护士的工作制度、工作程序和工作内容，对综合、全面理解社区护理的知识作一全面回顾和总结。
（2）掌握要点
社区卫生服务中心（站）的设施、设备；社区护士工作制度、方法和内容等。
（3）实验内容
参观社区卫生服务中心（站）；了解社区护士的工作程序、方法和内容。
5. 实验考核办法
考核内容包括实践活动的参与程度60%和实践报告40%。考核成绩以20%计入课程总成绩。
五、大纲说明
本大纲是根据护理专业本科教学计划和学时要求制定的，适用于护理本科专业。教学总时数为32学时，其中课堂讲授24学时，实验8学时（实验教学可安排在课程教学过程中，也可安排在学期实践教学环节）。课堂教学以赵秋利主编《社区护理》第二版（人民卫生出版社、2006年）为主要教材，以林菊英主编《社区护理学》第二版（科学出版社，2001年）、李继坪主编《社区护理》（人民卫生出版社，2000年）等书为参考教材，按照本大纲的内容进行教学。本课程适宜安排在学生学完生理学、人体解剖学、病理学、内科护理学、外科护理学等有关课程之后开课，在教学内容上要注意与内科护理学、外科护理学、儿科护理学、妇产科护理学等课程的衔接，尽量避免不必要的重复。
六、教学参考书
[1] Judith A. Allender, Cherie Rector, Kristine D.Warner.Community Health Nursing. Lippincott Williams & Wilkins.7th edition. 2010
[2] 何国平.《社区护理学》湖南科学技术出版社，2005
[3] 廖淑梅.《康复护理学》湖南科学技术出版社，2005
[4] 曹和安.《健康评估》湖南科学技术出版社，2005
[5] 冯正仪.《社区护理》复旦大学出版社，2003
[6] 孙振球.《社区医学》人民卫生出版社，2001
[7] 赵晓文主译.《默克家庭诊疗手册》人民卫生出版社，1999
[8] 金宏义.《社区特殊人群护理》浙江大学出版社，2003
[9] 殷磊. 《老年护理学》人民卫生出版社，2000
[10] 林菊英.《社区护理》科学技术出版社，2001
[11] 金宏义.《重点人群保健》人民卫生出版社，2001
[12] 卫生部科技教育司编《社区护士岗位培训教材》中国协和医科大学出版社，2001
[13] 李德.《预防医学》人民卫生出版社，2002
[14] 南登昆.《康复医学》人民卫生出版社，2002
[15] 李惠娟.季正明《社区卫生服务实用手册》复旦大学出版社，2002
[16] 席焕久.《新编老年医学》人民卫生出版社出版,2002
[17] 李春玉.《灾害急救与管理》中国协和医科大学出版社，2004
[18] 季成叶.《儿童少年卫生学》人民卫生出版社，2005
[19] Stanhope. M., Lancaster, J. Community health nursing process and practice for promoting health (3rd). 1992. Mosby
[20] Karen Saucier Lundy. Community Health Nursing: Caring for the Public’s Health. Jones and Bartlett Publishers， 2000
[21] Patricia L Carroll. Community Health Nursing: A Practical Guide. Thomson Delmar Learning， 2003
[22] Judin AA, Barbara WS. Community Health Nursing Concepts and Practice. 5th ed. Lippincott: Williams, 2001
Syllabus of Community Health Nursing
CREDITS: 2 credits.
COURSE DESCRIPTION
Sessions explore the multidisciplinary theoretical foundations that are the basis for community health nursing practice. Topics examined include community health nursing practice and public health science; community health issues across the lifespan; methods of family and community analyses; disease management and prevention in the community; an overview of health organizations, and; epidemiological and bio-statistical indicators of community health. This course is required for all students in the specialty year. The majority of course work occurs during the spring term.
COURSE OBJECTIVES
Successful completion of this course indicates that the student demonstrates the ability to:
1. Identify the principles of population and community-based focus of nursing practice as they apply to the role of the community health nurse.
2. Identify structure, function and processes of various health systems in the community that influence health outcomes of individuals, families and groups.
3. Apply epidemiological principles to analyze health goals and outcomes of individuals, families and groups within the cultural and community context.
4. Review the purpose of Healthy People and apply initiatives during case studies.
5. Apply principles of community assessment, diagnosis, intervention, planning and evaluation consistent with meeting the health needs of the community.
6. Describe the nurse’s role in disaster management and implications for nursing practice in China and globally.
TEXTBOOK:
Stanhope & Lancaster (2004). Community and Public Health Nursing. 6thed. Mosby. Evolve Website.
Class Attendance and Participation:
Please note the class times on the calendar as class will start promptly at the designated time. While attendance is not mandatory, it is strongly encouraged as the material covered in class is important for application to clinical experiences and projects. Students are responsible for any announcements made during class, meeting course objectives, all of the material presented in class, and the required readings.
Evaluation of the Student:
The final grade for CHN will be based on the following:
Team Work………………………………………………………………………… 30%
Family Visit………………………………………………………………………30%
Community Assessment……………………………………………………………10%
Attendance…………………………………………………………………………10%
Final Exam…………………………………………………………………………20%
The final exam will be based on the material presented in class and assigned readings.
Accommodations for students with learning disabilities: Students with learning disabilities are expected to register with Nursing School on Disability and arrange for letter documenting their status to be sent to the course coordinator.
Final grade:
In accordance with Medical School of Yangtze University policy, the following demarcations will be used to determine exam and course grades:
Pass……………………………………… above 60 points
High Pass…………………………………70-89 points
Honors…………………………………… 90-100 points
Articles and Additional Readings
Optional and additional readings are listed in the units in the syllabus. Citations available on-line are listed by URL in the syllabus and are linked to the course website.
It is suggested that students refer to the Evolve Website during the course for additional resources and application of class materials. Please see required and additional readings.
UNIT I: INTRODUCTION TO COMMUNITY AND PUBLIC HEALTH NUSING
Objectives: 1. Define the four nursing areas in the community.
2. Differentiate between population and community-based nursing practice.
3. Discuss the multiple nursing roles in community health.
4. Define and discuss the core functions of Public Health.
Critical Thinking Questions: a) Review the 10 essential public health services. How could managed care organizations benefit from having a public health nurse on staff?
b) What health concerns in your community have resulted in death, disease, or injury? How could population-based community health nursing help prevent these problem?
c) Identify three effects of globalization on the health of the community in which you live. Prioritize these effects in terms of their impact and give the rationale for your choices.
UNIT II: INTRODUCTION TO EPIDEMIOLOGY
Objectives: 1. Define the basic principles of epidemiology.
2. Describe the essential elements of epidemiology and an epidemiologic approach.
3. Review and examine the relationship of the natural history of disease to the concepts of primary, secondary and tertiary prevention, and implementation of community interventions.
Critical Thinking Questions: a) Incidence and prevalence rates provide different information about the same health condition. Which rate provides the most useful information about the risk of illness?
b) Select a health issue such as asthma, domestic violence, or cardiovascular disease, that affects a large number of people. Draw a web of causation that connects the different factors that may result in this health condition.
UNIT III: THE HOME VISIT, HOSPICE AND END OF LIFE CARE IN THE COMMUNITY
Objectives: 1. Define home health and hospice care.
2. Examine the advantages and disadvantages of the home visit.
3. Describe the phases of the home visit.
4. Analyze the differences between nursing care in the home and in the hospital.
5. Apply nursing process for a home visit through discussion of case study.
Critical Thinking Question: a) Construct an eco-map of your family. Ask a peer to do the same thing. Assess the balance between your family and the resources in its environment. How does your eco-map compare with that of your peer? What changes are needed in each family system?
b) Complete a social network support map or grid on yourself. Discuss it with a peer. What areas need to be worked on?
c) Assess a family that you know well by completing a family assessment guide. Based on your assessment, determine nursing interventions as you can think of that could be used to promote this family’s health as practically as possible.
UNIT IV: ENVIRONMENTAL INFLUENCES ON HEALTH
Objectives: 1. Examine the influence of the environment on the health of individuals, families and groups.
2. Discuss taking environmental exposure histories and environmental health assessments.
3. Apply the nursing process to the practice of environmental health.
4. Describe exposure pathways.
5. Assess environmental issues that may influence the health of individuals, families and groups living in the community where your clinical site is located.
Critical Thinking Questions:
1) You are planning a visit to a young family who live in an older home. You know that older homes may have radon, lead pipes and lead-based paint and other safety, fire, and health threats. Please use nursing process to design a plan for determining whether any of these threats are present and deciding what actions should be taken if the dangers exist.
2) What collaborative actions would be appropriate to take to determine whether there is an environmental relationship?
UNIT V: COMMUNITY ASSESSMENT AND DIAGNOSIS; PROGRAM PLANNING DEVELOPMENT AND EVALUATION CONCEPTS
Objectives: 1. Review the phases of a community assessment.
2. Examine the core concept of community partnership as part of the Community as Partner theory.
3. Identify the process for deriving a community diagnosis from the community assessment.
4. Discuss the steps to planning a community health program.
5. Examine the principles of evaluating a community health program.
6. Apply the principles of Community as Partner Theory to case studies.
Critical Thinking Questions:
1) What opportunities exist for you to become in your community? Are these related to your role as a community health nurse?
2) Develop hypothetical information for the following community problem: “Potential for high-risk sexual behavior in high school teens.”
UNIT VI: COMMUNITY ASSESSMENT ABOUT OLDER ADULTS
Objectives: 1.Identify key national and global demographic characteristics of women and men throughout the adult life-span.
2. Identify desirable primary, secondary, and tertiary health promotion activities designed to improve the health of women and men.
3. Identify potential physical, chemical, biologic, ergonomic, and psychosocial stressors in a variety of work environments.
4. Discuss a variety of occupational health problems, including disorders related to ergonomics and workplace violence.
5. Compare and contrast three main types of occupational health programs.
6. Describe the role of the occupational health nurse and other members of the occupational health team in protecting and promoting worker’s health and safety.
Critical Thinking Questions:
1) You are asked to offer a weight-control program for a local milk-processing plant that has 100 employees. What steps would you take to develop a successful program?
2) Using the internet and the school library, research an injury and a disease often associated with your future profession. Write a two-page paper in which you identify the selected concerns and discuss both employee and employer responsibilities regarding management of these problems.
3) Survey your living quarters and make a room-by-room environmental assessment of potentially unsafe conditions. Describe a strategy for improving each condition.
UNIT VII: SUB-HEALTH STATE
Objectives:
1. Discuss activities to assist in the orientation of a new community health nurse to people in the state of sub-health.
2. Describe the main phenomenon about the sub-health people.
3. Discuss the challenges and opportunities related to community health nursing practice.
Critical Thinking Questions:
1) Assume you are a community health nurse in a community. Describe your approach to solve the problem of sub-health people.
2) Go on the Internet to locate health programs in various states. In addition, see whether the Internet has more information about the studies of sub-health people.
3) Complete a community assessment of a community with people who has some problem about insomnia.
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