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Community Empowerment: The Potential for Community Health Nursing Development

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Care Sciences & Services".

Deadline for manuscript submissions: closed (30 November 2021) | Viewed by 39348

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Prof. Dr. Pedro Melo

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Centre for Interdisiplinary Research in Health, Universidade Católica Portuguesa, 4169-005 Porto, Portugal
Interests: community health nursing; public health nursing; community empowerment; nursing diagnosis; epidemiology; health planning
Special Issues, Collections and Topics in MDPI journals

Prof. Dr. José Ramón Riera

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Departamento Enfermeria Comunitaria, Medicina Preventiva y Salud Publica e Historia de la Ciencia, Universidad de Alicante, E-03080 Alicante, Spain
Interests: community health nursing; continuity care; caregivers; healthy environments interrelation; community participation
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Dr. Tam Nguyen

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Guest Editor

William F. Connell School of Nursing, Boston College, Newton, MA 02467, USA
Interests: health promotion; disease prevention; chronic disease management; vulnerable/hard to reach populations; community-based participatory research; psychometrics
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Community empowerment, as a process and as the outcome of the community health nursing approach, finds itself as a potential context to promote the development of this specific area of science and the nursing profession. The reason for this opportunity is the fact that community empowerment, according to studies developed over the past 40 years, enhances the return on resources and investment in community intervention, so often led by community health nurses.
It is therefore important to present scientific evidence of the potential of community health nursing in different domains: in the conceptual domain (such as nursing theories and models); in the professional domain (for example, with case studies related to diagnosis, interventions and health gains sensitive to community health nursing care); but also in the economic and social domains (such as contributing to good health cost management or even increasing community empowerment).
In this Special Issue, the aim is to identify the evidence on community health nursing approaches, related to the community as a client of nurses and community empowerment, with relevance to contributions to community health nursing development. Articles addressing these topics are invited for this Special Issue, especially those combining a high academic standard coupled with a practical focus on community health nursing related to community empowerment.

Prof. Dr. José Ramón Riera
Prof. Dr. Tam Nguyen
Prof. Dr. Pedro Melo
Guest Editors

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Keywords

Community empowerment
Community leadership
Community participation
Community health nursing
Nursing decision making
Nursing diagnosis
Health policy

Published Papers (10 papers)

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Research

13 pages, 362 KiB

Open AccessArticle

Preference of Older Adults for Flexibility in Service and Providers in Community-Based Social Care: A Discrete Choice Experiment

by Kailu Wang, Eliza Lai-Yi Wong, Amy Yuen-Kwan Wong, Annie Wai-Ling Cheung and Eng-Kiong Yeoh

Int. J. Environ. Res. Public Health 2022, 19(2), 686; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19020686 - 08 Jan 2022

Cited by 5 | Viewed by 1939

Abstract

Empowerment of control and choice of the service users in health and social care has been incorporated into service provision in various countries. This study aimed to elicit the preference of community-based long-term care (LTC) service users on levels of flexibility in service provision. A discrete choice experiment was performed among older community care service users to measure their preference for attributes of LTC services identified from a prior qualitative study. Each participant was asked to make choices in six choice tasks with two alternatives of hypothetical LTC services that were generated from the attributes. A generalized multinomial logistic model was applied to determine the relative importance and willingness to pay for the attributes. It found that the participants preferred multiple flexible providers, determining services by themselves, meeting case managers every month and social workers as sources of information on service provision. Significant preference heterogeneity was found for flexibility in providers and flexibility in services between those with and without activity of daily living impairment. The findings highlighted the preference of older adults for greater flexibility in LTC, while they rely heavily on social workers in decision making. The enhancement of flexibility in LTC should be supported by policies that allow the older service users to make decisions based on their own preferences or communication with social workers instead of determining the services and providers for them. Options should be offered to users to decide their preferred level of flexibility to better reflect their divided preferences. Full article

(This article belongs to the Special Issue Community Empowerment: The Potential for Community Health Nursing Development)

14 pages, 1372 KiB

Open AccessArticle

Adolescents’ Empowerment for Mental Health Literacy in School: A Pilot Study on ProLiSMental Psychoeducational Intervention

by Tânia Morgado, Luís Loureiro, Maria Antónia Rebelo Botelho, Maria Isabel Marques, José Ramón Martínez-Riera and Pedro Melo

Int. J. Environ. Res. Public Health 2021, 18(15), 8022; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18158022 - 29 Jul 2021

Cited by 17 | Viewed by 5191

Abstract

Adolescence is a critical life phase for mental health and anxiety an emerging challenge for adolescents. Psychoeducational interventions to promote mental health literacy (MHL) on anxiety in adolescents are needed. This study aimed to test the primary outcome of a future full-scale trial: improvement of adolescents’ anxiety MHL components on recognition, prevention strategies, and self-help strategies. A sample of 38 adolescents, 24 (63.2%) females and 14 (36.8%) males, with an average age of 14.50 years (SD = 0.89) participated in this study. Each class was allocated to the intervention group (IG, n = 21) or the waiting list control group (WLCG, n = 17) with single-blinded randomization. MHL was assessed using the QuALiSMental. The ProLiSMental psychoeducational intervention consists of four or eight weekly sessions of 90 or 45 min for adolescents, using different active pedagogical methods and techniques. There also are initial and final sessions with adolescents, legal guardians, and teachers. There was a significant improvement with a small to relatively strong effect size in many dimensions of anxiety MHL components. This study suggests the progression to the full-scale trial and values the important role of mental health and psychiatric nurses in the adolescents’ empowerment for MHL in schools. Full article

(This article belongs to the Special Issue Community Empowerment: The Potential for Community Health Nursing Development)

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20 pages, 707 KiB

Open AccessArticle

Dimensions of Community Assets for Health. A Systematised Review and Meta-Synthesis

by Pablo Alberto Sáinz-Ruiz, Javier Sanz-Valero, Vicente Gea-Caballero, Pedro Melo, Tam H. Nguyen, Juan Daniel Suárez-Máximo and José Ramón Martínez-Riera

Int. J. Environ. Res. Public Health 2021, 18(11), 5758; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18115758 - 27 May 2021

Cited by 8 | Viewed by 3676

Abstract

Since Aaron Antonovsky’s salutogenesis theory and Morgan and Ziglio’s health assets model were first proposed, there has been a growing concern to define the resources available to the individual and the community to maintain or improve health and well-being. The aim of the present study was to identify the dimensions that characterise community assets for health. To this end, we conducted a systematised review with a meta-synthesis and content analysis of research or projects involving asset mapping in the community. Articles that met our eligibility criteria were: (1) based on the salutogenic approach and (2) described an assets mapping process and among their results, explained what, how and why particular community assets for health had been selected. The search included primary studies in the published and grey literature which were selected from websites and electronic databases (Web of Science, MEDLINE, Scopus, EBSCOhost, Dialnet, SciELO). Of the 607 records examined by a single reviewer, 34 were included in the content analysis and 14 in the qualitative synthesis. Using an inductive process, we identified 14 dimensions with 24 categories, for which in-depth literature reviews were then carried out to define specific indicators and items. These dimensions were: utility, intention, previous use, accessibility (“circumstances–opportunity–affordability”), proximity-walkability, connectivity, intelligibility (visibility, transparency), identity (uniqueness, appropriability, attachment), design (configuration, functionality, comfort), safety (objective/subjective), diversity, the dimension of public and private, and sustainability (which includes maintenance, profitability or economic sustainability, environmental sustainability, centrality-participation and equity-inclusiveness). Full article

(This article belongs to the Special Issue Community Empowerment: The Potential for Community Health Nursing Development)

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12 pages, 374 KiB

Open AccessArticle

Association between Life Skills and Academic Performance in Adolescents in the Autonomous Community of Aragon (Spain)

by Beatriz Sánchez-Hernando, Raúl Juárez-Vela, Isabel Antón-Solanas, Ángel Gasch-Gallén, Pedro Melo, Tam H. Nguyen, José Ramón Martínez-Riera, Elisa Ferrer-Gracia and Vicente Gea-Caballero

Int. J. Environ. Res. Public Health 2021, 18(8), 4288; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18084288 - 18 Apr 2021

Cited by 9 | Viewed by 3281

Abstract

Background: Learning and socio-emotional development is promoted through the creation and nurturing of an optimal school climate. This study aims to analyze the relationship between life skills and academic performance in a large sample of adolescents from the autonomous community of Aragón (Spain). Methods: A cross-sectional study was conducted on the life skills and academic performance of a sample of 7th and 8th grade middle school students during the academic year 2018–2019. A sample of 43 middle schools were randomly selected; the final sample comprised 1745 students. The following data were collected through an anonymized, previously validated questionnaire: sociodemographic variables, social skills, self-efficacy, affective balance, and academic performance. Results: We found a statistically significant association between life skills and academic performance (p < 0.001) in our sample. We also observed significant gender differences in life skills, with boys obtaining higher scores in cognitive skills and affective balance, and with girls achieving higher scores in social skills. Conclusion: We argue that life skills should be integrated into educational policies in order to improve the academic performance and health outcomes of students. Full article

(This article belongs to the Special Issue Community Empowerment: The Potential for Community Health Nursing Development)

17 pages, 751 KiB

Open AccessArticle

Results of Nurse Case Management in Primary Heath Care: Bibliographic Review

by Vicente Doménech-Briz, Rosario Gómez Romero, Isabel de Miguel-Montoya, Raúl Juárez-Vela, José Ramón Martínez-Riera, María Isabel Mármol-López, María Virtudes Verdeguer-Gómez, Álvaro Sánchez-Rodríguez and Vicente Gea-Caballero

Int. J. Environ. Res. Public Health 2020, 17(24), 9541; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17249541 - 20 Dec 2020

Cited by 12 | Viewed by 4547

Abstract

Background: The new characteristics of today’s population, together with the presence of chronic diseases in the elderly, require a new approach to care, promoting coordination between different levels of care. In this sense, we find the figure of the nurse case manager (NCM) in primary health care mainly responsible for ensuring continuity of care in complex patients with chronic diseases. Objective: to describe the role of the NCM in care management, determining its effectiveness in addressing chronic disease (health outcomes and quality of life) and its efficiency in the health system. Methods: Bibliographic review of scientific evidence on case management applied to nursing. Between March and April 2020 a bibliographic search was carried out in the Dialnet, Scielo, Scopus and Pubmed databases. Inclusion criteria: articles written in the last 5 years, which analyze how this nursing rol influences the care and health of patients. Results: A total of 16 articles were selected. The NCM reduced the use of the emergency department, hospital admissions, readmissions, and the duration of these in the patients studied. Conclusion: The NCM is effective and efficient for both patients and health institutions, and a common practice model is needed that includes standardized protocols and evidence-based practices. Full article

(This article belongs to the Special Issue Community Empowerment: The Potential for Community Health Nursing Development)

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15 pages, 387 KiB

Open AccessArticle

Risk Perception of COVID−19 Community Transmission among the Spanish Population

by José Miguel Mansilla Domínguez, Isabel Font Jiménez, Angel Belzunegui Eraso, David Peña Otero, David Díaz Pérez and Ana María Recio Vivas

Int. J. Environ. Res. Public Health 2020, 17(23), 8967; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17238967 - 02 Dec 2020

Cited by 24 | Viewed by 3753

Abstract

On 11 March 2020 the SARS-CoV−2 virus was officially declared a pandemic and measures were set up in various countries to avoid its spread among the population. This paper aims to analyse the perception of risk of COVID−19 infection in the Spanish population. A cross-sectional, descriptive observational study was conducted with a total of 16,372 Spanish participants. An online survey was used to gather data for 5 consecutive days over the compulsory lockdown period which was established after the state of emergency was declared. There is an association between socio-demographic variables and risk perception, and a very strong relationship between this perception and contact and direct experience with the virus in a family, social or professional setting. We also found that compared to working from home, working outside the home increased the perception of risk of infection and the perception of worsening health. Understanding the public perception of the risk of COVID−19 infection is fundamental for establishing effective prevention measures. Full article

(This article belongs to the Special Issue Community Empowerment: The Potential for Community Health Nursing Development)

13 pages, 376 KiB

Open AccessArticle

Qualitative Analysis by Experts of the Essential Elements of the Nursing Practice Environments Proposed by the TOP10 Questionnaire of Assessment of Environments in Primary Health Care

by José Ramón Martínez-Riera, Raúl Juárez-Vela, Miguel Ángel Díaz-Herrera, Raimunda Montejano-Lozoya, Vicente Doménech-Briz, José Vicente Benavent-Cervera, Ana Cristina Cabellos-García, Pedro Melo, Tam H. Nguyen and Vicente Gea-Caballero

Int. J. Environ. Res. Public Health 2020, 17(20), 7520; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17207520 - 15 Oct 2020

Cited by 3 | Viewed by 2607

Abstract

Background: A short TOP10 scale based on the Practice Environment Scale-Nursing Work Index questionnaire measures the characteristics of nursing work environments. Positive environments result in better quality care and health outcomes. Objective: To identify a small number of core elements that would facilitate more effective interventions by nurse managers, and compare them with the essential elements proposed by the TOP10. Method: Qualitative research by a nominal group of eight experts. The content analysis was combined with descriptive data. Results: Ten most important items were selected and analyzed by the expert group. A high level of consensus in four items (2, 15, 20, 31) and an acceptable consensus in five items was reached (6, 11, 14, 18, 26). The tenth item in the top ten was selected from content analysis (19). The expert group agreed 90% with the elements selected as essential to the TOP10. Conclusion: The expert group achieved a high level of consensus that supports 90% of the essential elements of primary care settings proposed by the TOP10 questionnaire. Organizational changes implemented by managers to improve working environments must be prioritized following our results, so care delivery and health outcomes can be further improved. Full article

(This article belongs to the Special Issue Community Empowerment: The Potential for Community Health Nursing Development)

12 pages, 411 KiB

Open AccessArticle

Descriptive Study of Children’s Nutritional Status and Identification of Community-Level Nursing Diagnoses in a School Community in Africa

by Pedro Melo, Maria Isabel Sousa, Matilde Mabui Dimande, Sónia Taboada, Maria Assunção Nogueira, Carlos Pinto, Maria Henriqueta Figueiredo, Tam H. Nguyen and José Ramón Martínez-Riera

Int. J. Environ. Res. Public Health 2020, 17(17), 6108; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17176108 - 21 Aug 2020

Cited by 5 | Viewed by 4231

Abstract

Effectively responding to children’s nutritional status and eating behaviors in Mozambique requires a community-based care approach grounded in sound nursing research that is evidence-based. The Community Assessment, Intervention, and Empowerment Model (MAIEC) is a nursing theoretical model that is based upon clinical decision-making for community health nurses using communities as a unit of care. We used the MAIEC to identify a community-based nursing diagnosis to address children’s nutritional status and eating behaviors in Mozambique. Objectives: (1) to conduct a descriptive study of children’s nutritional status and eating behaviors in a school community in Mavalane, Mozambique, and (2) to identify a community-based nursing diagnosis using the MAIEC clinical decision-making matrix in the same school community. Method: a cross-sectional, quantitative study was conducted to assess the nutritional status of children using anthropometric data, including brachial perimeter and the tricipital skinfold, and standard deviation for the relation of weight–height, in a sample of 227 children. To assess community management of the problem and identify a community-based nursing diagnosis, we surveyed 176 parents/guardians and 49 education professionals, using a questionnaire based on the MAIEC clinical decision matrix as a reference. Results: malnutrition was identified in more than half of the children (51.3%). We also identified a community-based nursing diagnosis of impaired community management related to the promotion of child health and healthy eating evidenced by the lack of community leadership, participation, and processing among more than 70% of the community members (parents/guardians and education professionals). Conclusion: a nursing diagnosis and diagnostic criteria for nutritional status and community management were identified. The need to intervene using a multidisciplinary public health approach is imperative, with the school community as the unit of care. In addition, reliable anthropometric data were identified as important criteria to complement the nursing diagnosis and guide future public health interventions. Full article

(This article belongs to the Special Issue Community Empowerment: The Potential for Community Health Nursing Development)

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20 pages, 2003 KiB

Open AccessArticle

I Want to Become a Registered Nurse as a Non-Traditional, Returning, Evening, and Adult Student in a Community College: A Study of Career-Changing Nursing Students

by Luis Miguel Dos Santos

Int. J. Environ. Res. Public Health 2020, 17(16), 5652; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17165652 - 05 Aug 2020

Cited by 17 | Viewed by 4781

Abstract

The current significant human resource and workforce shortages of registered nurses (RNs) are impacting urban, suburban, and rural hospitals and healthcare facilities all over the globe, regardless of the entities’ economic and financial backgrounds. The purpose of this research study is to understand why non-traditional, returning, evening, and adult (NTREA) students decided to enrol at the Associate Degree in Nursing programme during their mid-adulthood? 40 s-career nursing students who are pursuing their nursing programme were invited to individual interview sessions and focus group activities on sharing and expressing the motivations in the New England region in the United States. Based on the theoretical framework of Social Cognitive Career Theory, the researcher concluded that family consideration and higher social status were two of the major themes. The study provided a blueprint for human resource professionals, health and social caring leaders, government agencies, policymakers, and researchers to reform their current nursing curriculum and health workforce policy to attract potential second-career nursing joining the nursing profession. Full article

(This article belongs to the Special Issue Community Empowerment: The Potential for Community Health Nursing Development)

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16 pages, 508 KiB

Open AccessArticle

Male Nursing Practitioners and Nursing Educators: The Relationship between Childhood Experience, Social Stigma, and Social Bias

by Luis Miguel Dos Santos

Int. J. Environ. Res. Public Health 2020, 17(14), 4959; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17144959 - 09 Jul 2020

Cited by 20 | Viewed by 3774

Abstract

The population of nurses and nursing educators is facing significant human resource shortages. One of the pathways to combat this shortage is to recruit male individuals. However, due to social bias and social stigma, the social context may prevent male individuals from joining. There are two purposes of this study. First, this study aims to explore how the childhood experiences of these male nursing practitioners and nursing educators influence their educational decision. Second, from the perspectives of male nursing practitioners and nursing educators, the study aims to explore how the participants describe the relationships between their childhood experiences and lived stories. Based on Interpretative Phenomenological Analysis, the researcher collected data from 10 experienced male nursing practitioners and nursing educators in the United States. The general inductive approach was employed to categorize the themes. The results indicated that early life experiences, positive working experiences, and sense of belonging in the field of nursing always allowed the participants to overcome the social bias and stigma regarding the occupational bias of the nursing profession. The outcomes of this study provide clear recommendations to educators, policymakers, school leaders, and human resource planners to encourage gender social justice and improve their current curriculum for potential nursing professionals. Full article

(This article belongs to the Special Issue Community Empowerment: The Potential for Community Health Nursing Development)

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