Community Nursing Practice Assignment

Running head: COMMUNITY NURSING PRACTICE
Community nursing practice
Name of the student:
Name of the university:
Author note

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Table of Contents
Introduction:....................................................................................................................................2
Summary of health education and literacy:.....................................................................................2
Risk issues affecting key populations:.............................................................................................4
Health education and promotion by community nurses:.................................................................6
Conclusion:......................................................................................................................................8
References:....................................................................................................................................10

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Introduction:
For diseases such as HIV AIDS the role of a community nurse in managing the risk
factors and providing health education is vital against different target populations especially for
the ones that are culturally diverse with limited English proficiency. In this case the nursing roles
and responsibilities does not end in designing care and providing interventions to the patient but
it also takes into consideration the different social economic determinants of Health and their
impact on the probability of a disease on a target population and how to properly manage them
while addressing each and every care needs of the target population (Abe, Turale, Klunklin &
Supamanee, 2014). This assignment will attempt to explore the roles and responsibilities of a
community nurse with respect to its management and prevention for the target population. It will
include a summary of health education and health literacy and nurse's role associated with it, risk
factors affecting the target population with respect to HIV AIDS, and how community nurse is
can utilize health promotion and health education concepts to reduce the risks for key
populations.
Summary of health education and literacy:
In the pathway for better disease management and prevention health education and health
literacy plays a fundamental role. The researchers are of the opinion that helps literacy is a
concept that has been put forward to be serving as a potential mechanism that explains the well-
documented relationship between education and health. On a more elaborated note, health
literacy is a combination of different skills that are perceived to be important assets for
improving an individual's health. Hands as a result it can be stated that the lack of health literacy
is a significant period or restriction to better health outcomes of an individual or a community.

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As a result people with low health literacy have been found not only to have Poor health
outcomes but also be associated with chronic health diseases due to the lack of better disease
management and different preventative or promotional health behaviors that can either protect a
person vulnerable to a particular disease or can is the processes of disease management avoiding
further exacerbation (Cunha, Galvão, Pinheiro & Vieira, 2017). However it has to be mentioned
that for a vast majority of target population health literacy is very minimal and in order to
provide the populations with the basic health education for particular chronic diseases the nurses
have a fundamental role in providing the education in a manner that each and every social
economic state of the society can understand and retain.
According to the WHO, health literacy can be defined by an emerging concept that
postulates the critical link between health and literacy as a resource for everyday living. The
level of literacy directly affects the ability of an individual to not only act on heath information
but also be able to take control of their health status. As per the directives if the WHO, the
health literacy has three distinct levels functional literacy, conceptual literacy and literacy in the
form of empowerment. According to the van der Heide et al. (2013), the importance of health
literacy or health education is facilitated by many contributing factors such as a key populations
being affected by a chronic disease, poor or reduced health outcomes, rapidly increasing rates of
chronic diseases, health care expense, and health equity. Now it has to be mentioned for the
various different target populations, there are a variety of different social determinants of health
that restrict the development of proper health literacy in a target population leading reduced
health outcomes. For instance, low income, lack of education and low socioeconomic status can
be considered as one of the most common and impactful determinant. These key populations are
often bullied, discriminated against and are rejected from almost all of the social privileges

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which leads to low health outcomes and poor disease management as well. Hence health
promotional education can be a very important tool to enhance the health literacy levels of key
populations, especially the social minorities. According to the standard 3.2 of the Registered
nurse practice standards by NMBA, a nurse is accountable for providing the information and
health education to key populations in order to enhance their control over health. Hence, the
roles and responsibilities of the community nurses includes the educating the target population
while presenting the educational materials in a clear and understandable format. It has to be
mentioned in his account that the education cannot be limited to particular individuals, he
education strategies are employed to the families and communities as well to develop a
framework for healthy living and healthy choices as well (Nachega et al., 2012).
Risk issues affecting key populations:
The chronic health issue that has been chosen for the study is HIV. HIV infection leads to
acquired immunodeficiency syndrome or AIDS facilitated by the progressive failure of the
immune system and the disease paves way for opportunistic secondary infections and even
cancer to thrive in the host system. There are various risk factors to acquiring this disease,
however the most predominant ones include having unprotected sexual activities, sharing
syringes or any other injection equipments, and extreme alcohol or drug addiction which lowers
the individual’s inhibitions and logical thinking. However it has to be mentioned in this context
that the risk factors or issues prevailing in the AIDS scenario is subjective to the key vulnerable
populations. According to WHO, the key populations that are the most vulnerable for AIDS
include men who have sex with men, people who inject drugs, people in prisons and other closed
settings, sex workers and their clients, and transgender people (www.who.int, 2018).

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For the men who have sex with men, it has to be mentioned that researchers are of the
opinion that a vast majority of gay men have been reported to be having similar numbers of
unprotected sexual partners and sexual activities when compared to straight men and women.
According to a report by CDC, 70% of the total new HIV acquiring populations have been
reported to be the Gay and bisexual groups. One of the most important risk factor to the same
can be defined as the unprotected anal intercourse (Le, Lee, Stewart, Long & Quoc, 2016). It has
to be mentioned that HIV is far more easily transmitted by unprotected anal intercourse when
compared to the vaginal intercourse, hence, it has to be mentioned that this is a considerable risk
factor for this key population for acquiring HIV. Another key risk issue for this population is the
concept of condom fatigue, which is associated with AIDS optimism leading to a practice of
laxness in safe intercourse practices. According to the Wawrzyniak, Ownby, McCoy and
Waldrop-Valverde, (2013), lack of health education and awareness regarding the HIV infection
and its aftermath is one contributing factors to this risk issue in this particular population.
Another chosen population is the people who inject drugs, it has to be mentioned in this
context that the injection drug abusers are 28 times more at risk for HIV when compared to the
general population. Considering the global statistics, close to 13 million people all around the
world are injection drug abusers and among them 1.7 million have been reported to be suffering
from HIV. The greatest risk fir the injection drug abusers can be the practice of sharing the
syringes or the injection equipments with the HIV positive individuals. According to the report
shared by the Madden and Wodak, (2014), the HIV virus can sustain in the used needle for close
to 42 days depending on temperature and other contextual factors. As the majority of the
injection abusers belong to low socioeconomic classes, they often do not have any other
alternative other than sharing injecting equipments and hence it leads to higher risk of HIV

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infection. Along with that, it has to be mentioned that the lack of education can also lead to a
reduced protective behavior in the target population leading to far higher risk of the HIV.
For prisoners the risk factors are even more heightened, it has been reported that the
prisoners have been noted to be engaged in intravenous drug abuse and homosexual activities,
which are unprotected almost all the time (Egger, 2018). They neither have the resources or the
awareness to protective intercourse practice or injection drug abuse. Similarly for sexual workers
and the transgenders, the risk of unprotected intercourse is even higher. The lack of safe sex
education and the protective measures contribute to making these populations extremely
vulnerable for acquiring the deadly infection.
Health education and promotion by community nurses:
Based on the information outlined above, it can be safely stated that the most important
reason behind all of the different risk factors for the key populations in acquiring the infection is
associated with lack of awareness, education and preventative behaviors. Hence the strategies
will need to focus on enhancing the awareness of the key populate and changing their health
behaviors with respect to the activities with regards to the risk factors.
 First and foremost, there is need for campaigning to enhance the awareness and
knowledge in the target populations regarding the risks to AIDS and its aftermath.
For the key populations, especially for the MSM, the concept of AIDS optimism
is acutely related to the heightened risk for the target populations. Hence
preventative campaigning needs to be focused on not just enhancing the
awareness of the population but also changing their everyday health behaviors
leading to AIDS risk (Campbell et al., 2013).

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 The community nurse will have to focus on participative activities involving the
target populations and enhancing their basic understanding and education of the
AIDS risk factors. The campaigning must include seminars explaining how the
disease is spreads and what can be done to prevent the spread of it.
 Another very important aspect that can be attempted by the community nurses for
the educative campaigning in segmentalization of the target audience. According
to the Wilson, (2015), the health promotional and education needs of the target
population differ on the basis of the risk factors of the key populations. Hence for
injection drug abusers, the educational campaigns must focus on the impact of
sharing syringe and how to overcome the urge to indulge in the injection drug
practice whereas for the sex workers or the MSM population the majority of the
campaigning should focus on the educating the benefits of safe intercourse and
the use of protective measures such as condoms.
 For the prisoners as a key population, one of the major reasons to their lack of any
preventative health behaviors is the fact that they do not have the opportunity to e
included in the campaigning done for the mainstream society. Hence the
community nurse will have to arrange for the campaigning activities in the prison
setting itself. The community nurses will need to arrange for participative
campaigns and workshops in the prison to educate them on HIV, how it is
acquired and how safe intercourse habits and safe injection drug abuse practices
(Paudel & Baral, 2015).
 Lastly, it has to be mentioned that for the key population like the transgenders and
the sex workers or even the MSM population, the stigmatization and social

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rejection often hinders them from participating in the campaigning activities in
the fear of being bullied. The community nurse’s strategy for health education and
promotion should ensure absolute inclusion for these bullied and discriminated
groups (Golub & Gamarel, 2013).
 Lastly, educative pamphlets for better symptom recognition and disease
management have been reported to enhance the outcomes for AIDS patients.
Hence, hence the community strategy must also involve distribution of educative
pamphlets to the target population with regards to the cultural background and
language restrictions of the key population. The campaigning should also include
carers from the culturally diverse backgrounds to ensure optimal inclusion for all
of the key populations (Nachega et al., 2012).
Conclusion:
It has to be understood that the nurses have a significant place in the healthcare industry.
The nurses are responsible for not only providing the care facilities to the patients but they also
serve as the mediator between the health care programs and the patients, facilitating disease
management, health literacy, health related education, and preventative campaigning for
different patient populations. Community nurses play a fundamental role in facilitating and
streamlining the care delivery and health promotion of target populations against any
communicable or non-communicable outbreak. This assignment has attempted to outline the key
importance of health literacy and education, the risk factors affecting different vulnerable
populations and a robust strategy for the community nurses to improve the health outcomes and
prevent the risk of HIV infections in the target populations.

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References:
Abe, M., Turale, S., Klunklin, A., & Supamanee, T. (2014). Community health nurses' HIV
health promotion and education programmes: a qualitative study. International nursing
review, 61(4), 515-524. doi: 10.1111/inr.12140
Campbell, C., Nhamo, M., Scott, K., Madanhire, C., Nyamukapa, C., Skovdal, M., & Gregson,
S. (2013). The role of community conversations in facilitating local HIV competence:
case study from rural Zimbabwe. BMC Public Health, 13(1), 354. doi: 10.1186/1471-
2458-13-354
Cunha, G. H. D., Galvão, M. T. G., Pinheiro, P. N. D. C., & Vieira, N. F. C. (2017). Health
literacy for people living with HIV/Aids: an integrative review. Revista brasileira de
enfermagem, 70(1), 180-188. DOI: http://dx.doi.org/10.1590/0034-7167-2015-0052
Egger, S. (2018). HIV/AIDS and Australian Prisons [Ebook]. Australian Institute of
Criminology. Retrieved from
https://aic.gov.au/sites/default/files/publications/proceedings/downloads/04-egger.pdf
Golub, S. A., & Gamarel, K. E. (2013). The impact of anticipated HIV stigma on delays in HIV
testing behaviors: findings from a community-based sample of men who have sex with
men and transgender women in New York City. AIDS patient care and STDs, 27(11),
621-627. doi: 10.1089/apc.2013.0245
HIV/AIDS. (2018). HIV/AIDS. Retrieved from
http://www.who.int/en/news-room/fact-sheets/detail/hiv-aids

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Le, T. M. D., Lee, P. C., Stewart, D. E., Long, T. N., & Quoc, C. N. (2016). What are the risk
factors for HIV in men who have sex with men in Ho Chi Minh City, Vietnam?-A cross-
sectional study. BMC public health, 16(1), 406. doi: 10.1080/10810730.2013.825668
Madden, A., & Wodak, A. (2014). Australia's response to HIV among people who inject drugs.
AIDS Education and Prevention, 26(3), 234-244. doi: 10.1521/aeap.2014.26.3.234
Nachega, J. B., Morroni, C., Zuniga, J. M., Schechter, M., Rockstroh, J., Solomon, S., & Sherer,
R. (2012). HIV treatment adherence, patient health literacy, and health care provider–
patient communication: results from the 2010 AIDS Treatment for Life International
Survey. Journal of the International Association of Physicians in AIDS care, 11(2), 128-
133. doi: 10.1177/1545109712437244
Paudel, V., & Baral, K. P. (2015). Women living with HIV/AIDS (WLHA), battling stigma,
discrimination and denial and the role of support groups as a coping strategy: a review of
literature. Reproductive health, 12(1), 53. doi: 10.1186/s12978-015-0032-9
People who inject drugs. (2018). People who inject drugs. Retrieved from
http://www.who.int/hiv/topics/idu/en/
van der Heide, I., Wang, J., Droomers, M., Spreeuwenberg, P., Rademakers, J., &Uiters, E.
(2013). The relationship between health, education, and health literacy: results from the
Dutch Adult Literacy and Life Skills Survey. Journal of health communication, 18(sup1),
172-184. doi: 10.1080/10810730.2013.825668
Wawrzyniak, A. J., Ownby, R. L., McCoy, K., & Waldrop-Valverde, D. (2013). Health Literacy:
Impact on the Health of HIV-Infected Individuals. Current HIV/AIDS Reports, 10(4),
295–304. http://doi.org/10.1007/s11904-013-0178-4