Role of the Community Nurse in Developing Health Literacy for Patients
The promotion of strategies, policies, and initiatives aligns with the vision most local health communities have, that is, transforming the health practices and policies through nursing leadership and knowledge. Health literacy, as seen in Sangeeta’s case, is also congruent with these community health goals, as well as advancing the evidence-based policies which support the family and patient engagement in care decisions and health care in general. These goals include influencing the implementation and development of a system that improves population health and achieves health equity. The complex concept of health literacy puts into consideration the need for addressing and assessing health literacy for every patient, at all times, and in every encounter that involves health care. It also aims at ensuring patient know what they have to do after all health care achieve self-managed health, as can be seen in the subject patient’s case (Kolar, Kaučič, & Kolnik, 2017). Thus, it necessary to look at social health determinants of health, which impact the access to healthcare of patients like Sangeeta, as well as how the principles of primary health care can assist in the improved access to health care and the health results of the subject patient.
Part A: The Social Determinants Influencing Sangeeta’s Access to Health Care
Having migrated to Australia from India with her family, Sangeeta’s position as an immigrant is both a consequence influencing the social determinants of social and health determinants of health on its own. She has also been struggling to cope with adjusting to life due to language barriers and social isolation (Loan, Parnell, Stichle, VanFosson, & Barton, 2017). The challenge is profoundly affected by the currently noted lack of a dialogue between people working in the local health center she has visited and the people that deal with immigration issues, as it hassled to her missing opportunities in receiving the appropriate health care services.
Considering her immigration status as a social factor of health care service that has led to her not being eligible to receive Centre link benefits due to visa restrictions offers the connection between health care and immigration. Looking at why the average health of immigrants such as Sangeeta is not handled in the same way as the native-populations can go a long way in revealing the mechanisms noted in the maintenance or degradation of health (Loan, Parnell, Stichle, VanFosson, & Barton, 2017). Using a framework that depends on the social determinants of health may go a long way towards illuminating linking between health and the broad economic and social factors not only for immigrant populations like the subject patients but for all population members.
When arriving, many immigrants generally have better health compared to the natives. Such a healthy immigrant effect is often linked to factors such as immigration selected criteria like rigorous health screening. The immigration process, by itself indicates that more youthful people tend to move more compared to the ones with more inferior health status (Loan, Parnell, Stichle, VanFosson, & Barton, 2017). However, such a heath immigrant scenario appears to be diminishing with time, and the more immigrants live in their host countries, the worse their health status seems to be, as noted in Sangeeta’s case.
The pattern of the mental well-being of immigrants seems to differ from the overall health. In the first phase, which includes the euphoria of arriving in a new country, the mental health of immigrants can be equal or better than that of natives. The second phase, which includes nostalgia and disillusionment for the past, the mental health of immigrants tends to deteriorates as well as adaptation taking place, and the mental health of immigrants approximating that of the native-born. Resultantly, the mental health of immigrants can be impacted by various factors within as well as outside their control (Loan, Parnell, Stichle, VanFosson, & Barton, 2017). Accordingly, health literacy identifies the most pertinent factors which contribute to the mental health status of international immigrant women that migrate to other countries with different culture regardless of their reason as well as the legal state for pre-immigration experiences. Such factors refer to the social determinants of mental health.
Immigration can, therefore, be consequences of social determinants as well as a social factor in its own right. Having a good understanding of such a relationship may need to dig deeper into behaviorism and individualism in the interventions and scientific studies. Instead of tackling broader upstream structural fear factors affecting health, including working and living conditions, as can be noted in Sangeeta’s case, poverty, and income inequalities, immigration policies, access to health care as well as enforcement practices. Other factors that may be considered include a critical theory of race, structural vulnerability, structural violence, political economy, as well as intersectionality. However, it tries to avoid the strict delineations of variables in operationalization (Diderichsen, 2010). The more local health communities attempt fixing and making permanent the individual factors in the outlined definitions, the more the likelihood of losing the big picture as well as big and the radical reframing the requirements that require to be done.
There indeed exists strong evidence from not only in Australia but around the world that individuals that are less educated and poor usually depict more health issues and die earlier compared to the ones more educated and more productive. Such disparities take place in wealthy countries. In influencing health equity and catering for more care that is patient-centered, the principles of primary healthcare recognize then need to conceptualize and understand the underlying causes that come from poor health. However, physicians may often find themselves helpless as well as being frustrated when faced with intertwined and complex health as well as social challenges from their patients (Diderichsen, 2010). Many may avoid asking for social problems and can prefer instead to concentrate on lifestyle counseling and medical treatment.
Primary principles of health increasingly recognize that in improving population health, health equity will require one to become the main goal in the health sector, and measures of reducing disparities need to be more integrated into the health services and programs. Training nurses, physicians, and other allied health officials towards addressing the social determinant of health can be regarded as one of the main principles that promote health results essentially more equitable for families, patients, and communities. Local health communities are indeed socially accountable when contributing to meeting the needs of the population (Loan, Parnell, Stichle, VanFosson, & Barton, 2017). However, there is a question as to what nurses should be doing in positively impacting patients like Sangeeta.
The measures to take to ensure a positive influence include coping with social determinants like social support, income, education, early childhood development, employment, gender, and housing. A majority of these may come from the more insidious and upstream structural contributing forces. Local health communities continue to operate under a paradigm of a “risk factor,” one that is focused on the behavioral modification for the high-risk sects as a major strategy in the prevention disease, such as decreasing salt as well as fat intake and reducing a sedentary lifestyle (Diderichsen, 2010). However, such an approach has proved to be rather ineffective.
Part B: The principles of health education and the role of the community nurse in supporting Sangeeta
The values nurses choose to withhold go a long way in influencing the made choices in policymaking, ones that can be both explicit and implicit. The concept that comes with health equity stands out as the exact ethical foundation of the works carried out by health commissions. At the same time, human rights cater to the framework noted in social mobilization as well as the political leverage of advancing the agenda of equity (Kolar, Kaučič, & Kolnik, 2017).
Whether involuntary or voluntary, migration comes with challenges to communities and individuals, needing a nearly complete realignment of the regular life, which may have necessary economic, health, and social consequences (Kolar, Kaučič, & Kolnik, 2017). Even though immigration comes out as an effect of social determinants, such as educational and occupational opportunities, and political perception, there is a need for immigration need also to be stationed as a social determinant on its own.
Nurses are yet to have adequate knowledge on broad social determinants lens in understanding the experiences of immigrants and how related policies directly impact health. Despite such a perspective, the immigration experience stands cast as being secondary to the more primal factors like language, behavior, income, norms, or education, therefore limiting the explanatory power as well as the capacity of creating effective interventions which respond to some of the main causes of the ill-health in such communities, as noted in Sangeeta’s case (Kolar, Kaučič, & Kolnik, 2017). The many consequences of immigration in the regular life, and therefore on rather broad well-being and health, may not be reduced simply to a rather protective aspect or an acculturative derailed affecting health.
Nurses need to get more training in understanding the social determinants of health in order to be in a better position of servicing patients like Sangeeta. These concepts have both impacted and been viewed from the models that concentrate on the social determinants of health, and often focus on the upstream fundamental causes, such as how Sangeeta has been struggling to handle adjustments to life in new country due to language barriers and social isolation (Loan, Parnell, Stichle, VanFosson, & Barton, 2017). Many of these causes are useful to nurses, as they can help them examine health issues among immigrants and in guiding the related interventions to take.
Such principles of health education all emphasize on the making as well as the impact of social structures and the relative positions of communities and individuals in the power relationships and stratified hierarchies additionally, and such approaches tend to share a common concern with the structural, economic, or fundamental interconnectedness which affect health status (Homan, Delancey, & Tremellen, 2018).
The ability of nurses to analyze disease causation, and also intervention policies and strategies should change in a way that better addresses problems immigrant patients like Sangeeta face. It needs an understanding of how physical, social, and biological phenomenon overlaps and interrelate (Castañeda, Holmes, Madrigal, Young, Beyeler, & Quesada6, 2015). Resultantly, interactions and pathways have often been understood as complex and multiclausal, needing attention to institutional practices and the relationship between micro-level behaviors and macrostructural processes, such as the economic and social inabilities of Sangeeta.
Community nurses can support Sangeeta and other immigrant patients with similar issues through being trained to look at issues like immigration through social determinants of health lens. It is safe to argue that in the case where substantive changes in health results are achieved, there is indeed a need for immigration to be treated as a determinant of health itself. As an immigrant, Sangeeta is limited to behavioral choices and, indeed, often directly affects as well as significantly alters the impacts of another social positioning, like ethnicity, socioeconomic status, or gender, as it places individuals in ambiguous and often rather hostile relationships of the country and is intuitions.
Conclusively, health literacy stands out as among the factors that have a significant impact on the life quality of elderly immigrants such as Sangeeta. The results of the above evaluative research show that adult immigrants often have limited health literacy. Therefore, they may face danger as far as their health is concerned, as insufficient health literacy in such an already vulnerable population, can show itself in the form of not knowing the next measure to take in case they are in a situation such as Sangeeta’s. The best responses nurses can embrace to prevent such scenarios may include ensuring provided medication and health services are administered properly, chronic diseases like cancer are properly managed, suitable response to emergency situations, poor conditions of elderly patients are properly handled, as well as displaying confidence and self-efficacy. The current situation of health literacy in the Australian health system may be a sigh, but older adults, particularly the immigrants, need more health promotion and health-educational treatment.
References
Castañeda, H., Holmes, S. M., Madrigal, D. S., Young, M.-E. D., Beyeler, N., & Quesada6, J. (2015, March ). Immigration as a Social Determinant of Health. Annual Review of Public Health, 36(3), 75-392.
Diderichsen, F. (2010, October). A Conceptual Framework for Action on the Social Determinants of Health.
Homan, G. F., deLacey, S., & Tremellen, K. (2018). Promoting healthy lifestyle in fertility clinics; an Australian perspective. Human Reproduction Open, 2018(1).
Kolar, T. R., Kaučič, B. M., & Kolnik, T. Š. (2017). The role of the nurse in improving health literacy among older adults. University Medical Centre Ljubljana & College of Nursing in Celje, 16(59).
Loan, L. A., Parnell, T. A., Stichle, J. F., VanFosson, C. A., & Barton, A. J. (2017, November 27). Call for action: Nurses must play a critical role to enhance health literacy. Retrieved May 11, 2020, from https://www.nursingoutlook.org/article/S0029-6554(17)30628-0/fulltext#secst0020