Community health terms

48 terms

Ageism: Stereotypes, prejudice and discrimination directed at people because of their age. WHO reports that ageism is widespread and harms the health, well-being and access to care of older people. In health care, examples include dismissing symptoms as "just old age" or making decisions with the family instead of the older person. Speak to the older adult directly and assess new symptoms instead of attributing them to aging.
Andragogy: An approach to how adults learn; Knowles described adults as self-directed learners who bring life experience, want to know why they should learn something, are ready to learn what helps with their current roles and problems, and prefer knowledge they can apply at once. Pedagogy is the teaching of children. Ask what the client already knows and wants, and build teaching around real problems at home.
Cold chain: The system that keeps vaccines at the recommended temperature, +2 to +8 °C for most, from manufacture to administration. Vaccines exposed to heat or freezing can lose potency. Record refrigerator temperatures at least twice a day, never store vaccines on door shelves, do not use freeze-sensitive vaccines that have frozen, and report temperature excursions per procedure.
Cultural competence: The ability to give effective care to people of different cultures with respect for their values, beliefs and practices. It involves awareness of one's own culture and biases, cultural knowledge, communication skills and tailoring care to the person. Cultural humility frames this as a lifelong process of self-reflection and learning from each client. Ask each client about their own beliefs and preferences rather than assuming.
Directly observed therapy: A treatment approach in which a health worker or trained observer watches the client swallow every dose; used mainly for tuberculosis and other long treatments to improve adherence and prevent drug resistance. In Türkiye it is delivered through tuberculosis dispensaries in cooperation with family physicians. Monitor adherence, side effects and follow-up sputum results.
Disaster triage: Rapid sorting of casualties in a disaster or mass casualty incident by the severity of their injuries, so that treatment and transport are prioritized. In START, the "walking wounded" with minor injuries are tagged green; people with life-threatening problems of airway, breathing, circulation or neurological status red; those whose urgent needs can wait yellow; and those who have died or are expected to die soon black. Keep assessing and monitoring casualties.
Discharge teaching: Teaching that prepares the client and carers to manage safely at home: the diagnosis in plain words, the purpose, timing and main side effects of each medicine, warning signs and when to seek help, diet and activity, wound or device care, follow-up appointments and whom to call. It starts early in the stay, not on the day of discharge; confirm understanding with teach-back and document it.
Elder abuse: A single or repeated act, or a failure to provide needed care, within a relationship where there is an expectation of trust, that harms or distresses an older person: physical, psychological, sexual and financial abuse, and neglect. WHO estimates that around 1 in 6 people aged 60 and over experienced some form of abuse in community settings in the past year. Talk with the person alone, document findings objectively and report as the law requires.
Epidemiology: The study of the distribution and determinants of health states and diseases in populations, and the use of that knowledge to control health problems. Key concepts are person, place and time, the epidemiologic triangle (agent, host, environment) and outbreak investigation. Nurses use epidemiologic data in community assessment and during outbreaks.
Ethnocentrism: The tendency to judge other cultures by the standards of one's own and to see one's own culture as superior. Cultural relativism, by contrast, seeks to understand a practice within its own cultural context. Ethnocentrism can lead to stereotyping, poor communication and poorer care. Notice your own assumptions, and include the client's cultural practices in the care plan as far as they are safe.
Family health center: The primary care unit in Türkiye, staffed by a family physician and family health workers (nurses and midwives). It provides its registered population with preventive care, immunization, follow-up of pregnant women, infants, children and older adults, screening and basic treatment. Family health workers schedule follow-ups, give vaccines, provide health education and make home visits.
Family medicine: The way primary care is delivered in Türkiye under the Family Medicine Law (Law 5258). People are registered with a family physician, who gives preventive care and primary diagnosis, treatment and rehabilitation to everyone, comprehensively and continuously, regardless of age, sex or illness. The physician works with family health workers such as nurses and midwives. Apart from the exceptions the law lists, family medicine services are free, and no co-payment is charged for family physician visits.
Family planning: Counseling and contraceptive services that let individuals and couples have the number of children they want, when they want them. Methods include intrauterine devices, hormonal methods, barrier methods and permanent methods. Give unbiased information on effectiveness, correct use and contraindications, support the client's own decision, and explain that condoms also protect against sexually transmitted infections.
Gender: The socially constructed roles, norms, behaviors and relationships that a society assigns to women and men, as distinct from biological sex. WHO notes that gender norms and inequalities affect exposure to risk, health-seeking, access to care and the burden of caregiving; violence against women is among their most serious results. Consider how these roles shape the client's decisions and access to services.
Health belief model: A model that explains health behavior: people are more likely to act when they believe they are susceptible to a condition (perceived susceptibility) and that it is serious (perceived severity), when the benefits of acting outweigh the barriers, and when there is a cue to action; self-efficacy is also part of the model. Plan teaching around these perceptions, for example by lowering the barriers to a screening test.
Health inequities: WHO's term for avoidable and unfair differences in health between groups, arising not from biology but from social conditions such as poverty, education, discrimination and access to care. The social gradient means that health worsens step by step as social position falls, at every level of society. Nurses can reduce inequities by advocating for clients, easing access to services and addressing the social determinants of health in care.
Health literacy: A person's capacity to find, understand and use health information to make decisions. Low health literacy can lead to poor health outcomes, and anyone can have trouble understanding health information. Use plain, nonmedical language and visual aids, and confirm understanding with the teach-back method.
Health promotion: The process of enabling people to increase control over, and to improve, their health, as defined by the 1986 Ottawa Charter. It spans healthy public policy, supportive environments, community action, personal skills and reorienting health services. Nurses support behaviors such as healthy eating, physical activity and living tobacco-free.
Herd immunity: When a large enough share of a population is immune, through vaccination or prior infection, spread slows and people who are not immune are indirectly protected. The threshold depends on how contagious the disease is; highly contagious diseases such as measles need about 95% vaccination coverage. Infants too young to be vaccinated and immunocompromised people benefit from this protection.
Home visit: A visit in which the nurse assesses and cares for individuals and families in their own homes, for example home health care for chronically ill clients and their caregivers, or ongoing care that helps prevent the worsening or recurrence of disease. Provide teaching and care, involve the family and link them with community resources for follow-up.
Immunization: Producing immunity to a disease by giving a vaccine; one of the most effective forms of primary prevention. In Türkiye, vaccines in the Ministry of Health's Expanded Program on Immunization are given free of charge at family health centers. Before vaccinating, check the schedule, contraindications and any previous reactions; keep the cold chain intact, observe the client for a period afterwards and record the vaccine.
Incidence and prevalence: Two basic measures of disease frequency. Incidence is the rate of new cases in a population at risk over a given period and reflects the risk of getting the disease. Prevalence is the proportion of all cases, new and existing, at a point or over a period. For long-lasting chronic diseases, prevalence is high relative to incidence.
Learning domains: The three domains of learning: cognitive (knowledge and thinking, such as naming the signs of hypoglycemia), affective (attitudes, values and feelings, such as accepting the need for daily foot care) and psychomotor (physical skills, such as giving an insulin injection). They build on the classification of Bloom and colleagues. Each needs its own methods: explanation and discussion for cognitive, sharing experiences for affective, and demonstration with return demonstration for psychomotor learning.
Learning objectives: Client-centered, specific and measurable statements of what the learner will be able to do after teaching. They state who will do what, under what conditions and by when, with an observable action verb: "The client will demonstrate correct insulin self-injection before discharge." Avoid verbs that cannot be observed, such as "know" or "understand". Objectives guide both the teaching plan and its evaluation.
Levels of health care: In Türkiye, health care providers are grouped into three levels under Law 5510 and the 2022 regulation on levels of care: primary (family health centers, community health centers, private practices and pharmacies), secondary (state hospitals that are not training and research hospitals, private hospitals and medical centers) and tertiary (training and research hospitals, university hospitals and private hospitals that meet the regulation’s standards, for diseases needing advanced tests and specialized treatment). The SGK sets the referral chain between the levels.
Levels of prevention: Tiers of prevention aimed at different stages of a disease. Primary prevention lowers risk before disease develops (vaccination, health education); secondary prevention detects and treats disease early (screening); tertiary prevention limits complications and disability from established disease (rehabilitation). Nurses plan interventions at every level.
Notifiable diseases: Diseases that must by law be reported to the health authority when diagnosed, because they threaten public health; for example measles, tuberculosis, rabies-risk exposures and viral hepatitis. In Türkiye the Ministry of Health's communicable disease notification system sets which diseases are reported and how quickly. Prompt reporting allows outbreaks to be detected and contacts to be traced.
Occupational accident: Under Law 6331, an event at the workplace or due to the conduct of work that causes death or leaves the person physically or mentally disabled. The employer records every work accident and reports it to the SGK within 3 working days, and a health provider that treats a work accident reports it within 10 days. Nurses report their own injuries, such as needlestick injuries, at once according to the institution’s procedure. No co-payment is charged for care related to a work accident.
Occupational disease: Under Law 6331, a disease that results from exposure to occupational risks, such as noise-induced hearing loss, which is permanent but preventable, or, in health care workers, hepatitis B, hepatitis C or HIV after a sharps injury. The workplace physician or health provider who suspects one refers the worker to a provider authorized by the SGK, which reports a confirmed diagnosis to the SGK within 10 days. No co-payment is charged for care related to an occupational disease.
Occupational health and safety: Work that protects workers from health and safety risks arising from their work. Under Türkiye's Law 6331, the employer assesses risks, trains workers and keeps them under health surveillance, and assigns a workplace physician, an occupational safety specialist and, in very hazardous workplaces with 10 or more workers, other health personnel, or buys these services from joint health and safety units or from the Ministry of Health's employee health centers (ÇASMER). Nurses working in hospitals are workers under this law too.
Occupational health nursing: The nursing field that protects and promotes workers’ health at the workplace. Under Türkiye’s Law 6331, nurses, midwives and the other listed health workers in this role need the other health personnel (DSP) certificate issued under the authority of the Ministry of Labour and Social Security. They work with the workplace physician: collect data and keep records, write the health and work history on the pre-employment or periodic examination form, follow groups needing special protection, such as pregnant, young or chronically ill workers, and help organize first aid and health education.
Periodic health examination: An examination repeated at regular intervals while the work continues. Under the Turkish regulation on workplace physicians and other health personnel, it is repeated at least every 5 years in less hazardous work, every 3 years in hazardous work and every year in very hazardous work, and at least every 6 months for child, young and pregnant workers; the workplace physician may shorten these intervals. When a worker receives a diagnosis or suspected diagnosis of occupational disease, coworkers in the same environment are examined again.
Pre-employment examination: An examination before starting work to decide whether the worker is fit, in health terms, for the job. Under Law 6331, people who will work in hazardous or very hazardous jobs cannot start without a health report stating they are fit for the work. The report comes from the workplace physician; for less hazardous workplaces with fewer than 50 workers, it may also come from an employee health center (ÇASMER), a family physician or another public provider. A nurse working as other health personnel writes the health and work history on the examination form and assists the physician.
Primary health care: WHO's whole-of-society approach to health, which meets people's needs as early as possible and as close as feasible to where they live, with services running from promotion and prevention through treatment and rehabilitation to palliative care, aiming at the highest possible level of health, fairly shared. Its three components are integrated primary care and public health services, multisectoral policies on the wider determinants of health, and empowered communities. It builds on the Alma-Ata (1978) and Astana (2018) declarations.
Public health nursing: The nursing specialty that protects and promotes the health of communities and at-risk groups, not only individuals, and works to prevent disease. Its main roles are community assessment, health education, communicable disease control such as contact tracing, immunization and preparing for public health emergencies. Public health nurses work in health departments, community centers, shelters and other community settings.
Readiness to learn: A person's physical, emotional and experiential readiness to learn. Pain, fatigue, nausea, high anxiety and denial block learning; motivation and past experience help it. A "teachable moment" is when the client asks a question or faces a change and is most open to learning. Relieve pain and wait for anxiety to ease before teaching anything complex.
School nursing: The area of public health nursing that protects and promotes students' health and removes health barriers to learning. Main duties include health screenings, direct care and medications, health care and emergency action plans for students with chronic conditions, health education and a safe school environment.
Screening: Testing or examining people without symptoms to detect disease early; an example of secondary prevention. A test's sensitivity is its ability to correctly identify people with the disease, and its specificity its ability to correctly identify those without it. A positive screen is not a diagnosis and must be confirmed by a diagnostic test. In Türkiye, breast, cervical and colorectal cancer screening is offered through national programs, including Cancer Early Diagnosis, Screening and Training Centers (KETEM).
Sick role: The sociologist Talcott Parsons' view of illness as a social role: the sick person is excused from usual duties and not blamed for being ill, but is expected to want to get well and to seek and cooperate with competent help. The model fits acute illness better than chronic illness, which people manage for life. Assess how illness changes the client's roles and others' expectations of them.
Social determinants of health: The conditions in which people are born, grow, live, work and age, such as income, education, employment, housing, food security, social support and access to care. WHO identifies them as a major driver of health inequities. Include them in assessment, fit the care plan to the client's circumstances and refer to resources such as social services when needed.
Sustainable Development Goals: The 17 goals the world's nations adopted in 2015 to reach by 2030. The health goal, SDG 3, is to ensure healthy lives and promote well-being for all at all ages, with targets on maternal, newborn and child health, communicable and noncommunicable diseases, health security and universal health coverage. WHO notes that nearly all the other goals are linked to health, directly or indirectly.
Teach-back method: A way to confirm understanding by asking clients to explain or show, in their own words, what they have been taught: for example, "Can you tell me how you will take this medicine at home?" If a point was misunderstood, adjust the teaching and check again.
Tobacco cessation: Counseling and treatment to help tobacco users quit. A brief intervention is recommended at every contact (the 5 As: ask, advise, assess, assist, arrange follow-up), and nicotine replacement and other medications improve success. In Türkiye the ALO 171 quitline (24/7; free from landlines) and free smoking cessation clinics offer support. Support clients through withdrawal symptoms and relapses without judgment.
Universal health coverage: Everyone being able to get the quality health services they need, where and when they need them, without suffering financial hardship. It spans essential services across the life course, from promotion and prevention through treatment and rehabilitation to palliative care. It is one of the targets of the Sustainable Development Goals adopted in 2015 and is monitored by two indicators: the coverage of essential services and the share of people facing financial hardship from health spending.
Vulnerable populations: Groups more exposed to poor health outcomes because of social, economic, health or environmental conditions, such as people living in poverty, homeless people, migrant workers, people with disabilities, older adults, children and people with chronic illness. Identify barriers to care, provide culturally responsive care and advocate for these groups.
Workers' health surveillance: The employer's duty to monitor workers' health in light of the risks they face at work. Under article 15 of Law 6331, health examinations are done on hiring, on a change of job, on request when returning after a work accident, occupational disease or repeated sickness absence, and at regular intervals set by the hazard class while the work continues. The employer bears the cost, which cannot be passed on to the worker, and health information is kept confidential. The workplace physician informs workers about examinations and tests and obtains their consent.
Workplace hazard classes: Under Law 6331, workplaces are classed as less hazardous, hazardous or very hazardous according to their main activity, by a communique of the Ministry of Labour and Social Security. The class decides how often periodic examinations are repeated, whether a pre-employment health report is required, and the assignment of the workplace physician and other health personnel.
World Health Organization: The United Nations agency for health, founded in 1948. It works with its Member States across 6 regions; Türkiye belongs to the European Region. Its decision-making body is the World Health Assembly, attended by all Member States and held every year in Geneva. WHO directs and coordinates international health work and the global response to health emergencies, issues guidelines and classifications such as the ICD, and supports countries toward universal health coverage. It defines health as complete physical, mental and social well-being, not merely the absence of disease or infirmity.