Primary Intervention and the Homeless - Term Paper Example

Primary Intervention and the Homeless Introduction According to the metaparadigms discussed by Tourville & Ingalls (2003), there are four perspectives which must be considered when designing interventions to use within an aggregate. These are the person, the environment, the health and the nursing paradigms. In the case of the homeless as the aggregate, the person is the individual with whom the nurse is interacting, or possibly a family or small group of homeless people. The environment in this case will be within the community, and is likely to be a health care drop in centre which has been set up specifically to see the homeless. Health relates to ensuring the optimal level of well-being in the individual. In the homeless this relates to ensuring that they are as well protected from the effects which being homeless may have on their health as possible. The nursing paradigm relates to the use of the skills of the community nurse in creating and maintaining a relationship with the individual as well as offering appropriate treatment and care. Taking these four metaparadigms into account, primary prevention would be considered to be an effective community health care strategy to use with the homeless. Primary Prevention Prevention of Risk Behaviors Primary prevention relates to the interventions which the community nurse creates to prevent risk behaviors before they start. In the case of the homeless aggregate this pertains to preventing behaviors which may put the homeless person’s health and well being at risk in order to maintain this at the optimal levels possible given the situation. This could also be considered in terms of maintaining the fourteen areas of nursing care as established by Henderson in the Interactive model of nursing (Tourville and Ingalls, 2003). This framework can be seen in Appendix 1. Primary prevention will be achieved through health promotion and education and health protection in line with this framework, focusing in preventing any behavior which may compromise the elements of the framework. The importance of primary prevention is that it is independent of diagnosis (Wenger, 2006). This means that it is an accessible form of health care, making it particularly suitable for those groups who may resist diagnosis, as may be the case for some subgroups of the homeless. Health Promotion and Education This step of primary prevention focuses on the development of accessible health education programs for the homeless. This focuses on using education to prevent any behaviors which may put the health of the individual at risk, such as heavy alcohol consumption, unprotected sex and other risky behaviors. The strategies are aimed at establishing decision making skills and encouraging the homeless people to accept self responsibility for prevention. Health promotion which promotes the use of support services may also aid with the social aspects of behaviors (Doherty & Stuttaford, 2007). This is pertinent in addressing the issues of the homeless, as it is possible to also address the actual issues which have resulted in homelessness through primary prevention. Health Protection Health protection focuses on actively protecting the health of the homeless individual, such as through the provision of vaccines, needle exchange programs and providing washing and laundry facilities. Health protection for the homeless should also ensure the availability of client-friendly preventative measures including nutrition supplementation for the poor diets which the homeless are likely to maintain. Health protection should also encourage the use of support systems such as shelters and missions which are available to the homeless (Wright & Tompkins, 2006). Comprehensive Health Programs This level of prevention is crucial to developing comprehensive health programs as it ensures that these programs are not overwhelmed when they are introduced. Without primary prevention strategies in place it would be difficult to offer comprehensive health programs to the homeless as the numbers which would require higher levels of prevention and treatment would be too large. This would result in lack of funding for the projects and it would be likely that the services would be withdrawn. The use of primary prevention ensures that the number of individuals requiring higher levels of prevention and treatment are minimized. Cost Effectiveness Primary prevention in the homeless is a cost effective strategy as it is a level of prevention in which the homeless can be addressed as a group rather than individuals which means that the resources required are less than for higher levels of prevention. Primary prevention also limits the numbers of individuals seeking higher levels of treatment, which can drastically reduce the health care costs associated with homeless individuals who fall ill. For example primary prevention may incorporate health protection in the form of vaccines. Although the vaccines and the staff used to deliver the vaccines would cost money, the numbers of homeless seeking hospital treatment for preventable illnesses would decrease. The cost of providing the vaccine to an individual is far less than the expenses involved in a long term hospital stay and subsequent follow-up procedures. Limitations of Primary Prevention When considering primary prevention applied to the aggregate of the homeless there are several limitations of primary prevention which can be demonstrated. The success of primary prevention is dependent upon the audience and will be more effective for those who are receptive. It may be difficult to engage those who are homeless due to the limited nature of the power which they may perceive to have over their health (Wilson, 2005). Primary prevention for the homeless is also difficult as there are many different subgroups to consider within the aggregate. For example homeless children will have different health care needs to homeless adult drug users (Wright & Thompkins, 2006). However primary prevention should by its nature be accessible for all members of the aggregate. Conclusion Primary prevention is a level of prevention which is concerned with the prevention of behaviors which may put the health of an individual at risk before these behaviors begin. This can be considered in terms of maintaining the framework laid out by Henderson in the Interactive Care Model. The importance of primary prevention is that it enables prevention to occur without diagnosis, which promotes access to groups who may not otherwise seek health care. Primary prevention is achieved through health education and health protection, which may include strategies such as needle exchange programs for the homeless and education relating to nutritional needs. Overall, primary prevention is an effective strategy to reach the homeless and is important to ensure a comprehensive health program for them as it limits those requiring further intervention or treatment. For this reason, it would also be considered cost effective, as it limits the number of homeless people requiring hospital and other medical treatment which have no means of paying for their own health care. References Doherty, J. and Stuttaford, M. (2007) Preventing homelessness among substance users in Europe. The Journal of Primary Prevention, 28(3-4), 245-263. Tourville, C. and Ingalls, K. (2003). The living tree of nursing theories. Nursing Forum, 38 (3), 21 – 36. Wenger, C.H. (2006) Helping the homeless stay healthy. Northwest Public Health, Spring/Summer 2006, 16-17. Wilson, M. (2005) Health-promoting behaviors of sheltered homeless women. Family & Community Health, 28(1), 51-63. Wright, N.M.J. and Tompkins, C.N.E. (2006) How can health services effectively meet the health needs of homeless people? British Journal of General Practice, 56(525), 286-293. Appendix 1 Taken from Tourville & Ingalls (2003). Read More