Population Based Nursing

Population-Based Nursing
Iqbal Pramukti, Ph.D., RN

Definition of Population
• All of the people inhabiting a specified area
• The total number of inhabitants constituting a particular race, class,
or group in a specified area
• Subpopulations may be referred to as aggregates
(The American Heritage Dictionary of the English Language, “Population,” 2002, p. 1366)
To provide evidence-based care to targeted groups of people
with similar needs in order to improve outcomes.
Population-based nursing uses a defined population or
Population- aggregate as the organizing unit for care.
Aggregates may be defined by:
based • ethnicity (e.g., African American, Hispanic, Javanese, Sundanese),

• religion
nursing
• geographic location (e.g., Java, Sumatera, etc)
• age or occupation.
• a shared diagnosis (e.g., diabetes)
• a shared risk factor (e.g., smoking)
One person may belong to more than one such group (e.g.,
Sundanese, younger than 18 years, current smoker, etc.).
Nursing & Population Health
Fawcett, J., & Ellenbecker, C. H. (2015). A proposed conceptual model of nursing and population health.
Nursing outlook, 63(3), 288–298. https://doi.org/10.1016/j.outlook.2015.01.009
Public Health Intervention Model
Keller, L. O., Strohschein, S., Lia-Hoagberg, B., & Schaffer, M. (1998). Population-based public health nursing interventions:
a model from practice. Public health nursing (Boston, Mass.), 15(3), 207–215. https://doi.org/10.1111/j.1525-1446.1998.tb00341.x
Strengthening health promotion and health protection
Shahzad, M., Upshur, R., Donnelly, P., Bharmal, A., Wei, X., Feng, P., & Brown, A. D. (2019). A population-based approach to integrated healthcare delivery:
a scoping review of clinical care and public health collaboration. BMC public health, 19(1), 708. https://doi.org/10.1186/s12889-019-7002-z
Measuring
outcome
(Curly, ALC & Vitalae, PA, 2016. Population-Based Nursing Concepts

and Competencies for Advanced Practice. 2nd ed. Springer)
Stage of susceptibility
• time prior to disease development.

• risk factors, genetics, or environment
The Preclinical stage of disease
• the changes are not always detectable.
Natural
• Screening
Clinical stage of disease
history of • Sufficient physiological changes

• Symptom of disease
disease Non-clinical disease stage
• Unappeared symproms
Iceberg phenomenon
• Diabetes, hypertension
Primary
• Immunization
Prevention Secondary
• Screening
program • Pap Smear
Tertiary
• Slower the progression of the disease

Micro & macrofactors in
obesity as health outcome
Target group
Strategi promosi Diversity of target group

kesehatan pada
kelompok khusus: Involvement of target group
lansia Empowerment of target group
(Lis et al, 2008)

Target group
Definisi: Rekomendasi:
kelompok tertentu yang sudah ditentukan Identifikasi target group
sebelumnya untuk dilibatkan dalam program melalui keypersons
promosi kesehatan Media-based approach
Rasional: Kaji data demografi target
Kelompok lansia bersifat heterogen (ex: group
materi, social, kebutuhan) Need assessment
Fokus pada kelompok yang paling Support system seperti
termarginalkan atau beresiko keluarga
(Lis et al, 2008)
Diversity of • Definisi:
Keragaman perspektif
• Rekomendasi:
 Pastikan program
target group lansia, latar belakang dan
pengalaman
sesuai dengan
kebutuhan kesehatan
dan sosial yang
• Rasional: berkaitan dengan
 Promosi kesehatan pada agama dan budaya
lansia harus heterogen  Pertimbangkan
disesuaikan dengan keragaman karakteristik
karakteristik mereka  Identifkasi ada tidaknya
 Sensitifitas lansia inequality
terhadap keberagaman  Kaji pola komunikasi
akan berpengaruh target group
terhadap tingkat
partisipasi
(Lis et al, 2008)

Involvement • Definisi:
Melibatkan target group
• Rekomendasi:
 Berikan lansia
of target dalam program sehingga
mereka bertanggung
kesempatan untuk
berpendapat
group jawab terhadap kesehatan
mereka sendiri
 Spesifik metode: FGD,
observasi
• Rasional:  Kembangkan potensi
Keterlibatan lansia yang ada pada lansia
membuat mereka menjadi
lebih “aware” terhadap
pentingnya program
(Lis et al, 2008)

Empowerment of target group
• Definisi: • Rekomendasi:
Proses sosial, budaya, psikis, dan politik yang  Peningkatan pengetahuan dan IT
membuat lansia dapat memenuhi kebutuhan  Kelompok diskusi
mereka  Peningkatan sense of self-worth
• Rasional:  Sosialisasi kebijakan terkait
Individu/kelompok dapat merasakan keterkaitan  Pengenalan potensi diri
antara tujuan hidup mereka dengan support yang
ada
(Lis et al, 2008)

Evidence-Based Practice
• Definisi: • Rekomendasi:
Mengintegrasikan riset berbasis Pencarian artikel berbasis
fakta ke dalam praktik evidence
• Rasional: Monitor dan evaluasi program
Menentukan jenis promosi Pastikan target group
kesehatan memahami program
Efektifitas program
(Lis et al, 2008)

Holistic • Definisi:
Pendekatan secara
• Rekomendasi:
 Diskusikan
approach utuh meliputi pemahaman
berbagai dimensi holistik kepada
yaitu fisik, spiritual, lansia
mental, sosial, dan  Peer discussion &
seksual life story
 Buat program yang
• Rasional: comprehensive
Keberhasilan
program
dipengaruhi oleh
berbagai elemen
yang saling
berkaitan
(Lis et al, 2008)

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Population-Based Nursing

Iqbal Pramukti, Ph.D., RN

Population-based nursing uses a defined population or

Population- aggregate as the organizing unit for care.

Aggregates may be defined by:

based • ethnicity (e.g., African American, Hispanic, Javanese, Sundanese),

(Curly, ALC & Vitalae, PA, 2016. Population-Based Nursing Concepts

• time prior to disease development.

The Preclinical stage of disease

• the changes are not always detectable.

Clinical stage of disease

history of • Sufficient physiological changes

disease Non-clinical disease stage

• Slower the progression of the disease

Strategi promosi Diversity of target group

lansia Empowerment of target group

(Lis et al, 2008)

(Lis et al, 2008)

(Lis et al, 2008)

(Lis et al, 2008)

(Lis et al, 2008)

(Lis et al, 2008)

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