GLOSSARY
intense fear of becoming fat or gaining weight, and re-
Accommodation—being sufficiently mature so that previ-
ously unsolved problems can now be solved.
Acquired immunodeficiency syndrome (AIDS)—a se-
vere, life-threatening condition representing the late
clinical stage of infection with the human immunodefi-
ciency virus (HIV), in which there is progressive dam-
age to the immune and other organ systems.
Active immunity—a long-term resistance to a specific dis-
ease-causing organism, acquired naturally or artificially.
Active listening—the skill of assuming responsibility for
and understanding the feelings and thoughts in a
sender’s message.
Adaptation—the ability to cope with the demands of the
environment.
Addiction—compulsive use of or impaired control over
use of a substance; preoccupation with obtaining and us-
ing a drug, substance, or activity; and continued use de-
spite adverse consequences.
Adult—anyone between 18 and 64 years of age.
Advocate—someone who pleads clients’ causes or acts on
their behalf.
Affective domain—learning that involves changes in
emotion, feeling, or affect.
Ageism—stereotyping of older adults, perpetuating false
information and negative images and characteristics
about them.
Agent—a factor that causes or contributes to a health prob-
lem or condition.
Aggregate—a mass or grouping of distinct individuals
who are considered as a whole and who are loosely as-
sociated with one another.
Alcoholics Anonymous (AA)—a self-help program de-
signed to keep alcoholics sober one day at a time and
based on the “12-step” model that includes a belief in a
higher power.
Al-Anon—a self-help organization designed around the
principles of Alcoholics Anonymous and intended for
family members and close friends of alcoholics.
Alateens—a self-help organization modeled after Al-
Anon, designed around the principles of Alcoholics
Anonymous, and intended for older children and
teenagers affected by an alcoholic in the family.
Alzheimer’s disease (AD)—a progressive dementia af-
fecting older adults in increasing numbers as people age;
judgment and reasoning are lost, eventually affecting the
person physically with increased weakness, wasting, and
immobility.
Analytic epidemiology—seeks to identify associations
between a particular human disease or health problem
and its possible causes.
Anorexia nervosa—an eating disorder of emotional etiol-
ogy that is characterized by body image disturbance, an
fusal to maintain an adequate body weight.
Anticipatory guidance—a process of assisting the client
in preparing for a future role or developmental stage.
Arson—the deliberate burning of buildings.
Assault and battery—the threat to use force against an-
other person, and the accomplishment of that threat.
Assessment—gathering and analyzing information that
will affect the health of the people to be served.
Assets assessment—an assessment that focuses on the
strengths and capacities of the community rather than on
the problems alone.
Assimilation—reacting to new situations by using skills
already possessed.
Assisted living—a special combination of housing, sup-
portive services, personalized assistance, and health care
designed to respond to the individual needs of those who
need help with activities of daily living and instrumental
activities of daily living.
Assurance—those activities that make certain that ser-
vices are actually provided.
Attention-deficit disorder (without hyperactivity)
(ADD)—a cluster of problems related mainly to inatten-
tion, poor motivation, and disorganization.
Attention-deficit/hyperactivity disorder (ADHD)—a
cluster of problems related to hyperactivity, impulsivity,
and inattention.
Audit—an organized effort whereby practicing profession-
als monitor, assess, and make judgments about the qual-
ity and appropriateness of nursing care provided by
peers as measured against professional standards of
practice.
Autocratic leadership style—an authoritarian style in
which leaders use their power to influence their followers.
Autonomous leadership style—a facilitative style of
leadership that encourages group members to select and
carry out their own activities and function indepen-
dently.
Autonomy—freedom of choice and the exercise of peo-
ple’s rights.
Baby boomers—those people born after World War II,
specifically between 1946 and 1964.
Battered child syndrome—the collection of injuries sus-
tained by a child as a result of repeated mistreatment or
beatings.
Benchmarking—studying another’s processes in order to
improve one’s own processes.
Beneficence—doing good or benefiting others.
Bilateral agencies—agencies that usually deal directly
with other individual governments, such as the U. S.
Agency for International Development, the Peace Corps,
and the U. S. Centers for Disease Control and Prevention.
Biostatistics—the science of statistically measuring popu-
lation health conditions.
Bioterrorism—the use of living organisms, such as bacte-
ria, viruses, and other organic materials, to harm or in-
timidate others in order to achieve political ends.
Blended family—a family in which single parents marry
and raise the children from each of their previous rela-
tionships together.
Brainstorming—an idea-generating process that encour-
ages group members to freely offer suggestions.
Bulimia—an eating disorder characterized by recurrent
episodes of binge eating with repeated compensatory
mechanisms to prevent weight gain, such as causing
vomiting or taking laxatives.
Burden of disease—the impact of premature death and
disability on a population’s health status; assessed by
measuring the gap between the population’s health sta-
tus and some reference status.
Camp health aides—bilingual and bicultural individuals,
usually women, who help reinforce positive health val-
ues and create a sense of self-esteem and empowerment
among migrant farmworkers.
Capitation rate—a fixed amount of money paid per person
by the health plan to the provider for covered services.
Case management—a systematic process by which a
nurse assesses clients’ needs, plans for and coordinates
services, refers to other appropriate providers, and moni-
tors and evaluates progress to ensure that clients’ multi-
ple service needs are met in a cost-effective manner.
Casualty—a human being who is injured or killed during
or as a direct result of a traumatic event.
Causal thinking—relating disease or illness to its cause.
Causality—the relationship between a cause and its effect.
Change—any planned or unplanned alteration of the status
quo in an organization, situation, or process.
Channel—the medium through which the sender conveys
the message.
Chemical dependence—a strong, overwhelming preoc-
cupation with and desire to have a drug.
Child abuse—the maltreatment of children, including any
or all of the following: physical, emotional, medical, or
educational neglect; physical punishment or battering; or
emotional or sexual maltreatment and exploitation.
Chronic disease—a set of diseases occurring mainly
among adults and including degenerative diseases, dis-
eases of the circulatory system, cancer, and diabetes.
Client myth—the belief that the primary clients in com-
munity health nursing are individuals and families.
Clinician—a nursing role in the community that ensures
that health services are provided to individuals, families,
groups, and populations.
Coalition—an alliance of individuals or groups working
together to influence outcomes of a specific problem.
Codependence—dysfunctional behaviors that are evident
among family members.
Cohabiting couples—the forming of a family alliance
outside marriage or through a private ceremony not
legally recognized as marriage.
Cohort—a group of people who share a common experi-
ence in a specific time period.
Cognitive domain—the area of leaning that involves the
mind and thinking processes.
Collaboration—working together in cooperation with
other team members, coordinating services and address-
ing the needs of population groups.
Collaborator—a role in which the nurse works jointly
with others in a common endeavor.
Common-interest community—a collection of people
who, although they are widely scattered geographically,
have an interest or goal that binds them together.
Commune family—a group of unrelated, monogamous
couples living together and collectively rearing their
children; considered a nontraditional family.
Communicable disease—a disease that can be transmit-
ted from one person to another.
Communication—transferring meaning and enhancing
understanding.
Community—a collection of people who interact with one
another and whose common interests or characteristics
form the basis for a sense of unity or belonging.
Community as client—the concept of a community-wide
group of people as the focus of nursing service.
Community-based—a term used to describe the setting
for nursing care delivery.
Community collaboration—the ability of the community
to work together as a team of citizens, professional and lay
people alike, to meet an identified need in the community.
Community development—the process of collaborating
with community members to assess their collective
needs and desires for a positive change and to address
those needs through problem-solving, use of community
experts, and resource development.
Community diagnoses—nursing diagnoses about the
community’s ineffective coping ability and potential for
enhanced coping.
Community health—the identification of needs and the
protection and improvement of collective health within a
geographically defined area.
Community health advocacy—efforts aimed at creating
awareness of and generating support for meeting the
community’s health needs.
Community health nursing—a field of nursing combin-
ing nursing science with public health science to formu-
late a practice that is community based and population
focused.
Community mental health—a field of practice that seeks
 to address the needs of the mentally ill, prevent mental
illness, and promote the mental health of the community.
Community mental health centers (CMHC)—sites that
provide comprehensive, publicly funded services to the
mentally ill population.
Community needs assessment—the process of deter-
mining the real or perceived needs of a defined commu-
nity of people.
Community of solution—a group of people who come
together to solve a problem that affects all of them.
Community-oriented, population-focused care—care
that is shaped by the characteristics and needs of a given
community and employs population-based skills.
Community subsystem assessment—an assessment
that focuses on a single dimension of community life,
such as churches or schools.
Community support programs—a publicly funded set
of services designed to assist persons with serious and
persistent mental illness (SPMI).
Commuter family—a family in which both partners work
but have jobs in different cities; one parent raises the
children in the “home” city while the second partner
lives in the other city and commutes home for weekends
or less frequently, depending on the distance.
Competition—a contest between rival health care organi-
zations for resources and clients.
Comprehensive assessment—an assessment that seeks
to discover all relevant community health information.
Conceptual model—a framework made up of ideas for
explaining and studying a phenomenon of interest, con-
veying a particular perception of the world.
Conceptual skills—the mental ability to analyze and in-
terpret abstract ideas for the purpose of understanding
and diagnosing situations and formulating solutions.
Concurrent review—an assessment of care while in the
process of being given; often combined with a retrospec-
tive review.
Confidant—a close friend; someone in whom an older
adult can confide, reflect on the past, and trust.
Contaminant—organic or inorganic matter that enters a
medium, such as water or food, and renders it impure.
Contemporary families—emerging family patterns that
did not exist a few years earlier, such as “loose shirt”
families, in which parents work from home via the com-
puter and Internet.
Continuing care center—a type of housing facility for
older adults that provides a homelike setting for people
at all levels of functioning, from total independence to
dependence on skilled nursing care, offering older adults
a home for life; often referred to as a total life center.
Continuous needs—the birth-to-death developmental
health care needs of populations in all age groups.
Contracting—negotiating a working agreement in which
two or more parties come to a shared understanding and
mutually consent to the purposes and terms of the trans-
action.
Control group—randomly assigned subjects in a research
study who are not receiving the intervention.
Control of communicable disease—the point at which
a specific disease has ceased to be a public health threat.
Controller—a management function of the community
health nurse in which the nurse monitors the plan and
ensures that it stays on course.
Coping—those actions and ways of thinking that assist
people in dealing with and surviving difficult situations.
Core public health functions—three basic areas of pub-
lic health services (assessment, policy development, and
assurance) that encompass a wide variety of activities.
Corporal punishment—violence against a child as a form
of discipline.
Correctional facility—one whose primary objective is to
provide safety to the public by incarcerating those who
have committed crimes and who are deemed a threat to
the community.
Cost sharing—a cost-containment strategy in which con-
sumers pay a portion of health care costs.
Crew leader—a person who acts as a mediator between a
group of migrant laborers, called crews, and a farmer;
often the farmer pays the crew leader, who then pays the
laborers.
Crisis theory—a body of knowledge that helps to explain
why people respond in certain ways; it is useful to pre-
dict the phases that people will go through in a crisis of
any kind.
Critical incident stress debriefing (CISD)—a mecha-
nism for providing victims emotional reconciliation after
a disaster, ideally between 24 and 72 hours after the
event.
Critical pathway—written plans and outcomes for patient
care with a timetable; a term used synonymously with
clinical pathway.
Cross-sectional study—exploring the relationship of a
health condition to other variables in a specific popula-
tion at a particular point in time.
Culture—the beliefs, values, and behaviors that are shared
by members of a society and that provide a design or
“map” for living.
Cultural assessment—obtaining health-related informa-
tion about a designated cultural group concerning their
values, beliefs, and practices.
Cultural brokering—facilitating health care for migrant
workers who are unable to overcome the barriers of ex-
isting health care.
Cultural diversity—a variety of cultural patterns that co-
exist within a designated geographic area.
Cultural relativism—recognizing and respecting alterna-
 tive viewpoints and understanding values, beliefs, and
practices within their cultural context.
Cultural self-awareness—recognition of one’s own val-
ues, beliefs, and practices that make up one’s culture.
Cultural sensitivity—recognizing that culturally based
values, beliefs, and practices influence people’s health
and lifestyles.
Culture shock—a state of anxiety that results from cross-
cultural misunderstanding and an inability to interact ap-
propriately in the new context.
Curanderas—Mexican folk healers.
Custodial care—personal care that is considered non-
skilled, such as bathing, dressing, feeding, and assisting
with mobility and recreation.
Cycle of violence—the repetitive cyclic pattern of abuse
seen in domestic violence situations.
Dating violence—physical, sexual, emotional, or verbal
abuse between persons who are or have been in a casual
or serious dating relationship.
Decoding—translating a message into understandable
form.
Deforestation—the clearing of tropical and temperate
forests for cropland, cattle grazing, or urbanization.
Deinstitutionalization—the process of transferring the
mentally ill from public institutions to community-based
care settings.
Delphi technique—a method of arriving at group consen-
sus through a systematic pooling of separate individuals’
judgments by written questionnaire and suggestions.
Demographic entrapment—the effect on a population of
exceeding the ability of its ecosystem to support it or to
acquire the support needed, or exceeding its ability to
migrate to other ecosystems in a manner that preserves
its standard of living.
Department of Health and Human Services (DHHS)—
the federal level of five primary agencies concerned with
health and organized under the umbrella of the DHHS:
the Public Health Service, the Office of Human Devel-
opment Services, the Health Care Financing Administra-
tion, the Family Support Administration, and the Social
Security Administration.
Descriptive epidemiologic study—a study that exam-
ines the amount and distribution of a disease or health
condition in a population by person, place, and time.
Descriptive epidemiology—investigations that seek to
observe and describe patterns of health-related condi-
tions that naturally occur in a population.
Descriptive statistics—those that describe in quantitative
or mathematical terms the data collected.
Desertification—the conversion of fertile land into desert
that is unable to support crop growth or wildlife.
Detoxification—the process of ridding the body of harm-
ful substances.
Developmental crisis—periods of disruption that occur at
transition points during normal growth and development.
Developmental disability—any of a broad scope of limi-
tations, including intellectual limitations and the inabil-
ity to perform certain activities of daily living, that is
identified before age 22 years.
Developmental framework—studies families from a life-
cycle perspective by examining members’ changing
roles and tasks in each progressive life-cycle stage.
Diagnostic-related groups—a billing classification sys-
tem based on 23 major diagnostic categories and 467 di-
agnosis-related groups that provides fixed Medicare re-
imbursement to hospitals.
Direct transmission—immediate transfer of infectious
agents from a reservoir to a new host.
Direct victim—a person who experiences an event such as
a fire, volcanic eruption, war, or bomb.
Disabling injury—an injury that results in restriction of
normal activities of daily living beyond the day on
which the injury occurred.
Disability-Adjusted Life Year (DALY)—the combination
of years of life lost due to premature mortality and years
of life lived with disability, adjusted for the severity of
disability; developed to compare across conditions and
risk factors.
Disaster—any event that causes a level of destruction that
exceeds the abilities of the affected community to re-
spond without assistance.
Disenfranchised—someone who does not have full privi-
leges and rights as a citizen.
Displaced persons—those who are forced to leave their
homes to escape the effects of a disaster.
Distributive health policy—promotes nongovernmental
activities thought to be beneficial to society as a whole.
Distributive justice—a belief that benefits should be
given first to the disadvantaged or those who need them
the most.
District nursing—the formal organization of visiting
nursing, known as district nursing in England; the period
in the history of community health/public health nursing
from the mid-1800s to 1900.
Domestic violence—morbidity and mortality attributed
to violence within the home setting.
Dominant values—the beliefs and sanctions of the domi-
nant or majority culture.
Drug-dependent—a person who physically and psycho-
logically requires use of drugs to function and, if preg-
nant, gives birth to an infant exhibiting withdrawal
symptoms.
Drug-exposed—a person who uses drugs intermittently
and, if pregnant, gives birth to a drug-exposed infant.
Durable medical equipment (DME)—the equipment
used for a long period of time in a person’s home that
 can be used again by others, such as wheelchairs, walk-
ers, hospital beds, ventilators, and IV poles.
Ecologic perspective—a viewpoint about the community
of living organisms and their interrelated physical and
chemical environments.
Eco-map—a diagram of the connections between a family
and the other systems in its ecologic environment; origi-
nally devised to depict the complexity of the client’s
story.
Ecosystem—a community of living organisms and their
interrelated physical and chemical environments.
Educator—the role of health teacher; a major function of
the community health nurse.
Egalitarian justice—a system that promotes decisions
based on equal distribution of benefits to everyone, re-
gardless of need.
Elder abuse—the mistreatment or exploitation of older
adults.
Electronic meetings—a method of meeting that applies
nominal group technique combined with computer tech-
nology.
Elimination—reduction of prevalence to a level of less
than 1 case per million population in a given area.
Elite-old—those older than 100 years of age, or centenar-
ians.
Emotional abuse—psychological mistreatment and/or ne-
glect, such as when caregivers or family members do not
provide the normal experiences producing feelings of
being loved, wanted, secure, and worthy.
Empathy—the ability to communicate understanding and
vicariously experience the feelings and thoughts of others.
Empiric-rational change strategies—strategies used to
effect change based on the assumption that people are
rational and when presented with empiric information
will adopt new practices that appear to be in their best
interest.
Employee assistance programs—programs coopera-
tively sponsored by employers and bargaining agencies
with the intent to promote the mental health of the em-
ployee by providing an outlet for employee concerns.
Empowerment—a process of developing knowledge and
skills that increase one’s mastery over the decisions that
affect one’s life.
Encoding—the sender’s conversion of a message into
symbolic form.
Enculturation—learning one’s own culture through so-
cialization with the family or significant group.
Endemic—the continuing presence of a disease or infec-
tious agent in a given geographic area.
Energy exchange—materials or information that families
exchange with their environment.
Environment—all the external factors surrounding the
host that might influence vulnerability or resistance.
Environmental health—assessing, controlling, and im-
proving the impact people make on their environment
and the impact of the environment on them.
Environmental impact—the effect of positive or negative
changes on the environment and on the people, animals,
and plants living in it.
Environmental justice—a movement that has sought to
ensure that no particular part of the population is dispro-
portionately burdened by the negative effects of pollution.
Epidemic—a disease occurrence that clearly exceeds the
normal or expected frequency in a community or region.
Epidemiology—the study of health, disease, and injury
determinants and distribution in populations.
Episodic needs—one-time, specific negative health
events, such as illness or injury, that are not an expected
part of life.
Equity—being treated equally or fairly.
Eradication—the interruption of person-to-person trans-
mission and a limitation of the reservoir of infection
such that no further preventive efforts are required.
Ergonomics—a field of study in occupational health con-
cerned with the design of workplaces, tools, and tasks to
match the physiologic, anatomic, and psychological
characteristics and capabilities of the worker; sometimes
called human engineering.
Ethical decision-making—making a choice that is con-
sistent with a moral code or that can be justified from an
ethical perspective.
Ethical dilemma—a decision involving a potential con-
flict between moral values.
Ethics—a set of moral principles or values; a theory or
system of moral values.
Ethnic group—a collection of people with common ori-
gins and with a shared culture and identity.
Ethnicity—that group of qualities that mark a person’s as-
sociation with a particular ethnic group.
Ethnocentrism—the belief and feeling that one’s own
culture is best.
Evaluation—the process by which a practice is analyzed,
judged, and improved according to established goals and
standards.
Evaluator—a management function in which the nurse
compares and judges performance and outcomes against
previously set goals and standards.
Evolutionary change—change that is gradual and re-
quires adjustment on an incremental basis.
Experimental design—a research method in which the
investigators institute an intervention and then measure
its consequences.
Experimental epidemiology—follows and builds on in-
formation gathered from descriptive and analytic ap-
proaches; used to study epidemics, the etiology of hu-
man disease, the value of preventive and therapeutic
 measures, and the evaluation of health services.
Experimental group—randomly assigned subjects who
are receiving the intervention in a research study.
Experimental study—a study in which the investigator
controls or changes factors suspected of causing a condi-
tion and observes the results.
Extinction—the loss of a species from the earth forever.
Familialism—taking responsibility for one’s own family
and protecting them from harm.
Familiarization assessment—studying data already
available on a community, and gathering a certain
amount of firsthand data, in order to gain a working
knowledge of the community; sometimes called a
“windshield” survey.
Family—two or more individuals who share a residence or
live near one another; possess some common emotional
bond; engage in interrelated social positions, roles, and
tasks; and share a sense of affection and belonging.
Family crisis—a stressful and disruptive event, or series
of events, that comes with or without warning and dis-
turbs the equilibrium of the family.
Family culture—the acquired knowledge that family
members use to interpret their experiences and to gener-
ate behaviors that influence family structure and func-
tion.
Family functioning—those behaviors or activities by
family members that maintain the family and meet fam-
ily needs, individual member needs, and society’s views
of family.
Family health—how well the family functions together as
a unit.
Family map—a diagram that illustrates the pattern of in-
teractions and interdependence among family members.
Family nursing—a kind of nursing practice in which the
family is the unit of service.
Family structure—comprises the characteristics of indi-
viduals who make up a family unit: age, gender, and
number.
Family system boundary—the greater concentration of
energy that exists within the family than between the
family and its external environment.
Family violence—action by a family member with the in-
tent to cause harm to or control another family member.
Feedback loop—Indication by the receiver that the mes-
sage has been understood (decoded) in the way that the
sender intended (encoded).
Felony—a serious crime such as murder, rape, or burglary,
for which the criminal is typically housed in a maxi-
mum-security prison.
Feminization of poverty—the growing numbers of
women who have fallen into poverty, caused by weaken-
ing of the nuclear family as more women head house-
holds alone, by low-wage jobs for unskilled work, and
by the dismantling of social programs for women.
Fetal alcohol effects (FAE)—a combination of birth
anomalies characterized by some, but not all, of the
symptoms of fetal alcohol syndrome.
Fetal alcohol syndrome (FAS)—a combination of birth
anomalies characterized by structural abnormalities of
the head and face including microcephaly and flattening
of the maxillary area, intrauterine growth retardation,
decreased birth weight and length, developmental de-
lays, intellectual impairment, hyperactivity, altered sleep
pattern, feeding problems, perceptual problems, mood
problems, and language dysfunction; caused by maternal
alcohol consumption during pregnancy.
Fidelity—keeping one’s promises.
Force field analysis—a technique for examining all the
positive and negative forces influencing a change situation.
Forensics—the science of medical or health care jurispru-
dence in which legal argument is used to advocate for
offenders.
Formal caregivers—professionals and paraprofessionals
who are compensated for in-home care they provide.
Formal contracting—a process in which all parties nego-
tiate a written contract by mutual agreement, sign the
agreement, and sometimes have it witnessed or nota-
rized.
Foster families—families who have had formal training
and are licensed to accept nonrelated children into their
homes to raise temporarily while the families of origin
resolve their problems.
Frail elderly—those older than 85 years of age who need
assistance in attending to activities of daily living.
Frontier area—sparsely populated place with six or fewer
persons per square mile.
Gang—a loose-knit organization of individuals between
the ages of 14 and 24 years that has a name, is usually
territorial or claims a certain territory as under its exclu-
sive influence, and is involved in criminal acts.
Generalizability—the ability to apply research results to
other similar populations.
Genetic engineering—gene manipulation in a laboratory
setting.
Genocide—the killing of a group of people because of
their race, politics, or culture.
Genogram—a display of family information in a graphic
form that provides a quick view of complex family pat-
terns.
Geographic community—a community defined by its
geographic boundaries.
Geriatrics—the medical specialty that deals with the phys-
iology of aging and with the diagnosis and treatment of
diseases affecting the aged.
Gerontology—a broad, interdisciplinary practice that in-
cludes all aspects of the aging process (economic, social,
 clinical, and psychological) and their effects on the older
adult and society.
Gestalt-field—a family of cognitive theories that assumes
that people are neither good nor bad; they simply inter-
act with their environment, and their learning is related
to perception.
Gestational diabetes—glucose intolerance of variable
degree with onset or first recognition during pregnancy.
Global burden of disease (GBD)—disparities, verified
with quantifiable data, in the burden of disease world-
wide among the developing countries, especially among
children.
Global economy—international trade, investment, travel,
and ownership of information and ideas.
Global health patterns - the route, form, and virulence
with which diseases appear in countries around the
world, based on environmental, ecologic, human, tech-
nologic, and political factors.
Global nursing—paid employment or volunteer nursing
in foreign/developing countries in a variety of nursing
positions based on interest, experience, skills, and cre-
dentials.
Global warming—the trapping of heat radiation from the
earth’s surface that increases the overall temperature of
the world, causing a “greenhouse” effect.
Goals—broad statements of desired end results.
Gross national product—the total value of all goods and
services produced in the national economy in 1 year.
Group homes—homes designed to meet the needs of spe-
cific populations, such as the mentally ill, the develop-
mentally disabled, the elderly, or people with
Alzheimer’s disease.
Group-marriage family—several adults who share a com-
mon household, consider that all are married to one an-
other, and share everything, including sex and child
rearing.
Group-network family—nuclear families not related by
birth or marriage but bound by a common set of values,
such as a religious system, who share goods, services,
and child-rearing responsibilities.
Halfway house—a residential program for individuals
with serious and persistent mental illness (SPMI) that, in
addition to housing, offers supervision, treatment,
safety, socialization, recreation, and support.
Head Start—federally funded preschool programs for 3-
to 5-year-old children from low-income families in dis-
advantaged communities.
Health—a holistic state of well-being that includes sound-
ness of mind, body, and spirit.
Health care economics—a branch of the science that de-
scribes and analyzes the production, distribution, and
consumption of health care goods and services.
Health continuum—a range of degrees from optimal
health at one end of a spectrum to total disability or
death at the other end.
Health for all—a major social goal of governments and the
World Health Organization (WHO), initially declared at
Alma-Ata in 1978; the attainment by all people by the
year 2000 of a level of health that would allow them to
lead a socially and economically productive life.
Health maintenance organizations (HMOs)—systems
in which participants pay a fixed monthly premium to
receive comprehensive health services delivered by a de-
fined network of providers to plan participants.
Health policy—any policy that constitutes the governing
framework for providing health services on a local,
state, national, or international level.
Health promotion—efforts that seek to move people
closer to optimal well-being or higher levels of wellness.
Hearty elderly—people older than 65 years of age who
maintain a level of wellness and activity well above cur-
rent expectations for that age.
Hebrew hygienic code—possibly the first written code in
the world, which serves as a prototype for personal and
community sanitation.
Herd immunity—the immunity level present in a particu-
lar population of people.
High-risk families—families exhibiting the symptoms of
potentially abusive or neglectful behavior or who are un-
der the types of stress associated with abuse or neglect.
High-risk infant—an infant whose mother has not re-
ceived adequate nutrition or care during pregnancy due
to a lack of proper prenatal care, economic disadvan-
tage, or disease exposure.
Home care nurse—a community health nurse who pro-
vides skilled nursing services focusing on physical nurs-
ing care needed by family members who are ill, injured,
or in the acute or terminal phase of a disease process.
Home health care—all of the services and products pro-
vided to clients in their homes to maintain, restore, or
promote their physical, mental, and emotional health.
Home health nursing—the provision of nursing to acute,
chronic, and terminally ill clients of all ages in their
homes, while integrating community health nursing
principles that focus on the environmental, psychosocial,
economic, cultural, and personal health factors affecting
the client’s and family’s health status and well-being.
Home visit—visiting a family where they live in order to as-
sist them to achieve as high a level of wellness as possible.
Homebase—a migrant farmworker’s permanent address.
Homebound—as defined by Medicare, a person who can
leave the home only with difficulty in mobility and only
for medical appointments or adult day care related to the
client’s medical care; as a general definition, a person
who can leave the home only with great difficulty, for
short periods of time, and with assistance.
Homemaker agency—provides homemaker aides, who
perform services such as cooking, cleaning, and shop-
ping, or home health aides, who perform personal client
care such as bathing and dressing, or both.
Homeless family—a family who finds itself without per-
manent shelter due to a lack of marketable skills, negative
economic changes, or chronic mental health problems.
Homicide—any action taken to cause non–war-related
death to another person.
Hospice—a philosophy of care that recognizes that death
is inevitable and near and that a cure is not within cur-
rent human reach.
Hospice care—a philosophy of holistic caregiving to fam-
ilies with a dying family member; the purpose is to
make the dying process as dignified, free from discom-
fort, and emotionally, spiritually, and socially supportive
as possible.
Hospital-based agencies—outreach services, including
home health care, provided by an acute-care facility with
missions similar to those of the sponsoring hospital.
Host—a susceptible human or animal who harbors and
nourishes a disease-causing agent.
Human immunodeficiency virus (HIV)—a retrovirus
that attacks the body’s immune system; transmitted
through sexual contact, through sharing of HIV-contam-
inated needles or syringes, through transfusion of blood
or blood byproducts, and from infected mother to child
during the perinatal period.
Human skills—the ability to understand, communicate,
motivate, delegate, and work well with people.
Illness—a state of being relatively unhealthy.
Immunity—the host’s ability to resist a particular infec-
tious disease-causing agent.
Immunization—the process of introducing some form of a
disease-causing organism into a person’s system in or-
der to cause the development of antibodies that will re-
sist that disease.
Implementation—putting a plan into action and carrying
out the activities delineated in the plan.
Incest—sexual abuse among family members who are re-
lated by blood.
Incidence—all of the new cases of a disease or health con-
dition that appear during a given time.
Incubation period—the time interval between exposure
and onset of symptoms.
Indigent—people who are impoverished and deprived of
basic comforts.
Indirect transmission—occurs when the infectious agent
is transported within contaminated inanimate materials
such as air, water, or food.
Indirect victims—the relatives and friends of direct victims.
Individualism—a belief that the interests of the individual
are or ought to be paramount.
Infant—child from birth to 1 year old.
Infectious—capable of producing infection.
Inferential statistics—making inferences about features
of a population based on observations of a sample.
Informal caregivers—family members and friends who
provide care in the home and are unpaid.
Inmates—people detained in correctional facilities.
Insanity—a legal term reserved for mental impairment that
may relieve a person from the legal consequences of his
or her actions.
Instrument—the specific tool, often a questionnaire or in-
terview guide, used to measure the variables in a study.
Instrumental values—codes of conduct, such as confi-
dentiality, keeping promises, or being honest.
Integrated management of childhood Illness (IMCI)—
an intervention that promotes wider immunization cov-
erage, rapid referral of serious cases, prompt recognition
of secondary conditions, and improved nutrition.
Intensity—the physical or emotional level of something;
in a disaster, the level of destruction and devastation.
Interaction—reciprocal exchange and influence between
people.
Interactional framework—describes the family as a unit
of interacting personalities and emphasizes communica-
tion, roles, conflict, coping patterns, and decision-mak-
ing processes.
Intermediate care—a level of caregiving at which the
amount and type of skilled care given is decreased.
Intrafamilial sexual abuse—sexual activity between
family members not related by blood.
Intrarole functioning—playing several roles at the same
time, such as when one woman is a wife, mother, grand-
mother, aunt, teacher, volunteer, author, neighbor, and
friend.
Isolation—separation of infected persons or animals for
the period of communicability in order to limit transmis-
sion of the infectious agent to susceptible others.
Jail—a facility where people accused of committing a
crime await arraignment, the summons to appear in
court to answer charges; also called a detention center or
holding cell.
Justice—treating people fairly.
Key informants—persons who know much about their
community and are willing to share their information
with the community health nurse.
Kin-network—several nuclear families who live in the
same household, or near one another, and share goods
and services.
Lay workers—migrant camp members who are trained
and supervised by community health nurses and who
form formal and informal links with the community to
promote health and provide continuity of care.
Leader—a function of the community health nursing role
in which the nurse directs, influences, or persuades oth-
ers to effect change that will positively affect people’s
health and move them toward a goal.
Leadership—an interpersonal process in which one per-
son influences the activities of another person or group
of persons toward accomplishment of a goal.
Learning—the process of assimilating new information
that promotes a permanent change in behavior.
Learning disability—a genetic, environmental, or cultural
influence that affects a child’s ability to learn; it is esti-
mated that 2% to 10% of school-age children have some
type of learning disability.
Life expectancy—the average number of years that an in-
dividual member of a specific cohort (usually a single
birth year) is projected to live.
Literacy—the ability to read and write to an extent that al-
lows the individual to function in daily life.
Lobbying—the process by which an individual or group
acts on behalf of others to influence specific decisions of
policy makers, such as legislators.
Location myth—a belief that community health nursing
can be described in terms of where it is practiced (ie,
in a specific setting or location such as outside of the
hospital).
Location variables—a profile of the community that in-
cludes community boundaries, location of health ser-
vices, geographic features, climate, flora and fauna, and
the human-made environment.
Long-term care—an assortment of settings that are resi-
dences for people who are unable to physically care for
themselves independently due to physical or cognitive
alterations.
Looting—stealing goods.
Low birth weight—weight less than 2500 g at birth.
Lynching—executing without due process of law.
Machismo—male qualities of dominance that include
pride, honor, and dignity.
Macroeconomic theory—concerned with the broad vari-
ables that affect the status of the total economy.
Mandated reporters—people who have responsibility for
the welfare of children, such as nurses, doctors, teachers,
counselors, and certain other professionals.
Managed care—a broad system, under which case man-
agement exists, that is designed to be a cost-containing
system of health care administration.
Managed competition—combining market competition
to achieve cost savings with government regulation to
achieve expanded coverage.
Manager—a nursing role in which the nurse exercises ad-
ministrative direction toward the accomplishment of
specified goals by assessing clients’ needs, planning and
organizing to meet those needs, directing and leading to
achieve results, and controlling and evaluating the
progress to ensure that goals are met.
Marginalized—people who live on the margins, or edges,
of society, rather than in the mainstream.
Maximum security—a correctional facility with the high-
est security level, generally housing prisoners who have
committed violent crimes.
Medicaid—known as Title XIX of the Social Security Act
Amendments of 1965; provides medical assistance for
certain individuals and families with low incomes and
resources.
Medically indigent—those who are unable to pay for and
totally lacking in medical services.
Medicare—known as Title XVIII of the Social Security
Act Amendments of 1965; provides mandatory federal
health insurance for adults age 65 years and older and
certain disabled persons.
Mental health—a state of successful mental functioning,
resulting in productive activities, fulfilling relationships,
and the ability to change and cope with adversity.
Mental health promotion—interventions that enhance
well-being and strengthen life-sustaining and life-en-
hancing activities.
Mental illness—collectively, all mental disorders; health
conditions that are characterized by alterations in think-
ing, mood, or behavior (or some combination thereof)
associated with distress or impaired functioning.
Message—an expression of the purpose of communication.
Meta-analysis—a research method that allows researchers
to evaluate the results of many similar quantitative re-
search studies in an attempt to integrate the findings.
Metropolitan—counties that include one or more cities of
50,000 or more residents and a total population of
100,000 or greater.
Microcultures—systems of cultural knowledge character-
istic of subgroups within larger societies.
Microeconomic theory—concerned with the supply and
demand of goods and services as these relate to con-
sumer income allocation and distribution.
Migrant farmworkers—farmworkers who travel to find
agricultural work throughout the year, usually from state
to state with the seasons.
Migrant health programs—health programs for migrant
workers that depend on referrals and vouchers to address
gaps in health care services.
Migration—the act of moving from one region or country
to another, often temporarily or seasonally.
Minimum security—a correctional facility with a mini-
mum level of security, generally housing prisoners who
have committed nonviolent crimes.
Minority group—a part of the population that differs from
the majority and often receives differential and unequal
treatment.
Model—a description or analogy used as a pattern to en-
hance understanding of some reality.
Moral—conforming to a standard that is right and good.
Moral evaluations—judgments concerning adherence to
standards of what is right and good.
Morbidity rate—the relative incidence of disease in a
population.
Mortality rate—the relative death rate or the sum of deaths
in a given population over a given time.
Multigenerational family—several generations within
one family, such as the aged mother of the husband,
wife, teenage children, and one teen’s infant.
Multilateral agencies—multinational agencies that sup-
port development efforts of governments and organiza-
tions in less developed nations of the world, such as the
United Nations, the World Health Organization (WHO),
and the World Bank.
Munchausen syndrome by proxy—a psychological dis-
order in which clients bring medical attention to them-
selves by injuring or inducing illness in their children;
they fabricate the symptoms of a disease so that the
child will undergo medical tests, hospitalization, or even
medical or surgical treatment.
Mutual goals—goals that the family and the nurse plan
and take action on together.
National health insurance (NHI)—a solution to the high
cost and inaccessibility of health services whereby
health insurance coverage would be provided for all citi-
zens through a single-payer system.
Natural history—events that occur preceding a disease’s
development, during its course, and during its conclusion.
Neglect—a state in which the physical, emotional, or edu-
cational resources necessary for healthy growth and de-
velopment are withheld or unavailable.
Neurosis—a general term denoting any of a variety of
mental or emotional disorders involving anxiety, phobia,
or other abnormal behavioral symptoms.
New and emerging diseases—diseases not known pre-
viously and diseases that were previously thought to be
under control.
Nominal group technique—a group decision-making
method that pools face-to-face group ideas after members
initially think and write down their ideas independently.
Nonexperimental design—a research design used to de-
scribe and explain phenomena or examine relationships
among phenomena; also called a descriptive design.
Nongovernmental organizations (NGO)—organizations
not under government sponsorship or control; also
called private voluntary organizations (PVO).
Nonmetropolitan—counties that do not have a city of
50,000 residents within their borders.
Nonmaleficence—avoiding or preventing harm to others
as a consequence of one’s own choices and actions.
Nontraditional family—a family pattern that has not tra-
ditionally been socially acceptable, such as a single-par-
ent household headed by a woman.
Nonverbal messages—messages that are conveyed with-
out words; constitute almost two thirds of the messages
transmitted in normal communication.
Normative-reductive change strategies—strategies
used to influence change that not only present new infor-
mation but also directly influence people’s attitudes and
behaviors through persuasion.
Nuclear family—a mother, father, and one or more bio-
logic or adopted children living together, separate from
others.
Nuclear-dyad family—husband and wife.
Nursing bag—a carry-all nurses take on home visits that
contains supplies needed on the visits.
Nursing informatics—a term for the collective techno-
logic sciences available to nurses in the health care de-
livery system today for the delivery of nursing care.
Objectives—specific statements of desired outcomes
stated in behavioral terms that can be measured and that
include target dates.
Occupational disease—any condition or disorder caused
by an exposure that resulted from employment.
Occupational health—a specialty health practice that fo-
cuses on the health and well-being of the working popu-
lation, including both paid and unpaid laborers, thus
covering most of the country’s well adults.
Occupational health nurse—a nurse employed to ensure
that the work force is, and remains, healthy and produc-
tive.
Official health agencies—health care agencies that are
publicly funded and operated by federal, state, or local
governments and supported by taxes.
Ombudsman—a person hired through the Area Agency
on Aging (AAA) or agency, who serves the residents of
assisted living or skilled nursing facilities by speaking
for them and acting as an advocate in all matters con-
cerning the residents’ stay in the facility.
Operationalizing—putting ideas or concepts into words
that can be used.
Opposition defiant disorder (ODD)—a set of “external-
izing” behavior problems, including noncompliance,
temper tantrums, and other socially provocative behav-
iors, first diagnosed in the preschool years.
Organizer—a function of the community health nurse’s
manager role that involves designing a structure within
which people and tasks can function to reach desired
objectives.
Osteoporosis—a systemic skeletal disease characterized
by low bone mass and microarchitectural deterioration
of bone tissue, leading to increased bone fragility and a
consequent increase in fracture risk.
Outcome criteria—measurable criteria toward which the
community will work and by which they will measure
their success as they attempt to improve the health of
their community.
Outcome evaluation—the assessment of change in the
family’s (client’s) health status based on mutually
agreed upon activities.
Outmigration—the phenomenon of young and middle-
age adults leaving their rural homes for a more urban
environment.
Palliative care—comfort care directed at the alleviation of
pain and other symptoms.
Pan American Health Organization (PAHO)—an arm
of the World Health Organization (WHO) that serves as
the central coordinating organization for public health in
the Western hemisphere.
Pandemic—an epidemic that is worldwide in distribution.
Paraphrasing—stating back to the sender what you
thought you heard.
Participative leadership style—a democratic style in
which leaders involve followers in the decision-making
process.
Partnerships—agreements between people and agencies
to benefit a joint purpose.
Passive immunity—short-term resistance to a specific
disease-causing organism that may be acquired naturally
or artificially through inoculation with a vaccine that
gives temporary resistance.
Passive smoking—exposure to tobacco smoke from
other people smoking in one’s environment.
Peer review—an organized system by which peer profes-
sionals assess the quality of care being delivered.
Penitentiary—a federal correctional facility, commonly
referred to among prisoners as “the big house,” which
may have a minimum or maximum security level.
Personal-care homes—homes that offer basic personal
care, such as bathing, grooming, and social support, but
provide no skilled nursing services.
Pediculosis (pediculus humanus capitis; head
lice)—parasites that live and feed on the human scalp;
considered a nuisance disease and affecting one in four
elementary schoolchildren.
Pedophile—an adult whose main sexual interest is a child.
Personalismo—the quality of pleasant conversation ap-
preciated by Hispanics.
Physical abuse—the intentional harm to someone by an-
other person that results in pain, physical injury, or
death.
Planned change—a purposeful, designed effort to effect
improvement in a system with the assistance of a change
agent.
Planner—a function in the management process that re-
quires the nurse to set goals and directions for the orga-
nization or project and determine the means for achiev-
ing them.
Planning—a logical, decision-making process of design-
ing an orderly, detailed program of action to accomplish
specific goals and objectives.
Pluralistic medical systems—consist of traditional heal-
ing systems, lay practices, household remedies, transi-
tional health workers, and Western medicine.
Polarization—the process by which a group is split into
two or more factions over a political issue.
Policy—an authoritatively stated course of action that
guides decision making.
Policy analysis—the systematic identification of causes or
consequences of policy and the factors that influence it.
Policy development—formulating local and state health
policies and directing resources toward those policies
with information gathered during assessment.
Policy system—an entity that receives input from exter-
nal sources and has legal authority to generate or re-
vise policies governing or managing the constituents it
represents.
Political action—action taken by an individual or group
to influence the political decisions of others toward is-
sues or policies beneficial to the welfare of the individ-
ual or group.
Political action committee (PAC)—a group or organiza-
tion that endorses and financially backs candidates and
supports the group’s position on issues.
Political empowerment—a conscious state in which an
individual, group, or organization becomes recognized
as influential in determining policy.
Politics—an interactive process of influencing others to
make decisions that favor a person’s or group’s chosen
position and the allocation of scarce resources to support
that position.
Pollution—the contamination of natural resources such as
air, water, and soil, making them foul and unfit for hu-
man use.
Polysubstance use and abuse—when a person uses or
abuses more than one chemical, such as alcohol with
marijuana or cocaine with antianxiety medications.
Population—all of the people occupying an area or all of
those sharing one or more characteristics.
Population-focused—the concern for the health status of
population groups and their environment.
Population variables—the size, density, composition,
rate of growth or decline, cultural characteristics, so-
cial class, and mobility of people within a designated
community.
Poverty threshold—an income line below which people
are defined as poor.
Power—the ability to influence or control other people’s
behavior to accomplish a specific purpose.
Power bases—knowledge or skills the powerholder pos-
sesses that enable him or her to exert influence over others.
Power sources—the qualities or situations from which
the power holder gains a power base.
Power-coercive change strategies—use of coercion
based on fear to effect change.
Preferred provider organizations (PPOs)—a model of
managed or coordinated care that consists of a network
of physicians, hospitals, and other health-related ser-
vices that contract with a third-party payer organization
to provide comprehensive health services to subscribers
on a fixed fee-for-service basis.
Preschooler—a child 3 or 4 years of age.
Prevalence—all of the people with a health condition ex-
isting in a given population at a given point in time.
Prevalence studies—those that describe patterns of oc-
currence, always looking at factors from the same point
in time and in the same population.
Primary health care—in developed countries, the part-
nership between health professionals and communities;
in most developing countries, a voluntary health service
created at the village level.
Primary prevention—measures taken to keep illness or
injury from occurring.
Primary relationship—two or more people interacting in
a continuing manner within the greater environment.
Prison—a state department of corrections facility that may
be assigned a security level ranging from minimum to
maximum.
Private voluntary organizations (PVO)—organizations
not under government sponsorship or control: also
known as nongovernmental organizations (NGO).
Problem-oriented assessment—an assessment that be-
gins with a single problem and then assesses the com-
munity in terms of that problem.
Proprietary health services—privately owned and man-
aged health care services.
Prospective payment—a payment method based on rates
derived from predictions of annual service costs that are
set in advance of service delivery.
Prospective study—looking forward in time to find a
causal relationship.
Psychomotor domain—visible, demonstrable perfor-
mance skills that require some kind of neuromuscular
coordination.
Psychosis—a mental disorder characterized by partial or
complete withdrawal from reality.
Public health—the science and art of preventing disease,
prolonging life, and promoting health and efficiency
through organized community efforts for the sanitation of
the environment, the control of communicable infections,
the education of the individual in personal hygiene, the
organization of medical and nursing services for early di-
agnosis and preventive treatment of disease, and the de-
velopment of the social machinery to ensure everyone a
standard of living that is adequate for the maintenance of
health, so organizing these benefits as to enable every citi-
zen to realize his or her birthright of health and longevity.
Public health nursing—the term describing community
health nursing from 1900 to 1950; replaced by the term
community health nursing to better describe where the
nurse practices. In this text, the terms are used inter-
changeably.
Public Health Service (PHS)—a federal umbrella organi-
zation concerned with the broad health interests of the
country.
Public policy—decisions made by government at the lo-
cal, state, or federal level that affect the public.
Qualitative research—emphasizes subjectivity and the
meaning of experiences to individuals.
Quality assurance—initial setting of standards, formal
auditing, and peer review in the health care delivery sys-
tem to ensure quality.
Quality care—the state in which services provided match
the needs of the population, are technically correct, and
achieve beneficial results.
Quality circles—a participative management approach in
which employees and managers share the responsibility
for decision making and problem-solving in client care.
Quality improvement—studying the impact of interven-
tion and instituting tighter controls on the delivery of
specific community health nursing services.
Quality indicators—quality-focused objectives used as
markers to determine whether a goal has been achieved
and to measure client outcomes or process outcomes.
Quality measurement—the ability to identify services
and programs that best serve the needs of the community.
Quantitative research—concerns data that can be quanti-
fied or measured objectively.
Quarantine—a period of enforced isolations of persons
exposed to a communicable disease during the incuba-
tion period to prevent spread of the disease should infec-
tion occur.
Quasi-experiment—a research method that lacks one of
the elements found in a true experiment, such as ran-
domization of the subjects.
Race—a biologically designated group of people whose
distinguishing features are inherited.
Randomization—the systematic selection of research sub-
jects so that each one has an equal probability of selection.
Rape—an act of sexual aggression in which the perpetrator
is motivated by a desire to dominate, control, and de-
grade the victim.
Rate—a statistical measure expressing the proportion of
persons with a given health problem among a population
at risk.
Rationing—limiting the provision of adequate health ser-
vices in order to save costs, but in so doing jeopardizing
the well-being of some groups of people.
Receiver—person to whom the message is directed and
who is its actual recipient.
Recidivism—an inmate’s relapse into criminal behavior
after release, with subsequent reincarceration.
Referral—a request for service from another agency or
person.
Refugee—a person who is forced to leave his or her
homeland because of war or persecution.
Regulation—mandated procedure and practice affecting
health services delivery that is enforced by law.
Regulatory health policy—policy that attempts to con-
trol the allocation of resources by directing those agen-
cies or persons who offer resources or provide public
services.
Rehabilitation—efforts that seek to reduce disability and,
as much as possible, restore function.
Relapse—continuing to use a chemical after a period of
nonuse.
Relationship-based care—care that incorporates the val-
ues of establishing and maintaining a reciprocal, caring
relationship with the community.
Reliability—how consistently an instrument measures a
given research variable within a particular population.
Research—the systematic collection and analysis of data
related to a particular problem or phenomenon affecting
community health and community health practice.
Researcher—a role of the community health nurse in
which the nurse engages in systematic investigation, col-
lection, and analysis of data for the purpose of solving
problems and enhancing community health practice.
Reservoir—any person, animal, or substance in which an
infectious agent normally lives and multiplies and then
is transmitted from its source to a susceptible host.
Resource directory—a published source of community
services developed for professionals and the broader
community.
Respect—treating people as unique, equal, and responsi-
ble moral agents.
Respite care—a break for caregivers from the intensity of
caregiving, in which they can care for themselves for a
few days; not a luxury but a necessity for successful
caregiving.
Restorative justice—a belief that benefits should go pri-
marily to those who have been wronged by prior injus-
tice, such as victims of crime or racial discrimination.
Retrospective payment—reimbursement for a service af-
ter it has been rendered.
Retrospective review—a quality assessment process that
examines patterns of care over a specified period in
health records of care given in the past.
Retrospective study—looking backward in time to find a
causal relationship.
Revolutionary change—change that is rapid, drastic, and
threatening and that may completely upset the balance
of a system.
Riot—a violent disturbance created by a large number of
people assembled for a common purpose.
Risk—the probability that a disease or other unfavorable
health condition will develop.
Risk assessment—the process of identifying factors that
lead to negative events.
Roles—the assigned or assumed parts that members play
during day-to-day family living; they are bestowed and
defined by the family.
Rural—communities with fewer than 10,000 residents and
a county population density of fewer than 1000 persons
per square mile.
Sanitation—the promotion of hygiene and prevention of
disease through maintenance of health-enhancing (sani-
tary) conditions.
School-based health centers (SBHC)—clinics on
school sites that provide ready access to health care for
large numbers of children and adolescents during school
hours, making absences from school due to health care
appointments unnecessary.
School nurse—a specialty branch of professional nursing
that serves the school-age population.
School nurse practitioner—a registered nurse with ad-
vanced academic and clinical preparation and experi-
ence in physical assessment, diagnosis, and treatment,
who provides primary care to schoolage children.
Scope—the range of effects.
Screening—delivering a testing mechanism to detect
disease in groups of asymptomatic, apparently healthy
individuals.
Seasonal farm worker—a farm worker who lives in one
geographic location and labors in the fields of that par-
ticular area.
Secondary prevention—efforts that seek to detect and
treat existing health problems at the earliest possible
stage when disease or impairment already exists.
Self-care—the process of taking responsibility for devel-
oping one’s own health potential.
Self-care deficit—when people’s ability to continue self-
care activities drops below their need.
Self-determination—a person’s exercise of the capacity
to shape and pursue personal plans for his or her life.
Self-help group—peers who come together for mutual as-
sistance to satisfy a common need, such as overcoming a
handicap or life-disrupting problem.
Self-interest—the fulfillment of one’s own desires without
regard for the greater good.
Sender—person conveying a message.
Senility—a term widely used by health professionals and
lay people alike to denote deteriorating mental faculties
associated with old age.
Serious and persistent mental illness (SPMI)—the pre-
ferred term for serious mental illness of a chronic nature.
Serious mental illness (SMI)—any mental illness that
has compromised both the client’s level of function and
the quality of life.
Setting priorities—assigning rank or importance to
clients’ needs to determine the order in which goals
should be addressed.
Sexual abuse—acts of sexual assault or sexual exploita-
tion of a person; may consist of a single incident or
many acts over a long period of time.
Sexual exploitation—conduct or activities related to
pornography depicting people in sexually explicit
situations.
Shaken baby syndrome—the effect of the intentional
abusive action of violently shaking an infant or toddler,
usually younger than 18 months of age.
Shattuck Report—a landmark document, written in 1850
and called the “Report of the Sanitary Commission of
Massachusetts,” that described public health concepts
and methods on which much of today’s public health
practice is based.
Simpatica—the quality of positive interpersonal relation-
ships appreciated by Hispanics.
Single-adult family—one adult living alone either by
choice to remain single or because of separation from
spouse and/or children because of divorce, death, or dis-
tance from children.
Single-parent family—a mother or father (but not both)
and their children.
Single-payer system—an approach to health care that
emphasizes universal health insurance coverage through
a stronger role played by government.
Situational crisis—a stressful disruption arising from an
external event that occurs suddenly, often without warn-
ing, to a person, group, aggregate, or community.
Skilled nursing facilities (SNF)—residences designed to
meet the caregiving needs of the frailest of society’s citi-
zens who need long-term rehabilitative, recuperative, or
custodial care, including the skilled procedures and
equipment.
Skilled nursing services—includes skilled observation
and assessment, teaching, and performing procedures
that require nursing judgment.
Skills myth—a belief that community health nurses em-
ploy only the skills of basic clinical nursing when work-
ing with community clients.
Smokeless tobacco products—products such as snuff
or chewing tobacco, which provide tobacco exposure
without exposure to smoke.
Social class—the ranking of groups within society by in-
come, education, occupation, prestige, or a combination
of these factors.
Social status—a person’s ranking or standing in society,
which can be affected by gender, age, and race.
Social support—the quality of interpersonal ties be-
tween individuals and the strength and extent of these
personal ties.
Social support network map—a detailed display regard-
ing the quality and quantity of social connections.
Social system variables—the various parts of a commu-
nity’s social system that interact and influence the system.
Special interest group—any group of people sharing a
common goal who are politically active in attempting to
influence policy makers to support their goal.
Spousal abuse—acts of violence against an intimate
partner.
Stages of change—the three sequential steps leading to
change (unfreezing, changing, and refreezing), which
have become a cornerstone for understanding the change
process; first described by Lewin.
Standards of care—desired goals that can help in plan-
ning and evaluation of nursing practices.
Stigma—an unjustified mark of shame and discredit at-
tached to mental illness.
Strengthening—a communication technique in which, ei-
ther verbally or in writing, the nurse lists positive points
about an otherwise negative situation.
Structural-functional framework—describes the family
as a social system relating to other social systems in the
external environment, such as church, school, work, and
the health care system.
Subcultures—relatively large aggregates of people within a
society who share separate distinguishing characteristics.
Substance abuse—excessive and prolonged use of some
chemical (alcohol, tobacco, drugs) that leads to serious
physical, emotional, and social problems.
Suicide—taking action that causes one’s death.
Surveillance—the continuous scrutiny of all aspects of
occurrence and spread of a disease that are pertinent to
effective control.
Survey—an assessment method in which a series of ques-
tions is used to collect data for analysis of a specific
group or area.
Tacit—describes a guide for human interaction that is
mostly unexpressed and at the unconscious level.
Teaching—a specialized communication process in which
desired behavior changes are achieved.
Technical skills—the ability to apply special manage-
ment-related knowledge and expertise to a particular sit-
uation or problem.
Technology—the application of science for changing
processes of production or industry.
Telehealth—electronically transmitted clinician consulta-
tion between the client and the health care provider.
Temporary Aid to Needy Families (TANF)—the restruc-
turing of Aid to Families with Dependent Children in
1996, which created federal funding to be channeled to
individual states; each state has great latitude in setting
up programs, with support limited to 5 years in a per-
son’s lifetime.
Tenet—any principle or doctrine held as true.
Terminal values—end-states of existence, such as spiri-
tual salvation, peace of mind, or world peace.
Terminally ill—people with less than 6 months to live.
Terrorism—the unlawful use of force or violence against
persons or property to intimidate or coerce a government
or civilian population in the furtherance of political or
social objectives.
Tertiary prevention—attempts to reduce the extent and
severity of a health problem to its lowest possible level so
as to minimize disability and restore or preserve function.
Theory—a set of systematically interrelated concepts or
hypotheses that seek to explain or predict phenomena.
Third-party payments—monetary reimbursements made
to providers of health care by someone other than the
consumer who received the care.
Toddler—a child just out of infancy, from age 1 to 2 years.
Tolerance—the need for increasing amounts of a sub-
stance to achieve the desired effects, or a significantly
diminished effect with continued use of the same
amount of the same substance.
Total quality management (TQM)—a comprehensive
term referring to the systems and activities used to
achieve all aspects of quality care within a given agency.
Toxic agent—a poisonous substance in the environment
that produces harmful effects on human, animal, or plant
health.
Traditional family—the family structures that are most fa-
miliar and that are most readily accepted by society.
Traditional health care systems—ancient, ethno-cul-
tural-religious health beliefs and practices that have been
handed down through generations.
Transactional leadership—a process in which leader and
followers engage in a reciprocal transaction whereby the
roles and tasks of the followers are clarified and as-
signed as the group works to accomplish its goals.
Transcultural nursing—culturally sensitive nursing ser-
vice to people of an ethnic or racial background different
from that of the nurse.
Transformational leadership—leadership that inspires
followers to high levels of commitment and effort in or-
der to achieve group goals.
Triage—the process of sorting multiple casualties in the
event of a war or major disaster.
Triggers—events and activities that may cause a person to
continue addictive activities.
True experiment—characterized by instituting an inter-
vention or change, assigning subjects to groups in a spe-
cific manner, and comparing the group of subjects who
experience the manipulation to the control group.
Unintentional injuries—injuries resulting from unin-
tended exposure to physical agents, including heat, me-
chanical energy, chemicals, or electricity; usually re-
ferred to as accidents.
United Nations International Children’s Emergency
Fund (UNICEF)—organized in 1946 as a temporary
emergency program to assist children of war-torn coun-
tries after World War II; now promotes child and mater-
nal health and welfare globally through programs and
services.
United States Agency for International Development
(USAID)—an agency that provides economic and hu-
manitarian assistance overseas.
Universal coverage—provision of health care coverage
to all citizens through one system, replacing the 1500
health insurance companies currently involved in reim-
bursement for health care coverage.
Unsafe condition—any environmental factor, either so-
cial or physical, that increases the likelihood of an unin-
tentional injury.
Vaccine—a preparation made from killed, living attenu-
ated, or living fully virulent organisms and administered
to produce or artificially increase immunity to a particu-
lar disease.
Validity—the assurance that an instrument measures the
variables it is supposed to measure.
Value—a notion or idea designating relative worth or
desirability.
Value systems—organizations of beliefs that are of rela-
tive importance in guiding individual behavior.
Values clarification—a process that helps one identify the
personal and professional values that guide actions by
prompting examination of what one believes about the
worth, truth, or beauty of any object, thought, or behav-
ior, and where this belief ranks compared with one’s
other values.
Vector—a nonhuman carrier of disease, such as an animal
or insect.
Veracity—telling the truth.
Verbal messages—communicated ideas, attitudes, and
feelings transmitted by speaking or writing.
Violent crimes—those involving physical or psychologi-
cal injury or death, or the threat of injury or death.
Very low birth weight—weight less than 1500 g at birth.
Voluntary health agencies—privately funded and oper-
ated health care agencies not supported by taxes.
Wellness—includes the definition of health but incorpo-
rates the capacity to develop one’s potential to lead a
 fulfilling and productive life; can be measured in terms
of quality of life.
Well-being—a state of positive health or a person’s per-
ception concerning positive health.
Wetlands—natural inland bodies of shallow water, such as
marshes, ponds, river bottoms, and flood plains, that fil-
ter contaminated surface waters and support wildlife re-
production and growth.
Wider family—a family that emerges from lifestyle, is vol-
untary, and is independent of necessary biologic or kin
connections.
Withdrawal symptoms—physical and psychological
symptoms (eg, tremors, lethargy, anxiety, depression)
that typically are opposite to the effects of the addictive
substance and that occur when an addicted individual
does not use the substance for a certain period of time.
World Bank (WB)—a major international health-related
agency founded in 1944 with a goal of “a world free of
poverty.”
World Health Organization (WHO)—the body that pro-
motes health on a global basis, with 191 member coun-
tries; its mandates include acting as the directing and co-
ordinating authority on international health work.