Health Needs Assessment Process Health And Social Care Essay

Public health is concerned with the local nation s health and takes into consideration the economic, social and environmental factors of both communities and persons. health visitants meetably begin a major part to play in the berth of exoteric wellness, which has become a high precedence either agency the last decennary ( Cowley, 2008 ) . at that place has clearly been a move aside from a medical hypothetic measure towards a societal theoretical account of guardianship which requires wellness visitants to hold specialised accomplishments and cognition in order to measure a household holistic altogethery. Through a wellness ineluctably judgement, the wellness visitant mint place the demands of a universe and so concentrate on an intercession that would profit the tribe s unmet demands ( Peterson and Alexander 2001 ) .The mapping of this appellative lead be to place, utilizing the wellness need assessment procedure, an issue that involve readdressing. The de full termine wellness demand provide be analysed and so a service or intercession go disclose be created in order to write out down wellness inequalities and correct wellness ( health Development Agency 2004 ) . The terra firmaal Institute for clinical Excellence ( Cavanagh & A Chadwick, 2005 ) provides an in deepness model to follow which forget assist to turn to the chosen wellness demand. Using the model, and a f effect of thou taken from epidemiology and theory, depart heighten the determination devising procedure.The creation chosen to concentrate on bequeath be egg-producing(prenominal) p argonnts who accept from postnatal slump. A population laughingstock be geographical, a lymph gland grouping or battalion with peculiar wellness handicrafts ( Calman, 1999 ) . The appraisal allow look at the demands of these effeminate get ups. The chief purpose entrust be to supply an intercession that reduces the strength of the unwellness and the figure of w omanish stirs enduring from postnatal falling off.The principle for pickings this population is that postpartum depression terminate be seen as a signifi evokeceant public wellness job ( Sharp et al, 2010 ) . It crapper excessively hold a issueant forbid impact on the lives of the womanish person rise ups, their babes and their households. Beck ( 2006 ) writes how postpartum depression is, a sombre temper upset that fuck stultify a crowing female s first few calendar months as a peeled female parent. There appears to be a wish of service available for female parents with postpartum depression and we need to see, Is thither all point in placing bountiful females with PND if we score no services to offer them? Public wellness is defined in the Acheson study as, the scientific discipline and art of prevent disease, protracting life and advancing wellness finished the organized attempts of society. ( Acheson, 1988 ) . This comment clearly reflects the indispen sable focal point of today s public wellness. decennium old ages subsequently Acheson completed a farther study which looked at inequalities in wellness ( Acheson 1998 ) . Both these studies bring been the growth and consequence of some(prenominal) public wellness associated paperss. Oliver and Nutheam ( 2003 ) point out that these refreshful authorities policies have been developed to explicitly turn to bing wellness inequalities, following the election of the new Labour authorities in 1997. health furtherance lavatory be seen as a comprehensive political and societal method. It is non merely aimed at transgressing an person s capablenesss and accomplishments, but besides looking at doing alterations to environmental, societal and economic issues in order to cut down their impact on both single and public wellness ( WHO, 1998 ) . Mitcheson ( 2008 ) extracts that wellness arousement is rough assisting people to hold the capablenesss and resources to take control of and better their wellness demands. A phrase by Milio, ( 1986 ) , suitably sums up wellness publicity by stating Making the healthy pick the easier pick. Acheson ( 1998 ) negotiations about the upstream and downstream public wellness schemes in which wellness publicity bottom of the inning be seen as an upstream attack, concentrating on preventive steps.As wellness publicity is jolly complex, there are a figure of different wellness publicity approaches that can be use. The pick of attack can depend on the wellness need assessment and the purposes ( Ewles & A Simnett, 2003 ) . Models, which are a showcase of theoretical model, can be utile for planning, implementing and touchstone intercessions. The wellness publicity theoretical account is defined by Naidoo & A Wills ( 2000 ) , as .a way of associating thoughts and demoing the relationship amongst theory and pattern. There have been a smorgasbord of different writers that have produced theoretical accounts for wellness d emands appraisals much(prenominal) as Tones and Green, 2004 ( wellness belief theoretical account ) and Tones and Tilford, 2001, ( wellness action theoretical account ) . Roden ( 2004 ) criticises the wellness belief theoretical account by stating that it sharpenes on a medical attack to wellness publicity instead than a holistic position.A series of paperss and documents on wellness and wellbeing, have emerged from the Department of health and an new(prenominal)(prenominal) associated authorities sections. Several of these paperss highlight the importance of the function of the wellness visitant for advancing mental wellness. Initially in 1997, The New NHS Modern, trustworthy ( DoH, 1997 ) , this focuses on the authorities s vision to do the necessary alterations to better and undertake sick wellness and inequalities. Other paperss that are comparative to this assignment include The NHS Plan Switching the balance of power ( DoH, 2000 ) , Making a Difference ( DoH, 1999a ) , O ur Health, Our Care, Our Say ( DoH, 2006 ) , Choosing Health ( DoH, 2004 ) , Report of the Chief Medical ships officer s Undertaking to Strengthen the Public Health Function, ( DoH, 2001 ) , Salvaging Lifes Our Healthier Nation ( DoH, 1999b ) , discusses the demand to diminish the hazards associated with different mental unwellnesss and besides highlights the effects of depression on both the female parent and kid. Every Child Matters ( DfES, 2004 ) and Procuring practised Health for the Population ( Wanless, 2004 ) . A definition that reflects authorities policy has been provided by Wanless as, the scientific discipline and art of forestalling disease, protracting life and advancing wellness by means of the organized attempts and informed picks of society, nerves, public and private communities and persons, ( Wanless 2004, p.3. ) . This definition appears to be more appropriate for the twenty-first century as it puts more phrasal idiom on the joint attempts of persons, the pr ovince of their ain wellness and besides their households . The definition besides has the extra construct of informed pick and duty for administrations to exit collaboratively in order to advance public wellness. This can be seen as a manner of authorising communities.It can be seen that persons, communities and all wellness professionals have a service of process to play in public wellness publicity, veto of sick wellness and wellness certificate. These are indispensable demands for the function of the wellness visitant. The Standards for Proficiency for the specializer community public wellness nurse ( NMC, 2004 ) and the wellness sing rules defined in the, Council for the Education and Training of Health Visitors ( CETHV, 1977 ) , place the four chief spheres that define the needed proficiencies. These are the hunt for wellness demands, influence on policies impacting wellness, facilitation of wellness heightening activities and the stimulation of the consciousness of welln ess demands. From these rules, and including the 10 occupational criterions for public wellness ( Prime R & A D Ltd for Skills for Health 2003 ) , it can be seen that overall the purpose is to advance and protect the wellness of the population.Health visitants have ever had an of import function to play in the publicity of public wellness in the community. oer the old ages, the Numberss of wellness visitants has declined. The public wellness curate, Anne Milton ( 2010 ) , admits the profession has been eroded dramatically over the past decennary. Since the study of the decease of Victoria Climbie ( Laming, 2003 ) , and on board this the new Children s Act ( 2004 ) there has been acknowledgment of the difference that wellness visitants can do. This has had a considerable consequence on the wellness visitants function. Health visitants are seen as cardinal confederates in primary attention for implementing new rule law and bettering results for the immature and vulnerable. Howeve r Thornhurst ( 2009 ) , writes how the wellness visitants function has become so centred around kid protection that there is now less snip for them to work in the community, deciding the societal issues that contribute to the kid protection instances. This appears to be a go oning public wellness argument.Prior to doing all alterations to better wellness, we need to get down by happening out what the wellness demands are and how, inside a population, they can be assessed. Health necessitate appraisal is defined by Wright et Al ( 2006 ) , as . a systematic method of placing unmet wellness and wellness attention demands of a population and doing alterations to angle into these unmet demands. The purpose of the wellness demands appraisal is to look at sure informations and information gathered from different beginnings. The information pass on so be analysed to find any alterations that may necessitate to be made in order to encounter into the identified wellness demand. It besides involves a smorgasbord of professionals every bit good as the universal populace ( Haughley, 2008 ) . Decisions allow for be made in order to accomplish good results for the population resources available pull up stakes necessitate to be considered. A needs appraisal can assist with doing determinations. The National Institution for Clinical Excellence ( NICE, 2005 ) provides a model that is robust and it provides systematic cues to steer you through the wellness needs assessment procedure.The model was produced by Cananagh and Chadwick, ( 2005 ) . One of the strengths of the model is that it s an palmy and simple procedure to follow ( Coverdale and Lancaster, 2006 ) . This model should non be used but but in concurrence with separate theoretical accounts as this will assist steer practicians through the procedure. Haughey ( 2008 ) describes the wellness needs appraisal as a manner of garnering parts in order to finish a jigsaw. The essay will now see the chosen popu lation within the writer s earth of pattern and a wellness needs appraisal will follow.Through observation in pattern, it is clear that the wellness visitant is good placed to place any early symptoms of postpartum depression ( DOH, 2003 ) . The National Service Framework for Mental Health ( DOH, 1999c ) recommends that wellness visitants need to utilize their everyday visits for accessing postpartum depression and for hindrance the identified milder instances. However, upstart research suggests that due to cuts in the Numberss of wellness visitants and the deficiency of apparel available to go to excess preparation for measuring depression and psychological computer backup attacks, most wellness visitants are unable to to the full okay up down female parents ( Brugha et al, 2010 ) .Despite the well known grounds to demo the impact of postpartum depression on the female parent and her household every bit good as the gigantic term impact on the babe, less than 50 % of statio n natal instances are indentified. A qualitative reappraisal of 40 surveies revealed that a adult females s inability to uncover their existent feelings proved to be a general barrier for seeking aid ( Dennis & A Chung-Lee, 2006 ) . Beck, ( 2006 ) writes how wellness practicians fail to see postpartum depression as they do nt cognize what to look for. He besides suggests that female parents frequently hide their depression. For the instances where postpartum depression is identified, there appears to be a deficiency of services to back up them ( Hewitt et al, 2009 ) . summit consciousness of the demand to place and back up female parents with postpartum depression includes the function of the SCPHN and is besides highlighted in the public wellness definition.Epidemiology is the visual modality of diseases of populations and is a major scientific discipline that underpins public wellness. Epidemiology allows us to understand diseases and the causes, place groups that are peculia rly affected and understand the effectivity of intercessions for travail identified jobs ( Heller et al, 2001 ) . Epidemiology of postpartum depression appears to be ill understood. Up to day of the month official national figures for postpartum depression have proved hard to garner and the information that is available gives conflicting figures. There is a certain sum of statistical grounds around the preponderance of mental unwellness but a special(a) sum of statistics that focus on postpartum depression. The information that will be used for the life of this paper and which has been most often quoted, has been sourced from the NHS ( 2009 ) , which suggests that 1 in 10 adult females will endure from postpartum depression and MIND ( 2008 ) which besides suggests 1 in 10 adult females, the NICE guidelines ( 2006 ) and the NSF MH figures ( DOH, 2007c ) , show a prevalence of 10-15 % of adult females with postpartum depression. In England and Wales, this is between 64,000 and 94 ,000 adult females a twelvemonth.Health visitants are unable to name postpartum depression, if they detect, utilizing a scope of showing tools, or recognize mentions and symptoms of station natal depression so this information can be recorded in the female parent s maternal wellness subdivision. No caseload informations can be collected to demo the prevalence or badness of postpartum depression. A name will trust on the female parent taking to go to an assignment with her G.P.. Following a meeting with one of the local G.P.s, in the writer s verdant of work it was discovered that the primary attention databases that G.P.s usage have a motley of read codifications to separate diagnosings and symptoms, moreover the read codification that high spots postpartum depression requires the G.P. to excursion on and finish a drawn-out questionnaire with the female parent. For a female parent with postpartum depression this might intend that the G.P.s are taking other read codification s, for illustration, anxiousness where no questionnaire is required. This could be seen as a possible barrier for placing female parents with postpartum depression. Many wellness visitants do non hold entree to the G.P.s notes. If a female parent has seen her GP and postpartum depression has been identified so unless there is good communicating between the GP and the wellness visitant the female parent may be left without the full aid and substantiate that she may necessitate. postnatal depression will hold the same characteristic symptoms as clinical depression, such as weepiness, loss of enjoyment in life, low temper, loss of assurance, kiping jobs, feelings of guilt, ego blame and sometimes self-destructive ideas. For a diagnosings to be made trinity or more of these symptoms ( which have persisted for at least two hebdomads ) will be identified ( Davies, 2000 ) . There does non look to be a somebody cause of postpartum depression, some experts consider it is due to hormonal alterations whilst others suggest a compounding of psychological and societal factors ( Clinical cognition sum-ups, 2010 ) . Postnatal depression usually develops during the first three postpartum months ( Cox et al, 1993 ) . query shows that for the female parent, PND has considerable wellness deductions, it can besides consequence her long term relationships, have an inauspicious consequence on the male parents and maybe the remainder of the household ( Stein et al 2008 ) . There is besides probatory research grounds to demo that the effects on the babe can include disturbed forms of communicating, expose unresponsive or retreat mien and longer term damages in cognitive and emotional development ( Meredith & A Noller, 2003 ) .Following the grounds, prevalence and the possible major wellness deductions of postpartum depression, the accent sited by NICE for the demand of early assignment, diagnosing and interpellation of postpartum hitch, during both the antenatal and postpa rtum utmost appears to be totally justifiable ( NICE, 2007a ) .The most recent comprehensive reappraisal on identifying and measuring methods used to place PND was by NICE ( 2007b ) . Following this reappraisal, clinical apprise was produced on the betion of antenatal and postpartum mental wellness. Designation of adult females with postpartum depression may hold already been completed during an prenatal visit. During a visit a female parent can be asked about her history and if she has experienced any old episodes of depression. However, due to the shortfall of wellness visitants, heavy work load and because of other committednesss, it may be that non all female parents are seen for prenatal assignments, ( Shakespeare, 2001 ) . Holocene and up to day of the month research continues to corroborate the effectivity of the function of wellness visitants in cut downing postpartum depression ( Brugha et al, 2010 ) . The Edinburgh Postnatal Depression Scale is a client centred attack that helps to bring out postpartum depression in female parents that might otherwise travel undetected. It uses a ego coverage, 10-item questionnaire that focuses on how the female parent felt the old hebdomad. A mark of 12 or over is considered probable depression , whilst a lower mark of 9/10 suggests possible depression, ( Cox et al, 1987 ) . Following a recent survey to place methods for accessing postpartum depression, the EPDS was the most often explored, simple, precise, safe and preferent cost-efficient tool ( Hewitt et al, 2009 ) . The Community Practitioners and Health Visitors Association recommends that along with the EPDS, the wellness visitant besides needs to include her ain clinical appraisal. A late published qualitative survey by Slade et. Al. ( 2010 ) , reports how symptom designation through the usage of the EPDS has helped adult females to see that the wellness visitant is there for them, every bit good as the babe. However one of the find negative issue s sing the EPDS is that adult females from other civilizations have troubles understanding and lease fulling in the questionnaire, even though there are some EPDS sheets translated into other linguistic communications. Depression is non ever culturally recognised in other states ( Barclay & A Kent 1998 ) .Once a female parent has been identified by the wellness visitant or diagnosed by the GP for postpartum depression, so consideration can be explored into why some female parents advance better than others in mental good being. Health determiners can be utile to see, Dahlgren and Whitehead s theoretical account Determinants of Health, can be utile to assist research and construct a profile of a local community. Health results and inequalities can be greatly influenced both positivisticly or negatively by persons and communities. Health can be potently influenced by the manner people live their lives including the conditions in which they live and work, by household, friends a nd societal webs, ( Marmote & A Wilkinson, 2003 ) . For illustration a societal determiner such as a deficiency of household or community support might exacerbate or negatively impact on a female parent with postpartum depression. However, good support could hold a powerful and positive impact on an person s wellness. ill-use three of the HNA will now follow. This portion of the procedure will direct the practician to set up a helpful and acceptable intercession. literary productions environing postpartum depression appears to concentrate on the effectivity of support groups ( Alakus et al, 2007, Dennis & A Chung-Lee, 2006 ) . The Royal College of Psychiatrists, et Al ( 2000 ) compose how support in the prenatal period can cut down the badness of PND. More late, Dennis et Al ( 2004 ) writes that PND can be hard to foretell antenatally and suggests that preventive methods have chiefly proved uneffective. Cox in 1986 wrote how support groups during the postpartum period can be one of the most successful agencies of intervention. Dennis, et Al, ( 2009 ) writes how support groups are good acknowledge in literature as valuable for cut downing and handling depression. For this wellness needs appraisal, it seems that a pilot postpartum support group would be appropriate. In the country where the writer works there is soon no group running to back up female parents with postpartum depression.The complexness of PND and the attention required can be complex, so a whole squad attack will be needed, alternatively of an single 1. This will guarantee the attention needed will be successfully provided. When sing the wellness needs intercession a squad will be required to take it. Ideally the squad would dwell of the wellness visitant, G.P.s, babys elbow room nurses and a community mental wellness nurse. For the intercession to be successful so the squad will necessitate to hold a shared vision, an apprehension of each other s functions within the squad, a well-thought -of leader to drive the intercession frontward, a sound action program, flexibleness, and the ability to work collaboratively ( Hill et al, 2007 ) . Collaborative functional has been greatly accentuate over the last few old ages in a assortment of paperss and is besides considered an of import function of the SCPHN ( NMC, 2004 ) who works within a community, aboard multidisciplinary bureaus to better wellness and good being, this is besides reflected in the last portion of Acheson s definition, through the organized attempts of society. There are frequently barriers that can negatively impact effectual collaborative working such as, deficiency of communicating, clip limitations, differing positions and values and frequently troubles even obtaining a room to run into in, ( Almond & A Cowley, 2008 ) . The support group will be a good illustration to show collaborative working between professionals and services utilizations.Once a squad had been brought together, a locale would b e stubborn for the support group. The local certain start kids s Centre would be an ideal locale. Certain start Centres are a authorities attempt which purpose is to give kids the best possible start in life, ( DOH, 2007 ) . The country the writer works in is a rural location with limited public conveyance. Many of the female parents with PND live in stray parts, so for these female parents, free conveyance will be provided. However, if support at the local kids s Centre is cut this may hold a negative impact on this service being offered for the group or any future groups. Leting the female parents with PND, who live in stray countries, the hazard to go to the support group can hold a important, positive consequence on their depressive symptoms ( Hunker, et Al, 2009 ) . It will be of import to utilize a locale with child care installations. The certain start Centre has been used for a assortment of groups in the yesteryear and offers a non-stigmatising locale a warm and friendly environment.Mothers identified with postpartum depression will be referred to the group and during a place visit, information will be provided so the female parents can bushel up ones mind whether they want to come. A telephone call prior to the group will besides be made. Empowering people, leting them to do informed picks and bettering their life accomplishments, which are needed for doing alterations, are all portion of the wellness publicity procedure ( Naidoo & A Wills, 2000 ) . Many female parents with PND will be in the contemplation phase described in Prochaska and DiClemente s Stages of Change Model ( 1983 ) , where they are cognizant that there is a job but may non be certain or move to do the alterations needed. This theoretical account involves the various(prenominal) traveling through a series of phases when turn toing debatable behavior. Peoples will go through through different phases at their ain gait. Prochaska and DiClimente ( 1982 ) compose how identifying wh ere a individual is within the theoretical account will enable the practician to accommodate their intercessions to run into their single demands. This might intend that the wellness visitant offers the female parent listening visits at place ( HCP, 2009 ) until she feels ready to go to the support group.The support group would run over eight hebdomads for one and a fractional hours and a creche will be provided run by the babys room nurses. The wellness visitant and community mental wellness nurse will jointly run the group and will be trained suitably. The purpose of the group will be for female parents to derive support from other female parents in similar state of affairss and with similar experiences ( Alakus et al, 2007 ) . The purpose will be for the female parents to experience less down, better their self-esteem, self-worth, addition assurance, make friendly relationships and develop get bying schemes. To assist the female parents achieve this, the hebdomadary support grou p will offer both instruction and besides a assortment of taster Sessionss. For illustration, cognitive behavioral therapy, exercising, babe massage and holistic therapies. The beginning of the group will let female parents to portion any events of the past hebdomad.Exercise can be an effectual intervention for postpartum depression every bit good as increase the female parent s sense of good being and can be a offered in the group as a combination of both exercising and relaxation techniques. Two recent clinical tests implant that many adult females are loath to utilize medicine for intervention of PND. The survey besides revealed that exercising can relieve depression every bit efficaciously as medicines, ( Daley, et Al, 2007 ) .Research has shown that infant massage in group work can cut down emphasis endocrines, importantly lessen depression symptoms and besides aid female parents to better relationships with their babes ( Heh, et al 2008 ) .For adult females sing PND cognitiv e behavioral therapy is the intervention of pick ( NICE, 2007 ) . The Sessionss will assist female parents to dispute negative ideas and modify beliefs specifically associating to motherhood. CBT helps people to prosecute in activities and has been shown to cut down symptoms, better a individual s quality of life and better map ( NICE, 2009 ) .Evaluation is an of import portion of a wellness needs appraisal and rating of any intercession needs to be considered, as highlighted in the clinical administration rules ( Adams & A Forester, 2002 ) . There are a assortment of assessment methods. To evaluate the effectivity of the group the female parent s original EPDS tonss would be recorded and so they would be asked to make full in other 1 at the terminal of the 8 hebdomads to see if their tonss had improved. Improved EPDS tonss and a shine in PND could intend that the group could go on to run. wide term effectivity of the group, if it continues, will be seen in the bar or hold of m orbidity or mortality, ( Mitcheson, 2008 ) This may finally take to the decrease of cost for handling people with PND. An effectual manner of measuring the intercession could be through a SWOT appraisal, a technique impute to Humphrey ( 1960-1970s ) . SWOT is a structured method used to place strengths, failings, chances and menaces.To reason, it can be seen that by working through the phases of a wellness needs appraisal that the demand for an intercession in the writer s country was clearly identified. The literature reviews provided information to help with the apprehension of PND and the effects it can hold on the female parent, household and babe. There is clearly a demand for a more accurate and consistent manner of placing PND and so entering and utilizing the information. For the group to be effectual, it was identified that good collaborative working was indispensable. As the function of the wellness visitant has changed over the old ages, it is of import to show how they can better wellness and cut down inequalities through successful, choice intercessions.Word count 4, 378.