Reviewing community health

nursing concepts

Dr. Fatma Magdi

Assistant professor- Community Health Nursing
RAK College Of Nursing
RAK Medical and Health Science University, UAE
 Learning objectives
At end of this session the student will be able to

 Mention the Scope and Purpose of Community Health

Nursing
 Define Public Health/Community Health Nursing
 Identify the roles of the Community Health Nurse

restore patient health ------Community main goal

Successful community effective assessment

Understand real satiation
 Introduction
 Opportunities and challenges in nursing are boundless and ever-
changing. You have spent a lot of time and effort learning how to
care for individual patients in medical surgical and other acute-care
oriented nursing specialties. Now you are entering a unique and
exciting area of nursing—community/public health.

 Community health and public health share many features. Both are
organized community efforts aimed at the promotion, protection,
and preservation of the public’s health.
 Definition of health

 Is a state of complete physical, mental and social

well-being and not merely an absence of disease
or infirmity. (WHO,1948)

Overview of Community Health Nursing 4

 Definition of health

Health is a common theme in most culture. All

communities have their concept of health at part of
their culture. Health differs within members.

In some culture: health=harmony (being at peace

with the self, the community, God and Cosmos.

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 Population, aggregates

Population refers to all of the people occupying

an area or to all of those who share one or more
characteristics. Do not necessarily interact with one
another or share a sense of belonging to that group.

Aggregate refers to a mass or grouping of

distinct individuals who are considered as a whole
and who are loosely associated with one another.
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 Definition of community

Community is a group of interacting individuals who:

- are bound in time and space
- are dependent on each other
- share common customs, traditions, beliefs, attitudes and
values
- have similar needs and aspirations
- act together for the achievement of common goals

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 Definition of community (Cont.)

 A group of people with at least one common

characteristics (geographic location, occupation,
ethnicity, housing condition….)

- Both communities and populations are types of

aggregates.

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 Types of communities

1- Geographic communities
These are communities that exist at a defined
geographic area. Such as a village community,
city, ..etc.
2- Communities based on religion Such as Muslims,
Christians, Hindus, …etc.
3- Community based on the extent of civilization
Rural and urban, forward and backward communities
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 Types of communities (Cont.)

4- Virtual or online community

It is made up of the people who log on to social media
like Facebook, Twitter, ..etc.

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 Functions of the community

▪ Provide protection and security to the members

▪ Ensure the community continues when members

die by their replacement with those who are newly
born.

▪ Provide opportunities for participation in various

activities necessary for continuation and progress.

▪ Set up guidelines, rules and regulations to prevent

undertaking antisocial acts and punishment
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 Functions of the community (Cont.)

▪ Provide opportunities for the production of useful

products, for their distribution and safe.
▪ Provide the children in the community thorough
education and training so they acquire the
knowledge, skills and abilities to become useful and
productive adult.

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 Healthy community

 Clean, safe and high quality physical

environment.

Strong and supportive community

High degree of community participation.

Meet their basic needs.

 Makes wide use of its resources

 Prepared to meet threats and dangers

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 Healthy community (Cont.)

Innovative community.
Historical and cultural heritage is promoted.
 Good health status.
 Optimal appropriateness public health and
illness care services accessible to all, equity.

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 Definition of community health

Is the science and art of preventing diseases in the

members of the community, prolonging their life
span and promoting their health and efficiency,
through their active and continued participation.

(Promotion of health: making an individual function

to the best of his or her innate capacity)

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 Community health (Cont.)

Actions to protect and improve community or

population health can organized into three areas:
Health promotion
Health protection
Health services

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 Definition of public health

Generally regarded as synonymous with community

health, but public health differs in the following:
• It emphasis on the role of the official agencies in
implementing the promotional measures.
• It emphasis on setting up of the needed medical, nursing,
and allied services.
• It emphasis on education of the community in adopting
healthy life styles.

Overview of Community Health Nursing 17

 Definition of public health (Cont.)

• It emphasis on obtaining the full-hearted community

participation and involvement for the maintenance or
improvement of health.

Encourage how participation -----Listen to their problem

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 Definition of community health nursing

Is the systematic use of knowledge from the science

of nursing, from the social sciences and from
community health for promoting and protecting the
health of populations. It focuses on individuals,
families, and other population groups.

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 Historical development of community health nursing

• Early home care nursing (Before Mid-1800s)

- Female family members and friends tended the sick at
home to reduce suffering and promote healing.
• District nursing (Mid-1800s to 1900)
- Visiting the sick poor in their homes and teaching them
proper hygiene to prevent illness.
- Recording temp., pulse, giving simple medicine under
immediate direction of a physician.

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 Historical development of community health nursing (Cont.)

• Public health nursing (1900 to 1970)

- Broadened its focus to include health and welfare of the general
public, not just the poor.
- Providing holistic services, integrated family services with other
professionals specialized in nutrition, mental health, social
work and education.
- Expanded industrial, school and rural public health nursing.
• Community health nursing (1970 to the present)
- Focus on care of individuals, families and communities

Overview of Community Health Nursing 21

 Goals of community health nursing

1- Prevention of diseases and disabilities among all

people of the community through health promotion
and specific protection.

2- Restoration of health for diseased persons and

rehabilitation for persons with disabilities.

3- Involvement of the community in preventing

diseases by educating them about principles of self-
care and self-management.

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 Community-based Nursing practice

- It refers to "application of the nursing process in

caring for individuals, families and groups where
they live, work or go to school or as they move
through the health care system".

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 Functions of the community health nurse
(CHN)

• Assisting families to solve their health problems,

improve environmental sanitation, and cope with
their emotional and social problems.
• Determines population risk factors and educates the
masses to avoid them and adopt alternative, low
risk, life styles.
• organize classes in nutrition, personal hygiene,
sanitation, family planning, child care and so on, for
the benefit of families and groups.

Overview of Community Health Nursing 24

 Functions of the CHN (Cont.)

• Gathers epidemiological and vital statistical data and

furnishes them to the health planners and medical
researchers.

• Coordinates with other health professionals and

welfare organizations in promoting community health
and welfare.

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 Scope of community health nursing

Home care
Nursing homes
MCH and Family planning
School health nursing
Industrial nursing services
Rehabilitation centers
Geriatric nursing service
Mobile camps
Special clinics

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 Components of community health nursing
practice

(1) Promotion of health

(2) Prevention of health problems

(3) Treatment of disorders

(4) Rehabilitation

(5) Evaluation

(6) Research.

Overview of Community Health Nursing 27

 Component of community health
nursing practice

Promotion of health
Heath promotion includes all efforts that seek to move
people closer to optimal well- being.
 Component of community health nursing
practice
Prevention of health problems
Prevention means anticipating and averting problems or discovering them as
early as possible in order to minimize potential disability and impairment.
(1) Primordial prevention

(2) Primary prevention,

(3) Secondary prevention and

(4) Tertiary prevention.

Overview of Community Health Nursing 30
 Levels of prevention
Primordial prevention Primary level Secondary level Tertiary level
A relatively new An intervention implemented An intervention An intervention
concept, is receiving before there is evidence of a implemented after a implemented after
special attention in disease or injury. disease has begun, but a disease or injury
is established.
the prevention of Goal: to promote positive
before it is
chronic diseases. symptomatic. Goal: preventing
general health of individuals,
further disability or
families, and communities. Goal: Early ↓ functioning.
Prevention of - Risk reduction identification through
development of risk screening and
factors which they treatment.
have not yet
appeared.
Goal: discourage
adopting harmful life
styles/habits
Components Components Components Components
Health education Health promotion (health Early diagnosis Disability
National programs and education programs, Regular health checkup of limitation
policies on: immunization, physical and community,
Food, nutrition, promote nutritional fitness activities ) And health risk groups like
regular physical activity, Specific protection smokers, obese, Rehabilitation
policies for discourage (Immunizations, sanitation of food, alcoholic,…
smoking and alcohol water, milk and air, hand washing, Prompt treatment
…)
take drugs
Overview of Community Health Nursing 31
 Component of community health nursing
practice
Rehabilitation
It involves efforts to reduce disability and as much as
possible restore function.
Overview of Community Health Nursing 33
 Component of community health
nursing practice

Evaluation
It is a process by which that practices is analyzed , judged and improved
according to stablished goals and standards.

Research
It is systematic investigation to discover facts affecting community health
and community health practice, solve problems, and explore improved
methods of health services.
 Characteristics of community health nursing

1- It is a scientific discipline, based on up-to-date scientific

knowledge.

2- It uses criteria and standards of nursing practice based on

evidence gathered from well planned epidemiological
studies.

3- It considers the patient not as a passive recipient of

nursing care but as an active partner.

Overview of Community Health Nursing 35

 Characteristics of community health nursing (Cont.)

4- It works with and not above the community.

5- It works within the limitation of the available resources.

For this purpose it carries out prioritization at the least
cost and in the least time.

6- It respect social justice and hence provides nursing care to

all persons irrespective of ethnic origin, gender,
possessions, race, religion, culture, etc.
7- Opportunities for continuing staff education programs for
nurses.
Overview of Community Health Nursing 36
 Characteristics of community health nursing (Cont.)

8- It based on recognized needs and functioning within the

total health programs.

9- It recognized the family and community as units of

service.

10- Health education and counseling are the integral part of

community health nursing.

10- Periodic evaluation of health services.

Overview of Community Health Nursing 37

 Characteristics of community health nursing (Cont.)

11- Community health nurse (CHN) should:

- Not belong to any one section or any political group.

- Understand the objectives and policies of the agency she
represents.
- Works as a member of the health team.
-Responsible for health teaching.
-Function as an important member of the health team.

Overview of Community Health Nursing 38

 Approaches of community health nursing

1- Persuasive approach
- Through dialogue and education to change or modify
their health behavior.
-CHN use this approach in all types of nursing
interventions related to levels of prevention.

2- Team approach
- Very necessary to deal with varied and complex health
needs and problems at large.

Overview of Community Health Nursing 39

 Approaches of community health nursing (Cont.)

3- Community involvement : responsibilities of

- Health of themselves, helping, participation,
cooperation, planning, implementation, etc.
- It may depend on socioeconomic, culture, health and
attitude of knowledge.

4- Intersectoral approach : CHN needs to identify

other sectors and coordinate with them to provide
desired services

Overview of Community Health Nursing 40

 Approaches of community health nursing (Cont.)

5- Epidemiological approach
- Analysis and measurements, surveillance, etc.
6- Nursing process approach

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 Roles of the CHN

1- Manager 2- Leader
3- Collaborator/Coordinator
4-Educator/Counselor /Trainer
5- Consultant 6- Advocator
7- Suppresser 8- Promoter
9- Provider 10- Enhancer
11- Role Model 12- Change Agent
13- Recorder/Reporter 14- Researcher

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 THE ROLE OF THE COMMUNITY HEALTH NURSE

 1- Care provider ( Clinical role): she provides continues and

comprehensive care not only to the patient but also to the family and
community, she is focusing on promoting and preventive health care.

 2- Educator: She provides the patients and family members with

adequate information through the health education.

 3- Counsellor: The community health nurse helps individuals, families

and communities at large to recognize and understand their problems
to be solved, find the solutions within the resources and implement
feasible and acceptable solutions.
 THE ROLE OF THE COMMUNITY
HEALTH NURSE

4-Collaborator: she collaborates with other health care

members to provide the best care to the patient, families
and communities.

5- Researcher: She engages in research to find out the

new.

6- Advisor: she give suggestions on practical situations

which need immediate actions

7- Manager: community health nurse implements the

care which is planned for the family and community.
THE ROLE OF THE COMMUNITY
HEALTH NURSE
 CHN VS. Hospital Nurse
Item Community health Hospital nurse
nurse
Focus of concern Health problems of the Disease in an individual
community
Clients Sick persons and their Sick
families inpatients/outpatients
Timing of Before the onset of After the disease onset
intervention disease
Intervention Prevention of disease, Restoration of patient’s
objective promotion of health health
Client Community participates Patients are passive
participation in planning and recipients of services
intervention
Client None Depends on hospital cost
disqualification and reputation
Overview of Community Health Nursing 46
CHN VS. Hospital Nurse (Cont.)
Item Community health nurse Hospital nurse
Nature of work Observing, interpreting, thinking, Following instruction
deciding, and acting
Scope of early Detect unrecognized cases None
detection
Work setting Primary health care centers: Hospitals
industerial, school clinics, MCH,
rural health units, home, hospitals
(outpatients’ clinics), community at
large
Function Preventive, curative, rehabilitative Mainly curative
Skills Nursing, research, educational, Nursing, administrative,
administrative, public health and educational, and
epidemiological skills. research skills.
Overview of Community Health Nursing 47
 Definition of holistic nursing

Holistic nursing is a method of nursing practice

which focuses on treating the patient as a whole as
opposed to merely treating the symptoms of their
present condition(to ensure comprehensive care). It
encourages nurses to integrate self-care, self-
responsibility, spirituality, and reflection in their lives.

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 Holistic nursing (Cont.)
Holistic nursing care involves healing the body, mind,
spirit, emotion, economic, political and environmental in
daily life and clinical practice .

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Parts, organs, perception,
Mental
tissues (Intellectual intelligence,
Physical
Systems,.etc. &Emotional) memory,
learning capacity,.etc

communication, Spiritual ethics, values, etc

Social
resection, .etc

Dimensions of health
Overview of Community Health Nursing 50
 References

Dash, B. (2017). A comprehensive textbook of Community health.

Jaypee Medical Publisher.
Rao, S. (2016). Community Health Nursing. Publisher : AITBS. 11-19.
Rector, C. (2018). Community and public health nursing. (9th ed.).
Philadelphia: Wolters Kluwer. 5-27, 31-57.
Chilton, S and Brain, H (Eds.). (2018). A textbook of community
nursing: Nursing in a community environment. (2nd ed.). New
Yourk: Taylor & Francais. 1- 43.

Overview of Community Health Nursing 51