Chn

report
Group
1
 TABLE OF
CONTENTS
population focused practice and
● Alexis Enriquez
01 community health nursing
intervention
● Angelica Mill Briz

● Carl Afable
● Catherine Guleng

02 Level of clientele ●
●
Charlyn Mirador
Derick Nyl Pascual

03
● Ericka Acop
The intervention wheel ● Aira Aringo
● Arrbelle Alberca

04 The prepayment mechanism of

chn practice
 population focused
practice and community
health nursing
intervention
★ Population-focused nursing concentrates on specific
groups of people and focuses on health promotion and
disease prevention, regardless of geographic location
(Baldwin et al., 1998).
★ Community/public health nurses must use a population-
focused approach to move beyond providing direct care to
individuals and families.
★ The goal of population-focused nursing is “provision of
evidence-based care to targeted groups of people with
similar needs in order to improve outcomes”(Curley, 2016,
p. 4).
 Population-focused practice
★ Focuses on the entire population.
★ Is based on assessment of the population’s health
status.
★ Considers the broad determinants of health.
★ Emphasizes all levels of prevention.
★ Intervenes with communities, systems, individuals, and
families.
 Public health nursing practice requires
the following types of data for scientific
approach and population focus:
(1) the epidemiology, or body of knowledge, of a particular
problem and its solution.
(2) information about the community.
 Public Health Interventions
Information Useful for Population Focus
● To determine the overall patterns of health in a population, data collection for assessment and
management decisions within a community should be ongoing, not episodic.

Type of Information Examples Sources

Demographic data Age, gender, race/ethnicity, socioeconomic status, education Vital statistic data (national, state,
level county, local); census

Groups at high Health status and health indicators of various subpopulations Health statistics (morbidity, mortality,
risk in the community (e.g., children, elders, those with natality);
disabilities) disease statistics (incidence and
prevalence)

Services/providers Official (public) health departments; health care providers City directories; phone books; local
available for low income individuals and families; community service or regional
agencies and organizations (e.g., Red Cross, Meals on social workers; low-income
Wheels) providers’ lists; local
community health nurses (e.g., school
nurses)
 Public Health Interventions

● Public health nurses focus on the care of individuals, groups, aggregates, and
populations in many settings, including homes, clinics, worksites, and schools.
● PHN must work with the community to identify and implement programs that meet
health needs and to evaluate the effectiveness of programs after implementation.
● E.g. school nurses - first-aid stations and monitoring immunization compliance;
assessing the needs of their population and defining programs to meet those needs
through activities such as health screening and group health education and
promotion.
 Public Health Interventions
Occupational health nurses (OHN) are no longer required to
simply maintain an office or dispensary.

OHN involved in many different types of activities

included:

● maintaining records of workers exposed to

physical or chemical risks
● monitoring compliance with Occupational Safety
and Health Administration (OHSA) standards
● teaching classes on health issues
● acting as case managers for workers with chronic
health conditions
● leading support group discussions for workers
with health-related problems
 Public Health Interventions
Private Association (American Diabetes Association or the
Red Cross) employ public health nurses for their
organizational ability and health-related skills.

Other Public Health Nurses:

- works multidisciplinary groups of professionals

- serve on boards of voluntary health associations such as the

Philippine Heart Association (AHA)

- work as case managers for insurance companies

- members of health planning agencies and councils

Level of
clientele
 LEVEL OF CLIENTELE
Community health nurse focus on the care of several levels of
clientele: the individual, the family , the group/aggregate, and the
community as a whole in many setting, including homes, clinics and
schools.
 FAMILY

A family is a group of two or more persons related by birth, marriage, or

adoption who live together; all such related persons are considered as
members of one family. For instance, if an older married couple, their
daughter and her husband and two children, and the older couple's nephew all
lived in the same house or apartment; they would all be considered members
of a single family.
 TWO BASIC FAMILY STRUCTURES

1. Family of orientation- refers to the family in which a person is raised.

2. Family of procreation- refers to a family unit created by two or more people.

 Nuclear Traditional Family

A traditional nuclear family consists

of a married couple and their
biological child or children. A child
in a traditional nuclear family lives
with both biological parents, if
siblings are present, only full
brothers and sisters.
 Extended or Multigenerational Family

A house where adults of two or more

generations live under the same roof. Often, this
means middle-aged or senior adults and one or
more adult children. Young children or
grandchildren may live there too.
 Two-Career Family

Is the type of family in which

both heads of household
pursue careers and at the same
time maintain a family life
together.
 Blended Family

Is a couple family containing two or

more children, of whom at least one is
the natural or adopted child of both
members of the couple, and at least one
is the stepchild of either partner in the
couple.
 Single Parent Family

Comprised of a parent/caregiver and one or

more dependent children without the presence
and support of a spouse or adult partner who is
sharing the responsibility of parenting.
 Cohabitation Family

is an arrangement where two people are not

married but live together. They are often
involved in a romantic or sexually intimate
relationship on a long-term or permanent
basis.
 Binuclear Family

A social unit composed of an

extended family, usually the
children and subsequent
spouses of divorced parents.
 Dyadic Nuclear Family

is when couples choose not

to have children.
 Gay and Lesbian Family

Individuals of the same sex live together as

partners for companionship and sexual
fulfilment.
 The Foster Family

A foster family must make the

youth feel that they are part of
the family. Foster family care
was selected because it was
determined that the youth
needed a setting that is most
similar to the family setting.
That means more than
providing a physical home.
Classifications of
Family Structure:Based on Internal Organization and
Membership

NUCLEA EXTENDE
R D
 Based on Place of
Patrilocal – requires the newly wed Residency
couple to live with the family of the bridegroom or
near the residence of the parents of the bridegroom.

Matrilocal – requires the newlywed to live with or near the residence of the bride’s
family.

Bilocal – provides the newly wed couple the choice of staying with either the groom’s
parents or the bride’s parents, depending on the factors like the relative wealth of the
families or status, the wishes of their parents or certain personal preferences of the
couple.

Neolocal – permits the couple to reside independently of their parents. They can decide
on their own as far as their residency is concerned.

Avunculocal - prescribe the newly wed couple to reside with the or near the maternal
uncle of the groom.
 Based on Descent

Patrilineal - affiliates a person with the group of relatives through his or her
father.

Matrilineal - affiliates a person with the group of relatives through his or her
mother.

Bilateral - affiliates a person with a group of relatives both his and her
Parents
 Based on Authority/ Dominance

Patriarchal - authority is rested on the oldest male in the family, often the
father.

Matriarchal - authority is rested in the mother or mother’s kin.

Egalitarian - the husband and the wife exercise more or less equal amount of
authority.

Matricentric - prolonged absence of the father gives the mother a dominant

position in the family, although the father may also share with the mother in
decision-making.
 Family function
Provides the individual with the necessary environment for development and
social interaction
➢ Physical
➢ Economic
➢ Reproductive
➢ Affective and Coping
➢ Socialization
 FILIPINO
FAMILIES
● In the Philippines, many social changes have affected the family. In the past
decade, there has been a sharp increase in The member of men and women
working abroad. Today, there are more women who work outside the homes than
in the past. In many cases, it is the husbands who stay at home and performed the
task that traditionally associated with women.

● However in many families were both the husband and the wife are working it is
still the latter who does the most household chores. Caring for family members
particularly the sick is still domain of women.

● An increase in the population of nuclear families and single parent households has
been noted.
● The migration of young people to urban centers has resulted on the loss of
network of support system, primary concept of relatives.

● Migration and urbanization have also caused a number of problems such as

housing shortage, overcrowding, and poor environment sanitation, which in turn
have resulted in a number of health problems.

● The changes in the definition, composition and context of the family have not
changed the essence of its health tasks and its capacity to remain as the primary
source to its members. All things bring equal or comparable families with
absentee heads (mother and/or father) are more likely to be more handicapped
than those with mothers and father.
 Health task of the family

1. recognizing interruptions of health or development

2. seeking health care
3. managing health and non-health crises
4. providing nursing care to the sick, disabled and dependent member of
the family
5. maintaining a home environment conducive to good health and personal
development
6. maintaining a reciprocal relationship with the community and health
institution
 Characteristic of asian including filipino family

1. Strong family ties – tendency to cling together in their activities and feelings.

2. Strong loyalty – the interest of the individual is often sacrificed for the welfare of the
group. Each member is duty bound to help others in case of need.

3. Usually an extended type and therefore big. Another reason for its size is that children
are desired and the masses usually not practice family planning.

4. Support of the family falls on the father’s shoulder while caring and upbringing of the
children become the mother’s responsibility, although may wives now work to help the
household expenses.

5. Parents sometimes show favoritism for the eldest and youngest. Discipline is
inconsistent, alternating bet indulgent and strictness.
6. In the Filipino families, kinship ties are extended to include the “compadre” or sponsors – who are
suppose to act as 2 nd parents to the child. There is also the courtesy relationship where children of
close friends are looked upon as nephews and nieces. The children usually address the adults as “tiyo
or tiya”.

7. The patriarchal family system is followed which may account for close family ties. The oldest man
in the family usually rules and he wield tremendous authority in the group. The son who marries may
take his wife to the parent’s home. The parents of the groom assume the expenses for the wedding.

8. Land and property keep the family group intact and loyal to one another. Property is held in
common and not disposed of except in due necessity or for family welfare. Asian family’s vale land as
it represents life and stability and hold generations together. Transmitted from generations to
generations, land becomes a symbol of unity and reminder of common ancestry. Land serves as the
connecting link between the new and old generations

9. In the Asian family, a great difference exists in the roles of men and women. A women’s position in
the home and society is much lower than men. This is not so with Filipino family where a much higher
regard is attributed to the Filipino woman, especially with the changing roles and functions of the
family.
 FAMILY DEVELOPMENTAL TASK

Beginning Family - occurs as the couple establish a home after marriage or

after a couple made a commitment to each other to live together.

Childbearing Families- begins with the birth of the first child and ends
when that child is 2 ½ y/o. Integration of the new baby into the family is a
major task as well as making the transition to parenthood

Families with PreSchool Children- this stage begins when the first child is
2 ½ & ends at age of 5
 FAMILY DEVELOPMENTAL TASK
Families with School age Children - begins when the eldest is 6 and
continue until the child reaches adolescence at the age of 13

Families with Teenagers - the length varies depending on the age of the
oldest child when he or she leaves the family home

Families launching Young Adult- start when the first child leaves home and
is finished when the last child leave home

Middle-Aged Families- start when the last child leave home and continues
until one patient retires or dies

Aging Family- begins with retirement of one or both of the spouses and
continue has to find satisfying alternative to work
intervention
wheel
Public Health Intervention wheeL

Public Health Intervention Model

was initially proposed in the late 1990s by
nurses from the Minnesota Department of
Health to describe the breadth and scope
of public health nursing practice

This model was later revised and

termed the Intervention Wheel and it has
become increasingly recognized as a
framework for community and public
health nursing practice.
Public Health Intervention wheeL

Intervention Wheel contains three important

elements:

1. It is population based
2. It contains three levels of practice;
a. Community
b. Systems, and
c. Individual/family
3. It identifies and defines 17 public
health interventions.
Public Health Intervention wheeL

Levels of Practice

1. SYSTEM - Intervention in a system

that would affect the health of the
Population
2. COMMUNITY- Intervention to an
entire population within the
community
3. INDIVIDUAL/FAMILIES-
Intervention to an individual and
families within the population.
Public Health Intervention wheeL

5 Intervention Wedges

1. Red Wedge
a. Surveillance
b. Disease and Health
Investigation
c. Outreach
d. Screening
e. Case Finding
Public Health Intervention wheeL

5 Intervention Wedges

2. Green Wedge

a. Referral and Follow-up

b. Case Management
c. Delegation Functions
Public Health Intervention wheeL

5 Intervention Wedges

3. Blue Wedge

a. Health Teaching
b. Counseling
c. Consultation
Public Health Intervention wheeL

5 Intervention Wedges

4. Orange Wedge

a. Collaboration
b. Coalition-Building
c. Community Organizing
Public Health Intervention wheeL

5 Intervention Wedges

5. Yellow Wedge

a. Advocacy
b. Social Marketing
c. Policy Development &
Enforcement
 Surveillance monitors health events

Disease and other Systematically gathers and analyzes data regarding threats to the health of
health event populations
investigation

Outreach Locates populations of interest or populations at risk

Screening Identifies individuals with unrecognized health risk factors

Case finding identifies risk factors and connects them with resources

Referral and Assists individuals, families, groups, organizations, and/or communities to

follow-up identify and access necessary resources
 Care Management Optimizes self-care capabilities of individuals and families.

Delegated Functions direct care tasks that the nurse carries out.

Health teaching Communicates facts, ideas, and skills that change knowledge,
attitudes, values, beliefs, behaviors and practices of individuals,
families, system, and/or communities.

Counseling Establishes an interpersonal relationship with the intention of

increasing or enhancing their capacity for self-care and coping.

Consultation Seeks information and generates optional solutions to to

perceived problems.
Collaboration Working together with one or more people to complete a project or
task.

Coalition building Promotes and develops alliances among organizations or

constituencies for a common purpose

Community organizing Helps community groups to identify common problems or goals .

Advocacy Pleads someone’s cause or acts on someone’s behalf, with a focus on

developing the community, system, and individual or family’s capacity to
plead their own cause or act on their own behalf

Social marketing Utilizes commercial marketing principles and technologies for programs
designed to influence the knowledge, attitudes, values, beliefs, behaviors,
and practices of the population of interest

Policy development Places health issues on decision makers’ agendas, acquires a plan of
resolution, and determines needed resources, resulting in laws, rules,
and enforcement regulations, ordinances, and policies.
PREpayme
nt
mechanism
in CHN
★ Community health nursing services are generally free at
the point of care.
★ The prepayment mechanism provides for the means to
“socialize” health services.
 “IT IS OUR DUTY TO LOVE
THE UNLOVED, HELP THE
HELPLESS, AND BRING HOPE
TO THE HOPELESS.”
THANK
YOU!!!!