COMMUNITY HEALTH NURSING

II (NCM 113)

IVY CLAIRE MOSURA-DIZON,R.N

CLINICAL INSTRUCTOR
 Definition
• COMMUNITY- A group people living in the
same place or having a particular characteristics
in common.
• HEALTH- A state of complete physical, mental,
and social well-being and not merely the
absence of disease or infirmity.
• NURSING- The profession or practice of
providing care for the sick and infirm.
 COMMUNITY HEALTH NURSING

• Community health nursing- is the field of

nursing in which the family and community
are the patients/clients. Although it is
concerned with the total health illness
spectrum, its primary focus is on the
prevention of diseases and the promotion and
maintenance of the highest level of health and
well-being.
 PHILOSOPHY AND PRINCIPLES
• What are the philosophy and principles of
community health nursing?
• Community- based nursing is a philosophy of
care that is characterized by collaboration,
continuity of care, client and family
responsibility for self-care, and preventive
health care (Hunt, 2005).
 PRINCIPLES OF CHN
• To promote, protect and preserved the health.
• Promote, protect and preserve the environment which contribute to the health.
• To support others health team members.
• To provide care for community people.
• To promote cleanliness and prevention of spread of diseases to the environment.
• Respect the rights of the client and care giver and nurses should focuses on the
linkage between health and illness.
• To achieve the client good health.
• Advocate for healthy public policy.
• Co-operate, co-ordinate and collaborate with the patients.
• Community health nursing is enable the system that support health that contribute
to health for all.
• Community health nursing is refers to the check of the society and society people
health status.
• To determine the health status of community people.
 THEORETICAL MODELS/APPROACHES

• As by the INTERNATIONAL COUNCIL OF NURSES (ICN,

1973) as written by Virginia Henderson: The unique
function of the nurse is to assist the individual, sick
or well, in the performance of those activities
contributing to health. Its recovery, or to a peaceful
death that the client would perform unaided if he
had the necessary strength, will or knowledge.
• Help the client gain independence as rapidly as
possible.
 HISTORICAL PERSPECTIVES ON NURSING
THEORY

• Many scholars agree that Florence Nightingale was the first nurse to
formulate a conceptual foundation for nursing practice.
• Nightingale believed that clean water, clean linen, access to adequate
sanitation and a quiet environment would improve health outcomes and
she put these beliefs into practice during Crimean War.

• From 1980 onwards, several nursing theorists, Dorothy Johnson, Sister

Callista Roy, Imogene King, Betty Neuman and Jean Watson among them,
have included COMMUNITY perspectives in their definition of health.
 THEORETICAL MODELS/APPROACHES

• The Health Belief Model- Proposed initially in 1958.

• states that people's beliefs influence their health-related actions or
behaviors. Individuals will likely take action when experiencing a personal
threat or risk, but only if the benefits of taking action outweigh the
barriers, whether real or perceived.
• 1. Perceived Susceptibility An individual’s assessment of their chances of getting a
disease or condition.
• 2.Perceived Severity An individual’s judgment of the severity of the disease
• 3.Perceived Benefits An individual’s conclusion as to whether the new behavior is
better than what they are already doing
• 4.Perceived Barriers An individual’s opinion as to what will stop them from
adopting the new behavior
• 5.Cues to Action Factors that trigger behavior change
• 6.Self-efficacy Personal belief in the ability to do something
 THEORETICAL MODELS/APPROACHES

• Milio’s Framework for Prevention (1976)

-Described a sometimes neglected role of community health
nursing to examine the determinants of a community's health
and attempt to influence those determinants through public
policy.
• Nancy Milio proposed that health deficits often result from an
imbalance between a population’s health needs and it’s
health-sustaining resources.
 APPLICATION OF MILLIO’S FRAMEWORK IN
PUBLIC HEALTH NURSING
• PROPOSITION SUMMARY • POPULATION HEALTH EXAMPLES
1. Population health deficits result - Individuals and families living in
from deprivation and or excess of poverty have poorer health status
critical health resources. compared with middle and upper
class individuals and families.
2. Behaviors of populations result from - Positive and negative lifestyle choices
selection from limited choices. are strongly dependent on culture,
socioeconomic status, and
educational level.
3. Organizational decisions and policies
- Health insurance coverage and
dictate many of the options
availability are largely determined
available to individuals and
and financed by the government
populations and influence choices.
through the NHIC (PHILHEALTH) and
private insurance.
 APPLICATION OF MILLIO’S FRAMEWORK IN PUBLIC
HEALTH NURSING

• PROPOSITION SUMMARY • POPULATION HEALTH EXAMPLES

4. Individual choices related to health - Choices and behaviors of individuals
promotion or health damaging are strongly influenced by desires,
behaviors are influence choices. values, and beliefs.
5. Alteration in patterns of behavior - Some behaviors such as tobacco use
resulting from decision making of a have become difficult to maintain in
significant number of people in a many settings in response to
population can result in social organizational and public policy.
change.
6. Without concurrent availability of - Addressing persistent health
alternative health promoting problems is hindered because most
options for investment of personal people are very aware of what causes
resources, health education will be the problem, but are reluctant to
largely ineffective in changing make lifestyle changes to prevent the
behavior pattern. condition.
 THEORETICAL MODELS/APPROACHES

• Nola Pender’s Health Promotion Model

- identifies factors that influence health behaviors.
Pender's Health Promotion Model is one of the most
widely used models to identify and change the
unhealthy behaviors and promote health.
• Developed in the 1980s and revised in 1996, (HPM)
explores many biopsychosocial factors that influence
individuals to pursue health promotion activities.
 Pender’s Health Promotion
• INDIVIDUAL BEHAVIOR-SPECIFIC COGNITIONS BEHAVIORAL OUTCOME
CHARACTERISTICS/EXPERIENCES AND AFFECT

Perceived benefits
of action

Perceived barriers to
Prior related
action
behavior

Perceived self-efficacy

Activity- related affect

Commitment
to a plan of Health
action Promoting
behavior
Interpersonal
influences
Personal
Factors

Situational
influences
 THEORETICAL MODELS/APPROACHES

• Lawrence Green’s Precede-Proceed Model

-Applies a medical perspective to public health, even though its focus is
health promotion, rather than treatment of disease. Just as a medical
diagnosis precedes treatment, the model assumes that a far-reaching
diagnosis should precede a public health intervention.
Precede- which stands for predisposing, reinforcing, and enabling constructs
in educational diagnosis and evaluation, is used for community diagnosis.
Proceed- an acronym for policy, regulatory, and organizational constructs in
educational and environmental development, is a model for implementing
and evaluating health programs based on PRECEDE.
 SUMMARY
• CHN have been instrumental in making many of life saving
advances in sanitation, communicable diseases and
environmental conditions that today’s society takes for
granted. Community health practice helps develop a broad
context of nursing practice because community environments
are inherently less restrictive than hospital settings.
• The nursing profession has advanced and with it so has the
need to develop nursing theories that formalize the scientific
base of community health nursing. The richness of community
health nursing comes from the challenge of conceptualizing
and implementing strategies that will enhance the health of
many people.
 DIFFERENT FIELDS
• SCHOOL HEALTH NURSING – is a specialty area in healthcare practice.
School nurses need education in specific areas, such as growth and
development, public health, mental health nursing, case management,
family theory, leadership, and cultural sensitivity, to effectively perform
their roles. They must work with children of different ages.
• OCCUPATIONAL HEALTH NURSING - The practice focuses on promotion
and restoration of health, prevention of illness and injury, and protection
from work-related and environmental hazards.
• COMMUNITY MENTAL HEALTH NURSING- is the application of knowledge
of psychiatric nursing in promoting and maintaining mental health of
community people, to help in early diagnosis and care and to rehabilitate
the clients after mental illness.
 CONCEPT OF THE COMMUNITY
1. TYPES OF COMMUNITIES
2. CHARACTERISTICS OF A HEALTHY COMMUNITY
3. COMPONENTS OF A COMMUNITY
4. FACTORS AFFECTING HEALTH OF THE COMMUNITY
- Characteristics of the population
- Location of the community
- Social system within the community
5. ROLES AND ACTIVITIES OF COMMUNITY HEALTH NURSE