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Community Health Nursing Review Part 1

Community Health Nursing Review Part 1

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Published by yunjung0518
A Short review about CHN.
A Short review about CHN.

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Published by: yunjung0518 on Jul 07, 2009
Copyright:Attribution Non-commercial


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Community a body of people living in a certain area and having common rights,responsibilities and interests.
Health – is defined as a “state of complete physical, mental, and social well-being, notmerely the absence of disease or infirmity (WHO.)”
Nursing – is primarily assisting the individual (sick or well) in the performance of thoseactivities contributing to health or its recovery (to a peaceful death) that he would performunaided if he had the necessary strength, will or knowledge.It is likewise the unique combination of nursing to help the individual to beindependent of such assistance as soon as possible (Virginia Henderson, 1958.)
Community Health Nursing – refers to a “service rendered by a professional nurse withcommunities, groups, families, individuals at home, in health centers, in clinics, in schools,in places of work for the PROMOTION of HEALTH, PREVENTION of ILLNESS, CARE of the sickat home and REHABILITATION.” (Ruth B. Freeman, one of the famous definitions of CHN)
Community Health Nursing is broader than public health nursing because itencompasses ‘nursing practice in a wide variety of community services and consumeradvocate areas, and in a variety of roles, at times including independent practice…community nursing is certainly not confined to public health nursing agencies. (Jacobson,1975: 6)
Public Health – the classic definition of public health comes from Dr. C. E. Winslow. Hedefines public health as the ‘science and art of preventing disease, prolonging life,promoting health and efficiency through organized community effort for the sanitation of the environment, control of communicable diseases, the education of individuals inpersonal hygiene, the organization of medical and nursing services for the early diagnosisand preventive treatment of disease, and the development of the social machinery toensure everyone a standard of living adequate for the maintenance of health, soorganizing these benefits as to enable every citizen to realize his birthright of health andlongevity.
Public Health – is defined by WHO as the ‘art of applying science in the context of politicsso as to reduce inequalities in health while ensuring the best health for the greatestnumber.’
Public Health Nursing refers to the practice of nursing in local/national healthdepartments (which includes health centers and rural health units) and schools. It is acommunity health nursing practiced in the public sector.
Public Health Nursing – The WHO Expert Committee of Nursing defined PHN as a ‘specialfield of nursing that combines the skills of nursing, public health and some phases of socialassistance and functions as part of the total public health programme for the promotion of health, the improvement of the conditions in the social and physical environment,rehabilitation of illness and disability.’
Public Health Nursing was coined by LILIAN WALD when she was director of the HenryStreet Settlement in New York City to denote a service that was available to all people.However, as federal, state and local governments increased their involvement in thedelivery of health services, the term public health nursing became associated with ‘public’or government agencies and in turn with the care of the poor people.’
Public Health Nurses – refer to the nurses in the local/national health departments orpublic schools whether their official position title is Public Health Nurse or Nurse or SchoolNurse.
Nursing Service – is a separate and distinct unit of the local health agency/ unit which iscomposed of nurses, midwives and auxiliaries such as barangay health workers, nursingaides and volunteers.
 The Central Focus of Nursing – is care provided to the people.- is man in his entirety.- is on man, sick or well, of any age, race or creed and at anysetting.
HEALTH PROMOTION and EDUCATION: The prominence of Health Promotion came about as a result of the changing patterns of health and the corresponding emphasis on “life style” as a factor.Life style is a composite expression of the social and cultural circumstances that conditionand constrain behavior. The behavioral change that health education is able to effect can only be “maintained” if supportive environment were provided through the effort of other sectors-political, economic,social, biomedical etc. (Green). The first use of the term Health Promotion occurred in 1945 when Henry E. Sigerist, thegreat medical historian defined the four major tasks of medicine as 1.) The promotion of health;2.) The prevention of illness; 3.) The restoration of the sick and 4.) Rehabilitation.According to him, ‘health is promoted by providing a decent standard of living, good laborconditions, education, physical culture, means of rest and recreation.’ These concepts are fond inthe OTTAWA CHARTER for HEALTH PROMOTION which occurred 40 years later.In 1986, the WHO, Health and Welfare Canada and the Canadian Public Health Associationorganized an International Conference on Health Promotion. The Conference came out with whatis now popularly known as the Ottawa Charter for health promotion which was adopted by 212participants from 38 countries. This charter remained to be the guiding principle in healthpromotion efforts currently. The OTTAWA CHARTER for HEALTH PROMOTION:Ottawa Charter defines HEALTH PROMOTION broadly, as the process of enabling people toincrease control over and to improve their health.’ To reach a state of complete physical, mentaland social well-being, and individual or group must be able to IDENTIFY and to REALIZEASPIRATION, to SATISFY NEEDS, and to CHANGE or COPE with the ENVIRONMENT.Health is seen as a resource of everyday life, not the objective of living.Health is a positive concept, emphasizing social and personal resources, as well asphysical capacities.Health Promotion is not just the responsibility of the health sector, but goes beyondhealthy lifestyles to well-being.BASIC PREREQUISITE for HEALTH:1.Peace6. A stable eco-system2.Shelter7. Sustainable resources3.Education8. Social justice4.Food9. Equity5.Income To operationalize the concept of Health Promotion, the Ottawa Charter recommend the followingaction areas:1.
Build Healthy Public Policy.
Health promotion goes beyond health care. It puts healthon the agenda of policy makers in all sectors and at all levels direction them to be awareof the health consequence of their decisions and to accept their responsibilities for health.2.
Creative Supportive Environments.
 The overall guiding principle for the world, nations,regions, and communities alike, is the need to encourage reciprocal maintenance-to-takecare of each other, our communities and our natural environment.3.
Strengthen Community Action.
Health promotion works through concrete and effectivecommunity action in setting priorities, making decisions, planning strategies andimplementing them to achieve better health.4.
Develop Personal Skills.
Health promotion supports personal and social developmentthrough providing information, education for health, and enhancing life skills.
Reorient Health Services.
Reorienting health services require stronger attention tohealth research as well as changes in professional education and training. This must leadto a change of attitude and organization of health services which refocuses on the totalneeds of the individual as a whole person. The WHO cites the following principles of Health Promotion:1.HP involves the population as a whole in the context of their everyday life, rather thanfocusing on people at risk from specific disease.2.HP is directed towards action on the determinants of health.3.HP combines diverse, but complementary methods or approaches, includingcommunication, education, legislation, fiscal development and spontaneous local activitiesagainst health hazards.4.HP aims particularly at effective and concrete public participation.5.HP is primarily a societal venture and not a medical service although health professionalshave an important role in advocating and enabling health promotion. The WHO adopts an ecologic view of Health Promotion and state that it is “mediatingstrategy between people and their environments, synthesizing personal choice and socialresponsibility in health.”HEALTH EDUCATION any combination of learning experiences designed to facilitatevoluntary adoptions conducive to health. (Green et al 1980)HEALTH EDUCATION – the process of assisting individuals, acting separately or collectively,to make informed decisions about matters affecting the personal health and that of others.(The National Task Force on the Preparation and Practice of Health Educators, 1983)HEALTH EDUCATION can take place in various settings:1.In health care setting such as health centers, clinics, hospital, health maintenanceorganizations.2.Schools where desirable health behaviors is installed from the grades up through healthteachings, supportive hygienic school environment, school health services, teacherstraining and the training of health professionals.3.Communities, where through the community organization approach, communities are ableto identify their health problems.4.The worksites such as industries, offices, food establishment, entertainmentestablishment, hotels etc.HEALTH PROMOTION MODEL (NOLA J. PENDER)Pender’s first encounter with professional nursing occurred at the age of seven (7) whenshe observed the nursing care given to her hospitalized aunt – influenced her belief that the goalof nursing was to help people care for themselves – conceptualized HEALTH PROMOTION MODEL.Pender was born in 1941 in Lansing, Michigan.She was the only child of parents who were advocates of education for women.Attended the School of Nursing at West Suburban Hospital in Oak Park, Illinois.She received her nursing diploma in 1962 and began working on a medical-surgical unitand subsequently in a pediatric unit in a Michigan Hospital.In 1964, Pender completed her BSN at Michigan State University in East Lansing.She earned her M.A. in ‘human growth and development’ from Michigan State University inEEvanston, Illinois.Health Promotion – is motivated by the desire to increase well-being and actualize humanpotential.

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