COMMUNITY HEALTH NURSING

- MR. GERARDO DYERI P. ANDAMO R.N.

COMMUNITY HEALTH NURSING: AN OVERVIEW
Defning Communit H!"#t$ Nu%&in' (CHN)
What is a community?
a group of people with common characteristics or interests living together
within a territory or geographical boundary
COMMUNITY AS CLIENT / PATIENT IN CHN
World Views on Community:
1. The community i !n integ"!# $!"t o% ociety !n& i com$oe& o%
%!mi#ie
'. Cont"!&iction/con(ict !"e inhe"ent in ! community
). The community i !#*!y in t!te o% continuou mo+ement !n&
ch!nge
COMMUNITY AS SETTIN, IN CHN P-ACTICE
- place where people under usual or normal conditions are found
(homes, schools and places of work)
- outside of purely curative institutions
What is health?
*. H!"#t$-i##n!&& +ontinuum mo,!#
He!#th i ! &yn!mic t!te !t !ny $oint .et*een o$tim!# *e##ne
!n& &e!th/ ! .!#!nce .et*een inte"n!# !n& e0te"n!# en+i"onment
Ho#itic ! it "e(ect $hyic!#1 emotion!#1 inte##ectu!#1
&e+e#o$ment!#1 oci!# !n& $i"itu!# &imenion
-. Hi'$-#!.!# /!##n!&& mo,!#
mo&e# "ecogni2e he!#th ! !n ongoing $"oce to*!"& ! $e"on3
highet $otenti!# o% %unctioning
0. A'!nt-$o&t-!n.i%onm!nt (E1i,!mio#o'i+)
mo,!#
The !gent1 hot !n& en+i"onment inte"!ct in *!y th!t c"e!te "i4
%!cto"1 !n& un&e"t!n&ing thee i im$o"t!nt %o" the $"omotion !n&
m!inten!nce o% he!#th
2. H!"#t$ 3!#i!4 mo,!#
Peo$#e t!4e $"e+enti+e !ction i% the th"ee con&ition e0it5
Se"ioune o% the &ie!e
Suce$ti.i#ity to the &ie!e
Cot e6ecti+ene o% the $"e+enti+e !ction
5. E.o#ution"%-3"&!, mo,!#
I##ne !n& &e!th ometime e"+e !n e+o#ution!"y $u"$oe
6. H!"#t$ 1%omotion mo,!#
"e%e" to the $o#icie1 !cti+itie !n& co&e o% $"!ctice !ime& !t
$oiti+e#y enh!ncing *e##7.eing
7. WHO ,!8nition
Not me"e#y the !.ence o% &ie!e
The t!te o% com$#ete $hyic!#1 ment!# !n& oci!# *e##7.eing
A oci!# $henomenon
1
An outcome o% the inte"$#!y o% .io#ogic!#1 $hyic!#1 eco#ogic!#1
$o#itic!#1 economic1 !n& ocio7cu#tu"!# %!cto"
What is community health ?
- $!"t o% $!"!me&ic!# !n& me&ic!# inte"+ention/!$$"o!ch *hich i
conce"ne& on the he!#th o% the *ho#e $o$u#!tion
- !im5
1. $"omotion o% he!#th
'. $"e+ention o% &ie!e
). m!n!gement o% %!cto" !6ecting he!#th
In&i+i&u!# APPLIED STUDY Community
An!tomy St"uctu"e Demog"!$hy
Phyio#ogy 8unction Socio#ogy
P!tho#ogy M!#%unction E$i&emio#ogy
Pu3#i+ H!"#t$ 9&efnition:
Winslow
7 cience !n& !"t o% $"e+enting &ie!e1 $"o#onging #i%e1 $"omoting he!#th !n&
e;ciency th"ough o"g!ni2e& community e6o"t to enu"e e+e"yone ! t!n&!"&
o% #i+ing !&e<u!te %o" the m!inten!nce o% he!#th1 o o"g!ni2ing thee .eneft
! to en!.#e e+e"y citi2en to %!"#i9! $i& 3i%t$%i'$t o4 $!"#t$ "n,
#on'!.it
Hanlon
7 &e&ic!te& to the common !tt!inment o% the highet #e+e# o% $hyic!#1 ment!#
!n& oci!# *e##7.eing !n& #onge+ity conitent *ith !+!i#!.#e 4no*#e&ge !n&
"eou"ce !t ! gi+en time !n& $#!ce to*!"& mo&t !:!+ti.! tot"#
,!.!#o1m!nt #i%e o% the in&i+i&u!# !n& ociety
Purdom
7 $"io"iti2e u"+i+!# o% hum!n $ecie !n& "ecogni2e th!t e!ch $h!e in
hum!n &e+e#o$ment i o% e<u!# im$o"t!nce *ith the othe" $h!e
What is nursing ?
!iting ic4 in&i+i&u!# to .ecome he!#thy !n& he!#thy in&i+i&u!#
!chie+e o$timum *e##ne 9Hen&e"on:
e#%7c!"e 9O"em:
$#!cing the in&i+i&u!# in !n en+i"onment th!t *i## m!0imi2e hi
c!$!city %o" e#%7"e$!i"
What is Community Health Nursing=
>The uti#i2!tion o% the nu"ing $"oce in the &i6e"ent #e+e# o%
c#iente#e7in&i+i&u!#1 %!mi#ie1 $o$u#!tion g"ou$ !n& communitie1
conce"ne& *ith the $"omotion o% he!#th1 $"e+ention o% &ie!e !n&
&i!.i#ity !n& "eh!.i#it!tion.?
- Maglaya, et al
,o!#5 >To "!ie the #e+e# o% citi2en"y .y he#$ing communitie !n&
%!mi#ie to co$e *ith the &icontinuitie in !n& th"e!t to he!#th in uch
! *!y ! to m!0imi2e thei" $otenti!# %o" high7#e+e# *e##ne?
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7 Nisce, et al
Communit H!"#t$ Nu%&in' 9&efnition:5
WHO Expert Committee on Health
$eci!#i2e& fe#& o% nu"ing th!t com.ine the 4i## o% nu"ing1 $u.#ic
he!#th !n& ome $h!e o% hum!n !it!nce !n& %unction
Jacoson
$"omotion o% c#ient3 o$timum #e+e# o% %unctioning th"ough te!ching !n&
&e#i+e"y o% c!"e
!reeman
&e+e#o$ing !n& enh!ncing he!#th c!$!.i#itie o% $eo$#e
;"&i+ Con+!1t& o4 CHN
1. P"im!"y %ocu i he!#th $"omotion !n& &ie!e $"e+ention.
'. P"!ctice e0ten& %"om in&i+i&u!# to %!mi#y1 $o$u#!tion g"ou$ !n&
community.
). CHNu"e !"e gene"!#it
@. Cont!ct *ith c#ient continue th"ough time !n& !## ty$e o% he!#th c!"e
A. N!tu"e o% $"!ctice "e<ui"e !$$#ic!tion o% conce$t o% +!"iou cience
B. im$#icit in CHN i the nu"ing $"oce.
;"&i+ P%in+i1#!& o4 CHN
1. The community i the 1"ti!nt in CHN1 the "amily i the unit o% c!"e !n&
the"e !"e %ou" #!.!#& o4 +#i!nt!#!: individual, family, population group
9thoe *ho h!"e common ch!"!cte"itic1 &e+e#o$ment!# t!ge !n&
common e0$ou"e to he!#th $"o.#em C e.g. chi#&"en1 e#&e"#y:1 !n& the
community.
'. In CHN1 the c#ient i coni&e"e& ! !n ACTIVE $!"tne" NOT PASSIVE
"eci$ient o% c!"e
). CHN $"!ctice i !6ecte& .y &e+e#o$ment in he!#th techno#ogy1 in
$!"ticu#!"1 ch!nge in ociety1 in gene"!#
@. The go!# o% CHN i !chie+e& th"ough mu#ti7ecto"!# e6o"t
A. CHN i ! $!"t o% he!#th c!"e ytem !n& the #!"ge" hum!n e"+ice ytem.
<! P%in+i1#!& o4 CHN
1. Nee& o% c#ient $"o+i&e .!i %o" CHN $"!ctice
'. O.Decti+e !n& $o#icie %!ci#it!te go!# !chie+ement
). 8!mi#y i the unit o% e"+ice
@. -e$ect +!#ue1 cutom !n& .e#ie% o% c#ient
A. He!#th e&uc!tion !n& coune#ing !"e +it!# $!"t o% CHN
B. Co##!.o"!ti+e *o"4ing "e#!tionhi$ *ith the he!#th te!m %!ci#it!te go!#
!chie+ement
E. Pe"io&ic !n& continuing e+!#u!tion i nece!"y
F. Continuing t!6 e&uc!tion $"og"!m enu"e <u!#ity c!"e !n& u$g"!&e
nu"ing $"!ctice
G. In&igenou !n& e0iting community "eou"Ace mut .e uti#i2e&
1H.Peo$#e mut !cti+e#y $!"tici$!te in &eciion7m!4ing
11.Nu"ing u$e"+iion $"o+i&e gui&!nce !n& &i"ection to *o"4
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1'. Accu"!te "eco"&ing !n& "e$o"ting e"+e ! .!e %o" e+!#u!tion !n& gui&e
%o" %utu"e !ction.
R!&1on&i3i#iti!& o4 CHN
.e ! $!"t in &e+e#o$ing !n o+e"!## he!#th $#!n1 it im$#ement!tion !n&
e+!#u!tion %o" communitie
$"o+i&e <u!#ity nu"ing e"+ice to c#iente#e .!e& on t!n&!"& et %o"
CHN $"!ctice
m!int!in coo"&in!tion/#in4!ge *ith othe" he!#th te!m mem.e"1
N,O/go+e"nment !gencie in the $"o+iion o% $u.#ic he!#th e"+ice
con&uct "ee!"che "e#e+!nt to CHN e"+ice to im$"o+e $"o+iion o%
he!#th c!"e
$"o+i&e o$$o"tunitie %o" $"o%eion!# g"o*th !n& continuing e&uc!tion
th"ough t!6 &e+e#o$ment
O;=ECTIVES> STRATEGIES AND METHODOLOGIES IN CHN
St%"t!'i!& "n, H!"#t$ St"tu& T"%'!t& to A+$i!.! O3?!+ti.!&
#trategies to promote e$uity in health
priority for the vulnerable and marginalized
primary Health Care as the Key Approach
HEALTH PROMOTION
7 Conit o% !cti+itie &i"ecte& to*!"& inc"e!ing the #e+e# o% *e##7
.eing !n& !ctu!#i2ing the he!#th $otenti!# o% in&i+i&u!#1 %!mi#ie1
communitie !n& ocietie.
M!t$o,&:
He!#th e&uc!tion
Nut"ition
Pe"on!#ity &e+e#o$ment
A&e<u!te houing1 "ec"e!tion1 !g"ee!.#e *o"4ing con&ition
,enetic coune#ing
Pe"io&ic e#ecti+e e0!min!tion
DISEASE PREVENTION
P-IMA-Y LEIEL O8 DISEASE P-EIENTION
7 conit o% !cti+itie &i"ecte& to*!"& &ec"e!ing $"o.!.i#ity o% $ecifc
i##nee o" &y%unction in in&i+i&u!#1 %!mi#ie !n& communitie
%hrough people
immuni2!tion
chemo$"o$hy#!0i
nut"ition
$e"on!#ity &e+e#o$ment
$e"on!# hygiene
chi#& $!cing
$"otection !g!int c!"cinogen !n& !##e"gen
En&ironmental control
!%e *!te" u$$#ie
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goo& %oo& hygiene
!%e e0c"et! !n& "u..ih &i$o!#
&iin%ection !n& te"i#i2!tion
+ecto" !n& !nim!# "ee"+oi" cont"o#
goo& #i+ing n!g *o"4ing con&ition
SECONDA-Y LEIEL O8 DISEASE P-EIENTION
7em$h!i2e e!"#y &i!gnoi !n& $"om$t inte"+ention to h!#t
$!tho#ogic!# $"oce1 the"e.y ho"tening it &u"!tion !n& e+e"ity !n&
en!.#ing in&i+i&u!# "eg!in no"m!# %unction !t the e!"#iet $oi.#e time.
creening
7 the $"eum$ti+e i&entifc!tion o% un"ecogni2e& &ie!e o" &e%ect .y
the !$$#ic!tion o% tet1 e0!min!tion o" othe" $"oce&u"e th!t c!n .e !$$#ie&
"!$i&#y !n& ine0$eni+e#y to $o$u#!tion
creening !ethods"
m! c"eening
c!e7fn&ing
cont!ct7t"!cing
mu#ti7$h!ic c"eening
u"+ei##!nce
Characteristics o" an ideal screening test:
High eniti+ity
High $ecifcity
TE-TIA-Y LEIEL O8 DISEASE P-EIENTION
7 Come into $#!y *hen ! &e%ect o" &i!.i#ity i f0e&. -eh!.i#it!tion
go!# i mo"e th!n h!#ting the &ie!e $"oce ite#%3 it i "eto"ing the
in&i+i&u!# to !n o$timum #e+e# o% %unctioning *ithin the cont"!int o%
&i!.i#ity.
Methods:
Di!gnoi
T"e!tment
M!n!gement
-eh!.i#it!tion
' (e&els o" Pre&ention
P-IMA-Y LEIEL
Health #romotion
and $llness
#revention
SECONDA-Y LEIEL
#revention of
Complications thru
%arly &' and ('
TE-TIA-Y LEIEL
#revention of
&isability, etc)
P"o+i&e& !t C
He!#th c!"e/-HU
J"gy. He!#th
St!tion
M!in He!#th
Cente"
Community
Khen ho$it!#i2!tion
i &eeme&
nece!"y !n&
"e%e""!# i m!&e to
eme"gency 9no*
&it"ict:1 $"o+inci!#
o" "egion!# o"
Khen high#y7
$eci!#i2e& me&ic!#
c!"e i nece!"y
"e%e""!# !"e m!&e
to ho$it!# !n&
me&ic!# cente"
uch ! P,H1 PHC1
5
Ho$it!# !n&
He!#th Cente"
P"i+!te !n& Semi7
$"i+!te !gencie
$"i+!te ho$it!# POC1 N!tion!#
Cente" %o" Ment!#
He!#th1 !n& othe"
go+3t $"i+!te
ho$it!# !t the
munici$!# #e+e#
COMMUNITY ORGANI@ING
Continuou !n& ut!ine& $"oce o% "!iing the #e+e# o% !*!"ene1
o"g!ni2ing !n& mo.i#i2ing
*evels of Awareness"
Po#itic!# oci!#i2!tion
Po#itic!# mo.i#i2!tion
Inte"et !gg"eg!tion
Inte"et !"ticu#!tion
Cu#tu"e o% i#ence/$!i+ity
)asic concepts and principles:
1. o.Decti+e !n!#yi o% o.Decti+e con&ition
'. .!ic t"ut on the $eo$#e
). %"om1 %o"1 .y !n& *ith the $eo$#e
@. $eo$#e *!nt !n& c!n ch!nge
A. e#%7*i##e& ch!nge !"e mo"e me!ning%u# !n& $e"m!nent th!n
im$oe& ch!nge
Cont!At o4 CO5 Cu""ent itu!tion
Go"# o4 CO5 Community &e+e#o$ment
PRIMARY HEALTH CARE
PHC *! &ec#!"e& in the ALMA ATA CON8E-ENCE in 1GEF1 ! ! t"!tegy to
community he!#th &e+e#o$ment. It i ! strategy aimed to pro&ide
essential health care that is:
Community7.!e&
Accei.#e
P!"t !n& $!"ce# o% the tot!# ocio7economic &e+e#o$ment e6o"t o% the
n!tion
Acce$t!.#e
Sut!in!.#e !t !n !6o"&!.#e cot.
B%"m!/o%C
Peo$#e3 Em$o*e"ment !n& P!"tne"hi$ i the
Ley St"!tegy to !chie+e the go!#1 H!"#t$ Bo% "## Bi#i1ino& 3 t$! !"%
-DDD
An, H!"#t$ in t$! H"n,& o4 t$! P!o1#! 3 t$! !"% -D-D
WHA( &+% %%,($A* H%A*(H CA-% $, PHC !%A,?
It t!n& %o"5 E&uc!tion o% $"e+!i#ing He!#th P"o.#em
Loc!##y7en&emic Die!e P"e+ention !n& Cont"o#
E0$!n&e& P"og"!m o% Immuni2!tion
M!te"n!# !n& Chi#& He!#th !n& 8!mi#y P#!nning
En+i"onment!# S!nit!tion !n& S!%e K!te" Su$$#y
Nut"ition !n& 8oo& Su$$#y
T"e!tment o% Communic!.#e M Non7communic!.#e
Die!e/ Con&ition
Su$$#y !n& P"o$e" ue o% Eenti!# D"ug !n& He".!#
Me&icine
6
Dent!# He!#th P"omotion
Acce to !n& ue o% ho$it!# ! Cente" o% Ke##ne
Ment!# He!#th P"omotion
Pi##"%& (m"?o% !#!m!nt&):
A. Mu#ti7ecto"!# !$$"o!ch
Inte"ecto"!# #in4!ge
Int"!ecto"!# #in4!ge
J. Community P!"tici$!tion
-ungs of #eoples #articipation"
,enuine P!"tici$!tion
To4en P!"tici$!tion
Non7$!"tici$!tion
#hases of C+ in Health"
Soci!# In+etig!tion
Ent"y to the community
Soci!# $"e$!"!tion
Community integ"!tion
Sm!##7g"ou$ %o"m!tion
CHK e#ection
L!unching o% o"g!ni2!tion
Community &i!gnoi
T"!ining !n& Se"+ice
Co"e7g"ou$ %o"m!tion
PHASE OUT
C. A$$"o$"i!te Techno#ogy
7 metho& ue& to $"o+i&e ! oci!##y !n& en+i"onment!##y !cce$t!.#e
#e+e# o% e"+ice o" <u!#ity $"o&uct !t the #e!t economic cot.
Criteria: Be!i.#e
Acce$t!.#e1 A6o"&!.#e
Com$#e0
E6ecti+e
S!%e
Sco$e7*ie
*+ ME,-C-N.( P(.N%#:
L!gun&i S!m.ong
U#!!ming7J!to Am$!#!y!
;!*!ng Niyog7niyog!n
;!y!.! T!!ng gu.!t
Ye".!7.uen! A4!$u#4o
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