COMMUNITY HEALTH NURSING 2:Levels of Clientele in CHN

- MR. GERARDO “DYERI” P. ANDAMO R.N.

 Individual
Basic approaches in looking at the individual:

 Holistic

 Atomistic
 Family
MODELS:
1. Developmental Model (Duvall)
Stages of Family Development
Stage 1 – The Beginning Family

Stage 2 – The Early Child-bearing Family

Stage 3 – The Family with Preschool Children

Stage 4 – The Family with School Age Children

Stage 5 – The Family with Teen-agers

Stage 6 – The Family as Launching Center

Stage 7 – The Middle-aged Family

Stage 8 – The Aging Family

Eight Family Tasks of the Developmental Model

1–
2–
3–
4–
5–
6–
7 --

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8–
2. Structural-Functional Model
Initial Data Base
 Family structure and Characteristics
 Socio-economic and Cultural Factors
 Environmental Factors
 Health Assessment of Each Member
 Value Placed on Prevention of Disease

First Level Assessment

 Health threats:
conditions that are conducive to disease, accident or failure to realize one’s health potential
 Health deficits:
instances of failure in health maintenance (disease, disability, developmental lag)
 Stress points/ Foreseeable crisis situation:
anticipated periods of unusual demand on the individual or family in terms of adjustment or
family resources

Second Level Assessment:

FAMILY TASKS:
 Recognition of the problem
 Decision on appropriate health action
 Care to affected family member
 Provision of healthy home environment
 Utilization of community resources for health care
Problem Prioritization:
Given Score
----------------------------- x weight
Highest possible score


Nature of the problem (1 )
Health deficit
Health threat
Foreseeable Crisis
 Modifiability (2)
Easily modifiable
Partially modifiable
Not modifiable
 Preventive potential (1)
High
Moderate
Low
 Salience (1)
High
Moderate
Low
The Family Service and Progress Record
The Family Case Study

 Population Group
Vulnerable Groups:
 Infants and Young Children

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  School age
 Adolescents
 Mothers
 Males
 Old People

Specialized Fields:

Community Mental Health Nursing

A unique clinical process which includes an integration of concepts from nursing, mental
health, social psychology, psychology, community networks, and the basic sciences
Focus:

Occupational Health Nursing

The application of nursing principles and procedures in conserving the health of workers
in all occupations
Aims:

School Health Nursing

The application of nursing theories and principles in the care of the school population
Components:
1. School health services

2. School health instruction

3. Healthful school living

4. School community linkage

 Community
 Community Diagnosis
- A process by which the nurse collects data about the community in order to identify factors
which may influence the deaths and illnesses of the population, to formulate a community health
nursing diagnosis and develop and implement community health nursing interventions and
strategies
2 Types of Community Diagnosis
Comprehensive Community Diagnosis Problem-Oriented Community Diagnosis
- aims to obtain general information about the - type of assessment responds to a particular
community need
STEPS:
 Preparatory Phase
1. site selection
2. preparation of the community
3. statement of the objectives
4. determine the data to be collected
5. identify methods and instruments for data collection
6. finalize sampling design and methods

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 7. make a timetable
 Implementation Phase
1. data collection
2. data organization/collation
3. data presentation
4. data analysis
5. identification of health problems
6. prioritization of health problems
7. development of a health plan
8. validation and feedback
 Evaluation Phase
1. Process evaluation
2. Product evaluation

Sources of data on health and disease:

1. Civil Registration

2. Reports of field personnel

3. Other sources

 Biostatistics

DEMOGRAPHY
- Is the study of population size, composition and spatial distribution as affected by
major processes like births, deaths and migration

Sources of demographic data:

1. Census – complete enumeration of the population
De jure De facto
People were assigned to the place where People were assigned to the place
they usually live regardless of where they where they are physically present at
are at the time of census. the time of census, regardless, of
their usual place of residence.
2. Continuing population registers
3. Other sources
Components:
Population size
Natural increase
Rate of natural increase
Net migration
Population composition
Sex ratio
Age- dependency ratio
Population pyramid
Population Distribution
Urban-rural distribution
Population density
Crowding index

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EPIDEMIOLOGY
- the study of distribution of disease or physiologic condition among human population s and the
factors affecting such distribution
- the study of the occurrence and distribution of health conditions such as disease, death, deformities
or disabilities on human populations
Basic Concepts:
1. Epidemiologic Triad
2. transmission
3. incubation period
4. herd immunity

Common Epidemiologic Studies:

PAST PRESENT FUTURE

Retrospective Cross-sectional Prospective Cohort

VITAL STATISTICS
- the application of statistical measures to vital events (births, deaths and common illnesses) that is
utilized to gauge the levels of health, illness and health services of a community.

 Fertility Rate
1. Crude Birth Rate
2. General Fertility Rate

 Mortality Rates
1. Crude Death Rate
2. Specific Mortality Rate
3. Infant Mortality Rate
4. Neonatal Mortality Rate
5. Post-neonatal Mortality Rate
6. Maternal Mortality Rate
7. Proportionate Mortality Rate A
8. Swaroop’s Index
9. Proportionate Mortality Rate B
10. Case Fatality Rate
11. Cause-of- Death Rate

 Morbidity Rates
1. Prevalence Rate
2. Incidence Rate



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