Far Eastern University

Institute of Nursing

NCM 104 COMMUNITY HEALTH NURSING I

Individual and Family as client.

MODULE 1: OVERVIEW of COMMUNITY HEALTH NURSING

(Part 1)

Course Outcomes:
At the end of the course the student will be able to;
1. Apply knowledge of physical, social, natural, health science, and humanities in the care of
individual and family in the community setting.
2. Provide safe, appropriate and holistic care to individuals and families in the community
utilizing the family nursing process.
3. Apply guidelines and principles of evidence- based practice in the delivery of care to individual
and family in the community setting.
4. Practice nursing in the community setting in accordance with law, legal, ethical, and moral
principles.
5. Communicate effectively in speaking, writing, and presenting using culturally appropriate
language in the community setting.
6. Document care of individual and family accurately and comprehensively.
7. Engage in lifelong learning with a passion to keep current with national and global
development in the care of individual and family in the community setting.
8. Adopt the nursing core values in the delivery of care to individuals and families.

Topic Outline:
1. Overview of Community Health Nursing.
2. Macro Framework components for Community Health nursing.
3. Characteristics of Community Health nursing.
4. Focused clients of Community Health nursing.
5. Public Health Nursing and its Core functions of Public Health.
6. Roles and Responsibilities of Public Health nurse.
7. Essential health services render in the Public health.
OVERVIEW of COMMUNITY HEALTH NURSING
Introduction:
Community health nursing is one of the two major fields of nursing in the Philippines, the other
is hospital nursing, some people use the terms community health nursing and public health
nursing interchangeably. However, the former is broader than the latter, it includes public health
nursing, occupational health nursing and school nursing,
There are three broad concept of community health nursing. First is the community, second is
health and last is nursing.

COMMUNITY
• defines as a group of people with common characteristics or interests living together
within a territory or geographical boundaries within a specific social system.
• Allender and Spradley, defines community as a social system that includes: health system,
family system, economic system, educational system, religious system, welfare system,
political system, recreational system, legal system and communication system.
• Leonard, defines community as a “webs of people shaped by relationships,
interdependence, mutual interests and patterns of interaction.”
• the community is the object or focus of care in CHN, with the family as the unit of service.

HEALTH
• Health is a basic human right, on the 6th global Conference on Health Promotion in 2005
the United nation affirmed its recognition that the enjoyment of the highest standard of
health is one of the fundamental rights of every human being. Health is viewed as a
continuum, and is considered as the goal of public health in general and community health
nursing in particular.
• The most frequently cited definition of Health is that of with World Health Organization,
Health is a state of complete physical, mental and social well-being and not merely the
absence of disease or infirmity.
• Dunn, emphasize high level wellness is an integrated method of functioning which is
oriented towards maximizing the potential which the individual is capable within the
environment where he is functioning.
• Rene Dubos, he defined health as the “a quality of life, involving social, emotional,
mental, spiritual and biological fitness on the part of the individual, which results from
adaptations to the environment”.
• Florence Nightingale, look into health and illness in relation to environment. She
prescribed ways to improve health by manipulating the environment.
• Dorothea Orem, defined health as a state characterized by soundness and wholeness of
human structures and bodily and mental functions.

Factors affecting Health

There is a strong link between a society’s health and its economic development, which in turn
determined by its social and political structures and processes. The link between inequalities in
income and wealth and inequalities in health is well established. Culture and environment which
impact on people’s health are also affected by the country’s politics and economy.

1. Poverty and health, poverty is an indication of the continuing social injustice and failure
of a country’s development efforts. The poor have poor health, because they do not have
the resources to afford the basic requisites of health, they are not covered by health
insurance, and they do not have the capacity to effectively transact or negotiate with the
health care system which seems to be more responsive to the needs of those with
necessary financial resources.
 2. Culture and health, culture is a way of life. It is the totality of who we are as a person. It
is stable that endures overtime and is passed on from one generation to the next. As such,
it is obviously an important influence on people’s health. Cultures includes many things
like beliefs, values and customs or practices, how we socialize or interact with others, how
we relax and spend our time, the food that we or not eat, how we prepare our food, how
we treat and care for pregnant woman, how we deliver baby’s and how we take care of
newborns, how we cope with our problems, how and when we seek help and many
others.
Culture has a positive effect on health. Families and friends are major source of financial,
emotional, instrumental and social support, especially during crisis situations. These
relationships contribute to our sense of emotional well-being and mental health.
Some people have beliefs and practices that adversely affect health. It is difficult to isolate
the effect of culture because of the concurrent influences of poverty and ignorance and
the inadequacies in health care delivery system.
3. Environment and health. The environment plays a direct influence on health of the
people. An unsanitary environment is a major factor in the causation of different kind of
disesases.it can be a breeding sites for insect vectors of diseases like malaria, dengue and
filariasis which are still the major health problems in some parts of the country. In the
environment could be found toxic substances such as lead, mercury, asbestos, pesticides,
tobacco and solvents that could adversely affect human reproduction, brain and immune
system that could cause cancer. A toxic environment can also cause heart and brain
damage, damage the lungs and can cause kidney and reproductive malfunctions.
4. Politics and health. Policies reflect the priorities of the government and the value system
of policy makers. The health budget is the most concrete expression of the government
political will. Many Filipinos do not have full access to basic health goods and services
because of the severely limited health financing. The severely limited health budget is also
the biggest hindrance to the full implementation of well-meaning policies such as national
health insurance.

Community Health
• Is a Part of paramedical and medical intervention/ approach which is concerned on the
health of the whole population.
• Its Aim is to Promote Health, Prevention of Disease and Management of factors affecting
health.

NURSING
• is the science and art of caring
• Nursing as an art is reflected in the nurse’s interactions and communication with clients
that are geared toward the improvement not just of their health but also their ability to
deal with the determinants and consequences of their health problems.
• Nursing, together with public health, is one of the helping professions in the health care
system which operates at three levels of clientele, individuals, families or groups, and
communities.

Community Health Nursing

• defined by Araceli Maglaya as the “The utilization of the nursing process in the different
levels of clientele-individuals, families, population groups and communities, concerned
with the promotion of health, prevention of disease and disability and rehabilitation.”
• The Goal Community Health Nursing is “To raise the level of citizenry by helping
communities and families to cope with the discontinuities in and threats to health in such
a way as to maximize their potential for high-level wellness”. (Nisce, et.al)
• WHO Expert Committee of Nursing define community health nursing as a Special field of
nursing that combines the skills of nursing, public health and some phases of social
assistance and functions as part of the total public health program for the promotion of
health, the improvement of the conditions in the social and physical environment,
rehabilitation of illness and disability
 • Jacobson defines Community Health Nursing as A learned practice discipline with the
ultimate goal of contributing as individuals and in collaboration with others to the
promotion of the client’s optimum level of functioning thru’ teaching and delivery of care.
• Dr. Ruth B. Freeman define Community Health Nursing as A service rendered by a
professional nurse to IFCs, population groups in health centers, clinics, schools, workplace
for the promotion of health, prevention of illness, care of the sick at home and
rehabilitation.

CHARACTERISTICS OF Community Health Nursing

1. Promotion of health and prevention of disease are the goals of professional practice.
2. Community health nursing practice is comprehensive, general, continual and not episodic.
3. There are different levels of clientele; individuals, families and population groups and the
practitioner recognize the primacy of the population as a whole.
4. The nurse and the client have greater control in making decisions related to health care and
they collaborate as equals
5. The nurse recognizes the impact of different factors on health and has a greater awareness of
his/ her client’s lives and situations.

GOAL of Community Health Nursing is to Raise the level of health of citizenry by;
• help communities and families cope with discontinuities in health and threats.
• Maximize their potential for high level wellness.
• Promote reciprocally supportive relationship between people and their physical and social
environment.

PRIMARY FOCUS of Community Health Nursing

• is health promotion of the people wherein the primary responsibility of the community
health nurse is health teaching, who is termed as generalist in practice, because of their
potentials to assume different roles as a community health nurse.

GOALS OF HEALTH EDUCATION

1. Encourage client to participate in health decision making
2. Increased potentials of the client to comply with health recommendations
3. Development of self-care skills
4. Improved client and family coping in their live situation in the community
5. Increased participation in continuing care for specific conditions
6. Be able to adapt on healthier lifestyles.

The framework for community practice has 4 components

1. The health care delivery system, with its subsystem.
2. The clients (Individual, family, Community)
3. Health which is the goal of the health care delivery system.
4. The economic, sociocultural, political and environmental factors that affects the health care
delivery system, the practice of community health nursing and the people’s health.

CLIENTS OF COMMUNITY HEALTH NURSES. There are different levels of clientele in community
health nursing. The individual, family, population group and community.
1. Individual, the primary client in the community health nursing. The community health nursing
deals with individuals, sick or well, on a daily basis. Since health problems of individuals are
intertwined with those of the other members of the family and community, they are also
considered an entry point in working with this client.

2. Family. From a system of perspective. Family is defined as a collection of people who are
integrated, interacting and interdependent. The family members that interact with each other
and the action of one affects the other members.
3. Population group. Is a group of people who share common characteristics, developmental
stage or common exposure to particular environmental factors and consequently common
health problems, issues and concerns

4. Community (See previous discussion)

Note: For questions/ queries regarding the activity you can contact me:
Email add: vvasquez@feu.edu.ph
Cellphone #: 09563060906
Messenger: Vilma Sabiniano Vasquez

VILMA S. VASQUEZ, MAN, RN, RM

PROFESSOR

Thank You!!!

References:

Maglaya, A. S. (2009). Nursing Practice in the Community (5th Edition). Argonauta Corp.
Cuevas, F.P.L. (2007). Public Health Nursing in the Philippines. (10th Edition).