Community health nursing

Definition of health and community

HEALTH

Is a state of complete physical, mental and social well-being and not merely the absence of disease or
infirmity.

SOCIAL

Relating to living together in organized groups or similar close aggregates

SOCIAL HEALTH

 Connotes community vitality and is a result of positive interaction among groups within the
community with an emphasis on health promotion and illness prevention

E.g Community groups may sponsor feeding programs in churches and civic organizations to
help alleviate problems of violence and lack of opportunity, which can negatively affect social
health

COMMUNITY

• A collection of people who interact with one another and whose common interest or
characteristics form the basis for a sense of unity or belonging (Allender et al.,2009, p.6)

• A group of people who share something in common and interact with one another, who may
exhibit a commitment with one another and may share a geographic boundary (Lundy and Janes,
2009, p16)

4 defining attributes of a community

1. People
2. Place
3. Interaction
4. Common characteristics, interest or goals

Determinants of health and disease

 Income and social status- higher income and social status are linked to better health. The greater
the gap between the richest and poorest people, the greater the difference in health
 Education- low education levels are linked with poor health, more stress and lower self
confidence
 Physical environment- safe water and clean air, healthy workplaces, safe houses, communities
and roads all contribute to good health
 Employment and working conditions- people in employment are healthier, particularly those who
have control over their working conditions
 Social support networks- greater support from families, friends and communities is linked to better
health
 Culture-customs and traditions, and the beliefs of the family and community affect the health
 Genetics-inheritance plays a part in determining lifespan, healthiness and the likelihood of
developing illnesses
  Personal behavior and coping skills- balanced eating, keeping active, smoking, drinking and how
we deal with life’s stresses and challenges all affect health
 Health services- access and use of services that prevent and treat disease influences health
 Gender-men and women suffer from different type of diseases at different ages

Overview of community health nursing

What is a community

• Is a group of people with common characteristics or interests living together within a territory or
geographical boundary
• Is place where people under usual conditions are found
• Derived from a latin word “comunicas” which means a group of people

What is community health?

• part of paramedical and medical intervention/ approach which is concerned on the health of the
whole population

Aims:
1. health promotion

• 2. disease prevention
3. management of factors affecting health

What is nursing?

• Assisting sick individuals to become healthy and healthy individuals achieve optimum wellness

What is Community Health Nursing?

“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.” - Maglaya, et al

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 (WHO Expert Committee of Nursing)

The definition of community health nursing highlights the following important points:

1. The goal of professional practice is the promotion and preservation of the health of populations
2. The nature of practice is comprehensive, general, continual and not episodic
3. The knowledge base comes from nursing and public health
4. The different levels of clientele- individuals, family and groups
5. The practitioner’s recognition of the primacy of the population as a whole

Definition and focus of public health and community health

Public health is the science and art of

 1. Preventing disease
2. Prolonging life
3. Promoting health and efficiency through organized community effort for
The sanitation of the environment
The control of communicable infections
The education of the individual in personal hygiene
The organization of medical and nursing services for the early diagnosis and preventive
treatment of disease
The development of a social machinery to ensure everyone a standard of living, adequate for
maintenance of health to enable every citizen to realize his birth right of health and longevity (Dr.
C.E Winslow)

Basic principles of CHN

The community is the patient in CHN, the family is the unit of care and there are four levels of
clientele

1. Individual
2. Family
3. Population group (those who share common characteristics, developmental stages and common
exposure to health problems – e.g. children, elderly),
4. Community

Individual

The PHN deals with individuals-sick or well-on a daily basis. These are the people who consult at the
health center and receive health services such as prenatal supervision, well-child follow-ups and
morbidity services.

These also include clients with chronic illnesses such as diabetes mellitus and hypertension who go to
health center for blood sugar and blood pressure monitoring.

Family

The family is a very important social institution that performs two major functions-reproduction and
socialization. It is generally considered as the basic unit of care in community health nursing for many
reasons.

The family is the locus of decision-making on health matters.

Population group

Population group or “aggregate” is a group of people who share common characteristics, developmental
stage or common exposure to particular environmental factors, and consequently common health
problems. Some of these groups are: children, men, women, farmers, factory workers, commercial
workers, prisoners, military men and elderly.

Community

The community is a group of people sharing common geographic boundaries and/or common values and
interests. It functions within a particular sociocultural context, which means that no two communities are
alike. The physical environment varies, and so with the people’s way of behaving and coping. The people
are different from each other, thus the dynamics in one community differs from that of the other.

Characteristics of a community

1. It is defined by its geographic boundaries within certain identifiable characteristics

2. It is made up of institutions organized into a social system with the institutions and organizations
linked in a complex network having a formal and informal power structure and a communication
system
3. A common or shared interest that binds the members together exists
4. It has an area with fluid boundaries within which a problem can be identified and solved
5. It has a population aggregate concept