NCM113
Lecture - Module 1
DEFINITION OF TERMS
1. Community
- A collection of people who interact with one another and
whose common interests or characteristics form the basis
for a sense of unity or belonging (Allender et.al, 2009)
- A group of people who share common interests, who
interact with each other and who function collectively
within a defined social structure to address common
concern (Clark, 2008).
- A group or collection of individuals interacting in social
units ns sharing common interests, characteristics, values
and goals (Maurer and Smith, 2013).
2. Community Health
- The health status of a community and the organized
responsibilities of public health, school health,
transportation, safety and other tax-supported functions
with voluntary and private actions to promote and protect
the health of local population identified as communities.
3. Community Health Nursing (ANA, 1980)
- A synthesis of nursing practice and public health applied
to promoting and preserving the health of the populations.
- The focus of community health nursing:
o prevention of illness
o promotion of health
o maintenance of health
4. Community Health Nursing
- It is service rendered by a professional nurse to
communities, groups, families, and individuals at home,
in health centers, in clinics, in schools, and in places of
work for the promotion of health, prevention of illness,
care of the sick at home, and rehabilitation. (Ruth B.
Freeman)
5. Community Health Nursing (Dr. Araceli Maglaya)
- 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.
6. Community Development
- An organized effort of people to improve the conditions
of community life and the capacity of the people for
participation, self-direction, and integrated efforts in
community affairs (Jimenez, 2008).
7. Community Development
- A process where community members come together to
take collective action and generate solutions to common
problems. Community wellbeing (economic, social,
environmental, and cultural) often evolves from this type
of collective action being taken at a grassroots level.
8. Community Organizing
- A process consists of steps or activities that instill and
reinforce the people’s self-confidence on their own
collective strengths and capabilities (Manalili, 1990).
- A process of educating and mobilizing members of the
community to enable them to resolve community
problems.
- A means to build the community’s capacity to work for
the common good in general and health goals (Famorca et
al, 2013).
9. Epidemiology
Prelims - GMJ
CHN Concepts
- The study of the distribution and determinants of health-
related states or events in specified populations and the
application of this study to the prevention and control of
health problems.
10. Health Statistics
- They refer to the numbers that summarize information
related to health which are collected by researchers,
experts from government, private, non-profit agencies,
and organizations. They are often used to learn about
public health and health care.
11. Health INDICATORS
- A list of information that would determine the health of a
particular community or country.
12. Population Group
- A group of people who share common characteristics,
developmental stage or common exposure to
environmental factors, and common health problems,
issues, and concerns (Maglaya, 2009).
- Population groups are the usual targets or beneficiaries of
social services and health programs.
PHILOSOPHY OF COMMUNITY HEALTH NURSING
 A philosophy is defined as a system of beliefs that
provides a basis for and guide action.
 It provides the direction and describe the whats, the whys
and the hows of activities within a profession.
o Humanistic values of the nursing profession.
o Unique and distinct component of health care
o Multiple factors of health considered
o Active participation of clients is encouraged
o Nurse considers availability of resources
o Interdependence among health team members is
practiced
o Scientific and up to date
o Tasks of community health nurse vary with time
and place
o Independence or self-reliance of the people is the
end goal
o Connectedness of health and development
PRINCIPLES OF COMMUNITY HEALTH NURSING
1. The focus is the community as the unit of care -
the responsibility of the nurse is to the community as
a whole
2. Give priority to the community needs - the CHN
nurse should develop skills in nursing process and
population-focused skills to help the community
identify their needs and produced benefits for the
community; Demographics and vital statistics are the
tools used by the Community Health Nurse to
achieve this benefit.
3. Work with the community as an equal partner of
the health team - client is considered as an active
partner, not a passive recipient of care. Team
approach and partnership between the health care
worker and the community produce effective and
sustainable results.
4. In selecting appropriate activities, focus on
primary prevention - strategies implemented are
focused on achieving optimal health, prevent diseases
and disability.
 5. Promote a healthful physical and psychosocial Constructs of HBM:
environment - health team should focus on Severity
designing strategies that focus on environmental PERCEIVED Susceptibility
determinants of health such as education, Benefits of Treatment
socioeconomic status, physical environment, and Barriers
social supports. 2. Milio’s Framework for Prevention
6. Promote optimum use of resources - effective - by Nancy Milio (1976)
usage of community resources for strategies that will - Complements the HBM and provides mechanism for
produce long term effects. directing and examining opportunities for nursing
7. Collaborate with others working in the interventions at the population level.
community - nurse must work with a variety of - Proposed that health deficits often result from an
sectors to settle issues that affect health, which is imbalance between a population’s health needs and its
considered as a product of multiple health health-sustaining resources
determinants. - Milio’s framework encourages the nurse to understand
health behaviors in the context of their societal milieu
FEATURES OF COMMUNITY HEALTH NURSING
Application of Milio’s Framework in CHN:
Milio’s Proposition Population Health
Population health deficits I and F living in poverty have
result from deprivation poorer health status compared
and/or excess of critical with middle- and upper-class
health resource. individuals
Individual choices related Choices and behavior of
to health promotion or individuals are strongly
health damaging behaviors influenced by desires, values,
are influenced by efforts and beliefs. (E.g. Use of
to maximize valued illegal drugs by adolescents is
resources. often dependent on peer
pressure and the need for
Community Health Nurse - it is the job of a community acceptance, love and
health nurse to help and keep the community health problems belonging.
under control (Mona, 2015) Alteration in patterns of Some behaviors such as
a) serve direct care behavior resulting from smoking have been difficult to
b) advocate for health improvement decision making of a maintain due to company
c) educate individuals or the public significant number of policies and laws
d) perform research in community health people in a population can implemented.
FEATURES OF COMMUNITY HEALTH NURSING result in social change
Behavior of populations Positive and negative lifestyle
 It is a specialty field of nursing
result from selection from choices (e.g. smoking, alcohol
 Its practice combines public health with nursing
limited choices (to include use, regular exercise, diet) are
 It is population based.
actual and perceived dependent on culture,
 It emphasizes on wellness and other than disease or
options available, beliefs, socioeconomic status and
Illness.
expectations resulting educational level.
 It involves inter-disciplinary collaboration.
from socialization,
 It increases client’s responsibility and self-care.
education, and experience)
FUNCTIONS OF COMMUNITY HEALTH NURSING
Without the availability of Addressing persistent health
1. Identification of community culture and resources (key
alternative health problems (e.g. HPN) is
factor in HCDS)
promoting options hindered because most people
2. Evaluate community health conditions, health risks and
are aware of what causes the
problems
problem but reluctant to make
3. Plan and implementation of comprehensive community
lifestyle changes to prevent or
health interventions, care, services, and program.
reverse the condition.
4. Develop health policy at the local community level

THEORIES AND APPROACHES (COMMUNITY

HEALTH NURSING PRACTICE)
1. Health Belief Model (HBM)
3. Pender’s Health Promotion Model
- Developed by social psychologists in1958 to explain why
- Developed by Nola Pender in 1980s and revised in 1996
people failed to participate in screening for TB.
- Explores may biopsychosocial factors that influence
- Provide the basis for current health education and health
individuals to pursue health promotion activities.
promotion practices.
- Depicts the multidimensional factors with which people
- HBM has been used to explain behavior change and
interact as they work to achieve optimum health.
maintenance of behavior change and to guide health
promotion interventions (janz et. Al. 2002)
- Major limitation of HBM – burden of action is on the
client
4. PRECEDE-PROCEED MODEL
- Developed by Dr. Lawrence W. Green and colleagues
- Provides a model for community assessment, health
education, planning and evaluation.
- In this model, predisposing factors refer to people’s
characteristics that motivate them towards health-related
behaviors.
- Enabling factors refer to conditions in people and the
environment that facilitate or impede health related
behavior.