Community

Diagnosis
 A. Comprehensive Community Diagnosis- aims to
obtain a general information about the
community

Types Elements:
* Demographic Variables
* Socio-Economic and Cultural Variables
 * Health and Illness Patterns
* Health Resources
Elements Cont. * Political/ Leadership
Patterns
 B. Problem-Oriented Community
Diagnosis
Types: - a community diagnosis that
responds to a particular need.
 Steps in Conducting Community Diagnosis
1. Determining the Objectives: N decides on the depth and scope of the
data she needs to gather. N must determine the occurrence and
distribution of selected environmental, socio-economic and behavioral
conditions important to disease control and wellness promotion

2. Defining the Study Population: N identifies the population group to be

included in the study. (Entire population or focused on specific
population such as women of reproductive age or infants or young
children)
 Steps in Conducting Community Diagnosis
3. Determining the Data to be Collected: Objectives will guide the N in in
identifying the specific data she will collect, also decides on the sources of
these data. Questions: Are these data available from records of agencies?
Or from people themselves.
4. Collecting the Data:
a. Records review: data may be obtained by reviewing those that have
been complied by health or non-health agencies from government or
other sources
b. Surveys and observations: qualitative or quantitative data
c. Interviews: can yield first hand observations
d. Participant observation: used to obtain qualitative data by allowing
the N to actively participate in the life of the community.
Steps in Conducting Community Diagnosis
5. Developing the Instrument: instruments or tools facilitate data
gathering
a. Survey questionare
b. Interview guide
c. Observation checklist
6. Actual Data Gathering: Before data gathering: N must meet the
people who will be involved, instruments are discussed and analyzed,if
necessary instruments may be modified or simplified in order not
overburden the people (limitations in terms of educational preparation
or available to finish the data collection, Pre testing of instruments is
highly recommended.
 Steps in Conducting Community Diagnosis
Data collectors must be given orientation and training on how to use the
instruments. N ask the data collectors to role play an interview scene so
they can place themselves in an actual interview
During the actual data gathering: N supervises the data collectors by
checking filled up instruments in terms of completeness, accuracy, and
reliability of the information collected.
7. Data Collection: N is now ready to put together all the information. Two
types of data: Numerical Data and Descriptive Data
8. Data Presentation: will depend largely on the type of data obtained.
Descriptive data: are presented in narrative reports ( geographic data,
history of a place or beliefs regarding illness and death.
Numerical data: are presented into table or graphs. ( useful in showing
key information making it easier to show comparisons including patterns
and trends
Steps in Conducting Community Diagnosis
9. Data Analysis: aims to establish trends and patterns in terms of health
needs and problems of the community. Also allows for comparison of
obtained data with standard values.
10. Identifying the Community Health Nursing Problems:
Categorized:
a. Health statues problems: described in terms of increased or decreased
morbidity, mortality, fertility, or reduced capability of wellness.
b. Health resources problems: described in terms of lack or absence of
manpower, money, materials or institutions necessary to solve health
problems
c. Health-related problems: described in terms of existence of social,
economic, environmental and political factors that aggravate the illness-
including situations in the community.
Steps in Conducting Community Diagnosis
11. Priority setting
Criteria:
a. Nature of the condition/problem presented: problems are
classified by the N as health status, health resources or health
related problems
b. Magnitude of the problem: refers to the severity of the problem which can be
measured in terms of the proportion of the population affected by the problem.
c. Modifiability of the problem: refers to the probability of reducing, controlling or
eradicating the problem
d. Preventive potential: refers to the probability of controlling or reducing the effects
posed by the problem
e. Social concern: refers to the perception of the population or the community as they
are affected by the problem and their to act on the population.
 Schemes in stating Community Diagnosis
1. Nanda: Have included diagnoses at community level in more recent
versions
2. Shuster and Goppingen: Has proposed a format of nursing diagnoses for
population groups previously presented by Green and Slate (2001).
The three part system consist of:
2.1. The health risk or specific problem to which the community is
exposed.
2.2. The specific aggregate or community with whom the nurse will be
working
to deal with the risk of the problem.
2.3. Related factors that influence how the community will respond to the
health risk or problem. ( refer to Nursing Care of the Community Book by
Famorca, Zenaida U. Box 7.3 page 143 for the sample).
 Schemes in stating Community Diagnosis
3. Omaha System, 2011a: Has been used as a framework for care of individuals, families, and communities by
nurses, nursing educators, physicians, and other health care providers.
•A comprehensive and research based classification system for client problems that exist in the public domain.
 Three components that are to be used together:
1. A problem classification scheme ( client assessment )
4 Levels:
• 1st Level: Composed of 4 domains
-Environmental domain: Material resources and physical surroundings both
inside and outside
the living area, and broader community.
-Psychosocial domain: Patterns of behavior, emotion, communication,
relationship, and development
-Physiological domain: Functions and processes that maintain life.
-Health-related behaviors domain: Patterns of activity that maintain or
promote
wellness, promote recovery, and decrease the risk of disease.

• 2nd Level: Consists of problems or areas of concern under the four domains.
(1) environmental, (2) psychological, (3) Physiological, (4) Health relat ed behavior
Taken from; Aylaz, Rukiye, Bilgin, Nevzat.(2020,
January). Impact of using the Omaha system of public
health nursing students working at community health
centers on family health, 29.
 Three components that are to be used together
con’t.

• 3rd Level: Problem area of concern is classified according to two sets of

qualifiers: First, Area of concern is categorized into health promotion,
potential problem, or actual problem.
• 4th Level: Made up of clusters of signs and symptoms that describe actual
Problems
 Three components that are to be used together:
• 2. An intervention scheme (care plans and services)
Categories of the Intervention Scheme:
• Teaching, Guidance, and Counseling: Activities designed to provide information and materials,
encourage action and responsibility for self-care and coping, and assist the
individual/family/community to make decisions and solve problems.

• Treatments and Procedures: Technical activities such as wound care or and medication
prescriptions that are designed to prevent, decrease, or alleviate signs and symptoms of the
individual/family/community.

• Case Management: Activities such as coordination, advocacy, and referral that facilitate service
delivery, improve communication among health and human service providers, promote
assertiveness, and guide the individual/family/community toward use of appropriate resources.

• Surveillance: Activities such as detection, measurement, critical analysis, and monitoring

intended to identify the individual/family/community status in relation to a given condition or
phenomenon
Three components that are to be used together:
3. A problem rating scale of outcomes ( client change/evaluation)

Concepts and Ratings of the Problem Rating Scale for Outcomes:

Concepts 1 2 3 4 5
Knowledge: Ability of Minimal Basic Adequate Superior
the client to No Knowledge Knowledge Knowledge Knowledge
remember and knowledge
interpret information

Behavior:Observable Not Rarely Inconsistent Usually Consistently

responses, actions, appropriate appropriate ly appropriate appropriate
or activities of the behavior behavior appropriate behavior behavior
client fitting the behavior
occasion or purpose

Status:Condition of Extreme Severe signs/ Moderate Minimal No signs/

the client in relation signs/ symptoms signs/ signs/ symptoms
to objective and symptoms synptoms symptoms
subjective defining
characteristics