NCM 113 Module 1 Concept of CHN

COLLEGE OF NURSING AND PHARMACY
C-NCM 113 – COMMUNITY HEALTH NURSING 2

(COMMUNITY) LECTURE
First Semester | AY 2021-2022
Second Semester | AY 2020-2021

Module 1: CONCEPT OF COMMUNITY HEALTH NURSING
Time Frame: Week 1 (2hours)
Schedule of synchronous sessions: Monday 6:00-9:00 a.m.
Mapped Learning Outcomes and Course Content for C-NCM 113, Module 1
Target Learning Outcomes Content and Activities
Hour (At the close of the period allotted, Online Session Offline Session
students should have :)
2hours • Discuss the relationship • Concept of ▪ Choose one of the theoretical
between the science public Community Health models of CHN and discuss its
health and community Nursing application to community setting
health nursing practice. ➢ Definition by giving example.
• Integrate principles and ➢ Goals ▪ Interview a person who are in a
concepts of physical, ➢ Principles specialized field of CHN and
social, natural and health ➢ Philosophies identify the roles, responsibilities
sciences in the care of ➢ Theoretical and activities.
population groups and models
communities. ➢ Specialized field
• Identify and discuss the 4 of CHN
levels of clientele and
theoretical models used in
Community Health
Nursing
• Analyze the basic
principles and
philosophies of
Community Health
Nursing and its application
to present practice.
• Identify the different
responsibilities and
functions of specialized
fields of Community
Health Nursing
1. Content / Discussion / Learning Resources / Link
COMMUNITY- derived from the Latin word “communitas” things held in common, a broad term for
fellowship or organized society
- Groups of network of persons who are connected (objectively) to each other by
relatively durable social relations that extend beyond immediate genealogical ties and
who mutually define that relationship (subjectively) as important to their social identity
and social practice.
HEALTH- is a state of complete physical, mental, social well-being and not merely the absence of disease or
infirmity and it leads to socially and economically productive life.
Faculty: Aurora R. Valencia, RN, MAN Page 1 of 13
(COMMUNITY) LECTURE

NURSING- is a profession within the health care sector on the care of individuals, families and communities,
so they may attain, maintain, or recover optimal health and quality of life.
PUBLIC HEALTH
• The practice of nursing in national and local government health departments (which includes health
centers and rural health units), and public schools.
• A community health nursing practiced in public sector.
• It is the combination of nursing skills, public health, and phases of social assistance and functions of
public health program for the promotion of health, the improvement, prevention of illness and
disability and rehabilitation
COMMUNITY HEALTH
• refers to the healthy status of the member of the community to solve the problems affecting their
health and to the totality of a health care provided for the community.
GOALS OF COMMUNITY HEALTH

1. To decrease morbidity and mortality rate
2. To increase the lifespan for an individual
AIMS OF COMMUNITY HEALTH

1. To improve quality of life
2. To improve standard of living
3. To reduce risk factors
4. To strengthen self -care activities of an individuals
COMMUNITY HEALTH NURSING: DEFINITION

➢ It is a synthesis of nursing and public health practice applied to promote and preserve the health of
the populations.
➢ It treats “Population as a Whole”
➢ Service rendered by a professional nurse to communities, groups, families, and individuals at home,
health centers, in clinics, in school and in place of work for promotion of health, prevention of
illness, care of the sick at home and rehabilitation. (Ruth Freeman)
➢ Nursing practice in a wide variety of community services and consumer advocate areas, and in a
variety of roles, at times including independent practice. Community nursing is not confined to
public health nursing agencies. (Jacobson, 1975)
➢ Utilization of nursing process in the different levels of clientele, concerning in the promotion of
health, prevention of diseases and rehabilitation. ( Maglaya)
➢ Nurses working in Rural Health Units (RHU) or health centers are Community Health Nurses and
are officially called “Public Health Nurses” (PHN).
➢ Occupational Health Nurses, such as Company Nurses and School Health Nurses, are classified as
“Community Health Nurse”

(COMMUNITY) LECTURE

PHILOSOPHY OF COMMUNITY HEALTH NURSING
• The philosophy of CHN is based dignity and worth of the individuals.

• The philosophy of care is based on the belief that are directed to the individual, family, and the group
that contributes to healthcare of the population as a whole.
PHILOSOPHY OF COMMUNITY HEALTH NURSING PRACTICE

1. Humanistic values of nursing profession upheld
2. Unique and distinct components of health care
3. Multiple factors of health are considered
4. Active participation of client is encouraged
5. Nurse considers availability of resources
6. Interdependence among health team members is practiced.
7. Scientific and up-to-date
8. Tasks of Community Health nurse vary with time and place
9. Independence and self-reliance of the people is the end goal
10. Connectedness of health and development regarded
GOALS OF COMMUNITY HEALTH NURSING

• To assist the individual, family and community in attaining highest level of health through a
multidisciplinary effort to promote reciprocally supportive relationship between people and their
physical and social environment.
CONCEPTS AND PRINCIPLES

1. Family- the family is the primary unit of care or basic unit of service of Community Health Care
where primary prevention is the priority. The individual client or patient is a member of the family.
The family may be a part of the population group like being a member of a regional group which in
turn is part of the bigger group which the community. The client of the community health nurse is the
COMMUNITY.
2. Partnership- the Community Health Nurse works with, not for, the individual patient, family, group
or community as the active partner and not passive receipt of care. Clients are actively involved in
organizing, planning, implementation, management and evaluation phase of care. All processes must
include partnering with the representatives of the people.
3. Change- The practice of Community Health Nursing is affected by changes in society in general, and
by the developments in the health field. The environment and socio-economic status affect the health
of the community.
4. Health Care Delivery System- Community Health Nursing is a part of community health system and
larger human services system. The CHN shares with other member of health team and other sectors
in the community the responsibility of delivering health care services.
SALIENT FEATURES OF COMMUNITY HEALTH NURSING
1. Population- or Aggregate-Focused- the hallmark of Community Health Nursing. The whole

community is the patient/client.
2. Greatest Good for the Greatest Number is the emphasis, the nurse must look at the health needs and
problems of the community rather than focusing on the needs of individual and families.
(COMMUNITY) LECTURE

3. Utilization of Nursing Process- CHN involves assessment pf health needs, planning, implementation,
and evaluation of the impact of health services on population group using nursing process.
4. Promotive-Preventive by nature- the priority of CHN is health-promoting and disease-preventing
strategies over curative interventions.
5. Uses a variety of instruments- CHN makes use of tools for measuring and analyzing community
health problems like using health statistics or vital statistics. Other tools like community map, survey,
interview, schedule and questionnaire.
6. Requires management skills- CHN applies the principle of management especially in organization of
health service or programs.
FOUR LEVELS OF CLIENTELE in COMMUNITY HEATH NURSING
I. INDIVIDUAL
➢ The PHN deals with individuals (sick or well) on a daily basis.
➢ 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 the health center for blood sugar and blood pressure
monitoring.
➢ Seen during home follow-ups, school health consultation, workplace visit conference and other
community-based activities such as case finding, screening, health education class, nutrition campaign
and promotion of healthy lifestyle.
II. FAMILY
➢ The family is the basic social institution and the primary group in society.
➢ The family is considered as the basic unit of care in community health nursing and contributes
knowingly or unknowingly to the development of health and nursing problems of its members.
➢ It also performs health-promoting, help-maintaining and disease-preventing activities. In many cases,
the family provides unfailing nursing care particularly to the chronically ill members and the source of
the most solid support to its members, particularly to the young, the elderly & disabled.
➢ Friedman (1992:9) defines a family to be composed of “two or more persons who are joined together
by bonds of sharing and emotional closeness and who identify themselves as being part of the family”.
➢ Murdok (1949), Defined family as a group characterized by common residence, economic cooperation
and reproduction. It includes both sexes, at least two of who maintain a socially approved sexual
relationship, and one or two children.
➢ Burgess and Locke (1963), Defined family as a group of persons united by ties of marriage, blood or
adoption, constituting a single household, interacting and communicating with each other in their
respective social roles of husband and wife, mother and father, son and daughter, brother and sister.
III. GROUP
 Composed of individuals who share a common interest with goal of achieving it
 A population group or aggregate (Clark 1995:5) is a group of people who share common
characteristics, developmental stage or common exposure to particular environmental
factors, thus resulting in common health problems.

(COMMUNITY) LECTURE

 Some of these groups are: children, men, women, farmers, factory workers, commercial
workers, prisoners, military men, and elderly.
IV. COMMUNITY
 The community is a group of people sharing common geographic boundaries and/or common
values and interests.
 It functions within a particular socio-cultural context, which means that no two communities
are alike.
 The physical environment varies, and so with the people’s way of behaving and coping.
THEORETICAL MODEL APPLIED IN COMMUNITY HEALTH NURSING
HEALTH BELIEF MODEL
 By Rosenstoch, Becker and Maiman.

 Addresses the relationship between a person beliefs and behavior
 This model helps understand factors influencing patient’s perceptions, beliefs and behavior to plan
care that will most effectively help patient maintain or restore health and prevent illness
CTTO: https://sbccimplementationkits.org/quality-malaria-medicines/wp-
content/uploads/sites/15/2016/11/healthbeliefmodel.png
First Component
 Individual’s perception of susceptibility to an illness

 Example: A patient needs to recognize the familial link for coronary disease. After this link is
recognized, particularly when one parent and two siblings died in the fourth decade from myocardial
infarction, the patient may perceive the personal risk of heart disease.
Second Component
 Individual’s perception to of the seriousness of the illness.

(COMMUNITY) LECTURE

 This is influenced and modified by demographic and sociopsychological variables, perceived threats
of illness and cues to action (e.g., mass media campaigns, advice from others, friends and medical
professionals
 Ex: A person may not perceive his heart disease to be serious, which may affect the way he takes care
of himself.
Third Component
 Likelihood that a person will take a preventive action.

 This component results from a person’s perception of the benefits of preventive action and barrier to
taking action.
 Preventive actions include lifestyle changes, increased adherence to medical therapies or search for
medical advice or treatment.
 A person’s perception of susceptibility to disease and his perception of the seriousness of an illness
help to determine the likelihood that the patient will or will not partake in healthy behavior
PENDER’S HEALTH PROMOTION THEORY (1996)
• Known for model as an organizational framework for theory development and research in the health
in promoting behavior.
• Illustrate the “multidimensional nature of persons interacting with their environment as they pursue
health”.
• Incorporates individual characteristics and experiences and behavior-specific knowledge and beliefs,
to motivate health promoting behavior.
• This can be used to design and provide nursing interventions to promote health for individuals,
families and communities.
CTTO: https://nursekey.com/wp-content/uploads/2017/02/B9780323056410500301_gr1.jpg

(COMMUNITY) LECTURE

Green and Kreuter (1991)
• Health promotion strategies are based on a systematic approach to achieve health goals
• The model is best used if the change agent begins with the final consequences (quality of life) then
works back deductively to the original causes. This involves phases as follows:
Phases
Phase 1: Social diagnosis – begins with an assessment of a community needs and aspirations
Phase 2: Epidemiological diagnosis – social goals and problems are identified and ranked
Phase 3: Behavioral and Environmental Diagnosis – specific health related behavior and
environmental factors are identified and ranked.
Phase 4: Educational and organizational diagnosis – the predisposing, reinforcing and enabling
factors are identified and prioritized
• Phase 5: Administrative and policy diagnosis – organizational and administrative capabilities and
resources are assessed at this stage.
• Phase 6: Implementation – represents the culmination of each of the previous phases.
• Phase 7, 8, 9: Evaluation – is an integral and continuous part of the entire diagnostic process.
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(COMMUNITY) LECTURE

Milio’s Framework of Prevention
- Nancy Milio, a nurse and leader in public health policy and public health education developed a
framework for prevention that includes concepts of community-oriented, population focused
care
- The basic treatise is that behavioral patterns of population and individuals who make up
population as a result of habitual selection from limited choices
- Stressed that a main determinant for unhealthful behavioral choice is lack of knowledge
- Governmental and institutional policies, she said set the range of options for personal choice
making
- Neglected the role of community health nursing, examining the determinants of community
health and attempting to influence those determinants policy.
- Three (3) general categories of nursing intervention have also been put forward, they are:
1. Education directed toward voluntary change to the attitude and behavior of the subjects
2. Engineering directed at managing risk-related variables
3. Enforcement directed at mandatory regulation to achieve better health
SPECIALIZED FIELDS OF COMMUNITY HEALTH NURSING
1. SCHOOL HEALTH NURSING

➢ Is a type of public health nursing that focuses on the promotion of health and wellness of the
pupils/students, teaching and non-teaching personnel of the schools.
➢ Aims at promoting the health of school children and preventing health problems that would hinder
their learning and performance of their developmental tasks. (Maglaya)
Objectives of School Nursing:
General: to promote and maintain the health of the school populace by providing comprehensive
and quality nursing care.
Functions of the School Nurse:
1. School health and nutrition survey
2. Putting up a functional school clinic
3. Health Assessment
4. Standard vision testing for school children
5. Ear examination
6. Height and weight measurement and nutritional status determination
7. Medical referrals
8. Attendance to emergency cases
9. Student health counseling
10. Health and nutrition education activities
11. Organization of school-community health and nutrition councils
12. Communicable diseases control.
13. Establishment of data bank on school health and nutrition activities
14. School plant inspection for healthy environment

(COMMUNITY) LECTURE

15. Rapid classroom inspection
16. Home visitation
2. OCCUPATIONAL HEALTH NURSING

➢ Is a prime position of public health nursing to assess the health needs of the working population
working and design healthful working interventions.
➢ Is nursing in the workplace; it is community health nursing focused on people in their places of
work, which of course, is part of the bigger community.
➢ It is the specialty practice that provides for and delivers health care services to workers
Functions of Public Health Nurse as an Occupational Health Nurse:

1. Work with occupational health team to lead the sanitary and industrial hygiene of all industrial
establishments including hospitals.
2. Recommends to Local Health Authority issuance of license or business permits and suspension or
revocation for any violations pursuant to existing rules and regulations.
3. Coordinate with the other government agencies relative to the implementations of rules and
regulations.
4. Attends to complaints of all establishments in the area of assignment.
5. Participates to provide and install in good condition all control facilities.
6. Inform all affected workers regarding the nature of hazards.
7. Makes a periodic testing for physical and health examination of the workers related to potential or
actual hazards in the workplace.
8. Provides control measures to health and other hazards.
9. Ensure strict compliance on the regular use and proper maintenance of Personal Protective
Equipment (PPE).
10. Prepares and submit yearly reports to the local and national government.
3. COMMUNITY MENTAL HEALTH NURSING

➢ Concerned with the promotion of mental, prevention of mental health disorders and nursing care of
patients during mental illness and rehabilitation
Goals:
1. Promotion of mental health

2. Decrease health-related effects of stressful lifestyle
3. Reduction of prevalence of mental ill health and disorders
NURSING RESPONSIBILITIES AND FUNCTIONS:
1. In Mental Health Promotion
• Participate in the promotion of mental health among families and the community.
• Utilize opportunities in the community to extend general knowledge on mental hygiene.
• Help people in the community to understand basic emotional needs and factors that promote
mental well being.
• Teach parents the importance of providing emotional support to their children during critical
periods of their lives.
(COMMUNITY) LECTURE
2. In Prevention and Control

• Recognize mental health hazards and stress situations.
• Recognize pathological deviations from normal in terms of acting, thinking and feeling so that
diagnosis and treatment could be done early.
• Be aware of the potential cause of breakdown.
• Help the family to accept and understand the patient’s health status and behavior.
• Encourage feeling of achievement by setting health goals that the patient can attain.
• Impart information and guidance about the treatment scheme of the patient.
3. In Rehabilitation
• Initiate patient participation in occupational activities.
• Encourage the patient to partake in Civic organization in the community.
• Advise the family about the importance of regular follow-up at the clinic.
• Make regular home visits.
4. In Research and Epidemiology

• Participate actively n the epidemiological survey of mental health problems in the community
and organize a program for better preventive, curative and rehabilitative measures.
2. Assessment of Learning
This section will enable you to do self-check of your progress in the discussion. During the self-
evaluation, you are expected to practice the virtue of honesty. A score equivalent to 75% will enable you to
proceed to the assignment section. A separate sheet will be utilized to answer the questions in this section.
You may repeat answering the questions until the required score equivalent is acquired.
IDENTIFICATION
ANSWER QUESTIONS
1. 1. The basic unit of care in community health
nursing.
2. 2. It means fellowship or organized society.
3. 3. It refers to the healthy status of the member of
the community to solve the problems affecting
their health and to the totality of a health care
provided for the community.
4. 4. It is the science and art of preventing disease,
prolonging life and promoting health and
efficiency through organized community
development.
5. 5. It is the term used before Community Health
Nursing.
6. 6. The patient in the Community Health Nursing.
7. 7. A system of beliefs that provides basis,
(COMMUNITY) LECTURE

direction, and guides’ action.
8. 8. Specialized fields of CHN that requires
application of nursing theories and principles
in the care of the school population
9. 9. Specialized fields of CHN that requires
application of principles and procedures in
conserving the health of workers in all
occupation
10. 10. A specialized fields of CHN requires
integration of concepts from nursing, mental
health, social psychology, community
networks and the basic sciences.
3. Evaluation of Learning
For the evaluation of learning for Module 1, a scheduled quiz will be assigned in the Google Classroom and
will be taken before the start of the next Module during the Synchronous Class.
Activity:
1. Interview: Specialized Fields of CHN
A. Learning Outcomes
• Adhere to ethico-legal considerations when providing safe, quality, and professional nursing care
• Protect client rights based on “Patient’s Bill of Rights and Obligations”
B. Description of the Activity
• Each RLE 113 group will have a virtual interview to a specialized field of community health nursing.
The clinical instructor will be one to designate the person to be interviewed.
• A letter will be forwarded to the person before the interview.
• Set of questions will be asked and other pertinent information related to the topic. (Roles,
responsibilities, activities and functions)
• Output of the interview will be presented through a powerpoint presentation with respective RLE 113
clinical instructors.
C. Rubrics in grading the output (Group work)
2. Group Activity: Theoretical Models of CHN
A. Learning outcomes
• Integrate relevant principles of social, physical, natural and health sciences and humanities in a given
health and nursing situation.
• Apply appropriate nursing concepts and actions holistically and comprehensively
B. Description of the activity
• The RLE 113 group will be assigned to the different theoretical models applied in CHN and
make a group discussion how it is being applied in the community setting by giving examples.
Each group member will share their insights and ideas in the class.
C. Rubrics in grading the output (Group work)

(COMMUNITY) LECTURE

Group Work Rubric
Criteria Excellent Good Fair Poor Score
4 marks 3 marks 2 marks 1 mark
Quality of Group members had a Most of the group Group members had Group members
Content stronghold on the members has a solid only a superficial had little
X1 (4pont) content and the content understanding of understanding of understanding of
were thoroughly the content. content. the content
addressed. No mistakes addressed in the
were made with regard presentation.
to content knowledge.
Quality of Group members covers Some of the Several of the Majority of the
Information all the required required elements required elements required elements
X2 (8ponts) elements, presented were missing or were missing and were not included.
topic thoroughly. contained minor mistakes were made
errors. during the
presentation.
Organization Output was very Output was fairly Output was not Output lacked
X1 (4pont) organized and was very organized and clearly organized. organization.
easy to follow. pretty followable.
Teamwork/ The group worked very The group worked Group Group did not
Participatio well with each other well with each other communicated work well
n and the work was and communicated relatively well with together. There
X1 (4pont) shared equally among well. With evidence a few lapses in the were obvious
the group members of good rapport and work; some miscommunicatio
with strong evidence of positive attitude but students dominated ns, lack of rapport,
excellent rapport with some members the work and others ability to get along
each other and positive participated slightly did not participate with each other
attitude even under more than others. much. With an and lapses in their
pressure. evidence of fair work.
rapport and getting
along with each
other.
Power point Power point includes Power point Power point is Power point is
presentation all material needed to includes most missing more than lacking several key
X1 (4pont) gain a comfortable material needed to two key elements. elements and
understanding of the gain a comfortable inaccuracies.
time period chosen understanding of
the time period
chosen.
Individual Student presented the Student presented Student had many Student was
Student material with material but could difficulties unable to
Presentation confidence. have been more presenting complete
X2 (8ponts) confident. materials. presentation
before the class.
Ability to Answers all the Answers most of the Answers few of the Was not able to
answer questions given. questions given. questions given. answers the
questions questions given.
X2 (8ponts)
TOTAL /40
Modified rubric from: https://www.rcampus.com/rubricshowc.cfm

(COMMUNITY) LECTURE
References
Castro- Estrada, Cecilia. Community Health Nursing and Community Health Development. 1st Edition. (
2012). Educational Publishing House. Ermita , Manila.
Cuevas, Frances Prescilla L.,Public Health Nursing in the Philippines. ( 2007). National League of the
Philippines Government Nurses, Incorporated.Philippines
Gesmundo, Monina H. The basics of Community Health Nursing. ( 2010). C and E Publishing Inc.,
Philippines.
Maglaya, Araceli. Public Health Nursing in the Philippines. 10th Edition, (2009). Argonuta Corporation,
Marikina City
Congratulations for having completed this C-NCM 113 Module 1! See you in the next Module

NCM 113 Module 1 Concept of CHN

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COLLEGE OF NURSING AND PHARMACY

C-NCM 113 – COMMUNITY HEALTH NURSING 2

Second Semester | AY 2020-2021

1. Content / Discussion / Learning Resources / Link

Second Semester | AY 2020-2021

GOALS OF COMMUNITY HEALTH

AIMS OF COMMUNITY HEALTH

COMMUNITY HEALTH NURSING: DEFINITION

Faculty: Aurora R. Valencia, RN, MAN Page 2 of 13

Second Semester | AY 2020-2021

• The philosophy of CHN is based dignity and worth of the individuals.

PHILOSOPHY OF COMMUNITY HEALTH NURSING PRACTICE

GOALS OF COMMUNITY HEALTH NURSING

CONCEPTS AND PRINCIPLES

SALIENT FEATURES OF COMMUNITY HEALTH NURSING

1. Population- or Aggregate-Focused- the hallmark of Community Health Nursing. The whole

Second Semester | AY 2020-2021

FOUR LEVELS OF CLIENTELE in COMMUNITY HEATH NURSING

Faculty: Aurora R. Valencia, RN, MAN Page 4 of 13

Second Semester | AY 2020-2021

THEORETICAL MODEL APPLIED IN COMMUNITY HEALTH NURSING

HEALTH BELIEF MODEL

 By Rosenstoch, Becker and Maiman.

 Individual’s perception of susceptibility to an illness

 Individual’s perception to of the seriousness of the illness.

Faculty: Aurora R. Valencia, RN, MAN Page 5 of 13

Second Semester | AY 2020-2021

 Likelihood that a person will take a preventive action.

PENDER’S HEALTH PROMOTION THEORY (1996)

Faculty: Aurora R. Valencia, RN, MAN Page 6 of 13

Second Semester | AY 2020-2021

Faculty: Aurora R. Valencia, RN, MAN Page 7 of 13

Second Semester | AY 2020-2021

SPECIALIZED FIELDS OF COMMUNITY HEALTH NURSING

1. SCHOOL HEALTH NURSING

Faculty: Aurora R. Valencia, RN, MAN Page 8 of 13

Second Semester | AY 2020-2021

2. OCCUPATIONAL HEALTH NURSING

Functions of Public Health Nurse as an Occupational Health Nurse:

3. COMMUNITY MENTAL HEALTH NURSING

1. Promotion of mental health

Second Semester | AY 2020-2021

2. In Prevention and Control

4. In Research and Epidemiology

Second Semester | AY 2020-2021

Faculty: Aurora R. Valencia, RN, MAN Page 11 of 13

Second Semester | AY 2020-2021

Faculty: Aurora R. Valencia, RN, MAN Page 12 of 13

Second Semester | AY 2020-2021

Faculty: Aurora R. Valencia, RN, MAN Page 13 of 13

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