Approaches to Community Health Nursing

Epidemiological Approach
Epidemiological analysis and measurement allow researchers to measure health
status and measurement of disease occurrences in a population. Surveillance of
disease yields epidemiological intelligence data by providing systematic count of
disease frequency. These data can be in turn used to estimate the magnitude of
health problems in the community, detect epidemics and understand natural
history of a disease or detect potential emerging infectious disease threats.
Another use of this approach is case finding to identify health status of people
who are at risk.
Nursing Process Approach
The nursing process is a modified scientific method. Nursing practice was first
described as a four-stage nursing process. It should not be confused with nursing
theories. The nursing process uses clinical judgment to strike a balance of
Epistemology between personal interpretation and research evidence in which
critical thinking may play a part to categorize the clients issue and course of
action. Nursing offers diverse patterns of knowing.
Phases of the nursing process:
The nursing process is goal-oriented method of caring that provides a framework
to nursing care. It involves five major steps:
A - Assess (what data is collected?)
D - Diagnose (what is the patient’s problem)
P - Plan (how to manage the problem)
I - Implement (putting plan into action)
E - Evaluate (did the plan work?)
Persuasive (influential) Approach
Persuasive approach implies convincing people through dialogue and educate
them to change or modify their health behavior.

Enforcement Approach
The enforcement implies the use of more coercive measures, such as use of
legislation e.g. prohibition of drug abuse, child abuse, immunization as a
condition to school admission etc.
Team Approach
Community health is a problem solving process and a team approach is very
necessary to deal with varied and complex health needs and problems at large. It
is just not possible for any one profession or discipline to provide such care.

Community Involvement Approach

Health of the individuals living in a defined community is not only their rights;
but also their "responsibility" to take care of their own health of the community
at large. Without people help, participation or cooperation, it is neither possible
to make health care services accessible and acceptable to them nor it is feasible to
achieve community health goals and aims.

Intersectoral Approach
Health of people at large cannot be attained by health sector alone because there
are many factors which affect people health but they are not under the purview of
the health sector e.g. food production and distribution, water, sanitation, housing,
environmental protection and education etc. Each one is dealt by separate sector
and socio economic development and health.
Evidence-base Practice Approach
Evidence-based practice (EBP) "entails making decisions about how to promote
health or provide care by integrating the best available evidence with practitioner
expertise and other resources, and with the characteristics, state, needs, values
and preferences of those who will be affected. This is done in a manner that is
compatible with the environmental and organizational context. Evidence is
comprised of research findings derived from the systematic collection of data
through observation and experiment and the formulation of questions and testing
of hypotheses.

Case Management Approach

Case management is a collaborative process that assesses, plans, implements,
coordinates, monitors, and evaluates the options and services required to meet the
client's health and human service needs. It is characterized by advocacy,
communication, and resource management and promotes quality and cost-
effective interventions and outcomes.

Philosophy of Case Management

Case management is an area of specialty practice within one's health and human
services profession. Its underlying premise is that everyone benefits when
clients(1) reach their optimum level of wellness, self-management, and functional
capability: the clients being served; their support systems; the health care
delivery systems; and the various payer sources.

Empowerment Approach
It refers to increasing the spiritual, political, social, educational, gender, or
economic strength of individuals and communities.
Community empowerment refers to the process of enabling communities to
increase control over their lives. "Communities" are groups of people that may or
may not be spatially connected, but who share common interests, concerns or
identities. These communities could be local, national or international, with
specific or broad interests. 'Empowerment' refers to the process by which people
gain control over the factors and decisions that shape their lives.

Health Promotion Approach

Health Promotion is the provision of information and/or education to
individuals, families, and communities that-encourage family unity, community
commitment, and traditional spirituality that make positive contributions to their
health status. Health Promotion is also the promotion of healthy ideas and
concepts to motivate individuals to adopt healthy behaviors.
According to the World Health Organization, Health promotion is the
process of enabling people to increase control over their health and its
determinants, and to improve their health.

Three basic strategies for health promotion:

1. advocacy for health to create the essential conditions for health indicated
above;
2. enabling all people to achieve their full health potential; and
3. mediating between the different interests in society in the pursuit of health.