You are on page 1of 105

COMMUNITY HEALTH

NURSING

COMMUNITY

Social group determined with geographic
boundaries, common values and
interest.
-Its members known to interact each
others
its function with a particular social
structure exhibits, and create norms,
values and social
institution .

HEALTH

It is a state complete physical, mental, social
wellbeing not merely the absence of disease or
Infirmity. (WHO)
State of well being and using power the individual
possess to the fullest extent. (Nightingale)
An on going process- a way of life through which a
person develops and encourages every aspects
of the body, mind and feelings to interrelate
harmoniously as much as possible. (Kozier)
The modern concept of health refer to optimum
level of individual, families, and community.

Nursing  Is an art and science of holistic. adaptive caring and helping profession with focus centered to client concerned with health promotion. health maintenance and health restoration. .

prevention of illness. It is an art & science of caring for individuals. families groups & communities geared toward promotion & restoration of health.NURSING (ADPCN) Nursing is a dynamic discipline. It is focused on assisting client as he or she responds to health –illness situations. practice Science –scientifically tested knowledge . utilizing the nursing process & guided by ethico-legal moral principles. alleviation of suffering & assisting clients to face death w/ dignity and peace. Art-gained frm experiences.

(B) public health (C) some phases of assistance and functions. It s practice directed to individuals. and groups. the dominant responsibility is to the population as a whole. The nature of practice is comprehensive.COMMUNITY HEALTH NURSING      Field of nursing practice where services are carried out in the community settings such as home. puericulture. curative & rehabilitative. continual and not episodic. general. clinic and the like. work place. preventive. Scope of services covered the whole range of health promotive. Special field of nursing that combines the (A) skills and knowledge of nursing. . families.

promoting health. . efficiency.PUBLIC HEALTH   Art & science of preventing disease prolonging life. Services for early diagnosis & preventive treatment of disease and the development of social machinery to ensure everyone standard of living adequate for maintenance of health organizing of these benefits as to able every citizen to realize his birthright of health and longevity.

every Filipino has a right to obtain health benefits as a result of his/her SSS membership . If our leaders today did not give emphasis on the health of citizens. injury or loss (Webster) If there were no laws to ensure protection from exploitative working conditions. The following are subcomponents 1. Today.Health as Multi Factorial Phenomenon A. manages and involves other people in decision making. Political The political climate affects health. there would be government funding nor would there be any government led programs for health. slavery could possibly exist and safety as a health need wouldnot be a right. how he/she rules. This involves one’s leadership. Government is also expanding access to social security. Safety · Is the condition of being from harm.

It ultimately contributes to the poverty of citizen and in the long run the health status of the people as they are not able to purchase the necessary drugs for their illness / condition. This does not mean that oppression does not exist today it still looms in our political environment.Political 2.  . people were more prone to oppression. Oppression Oppression is unjust or cruel exercise of authority or power. Before the advent of a democratic way of government.

Political 3. . This is a quality of a democratic government. The people are allowed to choose their representatives in congress for enactment of laws and government. Political will Political will is the determination to pursue something which is in the interest of the majority.

Empowerment Empowerment is the ability of a person to do something.Political 4. creating the circumstances where people can use their faculties and abilities at the maximum use level in the pursuit of common goals. When one is empowered he or she feels as though they are able to make responsible choices and decide on future steps based on their needs .

Cultural Culture is the representation of nonphysical traits such as values. 1993). these are customary actions usually done to promote and maintain health like use of anting -anting or lucky charms 2. Beliefs – which is a state or habit of mind wherein a group of people place a trust into something or a person (Webster) In health care. . beliefs motivate one’s behavior to achieve health. these can be: 1. although this not scientifically proven. people by virtue of their culture will not take baths because they believe that this could lead to sickness. Take for example the belief that you should not take baths on Fridays. attitudes and customs shared by a group of people and passed from one generation to the next (Potter.Cultural B. Practices – In health care.beliefs.

Heredity Of course heredity also affects health status of individuals.  . 1987) Certain diseases are found to be genetically transmitted. Heredity is the genetic transmission of traits from parents to offspring. genetically determined (Miller-Keane.

When we discuss our health situation you will discover that most illness prevalent are truly preventable with proper environmental sanitation and hygiene . 1987) Florence Nightingale was a pioneer who truly understood how the environment affected an individual’s health. (Miller -Keane.Environment Environment as a factor in health is the sum total of all theconditions and elements that make up the surrounding and influence the development of an individual.

Socio-economic Refers to the production activities. . Without the proper means to sustain a health lifestyle. It is difficult to choose between medications that must be bought today to address an illness and food that must be bought in order to survive another day. this need becomes neglected. distribution and consumption of goods of an individual.

2. early detection & prompt treatment Tertiary level . PA. Primary level – health promotion Secondary level – Preventive.Levels of Prevention 1. 3.rehabilitation .

. but goes beyond healthy lifestyles to well-being. and social well-being. seen as a resource for everyday life. not the objective of living. as well as physical capacities. mental. and to improve. Therefore.HEALTH PROMOTION  "Health promotion is the process of enabling people to increase control over. health promotion is not just the responsibility of the health sector. and to change or cope with the environment. Health is a positive concept emphasizing social and personal resources. therefore. an individual or group must be able to identify and to realize aspirations. to satisfy needs. their health. Health is. To reach a state of complete physical.

food. sustainable resources. Improvement in health requires a secure foundation in these basic prerequisites. . and equity. shelter.OTTAWA CHARTER FOR HEALTH PROMOTION  "The fundamental conditions and resources for health are peace. education. income. social justice. a stable ecosystem.

by health and other social and economic sectors. by nongovernmental and voluntary organizations. health promotion demands coordinated action by all concerned: by governments. More importantly.Mediate "The prerequisites and prospects for health cannot be ensured by the health sector alone. and by the media. by industry. by local authorities. .

families. and communities.People in all walks of life are involved as individuals. "Health promotion strategies and programs should be adapted to the local needs and possibilities of individual countries and regions to take into account differing social. Professional and social groups and health personnel have a major responsibility to mediate between differing interests in society for the pursuit of health.“ . and economic systems. cultural.

and reorienting health services toward health promotion in addition to curative services. .Health Promotion Action Means The Charter defines health promotion in terms of the following activities: building healthy public policy in the full range of administrative and legislative action. strengthening community action and democratic planning processes. creating supportive environments via a socio ecological approach to health. developing personal skills via education.

recognizing health and its maintenance as a major social investment. including: advocating a clear political commitment to health and equity in all sectors. and ecology as central issues. counteracting trends and products that harm health.Moving into the Future Citing caring. the signatories to the Charter pledged to promote health in various ways. holism. reorienting health services toward health promotion. .

Call for International Action  The Charter concludes with a statement calling on the World Health Organization and other international bodies to advocate the promotion of health. .

ACTION AREAS OF OTTAWA CHARTER FOR HEALTH PROMOTION .

. including legislation. Health promotion policy requires the identification of obstacles to the adoption of healthy public policies in non-health sectors and the development of ways to remove them. taxation and organisational change.Building healthy public policy Health promotion policy combines diverse but complementary approaches. fiscal measures.

Creating supportive environments

The protection of the natural
and built environments and the
conservation of natural
resources must be addressed in
any health promotion strategy.
Work, leisure and living
environments should be a source
of health for people.

Strengthening community action
Community development draws on
existing human and material resources
to enhance self-help and social support,
and to develop flexible systems for
strengthening public participation in, and
direction of, health matters. This
requires full and continuous access to
information and learning opportunities
for health, as well as funding support

Developing personal skills
Through information and education
skills - enabling people to learn
(throughout life) to prepare
themselves for all of its stages and
to cope with chronic illness and
injuries is essential. This has to be
facilitated in school, home, work
and community settings.

.Reorienting health services toward health promotion  All health services of different health agencies regardless of their status of work should promote Health.

options. Psychologic al sociocultural Behaviour-specific Cognitions & Affect Perceived benefit of action Perceived barrier of action Perceived self efficacy Activity related affect Interpersonal influences (family. peers. support Situational models influences. Behavioural Outcome Immediate competing demand (low control) & preference s Commitme nt to a plan of actionHealth promotin g behavio ur .Theories / Models of Health Promotion Pender’s Theory Individual Characteristics & Experiences Prior related Behaviour Personal Factors. providers) norms. Biological.

Perception  personality.Health Belief Model Conceptual Model Individual Modifying Likelihood of Age. socioeconomics. ethnicity. factors sex. knowledge Perceived susceptibility/ seriousness of disease Perceived threat of disease Cues to action • Education • Symptoms • Media information action Perceived benefits VS Barrier to behavioural change Likelihood of behavioural change .

Bandura Self Efficacy   Self-efficacy is “the belief in one’s capabilities to organize and execute the courses of action required to manage prospective situations”. and feel. behave. Self-efficacy is a person’s belief in his or her ability to succeed in a particular situation. . Bandura described these beliefs as determinants of how people think.

However. tasks. things they would like to change. and things they would like to achieve. People with a weak sense of self-efficacy:  Avoid challenging tasks.  Focus on personal failings and negative outcomes. People with a strong sense of self-efficacy:  View challenging problems as tasks to be mastered.  Believe that difficult tasks and situations are beyond their capabilities.  Form a stronger sense of commitment to their interests and activities. Bandura and others have found that an individual’s self-efficacy plays a major role in how goals. most people also realize that putting these plans into action is not quite so simple.  Recover quickly from setbacks and disappointments. and challenges are approached.  Quickly lose confidence in personal abilities (Bandura. .  Develop deeper interest in the activities in which they participate.Role of Self Efficacy The Role of Self-Efficacy Virtually all people can identify goals they want to accomplish. 1994).

. Consider a time when someone said something positive and encouraging that helped you achieve a goal. emotional states. A person who becomes extremely nervous before speaking in public may develop a weak sense of self-efficacy in these situations. 4. Psychological Responses Our own responses and emotional reactions to situations also play an important role in self-efficacy. physical reactions. According to Bandura. and stress levels can all impact how a person feels about their personal abilities in a particular situation. However. 3. Getting verbal encouragement from others helps people overcome selfdoubt and instead focus on giving their best effort to the task at hand. However. Social Persuasion Bandura also asserted that people could be persuaded to belief that they have the skills and capabilities to succeed. people can improve their sense of self-efficacy." Bandura explained (1994). “Seeing people similar to oneself succeed by sustained effort raises observers' beliefs that they too possess the capabilities master comparable activities to succeed” (1994). Bandura also notes "it is not the sheer intensity of emotional and physical reactions that is important but rather how they are perceived and interpreted" (1994).   Mastery Experiences The most effective way of developing a strong sense of efficacy is through mastery experiences. Moods.Sources of Self-Efficacy 1. failing to adequately deal with a task or challenge can undermine and weaken self-efficacy. 2. Social Modeling Witnessing other people successfully completing a task is another important source of self-efficacy. Performing a task successfully strengthens our sense of self-efficacy. By learning how to minimize stress and elevate mood when facing difficult or challenging tasks.

prolonging life and promoting health. What are the component of political factor in health? (1-4) What is this health factors that determine the sum total of all the condition& elements that makes up the surroundings? (5) It an art & science of preventing disease.Quiz     a. c. scrotal exam Diabetes awareness e. b. tooth brushing drill Application of braces for scoliosis . (7-16) Biopsy d.(6) Identify what level of preventions are the following activities.

Physical therapy . Removal of tumor in abdomen j.f. Proper Hand washing technique i. Toilet construction h. Immunization g.

 .  Define community health nursing.  Define nursing according to ADPCN.  Define community.Define Health.

DOH ROLES & FUNCTIONS    1. ENABLE AND CAPACITY BUILDER 3. ADMINISTRATOR OF SPECIFIC SERVICES . LEADERS IN HEALTH 2.

                    VISSION         The Leader of Health for All in the Philippines. Health Care Delivery System    DOH Mission Guarantee equitable.III Phil.     . and to lead the quest for excellence in health. sustainable and quality health     for all Filipinos. especially the poor.

STRONG POLICIES SYSTEM AND PROCEDURE CAPABLE HUMAN RSOURCES AND ADEQUATE FINANCIA RESOURCES .HSRA GOAL  SUPPORT MECHANISM WILL BE THROUGH SOUND ORGANIZATIONAL DEVELOPMENT.

Fourmula one for Health         Better health outcome More responsive health system Equitable health care financing ELEMENTS Health financing Health regulation Health service delivery Good governnce .

health services should reflect local needs and involve communities and individuals at all levels of planning and provision of services. education.Primary Health Care  Primary Health Care: as a philosophical approach to health and health care  This approach is characterised by an holistic understanding of health as wellbeing. industry. Equity is a crucial part of . The health status of communities is both a function of and a reflection of development in those communities. Through health promotion and preventive care. Services and technology should be affordable and acceptable to communities. The presence of good health is dependent upon multiple determinants. agriculture. rather than the absence of disease. health services are important but so too are housing. PHC aims to eliminate causes of ill health. The locus of control is important in PHC. public works. communication and other services.

Accepting that challenge. 1978. FP. the WHO and UNICEF proposed new concept of PHC. . in 1981 the 34 th WHO General conference drew up a set of global targets aimed at improving health for all by the year 2000. it culminated with a call for citizen led activities at the regional level in public hygiene. health education.PHC History  Alma Ata international conference on PHC in Sept. MCHC. This conference proved to be a turning point in the history of health care policy. 12. Backed by the fundamental tenet that health is a basic human right for which disparities or inequalities should not allowed.

PHC Philosophy        holistic understanding of health recognition of multiple determinants of health community control over health services health promotion and disease prevention equity in health care research-based methods accessible. affordable technology . acceptable. available.

prevention and treatment multi-disciplinary health workers .PHC Strategies       needs-based planning decentralised management education Inter-sectoral coordination and cooperation balance between health promotion.

PHC Services         locally based affordable and accessible . available. acceptable well integrated health care teams health promotion disease prevention illness treatment rehabilitation services .

Safe Water and Sanitation .Nutrition T.Maternal & Child Care E.Treatment of communicable diseases S.Expanded Program on Immunization M.Essential Drugs N.PHC Elements/ Components         E-Education for Health L.Local Endemic Disease Control E.

Communicable disease are still dominant cause of illness and death among all age group Rapid population growth rate. Poor environmental sanitation. Lack of basic health knowledge Thousands allied professionals were registered but prefer to work in secondary or tertiary level High cost of medical services now a days. Budgetary allocation for health care institution are not enough to sustain the health of the population .Rationale for PHC         Many people die w/o seeing by the health care provider.

family planning program . micronutrient supplementation 4.natal care – registration. tetanus toxoid immunization 3. tx of other diseases and conditions 5. Post partum care 7. Ante.DOH PROGRAMS          MATERNAL AND CHILD HEALTH Maternal care: 1.use of partograph 6. clean and safe delivery. visits 2.

CHILD CARE         Infant and child feeding Newborn screening EPI Management of childhood illnesses Micronutrient supplementation Dental health Early child development Child health injuries .

HEALTH SERVICES FOR NEWBORN. Birth registration Birth weight & monitoring Full immunization . INFANT AND CHILD         Newborn resuscitation Newborn routine eye prophylaxis Prevention & mgt of hypothermia of newborn Immediate & exclusive BF Complimentary feeding at six mos.

INFANT AND CHILD          Micronutrient supplementation Dental care Developmental milestone screening Advice on psychosocial stimulation Growth monitoring and promotion Nutritional screening Disability detection IMCI First aid .HEALTH SERVICES FOR NEWBORN.

REPRODUCTIVE HEALTH ELEMENTS:         FP MCH &Nutrition Prevention & mgt of RTI. men’s reproductive health & involvement Violence against women & children Prevention & mgt of infertility & sexual dysfunction . STI & HIV/AIDS Prevention & mgt of abortion & its complication Prevention & mgt of breast & repro CA other gynecological conditions Education & counselling on sexuality & sexual health.

dyspepsia. This Philippine herbal medicine has been found to be effective in the treatment of diabetes (diabetes mellitus). eczema. anti-allergy. colds and fever. Ampalaya (Momordica charantia) Common names include "bitter melon " or "bitter gourd " in English. ringworms. and being studied for anti-cancer properties. hemofrhoids. anti-inflammatory. and antigenotoxic in folkloric medicine. antioxidant hepatoprotective.known as "5-leaved chaste tree" in english is used in Philippine herbal medicine to treat cough. coughs. boils. scabies and itchiness."Guava" in English. antiinflammatory. anti-cough. burns and scalds. antimicrobial. anti-plasmodial. Lagundi (Vitex negundo) . anti-cancer and anti-hypertensive properties. It is widely used to reduce cholesterol level in blood. . and diarrhea. It is also used as a relief for asthma & pharyngitis.Herbal Medicines      Akapulko (Cassia alata) a medicinal plant called "ringworm bush or schrub" and "acapulco" in English. this Philippine herbal medicine is used to treat tinea infections. rheumatism. antidiabetic. Bawang is a used in Philippine herbal medicine to treat infection with antibacterial. Bayabas (Psidium guajava) . anti-spasmodic. Bawang (Allium sativum) Common name in english is "Garlic". insect bites. A Philippine herbal medicine used as antiseptic.

) .English :"Wild tea" is a Philippine herbal medicine taken as tea to treat skin allergies including eczema. wounds and cuts.is a vine known as "Chinese honey suckle". is used in Philippine herbal medicine as analgesic to relive body aches and pain due to rheumatism and gout. anti spasms.) . Sambong (Blumea balsamifera).     Niyog-niyogan (Quisqualis indica L. colds and coughs and hypertension Tsaang Gubat (Ehretia microphylla Lam. This Philippine herbal medicine is used to eliminate intestinal parasites. colds and insect bites .English name: "Ngai camphor or Blumea camphor" is a Philippine herbal medicine used to treatkidney stones. It is also used to treat coughs. rheumatism.commonly known as Peppermint. scabies and itchiness wounds in child birth Ulasimang Bato | Pansit-Pansitan(Peperomia pellucida) is a Phillipine herbal medicine known for its effectivity in treating arthritis and gout. anti-diarrhea. Yerba Buena (Clinopodium douglasii) .

Health related laws in the Phil.     Republic Act 349 – Legalizes the use of human organs for surgical. medical and scientific purposes Republic Act 1080 – Civil Service Eligibility Republic Act 1082 – Rural Health Unit Act Republic Act 1136 – Act recognizing the Division of Tuberculosis inthe DOH .

      Republic Act 1891 – Act strengthening Health and Dental services in the rural areas. Republic Act 2382 – Philippine Medical Act which regulates the practice of medicines in the Philippines Republic Act 3573 – Law on reporting of  Communicable Diseases Republic Act 4073 – Liberalized treatment of Leprosy Republic Act 6425 – Dangerous Drug Act of 1992 .

       Republic Act 6675 – Generics Act of 1988 Republic Act 7160 – Local Government Code Republic Act 7170 – Law that govern organ donation Republic Act 7277 – Magna Carta of Disabled Persons Republic Act 7305 – The Magna Carta of public Health Workers Republic Act 7432 – Senior Citizen Act .

     Republic Act 7600 – Rooming In and Breastfeeding Act of 1992 Republic Act 7719 –  National Blood Service Act of 1994 Republic Act 7883 – Barangay Health workers Benefits and Incentives Act Republic Act 8172 – Asin Law Republic Act 8423 – Philippine Institute of Traditional and Alternative Medicine .

Republic Act 8749 – The Philippine Clean Air Act of 1999  Republic Act 9165 – Comprehensive Dangerous Drugs Act 2002  Republic Act 9173 – Philippine Nursing Act of 2002  Republic Act 9288 –  Newborn Screening Act  Presidential Decree 147 –  Declares April & May as National Immunization Day  .

Public Health Nurses andRural Midwives .     Presidential Decree 491 –  Nutrition Program Presidential Decree 996 – Provides for compulsory basic immunization for children and infants below 8 years of age Presidential Decree 856 – Code of Sanitation Executive Order 51 – The Milk Code Administrative Order 114 – Revised/updated the roles and functions of theMunicipal Health Officers.

mechanism or means of attaining goal of community development Deals with problem solving Begins as a response to the need or problems Seek a social change Bringing people together who have similar needs or interest In small task oriented-groups with certain defined objectives and activities .Community Organization       A process.

co  In complex form. relevant government and non-government agencies and institution . it requires bringing together various sectors of the population.

Community Organizing  A continuous and sustained process of:  Guiding people to understand the existing condition of their own community  Organizing people to work collectively and efficiently on their immediate and long term problems .

Community organizing participatory action research  A social development approach that aims to transform the apathetic. individualistic and voiceless poor into dynamic participatory & politically responsive community.  .Community Organizing Mobilizing people  Develop their capacity  Readiness to respond  Take action on their immediate and l longterm needs COPAR.

 . liberalative. transformative. sustained and systematic process of building peoples organization by mobilizing & enhancing the capabilities & resources of the people for the resolution of their issues & concerns toward effective change in their existing oppressive & exploitative condition (1994 National Rural CO Conference).COPAR A collective. participatory.

IMPORTANCE OF COPAR    Tool for the community development & people empowerment as this helps the community workers to generate community participation in development activities. Maximizes community participation and involvement: Community resources are mobilized for health development services. Prepares people to eventually take over the management of development program in the future. .

PRINCIPLES OF COPAR

People, especially the most oppressed,
exploited & deprive sectors are open to
change, have the capacity to change &
are able to bring about change.
COPAR, should based on the interest of
the poorest sectors of the society.
COPAR, should lead to self reliant
community and society.

METHOD USED IN COPAR

A progressive cycle action- reflection action, w/c
begin with small, local & concrete issues, identified
by the people & the evaluation and reflection of and
on the action taken by them.
Consciousness-raising, through experiential learning
is central to the COPAR process because it place
emphasis on learning that emerges from concrete
action & w/c encircle succeeding action.
COPAR is participatory and massed-based, because
it is primarily directed towards & based in favor of
the poor, the powerless & the oppressed.
COPAR is grouped centered & not leader certered.
Leaders are identified emerge & are tested through
action rather than appointed or selected external
force

Process/Phases of COPAR





Pre-entry phase – conduct of preliminary social
analysis of the community is needed to be able to plan
the most effective way of entering the community
Preparation of staff
Do you like working for the people?
Do you believe on people’s capacity to change?
Do you believe that people have the potentials to
contribute to their own development?
Do you believe that people should be empowered to
make decision on matters affecting them?
Will you support people’s decision?
Are you committed to serving people’s interest?

Pre-entry       Site collection – steps Developing the criteria for site collection Identifying potential municipality/ catchment area Identifying potential barangay Choosing the final project village/ barangay Identification of the host family .

immersion phase Community integration Participating in community activities Conversing with people in places where they usually converge Conducting house to house visit or social calls Social investigation Collecting Synthesizing Collating Analyzing data .Process/ Phases of COPAR         Entry phase.

Process / Phases of COPAR      Core group formation.the core group will be a training ground for developing leaders in: Democratic & collective leadership Planning & assuming task for formation of a community wide organization Handling & resolving group conflicts Critical thinking & decision making process .

Task of core group  Integration with the core group members  Deeper social investigation  Training and education  Mobilizing the core group .

Process / Phases of COPAR  Organization – Building Phase – it signaled the start of the community management of any development program. The ultimate aim was to form a structure or organization that would coordinate & become responsible for community wide health & development activities .

Mobilization of the health organization . task of core group Possible issues that may arise & how to respond them Organizing & setting the committee Legal & technical recruitment By laws. registration Training & education of the organization Income generating project.Organization-Building phase          Activities pre-organization building activities Listing of speakers.

.Process / Phases of COPAR  Consolidation & Expansion phase or sustenance & Strengthening phase it is a process molding the community organization into cohesive unit & strengthening the leadership group & uniting the membership.

Consolidation & Expansion phase Strategies :  education & training  Networking & linkaging  Conduct of mobilization of livelihood & related development  Development of secondary leaders  Evaluation .

Family Basic unit of the society  Types :  Conjugal (nuclear) family The term "nuclear family" is commonly used. to refer to conjugal families. A "conjugal" family includes only the husband. Sociologists distinguish between conjugal families (relatively independent of the kindred of the parents and of other families in general) and nuclear families (which maintain relatively close ties with their kindred).  . and unmarried children who are not of age. the wife.

these children are her biological offspring. although adoption of children is a practice in nearly every society. This kind of family is common where women have the resources to rear their children by themselves. Generally. .  Matrifocal family (solo or single parent) A "matrifocal" family consists of a  mother and her children. or where men are more mobile than women.

Any society will exhibit some variation in the actual composition and conception of families. it refers to " kindred" who do not belong to the conjugal family. it serves as a synonym of "consanguinal family" (consanguine means "of the same blood"). . These types refer to ideal or normative structures found in particular societies. First. in societies dominated by the conjugal family. Second. This term has two distinct meanings.  Extended family The term "extended family.

" and non traditional to exceptions from this rule. bringing children of the former family into the new family.   Blended family Male same-sex couple with a child The term blended family or stepfamily describes families with mixed parents: one or both parents remarried. married to each other and raising their biological children. . traditional family refers to "a middleclass family with a bread-winning father and a stay-at-home mother.

 The nursing care plan. methods and materials which the nurse hopes will improve the problem situation. The interventions the nurse decides to implement are chosen from among alternatives after careful analysis and weighing of available options. strategies. The core of the plan are the approaches. It utilizes events in the past and what is happening in the present to determine patterns.Principles of family nursing care plan  The nursing care plan focuses on actions which are designed to solve or minimize existing problem. as with all plans. relates to the future. .  The nursing care plan is a product of a deliberate systematic process. The plan is a blueprint for action. the planning process is characterized by logical analyses of data that are put together to arrive at rational decisions. It also projects the future scenario if the current situation is not corrected. activities.

and the foci of the objectives of care and intervention measures. The nursing care plan is a means to an end. not a one-shot-deal. .Principles of FNCP    The nursing care plan is based upon identified health and nursing problems. The goal in planning is to deliver the most appropriate care to the client by eliminating barriers to family health development. not an end in itself. The results of the evaluation of the plan’s effectiveness trigger another cycle of the planning process until the health and nursing problems are eliminated. The problems are the starting points for the plan. Nursing care planning is a continuous process.

or giving a tube feeding can yield data that will help you complete the family picture. you can obtain more information about the family and their role in the patient’s health care management. adjusting an intravenous rate. Assessment data can be obtained anytime health care professionals interact with patients and families. Anytime the family is present. Gathering information about family structure. . and needs does not have to be restricted to structured interviews. function. Informal conversations with the patient and family while you are passing medications.FAMILY ASSESSMENT  A good family assessment requires astute observation skills and the ability to be an active listener.

Areas of Family Assessment         What is the family like? Who is considered part of the family? What is the patient’s position and role in the family? Who has most influence on the patient? What are the ages and sex of the family members? What are their occupations? What is the health status of family members? Are there physical limitations that would affect a family member’s ability to help with care needs? .

church. community organizations? .Areas of Family assessment        What resources are available to the family? Can the family provide for the patient’s physical needs? What is the patient’s home like? Does it provide sufficient safety and comfort features? What is the patient’s ability to perform self-care? What are the health insurance resources? What neihgborhood or community resources are available? What connections does the family have with friends. neighbors.

and beliefs? What is the level of education of the family members and their attitudes toward learning? Do all family members have basic literacy skills? Are there language barriers to verbal communication? What is the family’s lifestyle and cultural background? Does the family have any folk medicine beliefs? Are there potential conflicts between cultural beliefs and the recommendations of health professionals? What are the family’s normal dietary patterns? Does the family seem to be able to take in new information easily and apply what was taught? Does the family seem overwhelmed as a result of the need to learn new skills? .Areas of Family Assessment           What are the family’s educational background. lifestyle.

Areas of Family Assessment          What is the family’s understanding of the current health care problem? What do they think has caused the health care problem? Why do they think the problem occurred now? What do they think the illness does to the patient? How severe do they believe the illness is? What kind of treatment do they think the patient should receive? What are the most important results they think the patient should obtain from the treatment? What are the major problems the illness has caused for the family? What do they fear most about the situation? .

Areas of Family Assessment         How does the family seem to function? Do family members seem to be sensitive to the patient and to each other? Do family members appear to be able to communicate effectively with each other? Does the family indicate that they have the ability to accept help from others when it is needed? How open does the family seem to teaching? Do key family members have the ability to make effective decisions? What experience does the family have in handling crisis situations? How did the family react to crises in the past and what resources did they use to help them? .

Areas of Family Assessment          What is the family’s understanding of the current health care problem? What do they think has caused the health care problem? Why do they think the problem occurred now? What do they think the illness does to the patient? How severe do they believe the illness is? What kind of treatment do they think the patient should receive? What are the most important results they think the patient should obtain from the treatment? What are the major problems the illness has caused for the family? What do they fear most about the situation? .

Areas of Family Assessment        What are the patient and family’s teaching needs? What do the patient and family think are the most important things they need to know? Do the patient and family know others with the same health care problem? Do the patient and family understand and agree with the treatment plan? Are there any physical or cognitive limitations that will be barriers to learning? Are the patient and family willing to negotiate goals with the health care team? Are the patient’s perceptions about what to do similar to the family’s point of view? .

B. D. E. practices on health promotion. maintenance of disease prevention .Assessment Initial data base (IDB) A. C. Family structure Socio-economic & cultural characteristic Home & environment Health status of family members of the family Values habit.

Function. Data analysis       Sort data Cluster/ group related data Identify pattern (e. Behaviour.g.2. lifestyle) Compare pattern w/ norm/ standard Interpret result Make inferences/ draw conclusion .

foreseeable crisis 2nd level. Health conditions/problems and family nursing diagnosis       1st level define health conditions/problems A. health deficit C.3. wellness state B. health threats D.define the family nursing problems diagnosis as: family’s inability to perform health task on each health condition/problems specifying the barrier to performance or reason for non performance of family health task .

Prioritization of conditions/ problems knowledge . Plan of intervention 4. nurse community 2. technology. & intervention to enhance wellness Resources of family. Goals and objective of nursing care 3.Developing a Family Nursing Care Plan        Component: 1. Plan for evaluating care .

health action potentials  Community diagnosis (community dx ppt)  Community Planning (principles)  Intervention. health status b. health resources c. activities to be done as solution to the problems identified  Evaluation  . strategies.action.Community Health Nursing Process Assessment of community health needs Components: a.

fostering sustainability. goal.Elements of community planning process        Needs assessment: identifying the needs and assets of the community or neighborhood and the particular health concerns and disparities. Strategic planning: clarifying vision. Building understanding about multiple determinants of health : raising awareness about what contributes to good health and fostering buy-in into a preventive approach to improving health and safety outcomes Partnership and coalition building: determining and engaging the support of key stakeholders and decision makers. and ensuring that resources are being appropriately used. including community engagement Prioritization: selecting the appropriate factors and combination of factors Comprehensive approaches: implementing multifaceted activities to achieve desired outcomes Evaluation: ongoing assessment and evaluation of community efforts . and directives. establishing decision making processes and criteria.

VITAL STATISTICS Population natural increase: Formula: Number of births – Number of deaths Rate of natural increase= CBR – CDR Absolute increase per year= Pt –Po t Pt= population size at a later year Po= population size at earlier time t = number of years between time o and time t .

Po_ Po Population Composition: Sex Ratio= Number of males X Number of females Fertility rates: CBR= number of live births X 1000 Midyear population  .Population Increase Relative increase = Pt_.

Vital Statistics General fertility rates  = number of live births X 1000 Midyear population of women 15-44 yrs CDR = Number of deaths X 1000 Midyear population IMR=number of deaths < 1yr X1000 Number of live births  .

Epidemiology  The study of the distribution of diseases in populations and of factors that influence the occurrence of disease. but are related to environmental and personal characteristics that vary by place. how much the risk is increased through exposure. where risk of the disease is highest. it is based on the observation that most diseases do not occur randomly. time. and how many cases of the disease could be avoided by eliminating the exposure . and subgroup of the population. Epidemiology examines epidemic (excess) and endemic (always present) diseases. The epidemiologist attempts to determine who is prone to a particular disease. when the disease is most likely to occur and its trends over time. what exposure its victims have in common.

 n the course of history. by discovering what exposures or host factors were shared by individuals who became sick. the epidemiologic approach has helped to explain the transmission of communicable diseases. and demonstrated the value of mammography in reducing breast cancer mortality. linked menopausal estrogen use to increased risk of endometrial cancer but to decreased risk of osteoporosis. such as cholera and measles. shown that acquired immune deficiency syndrome (AIDS) is associated with certain sexual practices. By identifying personal characteristics and environmental exposures that increase the risk of disease. Modern epidemiologists have contributed to an understanding of factors that influence the risk of chronic diseases. particularly cardiovascular diseases and cancer. . epidemiologists provide crucial input to risk assessments and contribute to the formulation of public health policy. which account for most deaths in developed countries today. Epidemiology has established the causal association of cigarette smoking with heart disease.

the most common measures of disease occurrence are (1) mortality (number of deaths yearly per 1000 of population at risk). and population censuses. Data sources include death certificates. special disease registries.000 of population at risk). and (3) prevalence (number of existing cases at a given time per 100 of population at risk). (2) incidence (number of new cases yearly per 100. . Descriptive measures are useful for identifying populations and subgroups at high and low risk of disease and for monitoring time trends for specific diseases.Descriptive Epidemiology  Descriptive epidemiologic studies provide information about the occurrence of disease in a population or its subgroups and trends in the frequency of disease over time. They provide the leads for analytic studies designed to investigate factors responsible for such disease profiles. surveys.

but observes them to learn whether those exposed to different factors differ in disease rates. exposure. Usually two groups are studied.Analytic Epidemiology  Analytic epidemiologic studies seek to identify specific factors that increase or decrease the risk of disease and to quantify the associated risk. Outcome . Alternatively. In experimental studies. In observational studies. or treatment of people to determine the impact of the intervention on the disease. the researcher attempts to learn what factors distinguish people who have developed a particular disease from those who have not. the investigator alters the behavior. one that experiences the intervention (the experimental group) and one that does not (the control group). the researcher does not alter the behavior or exposure of the study subjects.