Community

Health Nursing

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Definitions of Health and
Community
Health; the WHO (1958, p. 1) defined health as “a state of complete
physical, mental, and social well-being and not merely the absence of
disease or infirmity.”
In the mid-1980s, the WHO expanded the definition of health to
emphasize recognition of the social implications of health. Thus health
is:
The extent to which an individual or group is able, on the one hand, to
realize aspirations‫ت طلع ات‬and satisfy needs; and, on the other hand, to
change or cope with the environment. Health is, therefore, seen as a
resource for everyday life, not the objective of living; it is a positive
concept emphasizing social and personal resources, and physical
capacities.

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Definitions of Health and
Community
Community:
In recent nursing literature, community has been defined as “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”
(Rector, 2017, p. 6);
“a group of people who share something in common and interact with
one another, who may exhibit a commitment with one another and may
share a geographic boundary” (Lundy & Janes, 2016, p. 13);
“a locality-based entity, composed of systems of formal organizations
reflecting society’s institutions, informal groups and aggregates”
(Shuster, 2012, p. 398).

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A population is composed of individuals who share some
common characteristic but who do not necessarily interact
with one another.

Community health nursing focuses on promoting and

preserving the health of population groups.

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Types of communities
Geopolitical communities are those most traditionally recognized or
imagined when the term community is considered.
Are defined or formed by natural and/or man-made boundaries and
include cities, counties, states, and nations.
Other commonly recognized geopolitical communities are school
districts, census ‫ا لتع داد‬tracts, zip codes‫ا لرموز ا لبريدية‬, and
neighbourhoods.

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Types of communities
Phenomenological communities: on the other hand, refer to relational,
interactive groups. In phenomenological communities, the place or
setting is more abstract, and people share a group perspective or
identity based on culture, values, history, interests, and goals.
Examples of phenomenological communities are schools, colleges,
universities, and mosques; and various groups and organizations, such
as social networks.

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Types of communities
A community of solution is a type of phenomenological community.
A community of solution is a collection of people who form a group
specifically to address a common need or concern.
A group of disabled people who challenge the owners of an office
building to obtain equal access to public buildings, education, jobs, and
transportation is an example.
They work together to promote optimal “health” and to address
identified actual and potential health threats and health needs.

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 Five Main Functions of a
Community
1. Production, distribution, and consumption of goods and
services. These are the means by which the community provides
for the economic needs of its members.
This function includes not only the supplying of food and
clothing but also the provision of water, electricity, and police
and fire protection and the disposal of refuse.

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2. Socialization:
Socialization refers to the process of transmitting values,
knowledge, culture, and skills to others.
Communities usually contain a number of established
institutions for socialization:
families, places of worship, schools, media, voluntary and
social organizations, and so on.

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3. Social control.
Social control refers to the way in which order is maintained
in a community.
Laws are enforced by the police; public health regulations
are implemented to protect individuals from certain
diseases.
Social control is also exerted through the family, religious
institutions, and schools.

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4. Social interparticipation.
Social interparticipation refers to community activities that
are designed to meet individuals’ needs for companionship.
Families have traditionally met this need; however, many
public and private organizations also serve this function.

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5. Mutual support.
Mutual support refers to the community’s ability to provide
resources at a time of illness or disaster.
Although the family is usually relied on to fulfill this
function, health and social services may be necessary to
augment the family’s assistance if help is required over an
extended period

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Determinants of Health and
Disease
The health status of a community is associated with a number of
factors:
1. health care access
2. economic conditions
3. social and environmental issues
4. cultural practices

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Ten Characteristics of a Healthy
Community
• Is one in which members have a high degree of awareness of being a
community.
• Uses its natural resources while taking steps to conserve them for future
generations.
• Openly recognizes the existence of subgroups and welcomes their
participation in community affairs.
• Is prepared to meet crises.
• Is a problem-solving community; it identifies, analyzes, and organizes to
meet its own needs.

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 Ten Characteristics of a Healthy
Community
• Possesses open channels of communication that allow information to flow
among all subgroups of citizens in all directions.
• Seeks to make each of its systems’ resources available to all members.
• Has legitimate and effective ways to settle disputes that arise within the
community.
• Encourages maximum citizen participation in decision making.
• Promotes a high level of wellness among all its members.

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Relation of community health
and public health
If public health identified as “activities that society undertake to assure
the condition in which people can be healthy” we can derive from this
the definition of community health as “identification of needs and the
protection and improvement of collective health with in geographical
areas”.

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The term public health is an organized, legislated, and tax-
supported efforts that serve all people through health
departments or related governmental agencies.
The term community health extends the realm ‫عا لم‬of public
health to include organized health efforts at the community
level through both government and private efforts.

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Definition of community
health
Community health defined as an “attainment of greatest
possible biological, psychological and social wellbeing of the
community as an entity and of its individual members.
Healthy community displays evidence of biological,
psychological, and social wellbeing in itself” , example; it is
economically stable, unpolluted ,and able to provide needs
of it people at adequate level

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Community health practice

Community health had three characteristics or dimension; status,

structure and process
1. Status: community health status involves emotional, social and
physical components.
Emotional component can be measured by consumer satisfaction and
health indicators .
Social status is measured by crime rate and functional level.

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Status:
Physical component is measured by different community health status
indicators ;
 infant mortality as total and per race, ethnic groups, ,
death rates for all causes
work related injuries
Suicide
lung, breast cancer
cardiovascular disease
 reported incidence of HIV, measles, tuberculosis, syphilis
other risk factors indicators;
- incidence of low birth weight,
- prenatal care, (measured by percentage of mothers delivering live infant who did
not receive prenatal care during first trimester)
- childhood poverty.

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2. Structure:
Is the services and resources of the community,
indicators used to measure the community health status are:
use pattern of services,
treatment data from various health agencies
provider/client ratio.

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3. Process; is the process of effective community
functioning or problem solving direct the study of
community health to promote effective community action
to promote health.

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Characteristics of Community Health
Nursing

 It is a field of nursing

It combines public health and nursing
It focus in population and environmental factors that may impact to
people’s health
It emphasize in health promotion, illness prevention, and wellness

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Component of community
health practice
Promotion of health; include all efforts to move people closer to optimum
wellbeing or to a higher level of wellness.
Health promotion activities and program include many forms of health
education as teaching danger of drug use, and it encompasses the
development and management of preventive health care services that are
responsive to community health needs.
Promotion:
Increase span of a healthy life for all people.
Reduce disparities in health among population groups.
Offer preventive services for all people .

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Component of community
health practice
Prevention of illness
Is the major part of community health practice , means anticipating and
averting problem as early as possible to minimize potential disability
and impairment , and it is practiced on three levels; primary, secondary
and tertiary prevention.

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Level of preventions

Primary prevention;
Obviate the occurrence of health problem it includes measures to keep
illness and injuries from occurring as:
work to control and prevent communicable disease
teach young adult healthy life style behaviors and it involve
planning interventions of needs and problems
designing programs to overcome problem so never occurs.

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Secondary prevention involves efforts to detect and treat existing
health problems at the earliest stage when disease already exists.
Hypertension and cholesterol screening program to identify high risk
individual and encouraging early treatment to prevent heart attack.
It attempts to discover a health problem at appoint the intervention will
lead to control or eradication. As watch for early sign of child abuse, or
teach children about a alcohol and drug abuse.
Tertiary prevention; Maximize recovery after an injury or illness,

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Continue: Component of
community health practice
Treatment
Focuses on the illness end of the wellness-illness continuum.
Provides direct services to people with health problems.
Offers indirect services that help people obtain treatment.
Develop programs to correct unhealthy conditions

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 Component of community
health practice
Rehabilitation
Individuals, Groups and communities.
Evaluation
Individual: Are client outcomes being reached?
Program: Are goals meeting the needs of the target population
Research
Systematically explores the effects of community health and practice
through scientific investigations and epidemiology
 

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Setting for community health nursing
practice

homes
ambulatory service settings
schools
occupational health setting
residential institutions
the community at large

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Major Aspects of a Community
Subsystems Assessment
PHYSICAL ENVIRONMENT
Consider the natural boundaries, size, and population density; types of
dwellings‫ ;ا لمساكن‬and incidence of crime, vandalism, and substance abuse.
EDUCATION
Consider educational facilities; existing school health facilities; type
and amount of health services handled by the school; school lunch
programs; extracurricular sports, libraries, and counseling services;
continuing education or extended education programs; and extent
of parental involvement in the schools.

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Major Aspects of a Community
Subsystems Assessment
SAFETY AND TRANSPORTATION
Consider fire, police, and sanitation services;
sources of water and its treatment;
quality of the air;
garbage disposal service;
availability and safety of public transportation;
availability of ambulance services.

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Major Aspects of a Community
Subsystems Assessment
POLITICS AND GOVERNMENT
Consider kind of government;
organizations active in the community;
influential individuals in the community;
issues that have recently appeared on local ballots‫;ا القتراعات‬
the average election turnout‫ن سبة ا لمشاركة ف يا النتخابات‬.

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Major Aspects of a Community
Subsystems Assessment
HEALTH AND SOCIAL SERVICES
Consider existing hospitals, healthcare facilities, and healthcare
services; number, type, and routine caseloads of community health
professionals;
Geographic, economic, and cultural accessibility to healthcare servic; sources
of health information;
level of immunization among children and adults;
life expectancy in the community;
availability of home healthcare and long-term care services;
availability of transportation service to all major health facilities.

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Major Aspects of a Community
Subsystems Assessment
COMMUNICATION
Consider local newspapers;
radio and TV stations,
postal services,
Internet access,
telephone services;
frequency of public forums;
presence of informal bulletin ‫ن شره‬boards.

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Major Aspects of a Community
Subsystems Assessment
ECONOMICS
Consider the main industries and occupations;
percentage of the population employed or attending school;
income levels and quality and type of housing;
occupational health programs;
major employers in the community.

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Major Aspects of a Community
Subsystems Assessment
RECREATION
Consider recreational facilities in the community and outside the
community;
theaters and movie houses; number and types of religious services;
number and utilization of playgrounds, pools, parks, and sports
facilities;
number and types of social committees, organizations, and clubs
available

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