CHN Lec

• Community Health Nursing according to WHO

  A specialized field of nursing, public health and some phases of social assistance that functions as part of the total public health program for the promotion of health, improvement of the conditions of social and physical environment, rehabilitation of illness and disability
• Clientele of the CHN

  • Individuals
  • Family
• Population group


  • Is a group of people who share common characteristics, developmental stage or common exposure to environmental factors and consequently common health problems: children, men, women, farmers, factory workers, commercial workers, prisoners, military men, and elderly
• CHN Highlights

  • The goal of professional practice is the promotion and preservation of health of populations
  • The nature of practice is comprehensive, general, continual, and not episodic
  • The knowledge base comes from nursing and public health
  • The different levels of clientele - individuals, families, and groups
  • The practitioner’s recognition of the primacy of the population as a whole
• Community Health Nursing according to American Nurses Association (ANA)


  Practice that promotes and preserves the health of populations by integrating the skills and knowledge relevant to both nursing and public health. The practice is comprehensive and general and is not limited to a particular age, diagnostic group, or episodic care
• Characteristics of a Healthy Community

  • Awareness that we are community
  • Conservation of natural resources
  • Recognition of, and respect for, the existence of subgroups
  • Participation of subgroups in community affairs
  • Preparation to meet crises
  • Ability to problem solve
  • Communication through open channels
  • Resour
• Community Health Nursing highlights important points:
• Community Health Nursing


  A service rendered by a professional nurse with communities, groups, families, individuals at home, in health centers, in clinics, in schools, in places of work for the promotion of health, prevention of illness, care of the sick at home and rehabilitation
• Community Health Nursing according to Jacobson


  A learned practice discipline with the ultimate goal of contributing as individuals and in collaboration with others, the promotion of the client’s optimum level of functioning thru teaching and delivery of care
• Health tasks of the family identified by Freeman (1981)

  • Recognizing interruptions of health development
  • Seeking health care
  • Managing health and non-health crises
  • Providing nursing care to the sick, disabled and dependent member of the family
  • Maintaining a home environment conducive to good health and personal development
  • Maintaining a reciprocal relationship with the community and health situations
• CHN Concepts from the Science of Public Health

  • Emphasis on the importance of the greatest good for the greatest number
  • Assessing health needs, planning, implementing, and evaluating the impact of health services on population groups
  • Priority of health-promotive and disease-preventive
  • Tools for measuring and analyzing community health problems
  • Application of principles of management and organization in the delivery of health services to the community
• Characteristics of a Community

  • Defined by its geographic boundaries within certain identifiable characteristics
  • Made up of institutions organized into a social system with the institutions and organizations linked in a complex network having a formal and informal power structure and a communication system
  • A common or shared interest that binds the members exists
  • Has an area with fluid boundaries within which a problem can be identified and solved
  • Has a population aggregate concept
• Essential Elements of Primary Health Care

  • Education
  • ... (additional elements may follow)
• Universal Declaration of Human Rights Article 25 Section 1: 'Everyone has the right to a standard of living adequate for health and well-being, including food, clothing, housing, medical care, necessary social services, and security in the event of unemployment, sickness, disability, widowhood, old age, or other lack of livelihood in circumstances beyond control'
• Health


  (WHO) is a state of complete physical, mental and social well-being, not merely an absence of disease or infirmity
• High-Level Wellness


  Integrated method of functioning oriented toward maximizing individual potential, maintaining balance and purposeful direction within the environment
• PHC as a Public Health Service


  Related to public health services in technical support, referral of patients, continuing education, health information provision
• Community Health Development Concepts, Principles and Strategies

  1. Goal: Health for All Filipinos and health in the Hands of the People by the year 2020

  2. Mission: To strengthen the health care system by increasing opportunities and supporting conditions for people to manage their own health care
• 10 Determinants of Health by WHO

  • Income and social status
  • Education
  • Physical environment
  • Employment and working conditions
  • Social support networks
  • Culture
  • Genetics
  • Personal behavior and coping skills
  • Health services
  • Gender
• Community Health Nursing Concepts

  1. Preparation to meet crises

  2. Ability to problem solve

  3. Communication through open channels

  4. Resources available to all

  5. Setting of disputes through legitimate mechanisms

  6. Participation by citizens in decision making

  7. Wellness of a high degree among its members
• Prerequisites for Health

  • Peace
  • Shelter
  • Education
  • Food
  • Income
  • A stable eco-system
  • Sustainable resource
  • Social justice and equity
• PHC as an Appropriate Strategy

  Feasible application for problem-solving appropriate to social conditions and problems, work pattern need not be identical in all villages
• Primary Health Care Concepts

  1. Cooperation of the Community

  2. Capability of people to determine and analyze their own problems and find solutions

  3. Voluntary Community involvement

  4. Villagers work to ensure better living of the community

  5. Basic Needs

  6. PHC to Achieve a Better Quality of Life

  7. Self Reliance

  8. PHC activities must be in harmony with existing institutions and daily life of the community
• Laws affecting practice of public health nursing

  • Republic Act No. 6713 - Code of Conducts and Ethical Standards for Public Officials and Employees
  • Republic Act No. 7305 - Magna Carta for Public Health Workers
  • Republic Act No. 6758 - standardized salaries of government employees including nursing personnel
  • Republic Act 9173 - Philippine Nursing Act of 2002
• Health Promotion Actions Means

  • Building healthy public policy
  • Creating supportive environments
  • Strengthening community actions
  • Developing personal skills
  • Reorienting health services
• Essential Elements of Primary Health Care

  • Education for health
  • Locally-endemic Disease Control
  • Expanded Program on Immunization
  • Maternal and Child Health
  • Essential Drugs
  • Nutrition
  • Treatment of Communicable Diseases
  • Safe Water and Sanitation
• Health Promotion is the process of enabling people to increase control over, and to improve, their health
• Health is seen as a resource for everyday life, not the objective of living
• Theory: An integrated set of propositions that serve as an explanation for a phenomenon
• Bandura's Social Cognitive Theory provides a framework for human behavior
• To reach a state of complete physical, mental and social well-being, an individual or group must be able to identify and to realize aspirations, to satisfy needs, and to change or cope with the environment
• PHC as an Appropriate Strategy

  • Feasible in its application for problem-solving appropriate to social conditions and problems being encountered
  • Pattern of work need not be identical in all villages
• Theories & Models of Health Promotion
• Health Belief Model is used to guide health promotion and disease prevention programs
• Levels of Health Care and Referral System

  1. Primary Level Facilities

  2. Secondary Level Facilities

  3. Tertiary Level Facilities
• Health is a positive concept emphasizing social and personal resources, as well as physical capacities
• Model: A subclass of theory that provides for investigating and addressing a phenomenon
• Perceived Barriers - one of the major reasons people don’t change their health behaviors is that they think that doing so is going to be hard. Sometimes it’s not just a matter of physical difficulty, but social difficulty as well. Changing your health behaviors can cost effort, money, and time
• Health Education


  Aims at learning experiences and voluntary actions people take, individually or collectively, for their own health, the health of others, or the common good of the community
• Health Behavior Model


  • One of the most widely models for understanding health behaviors
  • Based on the theory that a person’s willingness to change their health behaviors is primarily due to factors like Perceived Susceptibility, Perceived Severity, Perceived Benefits, and Perceived Barriers