Chapter 1

• 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
• 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
• 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
• 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
• Clientele of the Community Health Nursing

  • Individuals
  • Family
• Community Health Nursing 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
• 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
• 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
• 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
• 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
• Prerequisites for Health

  • Peace
  • Shelter
  • Education
  • Food
  • Income
  • A stable eco-system
  • Sustainable resource
  • Social justice and equity
• Universal Declaration of Human Rights Article 25 Section 1 states that "Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, 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 his control"
• 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


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


  Integrated method of functioning oriented toward maximizing individual potential, maintaining balance and purposeful direction within the environment
• Primary Health Care Concepts

  • Cooperation of the Community
  • Capability of people to determine and analyze their own problems and find solutions
  • Voluntary Community involvement
  • Villagers working for better community living
  • Basic Needs
  • PHC to Achieve a Better Quality of Life
  • Self-Reliance
  • PHC activities in harmony with existing institutions and daily life of the community
• 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
• PHC as an Appropriate Strategy

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

  • Education
• PHC as a Public Health Service


  Related to public health services in technical support, referral of patients, continuing education, health information provision
• Theories & Models of Health Promotion

  1. An integrated set of propositions that serve as an explanation for a phenomenon

  2. A systematic arrangement of fundamental principles that provide a basis for explaining certain happenings of life

  3. A subclass of theory that provides for investigating and addressing a phenomenon

  4. Provides the vehicle for applying the theories
• 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
• Health Promotion


  1. Process of enabling people to increase control over, and to improve, their health

  2. 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

  3. Health is seen as a resource for everyday life, not the objective of living

  4. Health is a positive concept emphasizing social and personal resources, as well as physical capacities
• 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 Actions Means

  • Building healthy public policy
  • Creating supportive environments
  • Strengthening community actions
  • Developing personal skills
  • Reorienting health services
• Bandura's Social Cognitive Theory


  1. Framework for human behavior

  2. Identifies human behavior as an interaction of personal factors, behavior, and the environment

  3. Helpful for understanding and predicting both individual and group behavior and identifying methods in which behavior can be modified or changed
• Health Belief Model

  1. Theoretical model used to guide health promotion and disease prevention programs

  2. Used to explain and predict individual changes in health behaviors

  3. Based on the theory that a person's willingness to change their health behaviors is primarily due to factors like perceived susceptibility
• Perceived Severity - the probability that a person will change his/her health behaviors to avoid a consequence depends on how serious he or she considers the consequence to be
• Perceived Susceptibility - people will not change their health behaviors unless they believe that they are at risk
• 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 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
• 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
• Perceived Benefits - it’s difficult to convince people to change a behavior if there isn’t something in it for them
• Health Education


  Combination of learning experiences designed to facilitate voluntary actions conducive to health
• Morbidity


  Cases of illness in a given population in a specified period of time
• Health Promotion


  Combination of educational and environmental supports for actions and conditions of living conducive to health
• Health promotion focuses on making more healthful choices easier choices