Community Health Nursing Concepts

Community Assessment

• Community health practice aims to apply methods and solutions to health problems, maximizing benefits for most people.
• Primary prevention is a core goal, protecting public health by preventing disease development and reducing associated pain, suffering, and costs.

Community as a Unit of Service

• The community is the focus of community health nursing care, not just the location.
• The community itself (not individuals) is the primary unit of service.
• Communities are complex social systems with interacting subsystems that are interconnected and interdependent.

Community as Partner

• The term "community as partner" is used, emphasizing equality in the nursing relationship.
• It's based on a total-person approach (Neuman, 1972).
• Key components: Community assessment wheel and nursing process.

Community Assessment Wheel

• The core of the wheel represents community residents (demographics, values, beliefs, history).
• Eight surrounding subsystems: Physical environment, Education, Safety and transportation, Politics and government, Health and social services, Communication, Economics and recreation.
• Community residents impact and are influenced by these subsystems.

Community Assessment Wheel - Lines of Defense

• A solid line surrounds the community, representing its normal line of defense (level of health).
• A broken line represents the flexible line of defense (buffer zone).
• Broken lines between subsystems indicate reciprocal influence.
• Lines of resistance (strengths) are internal mechanisms that defend against stressors.

Community Assessment Wheel - Stressors

• Stressors are stimuli that disrupt community equilibrium (either internal or external).
• The amount of disruption is the degree of reaction.

Community Assessment - Roles of the Nurse

• A community health nurse must define a community and describe its characteristics before applying the nursing process.
• Comprehensive assessment data are essential for directing effective primary prevention interventions within a community.
• The nurse works collaboratively with community members to identify problems, develop solutions, and ultimately improve the community's health.

Community Assessment - Process

• Community members gain an understanding of health concerns and health care systems.
• This process involves identifying, collecting, analyzing, and disseminating information on community assets, strengths, resources, and needs.

Objectives of Community Assessment

• Identify and prioritize community needs.
• Make decisions to improve the community based on needs and available resources.
• Identify organizations that can help meet community needs.
• Understand determinants of health issues.
• Decide on the best approach to address health issues.
• Provide a systematic basis for decision-making.
• Raise awareness of community concerns.

Steps of Community Assessment - Data Collection

• Obtain existing data (surveys, census data, vital statistics).
• Generate new data by interacting with community members (windshield surveys, participant observation, informant interviews, secondary & composite data).

Steps of Community Assessment - Problem Analysis

• Define the nature of the problem.
• Prioritize needs; consider Maslow's Hierarchy of Needs for a framework.
• Consider aggregate preferences, number affected, severity of need, available solutions, and practical limitations.

Steps of Community Assessment - Subsequent Steps

• Establish goals and objectives for interventions.
• Identify specific intervention activities.
• Implement planned intervention activities.
• Evaluate the effectiveness of the interventions.

Needs Assessment

• Assess health problems and causes.
• Apply nursing process; expand assessment, diagnosis, planning, intervention, and evaluation to the community level.
• Determine which problems require intervention and prioritize action.
• Identify desired outcomes of the intervention.

Sources of Community Assessment Data

• Windshield surveys
• Direct observation
• Interviews (key informants)
• Analysis of demographics and statistics
• Surveys
• Census data
• Vital statistics
• Local and regional reports

Community Assessment - Key Considerations

• Aggregate data may be more insightful than official data
• Community perspectives on health, needs, and services are crucial.

Community Needs Assessment

• Identifies community strengths and available resources to meet community needs.
• Focuses on community capabilities (citizens, agencies, organizations).
• Provides a framework for developing services, supporting children and families.

Steps in Needs Assessment Process

• Identify the target community.
• Determine needed information.
• Select methods for gathering data.
• Develop questionnaires & interview questions.
• Establish data collection procedures.
• Train data collectors.
• Select community representatives for a sample.
• Conduct needs assessment.
• Compile and analyze data.
• Identify community needs according to the data.
• Develop an action plan.

Additional Data Sources for Needs Assessment

• Community members knowledgeable about the community
• Focus groups

Diagnosing Community Health Problems

• Identify the health problem or increased risk.
• Describe the affected group.
• Provide an etiological statement.
• Present evidence/support for the diagnosis.

Types of Community Needs

• Perceived needs: What community members think they need.
• Expressed needs: Needs explicitly communicated by community members.
• Absolute needs: Necessary resources (clean water, food, safety).
• Relative needs: Needs contributing to a more equitable community.

This quiz focuses on key concepts in community health nursing, including the roles of community assessment, primary prevention, and the community as a unit of service. It emphasizes the importance of viewing the community as a partner in health care, applying a holistic nursing process. Test your understanding of these foundational ideas and their applications in public health practices.