Untitled Quiz

Community Health Nursing 2 (CHN 113 A&B)

• Community: A group of people living together within a territory or geographical boundary, sharing common characteristics or interests.
• Classifications of communities:
  • Urban: High population, industrial work.
  • Rural: Low population, agricultural work.
  • Rurban: Combination of rural and urban.
  • Suburban: Areas around urban centers.
  • Metropolitan: Expanding urban areas.

Aspects of Community

• Social: Communication and interaction among people.
• Cultural: Norms, values, and beliefs of the people.
• Political: Governance and leadership of the people.
• Geographical: Boundaries of the community.

Components of a Community

• People
• Subsystems:
  • Housing
  • Education
  • Fire and Safety
  • Politics and Environment
  • Health
  • Communication
  • Economics
  • Recreation

Health

• State of complete physical, mental, and social well-being, not merely the absence of disease or infirmity.
• Determinants of health:
  • Income and social status
  • Education
  • Physical environment
  • Employment and working conditions
  • Social support network
  • Culture
  • Genetics
  • Personal behavior and coping skills
  • Health services
  • Gender

Theoretical Models/Approaches

• Theories and Models for community health nursing:
  • Nightingale's theory of environment
  • Orem's Self-care model
  • Neuman's health care system model
  • Roger's model of the science and unitary man
  • Pender's health promotion model
  • Roy's adaptation model
  • Milio's Framework of prevention
  • Salmon White's Construct for Public health nursing
  • Block and Josten's Ethical Theory of population focused nursing

Florence Nightingale's Theory

• Born: May 12, 1820
• Founder of modern nursing.
• Known as "The Lady with the Lamp"
• Famous book: Notes on Nursing: What It Is, What It Is Not
• First to propose nursing education and training.
• Key contribution during the Crimean War
• Used charts and graphs to highlight data.
• International Nurses Day is May 12, in her honor
• Died: August 13, 1910

Nightingale's Theory Assumptions

• Natural laws: Mankind can achieve perfection.
• Nursing as a calling
• Nursing as art and science
• Nursing achieved through environmental alteration.
• Nursing requires a specific educational base.
• Nursing separate from medicine.

Nightingale's Canons: Major Concepts

• Ventilation and warming
• Light, Noise
• Cleanliness of rooms/walls
• Health of houses
• Bed and bedding
• Personal cleanliness
• Variety
• Chattering hopes and advices
• Taking food
• Petty management/observation

Nursing Paradigms

• Nursing is different from medicine; goal to place patient in best condition for nature to act.
• Nursing activities that promote health.
• Person: Multidimensional (biological, psychological, social, and spiritual).

Health (Additional Notes)

• Health is not only well-being but the ability to use all powers.
• Disease as Dys-ease, absence of comfort.
• Environment: "Poor or difficult environments led to poor health and disease," "Environment can be altered to improve conditions so that natural laws allow healing to occur"

Overview of Public Health Nursing in the Philippines

• Public Health Nursing evolved in response to global/local health trends.
• Nurses are becoming leaders in health promotion and advocacy.
• Validated by WHO reports' recognition of nursing's contribution to health outcomes, like Millennium Development Goals.

Changes in the Public Health System

• Demographic and epidemiological trends in diseases (emergence/re-emergence).
• Risk and protective factors
• New technologies for healthcare, communication, and information
• Existing and emerging environmental hazards (globalization)
• Health reforms

Global and National Health Issues

• Pandemics
• Environmental factors
• Economic disparities and access to healthcare
• Political factors
• Non-communicable diseases
• Animal health, food sourcing, and supply

Epidemiology

• Study of occurrences and distribution of diseases, health states, or events in populations
• The application of this process to controlling health issues.
• Epidemiologists concerned with deaths, illness, disability, and how to improve health.
• The backbone of disease prevention

Areas of Epidemiologic Investigation

• Distribution of health in terms of age, gender, race, geography, and time
• Patterns of disease in terms of causal factors.

Uses of Epidemiology

• Study disease history, rise and fall, and changes
• Assess community health status and people's conditions
• Measuring incidence, prevalence, disability, mortality
• Identify groups needing special attention
• Evaluate health services and improve them
• Estimate disease risks
• Identify clinical syndromes
• Evaluate disease history and causes

Epidemiologic Triangle

• Triangle with the points: Host, Agent, Environment

Agent

• Intrinsic property of microorganisms, to survive and multiply, and to produce disease in the environment.

Environment

• The sum of external conditions and influences on organism development (biological, social, physical)
• Affects both the agent and the host.

Host

• State of the host at any given time, is a result of genetic endowment and environmental interaction throughout life.

Community Organizing Participatory Action Research (COPAR)

• Social development, transform apathetic/individualistic/voiceless people into dynamic, participatory, and politically responsive communities.
• Identifies needs and goals, empowering community participation.

Importance of COPAR

• Tool for community development and empowerment.
• Generates community participation in development activities.
• Maximizes community participation and involvement.
• Prepares community members (clients) to manage development programs in the future.

Principles of COPAR

• People are usually most oppressed, exploited, and deprived to change and bring about change
• Based on the needs of the poorest sectors of society.
• Leaning to self-reliant communities and society

COPAR Process

• Progressive Cycle of Action-Reflection
• Consciousness-raising via experience to learn for concrete action
• Participatory and mass-based
• Group-centered, not leader-oriented; leaders emerge through actions rather than outside appointments.

Community Organizing Process

• Assess community health needs and problems.
• Plan and implement solutions for community health problems
• Goal is to motivate and enhance community participation in decisions and activities that positively promote community health

Stages in COPAR

• Stage 1: Community Analysis (assessing needs, opportunities, resources)
• Stage 2: Design and Initiation (core planning group, organize)
• Stage 3: Implementation (put design into action)
• Stage 4: Maintenance and Consolidation of Gains: integrating intervention activities, organizational culture, recruitment, results dissemination.
• Stage 5: Dissemination and Reassessment: updating community analysis, evaluating program effectiveness, adjusting strategies.

Phases of COPAR

• Pre-Entry Phase: Community consultation and dialogue
• Entry Phase: Community integration with social investigation and core team formation.
• Community Study/Diagnosis Phase: Research team and methods for gathering data, gathering and validating data, and presenting community diagnoses and recommendations.Prioritizing needs.
• Community Organization and Capability Building Phase: meetings to develop guidelines and roles, elections and delineations, team-building, legal establishment requirements for an organization.
• Community Action Phase: Organization and training, setting up linkages for referrals and resource mobilization schemes and project implementation and evaluation.
• Sustenance and Strengthening Phase: Establishment of community wide activities and implementation, secondary leaders, financing, formalizing systems, continuing development of leaders, CHWs, and CHO members.

Critical Steps/Activities in Building People and Organization

• Integration: immersing oneself in the community, understanding culture, economy, leadership, and life style.
• Social investigation: systematical data collection and community analysis.
• Tentative Program Planning: choose an issue to work on in order to organize the community
• Groundwork: motivating people individually about issues
• The Meeting: Collectively ratifying, sharing decisions
• Role Playing: Preparation and training of people and leadership about meeting and decision making
• Mobilization of Action: experiencing to empower the community
• Evaluation: People assessing steps 1-6
• Reflection: Dealing with the present issues
• Organization: people organization being the result of people activities

Types of Community Diagnosis

• Comprehensive Community Diagnosis: Aims to gather general information (demographics, socio-economic, cultural variables, health/illness patterns, health resources, political leadership patterns)
• Problem-Oriented Community Diagnosis: responds to a particular need.