Community Health Nursing 2 PDF

NCM 113 │ 3RD YEAR – FIRST SEMESTER │ BSN 3-K COMMUNITY HEALTH NURSING 2 Transcribed by: Guillergan, M.H. areas, and in a variety of roles, at times MODULE 1: COMMUNITY HEALTH NURSING...

NCM 113 │ 3RD YEAR – FIRST SEMESTER │ BSN 3-K COMMUNITY HEALTH NURSING 2 Transcribed by: Guillergan, M.H. areas, and in a variety of roles, at times MODULE 1: COMMUNITY HEALTH NURSING including independent practice… community CONCEPTS nursing is certainly not confined to public health A. Definition nursing agencies” - Jacobson, 1975 B. Philosophy and Principles “The utilization of the nursing process in the C. Features of CHN different levels of clientele–individuals, D. Theoretical Models/Approach population groups and communities, 1. Health Belief Model (HBM) concerned with the promotion of health, 2. Milio’s Framework for Prevention prevention of diseases, and disability and 3. Nola Pender’s Health Promotion rehabilitation.” - Maglaya, et al 4. Lawrence Green’s PRECEDE PROCEED MODEL GOAL: (Predisposing, Reinforcing, Enabling “Raise the level of citizenry by helping Constructs in Educational Diagnosis communities and families to cope with the and Evaluation) discontinuities in and threats to health in such 5. PROCEED (Policy, Regulatory and a way as to maximize their potential for Organizational Constructs in Educational high-level wellness.” - Nisce, et al and Environmental Development) E. Different Fields 3 BASIC CONCEPTS OF COMMUNITY AND PUBLIC 1. School Health Nursing HEALTH NURSING 2. Occupational Health Nursing 1. COMMUNITY as a client 3. Community Mental Health Nursing 2. HEALTH as a goal F. Types of Communities 3. NURSING as a means or vehicle to achieve its Characteristics of a Healthy Community aim Components of a Community I. COMMUNITY AS A CLIENT Factors Affecting Health of the Community 1. Characteristics of the Population Community is a collection of people who interact 2. Location of the Community with one another and whose common interests of 3. Social System within the Community characteristics form the basis for a sense of unity Roles and Activities of Community Health or belonging (Alexander et al., 2009) Nurse II. HEALTH AS A GOAL COMMUNITY HEALTH NURSING HEALTH is a state of complete physical, mental, and social well-being and not merely the “Service rendered by a professional nurse to absence of disease or infirmity (WHO, 2010) communities, groups, families, and individuals Health is more than a state of well-being at home, in health centers, in clinics, in schools, It is a multidimensional reality that includes and in places of work for the promotion of socioeconomic, environmental, and even health, prevention of illness, care of the sick at political factors home, and rehabilitation.” - Ruth B. Freeman Healthcare needs to be holistics “Nursing practice in a wide variety of community services and consumer advocate 1 NCM 113 │ 3RD YEAR – FIRST SEMESTER │ BSN 3-K COMMUNITY HEALTH NURSING 2 Transcribed by: Guillergan, M.H. The nurse in the community foster social justice. This principle speaks of promoting multidisciplinary efforts to address various core common good and not merely to be fair to all. determinants of health 7. One hallmark of the profession is having its own code of ethics. III. NURSING AS THE VEHICLE OR MEANS TO ACHIEVE ITS AIM PRINCIPLES OF CHN Nursing is the art and science of caring ★ The COMMUNITY is the patient in CHN According to Florence Nightingale (1973), ★ The FAMILY is the unit of care nursing is a means of ensuring that people are FOUR LEVELS OF CLIENTELE: placed in an optimum condition where nature - Individual can contribute to healing and wellness. - Family - Population group (those who share common PHILOSOPHY AND PRINCIPLES characteristics, developmental stages and common PHILOSOPHY OF CHN exposure to health problems–e.g., children, elderly) ★ CHN as philosophy of care - The community Characterized by: CHN - Collaboration The client is considered as an ACTIVE PARTNER, - Continuity of care not passive recipient of care - Client and family responsibility for self-care Practice is affected by developments in health - Preventive health care (Hunt, 2005) technology, in particular, changes in society, in Community-based nursing focuses on an general. individual and is family-centered in orientation The goal is achieved through multi-sectoral PHILOSOPHY efforts. 1. The practice of community and public health Part of the healthcare system and the larger nursing is anchored on the primary of the worth human service system. and dignity of man. PRINCIPLES OF COMMUNITY AND PUBLIC HEALTH 2. Respect for people’s inherent value regardless NURSING of their background and beliefs are edified in 1. Focus on the community as the unit of care. the universal bioethical principles. 2. Give priority to community needs. 3. Responsibility for health rests primarily on 3. Work with the community as an equal partner of people and not on agencies or professionals. the healthcare team. 4. The need for the attainment of independence 4. In selecting appropriate activities, focus on and self-reliance in health. primary prevention. 5. Health is a shared responsibility and therefore 5. Promote a healthful physical and psychosocial requires collective efforts from all sectors. environment. Working with communities requires active 6. Reach out to all who may benefit from a specific participation of the people. service. 6. A fundamental commitment of community and 7. Promote optimum use of resources. public health nurses is to adhere to the tenets of 2 NCM 113 │ 3RD YEAR – FIRST SEMESTER │ BSN 3-K COMMUNITY HEALTH NURSING 2 Transcribed by: Guillergan, M.H. 8. Collaborate with others working in the Assumes that preventive health behaviors are community. taken primarily for the purpose of avoiding disease FEATURES OF CHN Emphasizes change at the individual level It is a specialty field of nursing Describes the likelihood of taking an action to Its practice combines public health with nursing avoid disease It is population based Perceived susceptibility, seriousness, and It emphasizes on wellness and other than threat of a disease disease or illness Modifying factors (e.g., demographic, knowledge It includes interdisciplinary collaboration level) It amplifies client’s responsibility and self-care Cues to action (e.g., media campaigns, disease effect on family/friends, recommendations from CHARACTERISTICS AND FEATURES OF healthcare professionals) COMMUNITY AND PUBLIC HEALTH NURSING Perceived benefits minus perceived barriers 1. Developmental to taking action 2. Multidisciplinary 3. Ecology oriented MILIO’S FRAMEWORK FOR PREVENTION 4. Promotes social justice Complements the health belief model 5. Values consumer involvement Emphasizes change at the community level 6. Uses prepayment mechanism Identifies relationship between health deficit 7. Focuses on preventive service and availability of health-promoting resources 8. Offers a comprehensive care Theorize that behavior changes within a large 3 FEATURES OF A COMMUNITY number of people can ultimately lead to social change 1. People 2. Location PENDER’S HEALTH PROMOTION MODEL 3. Social system Similar to Health Belief Model THEORETICAL MODEL/APPROACH Does not consider health risk as a factor that provokes change CHN THEORIES Examines factors that affect individual actions to promote and protect health Nursing theory provides the basis for care of the - (biological, psychological, sociocultural), community and family behaviors, abilities, self-efficacy Theorists have developed sound principles to - Feelings, benefits, barriers, and guide nurses in providing high-quality care characteristics associated with the action HEALTH BELIEF MODEL - Attitudes of others, and competing demands Purpose is to predict or explain health and preferences behaviors 3 NCM 113 │ 3RD YEAR – FIRST SEMESTER │ BSN 3-K COMMUNITY HEALTH NURSING 2 Transcribed by: Guillergan, M.H. ESSENTIALS OF COMMUNITY NURSING PRECEDE - provides the structure for planning a targeted and focused public health program 1. DETERMINANTS OF HEALTH - factors that influence the client’s health P - predisposing Nutrition R - reinforcing, and Stress E - enabling Education C - constructs in Environment E - educational Finances D - diagnosis and Social status/stigma (prejudice) E - evaluation 2. HEALTH INDICATORS - describes the health status of a community and serve as targets for It involves assessing the following community the improvement of a community’s health factors: Mortality rates 1. SOCIAL ASSESSMENT - determine the social Disease prevalence problems and needs of a given population Levels of physical activity and identify desired results Obesity, tobacco or other substance use 2. EPIDEMIOLOGICAL ASSESSMENT - identify the HEALTH PROMOTION MODEL VARIABLES health determinants of the identified 1. Individual characteristics and experiences problems and set priorities and goals 2. Prior related behavior 3. ECOLOGICAL ASSESSMENT - analyze 3. Personal factors behavioral and environmental determinants 4. Behavior-specific cognitions and affect that predispose, reinforce, and enable the 5. Perceived benefits of action behaviors and lifestyles are identified 6. Perceived barriers to action 4. Identify administrative and policy factors that 7. Perceived self-efficacy influence implementation and match 8. Activity-related affect appropriate interventions that encourage 9. Interpersonal influences desired and expected changes 10. Situational influences 5. IMPLEMENTATION of interventions 11. Commitment to a plan of action PROCEED - structure for implementing and 12. Immediate competing demands and evaluating the public health program preferences 13. Health-promoting behavior P - policy LAWRENCE GREEN’S PRECEDE-PROCEED MODEL R - regulatory, and O - organizational A comprehensive structure for assessing health C - constructs in needs for designing, implementing, and E - educational and evaluating health promotion and other public E - environmental health programs to meet those needs D - development 4 NCM 113 │ 3RD YEAR – FIRST SEMESTER │ BSN 3-K COMMUNITY HEALTH NURSING 2 Transcribed by: Guillergan, M.H. It involves the identification of desired outcomes CONCEPTS OF A COMMUNITY and program implementation: A community is a group of people sharing 1. IMPLEMENTATION - design intervention, common geographic boundaries and or assess availability of resources, and common values and interest within specific implement program social systems 2. PROCESS EVALUATION - determine if program Maurer and Smith (2009) further addressed the is reaching the targeted population and concepts of community and identified four achieving desired goals defining attributes: 3. IMPACT EVALUATION - evaluate the change in 1. People behavior 2. Place 4. OUTCOME EVALUATION - identify if there is a 3. Interaction decrease in the incidence or prevalence of the 4. Common characteristics, interests, or goals identified negative behavior or an increase in Combining ideas and concepts, in this text, a identified positive behavior community is seen as a group or collection of locality-based individuals, interacting in social DIFFERENT FIELDS units and sharing common interests, 1. SCHOOL HEALTH NURSING - promote the health characteristics, values, and/or goals. of school personnel and students. TYPES OF COMMUNITIES It aims to prevent health problems that would hinder students' learning and 1. INTEREST - communities of people who share performance of their developmental task. the same interest or passion 2. OCCUPATIONAL HEALTH NURSING - aimed in ACTION - communities of people trying to assisting workers in all occupation bring about change 3. COMMUNITY MENTAL HEALTH NURSING - PLACE - communities of people brought promotion of mental health and prevention of together by geographical boundaries mental illness across the lifespan and across 2. PRACTICE - communities of people in the same sectors. profession or undertake the same activities 3. GEOPOLITICAL COMMUNITIES The services may include: Traditionally recognized or imagined when 1. Treatment planning considering the term community 2. Medication management Geopolitical communities are defined or 3. Assessment formed by both natural and man-made 4. Counseling boundaries and include barangays, 5. Family support municipalities, cities, provinces, regions, and 6. Education nations. Other commonly recognized 7. Group support - facilitate services with visiting geopolitical communities are congressional psychiatrists (e.g., referral) districts and neighborhoods. 8. Home healthcare Geopolitical communities may also be 9. Hospice home care called territorial communities 10. Faith community nursing 5 NCM 113 │ 3RD YEAR – FIRST SEMESTER │ BSN 3-K COMMUNITY HEALTH NURSING 2 Transcribed by: Guillergan, M.H. 4. PHENOMENOLOGICAL COMMUNITIES functions of life and developing to their Phenomenological communities, in the other maximum potential. hand, refer to relational interactive groups, in AIMS: which the place or setting is more abstract, a. Achieve a good quality of life and people share a group perspective or b. Create a health-supportive environment identity based in culture, values, history, c. Provide basic sanitation and hygiene needs interests, and goals d. Supply access to healthcare Includes schools, colleges, universities, COMPONENTS OF A COMMUNITY churches and mosques, and various groups of organizations. ★ The people ★ The environment CHARACTERISTICS OF A HEALTHY COMMUNITY ★ The economy A healthy community is one in which all Culture residents have access to a quality education, Health safe and healthy homes, adequate Quality of life employment, transportation, physical activity, and nutrition, in addition to quality healthcare. 1. Shared sense of being a community based on history and values 2. General feeling of empowerment and control over matters that affects the community as a whole 3. Existing structures that allow subgroups within the community to participate in decision making in community matters 4. Ability to cope with change, solve problems, and manage conflicts within the community through acceptable means 5. Open channels of communication and cooperation among the members of the community 6. Equitable and efficient use of community resources within the view towards sustaining natural resources A healthy city is one that is continually creating and improving those physical and social environments and expanding those community resources that enable people to mutually support each other in performing all the 6