CHN-PRELIMS-Y.PONS.pdf

COMMUNITY HEALTH NURSING 1 - MODULE 01 UNIT I. INTRODUCTION - THE FAMILY AND FAMILY HEALTH 4 MAJOR FUNCTIONS OF A FAMILY: (Friedman, 1981) A. CONCEPT and DEFINITION 1. Physical Function –...

COMMUNITY HEALTH NURSING 1 - MODULE 01 UNIT I. INTRODUCTION - THE FAMILY AND FAMILY HEALTH 4 MAJOR FUNCTIONS OF A FAMILY: (Friedman, 1981) A. CONCEPT and DEFINITION 1. Physical Function – - Family members carry out this function by providing a safe, FAMILY comfortable environment necessary for growth, development and - is the basic unit of society rest/recuperation of each family member. e.g. the family should provide quality meals for the nourishment of their body to boost - it serves as a buffer between the needs of the individual and the their immune system so that they will have good resistance against demands and expectations of society. infection. - It is a unity of interacting persons related by ties of marriage, birth 2. Economic Function or adoption, whose central purpose is to create and maintain a - The family should be the one to provide financial aid for members, common culture which promotes the physical, mental, emotional as well as, meeting monetary needs of society. and social development of each of its members (Duval). e.g. It should be the family that will support the finances for the education of their children. Likewise the family contribute - Family is defined as composed of two or more people who are economic development to the society through the taxes every able emotionally involved with each other and live in close family members pay. geographical proximity. (Friedman) 3. Reproductive Function - Family is a separate entity with its own structure, functions and - It is met by the birth of children. We all come from a family by needs, the most basic unit of society (Kristjanson and Chalmers virtue of birth. Nobody exists in these world by mere thunder and (1997) lightning but by birth from biologic parents. Likewise, we beget children within the family as couple/husband and wife. - Family means two or more individuals who share a residence or live near one another, possess some common emotional bonds, 4. Socialization Function engage in social positions that are interrelated, roles, and tasks, and - It is from our own family that we are taught to socialize with share a sense of affection and belonging. ( Murray and Zentner others. Socialization is of major importance and includes teaching; 1997; Friedman 1998) transmitting beliefs, values, attitudes and coping mechanisms; providing feedback and guiding problem – solving. - In science, the term "family" has come to be used as a means to classify groups of objects as being closely and exclusively related. TYPES AND FORMS OF FAMILY 2. Consanguine family which consists of members among whom there exists blood relationship- brother and sister, father and son 1. On the basis of marriage: Family has been classified into three major types: etc. 1. Polygamous or polygynous family - Polygamy refers to a person (male or female) being married to two Regardless of Family structure and configuration there are four famous types of or more people at the same time. Polygyny refers to a man, in a family structure; particular, being married to two or more women at the same time. 1. Nuclear 2. Polyandrous family 2. Single Parent - where one woman is married to several men. 3. Extended 3. Monogamous family 4. Childless - marriage with only one person at a time or the practice of having only one mate. UNIVERSAL CHRACTERISTICS OF FAMILIES 2. On the basis of the nature of residence family can be classified into three 1. Universality: main forms. Family is the basic unit structure of a society and is found in every 1. Family of matrilocal residence culture and almost all geographical locations and at all times. 2. Family of patrilocal residence 3. Family of changing residence 2. Emotional Basis: Emotional attachment between father-mother, parent-children and 3. On the basis of ancestry or descent family can be classified into two main between siblings, keeps the family members together as a unit. types 1. Matrilineal family 3. Limited Size: 2. Patrilineal family Since family is a group of people related to each other by the bonds of blood, adoption or marriage; the number of members in each group is 4. On the basis of size or structure and the depth of generations family can be limited thus restricting the size of the family. classified into two main types. e.g. Sosing Clan – is only limited within relationship of Sosing families 1. Nuclear or the single unit family in as much as other clans. 2. Joint family 4. Nuclear position in the social structure: 5. On the basis of the nature of relations among the family members the family Family is like a unit block in the formation of a social set-up and it can be classified into two main types. performs various functions. Although today many of its functions are 1. The conjugal family which consists of adult members among taken upon by the various social institutions, yet the central status of there exists sex relationship. family is indispensable.  e.g. the social structure of a social institution of abandoned children, home for the aged, rehabilitation centers for drug dependents, etc. that 1. Quality time may serve as a family. Family members who have healthy relationships spend time with one another. Indeed, family time is a fundamental building block to 5. Responsibility of Members: strengthening family bonds. It is not the number of hours we spent in a Each member of the family has a responsibility towards other family relationship but the quality of how we relate to each family member. members, towards family and towards society. e.g. the father as breadwinner, the mother as home-maker, the siblings 2. Communication with individual share of household chores. Ideas will be exchanged in families with good communication skills. Family members will be able to express their emotions, fears and desires 6. Social Regulations: without fear of repercussion or reluctance to say what one feels and think Family is bound to run by certain family and social regulations. These about because one will be reprimanded or punished for what one says or various rules called taboos, customs, laws etc., vary in different cultures. expresses. An individual is not free to overlook these (family and social) regulations 3. Trust which were rather more strict in olden days as compared to the present- - Healthy families have family members who trust one another. If day society. one trust each other within family, one will develop good sense of e.g. Each family has its own set of rules like everybody should be at self thus develops one’s potential and capability to the fullest as to home by 6:00 p.m. to say the Angelus and Holy Rosary; others may how one becomes. prohibit children to be around when elders gather to discuss matters only 4. Fulfilling Needs among elders; other families may hinder children to speak back to - Individual family members can go through times of duress and parents even to explain their side. need. During these times, other family members step up to provide support in a healthy family. In an unhealthy family, for example, 7. Permanent and Temporary Nature: family members may celebrate the troubles that siblings Family as an association is temporary in nature. When one of the partners experience. In functional family, one can be described as likened in a marriage dies, the association ends; thus the association is temporary to the Filipino family saying, “Hawak kamay, kapit lang walang in nature. On the other hand, family as an institution keeps changing its iwanan.” To support each other’s’ needs. members and has permanent existence. - e.g. family changes its members through intermarriages, separation, 5. Family Goals divorces. We become permanent in existence because we are permanent - Healthy families not only talk about family goals, further children of certain parents. Like what the saying goes in Filipino movies, enhancing the channels of communication, they work together to “ang asawa ay napapalitan pero ang anak hindi.” achieve family goals. This can be the accomplishing of family chores in order to keep the household running smoothly or the CHARACTERISTICS OF A HEALTHY FAMILY completion of family projects. 6. Boundaries - Parents and grandparents must accept the duties of managers and STAGES TASKS teachers, and children must Beginning Family  establishing a mutually satisfying marriage understand that the family depends  planning to have or not have upon their abilities to learn and children perform maintenance tasks. Parents Child – bearing Family  having and adjusting to infant have own set of obligations  supporting the needs of all the members likewise the children.  renegotiating marital relationship Family with Pre – school  adjusting to costs of family life 7. Mutual Respect Children  adapting to needs of pre-school children to simulate - When people follow through on growth and development their obligations, an atmosphere of  coping with parental loss of energy and privacy mutual respect is created. Despite Family with  adjusting to the motility of growing Children individual preferences and school age  promoting joint decisions between children and parents differences, respectful family Children  encouraging and supporting children’s relations serve to foster support and educational achievements encouragement when they are Family with Teenagers and  maintaining open communication among members needed Young Adults  supporting ethical and moral values within the family  balancing freedom with responsibility for teenagers STAGES OF FAMIL  releasing young adults with appropriate ritual and assistance  strengthening marital relationship  maintaining supportive home base Post – parental Family  preparing for retirement  maintaining ties with older and younger generations Aging  adjusting to retirement Family  adjusting to loss of spouse  closing family house  MODULE 02 - NCM 104 COMMUNITY HEALTH NURSING (Indiv’l and Level of prevention Family) 1. Primary - concerned with health promotion activities that prevent the actual Global Health Problems occurrence of a specific illness or disease. 1. Global average life expectancy increased by 5 years e.g. between 2000 and 2015, the fastest increase since the * education about good nutrition, the importance of regular. 1960. exercise, and the dangers of tobacco, alcohol and other drug. 2. Healthy life expectancy (HLE) at birth was estimated * education and legislation about proper seatbelt and helmet use. * regular exams and screening tests to monitor risk factors for illness. at 63.1 years * immunization against infectious disease. 3. More that 16,00 children under age of 5 died every * controlling potential hazards at home and in the workplace. day. 4. (45%) of deaths among children under 2. Secondary -promotes early detection or screening and treatment of disease 5 yrs. occur during the 1st weeks of life. and limitation of disability. This level of prevention is also called HEALTH 5. An estimated 2.6 million babies were stillborn. MAINTENANCE. 6. 1.3 million deaths were attributable to hepatitis. e.g. 7. Non communicable diseases (NCDs) caused 37% of * telling people to take daily, low-dose aspirin to prevent a first or second deaths in low income countries, up from 23% in 2000. heart attack or stroke. 8. Ischemic heart disease and stroke killed 15 million * recommending regular exams and screening tests in people with known people. risk factors for illness. 9. Diabetes are among the 10 leading causes of deaths & * providing suitably modified work for injured worker. disability worldwide. 10. Injuries claimed nearly 5 million lives in 2015 3. Tertiary -directed towards recovery or rehabilitation of a disease or condition after the disease has been developed. The individual is on the process of healing and recovery. Activities are done to prevent complications Philippines from the disease or injury of an individual or family. e.g. 1. Persistent inequities in health outcomes * cardiac or stroke rehabilitation programs 2. Restrictive and improvising healthcare costs * chronic pain management programs 3. Poor quality and undignified care synonymous with * patient support groups public clinic and hospitals.  Building blocks and tools - Nutritionist 1. Workforce or Human Resources - Dentist 2. Health Information Technology - Rural Health Midwife (RHM)-Registered Midwife 3. Patient-centered Outcomes Research - Public Health Nurse (PHN)-Registered Nurse 4. Quality Improvement - Medical Officer (MO)-Physician PUBLIC & COMMUNITY HEALTH NURSING - Is the science and art of preventing disease prolonging life, and promoting health and efficiency through organized community effort for - sanitation of the environment - Control of communicable disease - Education of the individual in personal hygiene - Organization of medical and nursing services for the early diagnosis & preventive treatment of disease. - Development of the social machinery to a standard of living as to enable every citizen to realize his birthright of health and longevity. - "It connotes organized, legislated & tax-supported Goal of Public Health - To improve the health of the public by promoting health lifestyles, preventing disease and injury, and protecting the health of communities. PUBLIC HEALTH WORKERS : - Rural Sanitary Inspector (RSI)-must be a sanitary engineer - Pharmacist - Medical Technologist Philosophy of CHN Is based on the worth and dignity of men. (M. Shetland) This is based on the belief that care directed to the individual, family, and the group contributes to the health care of the population as a whole.  UN Millennium Development Goals (MDGs) Module 3 - The Millennium Development Goals (MDGs) are the world's timebound and quantified targets for THE PHILIPPINE HEALTH CARE DELIVERY addressing extreme poverty in its many SYSTEM dimensions-income poverty, hunger, disease, lack of adequate shelter, and exclusion-while - WORLD HEALTH ORGANIZATION (WHO) promoting gender equality, education, and environmental sustainability. - Millennium development goals: 1. Eradicate extreme poverty and hunger 2. Achieve universal primary education 3. Promote gender equality and empower women 4. Reduce child mortality 5. Improve maternal health 6. Combat HIV/AIDS malaria and other diseases 7. Ensure environmental sustainability 8. A global partnership for development Sustainable development goals 1. No poverty 2. Zero hunger 3. Good health and well-being 4. Quality education 5. Gender equality 6. Clean and sanitation 7. Affordable and clean energy 8. Decent work and economic growth 9. Industry, innovation and infrastructure  10. Required inequalities between the community members and other levels of health 11. Sustainable cities and communities facility. 12. Responsible consumption and production 13. Climate action 2. SECONDARY LEVEL – health services are usually 14. Lie below water given in health facilities either privately or government 15. Life on land owned, such as municipal and district hospitals, OPD. It can 16. Peace, justice, and strong institutions perform minor surgeries and simple laboratory examinations. 17. Partnerships for the goal 3. TERTIARY LEVEL – is rendered by specialists in health DOH COMPOSITION facilities including medical centers as well as regional and provincial hospitals. 1. PUBLIC SECTOR – is largely financed through a taxbased budgeting system at both national and local levels The higher the level, the more qualified the health and where health care is generally given free at the point of personnel and the more sophisticated the health equipment. service. Socialized services is also considered. ROLES AND FUNCTIONS OF DOH 2. PRIVATE SECTOR – (profit/non-profit) is largely 1. LEADERSHIP IN HEALTH – serves as the national market-oriented and where health care is paid through user policy and regulatory institution, leads in formulation, fees at the point of service monitoring, and evaluation of national health policies, plans and TYPES/LEVELS OF PHC WORKERS programs, and to serves as advocate in the adoption of health policies. 1. VILLAGE OR BHW’S – refers to trained community health workers or traditional birth attendant or healer. 2. ENABLER AND CAPACITY BUILDER – innovate new strategies in health to improve the effectiveness of health 2. INTERMEDIATE LEVEL HEALTH WORKERS – programs, initiate public discussions, undertake and disseminate refers to doctors, nurses, sanitary inspectors, and midwives. policy research outputs to ensure public participation in policy decision making. 3. ADMINISTRATOR OF SPECIFIC SERVICES LEVELS OF HEALTH CARE – manage selected national health facilities, administer direct 1. PRIMARY LEVEL – is devolved to the cities and services for emergent health concerns, and administer health municipalities, provided by doctors, PHN, PHM, BHW’s at emergency response services. the barangay health stations, and the area for first contact DEVOLUTION OF HEALTH SERVICES To strengthen and to effect a more efficient and effective delivery of health services in the country by combination of - In 1993, health services were devolved or main health center and satellite barrio health stations. transferred from DOH to the LGU. - LOCAL GOVERNMENT CODE (RA 7160) - Physicians (1/20k) - Nurses (1/10k) AIMS: - Midwives (1/5k) - Transform LGU into self-reliant communities and - Sanitary inspectors (1/20k) active partners in the attainment of national goals - Dentist (1/50K) through a more responsive and accountable local - Medical technicians (1/20k) government structure instituted through a system of DECENTRALIZATION. - Each province, city and municipality has a LOCAL HEALTH BOARD (LHB) – this body is a good venue for making the local health system more responsive to the needs of the people. - It is mandated to propose annual budgetary allocations for the operation and maintenance of health facilities and services within the municipality, city or province. COMPOSITION: - Provincial level: governor (chair), PHO (vicechair), Chairman on the Committee on Health of the Sangguniang Panlalawigan, DOH Representative, and NGO representative - Municipal level: mayor (chair), municipal health officer (vice chair), Chairman on the Committee on Health of the Sangguniang Panlalawigan, DOH Representative, and NGO representative RESTRUCTURED HEALTH CARE DELIVERY SYSTEM