Community Health Nursing Practice: CHNN312 - Prelims PDF

THEORETICAL MODELS/ APPROACHES OF Perceived severity One's belief in the COMMUNITY HEALTH NURSING PRACTICE: seriousness of a given co...

THEORETICAL MODELS/ APPROACHES OF Perceived severity One's belief in the COMMUNITY HEALTH NURSING PRACTICE: seriousness of a given condition  Outreach – locates populations of interest or Perceived benefits One's belief in the ability populations at risk and provides information of an advised action to about the nature of the concern, what can be reduce the health risk or done about it, and how services can be seriousness of a given obtained condition  Screening – identifies individuals with Perceived barriers One's belief regarding unrecognized health risk factors or the tangible and asymptomatic disease conditions psychological costs of an  Case finding – locate individuals and families advised action Cue to an action Strategies or conditions with identified risk factors and connect them in one’s environment with resources that activate readiness  Surveillance – describes and monitors health to take action events through ongoing and systematic Self-efficacy One has confidence in collection, analysis, and interpretation of one's ability to take health data for planning, implementing, and action to reduce health evaluating public health intervention risks HBM: HOW THEORY PROVIDES DIRECTION TO NURSING:  Believed that individuals must know what to  Sets of assumptions, ideas, and concepts that do and how to do it before they can take action can be true or not  Major limitation: places burden of action  A systematic vision of reality, a set of exclusively on the client interrelated concepts that is useful for  Perception only prediction and control  Theory provides a way of thinking about and MILIO’S FRAMEWORK FOR PREVENTION: looking at the world around us –Torres  Nancy Milio (1976) provides a complement to  Theory organizes relationships between the HBMs complex events that occur in nursing situations so that we can assist human beings – Torres  Perception, with political side; multidimensional  Conceptual system or framework invented for  6 propositions of this framework are related to purpose. The purpose varies, and so too do the structure and complexity of the system – the following: 1. Health deficit – results from an imbalance Dickoff and James between a population's health needs and its  Creative and rigorous structuring of ideas health-sustaining resources; population health projects tentative, purpose deficits result from deprivation and/or excess  Set of ideas, hunches, hypotheses, provides of critical health resources predictions, explanation of the world – Pry a. Midwife: 1 is to 5000 HEALTH BELIEF MODEL (HBM): 2. Organizational dimensions and policies dictate many of the options available and influence  DEVELOPED IN 1958 by a group of US public their choices health service social psychologists 3. Alteration in the pattern of behavior resulting  Wanted to explain why so few people from the decision-making of a significant participate in programs to prevent and detect number of people in a population can result in tuberculosis social change concept definition 4. The behavior of the population results from a Perceived susceptibility One's belief regarding selection from limited choices; these arise the chance of getting a from the actual and perceived options given condition available as well as beliefs and expectations, resulting from socialization, education, and experience  5. Individual choices related to health promotion population, changes therein; study of or health-damaging behaviors are influenced population by efforts to maximize valued resources  Urban – city; rural - province 6. Without concurrent availability of alternative  Study of population size composition and health-promoting options, for the investment spatial distribution (geographic distribution) as of personal resources, health education will be affected by births, deaths, and migration largely ineffective in changing behavior  In Greek means description of the people patterns  Population size – refers to the number of people in a given place at a given time NOLE PENDER’S HEALTH PROMOTION:  Population distribution – is the specific  Developed in the 1980s and revised in 1996. geographic location; saang parte ng Explores many biophysical factors that community sila nakatira influence individuals to pursue health  Population composition – specific promotion activities but does not include characteristics of the population as to age, sex, threat as a motivator long-term occupation, or educational level  Pender’s model focuses on three areas: - characteristics, sino-sino mga nakatira, ilan individual characteristics and experiences, ang bata, matanda, babae, ano ang work at behavior-specific cognitions and affect, and natapos behavioral outcomes - Ilan babae, ilan lalaki, ilan matanda, ilan nakapagtapos ng highschool PRECEDE – PROCEED MODEL: - It is important to know this because the  Was developed for use in public health needs of the people are always based on  Precede - It stands for Predisposing, the composition of the community Reinforcing, and enabling constructs in - Big factor for decision-making of projects: educational diagnosis and evaluation, and is ex: males are more compared to females, used for community diagnosis the area will focus on male health first - Social assessment, administrative, and - PSA – holds and stores the demographic policy factor data of the whole Philippines  Proceed – policy, regulatory, and  Population – a group of individuals of the same organizational constructs in educational and species living and interbreeding within a given environmental development, is a model for area implementing and evaluating health programs  Population projections – an important based on precede demographic tool. They provide a basis for - Implementation, outcome, evaluation other statistical projections helping  Predisposing factors – refer to people’s government in their decision-making; a tool characteristics that motivate them toward that we use to project health-related behavior – KSAV- knowledge, - it is important to project the resources that skills, attitude, value we have for an equal distribution  Enabling factors – refers to conditions in COMPONENTS OF POPULATION GROWTH: people and the environment that facilitate or impede health-related behavior: i.e: resources,  Birth conditions of living, societal support  Death  Reinforcing factors – refers to the feedback  Migration given by support persons or groups resulting 3 demographic data: from the performance of the health-related behavior i.e: economic rewards, social support  Size, composition, distribution DEMOGRAPHY: POPULATION GROWTH:  Duncan and Hauser 1972 – is the study of the  changes in age composition mainly due to size, territorial distribution (san nakatira mga changes in birthrates and are presently tao), and composition (ano mga laman) of increasing the proportion of aged and reducing the proportion of children in many countries  - mas marami yung nanganganak,  Rate of natural increase (RNI) also known as maraming bata sa isang community natural population change – gaano ka kabilis tumaas, the difference between live births and SOURCES OF DEMOGRAPHIC DATA: deaths in a specified period of time Two types: - RNI = crude births rate – crude death rate - Crude birth rate = total number of births 1. primary source – data is directly taken from (live birth) / estimated population as of the people; ex: census, sample survey, July first x 1000 experimental - Crude death rate = number of deaths that 2. secondary source – not direct. ex: registration year / estimated population as of July first system, PSA, FHSIS/reports and records, x 1000 informal sources  Absolute increase per year – measures the  Census – conducted by a national government number of people that are added to the and attempts to enumerate every person in a population per year country; performed by the Philippine Statistic - Ex: from 2020-223 Authority, done every 5 years, mid-year - Latter time – 2023; recent around June or July - Earlier time – last year 1. De Jure – people were assigned to the - T – subtract the year place they usually lived regardless of - No need for decimal, round it off where they were at the time of the census - Permanent address kung saan talaga siya nakatira kahit nasan siya ngayon 2. De Facto – people were assigned to the place where they are physically present at the time of census regardless, of their usual place of residence - Kung nasa Valenzuela siya pero permanent address niya ay tondo, ikacount ang data nya sa Valenzuela kung nasan siya ngayon.  Relative Increase/ population growth rate –  Sample Survey – gather specific data from a the actual difference between the two census small number of people proportionate to the counts expressed in percent relative to the general population population size made during an earlier census; - A small number of people represents the the population growth rate measures the general population average yearly percentage change over the  Registration System – deals with recordings of same time frame vital events; maintained by PSA - Registry of vital events – pagnamatay yung isang tao, or pag may nanganak, siya mag ffile nung certificate; filed in city hall/municipal hall - Reports and record - FHSIS - FHSIS (field health information system) – maintained by the Department of Health, stores, and monitors vital events, data of morbidity, sakit, ikinamatay POPULATION COMPOSITION: DIFFERENT INCREASES IN POPULATION:  Second demographic data pertains to age, sex,  Natural Increase – the difference between live education, work births and deaths in a specified period of time  Sex composition – sex ratio is the ratio of - Number increase = number of births – males to females in a population number of deaths - EX: 100 MALES, 90 FEMALES SR: (111: 100) - 100 – 90 = 10 natural increase last year 2022   A proportion of the people living in urban compared to rural areas CROWDING INDEX:  An alternative measure of household  Age Distribution/composition – the crowding. It is defined as the number of usual proportionate numbers of persons in residents in a dwelling divided by the number successive age categories in a given population of rooms in the dwelling - Bilang ng tao sa age group  Formula:  Median age – age that divides a population Number of people in a household/number of into two numerically equally sized groups that rooms used for sleeping is, half the people are younger than this age and half are older; it is a single index that POPULATION DENSITY: summarizes the age distribution of a population  Calculated as population divided by total land - Ex- pinakabata is 2 yo pinaka matanda is area 75; 75 + 2 divided by 2 is 38.5 or 38-39 =  It is the people per square km of land area median age; add the two data then  Formula: divided into 2 Number of people/land area in terms of  Dependency ratio - specific age population square meters or kilometers group that is not in the labor force and those HEALTH INDICATORS: CHRONIC DISEASES: typically in the labor force; umaasa sa ibang tao; it is used to measure the pressure on the VITAL STATISTICS: population labor 1. Record of essential information on important - ilan ang nagwowork at hindi nagwowork events that influence human demography - Formula – total population from 0 to 14 2. Events like births, death, morbidities (illness), plus 65 and above / total population of mortalities (death), migration, marriages, 15-64 age group x 100 divorce, and aging - Final ans: ans:100 3. We can get the data from PSA or FHSIS  Age and sex composition – may be - FHSIS field health service information summarized in terms of age groups (ex: 0-15 system – health statistics / VS, from DOH years, 15-64 years, and 65 or above) and used by DOH POPULATION PYRAMID: - PSA – demographics (size, distribution, composition) PD 651 (BIRTH REGISTRATION LAW):  Registration of birth and death  Birth – should be registered within 30 days  Death – should be registered within 48 hours  Where do we register? – civil registry  Who registers the birth? – birth attendant  Death can be proclaimed by a health officer (physician)  Vertical axis – paano idivide ang age group, sa  Last resort to proclaim – barangay captain middle yun yung age ng age group  3753 - Civil register law of the Philippines  Horizontal axis – population MATERNAL MORTALITY RATE: POPULATION DISTRIBUTION:  Number of maternal deaths/number of  A pattern of where people live. Can be in urban livebirths x 1000 or rural URBAN-RURAL DISTRIBUTION: MORBIDITY RATE:  CASE FATALITY RATE – killing power of disease  The higher Swaroop’s index the better – pertains that a person reaches above 50 yo  Bar graph – check for graphing of morbidity and mortality  Line graph - Weekly cases of mpox in the Philippines FERTILITY RATE:  Ability to reproduce  Crude – general population EPIDEMIOLOGY:  Backbone for preventing diseases  Study upon people  EPI – upon MORTALITY RATE:  DEMI/DEMOS – people  OLOGY/LOGOS – study DEFINITION OF EPIDEMIOLOGY:  Study of occurrence distribution: you need to study data  Health circumstances (disease, death, deformities)  Probable factors that influence the development of health conditions   Study of distribution, and determinants of  Time patterns may be annual, seasonal, health-related states/events in a specified weekly, daily, hourly, weekday vs weekend, or population any other breakdown of time that may  Application of this study is to prevent and influence disease or injury occurrence control health problems DETERMINANTS: PROCESS OF EPIDEMIOLOGICAL STUDY:  Contains all biological, chemical, physical, Use a variety of concepts: social, cultural, economic, generic behavioral factors that influence health  Biology  Refers to any factor, whether event,  Demography – data about population, characteristic, or other definable entity, that information about people, age, sex group; can brings about a change in a health condition or be found in PSA other defined characteristic  Environmental science  As a nurse epidemiologist use analytic  Policy Analysis epidemiology or epidemiologic studies to  Sociology provide the why and how of such events  Geography - Why it happens and how to control it  Statistics HEALTH-RELATED STATES OR EVENTS: KEY TERMS:  Refers to states or events that may be seen as STUDY: anything that affects the well-being of a  Epidemiology is a scientific discipline with population sound methods of scientific inquiry at its  Focus and investigate the cause of death, foundation behaviors such as the use of tobacco, positive  Epidemiology is data-driven health states, reaction to preventive regimens, and provision/use of health services Comprise of:  Could be positive or negative  Surveillance, observation, hypothesis testing, SPECIFIED POPULATION: analytic research (analytic research), experiment  Epidemiologist is concerned about the collective health of people in a community or DISTRIBUTION: population  Epidemiology is concerned with the frequency  The epidemiologist’s “patient” is the and pattern of health events in a population community  Comprise those with identifiable Analysis by: characteristics such as occupational groups  Places, time, and classes of people affected 3 BASIC STEPS: FREQUENCY:  Identify exposure or source that caused the illness  Refers to the number of health events and the  Number of other persons who may have been relationship of that number to the size of the similarly exposed population  Potential for further spread in the community;  Compare disease occurrence across different and interventions to prevent additional cases population or recurrences  Number of diseases and how we correlate it with the total population APPLICATION TO PREVENTION AND CONTROL: PATTERN:  public health aims to promote, protect, and restore good health  Refers to the occurrence of health-related  Scientific methods of descriptive and analytic events by time, place, and person epidemiology in “diagnosing” the health of a community and proposing public health  interventions to control and prevent disease in STEPS: of nurse epidemiologists the community 1. Aids in ranking health problems – data BEGINNINGS OF EPIDEMIOLOGY: acquired 2. Identify risk factors – congested areas or  Hippocrates – disease is associated with squatter areas are at risk climate and physical environment 3. Design targeted health intervention – propose 3 components of an epidemiological triangle: to the mayor 4. Monitor and evaluate interventions 1. Need an agent, virus, bacteria, or - The program is effective if the disease is microorganism that will cause an outbreak being controlled, low recurrence 2. Need a host, human or animal 3. Environment such as biological, physical, and NATURAL LIFE HISTORY OF DISEASE: socioeconomic, that brings the host and agent 2 STAGES: together  Agent and host – are two important parts for 1. PRE-PATHOGENESIS – wala pa sakit the disease to happen 2. PATHOGENESIS – nakakuha na ng sakit  John Snow – investigation of the Cholera epidemic in 1854  William Farr – use of census and vital registration of data. The described pattern of mortality pattern in subgroups such as occupational groups, prisoners, and other age group PRE-PATHOGENESIS STAGE:  Framingham heart study – identified the risk factors for coronary heart disease  Exposure, papasok pa lang ang virus, virus  Richard Doll and Bradford Hill – doll and Hill’s needs host, then it will start na ang symptoms study, provided compelling evidence of the like disease, and patient with recover, disable, role of smoking in the incidence of lung cancer or lead to death  Jonas Salk – developed and introduced in 1955  Disease not started yet the Salk Vaccine. Field trials showed a  Interrelations of agent, host, and environment protective effect of the vaccine against  some factors favor disease occurrence (ex: paralytic poliomyelitis malnourish)  Susceptibility stage PATHOGENESIS STAGE:  Reaction of host and stimulus  Disease has already developed 3 sub-stages: - Pre-symptomatic - Discernible lesions - Advance disease PRE-SYMPTOMATIC:  Nandon na siya sa incubation period, ito yung time na nakuha na ang virus pero wala pang PRACTICAL APPLICATIONS FOR PHN: symptoms  Nurse epidemiologist measures the frequency  Or early pathogenesis. Pathologic changes and distribution of health conditions using vital began, but no symptoms statistical indices  Epidemiology is used to analyze different factors that contribute to disease development DISCERNIBLE LESIONS:  nagka covid 2 months ago then nag pa booster. Secondary prevention aims to prevent the  Early signs and symptoms developing. Changes recurrence of disease discernible with sophisticated lab test  Mag start na ang symptoms to develop TERTIARY PREVENTION:  people with a health problem  rehabilitation, preventing complications, and ADVANCE DISEASE: improving quality of life  Anatomical and functional changes produced  such as physical therapy identifiable signs and symptoms NATURAL LIFE HISTORY OF DISEASE AND  Nandon na ang lahat ng sintomas. APPLICATION OF LEVELS OF DISEASE PREVENTION: NATURAL LIFE HISTORY OF DISEASE:  PREPATHOGENESIS  Clinical data or patients with several stages of - Primary prevention the disease are put together to determine its  EARLY PATHOGENESIS natural history - Secondary prevention – nagkakasakit without symptoms PREVENTION:  DISCERNIBLE LESIONS  Refers to the identification of potential - Tertiary prevention problems to minimize or eradicate possible - Arrest disease process to prevent disability or deformity complication  Level of prevention – administered to the  ADVANCED DISEASE patient is dependent on the stage of disease - Tertiary prevention when the patient was diagnosed CONCEPT OF CAUSALITY AND ASSOCIATION: 3 levels of prevention:  Henle-Koch – postulate states that the cause 1. Primary – dealing with healthy individuals of a disease is an event, condition, 2. Secondary – individuals who are at high risk of characteristic, or combination of these factors developing a disease that play a vital role in generating disease 3. Tertiary – nagkasakit na ang patient and nag  Necessary cause – must be present for the rerecover na disease to occur  Sufficient cause – if a factor is present, disease PRIMARY PREVENTION: can occur, but the factor’s presence does not  Well promotion always result in the disease occurrence  health promotion, and addressing risk factors  Risk – the probability of an unfavorable event, social and genetic factors disease, disability, defect, or even death.  healthy individual who is receiving vaccination  Association – concurrence of two variables more often than would be expected by chance, 2 sub-classification: then two variables under investigation are said 1. Primordial prevention – focusing on to be associated preventing the emergence of risk factors. It is AGENTS ARE: all about loss and national policy 2. Specific protection – removal of the factors of  Biological – parasites, protozoans, bacteria, reducing their levels virus  Nutritive factors – food, iron, and iodine SECONDARY PREVENTION: deficiency  people at risk of a health problem  Chemical agents – gases and natural or  screening of at-risk individuals, control of risk synthetic compounds ex: lead, mercury, factors, and early intervention insecticides  any diagnostic test that would check if the  Physical agents – humidity, ionizing radiation, patient is a high-risk atmospheric pressure  Mechanical – trauma, stab ENVIRONMENT: EVALUATION EPIDEMIOLOGY:  Includes all external factors/surroundings,  Attempts to measure the effectiveness of other than host and agent that influence different health services and programs health STEPS OF EPIDEMIOLOGICAL INVESTIGATION: ELEMENT OF ENVIRONMENT:  Case definition – a set of standard criteria for  Physical – such as geology and climate classifying whether a person has a particular  Biological – such as insects that transmit the disease, syndrome, or other health condition. agent Listahan ng mga symptoms and if meron ka  Socio-economic – such as crowding, nito, meron ka ng certain disease non sanitation, and the availability of health  Screening – presumptive identifications of services unrecognized diseases or defects  Case finding – is done to look for previously EPIDEMIOLOGICAL APPROACHES: unidentified cases of diseases  Counts cases or health events, and describes  Sensitivity – is the proportion of persons with them in terms of time, place, and person a disease who test positive on a screening test  Divides the number of cases by an appropriate  Specificity – the proportion of persons without denominator to calculate rates a disease who have negative results on a  Compares these rates over time or for screening test different groups of people BASIC STEPS: Answer the question: 1. Operationally define what constitutes a “case”  Who is sick – pag ito yung symptoms positive sya sa sakit  What are their symptoms? - Case classified as suspected or probable  When did they get sick? while waiting for the laboratory results to  Where were they exposed to the illness? become available, if the laboratory provides the report, the case is reclassified PHASES OF EPIDEMIOLOGICAL APPROACHES: as either confirmed or not a case 2. Based on the operational definition, identify  Descriptive epidemiology the cases  Analytical epidemiology  Intervention or experimental epidemiology Classification:  Evaluation epidemiology  Suspected – a case that meets the clinical case DESCRIPTIVE EPIDEMIOLOGY: definition  Probable – a suspected case as defined above  Describe the frequency and distribution of or ongoing disease in a given population  Confirmed – a suspected or probable case with  Observes and records existing patterns of laboratory occurrence of disease 3. Based on the number of cases identified, verify  Describes disease as to person, place, and time the existence of an outbreak characteristics - Outbreak carries the same definition of ANALYTICAL EPIDEMIOLOGY: epidemic, but is often used for a more limited geographic area  Attempts to analyze the causes or - Cluster aggregation of cases grouped in determinants of disease through hypothesis place and time that are suspected to be testing greater than the number expected, even INTERVENTIONAL OR EXPERIMENTAL though the expected number may not be EPIDEMIOLOGY: known; magkakasamang cases sa isang lugar  Answers questions about the effectiveness of 4. Establish the descriptive epidemiologic new methods for controlling diseases or for (pattern, occurrence, frequency, and improving underlying conditions  distribution, we can correlate it with persons, 5. Record the clinical manifestation of cases place, or time) 6. Based on clinical manifestation, incubation period, available laboratory findings, and other Time variations: information gathered, formulate a hypothesis  Cyclical variation regarding probable etiologic agent, sources of - Fluctuation incidence infection, mode of transmission, and the best - short period of time approach for controlling an outbreak - Due to seasonal 7. Test the hypothesis by collecting relevant - Ex: measles specimens from patients and environment  Secular variation 8. Based on the results of the investigation, - Changes in the trend of disease occurrence implement prevention and control measures - Over a long period of time to prevent the recurrence of a similar outbreak  Short time fluctuations 9. Disseminate findings of investigation through - A. common source epidemic – media and other forms to inform the public simultaneous exposure of a large number MONITORING: of people to a common infectious agent - B. propagated epidemic – person-to-  Ongoing activity during program person transmission implementation to assess the current status of its implementation Place: Monitor in terms of:  Geographic scope of the problem  Geographic variation 1. Compliance with design of a program  Refers not only to the place of residence but to 2. Timeliness – natapos ba according sa time any geographic site pertinent to disease 3. Despite being red, mars is a cold place occurrence Monitoring results enables the team to: PATTERN OF DISEASE OCCURRENCE: 1. Assess the progress of program  Epidemic – a situation when there is a marked implementation upward fluctuation in disease incidence, 2. Identify problems malawakan 3. Take corrective action  Endemic – habitual presence of disease in a EVALUATION: given geographic location, consistent every month/year in a given geographical location.  Describe a systematic and objectively assessed Ex: malaria in Palawan compliance to  Sporadic – when disease occurs every now and  partially met, fully met then affecting only a small number of people  Design of the program – performance – relative to the total population. sakit na relevance – the success of the project lulubog lilitaw  Outcome evaluation – evaluates the extent to  Pandemic – worldwide, international which a project accomplishes its intended results. It measures program effects on the EPI CURVE: target population by assessing the progress in  X and y axes – two axes that intersect at right the outcomes or outcome objectives that the angles program is to achieve  Horizontal x-axis – date or time of illness onset  Impact evaluation – assesses the interval the among cases program's effectiveness in achieving its  Vertical y-axis – number of cases ultimate goals. The essence of impact  Each axis is divided into equally spaced evaluation is to comparison intervals. Intervals for 2 axes may differ COMMUNITY HEALTH NURSING: CHNN312:  WHO definition – complete state of physical, mental, and social well-being and not merely COMMUNITY HEALTH: SDG or SUSTAINABLE the absence of the disease or infirmity DEVELOPMENT GOALS: WHAT IS COMMUNITY HEALTH:  Part of paramedical and medical intervention/approach that is concerned with the health of the whole population AIMS: 1. Health Promotion – to make the individual level of health higher through health teaching,  Before 2015 – MDG/millennium development education, or wellness lifestyle-related goal composed of 8 goals activities  Goal 1 – no poverty 2. Disease Prevention – maintain the level of  Goal 6 – clean water and sanitation health the person has such as protection (use WHAT IS A COMMUNITY: of PPE, vaccination, handwashing, and isolation)  A group of people with common 3. Management of factors affecting health characteristics or interests living together within a territory or geographical boundary LEVEL OF PREVENTION:  Place where people under usual conditions are 1. Primary prevention – an intervention found implemented before there is evidence of a DEFINITION OF HEALTH: disease or injury. Reduce or eliminate causative risk factors  OLOF – optimum level of functioning – 2. Secondary prevention – an intervention modern definition of health. Our health is implemented after a disease has begun, but being influenced by our ecosystem through a before it is symptomatic. Early identification number of factors (through screening) and treatment 1. Political factors – safety, oppression, 3. Tertiary prevention – an intervention people empowerment. implemented after a disease or injury is 2. Behavior – whatever behavior you have established. Prevent sequelae (stop bad things will affect your health from getting worse) 3. Hereditary 4. Health care delivery system PUBLIC HEALTH NURSING: 5. Environment  The term used before for community health 6. Socioeconomic status nursing  Health-illness continuum – Neuman, changes  CHN is broader through time.  PHN is a subcomponent  High-level wellness – Halbert Dunn, maximized health potential, balance and DIFFERENT COMPONENTS OF PHN: direction within the environment 1. PHN  Agent-host-environment – used in 2. Occupational health nurse epidemiology, interrelated. 3. School health nurse  Health belief – belief based on perception  Evolutionary-based – life event, lifestyle According to Dr. C.E. Winslow, PHN is a science and determinants, evolutionary viability, viability art of 3 P’S emotion and health outcomes 1. Prevention of disease  Health promotion – increasing well-being 2. Prolonging life through health promotion behaviors 3. Promotion of health and efficiency through organized community effort WHAT IS COMMUNITY HEALTH NURSING?: MISSION OF CHN: 1. The utilization of the nursing process in the  Health Promotion different levels of clientele-individuals,  Health protection families, population groups, and communities,  Health balance concerned with the promotion of health,  Disease Prevention prevention of disease and disability, and  Social justice – equity, fairly rehabilitation, (Maglaya, et al., 2004) PHILOSOPHY OF CHN: 4 clients:  The philosophy of CHN is based on the worth  Family and dignity of man  Individual  Population including population aggregate – a 3 ELEMENTS CONSIDERED IN CHN: group of people with commonalities  Science of Public Health (core foundation in  community CHN) 2. Goal: to raise the level of citizenry by helping  Public Health Nursing Skills communities and families cope with the  Social Assistance Functions discontinuities and threats to their health 3. A special field of nursing that combines the OBJECTIVES OF PUBLIC HEALTH: CODES: skills of nursing, public health, and some  Control of communicable diseases phases of social assistance and functions as  Organization of medical and nursing services part of the total public health program for the  Development of social machinery promotion of health, the improvement of the  Education of IFC on personal hygiene – health conditions in the social and physical education is the essential task of every health environment, rehabilitation of illness and workers disability (WHO expert committee of nursing)  Sanitation of the environment 4. A learned practice discipline with the ultimate goal of contributing as individuals and in BASIC PRINCIPLES OF CHN: collaboration with others to the promotion of the client’s optimum level of functioning  The community is the patient through teaching and delivery of care  The family is the focus of care or the unit of (Jacobson) care, and the individual is the entry point 5. A service rendered by a professional nurse to  The 4 levels of clientele: family, individual, IFCs, population groups in health centers, population group (those who share common clinics, schools, workplaces for the promotion characteristics, developmental stage, and of health, prevention of illness, care of the sick, common exposure to health problems), and at home, and rehabilitation (Dr. Ruth Freeman) the community  Client is considered an active partner not a PUBLIC HEALTH: passive recipient of care  Assisting every citizen to realize his birth  CHN practice is affected by developments in rights and longevity. The science and art of health technology, in particular, changes in preventing disease, prolonging life, and society in general efficiency through organized community effort  The goal of CHN is achieved through multi- for: sectoral efforts - The sanitation of the environment  CHN is part of the health care system and the - The control of communicable infections larger human services system - The education of the individual in personal ROLES OF THE PUBLIC HEALTH NURSE: hygiene - The organization of medical and nursing  Clinician – who is a healthcare provider, taking services in the early diagnosis and care of sick people at home or in the RHU preventive treatment disease  Health educator – who aims towards health - The development of social machinery to promotion and illness prevention through ensure the standard of living  dissemination of correct information;  Maintain coordination/linkages with other educating people health team members, NGO/government  Facilitator – who establishes multi-sectoral agencies in the provision of public health linkages by referral system services  Supervisor – who monitors and supervises the  Conduct research relevant to CHN services to performance of midwives improve the provision of healthcare  Health advocator – who speaks on behalf of  Provide opportunities for professional growth the client and continuing education for staff  Advocator – who acts on behalf of the client development  Collaborator – who works with other health STANDARDS OF CHN: team members 1. Theory – applies theoretical concepts as a Other specific responsibilities of a nurse, spelled by basis for decisions in practice the implementing rules and regulations of RA 7164 2. Data collection – gathers comprehensive, (Philippine Nursing Act of 1991) include: accurate data systematically  Supervision and care of women during 3. Diagnosis – analyzes collected data to pregnancy, labor, and puerperium determine the needs/health problems of IFC  Performance of internal examination and 4. Planning – at each level of prevention, deliveries of babies develops plan that specify nursing actions  Suturing lacerations in the absence of a unique to needs to clients physician 5. Intervention – guided by the plan  Provision of first aid measures and emergency 6. Evaluation – evaluates responses of clients to care interventions to note progress toward goal  Recommending herbal and symptomatic meds achievement, revise data base, diagnoses and plan ROLES OF PUBLIC HEALTH NURSE: 7. Quality assurance and professional development In the care of the families: - Participates in peer review and other  Provision of primary health care services means of evaluation to assure quality of  Developmental/utilization of family nursing nursing practice care plan in the provision of care - Assume professional development - Contributes to the development of others In the care of the communities: 3 ELEMENTS IN HEALTH EDUCATION: IFC:  Community organizing mobilization, community development, and people  Information – to share ideas to keep development population group knowledgeable and aware  Case finding and epidemiological investigation  Education – change within the individual  Program planning, implementation, and - 3 key elements of education: KAS: evaluation knowledge, attitude, skills  Influencing executive and legislative  Communication – interaction involving 2 or individuals or bodies concerning health and more persons or agencies development - 3 elements of communication: message,  MAYOR – chairman of municipal of board sender, receiver  DOCTOR/MUNICIPAL HEALTH OFFICER – Vice- PUBLIC HEALTH WORKERS: phw: chairman  Members of the health team who are RESPONSIBILITIES OF CHN: professionals namely  Be part in developing an overall health plan, its - Medical officer (MO) - physician implementation, and evaluation for - PHN – RN communities - Rural health midwife – registered midwife  Provide quality nursing services to the three - Dentist levels of clientele - Nutritionist  - Medtech - Pharmacist - Rural sanitary inspector – must be a sanitary engineer DOH FIVE MAJOR FUNCTIONS:  Ensure equal access to basic health services  Ensure formulation of national policies for proper division of labor and proper coordination of operations among the government agency jurisdictions  Ensure a minimum level of implementation nationwide of services regarded as public health goods  Plan and establish arrangements for the public health systems to achieve economies of scales  Maintain a medium of regulations and standards to protect consumers and guide providers EO 103: 3 MAJOR FUNCTIONS:  Leadership in health – policies in health  Enabler and capacity builder – new strategies and training  Administrative function – manages tertiary facilities Vision: Filipinos will be healthiest in Southeast Asia in 2022, in Asia in 2040 Mission: to lead the country in the development of a productive, resilient, equitable, and people-centered health system for universal healthcare Must know:  Health education – change undesirable wrong knowledge into a desirable useful one  Phn role – hc provider, leader, epidemiologist, researchers  OLOF – influence ecosystem through a myriad of factors is true  SDG – 17, 6 is sanitation, 1 is poverty  Clinical and non-clinical – PHN  3 specialized field: chn, phn, shn  Focus of care – family  Entry point – individual  Patient – Community  Bar graph – check for morbidity and mortality  Line graph – weekly cases of mpox