NCM113 CHN Module 1 - Community Health Nursing Concept PDF

MODULE 1: Community Health Nursing Concept NCM113 CHN LECTURE BSN 3E | A. DARACAN | 1ST SEM | 9/7/2022 6. Community Development Definition of Terms An organized effort of peo...

MODULE 1: Community Health Nursing Concept NCM113 CHN LECTURE BSN 3E | A. DARACAN | 1ST SEM | 9/7/2022 6. Community Development Definition of Terms An organized effort of people to 1. Community improve the conditions of A collection of people who interact community life and the capacity of with one another and whose the people for participation, common interests or self-direction, and integrated efforts characteristics form the basis for a in community affairs (Jimenez, sense of unity or belonging (Allender 2008). et.al, 2009) A process where community A group of people who share members come together to take common interests, who interact with collective action and generate each other and who function solutions to common problems. collectively within a defined social Community wellbeing (economic, structure to address common social, environmental, and cultural) concern (Clark, 2008). often evolves from this type of A group or collection of individuals collective action being taken at a interacting in social units ns sharing grassroots level. common interests, characteristics, 7. Community Organizing values and goals (Maurer and Smith, A process consists of steps or 2013). activities that instill and reinforce 2. Community Health the people’s self-confidence on their The health status of a community own collective strengths and and the organized responsibilities of capabilities (Manalili, 1990). public health, school health, A process of educating and transportation, safety and other mobilizing members of the tax-supported functions with community to enable them to resolve voluntary and private actions to community problems. promote and protect the health of A means to build the community’s local population identified as capacity to work for the common communities. good in general and health goals 3. Community Health Nursing (American (Famorca et al, 2013). Nurses Association, 1980) 8. Epidemiology A synthesis of nursing practice and The study of the distribution and public health applied to promoting determinants of health-related and preserving the health of the states or events in specified populations. The focus of community populations and the application of health nursing: this study to the prevention and ○ prevention of illness control of health problems. ○ promotion of health 9. Health Statistics ○ maintenance of health They refer to the numbers that 4. Community Health Nursing summarize information related to It is service rendered by a health which is collected by professional nurse to communities, researchers, experts from groups, families and individuals at government, private, non-profit home, in health centers, in clinics, in agencies, and organizations. They schools, and in places of work for the are often used to learn about public promotion of health, prevention of health and health care. illness, care of the sick at home, and 10. Health INDICATORS rehabilitation. (Ruth B. Freeman) A list of information that would 5. Community Health Nursing (Dr. determine the health of a particular Araceli Maglaya) community or country. The utilization of the Nursing Process 11. Population Group in the different levels of A group of people who share clientele-individuals, families, common characteristics, population groups and communities, developmental stage or common concerned with the promotion of exposure to particular health, prevention of disease and environmental factors, and common disability and rehabilitation. health problems, issues, and concerns (Maglaya, 2009). Population groups are the usual targets or beneficiaries of social services and health programs.  Features of Community Health produce effective and sustainable Nursing results. (Famorca, 2013) 4. In selecting appropriate activities, focus BASIC CONCEPTS on primary prevention. The strategies implemented are focused on achieving optimal health, prevent diseases and disability. 5. Promote a healthful physical and psychosocial environment. The health team should focus on designing strategies that focus on environmental determinants of health such as education, socioeconomic status, physical environment, and social supports ➔ Serve direct care 6. Promote optimum use of resources. ➔ Advocate for health improvements Effective usage of community resources ➔ Educate individuals of the public for strategies that will produce ➔ Perform research in community long-term effects. health It is the job of a community health nurse to help and keep the community health problems under control (Mona, 2015). Features of Community Health Nursing 1. It is a specialty field of Nursing. 2. Its practice combines public health with Nursing. 3. It is population-based. 7. Collaborate with others working in the 4. It emphasizes on wellness and other community. The nurse has to work with than disease or illness, a variety of sectors to settle issues that 5. It involves interdisciplinary affect health, which is considered as a collaboration. product of multiple health 6. It increases the client’s responsibility determinants. and self-care. Functions of Community Health Nursing Philosophy of Community Health Identification of community culture and Nursing resources (key factor in HCDS) Evaluate community health conditions, A philosophy is defined as a system of health risks and problems beliefs that provides a basis for and guides Plan and implementation of action. comprehensive community health interventions, care, services and It provides the direction and describe the program. whats, the whys, and the hows of activities Develop health policy at the local within a profession. community level Principles of Community Health ➔ Humanistic values of the nursing Nursing profession – community/hospital 1. The focus is on the community as the ➔ Unique and distinct component of unit of care. The responsibility of the health care – Nurses: bedside care nurse is to the community as a whole. ➔ Multiple factors of health considered 2. Give priority to the community needs. ➔ Active participation of clients is The CHN nurse should develop skills in encouraged – Alay Linis; nurses must Nursing Process and initiate or elicit participation population-focused skills to help the ➔ Nurse considers availability of community identify their needs and resources produced benefits for the community. ➔ Interdependence among health team Demographics and vital statistics are members is practiced the tools used by the Community Health ➔ Scientific and up-to-date Nurse to achieve these benefits. ➔ Tasks of community health nurse vary 3. Work with the community as an equal with time and place partner of the health team. The client is ➔ Independence or self-reliance of the considered as an active partner, not a people is the end goal passive recipient of care. Team ➔ Connectedness of health and approach and partnership between the development health care worker and the community  Theoretical Models and Approaches targets social and emotional related to Community Health Nursing health challenges including Theories are often used as a method to nutrition, physical activity, help people understand a certain alcohol and drug use, safety, concept. They often help in providing a and personal health, among way to explain certain behavior or other topics. This model adapts why things happen in a certain way. components of the Health Belief One of the major purposes of a theory is Model related to knowledge, to provide an answer to the question skills, self-efficacy, and "why?" Asking, "why?" increases the environmental support. knowledge of a subject area and Considerations for Implementation realigns the thoughts and opinions. ○ The Health Belief Model can be This is considered as an essential skill used to design short- and for anybody who wants to learn and long-term interventions. The 5 develop. key action-related components The following are the theories and that determine the ability of the approaches that have been utilized to Health Belief Model to identify key explain and understand certain decision-making points that concepts in Community Health Nursing influence health behaviors are: and the behavior of clients in a Gathering information by community setting. conducting health needs assessments and other efforts Health Belief Model to determine who is at risk and a theoretical model that can be used to the population(s) that should be guide health promotion and disease targeted. prevention programs. It is used to Conveying the consequences explain and predict individual of the health issues associated changes in health behaviors. It is one with risk behaviors in a clear of the most widely used models for and unambiguous fashion to understanding health behaviors. understand perceived severity. Developed by social psychologists in Communicating to the target 1958 to explain why people failed to population the steps that are participate in screening for TB. involved in taking the Provide the basis for current health recommended action and education and health promotion highlighting the benefits to practices. action. Has been used to explain behavior Providing assistance in change and maintenance of behavior identifying and reducing change and to guide health promotion barriers to action. interventions (janz et. Al. 2002) Demonstrating actions Major limitation of HBM: Burden of through skill development action is on the client activities and providing support Key elements: focus on individual that enhances self-efficacy and beliefs about health conditions, which the likelihood of successful predict individual health-related behavior changes. behaviors. ○ These actions represent key Constructs of HBM elements of the Health Belief Model ○ Perceived Severity and can be used to design or ○ Perceived Susceptibility adapt health promotion or ○ Perceived Benefits of Treatment disease prevention programs. The ○ Perceived Barriers HBM is appropriate to be used Defines the key factors that influence alone or in combination with other health behaviors as an individual's theories or models. To ensure ○ perceived threat to sickness or success with this model, it is disease (perceived susceptibility) important to identify "cues to ○ belief of consequence action" that are meaningful and (perceived severity) appropriate for the target ○ potential positive benefits of population. action (perceived benefits) ○ perceived barriers to action Milio’s Framework for Prevention Model ○ exposure to factors that prompt by Nancy Milio (1976) action (cues to action) Complements the HBM and provides a ○ confidence in ability to succeed mechanism for directing and examining (self-efficacy) opportunities for nursing interventions Health Belief Model Examples at the population level. ○ The Michigan Model for Proposed that health deficits often Health™ is a curriculum designed result from an imbalance between a for implementation in schools. It  population’s health needs and its Without the availability Addressing persistent health health-sustaining resources of alternative problems (e.g. HPN) is Milio’s framework encourages the nurse health-promoting hindered because most to understand health behaviors in the options people are aware of what context of their societal milieu causes the problem but Provides that the health status existing reluctant to make lifestyle in the population occurs due to too changes to prevent or little or excess critical health reverse the condition. sustaining resources whereby people who have enough and safe food, shelter, Pender’s Health Promotion Model water, and environment are vulnerable Developed by Nola Pender to be a to infectious diseases which too much “complementary counterpart to models food will lead to obesity. Population of health protection” in the 1980s and behavior patterns also affect health revised in 1996. since knowledge and perception are Defines health as a positive dynamic influenced by informal and formal state rather than simply the absence of learning and also by experience. Health disease is also influenced by organizational Explores may biopsychosocial factors behavior which includes policymakers that influence Individuals to pursue since they provide options available to health promotion activities. thus influencing selections made by Depicts the multidimensional factors individuals. with which people interact as they work Milio (1976) provides that an individual’s to achieve optimum health. health selections are influenced by the Focuses on 3 areas: individual objective to maximize valued resources characteristics and experiences, therefore selection is based on personal behavior-specific cognitions and affect, resources and societal resources. and behavioral outcomes. Change in choice-making among a Health-promoting behavior is the large number of people in the desired behavioral outcome, which population leads to social change and makes it the endpoint of the Health that teaching and learning may be Promotion Model. insignificant in affecting behavior These behaviors should result in patterns if new health improved health, enhanced functional Application of Milio’s Framework in CHN ability, and better quality of life at all stages of development. Milio’s Proposition Population Health The final behavioral demand is also Population health I and F living in poverty have influenced by the immediate competing deficits result from poorer health status demand and preferences, which can deprivation and/or compared with middle and derail intended actions for promoting excess of critical health upper-class individuals health. resource. Individual choices Choices and behavior of related to health Use individuals are strongly promotion or influenced by desires, values, health-damaging and beliefs. (Eg. of illegal behaviors are influenced drugs by adolescents are by efforts to maximize often dependent on peer valued resources. pressure and the need for acceptance, love, and belonging. Alteration in patterns of Some behaviors such as behavior resulting from smoking have been difficult PRECEDE-PROCEED Model the decision-making of a to maintain due to company Developed by Dr. Lawrence W. Green significant number of policies and laws people in a population implemented. and colleagues can result in social Provides a model for community change. assessment, health education, planning, and evaluation. Behavior of populations Positive and negative In this model, predisposing factors refer result from selection lifestyle choices (e.g. to people’s characteristics that from limited choices (to smoking, alcohol use, regular motivate them towards health-related include actual and exercise, diet) are dependent behaviors. perceived options on culture, socioeconomic Enabling factors refer to conditions in available, beliefs, and status, and educational level. expectations resulting people and the environment that from socialization, facilitate or impede health-related education, and behavior. experience)  Reinforcing factors refer to feedback given by support persons or groups resulting from the performance of the health-related behavior. PRECEDE stands for: ➔ Predisposing ➔ Reinforcing ➔ Enabling ➔ Constructs ➔ Educational ➔ Diagnosis ➔ Evaluation - It involves assessing the following community factors: Implementation Considerations ○ Social assessment: Determine the The PRECEDE-PROCEED model provides social problems and needs of a given a structure that supports the planning population and identify desired and implementation of health results. promotion or disease prevention ○ Epidemiological assessment: programs. Identify the health determinants of This model has worked well for many the identified problems and set health promotion topics, and can priorities and goals. effectively support one-time ○ Ecological assessment: Analyze interventions or long-running programs. behavioral and environmental Like the Community Readiness Model, determinants that predispose, PRECEDE-PROCEED invites reinforce, and enable the behaviors participation from community and lifestyles are identified. members, and has the potential to ○ Identify administrative and policy increase community ownership of the factors that influence program. implementation and match When determining whether to use appropriate interventions that PRECEDE-PROCEED as a model for encourage desired and expected health promotion or disease prevention changes. programs, it is important to consider ○ Implementation of interventions whether all parts of the model are PROCEED stands for appropriate for the program and the ➔ Policy resources available to support ➔ Regulatory implementation. ➔ Organizational It is also important to remember that ➔ Constructs components of the plan may be ➔ Educational adapted over time, as needed. ➔ Environmental ➔ Development Other CHN Practice Settings - It involves the identification of desired School, Occupational, Mental Health Nursing outcomes and program Occupational Health implementation: – application of public health, medical and ○ Implementation: Design engineering practice for the purpose of intervention, assess availability of conserving, restoring the health and resources, and implement program. effectiveness of workers through their places ○ Process Evaluation: Determine if of employment program is reaching the targeted a. Application of Nursing Principles population and achieving desired ○ Prompt and efficient nursing care goals. of the ill impaired ○ Impact Evaluation: Evaluate the ○ Participation in teaching health change in behavior. and safety practices on the job ○ Outcome Evaluation: Identify if ○ Cooperation with plant there is a decrease in the incidence department administrators. or prevalence of the identified ○ Keeping the health clinic and negative behavior or an increase in staff ready to handle identified positive behavior. emergencies. ○ Advising workers in the utilization of community and welfare services. b. Objectives of OHN: ○ Assist, maintain, and promote positive health of laborers and employees through early detection.  ○ Prevent occupational diseases learning and performance of their and hazards of industrial developmental tasks. processes. QUALIFICATIONS OF A SCHOOL NURSE: ○ Coordinate and cooperate with Registered Nurse activities of other community Member of Professional Organization health and welfare services. With Basic ICT Skills c. Nurse’s Role in OHN: SCHOOL NURSING PRACTICE ○ Assists/participates in a. School nursing is a specialty unto itself. developing an adequate health b. Prepared to work with children of program different ages and under highly variable ○ Encourages periodic P. E. circumstances. ○ Cooperates with occupational c. School nurse's practice is relatively medical programs in the independent and autonomous and is prevention of accidents. comprised of many roles ○ Helps in teaching others in giving d. The school setting is a perfect place to good nursing care to the sick or conduct research and advocate for handicapped in their own homes health promotion Presidential Decree No. 443, as amended 8 COMPONENTS OF SCHOOL HEALTH May 1, 1974: NURSING The services of a full-time registered nurse a. Topics for Health Education when the number of employees exceeds fifty i. Health Education (50) but not more than two hundred (200) ○ Health education activities are except when the employer does not maintain culture-sensitive and based on hazardous workplaces, in which case, the the identified educational needs services of a graduate first-aider shall be of the target population. provided for the protection of workers, where ○ Life skills education ad staff no registered nurse is available. education through training and development of school person. School Health Nursing ○ Prevention of communicable – a specialized practice of professional nursing diseases that advances the well-being, academic ○ Use of traditional and alternative success, and lifelong achievement of students. health care in the management School nurses facilitate positive student of common health conditions responses to normal development, promote ○ Oral hygiene health and safety, intervene with actual and ○ Injury prevention and developing potential health problems, provide case safety conscious behavior management services and actively collaborate ○ Tobacco use with others to build student and family ○ Substance Abuse capacity for adaptation, self-management, ○ HIV/AIDS and other self-advocacy, and learning (National sexually-transmitted Infections Association of School Nurses, 2000). ○ Personal and oral hygiene, Integrated School Health and Nutrition including WASH (water, Program (ISHNP) – designed to maintain and sanitation, and hygiene) improve the health of school children by ○ Prevention of communicable preventing diseases and by promoting diseases health-related knowledge, skills and practices ○ Use of traditional and alternative (DepEd Order No. 43, s. 2011). health care in the management School Health Services (SHPs) cover: of common health conditions 1. School health services ○ Oral hygiene 2. School health education, and ○ Injury prevention and developing 3. A healthy school environment to include safety conscious behavior both physical and psychosocial aspects ○ Tobacco use of environment ○ Substance abuse Legal Basis: School health services are ○ HIV/AIDS and other STIs governed by R.A. 124 (1947) - “An Act to b. Physical Education Provide for Medical Inspection of Children Habits in childhood are likely to Enrolled in Private Schools, Colleges and continue into adulthood, making Universities in the Philippines”. This law states it imperative that children are that it is the duty of the school heads of taught the importance of being private schools with a total of enrollment of physically active 300 or more to provide for a part-time or full c. Health Services time physician for the annual medical Health Screening examinations of pupils or students. ○ Emergency care AIMS: (Maglaya, 2009) School Nursing aims to ○ Management of Acute promote the health of school personnel and andChronic Conditions students. School Nursing aims to prevent ○ Appropriate Referrals health problems that could hinder students' ○ Regular Deworming  d. Nutrition DOH and Nutrition service offers a School-Based Feeding Program Teachers' Health Welfare Enhancement (SBFP) – aims to rehabilitate at Program which conducts health least 70% of the identified examination and health profiling of all severely wasted school children teachings and non-teaching personnel. to normal nutritional status at the h. Family and Community Involvement end of 100-120 feeding days; and Provide health content to families, increase attendance by 85-100% parents, and communities on topics ○ Eating Disorders such as communicable diseases and ○ Obesity substances abuse. ○ Nutritional Education Programs are designed to positively Programs influence parents. staff and others in i. Student Records – student health matters related to health. records should be afforded the Nurses can help develop physical same level of confidentiality as activity programs in the community that that given to clients and patients include both the child and the family. in other settings. Common Health Concerns of ○ Counseling, Psychological, and Schoolchildren Social Services – Children and Drugs and alcohol abuse teens often struggle with STDs/STIs depression, substance abuse, Teenage Pregnancies conduct disorders, self-esteem, Mental Health suicide ideation, eating Dermatological Disorders – disorders, and under or pimples/acne, fungal infections, overachievement. The school allergies nurse may help the child learn Respiratory Conditions – asthma, URTI how to solve problems, how to Nutrition cope, and how to build Dental Health self-esteem. School Nursing Practice ○ Psycho-Social Intervention School nursing is a specialty unto itself. Project – allows training of other Prepared to work with children of school personnel on crisis different ages and under highly variable management, especially in circumstances. war-torn calamity-stricken areas. School nurse’s practice isrelatively e. Counseling, Psychological and Social independent and autonomous and is Services comprised of many roles. The school Children and teens often struggle with setting is a perfect place to conduct depression, substance abuse, conduct research and advocate for health disorders, self-esteem, suicide ideation, promotion eating disorders, and under or overachievement The school nurse may help the child learn how to solve problems, how to cope, and how to build self-esteem. f. Healthy School Environment The school environment should consist of (WHO, 1997): A physical, psychological, and social environment that is developmentally oriented and culturally appropriate, and that enables student to achieve their potential. A healthy organizational culture within the school. Productive interaction between the school and the community. (A physical, psychological, and social environment that is developmentally oriented g. Health Promotion for School Staff Health promotion programs improve morale, reduce job stress and absenteeism and increase interest in teaching health-related topics to students. Health promotion programs at work also have positive effects on blood pressure control, daily physical activity, smoking cessation and weight control.