CHN LECTURE 1

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Hanchett (1979, in Stanhope and Lancaster, 1992)

            “A group of people in relationship with each other.”

The Expert Committee Report on Community Health Nursing of the World Health Organization (1974)

A social group determined by geographic boundaries and/or common values and interests, its members know and interact with one another.

Hawe, 1994

A group of people composed of collection of families living together in a geographical location and shares the same special interest

According to WHO

community is a group of people that may or may not be spatially connected, but who share a common interest, concerns or identities

(Allender et al. 2009; Lundy and James, 2009; Clark, 2008)

• Has common interests or characteristics

• Interacts with one another

(Allender et al. 2009)

Has sense of unity or belonging

(Clark, 2008)

Functions collectively within a defined social structure to address common concerns

The community is described in many dimensions/features:

• Aggregate of people

• Location in space

• Social System

Aggregate of people

-        composed of people who have similar demographic characteristics, common activities, concerns & goals.

Location in space

• physical location or geographic boundaries of a group of people

• geopolitical communities highly define by their geographical landmarks

Social System

• Relationship of members

• interaction of members to fulfill their essential functions to achieve a goal

Dimensions / Conditions in the Community Affecting Health

• People

• Place/Location

• Function/Social System

Health According to WHO

• “A state of complete physical, mental and social well-being, note merely the absence of disease or infirmity.”

Health According to Dunn (1961 in Archer & Freshman, 1975)

•             “Optimum level of functioning of individuals, families and communities (OLOF”

Factors in the Ecosystem Affecting OLOF:

• Political

• Behavioral

• Hereditary

• Healthcare Delivery System

• Environmental

• Socio-Economic

Political Influences

• safety

• oppression

• & people empowerment

Behavioral Influences

• culture

• habits

• & ethnic customs

Hereditary Influences

• genetic endowment

Healthcare Delivery System Influences

• promotive

• preventive

• curative

• rehabilitative

Environmental Influences

• air

• food

• water waste

• urban/rural

• Noise

• radiation

• & pollution

Socio-economic Influences

• employment

• education

• & housing

Activities of the CHN towards promoting OLOF:

• Direct Actions

• Semi-Direct Actions

• Indirect Actions

Direct Actions

• Nurse is the deliverer of care or services to the client

Semi-Direct Actions

• Carried out with others than the actual client

Indirect Actions

• Focused on the health care delivery system yet are not dealing with the system’s client. (concentrated on improving the system)

Community Health Defined by Stanhope and Lancaster (1992)

• “The meeting of collective needs, through identifying problems and managing interaction between the Community itself and between the community and society.”

Community Health Nursing defined by American Nursing Association (1973)

• synthesis of nursing practice and public health practice applied to promoting and preserving the health of populations.

Community Health Nursing defined by Tinkham and Voorhies (1972)

• Community health nursing is that field of nursing in which the family and community are patients.

Community Health Nursing defined by Freeman (1970)

• unique blends nursing and public health practice aimed at developing and enhancing the health capabilities of people

SALIENT FEATURES OF COMMUNITY HEALTH NURSING:

• Theoretical Based for Practice

• Setting/Place of Practice and Action

• Objectives

• Patients and Levels of Clientele

• Perspective and Orientation when Establishing Priorities for Care

• Range of Service Provided

• Priority Concern / Stress or Emphasis in Care

• Unit of Focus of Care

• Types of People/ Patients Seen and Served

• Ultimate Goal

Community

• a social group of people interacting with each other, determined by geographic boundaries living together to attain certain and common goals and sharing the same interest

Classification of Community

• Rural or the Open land

• Urban or the City

• Suburban or the Capitals

Rural or the Open land

• places in the provincial areas

• earn their living by agriculture

Urban or the City

• a non-agricultural type of community

• dense

• major source of income are the industrial products and technology.

Suburban or the Capitals

• usually the capital of province

• a mix of agriculture and industry

• technology is not in it highest peak in this type of community

Characteristics of the Community

• Physical

• Community self

• Community guiding values

• Community style

• Structural characteristics

• Communication network

Physical

• where is the community located geographically

Location and resources

• service agencies, institutions, schools, hospitals, shopping malls and commercial center

Physical size

• population density, trends in population growth

Topography

• elevate sections

• mountain ranges

• hilly

• coastal

Community self

• image-friendly

• rugged people

• hustlers

• gamblers

Community style

• "We have our own way of doing things."

Structural Characteristics

• Authority

• Power

• Prestige

Authority

• formal responsibilities

Power

• ability to influence decisions and actions of other people

Prestige

• social positions, family background, inherited wealth

Communication Network

• "who talks to whom?", "about what and under what circumstances?"

Healthy Community

• context of health promotion as the process of enabling people to increase control over and to improve their health.

Hayes and Willms (1990)

• suggest that definition of a healthy community may vary from one community to another and that, on the basis on its own culture.

ROLES AND FUNCTIONS OF THE COMMUNITY HEALTH NURSE

• Health Monitor

• Provider of Nursing Care to the Sick or Disabled

• Health Teacher/Counselor / Trainer

• Coordinator of Services to the Individuals and Family

• Community Organizer

• Change Agent

• Role Model

• Supervisor/Manager

• Planner/Programmer

• Recorder/Reporter / Statistician

• Researcher

Health Monitor

• detects deviations from health by individuals

Provider of Nursing Care to the Sick or Disabled

• provides nursing care to the sick/disabled in the home, clinic, school or place of work

Health Teacher/Counselor / Trainer

• health education is one of the most frequently used interventions of the nurse

Coordinator of Services to the Individuals and Family

• she is in a position to coordinate health services provided by various members of the health team so that they are delivered and received

Community Organizer

• takes active participation in stimulating and enhancing community participation in planning, organizing, implementing and evaluating health programs

Change Agent

• involves individual, family, groups and community's health behavior, including lifestyles in order to promote and maintain health

Role Model

• the nurse is expected to provide a good example or model of healthful living to the public community

Supervisor/Manager

• the nurse often functions as trainer and supervisor to lower level health personnel in the health agency

• the nurse also participates in the planning and evaluation of the total program of the health agency

Planner/Programmer

• the nurse identifies needs, priorities and problems, formulates nursing component of health plans

Recorder/Reporter / Statistician

• the nurse prepares and submits required reports and records, maintains adequate, accurate recording and reporting, reviews, validates, consolidates, analyzes and interpret

Researcher

• participates/ assists in the conduct of surveys and studies on nursing and health related subjects

COMPETENCIES REQUIRED OF THE COMMUNITY HEALTH NURSE

1. Technical nursing skills

2. Human relation skills

3. Communication skills

4. Teaching skills

5. Management skills

6. Personal attitudes and attributes

FUNCTIONS AND ACTIVITIES OF THE PUBLIC HEALTH NURSE

• Management

• Training

• Supervision

• Provision of health and nursing care

• Health education

• Coordination

Demography

• the science which deals with the study of the size, composition and distribution of human population and changes overtime brought about by births, deaths and migration.

Demos

• people

Graphos

• count