1. NCM 113: COMMUNITY HEALTH NURSING 2

Community Organizing Participatory Action Research

COPAR-

COMMUNITY

a group of people with common characteristics or interest living together within a territory or geographical boundary

URBAN

increased in population; industrial-type of work

RURAL

decreased in population; agricultural-type of work

RURBAN

combination of rural and urban

SUBURBAN

periphery around the urban areas

METROPOLITAN

expanding urban areas

URBAN

RURAL

RURBAN

SUBURBAN

METROPOLITAN

CLASSIFICATIONS OF COMMUNITIES

SOCIAL

cultural

georgraphical

political

4 ASPECTS OF COMMUNITY

SOCIAL

4 ASPECTS OF COMMUNITY

communication and interaction of the

people.

CULTURAL

4 ASPECTS OF COMMUNITY

norms, values and beliefs of the people.

POLITICAL

4 ASPECTS OF COMMUNITY

governance and leadership of the people.

GEOGRAPHICAL

4 ASPECTS OF COMMUNITY

boundaries of the community.

• PEOPLE

• 8 SUBSYSTEMS

1. Housing

2. Education

3. Fire and Safety

4. Politics and Environment

5. Health

6. Communication

7. Economics

8. Recreation

COMPONENTS OF A COMMUNITY:

ENVIRONMENTALLY HEALTHY COMMUNITY

TRANSFORMED COMMUNITIES

the preservation of the environment is as urgent and important as self-preservation

PEACE ZONE

TRANSFORMED COMMUNITIES

adhere to common values and live in

harmony despite social, cultural or religious beliefs.

TOURIST SPOT

TRANSFORMED COMMUNITIES

decent homes and beautiful surroundings become the standard for others to emulate

PRODUCTIVITY CENTER-

TRANSFORMED COMMUNITIES

human and natural resources of the community are developed and tapped to sustain the growth of the community and lead it towards self sufficiency

FAITH COMMUNITY-

TRANSFORMED COMMUNITIES

there is mutual respect among

community members for each other’s religious beliefs

HEALTH

is the state of complete physical, mental and social well-being and not merely the absence of disease or infirmity (World Health Organization)

(Optimum Level Of Functioning)

OLOF

ENVIRONMENTALLY HEALTHY COMMUNITY

PEACE ZONE

TOURIST SPOT

PRODUCTIVITY CENTER

FAITH COMMUNITY

TRANSFORMED COMMUNITIES

Political

Behavior

Heredity

Environment

Socio-Economic

Health Care Delivery System

COMPOSITION OF ECOSYSTEM

Political

COMPOSITION OF ECOSYSTEM

power, authority, empowerment, safety

Behavior

COMPOSITION OF ECOSYSTEM

lifestyle related such as diet, exercise

Heredity

COMPOSITION OF ECOSYSTEM

genes, familial history

Environment

COMPOSITION OF ECOSYSTEM

air, water, garbage, food, noise

Socio-Economic

COMPOSITION OF ECOSYSTEM

education, employment, housing

Health Care Delivery System

COMPOSITION OF ECOSYSTEM

availability, accessibility and affordability of services and facilities

prevent

In clinical area, we treat patients but in

community, we __

(1) Health promotion and disease prevention; (2) treatment; and (3) rehabilitation.

Levels of Prevention:

GEOPOLITICAL COMMUNITIES AKA Territorial Communities

PHENOMENOLOGICAL COMMUNITIES AKA Functional Communities

TWO MAIN TYPES OF COMMUNITIES

GEOPOLITICAL COMMUNITIES AKA Territorial Communities

• Most traditionally recognized.

• Defined or formed by both natural and man-made boundaries and include barangays, municipalities, cities, provinces, regions, and nations.

PHENOMENOLOGICAL COMMUNITIES AKA Functional Communities

• Refer to relational, interactive groups, in which the place or setting is more abstract, and people share a group perspective or identity based on culture, values, history, interest, and goals.

o Grouped according to function

POPULATION

Typically used to denote a group of people having common personal or environmental characteristics.

AGGREGATES

Subgroups or subpopulations that have some common characteristics or concerns.

empowerment, self-reliance

Goal in COPAR

PLANNER / PROGRAMMER

ROLES OF THE CHNurse

1. Identifies needs, priorities, and problems of individuals, families, and communities

2. Formulates municipal health plan in the absence of a medical doctor

3. Interprets and implements nursing plan, program policies, memoranda, and circular for the concerned staff personnel

4. Provides technical assistance to rural health midwives in health matters

PROVIDER OF NURSING CARE

ROLES OF THE CHNurse

1. Provides direct nursing care to sick or disabled in the home, clinic, school, or workplace

2. Develops the family’s capability to take care of the sick, disabled, or dependent member

1. Formulates individual, family, group, and community-centered plan

2. Interprets and implements programs, policies, memoranda, and circulars

3. Organizes work force, resources, equipments, and supplies at local level

4. Provides technical and administrative support to Rural Health Midwives (RHM)

5. Conducts regular supervisory visits and meetings to different RHMs and gives feedback on accomplishments

ROLES OF THE CHNurse

MANAGER / SUPERVISOR

COMMUNITY ORGANIZER

ROLES OF THE CHNurse

1. Motivates and enhances community participation in terms of planning, organizing, implementing, and

evaluating health services

2. Initiates and participates in community development activities

COORDINATOR OF SERVICES

ROLES OF THE CHNurse

1. Coordinates with individuals, families, and groups for health-related services provided by various members of the health team

2. Coordinates nursing program with other health programs like environmental sanitation, health

education, dental health, and mental health

1. Identifies and interprets training needs of the RHMs,

Barangay Health Workers (BHW), and hilots

2. Conducts training for RHMs and hilots on promotion and disease prevention

3. Conducts pre and post-consultation conferences for clinic clients; acts as a resource speaker on health and

health-related services

4. Initiates the use of tri-media (radio/TV, cinema plugs, and print ads) for health education purposes

5. Conducts pre-marital counseling

ROLES OF THE CHNurse

TRAINER / HEALTH EDUCATOR

HEALTH MONITOR

ROLES OF THE CHNurse

Detects deviation from health of individuals, families, groups, and communities through contacts/visits with them

o You have to be equipped with your papers: (1) DPA; (2)

Home visit record; (3) Charting; and (4) ARAS Journal

ROLE MODEL

ROLES OF THE CHNurse

Provides good example of healthful living to the members of the community

CHANGE AGENT

ROLES OF THE CHNurse

Motivates changes in health behavior in individuals, families, groups, and communities that also include lifestyle in order to promote and maintain health

RECORDER / REPORTER / STATISTICIAN

ROLES OF THE CHNurse

1. Prepares and submits required reports and records

2. Maintain adequate, accurate, and complete recording and reporting

3. Reviews, validates, consolidates, analyzes, and interprets all records and reports

4. Prepares statistical data/chart and other data presentation

RESEARCHER

ROLES OF THE CHNurse

1. Participates in the conduct of survey studies andresearches on nursing and health-related subjects

2. Coordinates with government and non-government organization in the implementation of

studies/research

RA 124

–it mandates the school to provide clinics for the minor treatment and attendance to emergency cases

Primary role of CHNurse

To ensure that educational potential is not hampered by unmet health needs

• School health and nutrition survey

• Putting up a functional school clinic

• Health assessment

• Standard vision testing

• Ear Examination

• Height and weight measurement and nutritional

status determination

• Medical referrals

FUNCTIONS OF A SCHOOL NURSE

HOME HEALTH CARE

Practice involves providing nursing care to individuals and families on their own places of residence mainly to minimize the effects of illness and disability

HOSPICE HOME CARE

• Home care rendered to the terminally ill

• Palliative care is particularly important

ENTREPRENURSE

Project initiated by DOLE in collaboration with the Board of Nursing of the Philippines, DOH, PNA and other

stakeholders to promote nurse entrepreneurship by introducing a home health care industry in the Philippines

To deliver home health care services

MAIN PURPOSE OF ENTREPRENURSE

AIMS OF ENTREPRENURSE

• Reduce the cost of health care for the country’s indigent population by bringing primary health care services to poor rural communities

• Maximize employment opportunities for

unemployed nurses

• Utilize the country’s unemployed human resources for health for the delivery of public health services

I. Primary Prevention

LEVELS OF PREVENTION

1. Health Promotion

2. Specific Protection

Secondary Prevention

LEVELS OF PREVENTION

Early Diagnosis

Prompt Treatment

Tertiary Prevention

LEVELS OF PREVENTION

Rehabilitation

PRIMARY PREVENTION

Relates to activities directed at preventing a problem before it occurs by altering susceptibility or reducing

exposure for susceptible individuals.

SECONDARY PREVENTION

• Early detection and prompt intervention during the period of early disease pathogenesis.

• Implemented after a problem has begun but before

signs and symptoms appear and targets

TERTIARY PREVENTION

• Targets populations that have experienced disease or injury and focuses on limitations of disability and

rehabilitation.

• AIM: Reduce the effects of disease and injury and to restore individuals to their optimum level of functioning.

INDIVIDUAL

LEVELS OF CLIENTELE

“point entry”

FAMILY

LEVELS OF CLIENTELE

center of delivery of care.

GROUP

LEVELS OF CLIENTELE

point of specific care.

LEVELS OF CLIENTELE

LEVELS OF CLIENTELE

point of entire care

1. INDIVIDUALS

2. FAMILIES

3. COMMUNITIES

4. POPULATION GROUPS

TYPES OF CLIENTELE

INDIVIDUAL

CHNurse provide care to specific

patient/clients in various conditions of health and illness; from the healthy/well to the dying; and all age

groups from birth to senescence

FAMILY

two or more individuals joined or related

by ties of blood, marriage or adoption and who constitute a single household, interact with each other in their respective familial roles and

GROUP

CHNurse focuses their activities to certain population groups with common unique health needs; are at risk of developing or have already developed certain defined health problems. (e.g. pregnant women, infants, pre-school age children, school children, workers in industrial establishments

COMMUNITY

CHNurse delivers nursing services addressed to community-wide health problems, in cooperation and coordination with other members of the health team as well as relevant intersectoral teams

COMMUNITY MENTAL HEALTH NURSING

• Application of specialized knowledge to population communities

• To promote and maintain mental health

• To rehabilitate population at risk

• Must possess knowledge about community resources

Help individuals develop a sense of

self-worth and independence

Anticipate emotional problems

Provide how to assess mental health

GOALS OF COMMUNITY MENTAL HEALTH NURSING

NURSING

• An art and science of rendering nursing care to IFGC

o Groups or aggregates

o IFGC- Individual, Family, Group, Community

• assisting an individual, sick or well, in the performance of those activities contributing to health or its recovery in such a way as to help gain independence. (OLOF)

(ANA,3)

COMMUNITY HEALTH NURSING

a direct goal oriented and adaptable to the needs of the individual, the family and community during health and illness.

(______)

(John Henrich, 1981)

COMMUNITY HEALTH NURSING

an area of human services directed toward developing and enhancing the health capabilities of people – either singly, as an individual or collectively as groups and communities.

(______)

- (Aracelli Maglaya)

the utilization of the nursing process in different level of clientele concerned with the promotion of health, prevention of disease and disability and rehabilitation.

(______)

-(Dr. Ruth Freeman)

COMMUNITY HEALTH NURSING

a service rendered by a professional nurse with the community, groups, families and individuals at home, in health centers, in clinics, in schools, in places of work for the promotion of health, prevention of illness, care of the sick at home and rehabilitation.

(______)

INCOME AND SOCIAL STATUS

DETERMINANTS OF HEALTH

• Higher-income and social status are linked to better health.

• The greater the gap between the richest and poor health, the greater differences in health.

EDUCATION

DETERMINANTS OF HEALTH

• Low education levels are linked with poor health, more stress and lower self-confidence.

PHYSICAL ENVIRONMENT

DETERMINANTS OF HEALTH

• Safe water and clean air, healthy workplaces, safe houses communities and roads all contribute to good health.

EMPLOYMENT AND WORKING CONDITIONS

DETERMINANTS OF HEALTH

• People in employment are healthier, particularly those who have control over their working conditions.

SOCIAL SUPPORT NETWORKS

DETERMINANTS OF HEALTH

• Greater support from families, friends and communities is linked to better health.

GENETICS

DETERMINANTS OF HEALTH

• Inheritance plays a part in determining lifespan, healthiness, and the likelihood of developing illnesses.

PERSONAL BEHAVIOR COPING SKILLS

DETERMINANTS OF HEALTH

• Balanced eating, keeping active, smoking, drinking and how we deal with life’s stresses and challenges all affect health.

HEALTH SERVICES

DETERMINANTS OF HEALTH

• Access and use of services that prevent and treat disease influences health.

O Health services should be affordable,

accessible

O HCDS: Healthcare Delivery Services

GENDER

DETERMINANTS OF HEALTH

• Men and women suffer from different types of diseases at different ages.