UNIT 1

Community

- A group of people with common characteristics or interests living together within a territory or geographical boundary

- a group of people who share something in common and interact with one another, who may exhibit a commitment with one another and may share a geographic boundary

- Place where people under usual conditions are found

Community

- Derived from a latin word "comunicas" which means a group of people

- a social group determined by geographic boundaries and/or common values and interest, its members know and interact with each other.

- functions with a particular structure and exhibits and creates norms, values and social institutions

- composed of people, place, identity, common culture and social system

- a collection of people who interact with one another and whose common interests or characteristics form the basis for a sense of unity or belonging

Development

A gradual evolution or completion, also the result of such an evolution; synonymous to progress

Public Health Nursing

(WHO) a special field of nursing, public health and some phases of social assistance and functions as part of the total public health programme for the promotion of health, the improvement of the condition in the social and physical environment, rehabilitation of illness and disability

Public Health Nursing

(Ruth B. Freeman) a service rendered by a professional nurse with communities, groups, families, 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

Community Health Nursing

(ANA) a practice that promotes and preserves the health of populations by integrating the skills and knowledge relevant to both nursing and public health. The practice is comprehensive and general, and is not limited to episodic care

- While this practice includes nursing directed to individuals, families and groups, the dominant responsibility is to the population as a whole

Community Health Nursing

- a synthesis of Nursing and Public Health Practice applied to the promotion of client's optimum level of functioning and preserving the health of the population

- The nature of this practice is general and comprehensive, it is not limited to a particular age or diagnostic group.

- It is continuing not episodic.

- The dominant responsibility is to the population as a whole. Therefore, nursing is directed to individuals, families or a group that contributes to the health of the total population

Community health nursing

- a discipline that incorporates evidenced-based research along with advances in science and new approaches for improving the health

- takes into consideration the cultural and socioeconomic backgrounds of the people in the community to ensure appropriate interaction and sensitivity when working with them

Community

a group of people in a specific location, which includes places where people live, work and go to school

Community Health Nursing

commonly practiced in geographic locations like cities and rural areas

Health

- a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity

- An individual adapts to changes in internal and external environment to maintain a state of well- being

Wellness

- Condition in which an individual functions at an optimum level; integrated method of functioning which is oriented towards maximizing the potential of which the individual is capable.

- requires the balance and purposeful direction within the environment where he is functioning

Wellness

- a condition of change in which the individual moves forward, climbing toward a higher potential of functioning

- a "concept in which family, community, society, and environment are interrelated and have an impact on health"

Illness

- Inability of an individual's adaptive responses to maintain physical and emotional balance that subsequently results in impairment in functional abilities;

- is a state in which someone's needs are not sufficiently met to allow the individual to have a sense of physical and psychological well-being

Empowerment

a process enabling others to do for themselves, it consists of encouraging the client to be an active participant in the treatment rather than a passive recipient of care

Population

a group of people having common personal or environmental characteristics

Aggregates

- Are subpopulations that have some common characteristics or concerns

- a group of people with some characteristics in common, may or may not be communities depending on the presence of the defining attributes.

- subgroups or subpopulations that have some common characteristics and concerns.

- ex. A research group who have been selected for having the common. experience of being diagnosed with cancer, Elderly, pregnant, children, PWD.

Common Elements of a Community

the attributes that define a group of people in the community

- Group Orientation

- Bond between individuals

- Human interaction

Group Orientation

The goals of the group take priority over those of an individual members to take collective action with regards to common concern

Bond between individuals

may take these forms:

- lifestyle held in common

- shared ethnicity or culture

- fact of living in a specific geographic location

- similar interest, goals or occupation

human interaction

There must be significant social interaction between individuals in order for a community to exist

Working Definition of a Community

- A group of people who share some type of bond and commonalities, who engage in interaction with each other and which functions collectively regarding common concerns

- seen as a group or collection of locality-based individuals, interacting in social units and sharing common interests, characteristics, values and/or goals

Community

(Allender) A collection of people who interact with one another and whose common interests or characteristics form the basis for a sense of unity or belonging

Community

(Lundy and James) A group of people who share something in common and interact with one another, who may exhibit a commitment with one another and may share geographic boundary

Community

(Clark) A group of people who share common interests, who interact with each other, and who function collectively within a defined social structure to address common concerns

Community

(Shuster and Geoppinger) A locality-based entity, composed of systems of formal organizations reflecting society's institutions, informal groups and aggregates

Working Definition of a Community

- a social group determined by geographic boundaries and/or common values and interest.

- members know and interact with each other.

- it functions within a particular social structure and exhibits and creates norms, values and social institution

Working Definition of a Community

- a system of formal and informal groups characterized by interdependence and whose functions is to meet the collective needs of group members.

- ex. Need for education, shelter, leadership and etc.

Working Definition of a Community

- a collection of people who share some important features of their lives.

- ex. Expat community (Filipino, American, British), LGBTQ community

Working Definition of a Community

- a social unit in which there is a transaction of a common life among the people making up the unit

Characteristics of a Community

- Environment

- Population behavior/lifestyle

- Human Biology

- Systems of Health Care

Environment

- physical, socio-cultural, educational and employment milieu;

- living and working conditions, development of adequate coping skills and the ability to environmental changes without diminishing health

- consist of: physical, social, psychological

Physical Environment

geographic locale, weather, soil, composition, housing conditions, education milieu.

Social Environment

accepted modes of behavior, social norms, family structure, prevailing social attitudes.

Psychological Environment

self-image, stressors.

Population behavior/lifestyle

- self-responsibility, self-care competency

- consumption patterns

- employment/occupation

- incorporate adequate rest, exercise and nutrition, leisure activities

- consistent use of safety devices such as seatbelts, hearing protection and smoke detectors

Human Biology

- genetic characteristics of population, maturation and aging

- includes anatomical (height and weight), physiological (HPN), chemical (blood cholesterol levels) and immunologic (immunity to certain disease)

Systems of Health Care

includes the availability, accessibility, adequacy & use of health care services at levels of prevention

- Promotion (Promotive)

- Prevention (Preventive)

- Diagnosis and Treatment/Cure (Curative)

- Rehabilitation (Rehabilitative)

Promotion/Promotive

- involves activities designed to improve or maintain health status.

- Ex. Individuals: ensuring adequate rest for the toddler, designing exercise program for the mother.

- Family: education on parenting for parents.

- Community: provision of well-child and family planning services and educational programs related to basic nutrition or physical fitness.

Prevention/Preventive

- specific measures aimed at disease prevention.

- Ex. Individual: immunizing a child. Family: support group for teenage parents to prevent child abuse.

- Community: chlorination of community water supply.

Diagnosis and Treatment/Cure (Curative)

- early recognition and therapy for health problems that have occurred.

- Ex. Individual: treatment of STDs.

- Family: provide counseling for existing marital problems.

- Community: mental health programs that require institutionalizing mentally ill patients.

Rehabilitation (Rehabilitative)

- attempts to limit the incapacitation caused by health problems and prevent recurrence.

- Ex. Individual: physical and occupational therapy for stroke patients.

- Family: family counseling for families of alcoholics (Alcoholic Anonymous).

- Community: opening schools for special children.

General Classification of Community

- Urban

- Rural

- Rurban/Suburban or Capitals

Urban

- high density community or the city;

- socially heterogeneous population;

- complex structure, non-agricultural occupation;

- something different from an area characterized by complex interpersonal social relations; and

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

Rural

- usually small in size or boundaries or open lands;

- less dense and more spacious;

- provincial areas;

- occupation of the people is usually farming, fishing and food gathering; and

- peopled by simple folks characterized by primary group relations, well-knit and having high-degree of group feeling

Rurban/Suburban or Capitals

- an outlying part of a city or town;

- a smaller place adjacent to or sometimes within commuting distance of a city;

- blending or characterized by the blending of urban and rural communities;

- usually the capital of provinces and mixed agriculture and industry for a living; and

- Technology is used to increase productivity in both industrial and agricultural side.

Classification of Communities according to Bonds

- Communities with Territorial Bond

- Communities with relational bonds or phenomenological communities

Communities with Territorial Bond

- Those with specifically defined boundaries that may either be separated or temporal or both;

- Reflect the where and when dimension.

- Geopolitical Communities, Communities with Problem Ecology, Communities of Solution

Geopolitical Communities

with defined geographic and jurisdictional boundaries such as towns, cities, countries and so on.

Communities with Problem Ecology

- the locale within which a particular problem exist:

- ecology is defined in terms of the interrelated factors that contribute to a health problem rather than its usual meaning related to natural environment;

- the area that encompasses any type of health problem and its contributing factors (ex. Polluted river starts from Brgy A but runs its course to Brgy B, so Brgy A and Brgy B are considered communities with problem ecology.)

Communities of Solution

the area in which the resources necessary to solve a problem found.

Communities with Relational Bonds/Phenomenological Communities

- Includes groups which the bonds between individuals exists in the form of a common relationships rather than specific boundaries;

- 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.

- also called Functional Communities

- Communities of Interest Orientation, Feeling Communities

Communities of Interest Orientation

- the relational bond is one shared of shared interest/goals

- ex. Professional Organizations share a common interest /concern and they use the group as a means of advancing that interest

Feeling Communities

- one in which the relational bond is an emotional feeling of belonging or camaraderie

- ex. Class, LGBTQ, Boys or Girl Scouts, OR/DR nurses

Components of a Community

- the CORE

- the 8 Subsystem

Core/Community Core

- represents the people that makes up the community.

- included are the demographics of the population as well as the values, beliefs and history of the people.

8 Subsystem

- Housing

- Education

- Fire and Safety

- Politics and Government

- Economics

- Health

- Communication Systems

- Recreation

Housing

- shelter, lodging, dwellings provided for number of people or for a community

- type of housing facilities, housing materials that are present

- adequacy and availability of the housing facilities to the whole population

- housing laws/regulations governing the people

Education

- laws, regulations, facilities and activities affecting education

- ratio of educators to learners

- distribution of education facilities

- recipients of education

- informal education facilities and activities existing in the community

Fire and Safety

- Fire protection facilities and fire prevention activities and their distribution of the community

- Police protection

ex. Brgy Tanods/Police Community roving patrol, Police Patrol

Politics and Government

- political structures present in the community

- decision-making process/pattern of leadership style observed

ex. Democratic, republic, Decentralized

Economics

- general occupation of the population

- types of economic activities (production, distribution marketing and buying of goods)

- income = poverty line, middle income earners, rich

Health

- health facilities and activities in the community

- distribution of health facilities

- utilization of health services

1:20

ratio of BHW:Households

1:5,000

ratio of BHM:Population

1:10,000

ratio of BHN:Population

1:20,000

ratio of MHO:Population

Communication Systems

- types of communication existing in the community

ex. Telephone, Mail, Telegrams, Internet, Pagers, Cellphones, Radio, Television and Print media

- Forms of Communication (Verbal, Written, Nonverbal)

- Formal and Informal communication

Recreation

- recreational activities/facilities present

- consumers of these facilities and their appropriateness

Development of Community and Society

1. Every Human Community has Institutions for the Socialization of Its Members

2. Development of Community Requires Sanction of Group Members

3. A Community is a Reflection of all the Functional Relationships that occur among its Individual Members

4. A Community or a Group can Change because of Conflict among Members

5. Family is the Primary Group

Development of Community and Society

6. Peer Groups help Youth to Establish Norms of Behavior and Assist in the Rites of Passage from the Family Group of Society

7. Group Memberships help Individuals achieve Goals that are not Attainable through Individual Efforts

8. Types of Leadership in a Group Depends on the Needs of the Group Members as Well as the Personality of the Leader

9. Types of Role Assumed by the Group Members

10. Community is a Social Organization that is Considered the Individual's Secondary Group

Institutions for Socialization

conform to customs of the group, rules and codes of conduct governing its members, , norms, values, morals, rights, duties, attitudes and actions, rewards leading to acceptance and punishment leading to rejection, separation, expulsion.

Sanction of Group Members

growth takes place in a social space, barriers to participation are established thru morals and customs, Leader's influence are limited to conditions set by the group, behavioral roles are established by the members of the group.

Reflection of all Functional Relationships

products of group life are a major determinants in an individual's intellect, memory, thinking and feeling. Human beings have no memory, thought, feeling that does not include the community. Intellect and creativity can be enhanced or hampered by the community. Acceptance of members and limited or segmented interactions to Nonmembers.

Conflict

happens when there is absence of certain members during meetings, new members or change in leadership

Change because of Conflict

tension caused by conflict -> Integration members learn about their problem or others problem and seek a solution -> Resolution (solved or not with members not giving in or rigid with fixed ideas and membership).

Family

help society establish and maintain code of behavior, provides individual family with strong emotional ties and feeling of security, communication, role identification, spirit of cooperation and competition and changes that have influenced the family's ability to indoctrinate children with norms of society.

Peer Groups

Youth learns about life through contact with these groups, develops self-concept with other youths, peer interaction can produce change in individual members and develop strong loyalty to the peer group because of reciprocal relationships and other rewards.

Groups help achieve goals

task oriented, therapy, self-awareness, socially oriented groups, task roles, group building or maintenance roles, individual or self-serving role, working on a subject matter or tasks, while working group deals with morale, feeling tones, influence, competition and conflict.

Types of Leadership

- Authoritarian Leader

- Democratic Leader

- Emotional Leader

- Laissez-Faire

- Bureaucratic Leader

- Charismatic Leader

Laissez-Faire

passive and unproductive, assumes participant-observer

Bureaucratic Leader

rigid and assumes that role is determined by formal criteria and not emotionally involved and not interrelating with group members

Charismatic Leader

assume any above behaviors "supernatural powers" to this person or office

Roles of Group Members

- Harmonizer

- Questioner

- Deserter

- Tension Reducer

- Encourager

- Monopolizer

- Clarifier

- Opinion Giver

- Initiator

- Listener

- Negativist

- Energizer

- Aggressor

Social Organization

relationship among members are more impersonal, individuals participate in a more delimited manner or in a specific manner, group frequently functions as a means to an end (diversified groups to communicate, helps other groups identify community problems and possible solutions). Meets large and intermittent basis and communication is maintained thru correspondence and establish laws necessary to limit anti-social behavior

Role of the Community

- Traditional communities care for their members when they are ill.

- Health maintenance and prevention has been given an increased priority.

- Community's provision for health maintenance

Community's provision for health maintenance

includes:

-protection of food, water and drug supplies

- establish public health agencies for supervision, prevention and control of disease and illness

- develop public health education programs

- award grants for health education

- develop unemployment insurance programs

- establish workmen's compensation insurance

- establish DOH programs, social welfare services and other health programs

- supervision of health center programs.

Determinants of Health

!. Income and social status

2. Education

3. Physical Environment

4. Employment and working conditions

5. Social Support Networks

6. Culture

7. Genetics

8. Personal behavior and coping skills

9. Health Services

10. Gender

Income and social status

higher income and social status are linked to better health; the greater the gap between the richest and the poor health, the greater difference in health.

Education

low education are linked with poor health, more stress and lower confidence.

Physical Environment

safe water and clean air, health workplace, safe houses communities and roads all contribute to good health

Employment and working conditions

people who are employed are healthier, particularly those who have control over their working conditions.

Social support networks

greater support from family, friends and communities linked to better health.

Culture

customs and traditions, and the beliefs of the family and community all affect health.

Genetics

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

Personal behavior and coping skills

balanced diet, keeping active, smoking, drinking, and how we deal with stress and challenges all affect health

Health services

access and use of services that prevent and treat disease influences health.

Gender

men and women suffer from different types of diseases at different age.

Health Agency as a social institution

- Has a bureaucratic structure;

- Policies, rules and regulations governing behavior of its members;

- An impersonal viewpoint;

- A status hierarchy;

- An increasingly specialized subculture.

Hospital as a subculture of the community

- Employees develop both written and unwritten hospital policies;

- Folklores and folkways of the hospital serve to maintain mystique of medicine, attached stigmas to certain social diseases, mental illness, drug addiction and alcoholism and perpetuate roles and values of health team members and maintain status quo;

- Hospital has several functions: Direct (care and treatment) and Indirect (education and research).