COMMUNITY HEALTH NURSING CONCEPTS PDF

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COMMUNITY HEALTH NURSING CONCEPTS
1. Definition
2. Philosophy and Principles
3. Features of Community Health Nursing
4. Theoretical Models/Approaches
5. Roles and Activities of Community Health Nurse...

Description

CHAPTER 1:

Community Heath Nursing Concepts

TOPIC OUTLINE 1. Definition 2. Philosophy and Principles 3. Features of Community Health Nursing 4. Theoretical Models/Approaches 5. Roles and Activities of Community Health Nurse

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Working together under a competent leader for the common good. The people in the community have the potential for continual development and are capable of dealing with their own problems if educated and helped. Socialism

DEFINITION PRINCIPLES: Community Collection of people who interact with one another and share common interests and characteristics. Two types Geopolitical Community Phenomenologi cal Community

of Community Barangays, cities, regions, nations Interactive groups/shared groups based on culture, values, perspective, interests, history and goals. Community Health Nursing The synthesis of nursing practice and public health practice applied to promoting and preserving the health of populations. Public Health Nursing Promoting and protecting the health of populations using knowledge from nursing, social, and public health sciences. CHN Goal Preserve the health of the community and surrounding populations by focusing in health promotion and health maintenance of individuals, families, and groups within the community. PHILOSOPHY AND PRINCIPLES PHILOSOPHY OF: 

Individual’s right of being healthy.

1. CHN is based on the recognized needs of communities, families, groups, and individuals. 2. The CH nurse must fully understand the objectives and policies of the agencies she represents. 3. In CHN, the family is the unit of service. 4. CHN must be available to all. 5. Health teaching is the PRIMARY responsibility of the CH nurses. 6. The CH nurse works as a member of the health team. 7. There must be provision for periodic evaluation of CHN services 8. Opportunities for continuing staff education programs for nurses must be provided by the agency. 9. The CH nurse makes use of available community health resources 10. The CH nurse utilizes the already existing active organization in the community 11. There should be accurate recording and reporting in CHN FEATURES OF CHN

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POPULATION-BASED Involves specific approach: community assessment, community diagnosis, planning, intervention, and evaluation CJRM

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Involves epidemiology and information about the community  Data collection for assessment and management decisions within a community is ongoing, not episodic DELIVERS CARE FOR DIFFERENT LEVELS OF CLIENTELE  individual  family  group/aggregate  community as a whole COLLABORATES WITH A VARIETY OF OTHER PREOFESSIONS, ORGANIZATIONS, ENTITIES, AND THE COMMUNITY ITSELF  identify  implement  evaluate  meet the health needs PRIORITIZES ON HEALTH PROMOTION AND DISEASE PREVENTION ACTIVELY REACHES OUT ALL WHO MIGHT BENEFIT OF THE SERVICE OPTIMAL USAGE OF RESOURCES AND SELECTED STRATEGIES ARE MADE TO ENSURE BEST SERVICES FOR THE POPULATION 

THEORETICAL MODELS/APPROACHES

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explain behavior change and maintenance of behavior change and to guide health promotion interventions. It includes different key concepts perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, self-efficacy.

KEY CONCEPTS  Perceived susceptibility One's belief regarding the chance of getting a disease  Perceived severity - One's belief regarding the seriousness of given condition  Perceived benefits - One's belief in the ability of an advised action to reduce the health risk or seriousness of a given condition  Perceived barriers - One's belief regarding the tangible and psychological costs of an advised action  Cues to action - Strategies or conditions in one's environment that activate readiness to act  Self-efficacy - One's confidence in one's ability to act to reduce health risks.

A. HEALTH BELIEF MODEL 

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It was initially proposed in 1958 by group of social psychologists -Irwin M. Rosenstock, Godfrey M. Hochbaum, Stephen Kegeles, and Howard Leventhal at the U.S. Public Health. This was developed by the group of psychologists to explain why the public failed to participate in the screening for tuberculosis. (Hochbaum,1958) It provides the basis for the practice of HEALTH EDUCATION and HEALTH PROMOTION It is the one of the most widely used conceptual framework in health behavior to be able to

Kurt Lewin's work lent itself to the model's core dimensions. He proposed that behavior is based on current dynamics confronting an individual rather than prior experiences The Health Belief Model assumes that the major dominant of preventive health behavior is disease avoidance. Disease avoidance includes:  perceived susceptibility to disease "X"  perceived seriousness of disease "X"  modifying factors CJRM

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Community Heath Nursing Concepts

cues to action perceived benefits minus perceived barriers to preventive health action perceived threat of disease "X" likelihood of taking a recommended health action

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HOW IS HBM USED BY NURSE? It assists clients in making necessary behavior modifications by making them conscious of the need for such modifications It is used by the nurse to determine client's misperceptions that serve as barriers to appropriate health action

LIMITATION OF HBM It places the burden or pressure to action exclusively on the client It focuses on giving Interventions designed to modify the client's perceptions It DOES NOT acknowledge the health's professional's responsibility to alter or reduce health care barriers

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MILIO’S FRAMEWORK FOR PREVENTION 

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B. MILIO’S FRAMEWORK FOR PREVENTION 

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This was proposed by Nancy Milio, a Public Health Nurse, and leader in public health policy and education. A framework for prevention that includes concepts of communityoriented, population-focused care. Inclusion of economic, political and environmental health determinants. This provides a mechanism for directing attention upstream and

examining opportunities for nursing intervention at the population level. Made of six propositions that relate an individual's ability to improve healthful behavior to a society's ability to provide accessible and socially affirming options for healthy choices. She challenged the common notion that a main determinant for unhealthful behavioral choice is lack of knowledge. According to Milio, the range of available health choices is critical in shaping a society's overall health status & that policy decisions in governmental and private organizations shape the range of choices available to individuals.

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Most human beings, professional or non-professional, provider or consumer, make the easiest choices available to them most of the time. Health-promoting choices must be done readily available and less costly than health-damaging options for individuals to gain health and for society to improve health status. Milio believed that national level policy-making was the best to favorably impact the health of most people rather than concentrating efforts on imparting information in an effort to change individual patterns of behavior. Individual's health and lifestyle choices are influenced by resources, availability, cost, and convenience more than knowledge obtained in education.

MILIO’S SIX PROPOSITIONS Population health deficits results from deprivation and/or excess of critical health sustaining resources Behaviors of populations result from selection from limited choices that arise CJRM

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from actual and perceived options available as well as beliefs and Expectations developed from socialization, education and experience. Organizational decisions and policies (both governmental and nongovernmental) sets the range of options available to individuals and populations and influence choices. Individual choices related to health promotion or health damaging behaviors are influenced by efforts to maximized valued resources. Alteration in patterns of behavior resulting from decision making or a significant number of people in a population can result in social change. Without concurrent availability of alternative health promoting options for investments of personal resources, health education will be largely ineffective in changing behavior patterns. C. PENDER’S HEALTH PROMOTION MODEL NOLA J. PENDER Living legend of the American Academy of Nursing  A nursing theorist who developed the Health Promotion Model.  An author and a professor emeritus of nursing at the University of Michigan.  Started studying healthpromoting behavior in the mid1970s and first published the Health Promotion Model in 1982. THE HEALTH PROMOTION MODEL   

Originally published in 1982 and later improved in 1996 and 2002. It explores many biopsychosocial factors that influence individuals to pursue health promotion activities. Does not include threat as a motivator, as threat may not be a

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motivating factor for clients in all age groups. Was designed to be a “complementary counterpart to models of health protection.”

Purpose: To help nurses know and understand the major determinants of health behaviors as a foundation for behavioral counseling to promote wellbeing and healthy lifestyles. Defines health as “a positive dynamic state not merely the absence of disease”. It describes the multidimensional nature of persons as they interact within the environment to pursue health. Health Promotion It is an approach to wellness Health Protection Focuses on illness prevention

The health promotion model focuses in the following areas: INDIVIDUAL CHARACTERISTIC AND EXPERIENCES PRIOR RELATED Personal Factors BEHAVIOR Prior behaviors Biological Factors: influence Age, body mass subsequent index, strength, behavior through and agility. perceived selfPsychological Factors: Selfefficacy, benefits, barriers, esteem, selfmotivation, and affects and perceived related to health status. that activity. Sociocultural Strong indicator: Factors: Race, Habit ethnicity, acculturation, education, and socioeconomic CJRM

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status. BEHAVIOR-SPECIFIC COGNITIONS AND AFFECT Perceived benefits of action Strong motivators of the behavior. These motivate behavior through intrinsic and extrinsic benefits

- Health is an integral part of a larger context, probably most clearly defined as the quality of life, and it's within that context that must be considered. - Health is more than physical wellbeing, or the absence of disease, illness, or injury.

Perceived barriers to action Perceived unavailability, inconvenience, expense, difficulty, or time regarding health behaviors. Perceived self-efficacy One’s belief that he or she is capable of carrying out a health behavior.

PREDISPOSING REINFORCING ENABLING CONSTRUCTS IN EDUCATIONAL DIAGNOSIS AND EVALUATION

BEHAVIORAL OUTCOME Health-promoting behavior This is the goal of the Health Promotion Model. To attain positive health outcomes. Immediate competing demands And preferences Alternate behaviors that one considers as possible optional behaviors immediately prior to engaging in the intended, planned behavior.

SOCIAL ASSESSMENT - Determine the social problems and needs of a given population and identify desired results. EPIDEMIOLOGICAL ASSESSMENT Identify the health determinants of the identified problems and set priorities and goals ECOLOGICAL ASSESSMENT - Analyze behavioral and environmental determinants that predispose, reinforce, and enable the behaviors and lifestyles to be identified. IMPLEMENTATION

Commitment to a plan of action Initiates a behavioral event. This commitment will compel one into the behavior until completed, unless a competing demand or preference intervenes. PERCEDE-PROCEED MODEL - provides a model for community assessment, health education planning and evaluation Behind PRECEDE-PROCEED lie some assumptions about the prevention of illness and promotion of health, and by extension, about community as well. These include: - PRECEDE-PROCEED model should be a participatory process. - Health is, by its very nature, a community issue.

POLICY REGULATORY AND ORGANIZATIONAL CONSTRUCTS IN EDUCATIONAL AND ENVIRONMENTAL DEVELOPMENT IMPLEMENTATION Design intervention, assess availability of resources, and implement program. PROCESS EVALUATION Determine if program is reaching the targeted population and achieving desired goals. IMPACT EVALUATION Evaluate the change in behavior CJRM

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OUTCOME EVALUATION Identify if there is a decrease in the incidence or prevalence of the identified negative behavior or an increase in identified positive behavior ROLES AND ACTIVITIES OF COMMUNITY HEALTH NURSE EDUCATOR

Assess the people and provides health education CLINICIAN Ensures health care services Holism, health promotion, and skill expansion ADVOCATE preserving human dignity, promoting patient equality, and providing freedom from suffering. MANEGERIA Administrative direction L towards the accomplishment of specified goals COLLABRAT Coordinates with patients and groups OR for health-related services. Coordinates nursing program with other health programs LEADER Acting as the strategic lead for patient care initiatives (Change agent) Influencing others through effective communication and interpersonal skills RESEARCHE Systematic R investigation, collection, and analysis of data to solve problems and enhance community health nursing practice. CJRM

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