MODULE 1 CONTENT “The utilization of the nursing process in the

different levels of clientele – individuals, population

A. Definition groups and communities, concerned with the
promotion of health, prevention of disease and
B. Philosophy and Principles disability and rehabilitation.”
-Maglaya, et al
C. Features of CHN
GOAL!!
D. Theoretical Models/Approach “Raise the level of citizenry by helping communities
1. Health Belief Model(HBM) and families to cope with the discontinuities in and
2. Milio’s Framework for Prevention threats to health in such a way as to maximize their
3. Nola Pender’s Health Promotion potential for high-level wellness”
4. Lawrence Green’s PRECEDE PROCEED Model -Nisce, et al
PRECEDE (Predisposing, Reinforcing, Enabling
Constructs in Educational Diagnosis and B. PHILOSOPHY AND PRINCIPLES
Evaluation)
PROCEED (Policy, Regulatory and Organizational Philosophy of CHN
Constructs in educational and Environmental Community health nursing is a philosophy of
Development) care that is characterized by collaboration,
continuity of care, client and family responsibility
E. Different Fields for self-care, and preventive health care (Hunt,
1. School Health Nursing 2005).
2. Occupational Health Nursing Community-based nursing focuses on an
3. Community Mental Health Nursing individual and is family-centred in orientation.

F.Concept of the Community Principles of CHN

A. Types of Communities • The community is the patient in CHN, the
B. Characteristics of a Healthy Community family is the unit of care and there are four levels
C. Components of a Community of clientele: individual, family, population group
D. Factors affecting health of the Community (those who share common characteristics,
developmental stages and common exposure to
1. Characteristics of the Population
health problems – e.g. children, elderly), and the
2. Location of the Community
community.
3. Social System within the Community
E. Roles and Activities of Community Health
• In CHN, the client is considered as an ACTIVE
Nurse
partner NOT PASSIVE recipient of care.
MODULE 1 LECTURE
• CHN practice is affected by developments in
health technology, in particular, changes in
A. DEFINITION
society, in general
Community Health Nursing
• The goal of CHN is achieved through multi-
“Service rendered by a professional nurse to
sectoral efforts.
communities, groups, families, and individuals at
home, in health centers, in clinics, in schools, and in • CHN is a part of health care system and the
places of work for the promotion of health, larger human services system.
prevention of illness, care of the sick at home, and
rehabilitation. “
C.FEATURE OF CHN
-Ruth B. Freeman
❖ It is a specialty field of nursing.
“Nursing practice in a wide variety of community
❖ Its practice combines
services and consumer advocate areas, and in a
public health with nursing.
variety of roles, at times including independent
❖ It is population based.
practice… Community nursing is certainly not 4 0 It emphasizes on wellness and other than
❖
confined to public health nursing agencies.”
disease or Illness
– Jacobson, 1975
❖ It includes inter-disciplinary collaboration.
 ❖ It amplifies client s responsibility and self-care.

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D.THEORETICAL MODEL/APPROACH stress, education, the environment, finances, and
social status/ stigma (prejudice).
Community Health Nursing Theories ● Health indicators (mortality rates, disease
prevalence, levels of physical activity, obesity,
❖ Nursing theory provides the basis for care of tobacco or other substance use) describe the
the community and family. health status of a community and serve as targets
❖ Theorists have developed sound principles to for the improvement of a community’s health.
guide nurses in providing high-quality care.

Nursing theories appropriate for community Lawrence Green’s PRECEDE-PROCEED MODEL

health include the following. A comprehensive structure for assessing health
needs for designing, implementing, and evaluating
Health Belief Model health promotion and other public health programs
● Purpose is to predict or explain health behaviors. to meet those needs.
● Assumes that preventive health behaviors are
taken primarily for the purpose of avoiding disease. PRECEDE
● Emphasizes change at the individual level. Provides the structure for planning a targeted and
● Describes the likelihood of taking an action to focused public health program.
avoid disease based on the following. Stands for Predisposing, Reinforcing, and Enabling
❖ Perceived susceptibility, seriousness, and Constructs in Educational Diagnosis and Evaluation.
threat of a disease It involves assessing the following community
❖ Modifying factors (e.g., demographics, factors:
knowledge level) ❖ Social assessment: Determine the social
❖ Cues to action (e.g., media campaigns, disease problems and needs of a given population and
effect on family/friends, recommendations identify desired results.
from health care professionals) ❖ Epidemiological assessment: Identify the
❖ Perceived benefits minus perceived barriers to health determinants of the identified problems
taking action and set priorities and goals.
❖ Ecological assessment: Analyze behavioral and
Milio’s framework for prevention environmental determinants that predispose,
● Complements the health belief model. reinforce, and enable the behaviors and
● Emphasizes change at the community level. lifestyles are identified.
● Identifies relationship between health deficits ✧ Identify administrative and policy factors that
influence implementation and match
and availability of health-promoting resources.
appropriate interventions that encourage
● Theorizes that behavior changes within a large
desired and expected changes.
number of people can ultimately lead to social
change. ✧ Implementation of interventions.

Pender’s Health Promotion Model PROCEED

Provides the structure for implementing and
● Similar to Health Belief Model.
evaluating the public health program.
● Does not consider health risk as a factor that
provokes change. Stands for Policy, Regulatory, and Organizational
Constructs in Educational and Environmental
● Examines factors that affect individual actions
Development. It involves the identification of
to promote and protect health.
desired outcomes and program implementation:
❖ Personal factors (biological, psychological,
❖ Implementation: Design intervention, assess
sociocultural), behaviors, abilities, self-
availability of resources, and implement
efficacy
program.
❖ Feelings, benefits, barriers, and
❖ Process Evaluation: Determine if program is
characteristics associated with the action
reaching the targeted population and achieving
❖ Attitudes of others, and competing
desired goals.
demands and preferences ESSENTIALS OF
❖ Impact Evaluation: Evaluate the change in
COMMUNITY NURSING
4 0 ❖ Outcome
behavior.
Evaluation: Identify if there is a
● Determinants of health are factors that influence
decrease in the incidence or prevalence of
the client’s health. These can include nutrition,
the identified negative behavior or
 an increase in identified positive behavior.

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 C. Components of a Community
E. DIFFERENT FIELDS :
A community is simply a group of people living
1. School Health Nursing together, especially within a defined geographical
Promote the health of school personnel and location, they mostly share norms, religion, values
students. It aims to prevent health problems that and identity in common.
would hinder students learning and performance of
their developmental task. A community can be described as a complex
whole resulting from the combination of the
2. Occupational Health Nursing environment, people, health, quality of life, and
Aimed in assisting workers in all occupation to cope economics.The functionality of a community
with actual and potential stresses in relation to depends solely on these key elements.
their work and work environment.
The components of the community are as follows
3. Community Mental Health Nursing
Promotion of mental health and prevention of ⮚ The people.
mental illness across the lifespan and across ⮚ The environment.
sectors. ⮚ The economy.
⮚ Culture
C. CONCEPTS OF A COMMUNITY ⮚ Health
⮚ Quality of life
✧ A community is a group of people sharing
common geographic boundaries and or These components will be discussed in details.
common values and interest within specific
social system People as Components of Community
A group of people is the most fundamental or
✧ Communities also vary in terms of essential component of community. When a group
community dynamics- citizen participation, of people live together and share a common life
power and decision making structures and and bind by a strong sense of community
community collaboration efforts consciousness at that moment a community is
(Allender and Spradley) formed. Hence a group of people is the first
prerequisites of community.
✧ Webs of people shaped by relationships,
interdependence, mutual interests and The Environment as Component of Community
patterns of interaction The environment as a component, influences
(Behringer and Richards) lifestyle in any community setting and it is an
indispensable component it cannot be overlooked.

A. Types of Communities The Economy/Economic System as a Component

of the Community
Interest. Communities of people who share the Since communities are made of people who
same interest or passion. ultimately interact with their physical and social
Action. Communities of people trying to bring about environment, thus making the community good for
change. business and employment. Many businesses
Place. Communities of people brought together by stabilize the economy and improve the social
geographic boundaries. conditions.
Practice. Communities of people in the same
profession or undertake the same activities. Health as a Component of the Community
As humans it is the ability of individuals or
B. Characteristics of a Healthy Community communities to adapt and self manage when facing
physical, mental, psychological and social changes
A healthy community is one in which all residents with environment. Health is an important
have access to a quality education, safe component of a community. The health of the
and healthy homes, adequate employment, 4 0
community is a function of their environment, and
transportation, physical activity, and nutrition, in the people. A community cannot be described
addition to quality health care. completely without due reference to the health of
its members.