Foundations of Community Health Nursing Community health

Foundations of Community   l  1
Health Nursing   Community health:-
 is the identification of needs and the protection and
improvement of collective health within a geographically
defined area.
Community :-
  it is a group of people who share common interests who
interact with each other.
Health :-
   It is state of balance between illness and wellness.
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 Community Health Nursing (C.H.N.) :-
It is concerned with the delivery of comprehensive nursing care to individuals
,family ,group and community as a whole to needs and solve their problems
through the application of nursing process to maintain wellness and prevent.
Public health:-  
is the science and art of preventing disease, prolonging life, and promoting
health
and efficiency through organized community efforts for the sanitation of the
environment, the control of communicable infections, the education of the
individual in personal hygiene,the organization of medical and nursing
services for the early diagnosis ,preventive ,treatmentof disease, and the
development of the social machinery to insure everyone a standard of living
adequate for the maintenance of health, so organizing these benefits as to
enable every citizen to realize his birthright of health and longevity.
Community health practice :- a part of public health, sometimes is
misunderstood. Even many health professionals think of community health
practice in limiting terms such as sanitation programs, clinics in poverty
areas, or massive campaigns to prevent communicable disease.   Three types of communities :-
Geographic Community :-
A community often is defined by its geographic boundaries and thus is
called a geographic community.
Common-Interest Community :-
A community also can be identified by a common interest or goal. A
collection of people, even if they are widely scattered geographically, can
have an interest or goal that binds the members together. Sometimes,
within a certain geographic area, a group of people become a community
by promoting their common interest. Common-interest communities
whose focus is a health related issue can become useful to agencies to
promote.  Community of Solution :-
A type of community encountered frequently in community health practice
is a group of people  who come together to solve a problem that affects all
of them.  
The shape of this community varies with the nature of the problem,  
the size of the geographic area affected, and the number of
 resources needed to address the problem. Such a community has been
called a community of solution.   Populations and Aggregates :-
population refers to all of the people occupying an area, or to all  
of those who share one or more characteristics.
A population also may be defined by common qualities or characteristics,
such as the elderly population  
or the homeless population. In community health, this meaning becomes
useful when a specific group of people (eg, homeless individuals) is
targeted for intervention: the population’s common characteristics (eg, the
health-related problems of homelessness) become a major focus of the
intervention.  
aggregate refers to a mass or grouping of distinct individuals who are
considered as a whole and who are loosely associated with one another.  Populations and Aggregates :-
population refers to all of the people occupying an area, or to
all of those who share one or more characteristics.
A population also may be defined by common qualities or
characteristics, such as the elderly population or the homeless
population. In community health, this meaning becomes useful
when a specific group of people (eg, homeless individuals) is
targeted for intervention: the population’s common
characteristics (eg, the health-related problems of
homelessness) become a major focus of the intervention.
 
aggregate refers to a mass or grouping of distinct individuals
who are considered as a whole and who are loosely
associated with one another.  The concept of  health  :-
Health in the abstract refers to a person’s physical, mental, and
spiritual state; it can be positive (as being in good health) or
negative (as being in poor health).
Health, refers to a holistic state of well-being, which includes
soundness of mind, body, and spirit. Community health practitioners
place a strong emphasis on wellness, which includes the definition
of health just mentioned but incorporates the capacity to develop a
person’s potential to lead a fulfilling and productive life, one that can
be measured in terms of quality of life. There is increasing
awareness of the strong relationship
of health to environment   Is one in which the various organizations,groups, and aggregates of people
making up the
community do at least four things:-
They collaborate effectively in identifying the problems and needs of the community.
They achieve a working consensus on goals and priorities.
They agree on ways and means to implement the agreedon goals.
They collaborate effectively in the required actions.
 Continuous and Episodic Health Care Needs :-
Community health practice encompasses populations in all age
groups with birth-to-death developmental health care needs.  
continuous needs may include, for example, assistance with
providing a toddler-proof home or establishing
positive toilet-training techniques, help in effectively dealing with the
progressive emancipation of preteens and
teenagers, anticipatory guidance for reducing and managing the
stress associated with retirement, or help coping with the death of
an aged parent.
episodic needs might derive from the birth of an infant with Down
syndrome, a head injury incurred from an automobile crash, or a
diagnosis of HIV/AIDS.
 Characteristics of community health nursing :-
eight characteristics of community health nursing are
particularly salient to the practice of this specialty:-
it is a field of nursing.  
it combines public health with nursing.
itis population focused.
it emphasizes prevention, health promotion, and wellness.
it promotes client responsibility and self-care.
it uses aggregate measurement and analysis.
it uses principles of organizational theory.
it involves interprofessional collaboration.  Combines Public Health with Nursing :-
Community health nursing is grounded in both public health science and
nursing science, which makes its philosophical orientation and the nature
of its practice unique. It has been recognized as a subspecialty of both
fields. Recognition of this specialty field continues with a greater
awareness of the important contributions made by community health
nursing to improve the health of the public.
 Knowledge of the following elements of public health is essential to
community health nursing :-  
History and philosophy of public health, including emphasis on the
greatest good for the greatest number
Concept of aggregates—assessing needs, planning and providing
services, and evaluating services’ impact on population groups—
including aggregate-level decision-making
Priority of preventive, protective, and health-promoting strategies over
curative strategies
Means for measurement and analysis of community health problems,
including epidemiologic concepts and biostatistics
Influence of environmental factors on aggregate health
Principles underlying management and organization for community
health, because the goal of public health is accomplished through
organized community efforts
Public policy analysis and development
Health advocacy and the political process.
 Population Focused :-
The central mission of public health practice is to improve the health of
population groups. Community health nursing shares this essential
feature: it is population focused, meaning that it is concerned for the
health status of population groups and their environment.

Basic nursing focuses on individuals, and community health nursing
focuses on aggregates, but the
many variations in community needs and nursing roles inevitably cause
some overlap
A population-oriented focus requires the assessment of
relationships. When working with groups and communities,
the nurse does not consider them separately but rather in context—
that is, in relationship to the rest of the community.  Promotes Client Responsibility and Self-Care :-
The goal of public health, “to increase quality and years of healthy life and
eliminate health disparities” requires a partnership effort.
The process of taking responsibility for developing one’s own health
potential is called self-care
 As people maintain their own lives, health, and well-being, they are
engaging in self-care.
When people’s ability to continue self-care activities drops below their
need, they experience a self-care deficit.
At this point, nursing may appropriately intervene.  Uses Aggregate Measurement and Analysis :-
Community health nursing uses aggregate measurement and analysis. The need to
collect and examine data on the entire population under study before making
intervention decisions is fundamental to community health nursing in a public health
practice. Health states, environmental factors, health related services, economic
patterns, and social policy are among the many foci of community health research and
evaluation,
Uses Principles of Organizational Theory :-
Community health nursing uses principles from organizational theory to provide effective
administration of health care services. Public health has long been defined as the
protection and improvement of community health through organized community efforts   Components of community health practice :-
Promotion of health.
Prevention of health problems.
Treatment of disorders.
Rehabilitation.
Evaluation.
Research.  Promotion of Health :-
Promotion of health is recognized as one of the most important
components of public health and community health practice. Health
promotion includes all efforts that seek to move people closer to optimal
well-being
or higher levels of wellness.
 Health promotion programs and activities include :-many forms of
health education—for example :
 --- teaching the dangers of drug use.
  -  demonstrating healthful practices such as regular exercise.
  -  providing more health-promoting options such as heart-healthy menu
selections.
The goal of health promotion is to raise levels of wellness for individuals,
families, populations, and   communities.Community health efforts
accomplish this goal through a three-pronged effort to:--
Increase the span of healthy life for all citizens
Reduce health disparities among population groups
Achieve access to preventive services for everyone
 Prevention of Health Problems :-
Prevention of health problems constitutes a major part of community health
practice. Prevention means anticipating and averting problems or discovering
them as early as possible to minimize potential disability and impairment.
three levels in community health:-  
Primary prevention.
Secondary prevention.
Tertiary prevention.
Primary prevention :-  
obviates the occurrence of a health problem; it includes measures taken to
keep illness or injuries from occurring. It is applied to a generally healthy
population and precedes disease or dysfunction.
Secondary prevention :-
 involves efforts to detect and treat existing health problems at the earliest
possible stage when disease
or impairment already exist. Hypertension and cholesterol screening
programs in many communities help to identify high-risk individuals and
encourage early treatment to prevent heart attacks or stroke.
Tertiary prevention :-
 attempts to reduce the extent and severity
of a health problem to its lowest possible
level, so as to minimize disability and
restore or preserve function. Examples
include treatment and rehabilitation of
persons after
stroke to reduce impairment, a
postmastectomy exercise programs to
restore functioning, and early treatment
and management of diabetes to reduce
problems or slow their progress.  
Health assessment of individuals, families,
and communities is an important part of all
three levels of preventive practice. Health
status must be determined to anticipate
problems and select appropriate preventive
measures.  Treatment of Disorders :-
The third component of community health practice is treatmentBof
disorders. It focuses on the illness end of the continuum and is the remedial
aspect of community health practice.
This occurs by three methods:-  
direct service to people with health problems.  
indirect service that helps people to obtain treatment.  
development of programs to correct unhealthy conditions.
.  Rehabilitation :-
Is it  the fourth component of community
health practice, involves efforts to reduce
disability and, as much as
possible, restore function.
Evaluation :-
is the process by which that practice is
analyzed, judged, and improved according
to established goals and standards.
Research :-
is systematic investigation to discover facts
affecting community health and community
health practice, solve problems, and
explore improved methods of health
service