Community Diagnosis: The process

1. COMMUNITY
DIAGNOSIS: THE
PROCESS

2. Community Diagnosis
• Is the process of determining the health status of the community and
the factors responsible for it.
Shuster and Goeppinger proposed a practical adaptation of nursing
diagnoses for population groups previously presented by Green and
Slade (2001):
• The health risk or specific problem to which the community is
exposed.
• The specific aggregate or community with whom the nurse will be
working to deal with the risk of problem.
• Related factors that influence how the community will respond to the
health risks or problem.

3. Steps in Conducting Community Diagnosis
1. Determining the objectives
• Decide on the depth and scope of the data that needs to be gathered.
Dever (198) explains that the nurse must determine the occurrence and
distribution of selected environmental, socio-economic and behavioral
conditions important to disease control and wellness promotion.
2. Defining the study population
• Identify the population group to be included in the study. When a complete
enumeration of the desired population is not possible, collection of data
from a subset of population may be done.

4. Cont’n. Defining the study population- Sample
• A fraction or portion of the population
• Types of Sample
1. Random Sampling-picking or selecting certain sample
2. Table of random sample- according to table of random
sample

5. cont’n Defining the study population
• 30 % of the representative- the minimum percentage that can be safely
considered as the representative of the whole community.
• Example: Total number of families in the community Y: 300 families
• Total number of families to be surveyed in community Y: 90 families
• Total number of questionnaires to be prepared in community Y: 100-
115 survey forms
• *10-15 is always added in the total number of deadfiles.

6. cont’n Defining the study population
• 60% or the quorum- Researchers choose this percentage because it shows vividly the
real status of the community, showing more than half, therefore, we can safely say that
the result of the survey most likely shows the general status of the community.
• Example: Total number of families in the community Y: 300 families
• Total number of families to be surveyed in community Y: 180 families
• Total number of questionnaires to be prepared in community Y: 190-195 survey forms
• *10-15 is always added in the total number of deadfiles.

7. cont’n Defining the study population
• 100% or the whole- for rigid surveys and for small communities, the data gatherers
must consider the whole community.
• Example: Total number of families in the community Y: 90 families
• Total number of families to be surveyed in community Y: 90 families
• Total number of questionnaires to be prepared in community Y: 100-115 survey forms
• *10-15 is always added in the total number of dead files.

8. Steps in Conducting Community Diagnosis
3. Determining the data to be collected
Types of Data
• Qualitative- refers to quantity describe attributes to be
observe to people being studied
• E.g. Sex, Race
• Quantitative- variables that can be measured.
• E.g. height and weight

9. Tools for community assessment
• Primary Data- data that have not been gathered before and
are collected by the nurse through observation, survey,
informant interview, community forum, and focus group
discussion.
• Secondary Data-are taken from existing data sources.

10. Collecting primary data
• Observation-rapid observation of a community may be done
through an ocular or windshield survey, either by driving or
riding a vehicle or walking through it.
• Survey-may be necessary when there is no available
information about the community or specific population
group to be studied.

11. • Informant interview-are purposeful talks with either key informants or
ordinary members of the community. It is consisting of formal and informal
community leaders or persons of position and influence, such as leaders in
local government, schools, and business.
• Community forum-is an open meeting of the members of the community
• Focus group-made up of a much smaller group, usually 6-12 members only.

12. Secondary data sources
• Registry of vital events- Act 3573 (Civil Registration Law, Philippine
Legislature), enacted in 1930, established the civil registry system in the
Philippines and requires the registration of vital events, such as births,
marriages, and deaths. RA 7160 (Local Government Code) assigned the
function of civil registration to local governments and mandated the
appointment of Local Civil Registrars.

13. • Health records and reports-EO No. 352, the Field Health Service
Information System (FHSIS), is the official recording and reporting
system of the Department of Health and is used by PSA to generate
health statistics.
• Disease registries- listing of persons diagnosed with specific type of
disease in a defined population
• Census data- periodic governmental enumeration of the population.

14. Steps in Conducting Community
Diagnosis
4. Collecting the data
• Records review
• Surveys and observations
• Interviews
• Participant selection
5. Developing the instrument
• Survey questionnaire
• Interview guide
• Observational checklist

15. Problems in Data Collection
• Uncooperative community- most common encountered problem especially in the urban areas.
• Preventive measures:
• Proper information dissemination especially in the objectives and purpose of the survey
• Conducting a General assembly or meeting with the community and barangay officials before the start of
the survey.
• Proper explanation and showing the proper attitude in conducting survey

16. Problems in Data Collection
• Defective or Inappropriate Questionnaires- survey forms will be inappropriate especially if the
researcher will be using ready-made questionnaire that are not appropriate for the community.
• Preventive measures:
• Proper observation in the part of the researcher.
• Formulating appropriate survey forms for the target community.
• Avoid using ready-made survey forms that are found in books or previous documents, these survey
forms are intended to be the researcher guide to make their own survey forms

17. Problems in Data Collection
• Too many deadfiles- Deadfiles are answered survey forms that are incomplete, inconsistent,
inadequate, doubled or lost data. These files should be discarded or should not be tallied or else
will cause damage or inconsistency to the analyze data.
• Preventive Measures
• The researchers should be well thought on how to fill-up the questionnaire
• Proper observation in the part of the researcher
• The source of the information should be reliable
• Questioning techniques should be reviewed and practiced
• Marking of the interviewed families should be properly observed

18. Problems in Data Collection
• Inconsistent Data- the most credible and the most reliable source should be interviewed are
parents not more than 65 years old and no degenerative disorders or eldest sibling at least 18
years old.
• Preventive measures
• Proper observation in the part of the researcher
• Inform the source of information to answer the questions as honestly and as sincerely as possible
• Avoid leading statements to minimize confabulation
• Questioning techniques should be reviewed and practiced

19. Problems in Data Collection
• Lost/ misplaced documents- one of the most simple but common problem
• Preventive measures
• At least two copies of the documents must be kept by two different researchers
• Consistency of the two copies should be maintained
• Used or unused documents must be kept confidential

20. Steps in Conducting Community
Diagnosis
6. Actual Data Gathering
Pre-testing of instrument is highly recommended.
7. Data Collation
Two types of data that may be generated:
-Numerical data which can be counted
-Descriptive data which can be described

21. Data Collation
To classify sex:
Male
Female
To classify monthly income:
Below P500
P500-P1000
P1000-1500
P1500- P2000

22. Data Collation
• After categorizing the responses, the next step will be to
summarize the data
Diseases Tally/Mark Frequency
Diarrhea IIIII-IIIII-IIIII-IIIII 20
Cough IIIII-IIIII-IIIII-II 17
Parasitism IIIII-IIIII-IIIII-IIIII-IIIII-IIIII 25

23. Steps in Conducting Community
Diagnosis
8. Data presentation
• Title-tells what the table shows. All columns should be clearly,
specifically labeled.
• Table- shows the inter relation among variables.
• 2 column frequency
• First column- classes of the group/category
• Second column-frequencies of the group.

24. Methods to present community data
• Community data are presented to the health team and the members of the community for the
following purposes;
• To inform the health team and members of the community of existing health and health-related
conditions in the community in an easily understandable manner
• To make members of the community appreciate the significance and relevance of health information to
their lives.
• To solicit broader support and participation in the community health process
• To validate findings
• To allow for a wider perspective in the analysis of data
• To provide a basis for better decision making

25. Graphs for presenting community data
and their uses
• Bar graph- compare values across different categories of data.
• Line graph- to have a visual image of trends in data over time or age.
• Pie chart- to show percentage distribution or composition of variable, such as population or
households.
• Scatter plot or diagram- to show correlation between two variables.

26. Bar graph

27. Line graph

28. Pie graph

29. Scatter diagram

30. Steps in Conducting Community
Diagnosis
9. Data Analysis
-aims to establish trends and patterns in terms of health needs and problems of the
community. It also allows for comparison of obtained data with standard values.
10. Identify the Community Health Nursing Problems.
Community health nursing problems are categorized as:
a. Health status problems- may be described in terms of increased/ decreased
morbidity/mortality.
b. Health resources problems-may be described in terms of lack of or absence of
manpower, money, or materials
c. Health-related problems- may be described in terms of existence of social,
economic, environmental and political factors,

31. Steps in Conducting Community
Diagnosis
11. Priority-Setting
• In priority-setting, the nurse makes use of the following criteria:
a. Nature of condition/problem presented-are classified by the nurse as health status,
health resources or health-related problems
b. Magnitude of the problem- refers to the severity of the problem which can be
measured in terms of the proportion of the population affected by the problem
c. Modifiability of the problem-refers to the problem of reducing, controlling or
eradicating the problem
d. Preventive potential- refers to the probability of controlling or reducing the effects
posed by the problem
e. Social concern- refers to the perception of the population or the community as they
are affected by the problem and their readiness to act on the problem.

32. Scoring system
Criteria Weight
Nature of the problem
• Health status 3
• Health resources 2
• Health-related 1
1
Magnitude of the problem
• 75% to100% affected 4
• 50% to 74% affected 3
• 25-49% affected 2
• <25% affected 1
3
Modifiability of the problem
• High 3
• Moderate 2
• Low 1
• Not modifiable 0
4

33. Criteria Weight
Preventive potential
• High 3
• Moderate 2
• Low 1
1
Social concern
• Urgent concern; expressed 2
readiness
• Recognized as a problem 1
but not needing urgent
Attention
• Not a community concern 0
1

34. Application of public health tools in
CHN
• Demography- is the science which deals with the study of the human population’s size,
composition and distribution in space.
• Vital statistics
• Sources of demographic data
• Census
• Two methods
• de jure- done when people are assigned to the place where they usually live
regardless of where they are at the time of the census
• de novo-done when people are assigned to the place where they are
physically present at the time of the census regardless of their usual place of
residence

35. Demography
• Population size
• Absolute increase per year
• Population projection
• Population Composition
• Sex composition
• Age composition
Median age
Dependency ratio
• Age and sex composition
• Population composition
• Urban-rural distribution
• Crowding index
• Population density

36. Functions of the Nurse
1.Collects data
2.Tabulates data
3.Analyze and interprets data
4.Evaluates data
5.Recommends, redirection and/or strengthening of a specific
areas of health programs as needed