Overall health and well-being are greatly impacted by the communities in which patients live and work. Access to care is influenced by economic, social, and political issues. Depending on the needs of the individual and the population, it may be a major factor in determining physical, emotional, and mental health as well as morbidity and mortality.

1. COMMUNITY
HEALTH NURSING
DIAGNOSIS
Individual, Family, and Community Diagnoses

2. NURSING
PROCESS
Source: www.allnurses.com

3. INTRODUCTION
• Creating nursing diagnoses
requires the application of
detailed assessment skills,
critical thinking, and decision
making. The formulation of
nursing diagnoses is related to
competency in diagnostic
reasoning.

5. DEFINITIONS
A diagnosis is a
that synthesizes (brings
together) assessment
It is a label that
situation (or state) and
implies an etiology
(reason) and gives
evidence to support the
inference.

6. NANDA-I
• The North American
Nursing Diagnosis
Association (NANDA)
defines nursing
diagnosis as a clinical
judgment about
individual, community
or family responses to
community to actual or
potential health
problems or life
processes.

7. FAMILY
A family nursing diagnosis is an extension of a
diagnosis to the family system and/or subsystems
is the outcome of family assessment. It includes
or potential health problems.
Diagnoses statement: Single diagnosis (no etiology
included BUT adding family member who had
problems)

8. COMMUNITY
A community diagnosis
in that it is focused on an
aggregate or a community
(rather than an individual).
It requires a multidisciplinary
action to address or treat,
multiple determinants must
considered when planning
interventions. Outcomes of
action may not be visible for
long time

9. WELLNESS DIAGNOSIS
Characteristics:
• Sometimes called positive or health oriented diagnoses.
• Focus is on an individual, family, community or aggregate.
• There is usually a desire for a higher level of wellness.
• Sometimes an effective program or status is present and there is a desire
to improve the functioning.
• Usually require multidisciplinary action to address or enhance.
• Multiple determinants must be considered when planning interventions.
• Outcomes/ actions may not be visible in the short term.
• Focus is on existing or potential individual/family/community strengths.

10. WELLNESS DIAGNOSIS:
Nurse’s Role in Wellness Diagnoses:
• The role of the nurse is basically to
facilitate healthy responses in order to
reach a higher level of health oriented
goals. There is a progression from one
level of wellness to a higher level of
wellness. For example, the nurse can help
clients to complete transitions, to achieve
higher levels of wellness or to attain
wellness status.
• Health promotion plays a significant role.

11. COMMUNITY DIAGNOSIS
IN NANDA -I
• Commonly located at Domain 1 (Health
promotion), but could be at other Domains
• Commonly labelled as :
- Deficient community health (D1, C2)
- Readiness for enhanced health management
(D1, C2)
(NANDA International, Inc. Nursing Diagnoses: Definitions &
Classification 2015–2017, Tenth Edition)

12. DEFICIENT COMMUNITY
HEALTH
•Definition Presence of one or
more health problems or factors
that deter wellness or increase
the risk of health problems
experienced by an aggregate.

13. DEFICIENT COMMUNITY
HEALTH
Defining Characteristics
■ Health problem experienced
by aggregates or populations
■ Program unavailable to
eliminate health problem(s) of an
aggregate or population
■ Program unavailable to
enhance wellness of an
aggregate or population
■ Program unavailable to
prevent health problem(s) of an
aggregate or population
• Program unavailable to reduce
health problem(s) of an
aggregate or population
• ■ Risk of hospitalization
experienced by aggregates or
population
• ■ Risk of physiological states
experienced by aggregates or
populations
• ■ Risk of psychological states
experienced by aggregates or
population

14. DEFICIENT COMMUNITY
HEALTH
Related Factors
■ Inadequate consumer
satisfaction with program
■ Inadequate program
budget
■ Inadequate program
evaluation plan
■ Inadequate program
outcome data
■ Inadequate social support
for program
• Insufficient access to
healthcare provider
• ■ Insufficient community
experts
• ■ Insufficient resources
(e.g., financial, social,
knowledge)
• ■ Program incompletely
addresses health problem

15. READINESS FOR ENHANCED
HEALTH MANAGEMENT
•Definition A pattern of regulating
and integrating into daily living a
therapeutic regimen for the
treatment of illness and its
sequelae, which can be
strengthened.

16. READINESS FOR ENHANCED
HEALTH MANAGEMENT
Defining Characteristics
■ Expresses desire to enhance
choices of daily living for
meeting goals
■ Expresses desire to enhance
management of illness
■ Expresses desire to enhance
management of prescribed
regimens
• Expresses desire to
enhance management of
risk factors
• ■ Expresses desire to
enhance management
of symptoms ■ Expresses
desire to enhance
immunization/vaccination
status

17. COMMUNITY
4 PARTS OF COMMUNITY DIAGNOSIS;
1. a description of the problem, response, or state
(risk, concern, issue, potential or actual),
2. a statement of the aggregate, population,
community, or focus (boundaries). THIS
DIFFERS FROM THE NURSING DIAGNOSIS, the
focus is added
3. an identification of factors etiologically related
to the problem ( factors), and
4. those signs and symptoms (manifestations)
that are characteristic of the problem.
EXAMPLE:
deficient community health among children
aged 0-5 y.o in the area of Village A related to
Insufficient access to healthcare provider as
evidenced by Health problem experienced by
children (malnutrition, etc), Program unavailable
to eliminate health problem(s) of an aggregate or
population (Ex: no health education)

18. COMMUNITY HEALTH
NURSING : PLANNING

19. PLANNING
Prioritize the
community-
health conditions
and problems
Define objectives
and goals
Develop the
intervention plan
Define persons,
time, place,
method, tools

20. CRITERIA TO ESTABLISH PRIORITIES
OF CHN NURSING DIAGNOSES
• Appropriateness to the community health
nursing role
• Prevalence of the risk in the community
• Severity of the risk
• Potential for risk reduction
• The level of the community's interest in
reduction of the risk
• Availability of appropriate resources
(personnel, money, equipment, space, time,
etc.).
Muecke, M. A. (1984). Community health
diagnosis in nursing. Public Health Nursing,1(1),
31.

21. DEFINE OBJECTIVES AND
GOALS
• Formulate expected outcomes : c
- onditions to be observed to show
problem is prevented, controlled,
resolved or eliminated  knowledge,
behavior, status (signs & symptoms)
• Individuals / families/ community responses
or behaviors
• Specific, measurable, community centered

22. DEVELOP INTERVENTION
PLAN
Categories of the intervention scheme:
Primary preventions
• Health teaching, guidance and counseling (assistance with decision
making and problem solving)
Secondary preventions
• Treatments and procedures (decreasing and alleviating sign and
symptoms)
Tertiary preventions
• Case management (coordination, advocacy and referral)
Independent or collaborative intervention

23. REFERENCES:
Freidman, M.M., Bowden, V.R., & Jones, E.G. (2003). Family nursing:
Research, theory, and practice. (5th ed.). New Jersey: Prentice Hall.
Muecke, M. A. (1984). Community health diagnosis in nursing. Public Health
Nursing,1(1), 31.
Sparks, S.M., & Taylor, C.M. (2001). Nursing diagnosis reference manual. (5th
ed.). Pennsylvania: Springhouse.
Stammler, L.L. & Yiu, L. (Eds.). (2008). Community health nursing: A
Canadian perspective. (2nd.ed.). Toronto: Pearson.
Stolte, K.M. (1996). Wellness: Nursing diagnosis for health promotion.
Philadelphia: J.B. Lippincott.
Vollman, A.R., Anderson, E.T. & McFarlane, J. (2004). Canadian community as
partner: Theory and practice in nursing. Philadelphia: Lippincott Williams &
Wilkins.