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1. CHN
Foundations of Community Health
Nursing
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2. Objectives
◼ Define community health.
◼ Explain the concept of community.
◼ Describe three types of communities.
◼ Diagram the health continuum.
◼ Differentiate among the three levels of prevention.
◼ Analyze the 6 components of community health
practice.
◼ Describe the 8 characteristics of community health
nursing.
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3. Introduction
◼ Challenges in nursing:
New biotechnologies
millions of people die each year from conflicts
resulting in wars & terrorism,
drought & starvation;
preventable ancient, new, & reemerging infectious
diseases;
and from unhealthy lifestyle choices.
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4. Introduction
Community Health Nursing is:
◼ Community based and, most importantly, it is population
focused.
◼ Operating within an environment of rapid change and
increasingly complex challenges,
◼ this field of nursing holds the potential for positively shaping the
quality of community health services and improving the health
of the general public.
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5. Community Health
◼ In acute care, the health of an individual is the primary focus.
◼Community health broadens that focus to concentrate
on families, populations, and the community at large.
◼ The community becomes the recipient of service, and health
become the product.
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6. Community Health
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◼ Many believe that health & illness are
individual issues ???????

7. Community Health
Community & National concerns include:
◼ rising incidence & prevalence of sexually transmitted
diseases,
◼ substance abuse,
◼ tuberculosis,
◼ teen pregnancy,
◼ family & teen violence,
◼ terrorism,
◼ pollution-driven environmental hazards
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8. Community Health
According to (ANA), Communities can:
◼ Influence spread of disease,
◼ Provide barriers to protect members from health hazards,
◼ Organize ways to combat outbreaks of infectious
disease,
◼ Promote practices that contribute to individual &
collective health.
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9. ◼ Many different professionals work in
community health to form a complex team.
For example:
A physician treating clients affected by a sudden
outbreak of hepatitis & seeking to find the
source is engaged in community health
practice.
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10. Community Health & Public Health
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◼ Community health & public health share many
features.
◼ Both are organized community efforts aimed at the
promotion, protection & preservation the health of
public .

11. Public Health
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Turnock (1997, p. 375) offered a more concise
definition of public health & stated that it includes:
“Activities that society undertakes to assure the
conditions in which people can be healthy. This
includes organized community efforts to prevent,
identify, and counter threats to the health of the
public.”

12. Community Health
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◼ Community health: is the identification of needs and the
protection & improvement of collective health within
a geographically defined area.
◼ Examples: health services and programs:
Health education,
Family planning,
Accident prevention,
Environmental protection,
Immunization,
Nutrition,

13. Community Health
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Early periodic screening,
School programs,
Mental health services,
Occupational health programs,
& the care of vulnerable

14. The Concept Of Community
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◼ A community is a collection of people who share
some important feature of their lives.
Example:
◼ Society of people holding common rights (eg, citizens
of a town).
◼ Sharing common interests (eg, a community of
farmers)

15. The Concept Of Community
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Three types of communities that have relevance
to community health practice:
◼ Geographic.
◼ Common interest.
◼ Health problem. Community of Solution

16. Geographic Community
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◼ Is defined by its geographic boundaries.
◼ Example: A city, town, or neighborhooh.
◼ WHY It is useful to identify a geographic area as
a community?
It becomes a clear target for analysis of health needs.
A geographic community is easily mobilized for action.
◼ The world can be considered as a global
community.

17. Common-Interest Community
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◼ Identified by a common interest or goal.
e.g: members of a national professional organization
◼ The kinds of shared interests that lead to the
formation of communities are widely varied.

18. Community of Solution
◼ A group of people who come together to solve a
problem that affects all of them.
For example, a water pollution problem may involve
several counties whose agencies and personnel must
work together to control upstream water supply,
industrial waste disposal, and city water treatment.
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19. Populations & Aggregates
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◼ Refers to all of the people occupying an area, or to all of those
who share one or more characteristics.
◼ Is made up of people who do not necessarily interact with one
another and do not necessarily share a sense of belonging to
that group.

20. Populations & Aggregates
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◼ Population may be defined geographically.
For example:
The population of the United States, or a city’s
population.
◼ Or defined by common qualities or characteristics.
For example:
elderly population or the homeless population

21. Populations & Aggregates
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Aggregate:
◼ Refers to a mass or grouping of distinct individuals who
are considered as a whole & who are loosely associated
with one another.
◼ It is a broader term that includes many different-sized
groups.
◼ Both communities & populations are types of aggregate.

22. For you as community health nurse student
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◼ You need to define the community targeted for study &
intervention
◼ Who are the people who compose the community?
◼ Where are they located,
◼ and what are their characteristics?

23. For you as community health nurse student
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◼What are the characteristics of the people in terms of
age, sex, race, socioeconomic level, and health status?
◼ How does the community interact with other
communities? What is its history?
◼ What are its resources?
◼ Is the community undergoing rapid change, and, if so,
what are the changes?

24. The Concept of Health
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◼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).
◼ According to WHO, “a state of complete physical, mental, and
social well-being and not merely the absence of disease or
infirmity” (Venes, 2001, p. 930).

25. The Health Continuum: Wellness–Illness
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◼Because health involves a range of degrees from optimal
health at one end to total disability or death at the other.
◼ This health continuum applies not only to individuals but
also to families and communities.

26. . ◼
,
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27. A healthy Community
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◼ Is one in which the various organizations, groups, & aggregates of
people making up the community do at least four things:
1. They collaborate effectively in identifying the problems & needs of
community.
2. They achieve a working consensus on goals and priorities.
3. They agree on ways and means to implement the agreed on
goals.
4. They collaborate effectively in the required actions.

28. Health as a State of Being
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◼ Health refers to a state of being, including many
different qualities & characteristics.
◼ An individual might be described in terms such
as energetic, outgoing, enthusiastic, beautiful,
caring, loving, and intense. Together, these
qualities become the core of a person’s
existence; they describe a state of being.

29. Health as a State of Being
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◼ A specific geographic community, such as a
neighborhood, has many characteristics. It might be
characterized by the terms congested, deteriorating,
unattractive, dirty, and disorganized.
◼ Workers involved in a massive layoff who band
together to provide support and share resources to
effectively seek new employment.

30. Subjective & Objective Dimensions of Health
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◼ Both how people feel (subjective).
and how well they can function in their environment
(objective).
◼ Healthy people are full of life and energy, capable of
physical and mental productivity. They feel minimal
discomfort and displeasure with the world around
them.

31. Subjective & Objective Dimensions of Health
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The subjective dimension (feeling well or ill)
and the objective dimension (functioning)
together provide a clearer picture of
people’s health.

32. the relationships between the subjective and objective
views of health.
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◼
.

33. Continuous & Episodic Health Care Needs
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◼ Continuous needs:
cover populations in all age groups with birth-to-death
developmental health care needs.
◼ Episodic needs:
one-time, specific, negative health events, such as an illness or
injury, that are not an expected part of life.

34. Components of Community Health Practice
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(1) Promotion of health,
(2) Prevention of health problems,
(3) Treatment of disorders,
(4) Rehabilitation,
(5) Evaluation, and
(6) Research.
These 6 basic components, when combined, include its
services and programs.

35. Promotion of Health
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◼ Includes all efforts that seek to move people closer to
optimal well-being or higher levels of wellness.
◼ Health promotion programs & activities include many
forms of health education—
for example, teaching the dangers of drug use,
demonstrating healthful practices such as regular
exercise.

36. Promotion of Health
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◼ The goal of health promotion is to raise levels of
wellness for individuals, families, populations, and
communities.

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38. Prevention of Health Problems
◼ Prevention means anticipate (PREDICT) and
averting (AVOIDANCE) problems or
discovering them as early as possible to
minimize potential disability & impairment.
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39. .
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40. Primary Prevention
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◼ Prevents the occurrence of a health problem; it includes
measures taken to keep illness or injuries from occurring.
Example:
◼ Educational programs that teach the dangers of smoking.
◼ Encouraging elderly people to install and use safety
devices to prevent injuries from falls

41. Secondary Prevention
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◼ Detect & treat existing health problems at the earliest
possible stage when disease or impairment already
exist.
Example:
◼ Hypertension and cholesterol screening programs in
many communities help to identify high-risk
individuals and encourage early treatment to prevent
heart attacks or stroke.

42. Tertiary Prevention
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◼ Attempts to reduce the extent (scope) and severity
of a health problem to its lowest possible level, so
as to minimize disability and preserve function.
Example:
◼ Treatment & rehabilitation of persons after a
stroke to reduce impairment.
◼ Post mastectomy exercise programs to restore
functioning, and early treatment and management
of diabetes to reduce problems or slow their
progress.

43. Treatment of Disorders
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◼ It focuses on the illness end of the continuum.
◼ This occurs by three methods:
(1) Direct service to people with health problems.
Example:
A nursing center serving a homeless population
provides referral services.

44. Treatment of Disorders
• (2) Indirect service that helps people to obtain treatment.
• Example:
• A social worker can help a family that is plagued by personal and
economic problems to enter a family therapy and counseling
program.
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45. Treatment of Disorders
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(3) Development of programs to correct unhealthy
conditions.
Example:
The health department developed new regulations for
industrial waste disposal as a result of increased
pollution of the water supply.

46. Rehabilitation
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◼ Involves efforts to reduce disability and, as much as
possible, restore function.
◼ For example:
A factory worker who lost his leg in an industrial accident
received good medical and nursing care, prosthetic
fittings, & physical and occupational therapy; he then
retrained to assume an office job.

47. Evaluation
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◼ Is the process by which that practice is analyzed,
judged, and improved according to established goals
and standards.

48. Research
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Systematic investigation to
◼ Discover facts affecting community health & community
health practice.
◼ Solve problems.
◼ Explore improved methods of health service.

49. Characteristics of Community Health
Nursing
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1- Field of Nursing:
◼ Community health nursing adds public health
knowledge and skills that address the needs and
problems of communities.
◼ Focuses care on communities and vulnerable
populations.

50. Characteristics of Community Health
Nursing
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It “synthesizes the knowledge from the public health
sciences and professional nursing theories”
to improve the health of communities & vulnerable
populations.

51. Characteristics of Community Health
Nursing
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2 Combines Public Health with Nursing:
Is grounded in both public health science and nursing
science.
3 Population Focused:
It is concerned for the health status of population groups
and their environment.
◼ It distinguishes it from other nursing specialties.

52. Characteristics of Community Health
Nursing
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4- Emphasizes Prevention, Health Promotion, &
Wellness:
◼ In community health nursing, the promotion of health
and prevention of illness are of first-order priority.
◼ Another distinguishing characteristic of community
health nursing is its emphasis on positive health, or
wellness

53. Characteristics of
Community Health Nursing
◼ Emphasis on wellness changes the
community health nursing role from a
reactive to a proactive
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54. Characteristics of Community Health
Nursing
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5- Promotes Client Responsibility and Self-Care:
When people believe that their health, and that of the
community, is their own responsibility, not just that of
health professionals, they will take a more active
interest in promoting it.

55. Characteristics of Community Health
Nursing
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6- 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.
◼ Focus of community health research and evaluation.
Health states,
environmental factors,
health related services,
economic patterns,
social policy.

56. Characteristics of Community Health
Nursing
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7- Uses Principles of Organizational Theory:
◼ To provide effective administration of health care
service.
◼Public health has long been defined as the protection
and improvement of community health through
organized community efforts.

57. Characteristics of Community Health
Nursing
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◼ Assess group and community needs,
◼ establish priorities, and plan, implement, and evaluate
services,
they are using public health management and
organizational principles.

58. Characteristics of
Community Health Nursing
8- Involves Inter-professional Collaboration:
◼ work in cooperation with other team members,
coordinating services and addressing the needs
of population groups.
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◼ WHY?

59. ◼ Individualized efforts and specialized
programs, when planned in isolation, can lead
to fragmentation and gaps in health service.
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60. Characteristics of Community Health
Nursing
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◼ Inter-professional collaboration requires clarification
of each team member’s role.
◼ Client participation is promoted when people serve
as partners on the health care team.
An aim of community health nursing is to collaborate
with people rather than do things for them.

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End
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