“introduction to community health nursing”

Date:7/7/2021 www. qadricohs.edu.pk FB Page: Qadri College of Health Sciences, Karachi, Sindh, Pakistan. 1
QADRI COLLEGE OF HEALTH SCIENCES, KARACHI
U-1, 1 OF 1
Community Health Nursing-I
Unit I : “Introduction to Community Health Nursing”
GBSN Year.1 , Semester.2
By: Aftab H. Abbasi
RN, DCHN, BSN, MA, LL.B
Lecturer Nursing
Qadri College of HealthSciences Karachi

Unit I: Introduction to Community Health Nursing
In this unit students will discuss the history,
philosophy and definition of Community
Health Nursing.
In this unit they will also discuss concepts of
health and illness and the role of public
health care team members.
Introduction to Community Health Nursing

Unit objectives:
At the completion of this unit,
students will be able to:
1- Define the terms:
 Community
 Community health, and
 Community health nursing.
 Urban
 & rural communities

Unit objectives: Continued…
2. Discuss the historical background of
Community Health Nursing from
Public Health Nursing.
3. Describe the philosophy of Community
Health Nursing.
4. Discuss the concepts of health, wellness,
illness and disease.
5. Discuss the roles of the Community
Health Nurse in community settings.

COMMUNITY:
“Community is the smallest territorial group
of people that can embrace all aspects of
social life.” (Kingsley Davis)
OR
“Community is a living population within a
limited geographical area carrying a
common interest.” (Lundlberg)
Definitions of Some Terms

DEFINITION:
“Community is an organic, natural kind of
social group whose members are bound
together by a sense of belonging, created
out of everyday contacts covering the whole
range of human activities”.
(Ferdinand Tonnies)

COMMUNITY HEALTH:
“Is an art and science of taking care of health
in all its aspects of life which includes
promotion and preservation of health,
prevention of disease”. (BTB 1998)
OR
“Community health refers to the health status
of the members of the community, to the
problems affecting their health, and to the
totality of health care provided for the
community.” (WHO)

COMMUNITY HEALTH NURSING:
The major focus of the nurse’s work –the
community- as well as the underlying
philosophy of population-focused practice,
which focuses on creating changes in
community norms, attitudes, awareness,
standards or practices.
OR
Community health Nursing is the synthesis of
nursing and public health practice applied to
promote and protect the health of
population. It combines all the basic
elements of professional, clinical nursing
with public health and community practice.

Community health nursing practice
promotes and preserves the health of
populations by integrating the skills and
knowledge relevant to both nursing and
community health.
OR
Community health nursing is the practice or
promoting and protecting the health of
populations using knowledge from
nursing science.

1- Urban Community:
City community/ Civilized society are the terms
which are used synonymously.
- Those places have local authority like
municipality and containment board.
- Other requirements of a minimum population
of 5,000 at least 75% of the working
population engaged in non-agricultural.
- Large, density and permanent settlement of
socially heterogeneous individuals living
place.
- The word ‘urbane’ suggests this way of life;
it indicates fashionable living.
Community Types

2- Rural Community:
Can be classified as rural based on the
criteria of lower population density, less
social differentiation, less social and
spatial (‫)مقامی‬ mobility, slow rate of social
change, etc.
Agriculture is the major occupation of rural
people.
Community Types

The specialty of community health nursing
developed historically through four
stages:
1- The early homecare stage:
(before the mid-1800s) emphasized care to the
sick poor in their homes by various lay and
religious orders.
2- The district nursing stage:
(mid-1800s) included voluntary home nursing
care for the poor by specialists or "health nurses"
who treated the sick and taught wholesome living
to patients.
Historical Background Of Community Health Nursing
From Public Health Nursing

3- The public health nursing stage:
(1900-1970) was characterized by an
increased concern for the health of the
general public.
4- The community health nursing stage:
(1970 to the present) includes increased
recognition of community health nursing
as a specialty field, with focus on
communities and populations.

The philosophy of community health
nursing derives from acceptance of
certain concepts and facts as a
foundation of working with people.
Among these are:
- The essential dignity and worth of
individual.
- The possession by individuals of
potentialities and resources for managing
their own lives.
Philosophy of Community Health Nursing

- The importance of freedom to express
one’s individuality.
- The right of the individual to basic
necessities (food, shelter, medical care)
without which fulfillment of life is often
blocked.
- The need for individuals to struggle and
strive to improve their life and
environment.
- The right of individual to help in times of
need and crisis.

The primary purpose of community health
nursing is to help determine the health
needs of systems (individual, family,
community) and to offer comprehensive
quality of nursing services that will help
them attain, maintain or regain high level
of wellness.
In brief‫مختصر‬, the following concepts are
basic to the philosophy of Community
Health Nursing:

- Everyone regardless of race, creed, sex
or sexual preference has a right to good
health and a long productive life.
- Everyone has some kind of health
learning need.
- Some people and communities need help
to recognize that they need assistance to
regain, maintain or attain a high level of
wellness.
- Health is dynamic adjustment of humans
to their environment.

- Health and health care enable a society
to be productive and perpetuate culture,
which affects the standards of living of
living of its people.
- The major purpose of community health
nursing is to help systems attain, maintain
or regain high level of wellness.
- Community health nursing remains an
effective force in society by utilizing and
participating in the development of health
knowledge and technology.

- Over time new health knowledge and
technology evolve to meet changing
health needs.
- Through community health nursing, a
comprehensive care that will move
populations up the wellness continuum
can be provided.

HEALTH: As defined by the World Health Organization (WHO),
is “a state of complete physical, mental,
social and spiritual well-being and not
merely (‫)محض‬ the absence of disease or
infirmity.” (WHO)
OR
Is a state/condition of complete wellbeing,
as physically, socially, mentally,
physiologically and economically.
Concepts of Health, Wellness, Illness and Disease

WELLNESS:
Wellness is an active process of becoming aware of
and making choices toward a healthy and fulfilling
life.
Wellness is more than being free from illness, it is
a dynamic process of change and growth.
OR
Wellness is much more than merely physical health,
exercise or nutrition. It is the full integration of
states of physical, mental, and spiritual well-being.
It includes social, emotional, spiritual,
environmental, occupational, intellectual and
physical wellness.

ILLNESS:
Is a highly personal state in which the
person feels unhealthy or ill.
Illness may or may not be related to
disease.

DISEASE:
A pathological condition of a body part, an
organ, or a system resulting from various
causes, such as infection, genetic defect, or
environmental stress, and characterized by
an identifiable group of signs or symptoms.
OR
Any condition that impairs the normal
functioning of the body.
OR
Means abnormal condition of the body.

DEFINITION OF HEALTH / ILLNESS CONTINUUM:
The Illness-Wellness Continuum is a graphical
illustration of a wellbeing concept first
proposed by John. W. Travis in 1972. It
proposes that wellbeing includes mental and
emotional health, as well as the presence or
absence of illness. It describes how
wellbeing is more than simply an absence of
illness, but also incorporates the individuals
mental and emotional health. Travis believed
that the standard approach to medicines,
which assumes a person is well when there
are no signs or symptoms of disease, was
insufficient.

One tool that nurses can use to help guide their
patients in the right direction is the health
continuum, also called the illness-wellness
continuum. The illness-wellness continuum is an
illustration that draw a connection between the
treatment paradigm and the wellness paradigm.
John W Travis said: “ The currency of wellness is
connection.”

DEFINITION OF ROLE:
The function assumed or part played by a
person or thing in a particular situation.
CONCEPTS OF ROLE AND IT’S TREND IN
NURSING:
There was a time when the nurses were
meant only for carrying out the orders of
physicians.
Now the traditional role of an assistant to
doctor has been changed in the following
ways with the evolution ‫ارتقاء‬ of community.
Roles of the CHN in community settings

- The nursing has evolved from that of
focusing on illness in the care of patients
only in the hospital, to concern for
promotion, restoration and maintenance
of health in all settings of community.
- The nursing has become knowledge
based rather than task oriented.
- Many nurses are engaged in research
and independent scholarly work.

- The dependent function of a nurse, of
carrying out prescriptions of physicians, has
changed to more independent and assertive
role in the given community.
- Nurses are more self directed and willing to
assume greater responsibility and
accountability for the care of patients.
- The role of a nurse moved from merely
following physicians orders to collaborative
or joint working relationship with medicine
and other disciplines concerned with health
care.

1- HEALTH CARE PROVIDER:
CHN have the main role is the health care
related services provider role providing all
kind of health care related services to the
community people at their door-step.
For example, providing first aid, MCH
(mother and child health) services,
treating minor illnesses, referral services
etc.

2- HEALTH EDUCATOR:
Teaching in the community individuals and
families regarding health care, promotion
of health and prevention of diseases.
3- COLLABORATOR:
The community health nurse works
collaboratively with patients and also with
members of health team in assessing,
planning, implementing, and evaluating
interventions.

4- COUNCELLOR:
The provision of professional assistance and
guidance in resolving personal or
psychological or health care related
problems.
5- RESEARCHER:
Community health nurse job involves
discovering or verifying information for use in
a book, Health programme / Policy by
government or higher authorities.

6- ADVOCATE:
• CHN is an advocate of patient’s rights in
relation to their care.
• As a patient’s advocate the nurse provides
the patient with sufficient information to
make the necessary health care decisions.
• The nurse also supports the patient’s
rights to make these decisions.
• The nurse explains, protects and defends
the rights of the patient.

7- MANAGER:
Nurse is expected to organize and manage
various planned programmes of health
and assume leadership of nursing team
for supervision of nursing and other
auxiliary personnel.
8- EVALUATOR:
When a nurse judge the quality,
importance, amount, or value of something
to reach on a point to make decision.

9- CONSULTANT:
As a consultant, the nurse shares nursing
knowledge and expertise to help solve a
problem or meet a need.
10- ADVISER:
Individuals and families are looking towards
the nurse as an adviser mainly in practical
and emergency matters which relates to
health Acceptance of advices from the
community health nurses are well
documented.

11- Preventer of illness.
12- Promoter of health.
13- Provider of direct care.
14- Good observer.
15- Participant in planning.
16- Primary health care provider.

Community Health Nursing
B. T. Basavanthappa
First Edition 1998
https://www.researchgate.net/publication/305428662_History_and_evolution_of_community_health_nursing

“Introduction to Home Visiting”

By: Aftab H. Abbasi
RN, DCHN, BSN, MA, LL.B
Lecturer Nursing
Qadri College of HealthSciences Karachi

“introduction to community health nursing”

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