DEFINITIONS AND CONCEPTS OF HEALTH: A COMMUNITY PERSPECTIVE

➲ (WHO) defined health as a “ state of complete physical, mental and social well being and not merely the absence of disease or infirmity “ ➲ The modern concept of health refers to optimum level of individuals, families and communities. ➲ Health which is viewed as a continuum, is consider as the goal of public health in general, and community health nursing, in particular.

Determinants of Health 1. Income and social status - Higher income and social status are linked to better health 2. Education - Low education levels are linked with poor health more stress and lower self – confidence 3. Physical Environment - Safe water and clean air, healthy workplaces, safe houses, communities and roads all contribute to good health 4. Employment and working conditions - People in employment are healthier, particularly those who have control over their working conditions

5. Social Support networks - Greater support from families, friends and communities is linked to better health 6. Culture - Culture and traditions, and the beliefs of the family and community all affect health 7. Genetics - Inheritance plays a part in determining lifespan healthiness and the likelihood of developing certain illnesses 8. Personal behavior and coping skills - Balanced eating, keeping active, smoking, drinking, and how we deal with life’s stresses and challenges all affect health

9. Health services - Access and use of services that prevent and treat disease influence health 10. Gender - Men and women suffer from different types of ages

Eco-system influences optimum level of functioning environment Environment Air Food Water waste Urban/Rural Noise Radiation Pollution Health care Delivery System Promotive Preventive Curative Rehabilitative Socio-economic Employment Education Housing POLITICAL Safety Oppression People Empowerment Behavioral/lifestyle Culture Habits Mores Ethic Customs Heredity Generic Empowerment - Defects - Strengths - Risks Familial Ethic Racial OLOF Individuals Family Groups Communities Populations

Health promotion and Level of prevention in Public Health Level of prevention Objectives and Focus of Activities I. Primary prevention1. Health Promotion 2. Specific protection II. Secondary prevention 3. Early diagnosis 4.Prompt treatment III. Tertiary5. Rehabilitation

➲ Primary prevention consists of activities which are undertaken before disease strikes and are applied to generally healthy people in order to keep them well ➲ Health promotion consists of activities aimed at maintaining or enhancing people's physical,mental or social well-being ➲ Disease prevention activities protect people from disease and the effects of disease

➲ Specific protection refers to activities which protect people from specific and known potential or actual threats to health, such as certain diseases or accidental injuries.It involves the identification and reduction of risk and hazards to health. ➲ Secondary Prevention includes activities for early diagnosis and prompt treatment of disease or health problem which has not been prevented,with the objectives of halting its progress, minimizing its severity, shortening its duration,preventing or reducing its complications, and bringing about cure

➲ Tertiary prevention consists of activities which are done when the disease process, an injury or a calamity has already exacted its damage and ill effects, with consequent disability or loss of function in varying degrees. The objective of rehabilitation is to restore the patient to an optimum level of functioning within the constraints imposed by the disability

DEFINITION and FOCUS : PUBLIC / COMMUNITY HEALTH NURSING

 WINSLOW defines public health as the science and art of preventing disease, prolonging life, promoting health and efficiency through organized community effort for the sanitation of the environment, control of communicable diseases,the education of individuals in personal hygiene 6/7/11

 FREEMAN defined as a field of professional practice in nursing and in public health in which technical nursing, interpersonal,analytical and organization skills are applied to problems of health as they affect

 WHO as a special field of nursing that combines skills of nursing, public health and some phases of social assistance, and functions as apart of total public health program for the promotion of health, the improvement of conditions in the social and physical environment, rehabilitation and the prevention of illness and disability.

GLOBAL and COUNTRY HEALTH IMPERATIVES 1.Shifts in demographic and epidemiologic trends in disease, including the emergence and re- emergence of new disease and in the prevalence of risk and protective factor; 2.New technologies for health care, communication and information ; 3.Existing and emerging environmental hazards some associated with globalization 4.Health reforms

Millenium Development Goals 1. Eradicate extreme poverty and hunger 2. Achieve universal primary education 3. Promote gender Quality and empower women 4. Reduce Child Mortality 5. Improve maternal health 6. Combat HIV/AIDS,malaria and other diseases 8. Develop a global partnership for development 7. Ensure environmental sustainability

Public Health Nursing is a synthesis of public and nursing practice 1. emphasis on the importance of the “greatest good for the greatest number “ 2. assessing health needs planning, planning, implementing and evaluating the impact of health services on population groups 3. priority of heath – promotive and disease- preventive strategies over curative interventions

4. Tools for measuring and analyzing community health problems ; and 5. Application of principles of management and organization in the delivery of health services to the community

Community Health Nursing (American Nurses Association ) is a synthesis of nursing practice and public health practice applied to promoting and preserving the health of populations  (Phil. Dept. of Health ) is a unique blend of nursing and public health practice woven into a human service that, properly developed and applied has a tremendous impact on human well-being,

 CHN is a field of nursing practice where services are delivered outside of purely curative institutions,but community settings such as the home,the school,places of work,health centers and clinics.

BASIC CONCEPTS AND PRINCIPLES IN COMMUNITY HEALTH NURSING PRACTICE

➲ 1. The family is the unit of care, hence the community health nurse consider the health needs of all members of the family in providing nursing services. ➲ 2. The community as a whole is the locus of service and the patient. ➲ 3. The goal improving in community health is realized through multidisciplinary approach. ➲ 4. The community health nurse is deeply concerned with the increasing capability of her four levels of clientele – individual, family, population groups and community to deal with its own recognized needs and health problems.

➲ 5. The public health nurse works with end not for the client who is an active partner. ➲ 6. Practice is affected by changes in society in general and by development in health field in particular. ➲ 7. Community health nursing is a part of functions within a large and complex system and any change in this system affects it. ➲ PHILOSOPHY According to Dr. Margaret Shetland the philosophy of community health nursing is based on the worth and dignity of a man.

ROLES, FUNCTIONS of and Competencies Required by A Community Health Nurse ROLE refers to a set of behaviour patterns that are deemed appropriate for and expected of a person by virtue of his/her status in society and/or a position he/she occupies in an organization FUNCTIONS i s a set of activities and task expected of a person to perform by virtue of his position or role in society COMPETENCY the quality of being functionally adequate in performimg the tasks ana assuming the role of a specific position

ROLES OF COMMUNITY HEALTH NURSES  Case Manager  Advocates  Teacher  Partner and Collaborator  Health Planner / Programmer  Manager/Supervisor

 Community Organizer  Health Educator/Trainer  Case Finder  Epidemiologist  Recorder / Reporter / Statistician  Community Leader

11 CORE COMPETENCIES 1.SAFE AND QUALITY NURSING CARE 2. MANAGEMENT O RESOURCE AND ENVIRONMENT 3. HEALTH EDUCATION 4. LEGAL RESPONSIBITY 5. ETHICO – MORAL RESPONSIBILITY 6. PERSONAL and PROFESSIONAL DEVELOPMENT 7. QUALITY IMPROVEMENT 8. RESEARCH 9. RECORD MANAGEMENT 10. COMMUNICATION 11. COLLABORATION and TEAM WORK

SPECIALIZED FIELD in Community and Public Health Nursing SCHOOL HEALTH NURSING aims to promote the health of school personnel and pupil/student FOUR PHASES I. Health Instruction – giving health education, group counseling, personal hygiene immunization, nutrition, dental care, environmental sanitation II. Health Services – attending to emergency cases, physical examination ( PE ) of students teachers. Refer for lab exam III. Health School Living - coordinate with other agencies like the insect and vermin control, identify health hazards, Participates in maintaining cleanliness. IV. School and Community Coordination - initiates projects to promote health in the environment

In 1987, DECS introduced the Redirected Approach in School Health Nursing ( RASHN ) utilizing the concept of Primary health Care Activities of the Program 1. School Health Survey – basis of evaluation 2. Functional school clinic 3. Comprehensive pupil health assessment 4. Referral of cases 5. School plan inspection 6. Attending to emergency cases 7. Organize and reactivating school community health council. 8. Intensify health educational activities 9.Establishing data in school health activities

OCCUPATIONAL HEALTH NURSING  is the application of public health to conserve, restore and maintain health status of workers in an industry Promotive Program of Care : 1. Teaching of health and safe practices in the job 2. Prevention of accidents and promotion of good relationship 3. Teaching simple nursing care in the home

Major Activities : 1. Assessment and control of environmental hazards 2. Assessment of capacity of employees for work 3. Maintenance of health of the employee 4. Organize and manage the health program