The

Royal PENTAGON Review Specialists Inc

COMMUNITY HEALTH NURSING
- MR. GERARDO “DYERI” P. ANDAMO R.N.

Unit 2 - LEVELS OF CLIENTELE IN CHN

 Individual

 Holistic – in relation to supra-systems, individual performs different

roles and responsibilities

 Atomistic – the individual is composed of subsystems that are

composed of organs, tissues and cells

 Family
Structural-Functional (Freeman, Baylon and Maglaya)
Assessment:
Initial Data Base
• Family structure and Characteristics
• Socio-economic and Cultural Factors
• Environmental Factors
• Health Assessment of Each Member
• Value Placed on Prevention of Disease

First Level Assessment

• Health threats:
conditions that are conducive to disease, accident or failure to realize one’s
health potential
• Health deficits:
instances of failure in health maintenance (disease, disability, developmental
lag)
• Stress points/ Foreseeable crisis situation:
anticipated periods of unusual demand on the individual or family in terms of
adjustment or family resources

Second Level Assessment:

• Recognition of the problem
• Decision on appropriate health action
• Care to affected family member
• Provision of healthy home environment
• Utilization of community resources for health care

Problem Prioritization:
• Nature of the problem
Health deficit
Health threat
Foreseeable Crisis

• Preventive potential
High
Moderate
Low
The
Royal PENTAGON Review Specialists Inc
COMMUNITY HEALTH NURSING
MR. GERARDO “DYERI” P. ANDAMO R.N
PAGE 1
 • Modifiability
Easily modifiable
Partially modifiable
Not modifiable

• Salience
High
Moderate
Low
Family Service and Progress Record

 Population Group
Vulnerable Groups:
• Infants and Young Children
• School age
• Adolescents
• Mothers
• Males
• Old People

Specialized Fields:
• COMMUNITY MENTAL HEALTH NURSING
A unique clinical process which includes an integration of concepts from
nursing, mental health, social psychology, psychology, community
networks, and the basic sciences
FOCUS: MENTAL HEALTH PROMOTION

• OCCUPATIONAL HEALTH NURSING

The application of nursing principles and procedures in conserving the
health of workers in all occupations
AIMS:
- HEALTH PROMOTION
- PREVENTION OF DISEASES, ACCIDENTS AND INJURIES
- RISK REDUCTION
- SAFE WORKPLACE

• SCHOOL HEALTH NURSING

The application of nursing theories and principles in the care of the school
population
COMPONENTS:
- SCHOOL HEALTH SERVICES
- HEALTHFUL SCHOOL LIVING
- SCHOOL HEALTH INSTRUCTION
- SCHOOL-COMMUNITY LINKAGE

 Community
Community Diagnosis
- A process by which the nurse collects data about the community in order to
identify factors which may influence the deaths and illnesses of the population, to
formulate a community health nursing diagnosis and develop and implement
community health nursing interventions and strategies
STEPS:
• PREPARATORY PHASE
1. site selection
2. preparation of the community
The
Royal PENTAGON Review Specialists Inc
COMMUNITY HEALTH NURSING
MR. GERARDO “DYERI” P. ANDAMO R.N
 PAGE 2
3. statement of the objectives
4. determine the data to be collected
5. identify methods and instruments for data collection
6. finalize sampling design and methods
7. make a timetable
• IMPLEMENTATION PHASE
1. data collection
2. data organization/collation
3. data presentation
4. data analysis
5. identification of health problems
6. prioritization of health problems
7. development of a health plan
8. validation and feedback

• EVALUATION PHASE
- product evaluation
- process evaluation

 Biostatistics
A. DEMOGRAPHY
-study of population size, composition and spatial distribution as affected by
births, deaths and migration.
Sources of Demographic Data:
1. Survey
a. Census – complete enumeration of the population
De jure (People were assigned to the place where they usually live regardless of
where they are at the time of census)
De facto (People were assigned to the place where they are physically present at
the time of census, regardless of their usual place of residence)
b. Sample survey
2. Continuing population registers
3. Other records

B. VITAL STATISTICS
the application of statistical measures to vital events (births, deaths and common
illnesses) that is utilized to gauge the levels of health, illness and health services
of a community.
• FERTILITY RATE

Crude Birth Rate = births / population x 1000

General Fertility Rate = births/ population of women 15-44 years x 1000
• MORTALITY RATES

Crude Death Rate = deaths/ population x 1000

Specific Mortality Rate = deaths fr. A particular group/ pop’n of that grp x 1000
Infant Mortality Rate = deaths of 0-1 year/ births x 1000
Neonatal Mortality Rate = deaths of 0-28 days / births x 1000
Post-neonatal Mortality Rate = deaths of those 28 days to 1 year x 1000
Maternal Mortality Rate = maternal deaths / births x 1000

The
Royal PENTAGON Review Specialists Inc
COMMUNITY HEALTH NURSING
MR. GERARDO “DYERI” P. ANDAMO R.N
PAGE 3
Proportionate Mortality Rate A = deaths fr. A particular group / total deaths x 100

Swaroop’s Index = deaths of 50 years and above / total deaths x 100

Proportionate Mortality rate B = deaths due to a particular cause/ total deaths x 100
Case Fatality Rate = deaths due to a particular cause / total cases x 100
Cause-of- Death Rate = deaths due to a particular cause/ total pop’n x 100,000

• MORBIDITY RATES

Prevalence Rate = old and new cases / total pop’n x 100,000

Incidence Rate = new cases / pop’n at risk x 100,000

C. EPIDEMIOLOGY
- the study of distribution of disease or physiologic condition among human
population s and the factors affecting such distribution
- the study of the occurrence and distribution of health conditions such as
disease, death, deformities or disabilities on human populations

Common Epidemiologic Studies:

Retrospective Cross-sectional Prospective Cohort

Cross-sectional study

Also known as prevalence study: establishes prevalence of a disease and prevalence of

a risk factor

Retrospective study

Also known as case-control study: establishes whether a relationship exists between a

risk factor and a disease

Prospective Cohort

Also known as incidence study: establishes presence of the disease among the risk
group and non-risk group

The
Royal PENTAGON Review Specialists Inc
COMMUNITY HEALTH NURSING
MR. GERARDO “DYERI” P. ANDAMO R.N
PAGE 4