FUNDAMENTAL CONCEPTS OF

COMMUNITY HEALTH NURSING

Gil P. Soriano, RN, MHPEd

 KEY CONCEPTS

• Community Client

• Health Goal

• Nursing Means
 DEFINITION OF COMMUNITY, HEALTH AND
NURSING

• Community
• A collection of people who interact with one another and whose common interests or
characteristics form the basis for a sense of unity of belonging (Allender et al., 2009, p. 6)

• Group of people sharing common geographic location, institution, where they are organized
into population aggregate concept (age group), common values or interest.

• Four defining attributes of the concept of community (Maurer & Smith, 2009)
• People
• Place
• Interaction
• Common characteristics, interests or goals
• Two main types of communities (Maurer & Smith, 2009)
• Geopolitical communities- defined or formed by both natural and man-made
boundaries

• Phenomenological communities-refer to relational, interactive groups, in which the

place or setting is more abstract and people share a group perspective or identity
based on culture, values, history, interests and goals.

• Levels of Clientele
• Individual
• Family-focus of care (CHN)
• Community-group of families, CHN directs its services to the community because
the client is the community
• Population Groups- common health needs
• Population
• Denote a group of people having common personal or
environmental characteristics. It can also refer to all of
the people in a defined community (Maurer & Smith,
2009)

• Aggregate
• Subgroups or subpopulations that have common
characteristics or concern (Clark, 2008).
• Health
• A state of complete physical, mental and social well-being and not merely the
absence of disease or infirmity (WHO, 1958, p.1)

• Soundness and wholeness of human structures and bodily and mental functions
(Orem, 2001)

• Dunn (1959) extended the conception of health by introducing the notion of

wellness as the integration of both people’s capacity to function in their
environment, and their ability to adjust to environmental stresses.

• Right of every individual

• Art. 25 Sec. 1 of Universal Declaration of Human Rights: Health is a basic right
of every individual
• Health as a Right
• Art. 25, Sec. 1 (Universal Declaration of Human Rights)
• Everyone has the right to a standard of living adequate for the health
and wellbeing of himself and of his family
• Dual responsibility of the government and the individuals

• Art. 2, Sec. 15
• The state shall protect and promote the right to health of the people
and instill health consciousness among them.

• Art. 13, Sec. 11

• The state shall adopt an integrated and comprehensive approach to
health development
• DOH
• Nursing
• Assisting an individual, sick or well in the performance of those
activities contributing to health or its recovery (or to peaceful
death) that he would perform if he had the necessary strength, will
or knowledge, and to this in such a way as to help him gain
independence as rapidly as possible (Henderson, 1964).

• Art-skills

• Science-involves a process in taking care of the patients; systematic

 DETERMINANTS OF HEALTH AND DISEASE

• Income and Social Status • Personal behavior and coping

• Education skills
• Physical Environment • Health Services
• Employment and working • Gender
conditions
• Social support networks
• Culture
• Genetics
 DEFINITIONS AND FOCUS OF PUBLIC HEALTH
AND COMMUNITY HEALTH

• Public health as defined by C.E. Winslow

• The science and art of (1) preventing disease, (2) prolonging life and (3) promoting
health and efficiency through organized community effort for:
• Sanitation of environment
• Control of communicable infections
• Education of individual in personal hygiene
• Organization of medical and nursing services for the early diagnosis and treatment
of disease
• Development of the social machinery to ensure everyone a standard of living
adequate for the maintenance of health, so organizing these benefits as to enable
every citizen to realize his birthright of health and longevity (Hanlon, 1960, p. 23).
 Public Health
• Philosophy-health and longevity
• Through organized community effort

• The application for science in context of politics to remove

inequalities in health and deliver the best health for the
greatest number (WHO, 2010)
• Three primary functions of Public Health (Institute of Medicine,
1988)
• Assessment-regular collection, analysis and information sharing about
health conditions, risks and resources in a community
• Policy development-use of information gathered during assessment to
develop local and state health policies and to direct resources toward
those policies
• Assurance-focuses on the availability of necessary health services
throughout the community.

• Community Health
• Extends the realm of public health to include organized health efforts at
the community through both government and private efforts
 ESSENTIAL PUBLIC HEALTH FUNCTIONS

• Health situation monitoring and analysis

• Epidemiological surveillance/disease prevention and control
• Development of policies and planning in public health
• Strategic management of health systems and services for population health
gain
• Regulation and enforcement to protect public health
• Human resources development and planning in public health
• Health promotion, social participation and empowerment
• Ensuring the quality of personal and population-based health service
• Research, development, and implementation of innovative public health
solutions
 CHN, PHN AND CBN

• Community Health Nursing focuses on the community.

• The synthesis of nursing practice and public health practice applied to promoting
and preserving the health of populations (ANA, 1980, p. 2)

• An area of human services directed toward developing and enhancing the health
capabilities of people-either singly as individuals or collectively as groups and
communities (Freeman & Heinrich, 1981)

• Setting: natural environment of people

• Home= PHN
• School= SHN
• Workplace= CHN
• Public Health Nursing
• The practice of promoting and protecting the health of of populations
using knowledge from nursing, social and public health sciences (ANA,
1996, p. 5)

• Public Health + Nursing + Social Assistance

• Promotion of Health
• Improvement of the physical and social environment
• Rehabilitation
• Prevention of illness and disability
• Community Based Nursing
• Application of nursing process in the caring for individuals, families, and
groups where they live, work or go to school or as they move through
the health care system (McEwen and Pullis, 2008, p. 6)
• Focus: Home health nursing and nursing in outpatient or ambulatory
settings.

Difference of CHN vs CBN (Zoti et al., 1996)

Goal Client Services
CHN Preservation and Community Nursing services
protection of health are direct
CBN Managing acute or Individuals and Can be direct or
chronic conditions families indirect