Concepts of community health and community health nursing

definition of public health, community health, community health nursing, scope concept etc for nursing students

1. Concepts of Community Health and Community Health Nursing P resented by: H arsh Rastogi N ursing T utor M.S. Institute of Nursing

2. Outline of the topic Introduction- Public Health, Community, Community Health, Community Health Nursing Concept of Community Definition of Community Health Nursing Concept of Community Health Nursing Philosophy of Community Health Nursing Aims and Objectives of Community Health Nursing Scope of Community Health Nursing

3. Introduction A community may be defined in many different ways. One definition of community is “a social group of any size whose members reside in a specific locality, share government, and often have a common cultural and historical heritage.” Culture, ethnicity, age, gender, sexuality all of these can be characteristics which define a community The community in which we live and work have a profound influence on our collective health and well-being.

4. Cont… The health of a community is more than the sum of the health of its individual citizens. Community as a field of practice seeks to provide organizational structure Community can influence- The 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 and collective health

5. Cont… Community health nurse work in every conceivable kind of community agency Their duties range from examining infants in a well-baby clinic, or teaching elderly stroke victims in their homes to carrying out epidemiologic research or engage in health policy analysis and decision making. Combines all basic elements of professional clinical nursing with public health and community practice.

6. Public Health The term public health came in general use around 1840 . it arose from the need to protect “the public” from the spread of communicable diseases. Later, it appeared in 1848 in the name of law, the Public Health Act in England. In 1920, Charles Edward Armory Winslow, former professor of public health at Yale University, gave the oft-quoted definition of public health.

7. Cont… The Science and Art of preventing disease prolonging life and promoting health and efficiency through organized community effort for the sanitation of the environment, the control of communicable infections, the education of the individual in personal hygiene, the organization of medical and nursing services for early diagnosis and preventive treatment of disease and the development of social machinery, to ensure for every individual a standard of living adequate for the maintenance of health, so organizing these benefits as to enable every citizen to realize his birth right of health and longevity.

8. Definition of Public Health The term public health was defined by ‘C.E.A. Winslow’ (1851) as science & art of preventing disease, prolonging life & promoting health & efficiency through organized community measures such as control of infection, sanitation, health education, health education, health services & legislation, etc. Public Health is defined as “the art and science of preventing disease, prolonging life and promoting health through the organized efforts of society” (Acheson, 1988; WHO)

9. Cont… Activities to strengthen public health capacities and service aim to provide conditions under which people can maintain to be healthy, improve their health and wellbeing, or prevent the deterioration of their health. Public health focuses on the entire spectrum of health and wellbeing, not only the eradication of particular diseases.

10. Cont… Many activities are targeted at populations such as health campaigns. Public health services also include the provision of personal services to individual persons, such as vaccinations, behavioral counseling, or health advice.

11. Current form of Public Health Public health in its present form, is combination of scientific principles (e.g. epidemiology, biostatistics, laboratory sciences, social sciences, demography) and skills & strategies (e.g. epidemiological investigations, planning and management, intervention, surveillance, evaluation) that are directed to the maintenance & improvement of health of the people.

12. Community Health Term community health has replaced in some countries, the term public health, preventive health, social health. The word community health has gained wide acceptance .

13. Cont… The EURO symposium(1966); “all the personal health and environmental services in any human community, irrespective of whether such services were public or private one.”

14. Concept of Community A community is a collection of people who share some important feature of their lives. It can be society of people holding common rights and privileges, sharing interests, living under same laws and regulations. The function of any community includes its members of collective sense of belonging and their shared identity, values, norms, communications and common interests and concerns.

15. Definition of C.H.N. “Community Health Nursing is a synthesis of nursing practice and public health practice applied in promoting and preserving the health of populations. The nature of this practice is general and comprehensive.

16. Cont… It is not limited to a particular age or diagnostic group. It is continuous and not episodic. The dominant responsibility is to the population as a whole. Therefore, nursing directed to individuals, families or groups contributes to the health of the total population.

17. Cont… Health promotion, health maintenance, health education, coordination and continuity of care are utilized in a holistic approach to the management of the health care of individual, family, group and community.

18. Cont… The nurse’s actions acknowledge the need for comprehensive health planning, recognize the influences of social and ecological issues, give attention to populations at risk and utilize dynamic forces which influence change.” (ANA)

19. Concept of C.H.N. The primary focus of community health nursing is on the health promotion Community health nursing practice is extended to benefit not only the individual but the whole family and community Community health nurses are generalist in terns of their practice Contact with the client and/or family may continue over a long period of time .

20. Cont… The nature of community health nursing practice requires the current knowledge The dynamic processes of assessing, planning, provide periodic measurement of progress, evaluation and a continuum of cycle until the termination of nursing is implicit in the practice of community health nursing.

21. Philosophy of C.H.N. Philosophy of community health pertains to underlying ideas and beliefs which govern its practices. These are as under: Philosophy of individuals right of being healthy Philosophy of working together under a competent leader for common good Philosophy that people in the community have potential for continued development and are capable of dealing with their own problems if educated and helped Philosophy of socialism .

22. Aims of C.H.N. To promote health and efficiency To prevent and control diseases and disabilities To prolong life by providing basic needs, well balanced comprehensive health care services to community at large through organized community efforts.

23. Objectives of C.H.N. The objectives of community health nursing are the same as that of community health which are achieved by meeting nursing needs of individuals, families, groups of people and community at large. To increase capability of individuals, families, groups and community to deal with their own health and nursing problems To strengthen community resources To control and counteract environment To prevent and control communicable and non-communicable diseases

24. Cont… To provide specialized services. To conduct research and contribute to the further refinement and improvement. To participate in preparing health personnel to function in community for community health care services. To supervise, guide and help health personnel in carrying out their function effectively .

25. Nature/Characteristics of C.H.N. Community health nursing is an integral part of community health Community health nursing is a specialized field of nursing Community health nursing synthesizes community health with n nursing In community health nursing, the whole community is the client Community health nursing emphasizes on primary level prevention Community health nursing promotes self-care responsibility

26. Cont… Community health nursing involves multidisciplinary team approach Community health nursing is working for people, with people and by people Community health nursing is seeking support from giving support to personnel from other sectors working for welfare and development in the community Community health nursing is dealing with wide range of health problems and health needs and providing need based generalized health services. Community health nursing is providing continuous care and not episodic care

27. Scope of C.H.N.

28. Home care Extended nursing care services are received by number of patients at their home when hospital are overcrowded for admitting the patients who require indoor care or when a patient is in need of isolated treatment. Even preventive and promotive services are provided to the people at their home to maintain and achieve health .

29. Nursing care The CHN includes nursing care of the family in sickness and health. The CHN should be able to To provide PHC in the community To conduct routine antenatal and postnatal visits and to conduct deliveries when required To carry out immunization To promote health of the children by conducting under five clinic and referring cases who require medical care To assess the social environmental and nutritional needs of the community. And get the help of social workers to meet these needs .

30. Geriatric care The number of old people increasing in the world today. The need of old is different and they need more care than the younger age groups. In many countries the old age people are visited by the nurses and other health care workers .

31. Occupational health nursing Occupational nursing is the application of nursing and public health philosophy and skills to the relationship of people to their occupation’s foe the purpose of prevention of disease and injury and the promotion of optimal health, productivity and social adjustment. OHN identifies health and nursing needs of workers following health and nursing needs of workers following health assessment, plans and implements nursing care within her capabilities, limitations, means and facilities.

32. Cont… In general, the responsibilities of nursing personnel are being stated by WHO Technical report series 24 are as follows: Carrying out the therapeutic programme designed by physicians for sick patients including personal services aimed at hygiene and comfort Maintenance of the physical and his family in his recovery and rehabilitation Engaging the patient and his family in his recovery and rehabilitation Carrying out measures for the prevention of diseases Instructing people sick or well, in measures promoting total health (physical and mental) Coordinating nursing efforts with other members of community groups.

33. Domiciliary nurse The areas where domiciliary nursing is practiced in our country are- Maternity services Health supervision Disease prevention services Services for illness and accidents The scope for limitless for organizing domiciliary visits

34. Mental health nursing Many developing countries have mental health services today. These services include- Early diagnosis and treatment Rehabilitation Psychotherapy Use of modern psychotropic drugs and after care services MHN is yet to be developed in India .

35. MCH & family planning The public health nurse plays a major role in the MCH and FP services. It consists of- Antenatal Postnatal Childcare services Nurse can easily motivate the mothers to accept the FP methods and gain their cooperation in adopting to a small family norm s.

36. School health nursing In general the functions of the school health nurse are related to establishment and implementation of school health policies and programmes for the protection and promotion of health of the students, the maintenance of a school environment which is conducive to healthful living .

37. Cont… The building of components of the curriculum which have significance for health; the management of the health service including screening programmes and emergency care services, the handling of special health problems and relating the school health problems and relating the school health programmes to those of the community.

38. Cont… The SHN renders services- To prevent diseases To promote and maintain good health of the school children’s The school health programme are carried out by the PHC The nurse provides her services in the area likes .

39. Rehabilitation centre Rehabilitation means restoration of all treated cases to the highest level of functional ability. Nursing is an important component in the rehabilitation of the disabled .

40. Conclusion Community as a field of practice seeks to provide organizational structure a broad set of resources and the collaborative activities needed to accomplish the goal of an optimally healthy community. The primary focus of community health nursing is on the health promotion.

41. Cont… Community health nursing is a nursing aspect of organized community health programme and is a specialized area of professional nursing practice. It is a unique blend of nursing and community health woven into a service which when properly developed and implemented can have a tremendous impact on health .

42. References Gulani KK. Community Health Nursing (Principles & Practices). 2 nd ed. Kumar Publishing House; Conceptual Aspects of Community Health Nursing; p 31-53. Allender JA. Rector C. Warner KD. Community Health Nursing Promoting and Protecting the Public’s Health. 7 th ed. Wolters Kluvers Health. Introduction to community health nursing; p 2-17. Bijyalakaskhmi D. A Comprehensive Textbook of Community Health Nursing. 1 st ed. Jaypee digital. Introduction to community health nursing; p 1-76. Kamalam S. Essentials in Community health nursing practice. 3 rd ed. Jaypee digital. Concepts of health and theoretical approaches in community health nursing; p 15-38 . Park P., textbook of preventive and social medicine.18 th Edition; Banarsidas Bhanot Publication.