PPT-INTRODUCTION-TO-COMMUNITY-B.SC-II-YR-CHN.pptx

Community health is the maintenance, protection, and improvement of the health of a defined population group through organized community efforts. It goes beyond individual care to encompass the health status of a community, the factors that affect it, and the collective actions taken to improve it, including preventive, promotive, and curative health services. Key goals are preventing disease and promoting well-being across physical, mental, and social dimensions by addressing issues from a community-wide perspective.

1. COMMUNITY HEALTH NURSING-I I UNIT – I- INTRODUCTION COMMUNITY HEALTH CONCEPT Prepared by Prof.Dr.Anjalatchi muthukumaran Vice principal Era college of nursing Era university Sarfrazganj Lucknow 226003 1

2. 2 O V E R V I E W Introduction to Community health nursing Definition Concept Dimenstions Measurement of health and diseases Vital statistics Maintenance of health

3. 3 INTRODUCTION C o m m un i t y hea l t h i m p l i e s i n i n t eg r a t i o n o f Preventive, Promotive and Curative aspects of he a l t h s e r v i c e s. concerned with T h e n u r se m o st d ir e c t l y giving health i nd i v i d ua l s a n d f a mi l i e s i n e du c a t i o n an d t h e care to c o m m u n i t y

4. DEFINITION COMMUNITY: It is a social group determined with geographical boundaries, common values and interests. It’s members know and interact with each other. It functions within a particular structure and exhibits and creates norms, values and social institutions 4

5. H E A L T H H ea l t h i s a s t a t e o f c o m p l e t e ph ys i c a l , m en t a l , social, spiritual wellbeing, and not merely an absence of disease or infirmity. 5

6. NURSING Nursing is a service which includes care to the sick, care of the whole patient, the care of patient’s environment, health education and health services to the individual family and society for the prevention of disease and promotion of health. 6

7. COMMUNITY HEALTH NURSING It is defined as nursing services organized by a community or agency to carry out nursing aspects of community health programme in homes, schools, industries or in the health centers 7

8. DEFINITION OF COMMUNITY HEALTH NURSING Community health nursing is a synthesis of nursing and public health practice applied of promoting and preserving the health of people. The practice is general and comprehensive. It is not limited to a particular age group or diagnosis, and continuing, not episodic.

9. Philosophy of community health nursing Individuals right of being healthy Working together towards common goal Social systems 9

10. Aims of community health nursing To improve quality of life To reduce risk factors To improve standard of living To strengthen self care activities of individuals 10

11. O b j e c t i ve s To prevent, promote, maintain and restore the community health To reduce morbidity and mortality rate among community To increase the life span for individuals 11

12. COMMUNITY HEALTH W e l l 12 health syst e m Establishing responsibility towards health Control of c o mm un i c a b l e and non communicable functioning diseases Education Safe e n v i r o n m en t C O M M UN I T Y HEALTH

13. 13 PRINCIPLES OF COMMUNITY HEALTH NURSING Nursing services should be planned according to the need of the community Community nurses should function in collaboration and coordination with other personnel to achieve optimum community health. Community health nurse should be qualified and are accountable, responsible and authorized health authority for her services

14. 14 C on t … J o b c o nd i t i o n s h ou l d b e c o nd u c t i ve fo r o pt im u m satisfaction Health services should be based on the felt needs All CHNs and supervisors should function as a team Professional relationship and etiquette are essential in community health services H ea l t h s e r v i c e s s hou l d b e a v a i l ab l e t o a l l irrespective of their age, sex and status The CHN should never accept money or gifts pe o p l e

15. 15 Cont….. H ea l t h s e r v i c e s h ou l d b e r e a l i s t i c i n t e r m s o f available personnel & facilities Follow up services Evaluation of services Facilities for further training & continuing education I n f l uen t i a l peo p l e s h o u l d he l p i n c a r r y i n g ou t t h e health activities

16. CONCEPT OF COMMUNITY HEALTH NURSING P r o m o t i n g health and wellness P r e v e n t i n g illness R e s t o ri n g health Care of dying 16

17. SCOPE OF COMMUNITY HEALTH NURSING ce Home care Nursing homes MCH and family planning School health nursing Health care services Industrial nursing services Domiciliary nursing service Geriatric nursing service Mental health nursing servi Rehabilitation centers 17

18. 18 FUNCTIONS OF CHN C o m p r ehen s i ve hea l t h c a r e t o i n d i v i du a l s, families and groups D e v e l o p s goa l s t o m ee t n e ed s- a c t i o n programme, evaluating progress Assistance to family in improving environmental conditions Providing safe environment in home, school and industry Providing supportive services to doctor such as early symptom detection

19. 19 Cont…. Demonstration and teaching of skilled nursing care of the sick in home Supervising the work of dais, midwives Helping in the adjustment of social and emotional conditions that affect health Coordination of work with health care professionals Revising and revitalizing plan and programmes Epidemiologic investigations in field of communicable diseases

20. 20 C on t … Organizing planned group classes in health Development and utilization of facilities Responsible for planning, implementation & evaluation of a practical plan of nursing administration Involving in research and collection of vital statistics

21. 21 QUALITIES OF CHN Educational qualification Interest Understanding in people’s behaviour Sincerity Empathy Friendly Charitable Resourceful

22. 22 C on t …. Cooperative responsible Initiative Skillful in Observation Communication Interviewing Technical skills Ability to Interpret Judge Take decisions

23. CONCEPTS OF HEALTH disease, then the person was c on s i de r e d healthy. This concept known as b i o m e d i c a l concept. Biomedical concept T r ad i t i ona l l y h ea l t h ha s bee n v i e w e d a s a n ab s e n c e o f d i s ea s e , an d i f on e w a s f r e e f r o m 23

24. 24 C on t … . . It has the basis in the germ theory of disease. The medical profession viewed the human body as a machine, disease as a consequence of the breakdown of the machine and one of the doctors task as repair of the machine.

25. D e f i c i en c i e s i n t h e b i o m ed i c a l c on c ep t ga ve rise to other concepts. Health as a dynamic equilibrium between man d i s ea se a o r gan i sm t o an d h i s en v i r o n m e n t an d maladjustment of human environment. Ecological concept 25

26. 26 Dubos defined “health ab s e n c e o f pa i n an d i m p l i e s t h e r e l a t i ve d i s c o m f o r t a n d a c on t i nu o u s a d ap t a t i o n a n d ad j u s t m en t t o t h e environment to ensure optimal function”. T h e e c o l og i c a l c on c ep t r a i s e s t w o i s s u e s- imperfect man and imperfect environment.

27. Contemporary developments in social science revealed that health is not only a biomedical phenomena, but one which is influenced by social, psychological, cultural, economic and political factors of the people concerned. Psychological concepts 27

28. 28 C on t …. These factors must be taken in to consideration in defining and measuring health. T hu s he a l t h i s b o t h a b i o l og i c a l a n d s o c i a l phenomena.

29. The holistic model is a synthesis of all the above concepts. It recognize the strength of social, economic, political and environmental influences on health. Holistic concept 29

30. 30 C on t … It has been variously described as a unified or multidimensional process involving the well- being of the whole person in the context of his environment. This approach implies that all sectors of society have effect on health.

31. 31 C on t … Agriculture, Animal Husbandry, Food, Industry, Education, Housing, Public Works, Communications and Other Sectors. The emphasis is on the promotion and protection of health.

32. DIMENSIONS OF HEALTH Health is multidimensional. Physical dimension Mental dimension Social dimension Spiritual dimension Vocal dimension Emotional dimension Others 32

33. Physical dimension 33 The stage of physical health implies the notion of “perfect functioning” of the body. It conceptualizes health biologically as a state in which every cell and every organ is functioning at optimum capacity and in perfect harmony with the rest of the body.

34. CONT…. The signs of physical health in an individual are: A good complexion, A clean skin, Bright eyes, Lustrous hair with a body well clothed with firm flesh, not too fat, A sweet breath, A good appetite, Sound sleep, R egu l a r a c t i v i t y o f b o w e l s an d b l add e r a n d smooth, easy, Coordinated bodily movements. 34

35. 35 Evaluation of physical health Self assessment of overall health Inquiry in to symptoms of ill-health and risk factors Inquiry in to medication Inquiry in to levels of activity Inquiry in to use of medical services S t an d a r d i z e d que s t i on n a i r e s f o r c a r d i o v a s c u l a r diseases, respiratory diseases. Clinical examination Nutrition and dietary assessment Biochemical and laboratory investigations.

36. Mental dimension 36 Mental health is not mere absence of mental illness. Good mental health is the ability to respond to many varied experiences of life with flexibility and a sense of purpose. Mental health has been defined as a state of balance between the individual and the surrounding world, a state of harmony between oneself and others, a coexistence between the realities of self and that of other people and that of the environment.

37. 37 The characteristics of a mentally healthy person are A m e n t a l l y hea l t h y p e r s o n i s f r e e f r o m i n t e r n a l conflicts: he is not at war with himself. He is well-adjusted, ie., he is able to get along well with others. He searches for identity. He has a strong sense of self-esteem. He has good self-control balances H e f a c e s p r o b l e m s an d t ri e s t o s o l ve t he m intelligently.

38. Social dimension 38 Social well-being implies harmony and integration within the individual, between each individual and the world in which they live. It has been defined as the quantity and quality of an individual’s interpersonal ties and the extent of involvement with the community.

39. 39 C on t …. The social dimension of health includes the level of social skills one possesses, social functioning and the ability to see oneself as a member of a large society. S o c i a l h ea l t h management i s r o o t e d i n po s i t i ve m a t e r i a l a n d po s i t i v e hu m a n e n v ir on m en t w h i ch i s c o n c e r n e d w i t h t h e s o c i a l ne t w o r k o f t h e individual.

40. Spiritual dimension 40 Spiritual health refers to part of the individual which reaches out and strives for meaning and purpose of life. It is the intangible something that transcends physiology and psychology . It includes integrity, principles and ethics, the purpose in life, commitment to some higher being and belief and belief in concepts that are not subject to state of the art explanation.

41. Emotional dimension 41 Historically the mental and emotional dimensions have been seen as one element or as two closely related elements. Mental health can be seen as knowing or cognition while emotional health refers to feeling. The mental and emotional aspects of humanness may have to viewed as two separate dimensions of human health.

42. Vocational dimension 42 T h e v o c a t i ona l a s pe ct dimension o f li f e i s a n e w It is a part of human existence When work is fully adapted to human goals, capacities and limitations, work often plays a role in promoting both physical and mental health.

43. 43 C on t …. Physical work is usually associated with an improvement in physical capacity, while goal achievement and self-realization in work are a source of satisfaction and enhanced self-esteem. Vocational dimension may be a source of income

44. O t he r s Philosophical dimension Cultural dimension Socio-economic dimension Environmental dimension Educational dimension Nutritional dimension Curative dimension Preventive dimension 44

45. VITAL STATISTICS 45 Introduction Vital statistics constitute an essential tool in demography like statistical study of population and public health. They provide answer to various health related questions

46. 46 Origin of vital statistics John Graunt (1620- 1674) Who studied the weekly bills of mortality and discovered Urban death and Rural death. He is called father of vital statistics William Farr ( 1807 – 1883) Who analyzed the vital events , which serve as Yard stick for measuring the health status of the population. He is called Father of Medical Statistics

47. 47 Definition Vital statistics may be defined as the systematic collection and compilation and presentation, analysis and distribution of statistics pertaining to vital events are recorded. E.g., live birth, deaths, marriages etc that occur in the community.

48. 48 Classification of Vital Statistics Mortality Statistic Morbidity Statistics Fertility Statistics Population Statistics

49. 49 Methods of collecting Vital Statistics Population Census Method Civil Registration Method Sample Registration System Model Registration System / Rural survey of causes of Death Medical certification of causes of death National Sample survey Institutional Records / Hospital Records

50. 50 Methods of collecting Vital Statistics Community survey Reports Notification Disease Register Epidemiological surveillance Report Environmental health Records Other Health Manpower Statistics Population Surveys Miscellaneous Sources

51. 51 Uses of Vital Statistics To find out what are the leading causes of morbidity and mortality. To know what is the age, sex, class and area wise distribution of various health related variables To find out what is the composition of the population and what are the future trends To know what health program should be given priority To compare the present health statistics with past statistics

52. 52 Uses of Vital Statistics For planning and administration of health services To determine the priority of health problems To discover the solution for any health problem To estimate future needs and demand To promote health legislation For the evaluation of the health program success or failure For the prediction of health trends.

53. 53 Method of calculating Mid Year Population Natural Increase Method Arithmetic Progression Method Geometric Progression Method

54. 54 Arithmetic Progression Method Eg: The population of Avadi in 2009- 5,10,000 and in the year 2018 – 6,20,000. Calculate the mid year population in 2007. Population in 2018 = 6,20,000 Population in 2009 = 5,10,000 So the difference = 1, 10,000 is for 10 year So Per year is 1,10000/10 = 11,000

55. 55 Mid year population always should be calculated from end February to 1 st of July ( so that is 6 year and 4 months)  = 6 1/3= 19/3 11,000 x 19/3 = 69,667 Now the calculation is Pt = Po + rt t = period in year after the last census. r = Annual increase rate Pt = population at the required time Po = population at the last census

56. Calculation of incidence and prevalence Rate Incidence Rate = No of new cases X 1000 Total Population Prevalence Rate = new cases + Existing cases Total population 56

57. 57 Mortality rates C r u d e D e a t h R a te = Total no of death - x 1 00 Mid Year Population

58. Perinatal Mortality Rate = Still birth + Death under 1 week x 1000 Total live birth + Still birth ASFR ( Age specific fertility Rate ) ASFR = No of birth in specific age of women - - - - - - - - - - - - - x 10 No of women in sp. Age with mid year population 58

59. Calculate the following TFR ( Total fertility Rate ) TFR = Sum of all specific fertility rate x width of each age group - - 1000 GFR ( Gross fertility Rate ) GFR = No of live Birth - x 1000 No of women between the age Gp of (15- 49) 59

60. Healthy Lifestyles Wellness is determined partly by lifestyle choices. Studies by the National Institute of Aging show that: Moderate alcohol use Safe environments Social supports Regular health care Healthy eating Physical activity Mental stimulation Not smoking Active social engagement are important in maintaining health and independence. MAINTENANCE OF HEALTH 60

61. Other Factors Related to Wellness Fitness : can prevent heart disease, hypertension, and lower back pain. Preventive care: including immunizations and health care screening tests. Spiritual health Safety : prevention of injuries and accidents, emergency preparedness, CPR. 61

62. Other Factors Related to Wellness Nutrition: prevent diseases like osteoporosis and cancer, proper nutrients. Tobacco Addiction Stress Management 62

63. Healthy Lifestyles-Health Maintenance Practices Become aware of the obvious and not-as- immediately obvious situations that trigger stress. Minimize or avoid exposure to those situations. Establish good dietary habits. Eat well balanced, nutritious meals. Moderate intake of salts, fats, white sugar, caffeine, and alcohol. 63

64. P r a c t i c e s C o n t . . Establish a pattern of regular cardiovascular exercise . Contributes to a positive mental attitude. Avoid smoking. Smokers are at a much greater risk of dying from heart disease, respiratory disease, and cancer. There are no “safe cigarettes”. Chewing tobacco and snuff should also be avoided. 64

65. Practices C on t d . . Learn how to relax. Relaxation brings to the body enormous restorative energy. Getting enough sleep is also important. Develop and maintain social supports. Feeling connected to family, friends, classmates, work colleagues, and/or to community, social, political, or religious organizations plays a vital role in the maintenance of one’s mental well-being . 65

66. P r ac t i ce s C on t d . . Conflicts. Expect conflicts to occur, but learn to deal with them in a head-on manner. An unnecessary burden is created when conflicts are allowed to go unaddressed for too long. 66

67. P r a c t i ce s C on t . . See your doctor regularly for preventive care. Preventive services the following: Tests/screenings Measurements Advice about diet, exercise, tobacco, alcohol and drug use, stress, and accident prevention. Immunizations. Special tests at certain times in your life. 67

68. 68 Practices C on t d . . To take care of your health, you need to feel comfortable talking with your doctors and nurses. Ask questions: if you don’t understand what they are saying, ask them to explain. Tell providers your health history as well as your health now: mention family history of diseases and conditions; provide a complete list of medications you are taking, etc. Follow up: Call the provider if you have questions or need more information after you leave.

69. Health Maintenance Practices Every day you have a chance to make good choices about your health. Set small goals instead of large ones that you won’t be able to meet. Reduce your risk for heart disease. Watch your weight. Eat right. Stay active. Prevent skin cancer. Prevent injuries. Take medicines correctly. Make smart choices about sexual and reproductive health. 69

70. 70 Health Maintenance Practices Overcome depression. Warning signs: Feel sad, hopeless, or guilty most of the time. Feel tired or lack energy. Thoughts of suicide or death. Sleep either too much or too little. Change in appetite – lost or gained weight. Lost interest and pleasure in daily activities. Problems making decisions or thinking clearly. Depression treated with counseling, medicine, or both. Treatment works gradually over several weeks .

71. 71 High Risk Behaviors Appropriate safety practices are essential. Sexual behaviors: abstinence, monogamy, seeking health care for signs of sexually transmitted infections . Obtain appropriate health screenings. Don’t use tobacco or illegal drugs. Don’t drink and drive. Use seat belts and other safety equipment. Take gun safety classes.

72. Alternative Health Practices Health or medical practices are called “alternative” if they are based on untested, untraditional, or unscientific principles, methods, treatments, or knowledge. If the “alternative” health practice is offered along with conventional medicine, it is referred to as “complementary” medicine. 72

73. Holistic Health Care Care that promotes physical, emotional, social, intellectual, and spiritual well-being by treating the whole body, mind, and spirit. Each person is recognized as a unique person with different needs. Uses many methods of diagnosis and treatment in addition to traditional Western medical practice. 73

74. 74 Be A Role Model To be a good health care employee, you must consider your own health and be a role model for your patients. Getting lots of sleep, maintaining good nutrition, and exercising daily are examples of healthy behaviors. Take care of your own health so that you can be productive and have a positive impact on your patients .

75. 75 Conclusion Health is not simply the absence of disease. It is the state of optimal physical and mental well being. Taking personal responsibility for your health care by developing positive health behaviors is the most cost-effective way to ensure a longer, healthier, perhaps more fun, and ultimately more productive life.

76. 76 Reference Dhaar G.M, Robbani.I, (2006)Foundations of community medicine, (I edition), Elsevier publication, New Delhi. Gupta.M.C, Mahajan.B.K,(2003) Book of preventive & social medicine , III Edition, Jaypee brothers medical Publishers, New Delhi. Park.K,(2011) Text Book of Preventive & Social medicine”, 24th Edition, Banasidas Bhanot Publication, Jalandhar city. Kamalam.S,(2012) , Essentials in community health nursing practice (2nd Ed), Jaypee brothers, New Delhi. TNAI, A community Health Nursing Manual ,TNAI publications, New Delhi. Ghai .O.P, Piyush, Essentials of Preventive medicine , Vikas publishing house pvt ltd, New Delhi.

77. 77 THANK YOU