COMMUNITY HEALTH NURSING 2:Levels of Clientele in CHN

- MR. GERARDO “DYERI” P. ANDAMO R.N.

 Individual

Basic approaches in looking at the individual:

 Holistic

 Atomistic

 Family

Structural-Functional Model
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:

FAMILY TASKS:
 Recognition of the problem
 Decision on appropriate health action
 Care to affected family member
 Provision of healthy home environment

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  Utilization of community resources for health care
Problem Prioritization:
 Nature of the problem
Health deficit
Health threat
Foreseeable Crisis
 Preventive potential
High
Moderate
Low
 Modifiability
Easily modifiable
Partially modifiable
Not modifiable
 Salience
High
Moderate
Low

The Family Service and Progress Record

The Family Case Study

 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:

Occupational Health Nursing

The application of nursing principles and procedures in conserving the health of workers
in all occupations
Aims:

School Health Nursing

The application of nursing theories and principles in the care of the school population
Components:

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 1. School health services

2. School health instruction

3. Healthful school living

4. 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

2 Types of Community Diagnosis

Comprehensive Community Diagnosis Problem-Oriented Community Diagnosis
- aims to obtain general information about the - type of assessment responds to a particular
community need

STEPS:

 Preparatory Phase

1. site selection
2. preparation of the community
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

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 Evaluation Phase

1. Process evaluation
2. Product evaluation

Sources of data on health and disease:

1. Civil Registration

2. Reports of field personnel

3. Other sources

 Biostatistics

DEMOGRAPHY
- Is the study of population size, composition and spatial distribution as affected by
major processes like births, deaths and migration

Sources of demographic data:

1. Census – complete enumeration of the population
De jure De facto
People were assigned to the place where People were assigned to the place
they usually live regardless of where they where they are physically present at
are at the time of census. the time of census, regardless, of
their usual place of residence.

2. Continuing population registers

3. Other sources

Components:
Population size
Natural increase
Rate of natural increase
Net migration

Population composition
Sex ratio
Age- dependency ratio
Population pyramid

Population Distribution
Urban-rural distribution
Population density
Crowding index

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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

Basic Concepts:
1. Epidemiologic Triad
2. transmission
3. incubation period
4. herd immunity

Common Epidemiologic Studies:

Retrospective Cross-sectional Prospective Cohort

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

General Fertility Rate

 Mortality Rates

Crude Death Rate

Specific Mortality Rate
Infant Mortality Rate
Neonatal Mortality Rate
Post-neonatal Mortality Rate
Maternal Mortality Rate
Proportionate Mortality Rate A
Swaroop’s Index
Proportionate Mortality Rate B
Case Fatality Rate
Cause-of- Death Rate

 Morbidity Rates

Prevalence Rate
Incidence Rate

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