COMMUNITY HEALTH NURSING

A. DEFINITION:
 is the synthesis of nursing and public health practice applied to promote and protect the health
of population. It combines all the basic elements of professional, clinical nursing with public
health and community practice.
 is essential particularly at this point in time because it maximizes the health status of individuals,
families, groups and the community through direct approach with them.
 Today community participation and involvement is getting a due attention before the
occurrence of illnesses as life-style changes to continue to play a significant role in morbidity and
mortality.

B. PHILOSOPHY:
1. Philosophy of individual’s right of being healthy
 Health is believed to be one of the rights of all human beings nationally and
internationally according to the WHO charter.
 Goal of health for all is based on the philosophy of individual’s right of being healthy.
This philosophy encompasses all the aspects of the society
i.e sociocultural, economic aspects, so that there is no hindrance of any kind to attain
these rights.

2. Philosophy of working together under a competent leader for the common good
 It is from the primitive ages of human ages; man has learnt to live together to meet
their needs.
 The basis of modern community health nursing is to share responsibility of helping each
other.
 When it comes to considering a organization, equal participation of the people working
through the community groups/people with the people, for the people for their mutual
benefit, change in behavior and health practices.
 A democratic team functioning is essential for effective delivery of health care services.

3. Philosophy that people in the community have the potential for continual development and are
capable of dealing with their own problems if educated and helped.
 An individual with average intelligence can learn and deal with his/her own needs,
modify his/her lifestyles adjust to his or her changing environment
i.e. he can learn to solve his or her problems.
 On the basis of this philosophy, emphasis is placed on health education projected
towards individuals in home, health center, place of work, school, community places or
hospital.
 This helps to modify their behaviors respective to health.

4. Philosophy of Socialism
C. FEATURES OF COMMUNITY HEALTH NURSING

 Important features of community health nursing have presented in the following:

1. It is a field of nursing.
2. It combines public health with nursing.
3. It is population focused.
4. It emphasizes prevention, health promotion, and wellness.
5. It promotes client responsibilities and self-care.
6. It uses aggregate measurement and analysis.
7. It uses principles of organizational theory.
8. It involves inter professional collaboration.

D. THEORETICAL MODELS / APPROACHES

1. Health Belief Model (HBM) (Rosenstock, 1974, as Modified by Stone 1991).
There is a relationship between a person’s belief and actions. Factors that influence person’s
belief’s:
 Personal expectation in relation to health and illness
 Earlier experience with illness or health
 Age and development state.
Health beliefs are person’s ideas, convictions and attitudes about health and illness. They
may be based on factual information, misinformation, commonsense or myths, or reality or
false expectations. Health beliefs usually influence health behavior this influence can be
positive or negative.
2. Milio’s Framework of prevention
 Nancy Milio a nurse and leader in public health policy and public health education
developed a framework for prevention that includes concepts of community-oriented,
population focused care. (1976,1981).
 The basic treatise is that behavioral patterns of populations and individuals who make
up populations are a result of habitual selection from limited choices. She challenged
the common notion that a main determinant for unhealthful behavioral choice is lack of
knowledge. Governmental and institutional policies, she said set the range of options for
personal choice making. It neglected the role of community health nursing, examining
the determinants of community health and attempting to influence those determinants
through public policy.

3. Health promotion model (HPM) proposed by Nola J Pender (1982; revised, 1996)
 was designed to be a “complementary counterpart to models of health protection.”
 It defines health as a positive dynamic state not merely the absence of disease. Health
promotion is directed at increasing a client’s level of well-being.
 The health promotion model describes the multi-dimensional nature of persons as they
interact within their environment to pursue health.

The model focuses on following three areas:

 Individual characteristics and experiences

 Behavior-specific cognitions and affect
 Behavioral outcomes

4. The Prec ede-
Proceed  framework
 for planning is founded on the disciplines of epidemiology; the social, behavioral, and
educational sciences; and health administration.
 Throughout the work with Precede and Proceed, two fundamental propositions are
emphasized: (1) health and health risks are caused by multiple factors and (2) because
health and health risks are determined by multiple factors, efforts to effect behavioral,
environmental, and social change must be multidimensional or multi sectoral, and
participatory.
 The goals of the model are to explain health-related behaviors and environments, and
to design and evaluate the interventions needed to influence both the behaviors and
the living conditions that influence them and their consequences
DIFFERENT FIELDS

1. School Nursing
 is a specialized practice of professional nursing that advances the well being, academic
success, and life-long achievement of students. To that end, school nurses facilitate
positive student responses to normal development; promote health and safety;
intervene with actual and potential health problems; provide case management
services; and actively collaborate with others to build student and family capacity for
adaptation, self management, self advocacy, and learning. (NASN, 1999)

2. Occupational health nursing

 is a field within the nursing discipline that involves developing business health and
safety programs or observing workers who have been injured on-the-job. If you are
interested in starting a career in nursing, it is important to be aware of all of the various
types of opportunities that exist. You can work in healthcare as a nursing professional
without working in a clinical setting at a doctor’s office, clinic or hospital. 

3. Community Mental Health Nursing

 are specialized field providing holistic nursing services for people with mental health
issues, in a community setting.
 Provide caring and confidential supports for our clients, using the recovery model for
care.

The services provided by the Community Mental Health Nursing Program include:

• Treatment Planning
• Medication Management
• Assessment
• Counseling
• Family Support
• Education
• Group Support
• Facilitate services with visiting Psychiatrists

References:

https://www.slideshare.net/krishnagar90/concept-objectives-scope-principles-philosophy-of-
community-health-nurse

https://www.nursinghelpline24.com/2018/12/community-health-nursing-characteristics-
importance.html

http://currentnursing.com/nursing_theory/theories_community_health_nursing.html

https://www.publichealthnotes.com/behavioral-change-approach-precedeproceed-model/