Gabriel Andrei C.

Relayo
RR31

Due August 17, 2021

Assignment # 1

1. Identify the different Theoretical Models and Approaches in Community

Health Nursing.

➢ Nightingale’s theory of environment

● Florence Nightingale’s Environmental Theory defined Nursing as “the act
of utilizing the patient’s environment to assist him in his recovery.” It
involves the nurse’s initiative to configure environmental settings
appropriate for the gradual restoration of the patient’s health and that
external factors associated with the patient’s surroundings affect the life or
biologic and physiologic processes and his development.

 Social Learning Theory of Albert Bandura

o Albert Bandura bases this on the belief that learning takes place in a
social context. The people learn from one another and the learning is
promoted by modeling or observing other people. The environment affects
the learning, but the learning outcomes depend on the learner’s individual
characteristics. 

➢ Orem’s Self care model

● Dorothea Orem’s Self-Care Deficit Theory defined Nursing as “The act of
assisting others in the provision and management of self-care to maintain
or improve human functioning at the home level of effectiveness.” It
focuses on each individual’s ability to perform self-care, defined as “the
practice of activities that individuals initiate and perform on their own
behalf in maintaining life, health, and well-being.”
● There are instances wherein patients are encouraged to bring out the best
in them despite being ill for a period of time. This is very particular in
rehabilitation settings, in which patients are entitled to be more
independent after being cared for by physicians and nurses. Between
1959 and 2001, Dorothea Orem developed the Self-Care Nursing Theory
or the Orem Model of Nursing. It is considered a grand nursing theory,
which means the theory covers a broad scope with general concepts
applicable to all instances of nursing.
➢ Neuman’s health care system model
● Betty Neuman describes the Neuman Systems Model as “a unique, open-
system-based perspective that provides a unifying focus for approaching a
wide range of concerns. A system acts as a boundary for a single client, a
group, or even several groups; it can also be defined as a social issue. A
client system in interaction with the environment delineates the domain of
nursing concerns.”
● A nursing theory developed by Betty Neuman is based on the person’s
relationship to stress, response, and reconstitution factors that are
progressive in nature. The Neuman Systems Model presents a broad,
holistic, and system-based method to nursing that maintains a factor of
flexibility. It focuses on the patient system’s response to actual or potential
environmental stressors and maintains the client system’s stability through
primary, secondary, and tertiary nursing prevention interventions to reduce
stressors.

➢ Roger’s model of the science and unitary man

● Martha Rogers’ theory is known as the Science of Unitary Human Beings
(SUHB). The theory views nursing as both a science and an art as it
provides a way to view the unitary human being, who is integral with the
universe. The unitary human being and his or her environment are one.
Nursing focuses on people and the manifestations that emerge from the
mutual human-environmental field process.
● The belief of the coexistence of the human and the environment has
greatly influenced the process of change toward better health. In short, a
patient can’t be separated from his or her environment when addressing
health and treatment. This view led to Martha E. Rogers’ theory, known as
the “Science of Unitary Human Beings,” which allowed nursing to be
considered one of the scientific disciplines.
● Rogers’ theory defined Nursing as “an art and science that is humanistic
and humanitarian. It is directed toward the unitary human and is
concerned with the nature and direction of human development. The goal
of nurses is to participate in the process of change.”

➢ Pender’s health promotion model

● The Health Promotion Model notes that each person has unique personal
characteristics and experiences that affect subsequent actions. The set of
variables for behavioral specific knowledge and effect have important
motivational significance. These variables can be modified through
nursing actions. Health-promoting behavior is the desired behavioral
outcome and is the endpoint in the Health Promotion Model. Health-
 promoting behaviors should result in improved health, enhanced functional
ability, and better quality of life at all development stages. The final
behavioral demand is also influenced by the immediate competing
demand and preferences, which can derail intended health-promoting
actions.

➢ Roy’s adaptation model

● First, consider the concept of a system as applied to an individual. Roy
conceptualizes the person in a holistic perspective. Individual aspects of
parts act together to form a unified being. Additionally, as living systems,
persons are in constant interaction with their environments. Between the
system and the environment occurs an exchange of information, matter,
and energy. Characteristics of a system include inputs, outputs, controls,
and feedback.

● The Adaptation Model of Nursing is a prominent nursing theory aiming to

explain or define the provision of nursing science. In her theory, Sister
Callista Roy’s model sees the individual as a set of interrelated systems
that maintain a balance between various stimuli.

➢ Milio’s Framework of prevention

● Nancy Milio developed a framework for prevention that includes concepts
of community: oriented, population and focused care.

● Milio stated that behavioural patterns of the 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 behavioural choice is lack of knowledge.

● Milio’s framework described a sometimes neglected role of community

health nursing to examine the determinants of a community’s health and
attempt to influence those determinants through public policy.

➢ Salmon White’s Construct for Public health nursing

● Mark Salmon White (1982) describes public health as an organized
societal effort to protect, promote and restore the health of people and
public health nursing as focused on achieving and maintaining public
health.
 ● He gave 3 practice priorities, for example, prevention of disease and poor
health, protection against disease and external agents and promotion of
health. For these 3 general categories of nursing intervention have also
been put forward, they are:
■ education directed toward voluntary change in the attitude and
behaviour of the subjects
■ engineering directed at managing risk-related variables
■ enforcement directed at mandatory regulation to achieve better
health

➢ Block and Josten’s Ethical Theory of population focused nursing

● Derryl Block and Lavohn Josten, public health educators proposed this
based on intersecting fields of public health and nursing. They have given
3 essential elements of population focused nursing that stem from these 2
fields:
■ an obligation to population
■ the primacy of prevention
■ centrality of relationship- based care

➢ Canadian Model
● The community health nurse works with individuals, families, groups,
communities, populations, systems and/or society, but at all times the
health of the person or community is the focus and motivation from which
nursing actions flow. The standards of practice are applied to practice in
all settings where people live, work, learn, worship and play.
● The philosophical base and foundational values and beliefs that
characterize community health nursing - caring, the principles of primary
health care, multiple ways of knowing, individual/community partnerships
and empowerment are embedded in the standards and are reflected in the
development and application of the commun ity health nursing process.
● The community health nursing process involves the traditional nursing
process components of assessment, planning, intervention and evaluation
but is enhanced by community health nurses in three dimensions.

2. What are the different fields of community health nursing?