MODULE 2.

1
INTRODUCTION
TO
COMMUNITY AND
PUBLIC HEALTH
NURSING
 MODULE 2.1
INTRODUCTION TO COMMUNITY AND PUBLIC HEALTH NURSING
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CONCEPTS OF HEALTH
“Health is a state of complete physical, mental, and social well-being and not
merely the absence of disease or infirmity.” – WHO, 1958
“Health is the extent to which an individual or group is able, on the one hand,
to realize aspirations and satisfy needs; and on the other hand, to change or cope with
the environment. Health is, therefore, seen as a resource for everyday life, not the
objective of living; it is a positive concept emphasizing social and personal resources,
and physical capabilities.” – WHO, 1986

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COMMON DESCRIPTIONS OF HEALTH

 Goal-directed or purposeful actions, processes, responses, functioning or

behaviors.
 Possession of integrity, wholeness and/or well-being.

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DUNN’S CLASSIC CONCEPTS OF WELLNESS

 Used by community and public health nurses for many years

 States that:
o Family, community, society, and environment are interrelated and have
an impact of health.
o Illness, health and peak wellness are on a continuum; health is fluid and
changing.
o State of health depends on the goals, potentials and performance of
individuals, families, communities and societies.

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HEALTH AS A HUMAN RIGHT

 Right to health consist of interrelated and indispensable components (UN

Committee on Economic, Social and Cultural Rights, 2000)
COMPONENTS:

 AVAILABILITY – requires that operational public health’s and channels of

service delivery, products and services as well as programs be adequate for
all.
 ACCESSIBILITY – health facilities, services, and goods must be made
possible and obtainable to everyone.
 ACCEPTABILITY – respect for medical ethics, being culturally appropriate
and gender sensitive.
  QUALITY – health facilities, commodities and services must be in
accordance with scientific and medical standards.

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MODELS OF HEALTH
 CLINICAL MODEL – health is the absence of signs and symptoms of disease
and refers to its presence.
 ROLE PERFORMANCE MODEL – health is the individual’s ability to
perform societal responsibilities and expectations at works, within the family
and society.
 ADAPTIVE MODEL – health is a dynamic state where an individual is
considered healthy if he/she was able to adjust positively to social, mental
and physiological changes.
 EUDAIMONOSTIC MODEL – highlights interactions between physical,
social, psychological and spiritual facets of life and the environment that
leads to goal attainment that creates meaning and purpose in life.

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DETERMINANTS OF HEALTH AND DISEASE

 Biology
 Behaviors
 Social environment
 Physical environment
 Policies and interventions
SOCIAL DETERMINANTS OF HEALTH

 Associated with a number of factors such as health care access, economic

conditions, social and environmental issues and cultural practices
 Conditions in which people are born, grow, live, work and age; might also be
circumstantial elements such as housing, and work conditions. May also
include occupation, culture, religion, education, racial and gender
discrimination

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FOUNDATIONS OF COMMUNITY AND PUBLIC HEALTH NURSING PRACTICE
KEY CONCEPTS OF COMMUNITY AND PUBLIC HEALTH NURSING
- COMMUNITY as a client
- HEALTH as a goal
- NURSING (or Nursing Practice/Nursing Interventions) as the vehicle or means to
achieve its aims

 Community - Often viewed as a group of people living in a particular area with

common beliefs, values and traditions
  Health - More than a state of well-being. It is a multidimensional reality that
includes socioeconomic, environmental, and even political factors.
 Nursing - Traditionally defined as the art and science of caring. Its body of
knowledge is grounded on the works of nursing theorists or philosophers.

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WHAT IS COMMUNITY AND PUBLIC HEALTH NURSING (CPHN?)

 A specialized field of nursing practice that renders care to individuals, families

and communities focusing on health promotion and disease prevention through
people empowerment.
 An area of human services directed toward developing and enhancing the
health capabilities of people – either singly, as individuals, or collectively, as
groups or communities. - Heinrich and Freeman (1981)

CHARACTERISTICS AND FEATURES OF CPHN

Developmental Nurses in the community / public health work believe
that individuals, families, and population groups are
primarily responsible for their health.

Health education is a primary activity.

Multidisciplinary Results from interaction of the core determinants of
health.

Nurse fosters collaboration with different professionals

and sectors from society
Ecology Oriented Care is provided in the natural environment of the
people, in sites that serve as a sanctuary for people to
stay, grow, and realize their potentials.

Nursing care done outside the hospital and on the

field where people are.
Promotes Social Justice Health is a human right and all people should enjoy
access to healthcare.
Values Consumer Patients in community/public health are not merely
Involvement consumers or end-users of healthcare service, but are
considered as partners in health.
Uses Prepayment Services are not given for free but is funded by taxes
Mechanism of the people.
Focuses on Preventive Services required does not limit to application of
Service science but extends to reducing risks of the current
patient being attended to and groups who may
similarly end up with the same condition.
Offers Comprehensive care On the field, nurses cannot choose who their patients
will be and predict what cases they will deal with.
ROLES OF THE COMMUNITY AND PUBLIC HEALTH NURSE:

 Healthcare provider
 Health educator
  Program Implementer
 Community Organizer
 Manager / Leader
 Researcher / Epidemiologist
 Client Advocate

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EXPANDING FIELDS OF CPH NURSING PRACTICE
OCCUPATIONAL HEALTH NURSING
- The specialty practice that focuses on the promotion, prevention, and
restoration of health within the context of a safe and healthy environment. It
includes the prevention of adverse health effects from occupational to
environmental hazards. It provides for and delivers occupational and
environmental health and safety programs and services to clients. – American
Assoc. of Occupational Health Nurses
- Usually practice autonomously in their role as health care providers
- Performs primary, secondary and tertiary prevention strategies
SCHOOL HEALTH NURSING
- Specialized practice of professional nursing that advances the well-being,
academic success, and life-long achievement of students.
- School nurses need education in specific areas such as growth and
development, mental health nursing, program management, family theory,
leadership and cultural sensitivity.
- Play an important role in all levels of prevention through assessment, planning,
intervention and evaluation
FAITH COMMUNITY NURSING OR PARISH NURSING
- Practice of nursing combined with spiritual care.
- May work in either paid or unpaid positions.
- Roles: health educator, personal health counselor, developer and coordinator of
support groups in the faith community, & integrator of health and healing
CORRECTIONAL NURSING
- Clients are inmates
- Care is negotiated and provided with recognition of safety and security issues
for the nurse and the constitutional rights of prisoners to receive adequate and
timely healthcare.
ENTREPRENEURSHIP IN NURSING
- Focuses on encouraging nurses to pursue independent practice and establish
singly or in collaboration, healthcare related business establishments.
- Examples: Nurses starting their own child wellness clinics, maternity clinics,
etc.