BRAINHUB REVIEW: SESSION 1 TYPES OF RESEARCH DESIGN (Q&Q)

NURSING RESEARCH 1. Qualitative - study of PHENOMENA

Research – a systematic inquiry of FACTS and 2. Quantitative - studies the CAUSE- Live experiences
ISSUES related to nursing. AND-EFFECT relationships
13 y/o
E.g. The effect of young maternal age
on the infant birth weight among in mother of
Goal of Research:
Barangay Skirt.
Low birthweight Independent Variable
Choose the “BEST” answer (IV)/Cause
Dependent Variable
(IV)/Effect – it changes,
1. Enhance the Nursing Profession (nurse- and it is measurable
centered)
How to
2. Improve the Client Care (client-centered) know if
it is DEPENDENT VARIABLE?
Outcome of Research
- changes
*Evidence-Based Practice – choosing the - measurable
BEST possible research in client care.
(e.g. Inflammation – Cabbage – (no EBP used) E.g. The effect of Malunggay
Capsule Independent Variable
in promoting lactation (IV)/Cause
SAMPLE EBP QUESTION among breastfeeding
mothers.
What is the BEST NURSING METHOD to Dependent Variable
confirm the placement (P) of NGT? (IV)/Effect – it changes,
and it is measurable
a. Xray (Best method)
b. Aspirate gastric content (check pH)
c. auscultating for G sound (still the stomach
will have gurgling sound) QUALITATIVE RESEARCH TYPES
d. Instill air 1. Experimental – manipulation;
(still the C and D are Inaccurate administration of treatment/IV
stomach will SAFE/BENEFICIAL
have
gurgling sound) 2. Non – Experimental - no manipulation, no
administration of treatment, of IV)
HARMFUL/UNETHICAL /CANNOT
RESEARCH DESIGN MANIPULATE INDEPENDENT VARIABLE
- Blueprint of the Research
- Roadmap
- Guide you in data collection
 Types of non-experimental:
1. Descriptive research

 describe the variable of research

Purposes:
Note: IV must be inherent by the subject  To identify new concept

 To gather
Experimental ELEMENTS (MCR) Occurrence
SAMPLE 1: MI
*Manipulation

Sample: Determine whether experimental or IV DV
complete
non-experimental

 The effect of young maternal age in salary

Factors
infants birthweight – non- experimental

 The effect of malunggay capsule in environment

promoting lactation – experimental
Incentives/Benefits
Security
 The effect of widowhood in the
psychological well-being of women – non-
Experimental
blockage of C.S caused by clot
 The effect of smoking in the development  cause: CA.D in both males and females
of lung cancer – non-experimental (identify)
 US: 300,000 mortalities (prevalence)
 The relationship Observational  pH: 50,000 deaths
Study
between NLE scores and SAMPLE 2: Identify new concept (opinion)
anxiety – non-
experimental Study: Factors affecting job satisfaction

Note: LOOK for IV to know if E/NON!!!!!

Answers the
EXPERIMENTAL RESEARCH question
WHAT?????
 Manipulation
 No Administration IV
 IV inherent subject

Factors: Opinion
- status
- Age
- Behavior Prevalence
- disease
Characteristic
s
 SAMPLE 3: to gather POC: COVID-19 2 1. Experimental group

 New Cases: 20,741/day  subject with independent

 Total cases: 2,061,084 variable / receive treatment
 Death: 34,062
2. Control Group
 Active Cases: 157,646
 Recovery: 1,869,376  no independent variable

IV DV Example: The difference of self esteem

of abused
2. Descriptive
and non-abused
Correlational
children in orphanage
 studies the relationship of variables
that coexist (association)
 ASSOCIATION: *(NON-EXPERIMENTAL WILL BE USED)

CROSS-SECTIONAL

*Comparing 2
APPROACHES IN RESEARCH
groups  Retrospective Approach (e.g. case
study) – going back Past
*IV is non-
Note: Correlation experimental Example 1:
does not prove IV: (1 yr. mode of feeding)
causation (MOTTO)
DV: IQ level, 7 yrs.
Situational: A nurse researchers is interested
Example 2:
in studying the relationship of length
exclusive breastfeeding on the IQ level (7 y/o) IV: Past ( 2nd hand smoking)
DV: (Lung cancer;
present) Purpose: For
Note: Data COMPARING
Collection happens
Experimental * DV does not change because of IV one (1) point in time

3. Descriptive Comparative (causation) (point Dependent

Variable
out)
 Prospective –
Control  studies the cause-and-effect Independent
relationship of variables Variable
Study: The relationship between
 2 groups = comparative height and weight.

DESCRIPTIVE COMPARATIVE TYPES going forward Present

Example: EG- students with special breakfast (top 10)
IV: smoking (subject) CG- ordinary breakfast (slow learner)
DV: Lung cancer Threat without randomization: SELECTION
BIAS – difference of 2 groups
Note: Data Collection ma take months and
years
Qualitative Research
- in-depth study of the PHENOMENA (real
world experience)
Data collection: interview (narrative data)
EXPIREMENTAL RESEARCH
(+) manipulation – administer the IV
Purpose: study the cause-and-effect Example:
relationship.
Phenomenological- lived experience
Data: Numerical
Ethnographical: Study of culture or tribes
Study: causation (can be point-out)
Focus: Language, artifacts, beliefs/tradition
3 elements:
1. Manipulation
2. Control – minimize bias and improve
reliability of result.
*Experimental (with IV)
*Control – for comparison – placebo,
traditional, LONGITUDINAL

The effect of Fucidin ointment in promoting

wound healing among patients with burn”
* Not effective if not compared
IV: Fucidin ointment
DV: Traditional treatment (betadine, herbal)

3. Randomization – ensures the groups are

equal; equal chance being assigned to
experimental and control group.
Example: the effect of special breakfast in
academic performance of Gr. 6 students
 Stage 2: INFANCY STAGE

 Neonate – 1st 28 days

 Formal infancy – day 29 to 1 year

Stage 3: EARLY CHILDHOOD STAGE

 Toddler - 1 to 3 years old

 Preschool – 3- to 6-year-old

Technique answering questions:

1st: Age – classify
2nd: Characteristics – classify

Stage 4: MIDDLE CHILDHOOD

 School age – 6-12 years old

Stage 5: LATE CHILDHOOD STAGE

 Adolescent – up 12 years old

NORMAL PEDIATRIC NURSING

*GROWTH NURSES
Techniques
– increases in size of structure
*Memory verse
- pertains to quantitative change
* Understand

How to measure growth of child

Basic Divisions of Life
1. Weight
----5 Stages-----
– most sensitive indicator of growth.
Stage 1: PRENATAL STAGE
Pre= before Natal= Birth - The weight is dependent of nutrition

O- ovum (Ovulation to fertilization)

Z- Zygote (Fertilization to implantation) – 2 *Common trends*
weeks x2 (double): early 4 months; average 6
E= Embryo (3- 8 weeks) months

F= Fetus (9 weeks until birth) x3 (triple) : 12 months/q year

x4 (quadruple): toddler stage - (2 – 2 ½ y/o)
- 9 y/o M=F (same height ) (grade 3)
Newborn: 2500-3500 g ( 3000g/3kg) - 12 years old (F> M) = earlier puberty
Infancy: - 13 years old (M>F) = taller
- 2lbs/month: 1st 6 mos.
- 1 lbs./month: 7-12 mos. Newborn:
- 1 year” 10 kg (22 lbs. ) male; 9.5 (21 lbs.) – - 47.5-53.5 cm
female
- Average (50 cm)
Toddler: 5 lbs./year
How to measure?
Preschool: 4,5lbs/year
- From the occiput to heel follow body
School ag: 3.5 lbs./year contour

Adolescence: Infancy:
Male – 15-65 lbs. all throughout - 1-6 mos. (increased truncal height)
Female – 15-55 lbs. all throughout - 7-12 mos. (increased lower extremities in
preparation for walking)

2. Height/Length – considered the less

sensitive indicator of growth Height gain:
*Hormones* 0-3 mos. – 9 cm
- Estrogen (female) 3-6 mos. – 8 cm
- Testosterone (male) 6-9 mos. – 5 cm
9-12 mos. – 3 cm
What are the jobs of these hormones? = 25 cm
- helps increasing the osteoblastic activity
(bone formation) = increased height of
How to measure the height of the infant?
children.
- lie supine /stand erect @ measuring board

*Common trends*
Toddlers:
- increased by 50% from birth length @ 1
year. - 5 inch/year
 *1st exam: 3 mos.
Preschool *2nd exam: 10 mos.
- 2-3.5 inches/year *3rd exam: 3y/0

School-age *4 AREAS to assess

- 1-2 inches/year
Adolescence:
Male= 4-12 inches all in all
Female: 2-8 inches all in all
- language (ability to communicate) (can
communicate by 2 years old) – if not (suspect
for autism)
- play social (ability to interact and socialize)
- Fine motor adaptive (prehensile ability)
(ability to use fingers) ( thumb- finger
coordination)
Pincer grasp (for thumb finger coordination)

- Gross motor skills (ability to use large body

muscles)

IMCI – 0-5 y/o.

DEVELOPMENT COGNITIVE DEVELOPMENT:

- increased in skills/functioning - IQ of the child = mental age/chronological
- qualitative change age
0-19: Profound Mental Retardation

How to measure development? 20-34: Severe MR (mental age: 0-2 y/o)

- direct observation of the child 35-49: Moderate MR

- note parents’ description - (mental age: 2-7 y/o)

- assessment tool (DDST) - trainable

*Denver Developmental Screening Test -grade 2

(international tool used) 50-69: Mild MR
Local version (MMDST – Metro Manila - (mental age: 7-12 y/o)
Developmental Screening Test)
-educable
– 0-6 y/o (used)
-grade 6
  C Cephalocaudal (Head to toe)
70-79: Borderline
 D Development proceeds from
80-89: Below average children proximal to distal (center to away)
 E Elevation proceeds from simple to
90-109: Average IQ
complex, gross to refined, mass to
110- 119: Average specific.
 F or play is the universal language for
120- 129: Superior children
130-139: Above superior  G Growth rate varies
 H Has DOP (Definite, Orderly,
Above 140: Genius Predictable) sequence
 I Important indicator of development
is behavior.
PRINCIPLE OF GROWTH AND  J Just as each child is unique
DEVELOPMENT (mnemonics)  K key optimum time for initiation of
learning
 A continuous process (womb to tomb
principle  L learn by practice
 B Body system do not develop at the  M must remember that Neonatal
same rate and time (asynchronous reflexes has to be lost first before
principle) development proceeds.

*Patterns of G&D
- adult-sized brain (5 y/o)
- adult-sized tonsils (5y/o)
- nervous system (@infancy) PLAY

- reproductive system (@adolescence)  Infancy : Solitary Play

*Begins at 4 mos.
*Rate of G&D – how fast or slow the G&D * Evident at 6 mos.
*Play alone and not interactive
- Standardized
*Priority: Safety of children
- cannot be modified/change
 Toddler: Parallel Play/Possessive
Stages:
Play
1. Fetal – most rapid *Sit beside each other but they
don’t share toys
2. Infancy- most rapid *Begins at 18 mos.
3. Toddler - slow *Evident at 24 mos.
*Management: provide the same
4. Preschool- alternating rapid and slow toys
5. School-age - slower
 Preschool: Cooperative
6. Adolescence – rapid/ growth spurt Play/Associative/Interactive/Imit
ative/Imaginative
 - enhance the creativity, imagination, and fine
 School-age: Competitive Play motor skills of the child

 Adolescence: Athletic Sports

School-Age:
TOYS * board games
Infancy: *table games
*1-3 mos. = crib mobile
*4 mos. = rattle Adolescence:
*5 mons. = mirror/teething rings *Music
*6 mos. =bumbo seat *Gadgets
* 8 mos. = stuff toys *Cellphones
* 9 mos. = jack in the box *Tablets
*10 mos. = large interlacting blocks/lego *Computers
*12 mos. = push-pull toys/ stacking blocks

Toddlers:
*Push-pulls CAR SEAT
*Stacking Blocks < 20 lbs. or < 1 yr.
*Wagon - middle of the backseat but rear-facing
*Ponding pegs
* Nesting toys More than / = 20 lbs. / more than or = y yr.
- middle of the backseat but front-facing
Preschool:
*Modelling clay *Car seat can be used up to preschool
* Finger painting (40-60 lbs. ) – using booster seat
*Crayons
*Pencils TEETH
*Early eruption of tooth – four months
*Average eruption of the tooth – six months - Begins at 9 mos.
- Evident at 18 mos.
Question: What do you call the first milk
teeth= 2 lower central incisors (Right first 3 Stages of SepAnx
then Left)
- Protest
*Completion of teeth (30 months) – 20
- Despair
complete milk teeth
- Detachment
- start brushing of teeth
*Management: Do not prolong goodbye
- best time to go to dentist
*Be firm in saying goodbye
Adult: 32 teeth
*Say when you will back
Child: 20 teeth
*Last milk teeth (posterior molars)
 Preschool:
A - abandonment
3 y/o: brush teeth with assistance B – Body Mutilation
C – Castration anxiety
6-7 y/o: Brush teeth alone; milk teeth starts
D – Dark
to fall off; brag dancing tooth
First permanent tooth (first molars)  School-Age
- Death
Last permanent (wisdom tooth) - Intrusion of privacy

TOILET TRAINING  Adolescence

D- Death
A- Acne
 The first to control: bowel H – Homosexuality
- the early bowel (15-18 mos.) O - Obesity
- average bowel (18-24 mos. ) R – Replacement from friends

 The second to control (bladder)

- daytime BC: (2-3 y/o)
Significant Others (Harry Stack Sullivan’s
- nighttime BD: (3-4 y/o)
Interpersonal theory of Growth and
Development)
FEAR
Infancy:
 Infancy: Stranger Anxiety
- Mother (ideal) / Primary Care Giver
- Begins 6 mos.
- Peaks at 8 mos. - recognizes mother @ 4mos.
-Starts to disappear by 9 mos.
- recognize father @ 6 mos.
 Toddler: Separation anxiety
 Preschool:
Toddler: - scald bums
- parents
School age:
Preschool: - drowning
- family (composed of the parents + siblings)
Adolescence:
School Age; - Vehicular Accident
- teachers
- classmates SLEEP
- neighbors usually of same sex Newborn: 20 hr./day
Infancy:
Adolescence: - Deep Sleep: 4-5 hrs./day
- peers of opposite sex - Light Sleep: 12-15 hrs./day
*Nighttime sleep pattern @4 mos.
Toddler: 12 hr./day
- alert for bedtime rituals (story telling)
- remind 30 mins. Before bedtime
ACCIDENTS Preschool: 12 hrs./day
- alert for nightmares
Infancy:
School-Age: 8-9 ½ hr./day
- aspiration (top 1)
Adolescence: 8 hrs./day
- falls (top 2)
= distance of the crib rails (2 3/8 inches)
*DEATH PERCEPTION*
1. Infant + Toddler
Toddler:
- no understanding
- lead poisoning from the toys
2. Preschool
* Sources of lead among children (gasoline,
- death is reversible
water lead pipes)
3. School-Age:
*6-9 y/o = irreversible; avoidable
*10-12 y/o = irreversible; inevitable b. O2 dependent – bronchopulmonary
dysplasia
4. Adolescence: irreversible, universal

II. Maintain thermoregulation

NEONATE (1st 28 days of life)
Birth: 37.2 C – stabilize after 8-10 hours
*Immediate newborn care
(36.5-37.5 C)
I: establish respiration and patent airway
Route: Rectal
 Proper positioning (Acute Rationale: check for anal patency – (best way
Trendelenburg position)- the head is to assess passage of meconium)
lower than the body: Rationale: drain
secretions *Prone to cold stress (hypothermia) why?
 Suctioning (not routine) why?
1. born wet
Introduce bacteria (pathogens) to the
sterile respiratory tract of the 2. lesser subcutaneous fats (brown fats)
newborns.
WHEN TO SUCTION? – Apparent 3. no shivering
mucus blockage (NB not breathing)

4 processes of heat loss

RULES to SUCTION: 1. Conduction: with body contact
* Suction (MN: mouth- nose) Why? Obligate Ex: cool crib
nose breathers @ birth
2. Convection: heat loss because of cool air
4 mos. : MOUTH BREATHERS currents
- to prevent stimulation of gasp reflex Ex: aircon
(inhalational reflex) – can lead to aspiration –
ARDS – respiratory arrest 3. Evaporation – water to vapor

*Time limit: 5-10 seconds only (suctioning) Ex: born wet

- avoid prolonged (hypoxia) & deep 4. Radiation- without body contact

(laryngospasm; stimulation of the vagus Ex: crib is near the wall
nerves) suctioning. (bradycardia)
D – dry
W – wrap
*Oxygenation: O2 concentration up to 40%
only! D - Droplight

- Avoid excessive oxygen ( to prevent the

following)
a. blindness - Retinopathy of prematurity EFFECTS OF COLD STRESS
(ROP); Retrolental fibroplasia (RF)
1. Hypoglycemia – why?
 No shivering (metabolize glycogen) – glucose * first minute to check cardio respiratory
stored in the LIVER. status
Metabolize glycogen – hypoglycemia * First 5 min check for neurologic status

Parameter 0 1 2 2. 5 AREAS TO BE ASSESS IN APGAR

(absent) (abnormal) (normal)
Heart rate Absent <100 bpm > 100 bpm
A – Appearance
Respiratio Absent Weak, Good
n irregular cry strong P – pulse
lasting cry
Muscle Flaccid Some flexion Good G – Grimace
tone Flexion A – Activity
Reflex No Grimace Sneeze
Irritability response R- Respiration
-catheter
@ nostril
Purpose: to prioritize
-
Tangential No Grimace Cry & H – heart rate (the most important to check)
Foot slap response withdraws R - respiration
foot M – muscle tone
Color Blue Acrocyanosi Totally R – reflex irritability
s ( blue pink C – color (least priority)
extremities;
pink body)

Metabolic Acidosis - Why?

Score Interpretations:
- no shivering – metabolism of fats – heat
production (results of ketone production 0 – 4: severely depressed (immediate
which is acidic) resuscitation)
- there will be compensation (respiratory 5 – 7:moderate depressed (O2, suction)
alkalosis – hyperventilation – increased RR-
early sign of cold stress 8-10: Good condition

III: Immediate Assessment – what could be Board Exam:

done? Score 0: no HR
APGAR SCORING (Dr Virginia Apgar) Score 9: acrocyanosis
- to assess the newborn (NSVD/CS)
1 min:
5 min: IV: Physical Assessment
NEWBORN
a. Anthropometric Measurement
- weight: 2500-3500 g – normal (physiologic
weight loss of 5-10% by 6th -10th day)
Why?
 Blood Pressure – not routinely
- passage of urine and stool
- no maternal hormone influence
- ineffective sucking
Characteristics of Breathing
*Abdominal/diaphragmatic
(fast/rapid, shallow, irregular
respiration with episodes of apnea for
5-15 seconds)
assessed unless (+) CHD.
*Normal BP @birth: 86/42 mmHg
*10 days: 100/50 mmHg

b. Length INFANCY( day 29-1 year)

normal : 47.5 – 53.5 cm A. Introduction of the solid food
HC = level of the eyebrows - early @ 4 mos.
Normal = 33-35 cm - average @ 6 mos.
Note: @ birth, the HC is 2cm bigger than CC *Proper sequence of solid food
CC = level of the nipples 1. Dried cereal (hypoallergenic: rice) – 6 mos.
Normal = 31-33 cm 2. Fruits – 7 mos.
AC = level of umbilicus 3. Vegetables – 8 mos.
Normal = 31-33 cm 4. Meat- 9 mos.
5. Egg yolk – 10 mos.
6. Whole egg – 11 mos.
Additional Information:
Note:
Question: White portion of whole egg
- @ birth HC> CC (albumin)
- 6-12 mos. HC=CC
- 2 y/o CC>HC Allergic foods:
- wheat
Vital Signs - chocolate
 Temperature = 36.5-37.5 (rectal - cow’s milk
route)
 Heart rate = 120 -160 bpm (apical ) Common problems during infancy:
 Respiratory Rate = 30-60
cycle/minute
1. SIDS (sudden infant death syndrome) – 11. crawl = 9 mos.
common in 1st of life
12. Pincer grasp = 9 mos.
Real cause: unknown/idiopathic
13. wave bye-bye = 10 mos.
Risk Factor: cosleeping, excessive bedding,
14. point object = 10 mos.
prone @ sleep
15.pull sell to stand: hold on to furniture = 10
mos.
Mngt:
16. respond to own name = 10 mos.
- put the child supine @ sleep
17. stand with assistance = 11 mos.
- remove excessive bedding and cosleeping
18. stand-alone = 12 mos.
2. BBS (Baby Bottle Syndrome)
19. Drink from a cup = 12 mos.
Cause: milk bottle @ night
20. Walk with assistance = 12 mos.
Reason; Why? Milk Ferments @ night
Fermentation – lactic acid production – erode
enamel
TODDLERS (1-3 years old)
*2 unaffected teeth (2 lower central incisors
because they will cover by tongue during *3 developmental milestone
sleep)
a. Walk alone @ mos.
Mngt: Bottle with water only! /dilute the milk
b. Run well @ 2 y/o
c. Write a tricycle @ 3 y/o
Characteristics
DEVELOPMENTAL MILESTONE (does not
change) 1. Protuberant abdomen (under develop
abdominal muscle); Waddling gait (little
1. social smile = 2 mos. pregnant)
2. rattle = 4 mos. 2. Negativistic (always say no to questions;
quest for autonomy)
3. recognize mother = 4 mos.
Mngt: limit questions and offer choices
4. mirror – teethers = 5 mos.
5. sit with support = 6 mos.
3. Transitional/Security Object (these objects
6. 1st milk teeth erupts = 6 mos.
represent parents)
7. turn side -side = 6 mos.
8. Stranger anxiety = 6 mos.
4. Temper tantrums
9. peak stranger anxiety = 8 mos.
Mngt:
10. Soft toys = 8 mos.
Initial: ignore but ensure safety
Recurrent: Set limits
5. Toilet Training
Criteria for readiness
a. Physiologic criteria
- the child should have sphincter control
- able to walk, sit, and squat alone
b. Psychological Criteria
- verbalize the need to defecate
c. stay dry for 2 hours
6. Dawdling
- slow in carrying task
7. Ritualistic
- want to gain mastery
- love routine
8. Physiologic anorexia
- preoccupied with the environment
PRESCHOOL (3-6 y/o)
Characteristics
1. C- Curious
- 300-400 questions in a day
- questions would start with why and how
2. C- Creative
3. I - Imitative
4. I - Imaginative
5. T- Tell tall tales (0ver imagination)
Mngt: Differentiate fiction from facts
6. R – Regression (go back to previous
development)
Example: bed-wetting
Mngt: Ignore but investigate the source of
stress
7. I – Imaginary Playmate
Mngt: expose to real children
8. M – Magical Thinking
- animism (give life to non-living objects)
9. S – Sibling rivalry
- jealousy
Mngt: move the preschool to another bed 3
mos. before the mother’s delivery
SCHOOL-AGE (6-12 y/o)
Characteristics
1. Industrious
2. Competitive
3. Compare abilities and achievements
4. Collect objects
5. Normal stealing until 9 y/o
6. Nutritional Problem: Obesity
ADOLESCENCE (< 12 y/o)
1. Idealistic
2. Rebellious
3. Reformers
4. Abstract thinking (think of possibilities)
5. Conscious about body image (eating
disorder: Anorexia, Bulimia)
Nursing
6. Body odor -due to the apocrine glands
- science and art of caring
st
7. 1 sign of puberty
- assisting sick individuals to become healthy
- Female (thelarche) and healthy individuals ach optimum
wellness.
- Male (Scrotal enlargement)
Community health = all population
Public health= poor people

Basic principles
1. the community is the client in CHN, the
-
family is the unit of care and there are 4 level
of client
a. Individual – acquire health services on a
daily basis
b. Family – basic unit of life/ unit of service
c. Sub-groups/population aggregates – group
of people with common characteristics,
developmental stages, and exposure to health
problems.
d. Community –
Models of Family Stages
COMMUNITY HEALTH NURSING
1. Beginning Family – newly-wed couple, no
children
Community Accomplished:
- A group of people with common - acceptance of the new member of the family
characteristics or interests, living together
within territory or geographical boundary.
Health 2. Family with newborn –

- state of complete physical, mental, social, Accomplished:

and well being and not merely the absence od - the couple needs to learn the parenthood
disease or infirmity.
- the state of being free from illness or injury
3. Family with preschooler child – good
- well-being, healthiness, fitness, good observer
condition, good shape, fine fettle.
Accomplished:
- responsible parenthood
4. Family with school-age
Accomplished:
- reinforce responsible parenthood
5. Family with teenager
Accomplished:
- an open communication
6. Post parental family- children now will
have their own family
Accomplished:
7. Retiring family – senior citizen; self-
actualize couple; they view death positively
2. In CHN, the client is considered as an
ACTIVE partner NOT PASSIVE recipient of
care.
- philosophy of CHN: WORTH and DIGNITY of
MAN
3. CHN practice is affected by on-going
changes in public health system such as:
a. Shift in demographic and epidemiologic
trends in diseases.
b. new technologies
c. Existing and emerging environmental
hazards
d. Health reforms
COPAR
(As one we can: Be a part of the action! Let’s
do great things together)
COPAR: a social development approach that
aims to transform the apathetic,
individualistic, and voiceless poor into
dynamic, participatory, and politically
responsive community.
Community Organizing
- pa process whereby people came together
and identify common problems and act on
these.
- people work together to get things done
(community centered)
- Goal: increase individual and community
control over their health conditions (self-
resilient)
Empowerment:
- building the capability of people for future
community action
- people decides for themselves
- heart of community organizing
Principles CO:
1. Active Participation
2. Inclusiveness
3. Wholeness and Generativity
4. Critical Perspective
Roles of a nurse in CO:
1. Facilitator – meetings, gatherings; inviting
them to attend a meeting to join activities;
provide guidance and guidelines
2. Trainor-trainee – there is an exchange of 3. Nurse/Midwife on duty
knowledge, culture, tradition etc.
3. Confidence Builder -
b. Deepening social investigation (formal data
4. Linkage builder gathering)
5. Health Advocate c. Integration (going around the area to
motivate the people to share their ideas and
6. Co-maker
concerns), (visiting where the people are)
7. Technical Consultant
d. Choosing potential leaders
8. Documenter: Purpose: for us to have proof
Criteria in choosing potential leaders:
of organizing
P - poor
R – respective member of the society
THE CO PROCESS C – Change agent

Jimenez e. Core group formation

1. Pre – entry (done by the nurse)

a. PSI ( preliminary social investigation) 3. Community Diagnosis (done by
community)
- Ocular visit (familiarize the community)
- reflection/investigation on their own health
- Ocular survey condition
b. Site selection - deeper understanding of the reality
- Depressed (away from the community) - Data gathering tools needed
- Oppressed (no access to basic health 4. Organizational
services)
- Doing a PLAN
- poor
*Election
- Exploited
*Seminars and trainings
c. Identification of community.
*Team building

2. Entry
5. Action
a. Courtesy call (pay respect to the barangay
of official, present intentions, safety and a. Mobilization (plan should be put into action
security)
b. Group Working
ask for:
1. Brgy. Captain
6. Sustainance and Strengthening
2. Kagawad
a. Formulate vision, mission, goal, philosophy
b. Solicitation and fund raising; register the
organization to SEC - less than 8 - up to 5 years old
years old
c. registration - 1 BCG shot
- 2 shots of BCG *at birth or
d. income generating programs
*at birth or anytime at birth
anytime
*School entrant * hepB (first
7. Turn over vaccine to be
- (BCG) first given)
- to promote self reliance
vaccine to be
Cuevas given

1. Community Analysis (pre entry) 5 years old

2. Design and Initiation (ORGANIZATION) *immunization
3. Implementation (ACTION PHASE) *Hep B – first vaccine to be given
4. Program Maintenance – consolidation *7+2 vaccines
(sustenance)
5. Dissemination-reassessment (turn over)
(insert [pics)

PARTICIPATORY ACTION RESEARCH (PAR)

DPT
- collectively activity to investigate their
health conditions *children have a hypersensitivity to pertussis
vaccines.
- it is an integral part of CO.
What content of DPT causes fever? Killed
Expanded Program on Immunization bacteria
Obesity: reduce morbidity and mortality
among infants and children
hepB
PD 996: compulsory immunization of
children less than 8 years old
RA 10152: mandatory infants and children How to know if fully immunized
up to 1 BCG
PD 996 RA 10152 3 DPT
- 7 immunizable 9 immunizable
disease disease 3OPV
*TB *Haemophilus
*Diphtheria Influenza Type B 3 HEPAB
*Tetanus *Any disease can 1 Measles
*Polio be prevented by
*Hepatitis B the vaccines
* Measles (ROTA VIRUS)
Pentavalent Vaccine (5 in 1) (6,10,14 weeks Timeframe for storage of vaccine
old) (IM)
1. 6 months at the regional level
HepB
2. 3 months at the provincial level/district
DPT level
HJB 3. 1 month at the main health centers (with
refrigerators)
4. Not more than 5 days at health center/BHU
ROTA VIRUS

HERBAL MEDICATIONS
Cold Chain Management
RA 8423: Utilization of medicinal plants as
- use to maintain potency of the vaccine
alternative for high-cost medications
*most sensitive to heat (@ -15 to – 25 C
10 medicinal plants
-OPV
1. lagundi (vitex negundo)
-Measles
– asthma, cough, fever
* Least sensitive to heat
- decoction (pakulo for 15-20 mins in a slow
- the rest of the vaccine fire)

- +2 to +8C 2. UlasimangBAto (Peperonia Pelucida)

- edema
Preparation (pancit-pancitan)

General Policies of Cold Chain - 1 and half cup of leaves with 1-2 glasses of
water
1. Stock vaccine neatly on the shelves not on
the door.
2. Keep diluents in lower shelve or in the 3. Bayabas (Psidium guajava)
door.
- antiseptic properties
3. Clearly separate different type of vaccines.
- 2 cups of leaves 4 glasses of water; slow fire
4. FEFO- first to expire, first to open
5. Store measles, and OPV with frozen ice
4. Bawang (Allium sativum)
pack in the transport.
- lowers cholesterol level
6. Discard BCG vaccines after 4 hours of
reconstitutes
7. Discard DPT, polio, measles, TT, after 8 5. Yerba Buena (Mentha Spicata)
hours of constituents.
- pain relief
- decoction
- Adult(4-6 tablespoon of leaves,

6. Sambong ( Blumea balsamifera)

antiedema, diuretic, Gout and rheumatism
(lowers uric acid)
7. Ampalaya (Mamordica charantia)
- diabetes mellitus

8. Niyug-niyogan (Combretum indicum)

- anti-helminthic

9. Tsang Gubat (Carmona Retusa)

- 10 to 12 leaves

10. Akapulko (Senna Alata)

- antifungal
Preparation: