NURSING PROCESS IN THE CARE OF POPULATION GROUPS AND COMMUNITY.

A. COMMUNITY HEALTH NURSING ASSESSMENT TOOLS.

1. WHAT IS A PRIMARY DATA?

 Primary data are data that have not been gathered before and are collected by the
nurse through observation (ocular/windshield survey and participant observation),
survey, informant interview, community forum, and focus group discussion.
2. DEFINE THE FOLLOWING TERMS AND GIVE ITS PURPOSE AS USED IN
COLLECTING PRIMARY DATA.
 OBSERVATION (OCCULAR SURVEY AND PARTICIPANT
OBSERVATION) – Rapid observation of a community may be done through
ocular or windshield survey. It gives the nurse the chance to observe people as
well as take note of environmental conditions and existing community facilities. -
Participant observation is a purposeful observation of formal and informal
community activities by sharing. This method helps the nurse in determining
community values, beliefs, norms, priorities, concerns, and power or influence
structures.
 SURVEY – A survey is made up of a series of questions for systematic collection
of information from a sample of individuals or families in community, and may
be written or oral (Maurer and Smith, 2009). For a comprehensive needs
assessment, data are collected about a random sample of the population.
Purposive sampling is indicated in a problem-oriented assessment where the
sample population consists of the population susceptible to the problem being
studied. In addition, a survey is also appropriate for determining community
attitudes, knowledge, health behaviors, and perceptions of health services.
 INFORMANT INTERVIEW – Informant interviews are purposeful talks with
either key informants or ordinary members of the community. Key informants
consist of formal and informal community leaders or persons of position and
influence such as leaders in local government, schools, and business.
 COMMUNITY FORUM – A community forum is an open meeting of the
members of community. Pulong-pulong sa barangay is a good example of a
community forum. Besides data gathering, the community forum may also be
used as a venue for informing the people about secondary data, for data
validation, and for getting feedback from the people themselves about previously
gathered data.

3. WHAT IS SECONDARY DATA?

 Secondary data are taken from existing data. It gives the nurse a picture of what is
already known about the population under study, which may facilitate collection
of primary data.

4. DEFINE AND GIVE THE IMPORTANCE OF THE FOLLOWING AS THE

SECONDARY DATA SOURCES.
 REGISTRY OF VITAL - Act 3753 (Civil Registration Law, Philippine
Legislature), enacted in 1930, establish the civil registry system in the Philippines
and requires the registration of vital events, such as births, marriages, and deaths.
 R.A 7160 (Local Government Code) assigned the function of civil registration
to local governments and mandated the appointment of local (city/municipal)
civil registrars. The NSO serves as the central repository of civil registries and
the NSO administrator and the civil registrar general of the Philippines.

 HEALTH RECORDS AND HEALTH REPORTS – As specified by Executive

Order No. 352 (Office of the President, Republic of the Philippines, 1996), the
Field Health Service Information System (FHSIS is the official recording and
reporting system of the Department of Health and is used by the NSCB to
generate health statistics.
 DISEASE REGISTRIES - a compilation of information about a particular
disease. It includes all cases of the disease in the registry without duplication.
 PUBLICATIONS – There are a variety of published sources available for
different research topics. The authenticity of the data generated from these
sources depends majority on the writer and publishing company. Public sources
may be printed or electronic as the case may be. They may be paid or free
depending on the writer and publishing company’s decision.
 CENSUS DATA - is a periodic governmental enumeration of the population
(Merriam-Webster Online Dictionary, 2012). Batas Pambansa Blg. 72 provides
for a national census population and other related data in the Philippines every 10
years.
- The Philippine Statistical System (PSS) provides statistical information and
services to the public.

5. WHY WE NEED TO PRESENT THE COMMUNITY DATA TO THE TEAM AND

MEMBERS OF THE COMMUNITY?
 To inform the health team and members of the community of existing health
and health-related conditions in the community in an easily understandable
manner.
 To make members of the community appreciate the significance and relevance
of health information to their lives.
 To solicit broader support and participation in the community health process.
 To validate findings.
 To allow for a wider perspective in the analysis of data.
 To provide a basis for better decision making.

6. GIVE THE GRAPHS USED IN PRESENTING COMMUNITY DATA AND

DIFFERENTIATE EACH TYPES AND GIVE SAMPLES.
 Bar graph: to compare values across different categories of data. For example,
a population pyramid is made up of two horizontal bar graphs representing the
age structure of the male and female population. Figure 1 shows the
 population pyramid of the based on the 2010 Census population and Housing.

 Line graph: to have a visual image of trends in data over time or age. This
appropriate for time series. For example, the trend of the total fertility rate or
average number of children per woman in the Philippines from 1973 to 2011
is shown in Figure 7.2.

66

5.2 5.1
5

4 4.1
3.7
3.5
3.2 3.1
3

0
1973 1978 1983 1993 1998 2003 2008 2011

 Pie chart: to show percentage distribution or composition of a variable, such a

population or households. A pie chart is an effective tool in highlighting the
value of a group in relation to the whole population. But it can illustrate only a
small number of categories, usually not more than six. As an example, a pie
chart may be used to visually represent the percentage distribution of
households based on environmental variables, such as water source, method of
refuse, and excreta disposal. Another example can be seen in Figure 7.3 that
shows the distribution of 0-to-5-year old children by nutritional status based
on Operation Timbang.
  A scatter plot or diagram: to show correlation between two variables. The
values of both variables in subjects are plotted in a graph with an x-axis and a
y-axis. For example, Figure 7.4 shows a positive correlation between body
mass index and waist circumference among men aged 18 years and above in a
hypothetical community, that is, a high waist circumference is associated with
a high body mass index.

B. COMMUNITY DIAGNOSIS.

7. DEFINE THE FOLLOWING TYPES

 TRADITIONAL -
 PARTICIPATORY
ACTION -
 RESEARCH (PAR) –

8. HOW ARE THE COMMUNITY DIAGNOSIS ARE STATED AND GIVE SAMPLE
COMMUNITY DIAGNOSIS OF EACH SCHEMES.
 NANDA – focused more on individual rather than community responses to health
conditions, have included diagnoses at the community level in more recent
versions.
 Shuster and Goppingen – proposed a practical adaptation of a format of nursing
diagnoses for population groups previously presented by Green and Slade (2001).
The three-part statement consists of:
1. The health risk or specific problem to which the community is exposed.
2. The specific aggregate or community with whom the nurse will be working to
deal with the risk or problem.
 3. Related factors that influence how the community will respond to the health
risk or problem.
 Omaha system – initially designed for clients in a community setting, the Omaha
System has been used as a framework for the care of individuals, families, and
communities by nurses, nursing educators, physicians, and other health care
providers. It is a comprehensive and research-based classifications system for
client problems that exists in the public domain, meaning, it is not held under
copyright.
The Ohama System: Domains and problems of the problem classification scheme
Environmental domain: Material resources and physical surroundings both inside and
outside the living area, neighbourhood, and broader community.
Income Residence
Sanitation Neighborhood/workplace safety
Psychosocial domain: Patterns of behaviour, emotion, communication, relationships,
and development.
Communication with community resources Mental health
Social contact Sexuality
Role change Caretaking/parenting
Interpersonal relationship Abuse
Spirituality Growth and development
Grief
Physiological domain: Functions and process that maintain life
Hearing Vision Speech and Language
Oral health Cognition Pain Consciousness
Skin Neuromusculoskeletal function Respiration
Circulation Digestion/hydration Bowel function Urinary function
Reproductive function Pregnancy Postpartum
Communicable/infectious condition
Health-related behaviors domain: Patterns of activity that maintain or promote
wellness, promote recovery, and decrease the risk of disease.
Nutrition Substance use
Sleep and rest patterns Family planning
Physical activity Health care supervision
Personal care Medication regimen

C. PLANNING COMMUNITY HEALTH INTERVENTIONS

9. PRIORITY SETTING
 GIVE WHO SPECIAL CONSIDERATIONS.
- Significance of the problem
- Community awareness
- Ability to reduce risk
- Cost of reducing risk
- Ability to identify the target population
- Availability of resources

10. FORMULATING GOALS AND OBJECTIVES

 GIVE YOUR OWN SAMPLE GOAL AND OBJECTIVES OF A COMMUNITY
HEALTH PLAN.
Sample Goal and Objectives of a Community Health Plan
 Problem: Risk of maternal complications leading to maternal mortality in Barangay
Bagong Silang
Goal: To reduce maternal mortality rate from 132/100,000 live births to 80/100,000
live births by the year 2015
Objectives: At the end of the year, the community of the Barangay Silang will:
1. Demonstrate the ability to organize groups to participate in the community health
process from assessment to evaluation.
2. Increase the proportion of facility–based births from 10% to 15%.
3. Lower the proportion of untrained hilot-attended births from 20% to 10%.
4. Reduce the prevalence of nutritionally at-risk pregnant women by 20%.
5. Reduce the prevalence of anemia among pregnant women by 20%.
Notes:
1. The data in this situation are based on the statistic of one of the Philippine regions
and provinces as seen in the 2008 FHSIS Report.
2. Detection of nutritionally at-risk pregnant women is based on weight for height.

11. DECIDING ON COMMUNITY INTERVENTIONS.

12. Often referred to as the action phase, implementation is the most exciting phase for
13. most health workers. Aside from being able to deal with the recognized priority health
14. concern, the entire process is intended to enhance the community’s capability in dealing
15. with common health conditions/problems.
16. - The nurses role therefore may be to facilitate the process rather than directly
17. implement the process rather than directly implement the planned interventions.
18. - Implementation also entails coordination of the plan with the community and the
other
19. members of the health team. This requires a common understanding of the goals,
20. objectives and planned interventions among the members of the implementing group.
21. - Collaboration with the other sectors such as the local government and other
agencies
22. may also be necessary.
23. Often referred to as the action phase, implementation is the most exciting phase for
24. most health workers. Aside from being able to deal with the recognized priority health
25. concern, the entire process is intended to enhance the community’s capability in dealing
26. with common health conditions/problems.
27. - The nurses role therefore may be to facilitate the process rather than directly
28. implement the process rather than directly implement the planned interventions.
29. - Implementation also entails coordination of the plan with the community and the
other
30. members of the health team. This requires a common understanding of the goals,
31. objectives and planned interventions among the members of the implementing group.
32. - Collaboration with the other sectors such as the local government and other
agencies
33. may also be necessary.
34. Often referred to as the action phase, implementation is the most exciting phase for
35. most health workers. Aside from being able to deal with the recognized priority health
36. concern, the entire process is intended to enhance the community’s capability in dealing
37. with common health conditions/problems.
38. - The nurses role therefore may be to facilitate the process rather than directly
39. implement the process rather than directly implement the planned interventions.
40. - Implementation also entails coordination of the plan with the community and the
other
41. members of the health team. This requires a common understanding of the goals,
42. objectives and planned interventions among the members of the implementing group.
43. - Collaboration with the other sectors such as the local government and other
agencies
44. may also be necessary.
45. Often referred to as the action phase, implementation is the most exciting phase for
46. most health workers. Aside from being able to deal with the recognized priority health
47. concern, the entire process is intended to enhance the community’s capability in dealing
48. with common health conditions/problems.
49. - The nurses role therefore may be to facilitate the process rather than directly
50. implement the process rather than directly implement the planned interventions.
51. - Implementation also entails coordination of the plan with the community and the
other
52. members of the health team. This requires a common understanding of the goals,
53. objectives and planned interventions among the members of the implementing group.
54. - Collaboration with the other sectors such as the local government and other
agencies
55. may also be necessary.
56. Often referred to as the action phase, implementation is the most exciting phase for
57. most health workers. Aside from being able to deal with the recognized priority health
58. concern, the entire process is intended to enhance the community’s capability in dealing
59. with common health conditions/problems.
60. - The nurses role therefore may be to facilitate the process rather than directly
61. implement the process rather than directly implement the planned interventions.
62. - Implementation also entails coordination of the plan with the community and the
other
63. members of the health team. This requires a common understanding of the goals,
64. objectives and planned interventions among the members of the implementing group.
65. - Collaboration with the other sectors such as the local government and other
agencies
66. may also be necessary.
- The group analyses the reasons for people health behaviour and direct strategies to
respond to the underlying causes. In the process of developing the plan, the group
takes into consideration the demographic, psychological, social, cultural, and
economic characteristics of the target population on one hand and the available health
resources on the other hand.