COMMUNITY HEALTH NURSE ROLES AND Identifies and interprets training needs of

FUNCTIONS QUALIFICATIONS the rhms, barangay health workers (bhw), and

hilots conducts training for rhms and hilots on
1. Bachelor of science in nursing
promotion and disease prevention
2. Registered nurse of the Philippines
Conducts pre- and post-consultation
conferences for clinic clients; acts as a resource
Planner/programmer
speaker on health and health related services
a. Identifies needs, priorities, and problems
Initiates the use of tri-media (radio/tv,
of individuals, families, and communities
cinema plugs, and print ads) for health
b. Formulates municipal health plan in the
education purposes conducts pre-marital
absence of a medical doctor
counseling
c. Interprets and implements nursing plan,
program policies, memoranda, and
circular for the concerned staff personnel
Health monitor
d. Provides technical assistance to rural
health midwives in health matters o Detects deviation from health of
individuals, families, groups, and
communities through contacts/visits with
Provider of nursing care them
o Provides direct nursing care to sick or Role model
disabled in the home, clinic, school, or
o Provides good example of healthful living
workplace
to the members of the community
o Develops the family’s capability to take
care of the sick, disabled, or dependent Change agent
member
o Motivates changes in health behavior in
individuals, families, groups, and
Community organizer communities that also include lifestyle in
order to promote and maintain health
o Motivates and enhances community
participation in terms of planning, Recorder/reporter/statistician
organizing, implementing, and evaluating
health services o Prepares and submits required reports
o Initiates and participates in community and records
development activities o Maintain adequate, accurate, and
complete recording and reporting
o Reviews, validates, consolidates,
analyzes, and interprets all records and
Coordinator of services
reports
Coordinates with individuals, families, o Prepares statistical data/chart and other
and groups for health-related services provided data presentation
by various members of the health team
Coordinates nursing program with other
health programs like environmental sanitation,
health education, dental health, and mental
health
Trainer/health educator
Researcher o Patients and families define their
families.
o Participates in the conduct of survey
studies and researches on nursing and
health-related subjects
FAMILY
o Coordinates with government and non-
government organization in the is the basic social institution and the primary
implementation of studies/research group in society is a social group characterized
by:
- Common residence
Responsibilities of CHN
- Economic cooperation
o Be a part in developing an overall health - Reproduction
plan, its implementation and evaluation -
for communities
A group of people united by ties of marriage,
o Provide quality nursing services to the
blood or adaption (Burgess and Locke)
three levels of clientele
o Maintain coordination/linkages with other The legal definition emphasizes
health team members, relationships through blood ties, adoption,
o Ngo/government agencies in the guardianship, or marriage.
provision of public health services
o Conduct researches relevant to CHN The biological definition focuses on
services to improve provision of health perpetuating the species.
care Sociologists define the family as a group of
o Provide opportunities for professional people living together.
growth and continuing education for staff
development Psychologists define it as a group with strong
emotional ties.

FAMILY & FAMILY HEALTH Traditional definitions usually include a

legally married woman and man with their
o Defining the Concept of Family, a group children.
of people related by blood, marriage, or
adoption living together.
Definition
o llender and Spradley (2008) - two or more
people who live in the same household
(usually), share a common emotional
bond, and perform certain interrelated
social tasks.

o The family, despite its changing and

increasingly diverse nature, remains the
basic social unit.
o The word "family" refers to two or more
persons who are related in any way—
biologically, legally, or emotionally.
Two ways that nurses identify families (by Gilliss
(1993))
Family as context: individuals are assessed,
the emphasis is on the individual
Family as a client: family is treated as a set of
interacting parts and assessment of the
dynamics among these parts is emphasized
Nursing theories for understanding families
Neuman's System Theory (1983):
The family is described as an appropriate
target for both assessment and nursing
interventions.
The way each member expresses self-
influences the whole and creates the basic
structure of the family.
The major goal of the nurse is to help
keep the structure stable within its environment.
NURSING THEORIES FOR
UNDERSTANDING FAMILIES
Roy's Adaptation Theory (1983):
The client is an individual, family, group,
or community in constant interaction with a
changing environment. The family system is
continually changing and attempting to adapt.
The goal of nursing is to promote
adaptation and minimize ineffective responses.
Social Sciences Theories for understanding
families
Structural-Functional Theory:
The family is viewed as part of the social
system, with individuals being parts of the family
system.
The family, as a social system, performs
functions that serve both the individual and
society.
Individuals act in accordance with a set of
internalized norms and values that are learned
primarily in the family through socialization
Five functions of the family important to
understand:
- Affective
- Socialization and social placement
- Reproductive
- Economic
- Health care
8 Duvall's Developmental Stages
- Beginning family
- Childbearing family
- Families with preschool children
- Families with school-aged children
- Families with teenagers
- Families launching young adults
- Middle-aged parents
- Families in later years
Family Types
Family of orientation (the family one is
born into; or oneself, mother, father, and
siblings, if any)
Family of procreation (a family one
establishes; or oneself, spouse or significant
other, and children)
Authority Patterns
Patriarchy: Father holds most of the authority
Matriarchy: Mother holds most of the authority
Egalitarian: Mother and father share authority
Matricentric: man is missing usually due to
death, divorce, abandonment, or no marriage
having taken place; the mother raises her
children more or less alone and subsequently
has the major role in their socialization.
Many industrialized societies are moving toward
egalitarian patterns
BILOCAL
Gives the couple a choice of staying with
either the groom’s parents or the bride parents,
depending on certain factors like the relative
wealth of the families or their status, and wishes
of the parents, or certain personal preferences
of the bride and the groom
AVUNCULOCAL
Prescribes that the newly married couple
resides with or near the maternal uncle of the
groom.
This type of residence is very rare. Accdg
to descent
The Dyad Family
- A dyad family consists of two people
living together, usually a woman and a
man, without children.
- Ex - Newly married couples
- Refers to single young same sex adults
who live together as a dyad in shared
apartments, dormitories, or homes for
companionship and financial security
while completing school or beginning
their careers.
- generally viewed as temporary
arrangements, but if the couple chooses
child-free living, this can also be a lifetime
arrangement.
The Cohabitation Family
- Cohabitation families are composed of
heterosexual couples, and perhaps
children, who live together but remain
unmarried.
- Many couples choose cohabitation as a
way of getting to know a potential life
partner better before marriage as it
seems as if this might make their
eventual marriage stronger.
The Nuclear Family
- The traditional nuclear family structure is
composed of a husband, wife, and
children. In the past, it was the most
common structure seen worldwide.
- The nuclear family is defined as a
husband, wife, and their children —
biological, adopted, or both (Friedman,
1998)
Monogamy: The marriage of one man to one
woman
Polygamy: Multiple marriage partners
The Polygamous Family
Polygyny: One man and multiple women (most
common form of polygamy)
Polyandry: One woman and multiple men (less
common)
The Extended (Multigenerational) Family
- An extended family includes other family
members such as grandmothers,
grandfathers, aunts, uncles, cousins, and
grandchildren.
- An advantage - contains more people to
serve as resources during crises and
provides more role models for behavior
or values.
- A possible disadvantage - family
resources, both financial and
psychological, must be stretched to
accommodate all members.
The Single-Parent Family
- A health problem in a single-parent family
is almost always compounded.
- Low income is often an additional
problem encountered by single-parent
families, because the parent is most
often a woman.
- Traditionally, women’s incomes are lower
than men’s by about 33% (Cherlin,
2008).
The Blended Family
- A divorced or widowed person with
children marries someone who also has
children.
- Advantages of blended families include
increased security and resources for the
new family.
- Another benefit is that the children of
blended families are exposed to different
customs or culture and may become
more adaptable to new situations.
The Communal Family
- Communes are formed by groups of
people who choose to live together as an
extended family.
- Their relationship to each other is
motivated by social or religious values
rather than kinship (Cherlin, 2008)
- The Gay or Lesbian Family
Individuals of the same sex live together as
partners for companionship, financial security,
and sexual fulfillment.
Such a relationship offers support in times of
crisis comparable to that offered by a nuclear or
cohabitation family.
The Foster Family
- Children whose parents can no longer
care for them may be placed in a foster
or substitute home by a child protection
agency (Risley-Curtiss & Stites, 2007).
- Foster parents may or may not have
children of their own.
- They receive remuneration for their care
of the foster child.
The Adoptive Family
Many types of families (nuclear, extended,
cohabitation, single-parent, gay and lesbian)
adopt children today.
No matter what the family structure, adopting
brings several challenges to the adopting
parents and the child, as well as to any other
children in the family (Fontenot, 2007).
ASSESSMENT OF FAMILY
STRUCTURE AND FUNCTION
FAMILY ASSESSMENT
- the process of collecting data about the
family structure, and the relationships
and interactions among individual
members.
- It is a continuous process.
- Its aim is to generate Nursing diagnoses
with goals and interventions for care
created in collaboration with the child and
caregivers.
Assessment Instruments
a. A genogram is a format for drawing a
family tree that records information about
family members and their relationships
over a period of time, usually three
generations.

b. An ecomap is a visual representation of
a family in relation to the community. It
demonstrates the nature and quality of
family relationships and what kinds of
resources or energies are going in and
out of the family.
Genogram
Ecomap
prevention of emergence of risk factors
(primordial prevention)
Removal of the risk factors or reduction
of their levels (specific protection)
may include: control of means of spread of
vector, proper disposal of waste
- immunization
- hand washing observed strictly
- designed to promote positive

General health
In-depth Family Assessment
a. development of good health habits and
Calgary Family Assessment Model (Wright &
hygiene
Leahey, 1994):
b. proper nutrition
- Gather information about family c. proper attitude towards sickness
structure, development and functioning. d. proper and prompt utilization of available
health and medical facilities
e.
Friedman Family Assessment Model Secondary Prevention
(Friedman, 1998): AIM: To identify and treat existing health
- consists of six broad categories of problems at the earliest possible time
interview questions. Consists of early diagnosis and prompt
treatment of the disease in order to arrest the
disease/ problem and to prevent its spread to
Levels of Prevention in Family Health other people
Prevention:
– refers to identification of potential problems so Secondary Prevention
that the person can minimize or probably even
eradicate possible disability or deformity in a Examples of Secondary Prevention
population at risk to a negative exposure factor - Public education to promote breast
examination
- Screening programs for hypertension,
Levels of Prevention diabetes, Paps smear
1. Primary Prevention - Case finding
2. Secondary Prevention - Disease surveillance
3. Tertiary Prevention
Primary Prevention Tertiary Prevention
- Directed to the healthy population limits disability progression
focusing on:
begins early in the period of recovery from
illness
Consists of:
a) Appropriate administration of
medications to optimize therapeutic
effects
b) Minimize residual disability and helping
the client learn to live productively with
limitations
c) Intensive periodic follow-up and
treatment – to prevent relapses in certain
diseases

Family Health Nursing:

- Involves a set of actions by which the nurse
measures the status of the family as a client
- Ability to maintain itself as a system and
functioning unit
A level of community nursing practices
directed on the family as the unit of care, with
the Health as the Goal and Nursing as the
medium, Channel or Provider of Care
Ability to prevent, control or resolve
problems in order to achieve health and well-
being among its members
Means by which nurses address the health
needs and problems of their clients
A logical and systematic way of processing
information gathered from different sources and
translating intentions into meaningful actions or
interventions