Definition of Community Health Nursing
The Community Health Nurse must fully
Community Health Nursing according to
Jacobson: It is a learned practice discipline with
the ultimate goal of contributing to the
promotion of the client’s OLOF (Optimum Level
of Functioning) through teaching and delivery of
care
• CommunitY Health Nursing According
to WHO:
- It is a special field of nursing that
combines the skills of nursing, public
health and some phases of Social
assistance and functions for the
promotion of health, Improvement of
social and physical conditions and
rehabilitation of illness and disability.
- Community Health Nursing by American
Nurses Association(ANA):
“The synthesis of nursing practice and
public health practice applied to promoting
and preserving the health of the
populations.”
Philosophy of Community Health Nursing
• A philosophy is defined as “a system of
beliefs that provides a basis for and
guides action.” A philosophy provides
the direction and describes the what's ,
the whys and the how's of activities
within the profession.
• Philosophy: According to Margaret
Shetland ,the philosophy of CHN is
based on the worth and dignity of a
man
Principles of Community Health Nursing
By Mary S. Gardner and Cobb/Jones Leahy
1.Community Health Nursing is based on
recognized needs of communities , families,
groups and individuals.
2.
understand the objectives and policies of the
agencies she represents.
3.In Community Health Nursing ,the family is
the unit of service.
4.Community Health Nurse must be available to
all.
5. Health teaching is the PRIMARY responsibility
of the Community Health Nurse
6.The Community Health Nurse works as a
member of the health team
7.There must be Provision for periodic
evaluation of Community Health Nurse services
8.Opportunities for continuing staff education
programs for nurses must be provided by the
agency.
9.The Community Health Nurse makes use of
available community health resources
10.The Community Health Nurse utilizes the
already existing active organization in the
community
11.There should be accurate recording and
reporting in Community Health Nursing
To Watch. View and understand the concept of
Community health and health promotion on link
provided: https://www.youtube.com/watch?
v=G2quVLcJVBk . MAKE A REACTION PAPER.
Features of CHN
- Preventive approach to health to health
- It is characterized by being population
or aggregate- focused
- It is development in nature
- With existence of payment mechanism
for consumers of community health
nursing services
- Care for different levels of clientle.
Different Fields of CHN b)Pupils who are recipients of rehabilitative
supplementary feeding program should be
Community Health Nursing is considered
weighted every quarter.
broader and more general specialty area that
encompasses sub specialties which includes: Health Status Of Public School Pupils In Public
Schools: infectious diseases(respiratory tract
1.Public Health Nursing Seen as a subspecialty
infections and diarrhoea) ,worm infestations
nursing practice generally delivered within
and Dental caries
“official” or government agencies.
3.Occupational Health Nursing As defined by
2.School Health Nursing Aims to promote the
American Association of Occupational Health
health of school personnel and pupil/students.
Nurses (AACHN) as a specialty practice that
It aims to prevent health problems that could
focuses on promotion, prevention and
hinder students learning and performance
restoration of health within the context of a
• Legal Basis: Republic Act 124 mandates
Safe and healthy environment .It includes the
that all schools are to provide school
prevention of adverse health effects from
clinics for the treatment of minor
environmental hazards. It provides for and
ailments and emergency cases
delivers occupational health and safety
• Eight Components of School Health programs and services to clients.
Services are:
Community Mental Health Nursing
Health Education ,Physical Education, Health
Unique clinical process that includes concepts
Services, Nutrition Services, Counselling,
of nursing, mental health, social psychology and
psychological and social services Healthy School
Community networks including social sciences .
Environment , Health Promotion for Staff. Lastly
Focus is on the Mental Health Promotion.
, the Family& Community Involvement
Theoretical Models/ Approaches
• Health Appraisal Activities To Be
Performed By The School Nurse: Health Belief Model(HBM)

I. Health Assessment-Done once a year .Priority • developed in the 1958 by group of U.S.
should be given to Grade I enrolee ; Public Health Services social
psychologists.
II. Rapid Class room Inspection-It should be
done after a long vacation, between health • Believed that individual must know
examination or if there is emending or actual what to do and how to do it before they
pandemic can take action .

iii. Test for the visual acuity should be done • Major limitation of HBM is that it places
once a year, preferably at the beginning of burden of action exclusively on the
school year; client.

IV. Height and Weight Measurement Perceived susceptibility

a) Measurement of height, weight is done at - One's belief regarding the chance of

beginning & end of school year. getting a given condition
Perceived severity
- One's belief regarding the seriousness
of a given condition
Perceived benefits
- One's belief in the ability of an advised
action to reduce the health risk or
seriousness of a given condition
Perceived barriers
- One's belief regarding the tangible and
psychological costs of an advised action
Cues to action
- Strategies or conditions in one's
environment that activate readiness to
take action.
Self-efficacy
- One's confidence in one's ability to take
action to reduce health risks
Milio’s Framework for Prevention
Nancy Milio (1976) provides complement to the
HBMs.
6 Propositions of this framework are related to
the following:
Population health deficits results
fromdeprivation &/or excess of critical health
resources
Organizational Dimension & policies dictate
many of the options available and influence
their choices
Alterations in pattern of behaviour resulting
from decision-making of significant number of
people in a population can result in social
change.
Individual choices related to health promotion
or health damaging behaviours are influenced
by efforts to maximize-valued Resources
With out concurrent availability of alternative
health-promoting options, for investment of
personal resources, health education will be
largely ineffective on changing behaviour
patterns
Behavior of population result from selection
from limited choices; arise from actual &
perceived options available as well as beliefs &
expectations, resulting from socialization,
education and experience.
Nole Pender’s Health Promotion(HPM)
Developed in1980’s influence individual to
pursue health promotion activities but does not
includes threat as a motivator.
Pender's model focuses on three categories:
• individual characteristics and
experiences , behaviour- and
revisedin1996.
• Explores many biophysical factors that
specific cognitions and affect, and
behavioural outcomes. Details are as
follow:
prior related behaviour
This influence
subsequent behaviour
through perceived
efficacy

Behaviour - specific cognition and affect
1. Perceived Benefits of Action These are strong
motivators through intrinsic and
Extrinsic benefits.
2. Perceived Barriers to Action-Are perceived
unavailability, inconvenience ,expense, difficulty
or time regarding health behaviours
3. Perceived Self-efficacy-Is one’s belief that he
or she is capable of carrying out behaviour 4.
4.Activity-related affect-Feeling associated with
behaviour likely affect individual to
repeat/maintain behaviour Interpersonal
Influences (family, peers, provident),Norms,
Support, Model
Behavioural Outcome
• Immediate competing demands( low
controls) &preferences (high control)
Health promoting behaviour
• Goal/outcome
-These are feelings or thoughts regarding the
beliefs or attitudes of others Situational
influences (Options ,Demand characteristics,
Aesthetics)
-These are perceived options available, demand
characteristics and aesthetics features of the
environment where the behaviour will take
place .
Commitment to a plan of action
- This initiates a behavioural event
PRECEDE–PROCEED Model Developed by
Dr.Lawrence Green and colleagues.
PRECEDE which stands for Predisposing ,
Reinforcing and Enabling Constructs in
Educational Diagnosis and Evaluation, is used
for community diagnosis.
• Predisposing factors refer to people’s
characteristics that motivate them
toward health-related behaviour. This
includes attitudes, beliefs and values
• Enabling factors refer to conditions in
people and the environment that
facilitate or impede health related
behaviour . This includes skills ,
Availability , accessibility & referrals.
• Reinforcing factors refer to feed back
given by support persons or groups
resulting from the performance of the
health related behaviour. This includes
Support from family , peers,
teachers ,employers , health care
providers
• PROCEED, an acronym for Policy,
Regulatory, and Organizational
Constructs in THE HEALTH BELIEF MOD
Educational and
Environmental Development ,
• is a model for implementing and
evaluating health programs based on
PRECEDE.
• Aggregate-is literally defined as the sum
or the whole.Community-is a part of
that whole.
• Geopolitical Community–is a
community with defined geographical
and jurisdictional boundaries, such as
rural municipalities, towns or city
communities. Is the procedure of
systematically acquiring and recording
information about the members of a
given population.

• Phenomenological Community- A
phenomenological community is said to
be a group of people who are defined
by sharing values, customs, interests,
religion or academic interests . It is a
phenomenological community because
members share common beliefs and
interests allocates them to the place
where enumerated—normally where
they spend the night of the day
enumerated.