people share a group

COMMUNITY - HEALTH NURSING perspective or identity based

\

on culture, values history,

COMMUNITY interest and goals

- Is seen as a group or collection of HEALTH

locality-based individuals, A. WHO- “a state of complete physical,
interacting in social units and mental and social well-being and not
sharing common interests, merely the absence of disease or
characteristics, values, and/or infirmity.”
goals
B. MURRAY- “a state of well-being in
a. Allender- “a collection of people which the person is able to use
which interact with one another and purposeful, adaptive responses and
whose common interest or processes physically, mentally,
characteristics from the basis for a emotionally, spiritually, and socially.”
sense of unity or belonging
C. PENDER- ‘actualization of inherit and
b. Lundy and Janes- “a group of people acquired human potential through
who share something in common and goal-directed behavior, competent
interact with one another, who may self-care, and satisfying relationship
exhibit a commitment with one another with others.”
and may share geographic boundary.
D. MODERN CONCEPT OF HEALTH-
c. Clark- “a group of people who share refers to optimum level of functioning
common interests, who interact with of individual, family, community
each other, and who function optimum level of health (OLOF) is
collectively within a defined social influenced by the EcoSystem:
culture to address common concerns.”  Socio- economic Status
 Heredity factor  genetic
d. Shuster and Goeppinger- “a locality-  Health care delivery system
based entity, compose of systems of  Activities and behavior
formal organizations reflecting  Political factors
society’s institutions, informal groups  Environmental factors
and aggregates.

TWO MAIN TYPES OF COMMUNITY

A. GEOPOLOTICAL communities
- also called as territorial
communities
 Are most traditionally
recognized
 Defined or formed by both
natural and man-made
boundaries and include
barangays, municipalities,
cities, provinces, regions and
nations

B. PHENOMENOLOGICAL communities
- also called as functional
communities What is nursing?
 Refer to relational, interactive
groups, in which the place or
setting is more abstract and
  Assisting sick individuals to become  Emphasizes preservation and
healthy and healthy individuals protection of health
achieve optimum wellness  The primary client is the
community
What is community health nursing?
 COMMUNITY BASED NURSING
 “The synthesis of nursing practice and
 Emphasizes on managing acute
public health practice applied to
and chronic
promoting and preserving health of the
 The primary clients are the
population” (ANA, 1990)
individual and the family
 Encompasses subspecialities that POPULATION-FOCUSED NURSING
include public health nursing, school
nursing, occupational health nursing,  Concentrates in specific groups of
and other developing fields of practice, people and focuses on health
such as home health, hospice care, promotion and disease prevention,
and independent nurse practice regardless of geographical location

 Focused practice:
PUBLIC HEALTH NURSING (PHN) 1. Focuses on the entire population
2. Is based on assessment of the
 The term used before for Community
populations’ health status
Health Nursing (broader and includes
3. Considers the broad determination of
independent nursing practice)
health
Ultimate Goal of CHN 4. Emphasizes all levels of prevention
5. Intervenes with communities, systems,
 “To raise the level of health of the individuals and families
citizenry”
 To enhance the capacity of individuals 3 IMPORTANT ELEMENTS OF CHN
families and communities to cope with
1. It is population based/ focused
their health needs
 Population-focused nursing
COMMUNITY HEALTH NURSING care means providing cared
(Maglaya et al) based on the greater need of
the majority of the population
 The utilization of the nursing process
in the different levels of clientele, 2. It contains 3 levels of clientele (IFC)
individual, family, community and  Individual
population groups concerned with the  Family (basic unit of care)
 Community (patients)
a. Promotion of health
b. Prevention of disease 3. It identifies and defines 12 PUBLIC
c. And disability and Rehabilitation HEALTH INTERVENTIONS

COMMUNITY BASED- NURSING o Surveillance- monitors health

 APPLICATION of nursing process in events
caring for individuals, families and
group where they live, work to go to o Disease and other health event
school or they move through the investigation
health care system
 Setting-specific such as home health o Outreach- locates populations of
nursing interest or populations at risk.

COMMUNITY HEALTH NURSING VS o Screening- identifies individuals

COMMUNITY BASED NURSING with unrecognized health risk
factors
 COMMUNITY HEALTH NURSING
o Case finding- identifies risk
factors and connects them with FAMILY
resources  Basic unit of the society

o Referral and follow-up- assist to

 Values, beliefs, and customs of
identify and access society influence the role and function
o Case management- optimizes of the family (invades every aspect of
self-care capabilities of individuals the life of the family)
and families  Provides a set of functions important
to the needs of the individual members
o Delegated functions- direct care and to society as a whole
tasks that the nurse carries out
 Provides the individual with the
necessary environment for the
o Health teaching- communicates development and interactions
facts, ideas, and skills that change
knowledge, attitudes values,
 It is a group of people united by ties of
behaviors and practice
marriage, blood or adoption (Burgess
and Locke, 1992)
o Counselling- establishes an
interpersonal relation with the
 A unity of interacting person related by
intention of increasing or
ties of marriage, birth or adoption,
enhancing their capacity of self-
who’s central purpose is to create and
care and coping
maintain a common culture which
promotes the physical, mental,
o Consultation- seeks information emotional, and social development of
and generates optional solutions each of its members (Duvall, 1971)
to perceived problems
 Composed of two or more people who
o Collaboration- commits two or
are joined together by bonds of
more persons or an organization sharing and emotional closeness and
who identify themselves as being part
o Coalition building- develops of the family (Friedman, 2003)
alliances among organizations
TYPE OF FAMILY
o Community organizing- helps
According to structure
community groups to identify
common problems or goals  Nuclear- a father, a mother with
mobilizes resources and develop child/children living together but apart
and implement strategies from both sets of parents and other
relatives
o Advocacy- pleads someone’s
cause or acts on someone’s  Extended- composed of two or more
behalf nuclear families economically and
socially related to each other.
o Social marketing- utilizes Multigenerational, including married
commercial marketing principles brothers and sisters, and the families
for programs
 Single parent- divorced or separated,
o Policy development and unmarried or widowed male or female
enforcement- place issues on with at least one child
decision markers agendas,
acquires plan of resolution
  Blended/ reconstituted- a  The husband leaves his family and
combination of two families with sets up housekeeping with or near
children from both families and his wife’s family
sometimes children from both families
and sometimes children of the newly 3. Neolocal
married couple. It is also a remarriage  The married couple establish a
with children from previous marriage new home; they reside
independently of the parents of
 Compound- one man/ woman with either groom or bride
several spouses

 Communal- more than one

monogamous couple sharing
resources 4. Bilocal
 It gives the couple a choice of
staying with either the groom’s
 Cohabiting/ live-in- unmarried couple
parents or the bride’s parents
living together
BASED ON DECISION IN THE FAMILY
 Dyad- husband and wife or other (Authority)
couple living along without children
PATRIARCHAL
 Gay/ lesbian- homosexual couple  Full authority on the father or any male
living together with or without children member of the family e.g., eldest son,
grandfather
 No-kin- a group of at least two people
sharing a relationship and exchange MATRIARCHAL
support who have no legal or blood tie
to each other  Full authority of the mother or any
female member of the family e.g.,
eldest sister, grand mother
 Foster- substitute family for children
whose parents are unable to care for EGALITARIAN
them
 Husband and wife exercise a more or
FUNCTIONAL TYPE less amount of authority, father and
mother decides
FAMILY OF PROCREATION
DEMOCRATIC
 Refers to the family you yourself
created  Everybody is involved in decision
making
FAMILY OF ORIENTATION
AUTHOCRATIC
 Refers to the family where you came
from  No one is involved in decision making

PATTERNS OF FAMILY LAISSEZ-FAIRE

ORGANIZATION
 “Full autonomy”
BASED ON RESIDENCE arrangements on
MATRICENTRIC
where the newlyweds will reside

1. Patrilocal  The mother decides/ takes change in

 The married couple live with or absence of the father (father is
near the husband’s family working overseas)

PARTICENTRIC
2. Matrilocal
  The father decides/ takes charges in PATRILINEAL – affiliates a person with a
absence of mother group of relatives who are related to him
through his father.
FUNCTION OF THE FAMILY
MATRILINEAL – related through mother.
The family meets the needs of society through:
BILATERAL – both parents.
PROCREATION
THE FAMILY AS UNIT OF CARE
 Despite the changing forms of the
family, it has remained the universally RATIONALE FOR CONSIDERING THE
accepted institution for reproductive FAMILY AS A UNIT OF CARE:
function and child rearing
1. The family is considered the natural
and fundamental unit of society
2. The family as a group generates,
SOCIALIZATION OF FAMILY MEMBERS prevents, tolerates and corrects health
problems within its membership
 Involves transmission of the culture of
a social group
3. The health problems of the family
STATUS PLACEMENT members are interlocking

 Family confers its social rank on the 4. The family is the most frequent focus
children of health decisions and action in
 Depending on the degree of social personal care
mobility in a society the family and
children’s future families may move 5. The family is an effective and
from one social class to another available channel for much of the
(Medina, 2001) effort of the health worker
ECONOMIC FUNCTION THE FAMILY AS A CLIENT
 Rural family is a unit of production  CHN reviewed family as an important
(work as a team) unit of health care, with awareness
 Urban family is more of a unit of that the individual can be best
consumption (work separately) understood within the social context of
the family
PHYSICAL MAINTENANCE

 Specifically, the family meets the  It is important for nurses to work with
individual needs through: families according to the ff reasons:
 Family provides for the survival needs 1. The family is a critical resource
of its independent members. 2. In a family unit, any dysfunction
(Illness, injury, separation) that affects
WELFARE AND PROTECTION one or more family members will affect
the members and unit as a whole.
 Family supports spouses or partners Also referred to as “ripple effect”
by providing for companionship and 3. “Cases finding” while assessing an
meeting, affective, sexual, and individual and family, the nurse may
socioeconomic needs identify a health problem that
 By developing a sense of love and necessitates identifying risks for the
belonging the family gives the children entire family.
emotional gratification and 4. “Improving nursing care”
psychological security (Medina, 2001)
 The family is the source of motivation THE FAMILY AS SYSTEM
and morale for its members
 Family is a system in which each
BASED ON DECENT (cultural norms, which member had a role to play and rules to
affiliate a person with a particular group of respect
kinsman for certain social purposes)
  Members of the system are expected and outside the
to respond to each other in a certain family (extended
way according to their role, which is family and
determined by relationship community)
agreements. 4. 4. Adjusting to
cost of family
life
 Within the boundaries of the system, 5. Adapting to the
patterns develop as certain family needs of pre-
members behavior is caused by and school child to
causes other family members behavior simulate
in predictable ways 6. Coping with
parental loss of
 Parke (2002) stated that there are energy and
three subsystems of the family that are privacy
most important: 4. FAMILIES 1. Promote school
1. Parent-child subsystem WITH SCHOOL- achievement
AGED and foster the
2. Martial subsystem
CHILDREN (6- healthy peer
3. Sibling-sibling subsystem
13 YRS OLD) relations with
DUVALLS’ DEVELOPMENTAL STAGES the children
2. Maintain a
AND TASKS satisfying
marital
STAGE TASK
relationships
1. BEGINNING 2. Establish couple
3. Meet the
FAMILY identify and
physical health
mutually
needs of the
satisfying
family
marriage
4. Adjusting to the
3. Realign
activity of school
relationships
age children
with extended
5. Promoting joint
family to include
decisions
spouse
between
4. Make decision
children and
about
parents
parenthood
5. FAMILIES 1. Balance
2. 1. integrate infant into
WITH freedom with
CHILDBEARIN family
TEENAGER responsibility as
G FAMILY 2. find mutually
AND YOUNG teenagers
(BIRTH- 2 ½ satisfying ways to dela
ADULTS (13-20 mature and
YEARS) with childcare
YRS OLD) become more
responsibilities
autonomous
3. expand relationships
2. Maintaining
with extended family by
open
adding parenting and
communication
grand parenting roles
among parents
3. FAMILIES 1. Socialize the
and children
WITH children
3. Supporting
PRESCHOOL 2. Integrate new
ethical and
CHILDREN (1 ½ children while
moral values
YRS OLD) still meeting the
within the family
needs with other
4. Releasing
children
adults with
3. Maintain healthy
appropriate
relationships
rituals and
within the family
assistance
(marital and
5. Strengthening
parent-child)
marital
 relationships 2. Making decisions about seeking health
6. Maintaining care/ to take action
supportive 3. Dealing effectively health and non-
home base health situations
4. Providing care to all members of the
6. FAMILIES 1. Develop adult- family
LAUNCHING adult 5. Maintaining a home environment
YOUNG relationships conductive to health maintenance
ADULTS (1ST with grown 6. Maintaining a reciprocal relationship
TO LAST CHILD children
with the community and its health
LEAVING 2. Expand family
HOME) circle to include institution
new members CHARACTERISTICS OF HEALTHY FAMILY
acquired by the
De Frain (1999) and Montalvo (2004)
marriage of
grown children A. Members interact with each other,
3. Assist aging and they communicate and listen
ill parents of repeatedly in many contexts.
husband and
B. Healthy families can establish
wife
priorities. Members understand that
4. Renew and
negotiate family needs are priority.
marital
relationships C. Health families affirm, support, and
7. MIDDLE 1. Strengthen respect each other.
AGED marital
PARENTS relationship D. The members engage in flexible role
(EMPTY NEST 2. Provide health relationships, share power, respond to
TO promoting changes, support the members and
RETIREMENT) lifestyle autonomy of others and engage in
3. Sustain decision-making that affects them.
satisfying
relationships
E. The family teaches societal values and
with aging
parents ang beliefs and shares a spiritual core.
children
8. AGING 1. Maintain F. Healthy family foster responsibility and
FAMILY satisfying living value service
(RETIREMENT arrangement
TO DEATH OF 2. Adjust to G. Have the ability to cope with stress
BOTH reduced income and crisis and grow from problems.
SPOUSES) 3. Maintain marital They know when to seek help from
relationships
professionals.
4. Continue to
make sense of
one’s existence
5. Maintain
intergenerationa
l family ties
6. Adjust to loss of
spouse

FAMILY HEALTH TASK

(Freeman and Heinrich, 1981)

1. Recognizing interruptions of health

development