Community Health Nursing

Introduction

1. Health

 According to WHO - health is a state of complete physical, mental and

social wellbeing and not merely an absence of disease or infirmity.
 Good health is very useful and right of every human beings because it is necessary
to lead a successful and quality life.
 Every person's internal and external growth depend on his good health.
 World health day celebrate on 7th April.

Early world health day themes

 2014- vector Borne Disease

 2015- food safety
 2016- beat diabetes
 2017- depression let's talk
 2018- universal health coverage everyone everywhere
 2019- universal health coverage everyone, everywhere
 2020- to support nurses and midwives

2. Community- community is a group of people, who lives in a particular

palace with the same characteristics and same environment they usually have
shared interests.

3. Community health- community health is a branch of public health in

which taking care of health, treatment, protection or prevention of disease

 According to ANA- community health refers to the health status of the member of
community, to the problems affecting their health and to totally of healthcare
provide to the community.
 4. Community health nursing

 According to ANA- community health nursing is a synthesis of nursing practice

and public health practice applied in promoting of health and prevention of illness.
 According to WHO- community health nursing comprises the skill of nursing
program for the promotion of health, improvement to the condition of social
and physical environment, prevention of illness, disability and rehabilitation.

Concept of health

1. Biological concept
2. Ecological concept
3. Psychological concept
4. Holistic concept

1. Biological concept- These concept based on the germ theory of the disease

 according to tradition, health was considered to the absence of disease,

healthy person if he was free from disease

2. Ecological concept- ecological health concept describe the relationship

between human health and environment condition

 It is a dynamic equilibrium between environment and human beings

3. Psychological concept- psychological health concept indicate the

normal behaviour, emotional and social maturity to person.
4. Holistic concept- Hollister concept of health is responsible to recognise and
strength of social, economic, political and environmental influences on health.

Goals of community health nursing

 To promote the health

 To restore the health
 To maintain the health
 To prevent the illness
 To provide the rehabilitation service
 To decrease the infant and maternal mortality rate
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 To provide the referral services in the community

 To prevent the disability rate
 To increase life expectancy rate

Scope of community health nursing

 Community health nursing provide the healthcare facility according to need of

the society to meet the needs
 Community health nursing scope are -

1. Home care- community nurse homecare was established in 1916

commoners provide the home care facility to a large number of patient.

 In home care service, providing office staff and equipment in the community by
the hospital.

2. Hospital care- community health nurse provide the health services at the
level of PHC and CHC.
3. Nursing home- nursing home run by privately and they are better than other
medical care centre because medical centre is very expensive.
4. School health nursing- community nurse help to provide promotive and
protective health services to school children.

Following health services are-

 Immunization
 Early detection of disease
 First aid treatment
 School well ventilation and sanitation
 Health check-up
 Dietary chart
 Health education

5. Maternal and child health- community nurse play important role in

community to provide family planning services like antenatal care,
postnatal care and child care.

Community nurse help to women during pregnancy.

6. Occupational nursing services- nurse also employee in the industries.

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 Nurse provide the following services in industries-

 First aid treatment

 ESI act registration
 Early check-up and detection
 Industrial safety and sanitation
 Health education

7. Mental health nursing services- nurse responsible to provide mental

health services in the community are following there-

 Early diagnosis
 Treatment and rehabilitation care
 Psychotherapy and psychoanalysis
 Provide psychiatric drugs

8. Domiciliary nursing services

 Prevention of accident
 Maternity care
 Supervision of health
 Prevention of illness

9. Geriatric nursing- geriatric nursing related to the health of the old peoples.
10. Community health nursing services

 Immunization services
 Health check-up services
 Maternal and children care

Principle of community health nursing

 All community health nursing services depend upon the need of society
and community
 Integral part of community health nursing is a health education and supervision
 community health nursing services provide health care within the
community without any discrimination
 Community nursing provide the population forecasting health services
 Provide the required health resources in the community
 For delivery of nursing care, set a planning goal of care
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 Well trained and registered staff should be requirement

 Community health nursing services focus on the whole community
 Nursing services should be flexible, comprehensive and continuous
 The community nurses always maintain professional dignity
 The nurse never accept the any gift item from patient and community peoples

Qualities of community health nurse

 Community nurse should be registered with the state nursing council

 community University bi a first course in general nursing / BSc nursing and
GNM course
 Nursing able to maintain good relationship and communication technique
 Include the ability of listening, interview, good motivator
 nurse mental good observation skill and observe the physical, emotional and
mental state of individual
 Nurse able to observe the need of community and any changes in the
demographics of community
 nurse should be capable to take the right decision according to emergency situation
 The nurse will always be honest about her work
 ability to early recognise sign and symptom of communicable and
noncommunicable disease
 Leader nurse will provide the training to other health workers
 Nurse participate in the every health program and training program
 Provide individual and group health education in the community

Role of community health nurse

 Care provider- the community health nurse provide the skilled care and clinics,
family and group of peoples.
 The nurse provide the promotive protective and preventive services in
the community

 Observer- the nurse observe the peoples for any kind of sign symptoms
of communicable and noncommunicable disease.

Nurse also observe the -

 Environmental modification
 Abnormal behaviour of patient
 Response to treatment

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 Advocate- community nurse as a advocate provide guide and support to take
right decision regarding health and protects the right of individual.

Nurse provide guidance about health sector policies.

 Educator- the main function of community health nurses provide health education to
individual, family and community to promote health and prevent illness.
 Counselor- community nurse able to conduct counselling process to find out
the appropriate solution to their problem.

Counselling helps to client understand and identify provide and alternative

solution.

 Motivator- community nurse motivate and encourage to community people

for actively participate in the health programme and other treatments.
 Manager- community nurse able to organise with the various community
health program as a manager and monitor the all health activities.
 Leader- leader is a person who is a manager or director of somethings.

Leader nurse motivate the group of people to act toward achieving a common
goal.
all team members work under the leader and react with direction of leader.

 Planner- a community nurse set a goal and objective and implement that plan
in order to achieve community health.
 Researcher- ability of nurse to find out the alternative solution of problem based
on the deep investigation.
 Participant- nurse also participant in the community health programme,
conference, meetings from health survey training camps and seminar.
 Interpersonal relationship- nurse play a major role in maintaining interpersonal
relationship with health team, individual, family and community.

Dimension of health

1. Physical dimension
2. Mental dimension
3. Social dimension
4. Emotional dimension
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5. Spiritual dimension
6. Vocational dimension
7. Cultural dimension
8. Political dimension
9. Educational dimension
10. Economical dimension
11. Philosophical dimension
12. Environmental dimension

Physical dimension

 Physical dimension of health indicate the perfect functioning of the body.

 Physically healthy person conduct the normal anatomical physiological
body function.
 indicate the optimum level of body functioning include every cell and every organ
 Physical dimension assessment by the physical examination are-

1. History collection and clinical examination

2. Nutritional assessment
3. Optimal vital sign
4. Good body posture and personal hygiene
5. Laboratory investigation
6. Normal sexual activity

Mental dimension

 mental health is balance between individual and environment and waste on the
body mind and soul.
 It is represent the healthy mind has a healthy body
 Mentally healthy person able to control and stable the mind.
 Mostly mental illness occur due to anxiety and depression

Social dimension

 every human being is a social creature so live in the society, it means

social background of person is directly related to his health.
 social wellbeing referred to social traditional activities between the individual
and society
 Maintain traditional harmony within family and society is essential for health.

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 Emotional dimension

 The emotional dimension mostly focus positively and negatively about his life
and his family.
 Emotional dimension include the emotional behaviour, experience, feelings, sense
of life and cognitive level.

Spiritual dimension

 Spiritual health always bring harmony, mental peace, happiness and positive health.
 Basic understanding about soul and supreme soul is essential for healthy
spiritual dimension.

Vocational / occupational dimension

 Generally this dimension focuses on the preparation for work that stimulate the
personal satisfaction and help in achieve goal of life.

Promotion and maintenance of health

Following factors are responsible for promotion and maintenance of health-

 Healthy lifestyle pattern

 Proper and healthy nutrition
 Proper daily exercise and meditation
 Routine checkup
 Healthy and sanitation living area
 Well economic condition
 Proper immunization
 Early diagnosis and treatment
 Proper health education

Factors affect the health

1. Gender- there are many diseases that occur only on the basis of gender.

Eg. Commonly osteoporosis and breast cancer occur in female and orchitis,
testis cancer only occur in male.

2. Age- some disease are such that only according to age.

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eg. Breast cancer of female after 50 years of age and autism occur in children.

3. Nutrition- improper and insufficient nutrition also called the disease

disorder. eg. Malnutrition

4. Physical activity- lack of physical exercise may cause

disease. Eg. Vertigo, weakness

5. Lifestyle- sedentary lifestyle is also effective in causing many disease.

6. Family relationship- poor and untruthful family relations are responsible
for causing the mental illness in the family.

Eg. Depression, anxiety

7. Environmental factor- due to frequent changes in the environment,

health also has a huge impact.

Irreversible changes in the climate may responsible for cause flu like
symptoms.

8. Economical condition- due to poor economic condition adequate resources

of the home are not fulfil and it directly affect the health.

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