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Community Health Nursing:
Empowering People for Better
Health
Community Health Nursing
Increasing Need for Community-Based Care
The increasing number of people who must learn to live with chronic illness in the community implies the need for the Public Health Nurse (PHN) to plan and implement a program on health education. This is because chronic illnesses require long-term management, and educating the community on self-care and disease management is crucial.
Necessary Skills for PHNs
In order to improve the health of a community, the PHN needs to develop skills in the following areas: 1. Informational gathering 2. Social communication 3. Environmental improvement 4. Management
These skills are necessary for the PHN to effectively assess the community's needs, communicate with the residents, address environmental factors, and manage community health programs.
Illness Prevention Activities
Illness prevention activities are directed toward helping the client and family reduce risk factors. These activities aim to decrease morbidity and mortality by addressing the underlying causes of health problems.
Identifying Health Deficits and Threats
In the case of Mrs. Luy, the underweight eldest son, thin and pale youngest daughter, and Mrs. Luy's current pregnancy can be considered a health deficit and a health threat. This situation indicates the need for the PHN to intervene and address the family's nutritional and health concerns.
Levels of Prevention
Tertiary prevention would best be described as rehabilitation of alcoholic and drug-dependent individuals, as well as preventing disability and maximizing the use of remaining capacity for those with chronic conditions.
Facilitating Community Projects
To facilitate the planning and implementation of an income-generating project in a barangay, the PHN should form working groups or committees, enlist the help of technical professionals for training and guidance, and form a core group to coordinate the various project activities. The PHN should not give the people complete freedom to do as they wish, as this may hinder the success of the project.
Formulating Objectives for Community Care Plans
When formulating objectives for a community care plan, the expected results and the people taking part in the activities should be clearly defined. This refers to an objective that is specific, measurable, and resource- oriented.
Appropriate Training Methods for Midwives
To enable midwives to apply the knowledge they will gain in a seminar on community diagnosis, the appropriate method to use is problem-solving. This method allows the midwives to practice the skills they have learned in a practical setting.
Nursing Interventions for Acute Respiratory Infection
In the case of a child with acute respiratory infection, the appropriate nursing interventions would be to advise the mother to watch for signs of pneumonia and to feed the child to avoid weight loss.
Strategies for Improving Environmental Health Conditions
To create public awareness and support for improving the environmental health conditions of a community, the PHN should meet with youth officials and parent group leaders, as well as request the mayor to create a task force to help implement the project.
Basic Principles of Building a Healthy Community
The basic principles of building a healthy community include the understanding that human beings do not function independently but as a group, and that the target of change is not the individual or family, but the community as a whole.
Considerations in Nursing Care Planning for the Sick at
Home
When planning the nursing care for a sick person in the home, the major point the nurse must keep in mind is who will be responsible for the patient during the nurse's absence from the home.
Addressing Myths and Misconceptions about Family
Planning
To combat myths and misconceptions about family planning in the community, the first step the PHN should take as a health educator is to identify the myths and misconceptions prevailing in the community and their sources.
Factors to Consider in Individualized Care Planning
When planning individualized care for a client, the most important factor the nurse should consider is the client's health status, as this will determine the appropriate interventions and the client's level of participation in their care.
Helping Families Decide on Actions
In helping a family decide on actions to take during a sick member's illness, the PHN should explain the consequences of inaction, identify the courses of action open to the family and the resources needed for each, and discuss the consequences of each course of action available.
Supervisory Activities for PHNs
As the immediate supervisor of Rural Health Midwives, the PHN's supervisory activities should include performing a needs assessment, listing supervisory activities, identifying training needs, and formulating objectives for supervision.
Characteristics of 2-3 Year Old Children
The characteristics of 2-3 year old children include preferring to feed themselves, eating small nutritious meals rather than three large meals, and being able to speak in longer sentences.
Calculating Maternal Mortality Rate
To calculate the maternal mortality rate of municipality X in 2002, the formula would be: Maternal deaths / Live births x 1000, which gives a rate of 8/1000 live births.
Roles of the PHN as a Change Agent
As a change agent, the PHN must play the roles of information provider, motivator, and leader to succeed in their efforts to improve the community's health.
Epidemiology and Its Concerns
Epidemiology is directly concerned with factors influencing the occurrence and distribution of diseases, defects, disability, or death of groups of individuals.
Health Service Development under the Local Government
Code
Under the Local Government Code, health services must be developed by the local governments, which means that local health agencies such as health centers/rural health centers must be under the municipal government office.
Examples of Prevention Strategies
An example of a secondary prevention strategy would be screening for breast cancer in women who have no symptoms, while an example of a primary prevention strategy would be educating teenagers about using condoms to prevent sexually transmitted diseases.
Components of the Continuum of Health and Wellness
Model
The continuum of health and wellness model sees health as a dynamic state, with a person being either well or not, and the emphasis is on continuously and aggressively treating people who are ill.
Integrative Models of Human Health
Integrative models of human health see health factors as intertwined and interactive, with multiple components such as physical, psychological, and social.
Healthy People Project
The Healthy People project is designed to follow health indicators such as activity, substance use, mental health, and environmental issues, in order to track health care trends and guide public health policies.
Cultural Influences on Health Behaviors
Cultural expectations influence behaviors such as talking openly about the details of an illness, deciding whether to "feed a cold" or "starve a fever," and taking herbal supplements to boost the immune system.
Providing Health Education to Vulnerable
Populations
Coordinating Access to Integrated Care of Population
Developing Comprehensive Systems of Health Care in a
Variety of Settings
Primary, Secondary, and Tertiary Prevention
Primary prevention is a nurse activity designed to diagnose and treat a disease or condition in its earliest stages, before it becomes full-blown.
Secondary prevention refers to activities aimed at reducing the frequency and severity of a disease or condition.
Tertiary prevention involves activities focused on reducing the impact of an ongoing illness or disability, and preventing complications.
Community Health Activities
A community that uses the resources of a neighborhood church to provide a latchkey's children program, sponsor prayer/support groups for people who are ill, and grow a community health garden that sends vegetables to elderly shut-ins are engaged in health protection activities.
A community health action that focuses on reducing the frequency and severity of asthma in inner-city children by requiring a local incinerator to install particulate filters is an example of upstream thinking, which involves addressing the root causes of a problem.
A person with no known illness whose daily routine consists of walking and following a healthy diet would be best characterized as engaging in health promotion activities.
Community Empowerment
As community health nurses engage in the process of community empowerment, it is essential that they form partnerships with people in the community, rather than making decisions for them or accepting responsibility for their actions.
Community Health Nursing Responsibilities
The community health nurse is primarily responsible for populations, rather than individuals or families.
Breastfeeding and the Milk Code
The milk code aims to ensure that: 1) the public gets correct information about breastmilk and breastfeeding, 2) health workers should not give examples of infant formula to pregnant women or mothers of infants, 3) companies always acknowledge the superiority of breastmilk, and 4) health workers should not accept any incentives from milk companies.
Essential Health Services
The essential health services include the provision of maternal and child care, basic sanitation and prevention and control of locally endemic diseases, and the promotion of proper nutrition, adequate supply of safe water, and health education. The provision of eyeglasses and dentures for the elderly is not considered an essential health service.
Nursing Processes in Family Health Care
In providing comprehensive family health care, the nurse utilizes the following four basic processes in the order in which they are carried out: assessment, planning, intervention, and evaluation.
Health Statistics and Measures
Prevalence rate measures the frequency of occurrence of a phenomenon during a given period of time and deals with both new and old cases.
Incidence rate deals with only new cases.
Case fatality rate measures the risk of dying from a particular disease or condition.
Proportionate mortality rate measures the frequency of occurrence of a phenomenon during a given period of time.
Community Health Nursing Principles
In the light of the primary health care (PHC) approach, community health programs/projects should be compatible with available resources and developmental in nature, rather than being managed by non-government organizations.
Health Education Strategies
To succeed in her health education program, the public health nurse needs to be adept in teaching-learning strategies, providing accurate information, and effective communication.
Acute Respiratory Infection (ARI) Cases
In 1996, the total number of children with ARI was higher in Barangay C than in Barangay B.
Tetanus Neonatorum Case Fatality Ratio
The case fatality ratio for Tetanus neonatorum in San Lazaro Hospital from January 1 to 15, 1996 was 25%.
Infant Mortality Rate
The infant mortality rate is the number of children dying in the first year of life for every thousand children born alive that year.
Measures of Disease Proportion
Prevalence ratio measures the proportion of the population that exhibits a particular disease at a particular time, and deals with both new and old cases.
Measures of Maternal Mortality
Maternal mortality measures the risk of dying from causes related to pregnancy, childbirth, and the puerperium.
Occupational Health Nursing Concepts
Occupational health nursing involves the prevention, recognition, and treatment of injury and illness, and requires special skills in the fields of health, education, and counseling.
Occupational Health Program Goals
The primary goal of the occupational health program is to promote the social and environmental conditions that contribute to the health and well-being of workers.
Occupational Health Nursing Priorities
In order to establish priorities in planning and implementing the occupational health program, the nurse will need data on disease trends, birth and death rates, and social environmental conditions.
Occupational Health Hazards
Biological hazards that are harmful to workers and their families include bacteria, fungi, and insects.
Community Health Nursing Practice
A nurse is practicing community health nursing when she is performing any of the following activities: leading a support group for obese adolescents, visiting an old woman in her condominium to change her postsurgical dressing, or instructing a couple about newborn care in a clinic.
Community Health Nursing Goals
The public health nurse can say that she is beginning to achieve her goal of more optimal health for her community when people learn self-care and assume responsibility for their own health.
Community Health Nursing Emphasis
The emphasis of community health nursing is on preventing problems and promoting optimum health, rather than on the treatment of health problems.
Community Health Nursing Features
When the public health nurse assesses needs and plans health interventions for a group of people in coordination with other health professionals, she is demonstrating the features of community health nursing that involve interdisciplinary collaboration and an epidemiologic approach oriented to populations.
Philippine Family Planning Program
The Philippine Family Planning Program seeks to improve and maintain proper spacing of pregnancies, proper timing of pregnancies, and fewer pregnancies, with special concern for mothers with lingering maternal illness.
Family Planning Target Groups
The major target of the Philippine Family Planning Program are women under 20 or over 35 years old, and women suffering from certain medical conditions that contradict pregnancy.
Determining Appropriate Health Teaching
To determine what specific health teaching should be appropriate for the people of this municipality, the best method to use is: c. Study knowledge, attitudes, and practices of the people
Contributing Factors to Disease Conditions
For Barangay Mabulaklak, which has poor hygienic practices and poor environmental conditions, the contributing factors to the following disease conditions are: c. Parasitism
Health Education Topics
For Barangay Mabulaklak, the topic for discussion that will be given the least priority in the health education sessions for a group of mothers is: d. Overcrowding and its effect
Well-Stated Objective
The well-stated objective in the plan of care for Barangay Mabulaklak is: d. To reduce the number of underweight children by 10%
Legal Basis for Delivery of Basic Health Services
The legal basis for the delivery of basic health services to the local government units is embodied in: c. RA 7160
Chairman of the Municipal Health Board
At the municipal level, the chairman of the local health board is the: c. Municipal mayor
Incorrect Health Policy/Strategy
The incorrect health policy/strategy is: c. Public sectors is encouraged to work separately from the private sector for effective utilization of resources
Responsibilities of the Local Government Unit
Under the present system, the local government unit shall be responsible for: b. All of these activities (operation and maintenance of health facilities, implementation of health programs/projects, and delivery of health services)
Management of Family Planning Program
With the present system, the family planning program at the municipal and barangay levels is managed by: b. LGU's
First Step in Preparing a Health Education Plan
The first thing to do in the preparation of a health education plan is: a. Assess community needs for health education
Characteristics of an Effective Educator
You are an effective educator if you can: a. Listen to people's problems and then decide the approach for meeting their needs
Best Approach in Teaching a Responsible Family Member
The best thing to do in teaching a responsible member of the family to perform a certain procedure for the patient is: d. Demonstrate the procedure
History of Nursing in the Philippines
First Filipino Nurse Supervisor
The first Filipino nurse supervisor that worked in the Bureau of Health was appointed to office in 1919. This nurse is: a) Ms. Carmen del Rosario
Earliest School of Nursing
The earliest school of nursing in the country is the: b) St. Paul's Hospital School of Nursing
Organization of Nurses Employed in the DOH
The organization of nurses employed in the DOH is the: a) Philippine Nurses Association
Minimum Requirement for Public Health Nurse
To be able to work as a public health nurse, the minimum requirement that should be met is: c) BSN, RN, 1 year experience
Functions of a Nurse as a Community Organizer
When the nurse acts as a community organizer, she does the following functions: i. Motivate and enhance community participation when planning and implementing health programs and services iii. Identifies needs, priorities, and problems of individuals, families, and community iv. Participates in community development activities v. Coordinates with government and nongovernment organizations in the implementation of research and studies
Reaching More People for Health Promotion
The CHN should utilize the following to reach more people in the community for health promotion: d) Community assemblies like mother class
Role of the PHN in Pre-Marriage Counseling
When the PHN conducts pre-marriage counseling or responsibility, she performs the role of: d) Counselor
Primary Function or Responsibility of the Public Health
Nurse
As a public health nurse, the primary function or responsibility is: c) Prevention of illness
Inaccurate Principle of Community Health Nursing
The inaccurate principle of Community Health Nursing is: d) The community health nurse works alone even as she is a member of the health team
Ultimate Goal of Community Health Services
The ultimate goal of the community health services being provided by the government is to: d) Raise the level of health of the citizenry
Primary Focus of Community Health Nursing
The primary focus of the community health nursing is: a) Health promotion
Primary Health Care (PHC)
Location of the WHO Meeting on Primary Health Care
The WHO held a meeting in Alma Ata where primary health care was discussed.
Members of the RHU Team
The RHU team consists of all except: d) City engineers
Primary Components of PHC
The primary components of the PHC include: d) All of the above (Immunization and Control Communicable Diseases, Health Education, Environmental Sanitation)
Legal Basis for PHC
The legal basis for the PHC is the: a) LOI 949
Key Strategy to Obtain the Mission of PHC
The key strategy to obtain the mission of PHC is: a) Partnership with people
Level of Primary Health Care Worker
Steven, a trained community worker in the community, is identified at the level of: b) BHW's
Strategies and Elements of Primary Health
Care
Cornerstones/Pillars in PHC
The 4 cornerstones/pillars in PHC do not include: d) Government funds
Elements of PHC
The elements of PHC, except: c) FHSIS
Legal Basis of PHC
The legal basis of PHC is: a) LOI 949
Mission of PHC
The mission of PHC is: b) Strengthening the health care system by increasing opportunities wherein people will manage their own health care
Definition of PHC
Primary Health Care is defined by the WHO as essential health care made universally accessible to individuals and families in the community by means acceptable to them.
Factors Affecting the Optimum Level of
Functioning
Mission of the DOH, Except
The mission of the DOH, except: d) Quality of life of all Filipinos
Primary Health Care (PHC)
The key points regarding Primary Health Care (PHC) are as follows:
The first international conference of PHC was held in Alma Ata, USSR on September 6-12, 1978. The elements or components of PHC include environmental sanitation, control of communicable diseases, immunization, health education, maternal and child health and family planning, adequate food and proper nutrition, provision of medical care and emergency treatment, treatment of locally endemic diseases, and provision of essential drugs. Letter of Instruction 949, signed into law by President Ferdinand Marcos on October 19, 1979, legalized the implementation of Primary Health Care in the Philippines. The core strategy of PHC is partnership with the people and empowerment of the people, where the people are not merely recipients of health care services but actively participate in achieving an acceptable level of health and well-being. The two levels of Primary Health Care in the community are the Village or Barangay Health Workers (trained community health workers, health auxiliary volunteers, traditional birth attendants, and trained healers) and the Intermediate Level Health Workers (professional health workers such as physicians, nurses, midwives, nurse auxiliaries, and rural sanitary inspectors). The cornerstones or pillars of PHC are active community participation, intra and intersectoral linkages, use of appropriate technology, and support mechanisms made available. The goal of PHC is "Health for all Filipinos and Health in the Hands of the People by the year 2020," as defined by the World Health Organization (WHO).
Health Care Delivery System and Factors Influencing
Health
The health care delivery system refers to promotive, preventive, curative, and rehabilitative activities and services. The factors influencing health include behavioral factors (culture, habits, morals, and ethnic customs), heredity factors (genetic endowment), environmental factors (air, food, water, waste, noise, radiation, pollution, urban or rural setting), and socio- economic factors (employment, education, and housing).
Definition of Health
According to the World Health Organization (WHO), health is a state of complete physical, mental, and social well-being, not merely the absence of disease.
