COMMUNITY HEALTH NURSING

What is CHN?

A utilization of NURSING PROCESS Different Clients

Individuals Families Population Group Communities

Promotion of Health Prevention of Disease and Disability and Rehabilitation Dr. Araceli Maglaya

Factors Affecting Health

Political Economic Cultural Heredity Environment Socio-Economic

Health Promotion
Directed towards healthy individuals or populations Focusing on prevention of the emergence of risk factors such as unhealthy lifestyle behaviors

Levels of Prevention

Primary Level Disease Prevention

For individuals who are at risk of developing a dx Pre-pathogenic stage Deals with removal of risk factors or specific protection

Immunization Food

supplementation Malaria or Dengue Prophylaxis

Secondary Level Disease Prevention

For individuals in subclinical stage or asyptomatic or symptomatic stage of a dx Aims to diagnose, treat problems at the earliest possible time To limit disabilities Screening, case finding, surveillance, tx of communicable dx

Tertiary Level Disease Prevention

For individuals at pathogenic stage of the dx Deals with reduction of magnitude and severity of the residual effects of communicable and non communicable dx Rehab of post stroke pt., control of spread of measles during an epidemic

THEORIES RELATED TO HEALTH PROMOTION

Penders Health Promotion Theory

Nora J. Pender (1982, revised, 1996)

PhD, RN, Professor in University of Michigan Designed to be a complementary counterpart to models of health protection

Health

A positive, dynamic state not merely the absence of dx Increasing ones well being

Health Promotion

The health promotion model describes the multi dimensional nature of persons as they interact within their environment to pursue health. The model focuses on following three areas:

Individual characteristics and experiences Behavior-specific cognitions and affect Behavioral outcomes

ASSUMPTIONS OF THE HEALTH PROMOTION MODEL

Individuals seek to actively regulate their own

behavior.

Individuals in all their biopsychosocial complexity interact with the environment, progressively transforming the environment and being transformed over time.

Health professionals constitute a part of the interpersonal environment, which exerts influence on persons throughout their life span. Self-initiated reconfiguration of personenvironment interactive patterns is essential to behavior change

Banduras Self Efficacy Theory

Alberta Bandura Self Efficacy Is the belief that one has the power to produce that effect by completing a certain task or activity r/t that competency Relates to a persons perception of their ability to reach a goal

It is the belief that one is capable of performing in a certain manner to attain certain goals.
It is the expectation that one can master a situation, and produce a positive outcome. Self-efficacy is an important concept in positive psychology.

Major Concepts

Banduras Social Cognitive Model says that there are 3 factors that influence self-efficacy:
Behaviors Environment, and personal/cognitive factors.

They all affect each other, but the cognitive factors are important.

Self-efficacy developing from mastery experiences in which goals are achieved through perseverance and overcoming obstacles and from observing others succeed through sustained effort.

Self-efficacy and self-esteem are different concepts, but related.

Self-efficacy relates to a persons perception of their ability to reach a goal, whereas selfesteem relates to a persons sense of selfworth.

Application of the Theory

"Motivation, performance, and feelings of frustration associated with repeated failures determine affect and behaviour relations" Bandura, 1986) SET is widely applied in health behaviour change. Cognitive and behavioural psychotherapy for depression are based on theoretical concepts of self-efficacy.

Conclusion

Self-efficacy is the most important precondition for behaviour change.

HEALTH BELIEF MODEL

is one of the first theories of health behavior. developed in the 1950s by a group of U.S. Public Health Service social psychologists who wanted to explain why so few people were participating in programs to prevent and detect disease

The health belief model proposes that a person's health-related behavior depends on the person's perception of four critical areas:
the the the the

severity of a potential illness, person's susceptibility to that illness, benefits of taking a preventive action, and barriers to taking that action.

HBM is a popular model applied in nursing, especially in issues focusing on patient compliance and preventive health care practices. The model postulates that health-seeking behaviour is influenced by a persons perception of a threat posed by a health problem and the value associated with actions aimed at reducing the threat.

HBM addresses the relationship between a persons beliefs and behaviors. It provides a way to understanding and predicting how clients will behave in relation to their health and how they will comply with health care therapies

There are six major concepts in HBM:

1. 2. 3. 4. 5. 6.

Perceived Susceptibility Perceived severity Perceived benefits Perceived costs Motivation Enabling or modifying factors

Perceived Susceptibility:

refers to a persons perception that a health problem is personally relevant or that a diagnosis of illness is accurate.
even when one recognizes personal susceptibility, action will not occur unless the individual perceives the severity to be high enough to have serious organic or social complications.

Perceived severity:

Perceived benefits:

refers to the patients belief that a given treatment will cure the illness or help to prevent it.
refers to the complexity, duration, and accessibility of the treatment.

Perceived Costs:

Motivation:

includes the desire to comply with a treatment and the belief that people should do what.
include personality variables, patient satisfaction, and socio-demographic factors.

Modifying factors: