1. https://sites.google.com/site/drmanaralazzam/
© Ma'en Aljezawi

2. Introduction to community health nursing
© Ma'en Aljezawi

3. Healthy community
System theory: a whole is greater than the sum of its parts
A healthy community is not healthy individuals only: also health promoting environment, resources and collaborative efforts to promote health.
Many different professions works towards a healthy community.
Nurses have an integral part in this community team (liaison between different members of the team)
© Ma'en Aljezawi

4. Community health and public health
Public health: an effort organized by the society to protect, promote and restore people health (medical health care=treatment).
Community health is the identification of needs, along with the protection and improvement in collective health in a geographically defined area.
© Ma'en Aljezawi

5. Community health and public health (cont)
Both concerned with the promotion and protection of the public health.
Community health focuses on specific, designated communities.
Community health goes under the large umbrella of public health
As a result community health encompasses a vast number of activities that can promote and protect health.
© Ma'en Aljezawi

6. Examples of such activities???
© Ma'en Aljezawi

7. The concept of community
A collection of people who interact with one another and whose common interests or characteristics form the basis for a sense of unity or belonging. E.g. citizens of a town, group of farmers ??? More examples ??
© Ma'en Aljezawi

8. Types of communities
Geographic community: a community defined by its geographical boundaries (village, city, town).
It become a clear target for analysis of health needs.
Can be easily found to carry on health care interventions.
It can be further broken to smaller communities
© Ma'en Aljezawi

9. Groups of communities in the whole world can be considered as the global community
© Ma'en Aljezawi

10. Types of communities (cont)
Common-interest community: people of this community can be geographically scattered. all of them have one common interest or goal. e.g. group of disabled people, group who have a chronic disease (DM). These communities can cooperate with the local health authorities to promote their health and solve their problems or meet their needs. E.g. mothers against drunk drivers
© Ma'en Aljezawi

11. Types of communities (cont)
Community of solution : a group of people who come together to solve a problem that affect all of them.
Example: Group of people work together to solve the air or water pollution.
Example: increase awareness of AIDS group in a high incidence area.
© Ma'en Aljezawi

12. Community of solution
© Ma'en Aljezawi

13. Global health
Health for all: an initiative raised because the whole world is considered one large community.
All government need to work together to protect the global health.
© Ma'en Aljezawi

14. Population
All people occupying an area, or all of those who share one or more characteristic.
Then how a community differs from a population: people in the population do not necessarily interact with each other like in community, and do not share a sense of belonging.
© Ma'en Aljezawi

15. Population (cont)
Population may be defined geographically (e.g. Jordanian population), or by a certain characteristic e.g. old age population.
Defining population is good for research e.g. epidemiological studies OR when a group of people is targeted for a health programme.
© Ma'en Aljezawi

16. Aggregates
A mass or grouping of distinct individuals who are considered as a whole and who are loosely associated with one another.
Aggregates is a broader term that encompasses populations and communities.
This term is mentioned in this context to mark the shift from individual care (as in acute care) to groups care as in community health.
© Ma'en Aljezawi

17. Health
State of complete physical, mental, and social well-being and not merely the absence of disease (WHO).
Health is also a holistic state of well-being (body, mind, spirit)
Wellness is of a great importance in community health:
Wellness: include in addition to health; developing the individual potential to be productive in life (can be measured in terms of quality of life).
Health is also related to environment
© Ma'en Aljezawi

18. Other perspectives of health
Some cultures consider health as being free from evil, illness is a punishment for being bad.
© Ma'en Aljezawi

19. The health continuum
Wellness and illness are relative concepts not absolute. Being ill is the same of being relatively unhealthy.
Because health may have different degrees of well-being it is often described as a continuum: from optimal health to total disability or death.
© Ma'en Aljezawi

20. © Ma'en Aljezawi

21. Community health nursing and the continuum
Community practice ranges across the entire continuum.
Particularly it works to preserve wellness. And works on individuals and aggregates.
© Ma'en Aljezawi

22. Two new concepts that may shift the health continuum
Genomics: the study of human gens and their interaction with each other and the environment
Pharmacogenomics: design of drugs that are tailored to a specific individual
© Ma'en Aljezawi

23. Ten health concerns that can shift the continuum
Physical activity
Over weight & obesity
Tobacco use
Responsible sexual behaviour
Mental health
Injury and violence
Environment quality
Immunization
Access to health care
© Ma'en Aljezawi

24. Subjective and objective dimensions of health
Subjective: how people feel
Objective: how well people function in their environment.
Well person who subjectively feel well
Ill person who subjectively feel ill
© Ma'en Aljezawi

25. Components of community health practice
There are two major components:
Promotion
Protection
© Ma'en Aljezawi

26. Promotion of health
All implemented efforts that seeks to move people towards the well-being state in the health continuum.
Most important to community practice
E.g. teaching about health life style practices
© Ma'en Aljezawi

27. Promotion of health (cont)
The goal for promotion i.e. optimum well-being is achieved through three pronged efforts:
Increase the health life span
Reduce health disparities among aggregates
Access to preventive services for every one
Health promotion should be achieved through a national agenda implemented over a period of time
Any examples of this in Jordan
© Ma'en Aljezawi

28. Prevention of health problems
Prevention: anticipating or avioding problems or discovering them as early as possible.
Goal: to minimize potential disability and impairment.
There are three types (levels) of prevention:
Primary prevention
Secondary prevention
Tertiary prevention
© Ma'en Aljezawi

29. Primary prevention
prevent the occurrence of a health problem. It includes measures implemented before a problem happens .
So it is applied to healthy population
E.g. seatbelts, safety equipments.
In order of a proper prevention process to take place; community nurse must project self into future.
© Ma'en Aljezawi

30. Secondary prevention
Definition: detect and treat a health problem as early as possible.
It takes place after the health problem has happened.
e.g. screening programs for DM, HTN, breast self exam
© Ma'en Aljezawi

31. Secondary prevention (cont)
Secondary prevention attempts to discover a problem at a point when interventions may lead to control or eradication of the problem.
© Ma'en Aljezawi

32. Tertiary prevention
Attempts to reduce the extent and severity of a health problem to its lowest possible level.
E.g. rehabilitation of brain attack victims to reduce physical impairment and enhance activity level.
Tertiary prevention aims at lessening the impact of a health problem that is already there.
© Ma'en Aljezawi

33. Levels of prevention pyramid
© Ma'en Aljezawi

34. Characteristics of community health nursing
As a speciality field in nursing community health nursing requires a broadened knowledge, these include:
Priority of prevention, health promotion strategies
Means of measurement and analysis of community needs (epidemiology)
Influential factors on community (environmental , social)
Management and organization skills
Public policy and laws
© Ma'en Aljezawi

35. Characteristics of community health nursing (cont)
Difference between a community nursing and community based nursing.
Many specialities are now practicing in the community (midwifes, home care, geriatric nursing). These are community based nursing activities because they take place at a community setting e.g. home
© Ma'en Aljezawi

36. Characteristics of community health nursing (cont)
Community nursing have the same role or do the same job, however community health nurse applies public health principles and health promotion to a large group or communities of people.
The focus in community nursing is on groups not individuals like the community based nursing.
© Ma'en Aljezawi

37. Characteristics of community health nursing (cont)
Community nursing: combines nursing science and public health science: applying to groups
© Ma'en Aljezawi

38. Eight characteristics of community health nursing
The unit of care (client) is the population
The goal is to achieve goodness for the largest group possible
Working with the client (not for) as a partner.
Primary prevention is the priority
Selecting strategies for health environment is the focus.
Activities are obligated to reach all
Optimum use of resources
Collaboration with other profession e.g. social worker.
© Ma'en Aljezawi