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Preface We enter the new millennium, the opportunities and challenges in nursing are boundless and ever-changing. New biotechnologies offer opportunities not experienced before: women can give birth to eight living babies in one delivery; multiple defective organs can be replaced; and through genomic typing we soon will be able to anticipate the anomalies that lead to illness.
However, challenges abound: millions of people die each year from conflicts resulting in wars, drought, and starvation; from preventable ancient, new, and reemerging infectious diseases; and from unhealthy lifestyle choices.
Community health The communities in which we live and work have a profound influence on our collective health and well-being. Here are examples: Research has established that both smoking and passive exposure to tobacco smoke are directly associated with serious negative health effects and premature mortality among more than 1 billion smokers worldwide
State laws that require the use of a seat belt, child restraints, and placing young children in the back seat reduce the risk of vehicular crashes, injures, and death.
Just as a whole is greater than the sum of its parts, the health of a community is more than of sum of the health of its individual citizens. A community that achieves a high level of wellness is composed of healthy citizens, functioning in an environment that protects and promotes health.
Community health, as a field of practice, seeks to provide organization structure, a broad set of resources, and the collaborative activities needed to accomplish the goal of an optimally healthy community.
Communities can influence the spread of diseases, provides barrier to protect members from health hazards, organize ways to combat outbreaks of infectious diseases, and promote practices that contribute to individual and collective health
Many different professionals work in community health to form complex team ?!!
The city planners becomes involved in community health. The social workers providing counseling about child abuse or the use of chemical substance among adolescents. A physician treating clients effected by a sudden outbreak of hepatitis in community health practice.
The professional nurse is an integrated member of this team. Their duties range from examining infant in a well-baby clinic, or teaching elderly stroke victims in their homes, to carrying out epidemiologic research or engaging in health policy analysis and decision-making.
Community health nursing is a specialized practice. It combines all of the basic elements of professional clinical nursing with public health and community practice.
Community health and public health are organized community efforts aimed at the promotion, protection, and reservation of the public's health.
Public health is the science and art of preventing disease, prolonging life, and promoting health and efficiency through organized community efforts.
Community health is the identification of needs and the protection and improvement of collective health within a geographically defined area.
The concept of community A community is 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. It can be a people holding common rights and privileges (e.g., citizens of a town); sharing common interests (e.g., a community of farmers),
or living under the same laws and regulations (e.g., a prison community). The function of any community includes its member‘s collective sense of belonging and their shared identity, values, norms, communication, and common interests and concerns.
Populations The three types of communities just discussed underscore the meaning of the concept of community: in each instance, a collection of people choose to interact with one another because of common interests, characteristics, or goals.
The concept of population has a different meaning. It refers to all of the people occupying an area, or to all of those who share one or more characteristics. In contrast to a community, a population is made up of people who do not necessarily interact with one another and do not necessarily share a sense of belonging to that group.
A population also may be defined by common characteristics, such as the elderly population or the homeless population.
The health continuum: Wellness-illness Continuum: Yet wellness is a relative concept, not an absolute, and illness is a state of being relatively unhealthy. Because health involves a range of degrees from optimal health at one end to total disability or death at the other (Fig.1-2), it often is described as a continuum. This health continuum applies not only to individuals but also to families and communities.
Health as a state of being Health refers to a state of being, including many different characteristics. Health involves the total person or community. All of the dimensions of life, including physical, psychological, spiritual, economic, and socio-cultural experiences. All of these factors must be considered when dealing with the health of an individual or community. The approach should be holistic.
Subjective and objective dimensions of health Health involves both subjective and objective dimensions; that is, it involves both how people feel (subjective) and how well they can function in their environment (objective).
Continuous and episodic health care needs Community health practice encompasses populations in all age groups with birth-to-death developmental health care needs (the continuous needs)
In addition, populations may have one-time, specific, negative health events, such as an illness or injury, that are not an expected part of life. These episodic needs might derive from the birth of n infant with down syndrome, a head injury from an automobile accident.
Components of community Health practice 1. Promotion of health Health promotion includes all efforts that seek to move people closer to optimal well-being or higher levels of wellness. The goal of health promotion is to raise levels of well-ness for individuals, families, populations, and communities.
2. Prevention of health problems prevention of health problems constitutes a major part of community health practice. Prevention means discovering problems as early as possible to minimize potential disability and impairment. It is practiced on three levels in community health: (a) primary prevention, (b) secondary prevention, and (c) tertiary prevention.
Primary prevention • prevents the occurrence of a health problem; it includes measures taken to keep illness or in-juries from occurring. • Examples: • - vaccination, • - teaching young adults healthy lifestyle behaviors
b. Secondary prevention involves efforts to detect and treat existing health problems at the earliest possible stage when disease or impairment already exist. Hypertension and cholesterol screening programs in many communities help to identify high-risk individuals and encourage early treatment to prevent heart attacks or stroke.
c. Tertiary prevention attempts to reduce the extent and severity of a health problem to its lowest possible level, so as to minimize disability and restore or preserve function. Examples include treatment and rehabilitation of persons after a stroke to reduce impairment.
3. Treatment of Disorders The third component of community health practice is treatment of disorders. It focuses on the illness end of the continuum.
4. Rehabilitation Rehabilitation, the fourth component of community health practice, involves efforts to reduce disability and, as much as possible, restore function. Handicapped people (e.g., stroke, heart condition, amputation, mental illness) can be helped to regain some measure of lost function or to develop new compensating skills.
5. Evaluation Evaluation, the fifth component of community health practice, is the process by with that practice is analyzed, judged, and improved according to established goals and standards. 6. Research Research, the sixth component of community health practice, is systematic investigation to discover facts affecting community health and community health practice, solve problems, and explore improved methods of health service.
Characteristics of community nursing Eight characteristics of community heath nursing are : (1) it is a field of nursing; (2) it combines public health with nursing; (3) it is population focused; (4) it emphasizes prevention, health promotion, and wellness; (5) it promotes client responsibility and self-care; (6) it uses aggregate measurement and analysis; (7) it uses principles of organizational theory; and (8) it involves interprofessional collaboration.
