Introduction to community health nursing

1
Introduction to community health nursing

• Lily L. Hsu
• School of Nursing
• Shanghai Jiao Tong University

2
History of Community Health Nursing

• ?Before mid 1800s-Early Home Care with focus in
  Sick and Poor individual.
• Orientation curative
• agencies lay religious orders
• St. Phoebe
• ? Mid 1800s to 1900-district Nursing with focus
  in Sick and poor individual
• Orientation curative/less in prevention
• agencies voluntary some government
• William Rathbone

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History of Community Health Nursing

• ? 1900-1970 public health nursing- Pubic Health
  Needs, focus in family and orientation in
  Curative and Prevention
• agencies government some voluntary
• Lilliam Wald
• ?1970 to present-Community Health Nursing, focus
  in total community and oriented to population
  health, services address
• health promotion illness prevention
• agencies many kinds some independent
  practice
• Ruth Freedman

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Public Health Nursing Development in China

• Early Stages
• 1925 Beijing Union Hospital-Public Health
  Agency
• (Dr. Gland).
• 1930 rural Health Education
• 2000 Pay attention to city and rural areas
  community center development and practice model
• 2006-2007 Government emphasize the
  importance of Community health, improve community
  health centers, functions, farmer health
  insurances?

5
Challenge for Chinas Community Health Nursing

• Elderly care issues

2000 Population
2050 Population
6
China Adult Population
7
National Health Statistics

• ???????40??,????11.30 ??????????13.15?
• ????????????????10???3540?
• 2007?????????3000???WHO??????,?2010?????????????4?
  ?
• ????????,??????????????880??

8
National Health Statistics

• Maternal Mortality Rate 48.3/10? (2004)
• Skillful Professional Handle delivery 97 (2003)
• Female male children attending school
  11,Junior school admission 0.92 (2002)
• Female children attending elementary school 95.8
  (2002)
• 15-25?????? 98 (2004)
• Newborn mortality rate 15.4/1000, 2004
• lt 1 year old infant death rate30/1000 (2003)
• lt5 years old children mortality 37/1000 (2003)

9
The Top Five Major Cause of Death in China

• Cardiovascular Diseases
• Malignant Tumor
• Cerebrovascular Disease
• Disease of Respiratory System
• Injury ? Intoxication
• (National data, 2004)

10
Issues in Chronic Diseases

• DM
• Hypertension
• Stroke
• Cardiovascular diseases
• Obese
• Smoking
• TB

11
Health Beyond Acute Care Settings-Community Care
and Public Health
12
Public Health Definition

• Public health is the Science and Art of
• preventing disease,
• prolonging life,
• promoting health and efficiency through
  organized community effort.
• 
  (Winslow, 1920)

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Definition of Community Health (ANA,2000)

• Community health nursing is a synthesis of
  nursing and public health practice applied to
  promoting and preserving the health of
  populations.
• Treat Population as a Whole
• Focus on individual, family, groups, community
• Utilizing Health promotion, health maintenance,
  health education, and management, coordination,
  and continuity of care for meeting population
  needs.

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Characteristics of Community Health Nursing

• It is a field of nursing
• It combines public health and nursing
• It focus in population and environment factors
  that may impact to peoples health
• It emphasize in health promotion, illness
  prevention, and wellness

15
Characteristics of Community Health Nursing

• It promotes client responsibility and self-care
• It uses aggregate measurement and
  analysis
• It use principle of organizational theory
• It involves inter-professional collaboration.

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Pubic Health is for

• The sanitation of environment,
• The control of communicable infections,
• The education of the individual in personal
  hygiene,
• The organization of medical and nursing services
  for The early diagnosis and preventive treatment
  of disease, and
• The development of the social machinery to insure
  everyone a standard of living adequate for the
  maintenance of health ,
• Healthy Life Style and Longevity .

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Community Health Practice
19
Roles of Community Health Nurses
20
Health Prevention
Tertiary Prevention
Secondary Prevention
Primary Prevention
21
Primary Prevention for Health Promotion

• Health Education
• Adequate Nutrition
• Individual Development
• Adequate working environment and recreation,
  resting
• Pre-marriage counseling and education
• Genetic Counseling
• Regular Physical Examination

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Primary Prevention for Health Protection

• Comply with immunization
• Individual hygiene
• Improve environment sanitary
• Occupational Safety
• Prevent Accident in all ages
• Adequate nutrition
• Avoid cancer cause agents
• Avoid allergic

23
Secondary Prevention

• Identify cases in the community
• Screen and test
• Conduct special physical examination
• Treat and prevent the progress of illness
• Avoid the spreading of disease
• Reduce the disability time

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Tertiary Prevention

• Treat and stop the disease progress and avoid
  complication and side effect
• Limit the chance for disability
• Provide rehabilitation for physical and
  psychological well-being, occupational therapy,
  availability of long-term care

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Characteristics of community health nursing

• it is a field of nursing
• it combines public health with nursing
• it is population-focused
• it emphasizes wellness
• it involves interdisciplinary collaboration
• it promotes clients responsibility and self care

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Setting for community health nursing practice

• homes
• ambulatory service settings
• schools
• occupational health setting
• residential institutions
• the community at large

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Opportunity for Future Community Health Nursing

• Chronic Disease management
• Home Care
• Extended care from Acute care setting
• Elderly care
• Rehabilitation care in different population
• Health promotion in every level
• Health system referral, emphasize individual role
  and function of community health sector