COMMUNITY HEALTH NURSING 2 continual (Continuous.

Evaluation. Until we reach our

(POPULATION GROUPS AND goal) and not episodic.
COMMUNITY AS CLIENTS 3. There are different levels of
clientele – individuals,
COURSE DESCRIPTION families, and population groups
and the practitioner recognize
This course deals with concepts, the primacy of the population as
principles, theories and techniques a whole.
in the care of population groups and 4. The nurse and the client have
communities utilizing community greater control in making
organizing strategies toward health decisions related to health care
promotion, disease prevention, and they collaborate as equals.
restoration and maintenance, and 5. The nurse recognizes the impact
rehabilitation and community of different factors of health
development. and has a greater awareness of
his/her and lives and situation.
The learners are expected to provide
safe, appropriate and holistic PHILOSOPHY OF CHN
nursing care to clients utilizing the o The philosophy of CHN is based
community health nursing process. on the worth and dignity of men.
o This philosophy of care is based
COMMUNITY HEALTH NURSING on the belief that care directed
o One major field of nursing to the individual, the family,
o CHN is broader than public and the group contributes to the
health nursing healthcare of the population as
▪ PHN: practice of CHN in a whole.
public sector; sub of CHN
“Synthesis of nursing knowledge and ROLES OF CHNs
practice and the science and practice
of public health, implemented via a
systemic use of the nursing process
and other process to promote health
and prevent illness in population
growth”

OTHER PROCESS o Client Oriented: Individuals

o Management: dealing with o Delivery Oriented:
population Collaborations among
o Supervision: Deal with group of institutions
individuals o Population Oriented: Community
o Research: Collecting data
o Advocacy: community needs. PRINCIPLES OF CHN
Heart. Protected. Pursued 1. The recognized need of
o Political Action: consider individuals, families and
affiliating with political group communities provides the basis
for assistance and for CHN practice
communication; Political 2. Knowledge and understanding of
Leaders the objectives and policies of
the agency facilitate goal
CHARACTERISTICS OF CHN achievement
1. Promotion of health and 3. Family as unit of service
prevention of disease are the 4. Respect for the values, customs
goals of professional practice. and belief.
2. CHN practice is comprehensive, 5. Health education and counselling
general (client is the as vital parts of functions.
community. General problem),
 6. Collaborative work community rather than the
relationships. individual and family
7. Periodic and continuing ▪ Community health problems
evaluation provides the means ▪ Benefitting the most
for assessing the degree to o Utilizes the Nursing Process
which CHN goals and objectives ▪ Assessment of health needs
are being attained. ▪ Impact of growth services
8. Continuing staff education on population groups
program quality services to o Promotive – Preventive by Nature
client and are essential to ▪ Priority of CHN
upgrade and maintain sound ▪ Promote health and prevent
nursing practices in their diseases
setting. o Uses a variety of Instruments
9. Utilization of indigenous and ▪ Same as family health
existing community resources nursing
maximizing the success of the
▪ Interviews
efforts of the CHNs.
▪ Questionnaires
10. Active participation of
the individual, family and ▪ Survey forms
community in planning and making ▪ Community spot mapping
decisions of their health care ❖ Collecting data and
needs, determine, to a large documenting
extent, the success of the CHN information
programs. ❖ Analyzed and
11. Supervision of nursing validated
services by qualified CHN ▪ Vital statistics
personnel provides guidance and (formula/equations)
direction for the work to be ▪ Health statistics
done. (formula/equations)
12. Accurate recording and ▪ MMDST (6 ½ years and below)
reporting serve as the basis for o Requires Management Skills
evaluation of the progress of ▪ Utilized during
planned programs and activities organization of nursing
and as a guide for actions. services in the local
▪ People person
GOAL OF CHN ▪ Good interpersonal
To assist the individual, family, relationships with the
community and population groups in health care team,
attaining their highest level of community and among
holistic health which is attained yourselves
through multidisciplinary effort and
to promote reciprocally supportive THE RECIPIENTS OF CARE BY
relationship between people and their COMMUNITY HEALTH NURSES
physical and social environment o The Individual
▪ Specific patient/client
SALIENT FEATURES OF CHN o The Family
o Population or Aggregate–Focused ▪ Basic unit of society
▪ Patient is the whole o The Population Group
community ▪ Vulnerable groups
▪ Population based ▪ People at risk
assessment ▪ Risk of developing certain
▪ Policy development illnesses related to
▪ Comprehensive health problems
o Greatest Good for the Greatest ▪ Member of minor group
Number (children, women)
▪ Nurse will look for health o Community
problems/needs of ▪ All together
 ▪ Client of CHN MILIO'S FRAMEWORK FOR PREVENTION
o An individual’s resources,
HEALTH BELIEF MODEL availability
o Guides health promotion and
disease prevention programs.
o Explains and predicts individual
changes in health behaviors.
o Widely used model for
understanding health behaviors.

Key factors that influence health

behaviors:
1. individual's perceived threat to
sickness or disease (perceived
susceptibility)
2. belief of consequence (perceived
severity) HEALTH PROMOTION MODEL
3. potential positive benefits of
action (perceived benefits)
4. perceived barriers to action,
exposure to factors that prompt
action (cues to action)
5. confidence in ability to succeed
(self-efficacy).

PRECEDE-PROCEED

*Health Belief: attacks Predisposing, Reinforcing, and

knowledge/perception Enabling Constructs in
Educational/Environmental Diagnosis
and Evaluation

Policy, Regulatory, and

Organizational Constructs in
Educational and Environmental PHASE 5 Administrative and Policy
Development Assessment
o Identifies administrative and
PHASE 1 Social Assessment political factors before program
o Concerns of population (compatibility)
o Identify social problem of o Resources that
community that affects their facilitate/hinder program
quality of life o Political factors (linkages)
o Subjective
o Gather information about how PHASE 6 Implementation
they see quality of life o Planned program will put into
▪ FGB: select participants action
from different sectors of
the population (mothers, PHASE 7 Process Evaluation
elderly, youth, PWD, o Evaluate implementation process
uneducated, etc.)
PHASE 8 Impact Evaluation
PHASE 2 Epidemiological Assessment o Carried out immediately after
o Health problems related to the evaluation of program
quality of life o Effectiveness/efficiency of
o Primary/secondary source of data program
o Reasons behind the perceived
quality of life gathered during PHASE 9 Outcome Evaluation
assessment o Evaluates if the program
o Why do they feel this way? evaluated is effective to phase
o Why are they experiencing this 1
kind of life? o Measures achievement of overall
o Vital stats, incidence rates plan

PHASE 3 Behavioral and Environment Precede: deductive

Assessment Phase 1: general problem
o Beliefs and lifestyle Phase 2-5: specific based on phase 1;
o Environment affects identified problem
epidemiological
DIFFERENT FIELDS OF CHN
PHASE 4 Educational and Ecological o Public Health Nursing
Assessment o Occupational Health Nursing
Predisposing o School Nursing
o Related to phase 1-3
o Characteristics of individuals COMMUNITY
that affects change in behavior, o A group of people with common
knowledge, beliefs, values, characteristics or interest
attitudes, personal norms living within a territory or
Reinforcing geographical boundary
o Feedbacks from others (peers, o “communitas” (cum, “with
teachers, or anyone significant) together” + munus, “gift”)
o Positive or negative
o May receive rewards, incentives, HEALTH
punishments o is the state of complete
o Can influence/motivate you physical, mental and social
Enabling well-being and not merely the
o Social and environmental factors absence of disease or
that enable motivation (people infirmity.(World Health
giving rewards; seller of items Organization)
that you might buy)
o Resources: money, skills
o Availability and accessibility
TYPES/CLASSIFICATION OF o The health services are
COMMUNITIES accessible and appropriate
1. Rural Communities: open land of o The historical and cultural
agriculture; less densely heritage is promoted and
populated celebrated
2. Urban Communities: cities; non- o There is a diverse and
agricultural by nature innovative economy
3. Suburban or “rurban” or the o There is a sustainable use of
capitals available resources for all

Used for basis of the action the nurse will

CHARACTERISTICS OF HEALTHY take
COMMUNITY (to know standards)
o Awareness that “we are a ADPCN (Association of Deans of
community” Philippine Colleges of Nursing) 10
o Conservation of natural CHARACTERICTICS OF HEALTHY COMMUNITY
resources (If limited, not a 1. Members are aware of their own
healthy community) health and biologic status
o Recognition of and respect for (knows if they are healthy or
the existence of subgroups not)
o Participation of subgroups in 2. Members give credit to the
community affairs governing authority (leaders:
o Preparation to meet crises mayor/chairman)
o Ability to solve problems o Formal leaders
o Communication through open ▪ Through ELECTION:
channels mayor, president,
o Resources available to all senators, kagawad,
o Settling of disputes through SK
legitimate mechanisms (going to ▪ Through APPOINTMENT:
court) by the president like
o Participation by citizens in nurses, cabinets
decision-making (public o Informal leaders
consultations) 3 ways:
o Wellness of a high degree among
▪ Through SENIORITY
its members (not sick and ill) (elderly)
▪ Through CHARISMA
HEALTHY VILLAGES: A GUIDE FOR
(priests/imam;
COMMUNITIES AND COMMUNITY HEALTH
religious leaders)
WORKERS (WHO)
▪ Through SKILLS
Characteristics of a healthy (nurses/doctors:
have specific skills
community
o The physical environment is needed to become a
clean and safe leader in the
o The environment meets everyone’s community in terms of
basic needs health)
o The environment promotes social ▪ Also, like barangay
harmony and actively involves tanods (barangay
everyone auxiliary
o There is an understanding of the volunteers; no
local health and environment official
issues appointment)
o The community participates in 3. The natural and biological
identifying local solutions to resources are open for everybody
local problems but the consumption is
o Community members have access to controlled to help in preserving
varied experiences, interaction these resources
and communication o Law of conservation
 o Cannot allow to destroy or consideration of the
selfish use of resources individual, family,
of community community)
o Ex. Botika o Acceptability (health care
o Consumption should be services should be
controlled compatible with culture,
o Resources belong to tradition, or religion)
everybody in the community 10. Everyone is working to
4. A healthy community has a strong attain healthy citizenry
and reliable governing body o Independent health care
5. People work together to attain (health in the hands of the
independence people)
o Self-reliant o Related to number 5
o Self-sustaining
6. Environmental and physiologic COMMUNITY HEALTH
needs are sustained by the
families Part of paramedical (work related to
o Independence medical/health) ex. firemen, health
o Support teachers, traffic enforcers
o Community can sustain your
needs Medical: nurses, doctors, physical
o Important facilities therapists, medical technologists
(hospitals) respiratory therapists
7. Parents and guardians serve as
role models for their children Nurse: utilize the nursing process;
o Considered as no specialization; nurses in the
reinforcements community are considered as
o Allow you to act this way GENERALISTS
because you’re doing these
things ANALYSIS
o Actions of children based
on parents/guardians
8. People are concerned with their
health status
o Related to number 1 and 5
o Awareness and attain
wellness and independence
as well
o Salience (awareness of
problem and needs to be
addressed)
o Attain optimum level of
wellness Individual:
9. Health needs are accessible and o accessing services (clinic
affordable to the public and visit)
free to the indigent o health care visit in homes in
4 A’s the community (home visit)
o Availability (are health
service offered in health Magnitude: how many experiences the
facilities?) problem (aggregate or population
o Accessibility (the focus; greatest good for the greatest
distance/travel time number)
required; the home must be
at least 30 minutes away
from the barangay station)
o Affordability (cheap or
free to the indigent;
COPAR COMMUNITY ORGANIZING AND 2. Working with the people
PARTICIPATORY ACTION RESEARCH collectively and efficiently on
their immediate needs
COMMUNITY ORGANIZING o group of people
o Social development method – o consider resources, time,
develop; improve social system effectivity (don’t let it
of community (refers to people go to waste)
in community as a whole) used to 3. Mobilizing the people to develop
facilitate in forming their capability and readiness
▪ Self-reliant to respond and take action on
▪ Self-determining their immediate needs to solve
▪ Self-sustaining their long-term problems
= independence o Active as trainers
o Mobilize, empower people,
COMMUNITY DEVELOPMENT empowering community
o Addresses livelihood and o Developing their
critical concerns aside from capabilities because of
health concerns in the community long-term problems for
for us to be ensured that the long-term solutions
community will be self- reliant,
self-determining, and self- Community Organizing Goal
sustaining. People empowerment for self-efficacy,
o Ensure that community attained self-confidence to overcome their
optimum wellness before leaving powerlessness and develop their
community. capacity and maximize self-control
o Those other factors/concerns can o Awareness building
affect health conditions of the o Mobilizing
community. o Identify organizations that can
o Making resources available to serve community
all
Achieve optimum level of wellness
(Ross, 1993) defined community
organizing as a process by which the Seeks to secure long and short-term
community: improvements in improving quality of
1. Identifies its needs or life (sustainable)
objectives
2. Orders or ranks these needs or COMMUNITY DIAGNOSIS (CDx)
objectives
3. Develops the confidence and will GOALS:
to work at these needs and o People Empowerment
objectives o Improved Quality of Life
4. Finds the resources
(internal/external) to deal with FACTORS AFFCETING HEALTH OF THE
needs and problems COMMUNITY (affecting OLOF: Optimum
5. Takes action concerning needs Level of Functioning)
6. Develops cooperative and o Political influences – power and
collaborative attitudes and authority to regulate the
practices in the community environment/community
(related towards one goal) o Health care delivery system –
primary health care (promotion
ACTIVITIES INHERENT IN COMMUNITY of health): partnership approach
ORGANIZING (nurse and community); levels of
1. Educating the people to develop prevention (primary-secondary-
critical awareness of their tertiary)
existing conditions (awareness) ▪ Promotion and prevention
of disease
 ▪ Effective promotion of
services using community
sources
o Behavioral components – culture,
morals, norms, habits, ethnic
customs
o Socioeconomic influences –
employment, education, housing
o Environmental influences – air,
food, water waste, urban/rural
noise, radiation, pollution
o Heredity – genes, genetic
endowment (defects/strength);
can be affected by ethnicity,
race, family

DETERMINANTS OF HEALTH
1. Income and social status
2. Education
3. Physical environment
4. Employment and working
conditions
5. Social support networks
6. Culture
7. Genetics
8. Personal behavior and coping
skills
9. Health services
10. Gender
 MIDTERMS Collection-Collation-Synthesis-
Analysis-Interpretation
COMMUNITY
o Primary client of community Active participation of community
health nursing (Spradley, 1990) people bringing about change to improve
o Direct influence their quality of life (independent
o Level where most health service community: self-reliant, self-
provision occurs sustaining, self-determining)

COMMUNITY DIAGNOSIS 2 IMPORTANT PARTS:

o A profile 1. The nurse collects data about the
o A process community in order to identify the
different factors that may
As a PROFILE, it is a description of directly or indirectly influence
the community’s state of health as the health of the population
determined by physical, economic, 2. The nurse proceeds to analyze and
political and social factors seek explanations for the
occurrence of health needs and
It defines the community and states the problems of the community
community problems
Why undertake community diagnosis?
Purpose: to be able to obtain a quick o To have a clear picture of the
‘picture’ of a community’s state of problems of the community and to
health which is as accurate as possible identify the resources available
to the community people
A community profile should: o Community diagnosis enables the
o Summarize information nurse/program coordinator to set
o Present results and figures priorities for planning and
clearly (tallied information; developing programs of health
graphical presentation of data) care for the community. The data
o Be useful for planning and gathered through the process
monitoring (baseline) serve as the material for analysis

As a PROCESS, it is a continuous COMMUNITY ASSESSMENT – keystone of

learning experience for the community health nursing process
nurse/program coordinator and the
staff, as well as the community people UTILIZATION OF DATA – the nurse
for the following reasons: utilizes these assessment data to
o It enables the nurse/program derive the community health nursing
coordinator/staff to adjust or diagnoses and become the bases for
alter the program for optimum developing and implementing community
effectiveness (modify) health nursing interventions and
o It allows the community to strategies
gradually become aware of the
solution (not aware of ECOLOGIC APPROACH TO THE COMMUNITY
solution/how to address) DIAGNOSIS
o It is an organized attempt to o Community is a product of the
involve people in recognizing and various interacting elements such
resolving problems that concern as population, the physical and
them most (salience) topographical characteristics,
o It enables the community to socio-economic and cultural
understand at its own pace the factors, health and basic social
potential advantages to change, services and the power structure
which may eventually lead to within the community
alterations in attitudes, values, o The interrelationship of these
and behavior (nurses become role elements will explain the health
models)
 and illness patterns in the Nurse starts by investigating the
community meaning of the population to the
o Payne (1965) attributes much of community people, proceeds to
the failure to address the health identifying the population affected by
problems of the community to this the hazards of the mine tailings, and
lack of ecologic approach then goes to characterize the
o Community health problems are environmental factors and other
often viewed as technical elements relevant to the problem
solutions without regard to the
interrelatedness of all factors ✓ Before data are collected, the
and forces that are bearing down community diagnosis objectives
on community health must be determined as these will
o According to Freeman and Heinrich direct the depth or the scope of
(1981), community health the community assessment
diagnosis is based on three
independent, interacting and The community is NOT a passive
constantly changing conditions: recipient of care. It Emphasizes active
1. The health status of the compliance of the client
community, including the
population’s level of The nurse works WITH and not for the
vulnerability community.
2. Community health capability or
the ability of the community to WHEN IS THE COMMUNITY’S PARTICIPATION
deal with its health problems REQUIRED? – at the start
3. Community action potential, or The community’s involvement starts
the patterns in which the early during the assessment phase to
community is likely to work on create awareness of their health needs
its health problems and problems

THE COMMUNITY COMMUNITY’S participation in the

a. A Place community diagnosis develops their
b. A People commitment and enthusiasm
c. A Social System
The nurse is a facilitator working in
TYPES OF COMMUNITY DIAGNOSIS a team composed of community members
The types of a community diagnosis may and leaders.
vary according to:
✓ The objectives or degree of detail The nurse must ensure the community’s
or depth of the assessment input in the community diagnosis
✓ The resources, and considering their capacities and
✓ The time available for the nurse limitations but enough with room to
to conduct the community develop their potentials
diagnosis
RAPID APPRAISAL
A. COMPREHENSIVE COMMUNITY DIAGNOSIS ✓ allows to gain a general
– aims to obtain general impression of the community
information about the community ✓ exploratory in nature
or a certain population group ✓ it can provide direction and
B. PROBLEM-ORIENTED COMMUNITY focus for the actual community
DIAGNOSIS – type of assessment diagnosis
that responds to a particular need ✓ an opportunity for the nurse to
(Spradley, 1990) immerse in the community and get
to know its problems, issues and
Example: a nurse was confronted with concerns that will contribute in
health and medical problem resulting shaping the plan for subsequent
from mine tailings being disposed into community organizing process
river systems by a mining company. ✓ it is participatory
STEPS IN CONDUCTING COMMUNITY DIAGNOSIS ▪ De jure
1. DETERMINING THE OBJECTIVES
2. DEFINING THE STUDY POPULATION ENSURE THAT THE FOLLOWING DESIRED
3. DETERMING THE DATA TO BE COLLECTED QUALITIES OF DATA HAS BEEN MAINTAINED:
4. DETERMINING METHODS OF COLLECTING ✓ Timeliness of data,
DATA ✓ Completeness,
5. DEVELOPING THE INSTRUMENT ✓ Accuracy, (correctness)
6. ACTUAL DATA GATHERING ✓ Precision, (same result)
7. DATA COLLATION ✓ Relevance and
8. DATA PRESENTATION ✓ Adequacy
9. DATA ANALYSIS
10. IDENTIFYING THE COMMUNITY 4. DETERMINING METHODS OF COLLECTING
HEALTH NURSING PROBLEMS THE DATA
11. PRIORITY SETTING
✓ Method of data collection
✓ Instruments/tools
OPD-MIG-CPAPP
Objectives, population, data-methods,
OBSERVATION
instrument, gathering-collation,
presentation, analysis, problems, ✓ Behavior
priority ✓ Environment
✓ Validation of verbal statements
1. DETERMINING THE OBJECTIVES: ensure ✓ Nurse may use tools (weighing
that objectives will answer these four scale, sphygmomanometer)
questions ✓ May have limitations when
✓ What is the present health observation is limited to a
condition of the people in the specific period of time
community? ✓ Historical or timeline approach:
✓ Why are the people in the ask elders/head of the community;
community in such condition? What recall past activities
specific problems are causing ✓ OCULAR SURVEY: whatever you can
these conditions? see while walking will be
✓ What are the roots of these documented as part of assessment.
problems? No need to go into details yet
✓ What solutions will address the ✓ WINDSHIELD SURVEY: inside the car
problems? ✓ PARTICIPATORY OBSERVATION: to
know the ways, prevent having
2. DEFINING THE STUDY POPULATION artificial behavior from the
✓ Identify the population group to family and individual
be included in the study ▪ Be careful with the
✓ It may include the ENTIRE “artificial” behavior
POPULATION in the community or
focused on a SPECIFIC POPULATION INTERVIEWS
GROUP ✓ Involves asking and answering
Additional: questions following a systematic
o Legit street dweller (nomad, no procedure
permanent address) not included ✓ Face to face interaction
in study population: makakasira ✓ Can be individual or group
sa data interviews
o Informal settlers are included ✓ Key informant interview
(make shift houses). 1 barong- ✓ Structured interview
barong = 1 household ✓ Unstructured interview

3. DETERMINING THE DATA TO BE COLLECTED FOCUS GROUP DISCUSSION

✓ Data ✓ Qualitative research technique
✓ Sources ✓ Understanding and documenting
▪ De facto: sino madatnan, human behavior
siya recorded
5. DEVELOPING THE INSTRUMENT ✓ Desired qualities of information
a. Survey questionnaire are acquired
b. FGD guide
c. KII guide 7. DATA COLLATION
d. Observation checklist Categorizing Data

SURVEY QUESTIONNAIRE ✓ Two types of data

✓ Survey instrument o Numerical
✓ Interview schedule o Descriptive
✓ Self-completed or self-
administered questionnaire ✓ Fixed response questions
HONEST ▪ Numerical data
COMPLETE ▪ Question with options
ACCURATE ▪ Answers will be limited
✓ Open ended questions
FOCUS GROUP DISCUSSION GUIDE
✓ Serves to facilitate the Summarizing Data
direction and flow of exchange of Tallying – manually or through use of
ideas on specific topics or computer (application)
concepts among the participants
EXCLUSIVE: 5 options, only one answer
KEY INFORMANT INTERVIEW GUIDE EXHAUSTIVE: 20 options, may provide
✓ Helps give direction to the nurse several answers
doing the interview using a set
of prepared questions on a very To know what could be tallied
specific subject
8. DATA PRESENTATION
OBSERVATION CHECKLIST ✓ Graph/tables for numerical
✓ List of data that are ✓ Narrative reports for descriptive
manifestations or indicators of a (telling stories)
health need or problem ▪ Geographic data (location,
boundaries)
6. ACTUAL DATA GATHERING ▪ History of
✓ Pre-testing of the instrument barangay/community
✓ Data collectors are oriented and ▪ Healthy activities of
trained community
✓ Role play may be done ✓ Presented to the community people
▪ Practice questioning using and make sure that it would easily
the tool be understood and pleasant to the
✓ Use of participatory tools and eyes
techniques ✓ Graph should be applicable
▪ Games/storytelling and data
are being collected
▪ Workshops
▪ Diagrams
✓ Do all members of the team
understand different variables of
the instrument?
✓ To know whether there is a need
to modify or difficulty with the
members of the team for it to be
simplified
✓ To have same level of
understanding with the
tool/instrument ✓ Graph will depend on the data,
data will depend on the questions,
 questions will depend on the 1. How are the main or central issues
diagnosis (goal) or problem related to one another?
– to know relatedness of one
9. DATA ANALYSIS information/problem to another
✓ The most crucial stage in 2. Which if the problems seem to be
community diagnosis the most serious or needing urgent
✓ Quantification, description, and attention? – data analysis will
classification of data help us identify what is the
✓ Process information priority nursing problem
✓ Calculate (memorize equations) 3. Among the roots of the problem,
✓ Relate information because there which are the easiest to address?
are data that are related to each Which is the most difficult? –
other (like Gordon’s) = analyzing prioritize
✓ Demographic data to socioeconomic 4. Which of the effects should not
status to health beliefs be allowed to continue –
✓ Sort and classify according to effect/implications
relatedness 5. What could possibly happen if
nothing is done? –
✓ Look for significance,
effects/implications
implications, reasons and relate
6. What should be done?
information to another
information
10. IDENTIFYING THE COMMUNITY HEALTH
✓ Look for standards (books,
NURSING PROBLEMS
references). Conduct interviews
✓ Health status problems
with key informants
▪ Increase in
✓ Identify extent of problems,
morbidity/mortality/fertili
magnitude of the problems
ty and other health related
✓ Who are involved in the data
matters
analysis? – nurses and
✓ Health resources problems
participants (community people)
▪ Nurses, doctors, things that
▪ Representatives of
can be used by the community
different sectors of the
people for them to access
community
health services
▪ Still collect information
(transportation, money)
which will supply the gaps
▪ Lack of resources cause
✓ Simplified Analysis – Problem
people not to access health
Tree Analysis Approach
services
▪ Trunk: main problems
✓ Health related problems
▪ More problems, more trees
▪ Social, economic,
environmental, political
factors that aggravate
people in the community
▪ Causes issues
o PRECED-PROCEED model
o Ecologic model (interaction of
environment to individual)

11. PRIORITY SETTING

a. Nature of the problem – health
status problem, health resources
problem, health related problems
(foreseeable crisis)
b. Magnitude of the problem -
tallying
c. Modifiability of the problem –
probability of eradicating the
problem; consider sources of the
 nurses and the community to be B. SOCIO-ECONOMIC AND CULTURAL
used to solve the problem VARIABLES
d. Preventive potential –
preventions if problems are 1. Social Indicator
solved; control possible effects a) Communication network
of problem in case it will be b) Transportation system
solved c) Educational level
e. Social concern – perceivable; d) Housing condition
salience; are CHNs considering
this problem to be solved? 2. Economic Indicator
a) Poverty level/income
Modifiability/preventive potential: b) Unemployment and underemployment
justification is needed; judgement rates
c) Proportion of the total
economically active population
that are salaried and wage earners
d) Typed of industry present in the
community
e) Occupation common in the
community
f) Land ownership
g) Recreational facilities

Cultural Factors
a. Variables that may break the
people into groups within the
community
▪ Ethnicity
What are the ELEMENTS of a ▪ Social class
comprehensive community diagnosis? ▪ Language
According to the Dones, as cited in ▪ Religion
Maglaya (2009), the following are ▪ Race
elements of a comprehensive community ▪ Political orientation
diagnosis: b. Cultural beliefs and practices
A. DEMOGRAPHIC VARIABLE c. Concepts about health and illness
B. SOCIO-ECONOMIC AND CULTURAL d. Other factors that may directly
VARIABLES or indirectly affect the health
C. HEALTH AND ILLNESS PATTERNS status of the community
D. HEALTH RESOURCES
E. POLITICAL/LEADERSHIP PATTERNS C. HEALTH AND ILLNESS PATTERNS
▪ Leading causes of morbidity
A. DEMOGRAPHIC VARIABLE
▪ Leading causes of mortality
Size, composition, and geographical
▪ Leading causes of infant
distribution:
mortality
✓ Total population and geographical
▪ Leading causes of maternal
distribution
mortality
✓ Age and sex composition
▪ Leading causes of hospital
✓ Selected vital indicators
admission
(epidemiology and vital
statistics; equations)
✓ Patterns of migration (movement
form one place to another)
✓ Population projections (rise and
fall of population; anticipation)
✓ Population groups with special
needs
 COMMUNITY HEALTH NURSING 2 o Compound- two nuclear families
FINALS ▪ One head of the family
▪ If there are two heads these
o To interpret a table, you only are two nuclear families
have to narrate what is in the o Blended- two divorced parents
table live together
o Or you may only include the o Dyad- two people
o Head of the family- bread winner,
highest and the lowest
frequencies person who is asked if there are
decisions to be made
▪ Significant value
o But If you are asked to interpret ▪ The decision maker
data, it is now analysis o The number of tools will be given
depending on the number of
▪ Comparable to deductive
families within a household
reasoning, we have to look
at what is behind that
certain variable, the reason
why that data turned out to
be
▪ Explain the reason why
▪ Look for possible reasons
▪ This can be answered through
RRLs, news, authorities,
Philippine Statistics
Office records
o Other methods of data collection
▪ Records review
▪ Observations
▪ Focused group discussions
➢ You also get the
chance as to why a
certain data came out
to be like that
➢ To explain why is
there such occurrence
o Health implication
▪ What will happen is this
current will continue? What
will be its effect to the
community?
▪ You can also use information
coming from references and
sources which may explain
what will happen
▪ E.g., garbage collection,
what will happen if this
only occurs at a certain
time

Definitions
o Households- the number of houses
o Nuclear- parents and children
▪ There is only one head of
the family
o Extended- parents, children,
grandparent or other family
members