HEALTH

What is health? The WHO defined health as "a state of complete physical, mental, and social well-
being and not merely the absence of disease or infirmity." Nursing theorists also contributed to defining
health. It must be noted that these definitions are focused on the individual. There is a need to come up
with the definitions of healthy families and healthy communities.

WHO's health definition was met with criticism because it is more of an ideal rather than a goal. We
must acknowledge the fact that health is the outcome of the dynamiNursing Theory | Nurse Keyc
interaction among different factors, many of which are beyond the control of the individual. With this in
mind, let us define health in a way that will include the ability of the individuals, families, and/or
communities to do something about the factors that adversely affect their health, make decisions about
seeking help, and effectively cope with situations that affect their health. Thus, for so many years
community and public health nurses used Dunn's (1961) classic concept of wellness, in which family,
community, society, and environment are interrelated and have an impact on health. From his
perspective, illness, health, and peak wellness are on a continuum; health is fluid and changing.

Foundations: Experiencing Health and Illness Flashcards | Quizlet

Reading Assignment: Health as a Human Right page 4-6

Components of Right to Health

1. Availability- operational public health and channels of service delivery, products, services,
programs be adequate for all.

2. Accessibility - health facilities, services, and goods must be made possible and obtainable to
everyone; non-discriminatory, physically accessible, affordable, information accessible

3. Acceptability - respect for the medical ethics, being culturally appropriate and gender-sensitive;
people-centered services, accommodates the specific needs of diverse groups
 4. Quality- health facilities, commodities, and services must be in accordance with specific and medical
standards; safe, effective, people-centered, timely, equitable, integrated, and efficient.

1987 Philippine Constitution, Article II Section 11 and 15: Health is a fundamental human right. The state
has the obligation to protect and promote the right to health of all Filipinos. This leads to the
establishment of the Department of Health (DOH), which works hand in hand with various sectors to
achieve its vision. "Filipinos are among the healthiest people in Southeast Asia by 2022, and in Asia by
2040".

MODELS OF HEALTH

Clinical Model - health is the absence of signs and symptoms of disease and illness and refers to its
presence.

Role Performance Model -health is the ability to perform societal roles

Adaptive Model - health is a dynamic state. The ability to adapt to change.

Eudaimonistic Model - wellness suggests optimal health and illness is reflected by lack of vitality. It is the
interaction of the different facets of life and environment that leads to goal attainment that creates
meaning and purpose in life.

DETERMINANTS OF HEALTH AND ILLNESS

A person's health is determined by his circumstances and environment. It is inappropriate therefore

to blame or credit the person's state of health to himself alone because he is unlikely able to directly
control many of these factors. However, knowledge of these factors is important in order to effectively
promote health and prevent illnesses. It is also important to note that in understanding the
multidimensional nature of health, the public health nurse will now be in a better position to plan and
implement health-promoting interventions for individuals and communities.
 It is essential for the nurse to understand the determinants of health and recognize the interaction of
the factors that lead to disease, death, and disability.

Biology is an individual's genetic make-up (heredity), family history, and any physical and mental health
problems developed in the course of life.

Behaviors are the individual’s response to internal stimuli and external conditions. Behaviors interact
with biology in a common relationship, as one may affect the other.

The social environment includes interactions and relationships with family, friends, coworkers, and
others in the community. Social institutions (law enforcement, religious communities, schools,
government agencies, housing, transportation, resources) has a great impact on health.

Physical environment refers to what is experienced by the senses. Ex. Sanitation

Policies and interventions can have a profound effect on the health of individuals, groups, and
communities. These are formulated and implemented by the different government agencies such as
DOH, DepEd, DILG, DOT, NHA.Ex. No smoking, wearing of seat belts, litter ordinances, enhanced health
care.

Some of these factors can be changed others cannot. Other factors may require policy to accomplish
the changes needed. Public health nurses must work with policymakers and community leaders to
advocate for activities and policies that promote health at the individual, family, aggregate, and
population levels.

The determinants of health can be further explained using the Optimum Level of Functioning (OLOF).
OLOF is a framework that describes how individuals, families, communities, and populations are being
influenced by several factors.

Optimum Level Of Functioning In Community Health Nursing

The Social Determinants of Health

 Social determinants of health are “conditions in which people are born, grow, live, work and age;
might also be circumstantial elements as such housing, work conditions, and access to recreational
activities; circumstances that influence how an individual will develop sickness, what risk factors they
are exposed to, how they access services, and how they utilize the appropriate services; and is shaped
by the distribution of money, power, and resources at global, national and local levels”

- may also include occupation, circumstances affecting the way in which people work, income, culture,
religion, education, racial and gender discrimination.

One Health Concept: A framework for community and public health nursing

One Health Concept is an effective response to the threats of Emerging Infectious Diseases (EIDs). It
recognizes the connection between human, animal, and environmental health. The One Health Concept
calls for a consolidated interaction between human health, veterinary medicine, and public and
environmental health professionals, clinicians, researchers, and agencies functioning hand in hand for
worthwhile and sustainable health interventions in addressing worldwide and environmental health
challenges.

Some of the Once Health Concept in the Philippines are the National Rabies Prevention Control
(NRPCP), Avian Influenza Protection Program (AIPP), and the Philippines Inter-Agency Committee on
Zoonoses. Agencies that are involved in Once Health Concept should collaborate and coordinate in
making any programs that are geared towards control and eventual elimination of emerging and
reemerging diseases a success.

ACTIVITY 1. PROCESS QUESTIONS

 1. As a student nurse, in what ways can you help the country achieve this health goal: "Filipinos are
among the healthiest people in Southeast Asia by 2022, and in Asia by 2040"?

2. Among the 5 listed categories of determinants of health, choose 1 for each category and opposite
write a rationale for how it could lead to disease, illness, or death.

ex. Biology: Family history - (rationale)

3. Using the OLOF, explain how components can affect the health of the individual, family, and
community.

Submit your output here: ACTIVITY 1

HISTORICAL BACKGROUND OF PUBLIC HEALTH NURSING

The word "public health nursing" was coined by Lillian Wald when she was the director of the Henry
St. Settlement in New York City to denote a service that was available to all people. With the
involvement of the federal, state, and local governments in the delivery of health services, the term
public health nursing became associated with "public" or government agencies and in turn with the care
of the poor people.

In a move to redefine the practice of public health nursing in the Philippines, the National League of
Philippine Government Nurses came up with the Standard of Public Health Nursing in the Philippines
2005. The Standards differentiated public health nursing and community health nursing through their
field of work as dictated by funding. The government is the employer of public health nurses both at the
national and the local health agencies. Position title or designation given to these nurses by the Civil
Service Commission working in these agencies is Public Health Nurse. Hence, Public Health Nurses refers
to the nurses in the local/national health departments or public schools whether their official position
title is Public Health Nurse or Nurse or School Nurse.

STANDARDS OF PUBLIC HEALTH NURSING IN THE PHILIPPINES

Theory -Applies theoretical concepts as a basis for decisions in practice

Data Collection -Gathers comprehensive, accurate data systematically

Diagnosis -Analyzes collected data to determine the needs/ health problems

Planning -At each level of prevention, develops plans that specify nursing actions unique to the needs of
clients

Intervention -Guided by the plan, intervenes to promote, maintain or restore health, prevent illness and
institute rehabilitation

Evaluation -Evaluates responses of clients to interventions to note progress toward goal achievement,
revise data base, diagnoses, and plan

Quality Assurance and Professional Development -Participates in peer review and other means of
evaluation to assure the quality of nursing practice; Assumes professional development; Contributes to
the development of others

Interdisciplinary Collaboration -Collaborates with other members of the health team, professionals, and
community representatives in assessing, planning, implementing, and evaluating programs for
community health

Research -Indulges in research to contribute to theory and practice in community health nursing

ROLES AND RESPONSIBILITIES OF A PUBLIC HEALTH NURSE

A Clinician, who is a health care provider, taking care of sick people at home or in the RHU

A Health Educator, who aims towards health promotion and illness prevention through the
dissemination of correct information; educating people

A Facilitator, who establishes multi-sectoral linkages by referral system

A Supervisor, who monitors and supervises the performance of midwives

A Health Advocator, who speaks on behalf of the client

An Advocate, who act on behalf of the client

A Collaborator, who work with other health team member

 *In the event that the Municipal Health Officer (MHO) is unable to perform his duties/functions or is
not available, the Public Health Nurse will take charge of the MHO’s responsibilities.

In the care of the families:

Provision of primary health care services

Developmental/Utilization of family nursing care plan (ADPIE) in the provision of care

In the care of the communities:

Community organizing mobilization, community development, and people empowerment

Case finding and epidemiological investigation

Program planning, implementation, and evaluation

Influencing executive and legislative individuals or bodies concerning health and development

There are specific competencies and skills that the public health nurse should have. These are the
community health nursing process, nursing procedures during the clinic and home visits, community
organizing, health promotion and education, surveillance, records, and reports.

QUALIFICATIONS AND FUNCTIONS

 PHNs occupy a range of positions from Public Health Nurse I to Nurse Program Supervisors to Chief
Nurse in public health settings. The PHN can only perform his/her functions effectively if he/she:

has the necessary knowledge, skills, and attitudes in dealing with the health needs and problems of
his/her clients

is familiar with the structure and dynamics of the health care system and its broader sociocultural,
economic, and political context

is knowledgeable of laws and policies affecting the health care system in general and nursing practice in
particular and of nursing and program standards.

The standards of Public Health Nursing in the Philippines developed by the National League of
Philippine government Nurses in 2005 described the qualification and functions of a Public Health Nurse.
Public health nurse:

Must be professionally qualified and licensed to practice in the area of public health nursing.

Must possess personal qualities and “people skills” that would allow her practice to make a difference in
the lives of these people.

Functions in accordance with the dominant values of public health nurses, within the ethico-legal
framework of the nursing profession, and in accordance with the needs of the clients and available
resources for health care.

Functions of PHN are consistent with the Nursing Law 2002 and program policies formulated by the
DOH and local government health agencies. They are related to management, supervision, provision of
nursing care, collaboration and coordination, health promotion, and education training and research.

Management Function

The management function of the public health nurse is inherent in her practice. The nurse, in
whatever setting and role have been trained to lead and manage.
This function is performed when she organizes the “nursing service” of the local health agency. Plans
and organizes the nursing service, and implements the nursing service plan of the health unit.

Program management. This is a function where the PHN actually excels. A program manager is
responsible for the delivery of the package of services provided by the program to the target clientele.

Participates in the preparation and implementation of the municipal health plan

Reports the program accomplishments with proper documentation.

Supervisory Function

PHN is the supervisor of the midwives and other auxiliary health workers in the catchment area.

Formulates a supervisory plan and conducts supervisory visits to implement plan.

Conducts supervisory visits using a supervisory checklist

During the visit, the PHN together with the supervisee identifies any issue or problem encountered and
addresses them accordingly.

Coaching about technical matters (breach of protocol or procedure).

Arranges enhancement of training for the supervisee

Report of the encounter is given to the supervisee and kept in her personal file for future reference.

Nursing Function

An inherent function of the nurse. Her practice as a nurse is based on the science and art of caring

Public health nursing is caring for individuals, families, and communities toward health promotion and
disease prevention

PHN uses her knowledge and skill in the nursing process. She does assessment, plans, and implements
care, and evaluates outcomes. - Establishes rapport with her client: individual, family, or community

Conducts home visits

Implement health care plans

Evaluates nursing interventions

 Collaborating and coordinating Function

Brings activities or group activities systematically into proper relation or harmony with each other.

Care coordinators for communities and their members

Actively involved both socially and politically to empower individuals, families, and communities as an
entity to initiate and maintain health-promoting environments.

Establishes linkages and collaborative relationships with other health professionals, government
agencies, the private sector, NGOs, people’s organizations to address health problems.

Identifies persons, groups, organizations, other agencies, and communities whose resources are
available within and outside the community and which can be tapped in the implementation of
individuals, family, and community health care.

Refers patients to appropriate levels of care

Promotion and Education Function

These functions go beyond health teachings and health information campaigns. Understands that
health is determined by various factors such as physical and political environment, socio-economic
status, personal coping skills, and many other circumstances, and it is inappropriate to blame or credit a
person’s health to himself alone because he is unlikely to control many of these factors. Understanding
the multidimensional nature of health will enable her to plan and implement health-promoting
interventions for individuals and communities.

Uses her skills in advocacy for the creating of a supportive environment through policies and
reengineering of the physical environment for healthier actions.

As an educator, the nurse provides clients with information that allows them to make healthier choices
and practices.

Health educa