Essentials of Community Health Nursing

1. The Concepts of
Community Health Nursing .................... 1
Introduction 1
Definitions of Community 1
Functions of Community 2
Concepts of Health 3
Definitions of Health 4
Relationships of Health and Illness 6
Concepts of Community Health 8
Concepts of Community Health
Nursing 11
Philosophy of Community
Health Nursing 11
Nature of Community Health Nursing 12
Definitions of Community Health
Nursing 13
Scope of Community Health Nursing 16
Goals of Community Health Nursing 19
Principles of Community Health
Nursing 22
2. Determinants of Health .......................... 25
Introduction 25
Human Biology as Determinant
of Health 25
Human Genetics 26
Preventive Measures of Genetic
Disorders 28
Lifestyle as Determinant of Health 30
Environment as a Determinants of
Health 31
Water as a Determinant of Health 33
Purification of Water 38
Chlorine Alternatives 43
Surveillance of Drinking Water Quality 45
Air as a Determinant of Health 52
Air Polution 54
Light as a Determinant of Health 58
Ventilation as a Determinant of Health 61
Noise as a Determinant of Health 63
Radiation Exposure and Environmental
Health 65
Climate as a Determinant of Health 69
Housing as a Determinant of Health 74
Disposal of Waste as a Determinant of
Health 79
Human Excreta Disposal 82
Methods of Excreta Disposal 83
Excreta Disposal in Unsewered Areas 83
Excreta Disposal in Sewered Areas 89
Sewage and its Treatment 90
Other Determinants 96
3. Epidemiology ......................................... 103
Introduction 103
Natural Life History of Disease 114
Dynamics of Disease Transmission 128
4. Communicable Diseases ...................... 139
A. Viral Diseases 139
Influenza 144
Avian Flu 146
Mumps 154
Measles (Rubeola) 156
Rubella (German Measles) 158
Viral Hepatitis 159
Smallpox (Variola) 161
Chickenpox (Varicella) 162
Dengue Fever 164
Chikungunya 168
Severe Acute Respiratory Syndrome
(SARS) 173
Trachoma 175
Rabies 178
Japanese Encephalitis 183
Kyasanur Forest Disease 187
B. Bacterial Diseases 190
Diphtheria 190
xii  Essentials of Community Health Nursing
Pertussis (“Whooping Cough”) 193
Tetanus 197
Tuberculosis 200
Leprosy 216
Meningococcal Meningitis 227
Gas Gangrene 230
Cholera 231
Typhoid 234
Diarrheal Diseases 239
Bacillary Dysentery 245
Leptospirosis 251
C. Protozoal Diseases 255
Amoebiasis (Amoebic Dysentery) 255
Malaria 257
Kala-Azar 264
D. Worm Infestations 269
Roundworm Infestation
(Ascariasis) 269
Epidemiological Features 269
Pin Worm Infestation 270
Hookworm Infestation 271
Guinea Worm Infestation 273
Filaria 275
Tapeworm Infestation 279
E. Sexually Transmitted Diseases 281
Syphilis 283
Gonorrhea 284
Chancroid 284
Lymphogranuloma Venereum
(LGV) 285
Granuloma Inguinale 285
Aids 288
5. Noncommunicable Diseases ................ 296
Introduction 296
Blindness 298
Cancer 307
National Cancer Control Programme 311
Cardiac Diseases 315
Diabetes Mellitus 322
Accidents 326
Suicide 327
6. Demography .......................................... 330
Introduction 330
Process in Demography 330
Demographic Profile 333
Demographic Rates and Ratios 333
Population Explosion 336
To Sum Up 337
Population Stabilization 338
7. Family Planning .................................... 339
Introduction 339
Spacing Methods: Non-Hormonal 345
Hormonal Contraceptives 351
Terminal Methods 352
Hormonal Methods 359
Medical Termination of Pregnancy 362
8. Evolution of Community Health ......... 370
Brief History of Community Health in
India 370
9. Health Planning and
Policies in India ..................................... 379
Introduction 379
Health Planning in India 380
Health Organization in India 401
State Ministry of Health and Family
Welfare 407
State Health Directorate 408
National Health Policy (1983) 411
National Health Policy (2002) 420
Current Scenario 422
NHP-2002 – Policy Prescriptions 429
National Population Policy (2000) 438
Health Problems of India 444
Current State of Public Health in
India 446
10. Delivery of Community Health Services
and National Health Program .............. 447
Evolution of PHC 447
Organization Chart of Primary Health
Center 449
National Rural Health Mission
(NRHM) 452
Duties of Medical Officer, Primary Health
Center 453
National Health Programs 471
National Antimalaria Program 473
Universal Immunization Program
(UIP) 479
Contents  xiii
11. Maternal and Child
Health Services ...................................... 486
Introduction 486
Maternal Health Services 505
Nursing Management in First Trimester 506
Signs and Symptoms of Pregnancy 514
Personal Hygiene in Pregnancy 516
Intranatal Care 523
Postnatal Care 542
Status of the Newborn and its Care 547
Nursing the Under-Fives 551
Protein Energy Malnutrition (PEM) 559
Vitamin A deficiency 562
Common Illness and their
Management 565
Immunization 570
Classification of Immunity 571
Immunoglobulins 573
Universal Immunization Program
(UIP) 573
Preservation of Vaccines 576
Administration of Vaccines 578
Administration of Measles and
BCG Vaccine 580
Planning and Implementation of
Immunization Session 581
12. Special Health Programs ...................... 586
School Health Program 586
Occupational Health Program 594
Community Mental Health Nursing
Program 602
13. Health Agencies .................................... 623
Voluntary Health Agencies 623
Community Audit 632
Nurse’s Role 634
Monthly Summary Report 636
World Health Organization (WHO) 637
United Nations International Children
Emergency Fund (UNICEF) 641
United Nations Development Programme
(UNDP) 646
Food and Agricultural Organization
(FAO) 647
Colombo Plan 647
14. Nursing Theories and
Nursing Process ..................................... 649
Nursing Theories and Conceptual
Frameworks 649
Community Health Nursing Process 657
Assessment 658
Community Health Diagnosis 659
Planning 662
Implementation 664
Evaluation 665
15. Community Approaches, Primary
Health Care and Health Education ..... 667
Problem-Solving Approach 667
Evidence-Based Approach 668
Primary Health Care 670
Meaning of Health for all 670
Definition of Health for all 671
Evolution of Health for all (HFA) 671
Principles of “HFA” Development 671
Definition of Primary Health Care 672
Characteristics of Primary Health
Care 672
Principles of Primary Health Care 673
Elements of Primary Health Care 674
Role of Nurses in Primary Health
Care 675
Health Education 678
Steps in Carrying out a Health
Education 689
Mass Media 693
16. Family Health Nursing .......................... 694
Family Health and Nursing 695
Home Visiting 697
Procedures Used in CHN Practice 700
Family Health Nursing Process 703
17. Disaster Nursing ................................... 717
Introduction 717
Meaning 717
Types 717
Epidemiology of Disaster 718
Factors Related to Epidemiological
Framework 718
Phases of a Disaster 720
xiv  Essentials of Community Health Nursing
Dimensions of a Disaster 722
The Nurses Role in Disasters 723
Phases of Disaster Management 724
Stages of Disaster and the Role of
Nurses 727
18. Biomedical Waste Management .......... 748
Introduction 748
Classification of Biomedical Waste 749
Sources of Health Care Waste 753
Index ............................................................... 773