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All professional disciplines are based on a unique body of knowledge that is expressed through conceptual models and theories that guide practice. The hallmark of professional nursing is theory based nursing. Community oriented nursing practice blends nursing and public health theory into a population-focused practice to promote and preserve the health of communities.

Theory is a set of interrelated concepts or hypothesis that seeks to explain or predict phenomena. Model is a description or analogy used as a pattern to enhance our understanding of something that is known.

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Community oriented, population focused

Community orientation is a process that is actively shaped by the unique experiences, knowledge, concerns, values, beliefs, and culture of a given community Population focus implies that a nurse uses population-based skills such as epidemiology, research in community assessment, and community organizing as the basis for interventions

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Nightingales Theory of Environment Orems Self Care Model Neumans Health Care Systems Model Rogers Model Of The Science Of Unitary Man Parsers Human Becoming Theory Penders Health Promotion Model Roys Adaptation Model

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Milios Framework For Prevention Salmon Whites Construct For Public Health Nursing Minnesota Wheel The Public Health Interventions Model Omaha System Model Block and Jostens Ethical Theory Of Population Focused Nursing Canadian Model For Community

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Focused on preventive care for populations Nightingale used observations to validate her hypothesis
Poor environmental conditions are bad for health Good environmental conditions reduce disease

Others have added social services and health care in addition to environment

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Communities can be considered to have a collective set of self-care actions and requirements that affect the well-being of the total group Self-care deficit: demand exceeds client abilities related to

Universal requirements Developmental requirements Health deviation requirements

Nursing care supports client

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Based on systems theory Whole is greater than the sum of the parts Three principles:
1. 2. 3.

Life proceeds in one direction along a rhythmic spiral Energy fields follow a certain wave pattern and organization Human and environmental energy fields interact simultaneously and mutually, leading to completeness and unity

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Originally Man-living-health theory Three themes:

1. 2.

3.

Meaning Rythmicity Transcendence

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Premise: Behavioral patterns of populations are a result of habitual patterns and limited choices Challenged lack of knowledge concept Proposed that government and institutional choices set the range of options for aggregate and individual choices

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Categories of nursing interventions

Education directed toward voluntary change in the attitudes and behavior of the subjects Engineering directed at managing risk-related variables Enforcement directed at mandatory regulation to achieve better health

Interventions target determinants in four categories:

human/biologic, environmental, medical/technologic/organizational, and social

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Three essential elements of population focused nursing An obligation to population The primacy of prevention Centrality of relationship - based care. The first two are from public health and the third element from nursing.

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Basis for the Canadian Community Health Nursing Practice Model

The values and beliefs of Community Health Nurses The community health nursing process
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1.

2. 3.

4.
5. 6. 7. 8.
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Use a comprehensive and systematic process Work in partnership with the people Focus on primary prevention Promote a healthful environment Target all who might benefit Give priority to community needs Promote optimum allocation of resources Collaborate with others in the community
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Communication technology Genetic engineering Global economy Migration Terrorism and bioterrorism Climate changes

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