概述-社區(qū)護(hù)理學(xué)Introductiontocommunityhealthnursing概述-社區(qū)護(hù)理學(xué)HistoryofCommunityHealthNursing

Beforemid1800s-EarlyHomeCarewithfocusinSickandPoorindividual.Orientation:curativeagencies:lay&religiousorders*St.Phoebe

Mid1800sto1900-districtNursingwithfocusinSickandpoorindividualOrientation:curative/lessinpreventionagencies:voluntary&somegovernment*WilliamRathbone概述-社區(qū)護(hù)理學(xué)HistoryofCommunityHealthNursing

1900-1970publichealthnursing-PubicHealthNeeds,focusinfamilyandorientationinCurativeandPreventionagencies:government&somevoluntary

*LilliamWald

1970topresent-CommunityHealthNursing,focusintotalcommunityandorientedtopopulationhealth,servicesaddresshealthpromotion;illnesspreventionagencies:manykinds;someindependentpractice*RuthFreedman概述-社區(qū)護(hù)理學(xué)PublicHealthNursingDevelopmentinChina

EarlyStages:1925BeijingUnionHospital-PublicHealthAgency(Dr.Gland).1930ruralHealthEducation2000Payattentiontocityandruralareascommunitycenterdevelopmentandpracticemodel2006-2007GovernmentemphasizetheimportanceofCommunityhealth,improvecommunityhealthcenters,functions,farmerhealthinsurances。概述-社區(qū)護(hù)理學(xué)ChallengeforChina’sCommunityHealthNursingElderlycareissues2000Population2050Population概述-社區(qū)護(hù)理學(xué)ChinaAdultPopulation概述-社區(qū)護(hù)理學(xué)NationalHealthStatistics現(xiàn)有宮頸癌患者40萬人，死亡率達(dá)11.30%；宮頸癌每年新發(fā)病例約13.15萬目前的乳腺癌發(fā)病率也已經(jīng)達(dá)到了每10萬人口35—40。2007年中國糖尿病人約有3000萬。據(jù)WHO最新數(shù)據(jù)預(yù)測(cè)，到2010年中國糖尿病人將達(dá)到目前的4倍。世界衛(wèi)生組織預(yù)測(cè)，中國每年確診的新增結(jié)核病例為880萬。概述-社區(qū)護(hù)理學(xué)NationalHealthStatisticsMaternalMortalityRate48.3/10萬（2004）SkillfulProfessionalHandledelivery97％（2003）Female:malechildrenattendingschool1：1，Juniorschooladmission0.92（2002）Femalechildrenattendingelementaryschool95.8%(2002)15－25歲婦女識(shí)字率98％（2004）Newbornmortalityrate15.4/1000,2004<1yearoldinfantdeathrate：30/1000（2003）<5yearsoldchildrenmortality：37/1000（2003）概述-社區(qū)護(hù)理學(xué)TheTopFiveMajorCauseofDeathinChinaCardiovascularDiseasesMalignantTumorCerebrovascularDiseaseDiseaseofRespiratorySystemInjury、Intoxication(Nationaldata,2004)概述-社區(qū)護(hù)理學(xué)IssuesinChronicDiseasesDMHypertensionStrokeCardiovasculardiseasesObeseSmokingTB概述-社區(qū)護(hù)理學(xué)HealthBeyondAcuteCareSettings-CommunityCareandPublicHealth概述-社區(qū)護(hù)理學(xué)PublicHealthDefinitionPublichealthistheScienceandArtof:preventingdisease,prolonginglife,

promotinghealth

andefficiencythroughorganizedcommunityeffort.(Winslow,1920)概述-社區(qū)護(hù)理學(xué)DefinitionofCommunityHealth(ANA,2000）Communityhealthnursingisasynthesisofnursing

andpublichealthpracticeappliedtopromoting

andpreservingthehealthofpopulations.Treat“PopulationasaWhole”

Focusonindividual,family,groups,communityUtilizingHealthpromotion,healthmaintenance,healtheducation,andmanagement,coordination,andcontinuityofcareformeetingpopulationneeds.概述-社區(qū)護(hù)理學(xué)CharacteristicsofCommunityHealthNursingItisafieldofnursingItcombinespublichealthandnursingItfocusinpopulationandenvironmentfactorsthatmayimpacttopeople’shealthItemphasizeinhealthpromotion,illnessprevention,andwellness概述-社區(qū)護(hù)理學(xué)CharacteristicsofCommunityHealthNursingItpromotesclientresponsibilityandself-careItusesaggregatemeasurementandanalysisItuseprincipleoforganizationaltheoryItinvolvesinter-professionalcollaboration.概述-社區(qū)護(hù)理學(xué)PubicHealthisfor:Thesanitationofenvironment,Thecontrolofcommunicableinfections,Theeducationoftheindividualinpersonalhygiene,TheorganizationofmedicalandnursingservicesforTheearlydiagnosisandpreventivetreatmentofdisease,andThedevelopmentofthesocialmachinerytoinsureeveryoneastandardoflivingadequateforthemaintenanceofhealth,

HealthyLifeStyleandLongevity.概述-社區(qū)護(hù)理學(xué)概述-社區(qū)護(hù)理學(xué)CommunityHealthPracticeHealthPromotion

1.Increasethespanofhealthylifeforallcitizens

2.Reducehealthdisparitiesamongpopulationgroups

3.Achieveaccesstopreventiveservicesforeveryone.概述-社區(qū)護(hù)理學(xué)RolesofCommunityHealthNursesResearcherLeadershipCollaboratorManagerAdvocateEducatorClinicianNurses概述-社區(qū)護(hù)理學(xué)HealthPreventionTertiaryPreventionSecondaryPreventionPrimaryPrevention概述-社區(qū)護(hù)理學(xué)PrimaryPreventionforHealthPromotion

HealthEducationAdequateNutritionIndividualDevelopmentAdequateworkingenvironmentandrecreation,restingPre-marriagecounselingandeducationGeneticCounselingRegularPhysicalExamination概述-社區(qū)護(hù)理學(xué)PrimaryPreventionforHealthProtection

ComplywithimmunizationIndividualhygieneImproveenvironmentsanitaryOccupationalSafetyPreventAccidentinallagesAdequatenutritionAvoidcancercauseagentsAvoidallergic概述-社區(qū)護(hù)理學(xué)SecondaryPreventionIdentifycasesinthecommunityScreenandtestConductspecialphysicalexaminationTreatandpreventtheprogressofillnessAvoidthespreadingofdiseaseReducethedisabilitytime概述-社區(qū)護(hù)理學(xué)TertiaryPreventionTreatandstopthediseaseprogressandavoidcomplicationandsideeffectLimitthechancefordisabilityProviderehabilitationforphysicalandpsychologicalwell-being,occupationaltherapy,availabilityoflong-termcare概述-社區(qū)護(hù)理學(xué)Characteristicsofcommunityhealthnursingitisafieldofnursingitcombinespublichealthwithnursingitispopulation-focuse