CHN approaches, concepts, and roles and
responsibilities of Nursing Personnel
Definition of Community
A group of people living in a specific geographical area who share common interests, norms,
values, and are organized into a social structure to work towards common goals and meet their daily
needs through mutual cooperation.
Approaches in Community Health Nursing
In Community Health Nursing, three main approaches are used to assess, analyze, and manage the
health needs of a population:
• Epidemiological Approach
• Problem-Solving Approach
• Evidence-Based Approach
Epidemiological Approach
Introduction
• Epidemiology is the basic science of preventive and social medicine.
• It deals with the study of disease distribution and determinants in human populations.
• The Greek physician Hippocrates, often called the Father of Epidemiology, was the first to
examine the relationship between the occurrence of disease and environmental influences.
• The word Epidemiology is derived from Greek:
- Epi = among
- Demos = people
- Logos = study
“Study among people”
Definition
“The study of frequency, distribution, and determinant of disease is known as Epidemiology.”
(International Epidemiological Association)
Aims of Epidemiology
Epidemiological studies aim to:
• Determine the distribution and size of the disease problem in human populations
(e.g., prevalence of hypertension in urban areas)
• Identify etiological (causative) factors in the pathogenesis of diseases
(e.g., tobacco use as a cause of oral cancer)
• Provide data essential for planning, treatment, prevention, and control of diseases
(e.g., designing malaria control programs based on incidence data)
• Set health priorities among various health care services
(e.g., focusing on maternal health in high-MMR regions)
Uses of Epidemiology
• Describes the health status of populations
(e.g., national health surveys indicating disease burden)
Epidemiology helps in understanding the overall health condition of a specific population by
collecting and analyzing data on diseases, mortality, morbidity, and risk factors. This allows
public health professionals to identify health trends, compare groups, and monitor changes over
time.
• Evaluates health care interventions and services
(e.g., assessing success of immunization drives)
Epidemiology helps in measuring the success or failure of health programs and interventions by
comparing health data before and after implementation. This evaluation tells whether the program
achieved its goals, what improvements are needed, and how effective it was in reducing disease.
• Helps in planning of health services, policies, and programs
(e.g., introduction of new maternal health schemes based on data)
Epidemiology provides data and evidence about disease patterns, population needs, and risk
factors, which helps health authorities in designing effective services and public health programs.
It ensures that health resources are directed where they are most needed.
• Identifies determinants of disease through the Epidemiological Triangle:
- Host – e.g., age, sex, immunity of the individual
- Agent – e.g., bacteria, virus, chemical agents
- Environment – e.g., climate, housing, sanitation
Methods of Epidemiology
Descriptive Epidemiology
Definition:
Descriptive epidemiology involves the systematic collection and analysis of data to describe the
occurrence and distribution of diseases in a population in terms of time, place, and person.
Purpose:
• To identify patterns and trends in health and disease.
• To provide a foundation for further analytical studies.
Key Questions:
• What is the health problem?
• When did it occur?
• Where did it occur?
• Who is affected?
Analytical Epidemiology
Definition:
Analytical epidemiology investigates the causes and risk factors of diseases by testing
hypotheses and examining the relationship between exposure and disease outcome.
Purpose:
• To determine the cause of disease.
• To assess the strength of association between risk factors and diseases
Approach:
• Compares groups (e.g., diseased vs. healthy) to find differences in exposures.
• Common study types: case-control studies and cohort studies.
Experimental Epidemiology
Definition:
Experimental epidemiology involves the deliberate intervention by the researcher to test preventive
or therapeutic measures and observe their effects on disease occurrence.
Purpose:
• To confirm cause-effect relationships.
• To test the efficacy of interventions such as vaccines or health programs
Approach:
• Controlled trials (e.g., randomized controlled trials).
• Participants are divided into intervention and control groups.
Approaches in Epidemiology
There are two key approaches in the application of epidemiological methods:
Asking Questions
This involves systematically asking:
• What is the event?
• What is the health problem?
• Where did it happen?
• When did it happen?
• Who are affected?
• Why did it happen?
• How should activities be organized?
Purpose: To identify, analyze, and respond to the health issue effectively.
Making Comparison
This approach involves making comparisons and drawing inferences to understand disease patterns.
Comparisons may include:
• Between different populations at a given time
e.g., Comparing COVID-19 spread in China, India, and the USA.
• Between various subgroups within a population
e.g., Comparing anemia prevalence in males vs. females.
• Between various time periods or seasons
e.g., Asthma exacerbations in winter vs. summer.
• Between disease types
e.g., Epidemic vs. Endemic vs. Pandemic (e.g., Dengue vs. Malaria vs. COVID-19)
