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KMID : 0388519900020010005
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Nursing Science - Ewha Womans University
1990 Volume.2 No. 1 p.5 ~ p.22
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An Inner-City Community Health Nursing Service Project
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Pope Marion
Han Young-Ran
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Abstract
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All people aspirfe to life of health from birth to death. Health is both a right and a responsibility. Health as a human right is expressed in the WHO stated purpose of "Health for All by the Year 2000." In Korea an unequal distribution of health services is related to the ever increasing cost of medical care due to the professionalization of health services, the costly training and education of health care professionals and the soaring costs of medical equipment.
It is now generally accepted that the health care wanted and needed by the people is first and foremost the activation and expansion of equally accessable primary health care.
This study was carried out by the nursing staff of the Community Health Nursing Clinic of the Social Welfare Centre of Ewha Womans Uni versity. The research problems included the identification of principles from theories supportive of community health nursing services and of criteria from these theories useful for the evaluation of the services and as objectives to guide future services : the description of the development of the services with a selected community group over a three year period : the evaluation of those services using the criteria developed from the theories : and the recommendation of guide-lines for the planning and practice of these and similar community health nursing services. The purpose was to develop a community health nursing model for the expansion and activation of primary health care.
The population was a group of women living with their families in a crowded poor area in one district in the Mapho area of Seoul. The women had organized as a mothers association to strength-en their autonomy and decision-making power.
The study describes the process whereby the nurses and women worked together from 1987 to 1989 and how the women changed to become active and critical participants in decision making about their health and, the nursing services.
A theoretical framework was developed to support and guide the practice using Rogers Science of Unitary Human Beings, concepts of Primary Health Care from Health for All by the Year 2000, the health challenges, promotion mechanisms and implementation strategies of the Framework for Health Promotion of the Canadian Ministry of Health and Welfare and principles from the Ottawa Charter for Health Promotion.
Four criteria for evaluation of the nursing services were developed from the concepts And principles of the theories. They were : 1. That a nursing theory worthy of providing a world view of the complexity of interrelationships between the human and environmental fields involved in community health nursing ?the Science of Unitary Human Beings suplemented by concepts from Primary Health Care and Health Promotion -- be used to direct services ; 2. That the people of a community participate in full partnership with service agencies in making decisions regarding the planning, provision and evaluation .of their health care : 3. That both the nurses and people be empowered ; and 4. That the community health services be strengthened.
Evaluation using the criteria demonstrated the effectiveness of the services in achieving the valued objectives of theory-directed care, empowennent and participation with this population, but relative ineffectiveness in achieving change in official public health policies which would strengthen services or promote a more healthy environment. The four criteria were proposed for use in building more concrete objectives for community health nursing services and the process as helpful for developing future services.
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