University of Baghdad
College of Nursing
Community Health Nursing Department
          Dimensions of Community Health Nursing
                               Prepared by:
                           Ahmed Abbas Darjal
                              Supervised by:
                        Prof. Dr. Arkan Bahlol Naji
Dimensions of Community Health Nursing
Dimensions of community health nursing is a model designed to incorporate
public health concepts in to CHN practice, including the nursing process and the
levels of prevention.
The model consists of three elements:
   1. The dimension of health
The dimension consists of six categories of factors that determine the population’s
health and can be used to organize community health assessment.
A. The biophysical dimension
Age and developmental level, Genetic inheritance, Physiologic function.
B. The psychological dimension
Internal psychological environments (ability to cope with stress). External
psychological environments (stressful life events).
C. The physical environmental dimension
Physical environment (weather, geographical locale). Environmental hazards
(exposure to pathogens, allergens, and pollution).
D. The socio-cultural dimension
  •   Social structure: employment, economic, politic.
  •   Social norms: culturally accepted behaviors.
  •   Social attitude: stigma attached to HIV infection.
  •   Social action: legislation to immunization.
E. The behavioral dimension
  •   Dietary practices
  •   Recreation and exercise
  •   Substance use and abuse.
  •   Sexual activity
F. The health system dimension
  •   Availability
  •   Accessibility
  •   Affordability
  •   Appropriateness
  •   Adequacy
  •   Acceptability and use
  2. The dimension of health care
The dimension that covers the plan for the nursing intervention to the identified
health needs and problems:
This care includes:
  1. Primary prevention: prevention of the occurrence of a condition or a
      problem, health promotion, illness and injury prevention.
  2. Secondary prevention: screening, diagnosis, and treatment
  3. Tertiary prevention: prevention of consequences, prevention of recurrence
      of the problem.
  3. The dimension of nursing
It includes:
  A. Cognitive dimension: knowledge.
  B. Interpersonal dimension: effective elements that include attitudes and
     values of the community health nurse. They effect the ability to practice and
     interaction skills of communication and collaboration.
  C. Ethical dimension: ethical decision making according to morals and ethical
     principles.
  D. Process dimension:
  1. Nursing process.
  2. Epidemiological process.
  3. Health education process.
  4. Home visits process.
  5. Case management process.
  6. Change process.
  7. Leadership process.
  8. Group process.
  9. Political process.
  E. Skills dimension:
Manipulative skill (the ability to perform). Intellectual skill (capacity for critical
thinking).