family case cha (1)

7/28/2019 Family Case Cha (1)

1/18

Republic of the PhilippinesUniversity of Northern Philippines

Tamag Vigan city

College of Health and SciencesFamily Case Study

In partial fulfilmentfor the requirement of the subject

NCM-106Related Learning Experiences

Presented by:

Charity C. Fabie

Presented to:Mr. Vicente Unciano RN


2/18

I. IntroductionThe family is the smallest unit of the society and the natural fundamental core of the community and

consequently, it is considered as the primordial recipient of the nursing effort, which is contributory to thedevelopment, and the progress of the community through active involvement and self-responsibilities ofeach constituent. It is composed of persons, male and female, being molded to be as one, working hand inhand to maintain a good atmosphere among the family members.

The community is a group of people sharing geographic boundaries and/or values andinterest.(maglaya2004) No two communities are alike. A nurse exposed in the community to learn how tointeract and adapt to different kinds of people. Family is the basic unit of the community, all members of thefamily are empowered to maintain their health status, they must be free from disease or infirmity with nodisabilities, the health of the family is considered as a whole and not individually. It is in the family where a

member develops his health values, belief and practices. The family is a major influence in the healthbehaviours of an individual. With this, it is important that families in a community are aware of the thingsand practices pertaining to their health.

Community health nursing, a field of nursing that is a blend of primary health care and nursing practicewith public health nursing. The community health nurse conducts a continuing and comprehensive practicethat is preventive, curative, and rehabilitative. The philosophy of care is based on the belief that caredirected to the individual, the family, and the group contributes to the health care of the population as awhole. The community health nurse is not restricted to the care of a particular age or diagnostic group.Participation of all consumers of health care is encouraged in the development of community activities thatcontribute to the promotion of, education about, and maintenance of good health. These activities require

comprehensive health programs that pay special attention to social and ecologic influences and specificpopulations at risk

Im IV-B student of University of Northern Philippines College of Health Sciences are currently havingour community duty at Sto. Tomas, Sto. Domingo Ilocos Sur. And as part of our requirement I must be ableto have our family case study for us to improve their health status and become self- reliant.

Conducting a family case study is a means by which student nurse reaches and feels the communitythrough its basic structure the family. It is a tool in determining the health status of a family throughassessment and critical inspection. Through this, health related problems are identified, thus giving thestudent nurse a hint on where to act and how to intervene. It is also a means towards improving the healthof the community people, making them more productive. To come up with a family case study gives a

sense of fulfilment to a student nurse as she was given the opportunity to share their skills, knowledge andtime to alleviate and uplift the living condition of a family.

The family of Lola Martina Rayray is extended it composed of his brother Melacio Rayray andmarried to Victoria Rayray and they have 2 sons and 1 daughter. The decision maker of their family iseither lola Martina or Mr. Melacio depends on who is present in their home. The type of the familyrelationship of each other, they are talking with each other and exchange idea but sometimes there aremisunderstanding between them so there is a no conversation sometimes but after only a hour they talkwith each other again.

II. ObjectivesAfter our community duty, I will be able to:


3/18

Improve their health status and become self-reliant in maintaining their health throughappropriate interventions in a given time frame.

Help the family to identify their arising health problem.

Give health teaching regarding the prevention and to control a disease.

Establish rapport between the student nurse and the family. Guide and educate them regarding the possible solutions and preventing the arising health

problems

Identify the various health threat and stress point or foreseeable crises of the family.

III. Initial Data BaseA. FAMILY STRUCTURE AND CHARACTERISTICS:

Head of the Family: Melacio Rayray

Age: 54 y/o

Address: Sto. Tomas, Sto. Domingo

Sex: Male

Occupation: Farming

Educational Attainment: Highschool Graduate

Civil Status: Married

Religion: Roman Catholic

Members Relationshipto head ofFamily

Age Sex CivilStatus

EducationalAttainment

Religion Address

MelacioRayray

Head of thefamily

54 Male Married High SchoolGraduate

RomanCatholic

StoTomas,

Sto.Domingo

VictoriaRayray

Wife 49 Female Married High SchoolGraduate

RomanCatholic

StoTomas,

Sto.Domingo

Martina Sister 68 Female Single Elementary Roman Sto


4/18

Rayray graduate Catholic Tomas,Sto.

Domingo

KatherineRayray

Eldest 13 Female Single High SchoolOngoing 2nd

year

RomanCatholic

StoTomas,

Sto.Domingo

MarvinRayray

2nd 10 Male Single ElementaryOngoingGrade-Vl

RomanCatholic

StoTomas,

Sto.Domingo

MelvicRayray

youngest 7 Male Single ElementaryOngoingGrade-2

RomanCatholic

StoTomas,

Sto.Domingo

Type of Family Structure:

> Extended

Dominant Family Member in terms of Decision Making:

> Either lola Martina or Mr. Melacio depends on who is present in their home.

General Family Relationship:

> They are talking with each other and exchange idea but sometimes there aremisunderstanding between them so there is a no conversation sometimes but after only a hourthey talk with each other again.

B. SOCIO- ECONOMIC CULTURAL FACTORS

1. Income and Expenses

A. Occupation of All Family Members:

Name Occupation Income Place of Work

Melicio Rayray farming 150 pesos per day Sto Tomas, Sto.Domingo

Victoria Rayray farming 150 pesos per day Sto Tomas, Sto.Domingo

B. Adequacy to meet basic necessities ( Food, clothing, shelter) > The family claims that they eat their meals 3x a day, sometimes rice, cooking oil and salt

may do, and with enough clothings most given by their relatives and friends.

C. Who makes decisions about the money and how it is spent?> Both Husband and Wife

2. Ethnic Background


5/18

> Ilocano.

3. Relationship of the Family to Community> neither of the two is a member of any organization in their barangay..

C. ENVIRONMENTAL FACTORS

1. Housing

A. Adequacy of living space

>The available space is inadequate the entire family. There are two sleeping rooms orbed rooms, one sala, dining room, kitchen.

B. Sleeping Arrangement> There are two sleeping rooms. one for Lola Martina and one for melicio and his wife, The

children sleep together in the sala.

C. Adequacy of Furniture> They only have three appliances such as television, electric fan and radio, wooden

chairs as well as tables are used in the kitchen during mealtime.

D. Presence of Insects and rodents> Aling Martina had mentioned of different insects ( mosquito, flies, cockroach and rats

present in their house.

E. Presence of accident hazards> In their surrounding and inside their house there are health hazard that are present and

easily observed upon entering their house and around their house such as scattered rags, brokenglass, untapped and unsafe wirings.

F. Presence of fire hazards:> they use dalikanas their means of cooking their food with dry woods beside it.

G. Food Storage and Cooking Facilities

> they just cover it with plate.

H. Water SupplySource: ( Pump Well )Ownership: ownedPotability: poor; dirty

I. Toilet FacilityType: water-sealedOwnership: ownedSanitary Condition: good

J. Garbage DisposalType: open - garbage was cast at their backyard for a long period of time.Sanitary Condition: Poor

K. Drainage System


6/18

Type: open / dirty water overflows and accumulates at their backyard.Sanitary Condition: poor

2. Kind of Neighborhood:>Not congested and it is conducive for living

3. Social Health Facility available:> Botika ng barangay and sometimes in the RHU.

4. Communication and Transportation Facility Available:> As to ownership none

D. HEALTH ASSESSMENT OF EACH MEMBER:

1.Past Significant Illnesses of the FamilyMember Past Illnesses Practice Conducive to Illness

Lola Martina Hypertension She seeks care to their Barangay HealthCenter, in their Rural Health Unit or forworse they go to a public hospital likegovernment/ private hospital.

All of them Fever, cough and colds They do practice self medication ofknown drugs

a. Beliefs of the Family and unto Disease

> They do not believe in superstitious beliefs but they do not solely rely on an

albularyo. They also seek care to their Barangay Health Center, in their Rural Health Unit

or for worse they go to a public hospital like government/ private hospital.

2.Nutritional Assessment

a. Dietary History Indicating Quality and Quantity of Food intake per day.

> The family eats their meal 3 times a day. The food preference is vegetables andmeat.

b. Eating/ Feeding Habits / Practices

> They eat their meals 3x a day on time, no habits and practices mentioned.

3. Current Health Status Indicating Presence of Illness State(Diagnosed/ Undiagnosed by Medical Practitioner)

> Lola Martina had hypertension.

E. Value Placed on Prevention of Disease

1. Immunization Status of children

> Complete Vaccination all of them


7/18

2. Use of Other Preventive Services:

> They use preventive services such as exercise through walking, cleaning their house,adequate sleep and rest.

IV. A Typology of Nursing Problem in Family NursingPractice

I. First and second level assessment

A. Presence of Health Threats

1. Accident Hazard

a.fire hazards

> exposed wiring that may cause burn. Another is the fire hazards, they use woodin cooking.

Inability to recognize the presence of the problem due to:a. Ignorance of fact that using candle as their light and using

dalikan in cooking can cause fire or can be source of fire.

b. Fall hazards

> The present of scattered rags that might cause falls especially to the elderlybecause they didnt see their way

Inability to recognize the presence of a problem due to:a. lack of knowledge or ignorance of the possibility that this can cause

injury or threat to health.

Inability to make decisions with respect to taking appropriate heathaction due to :

a. negative attitude towards the health problem.

2. stressprovoking factors

a. interpersonal conflicts between family members

> they are talking with each other and exchange idea but sometimes there aremisunderstanding between them so there is a no conversation sometimes but after only ahour they talk with each other again.


8/18

Inability to make decisions with respect to taking appropriate heathaction due to :

a. conflicting opinions among family members/ significant others regardingaction to take.

3. Poor home/environmental condition/sanitation

a. inadequate living space

>The available space is inadequate the entire family. There are two sleepingrooms or bed rooms, one sala, dining room, kitchen.

Inability to recognize the presence of the problem due to:a. fear of consequences of diagnosis of the problem ( Economic in

nature, )

Inability to make decisions with respect to taking appropriate healthaction due to:a. Low salience of the problem due to financial constraint no action isdone.b. Fear of consequences of action due to financial in nature.

Inability to provide a home environment which is conducive to healthmaintenance and personal development :

a. due to inadequate family resources (financial constraint.)

b. inadequate personal belongings/ utensils

> not sanitized cooking utensils.> After eating, they immediately clean the dining table but sometimes after eatingthey just leave the kitchen utensils in the sink.

Inability to recognize the presence of a problem due:a. to fear of consequences of diagnosis of problem(Economic in nature)

Inability to make decisions with respect to taking appropriate healthaction due to:

a. low salience of the problem- (not a felt need)

Inability to provide a home environment which is conducive to healthmaintenance and personaldevelopment due to:a. inadequate family resources (financial reason)

c. lack of food storage facilities

> they just cover it with plate.

Inability to recognize the presence of a problem due to:a. fear of consequences of diagnosis of problem (Economic in nature)

Inability to make decisions with respect to taking appropriate healthaction due to:a. low salience of the problem- (not a felt need)


9/18

Inability to provide a home environment which is conducive to healthmaintenance and personaldevelopment due to:a. inadequate family resources (financial reason)

d. presence of breeding places of insects and rodents

> Inside their house you will see scattered rags, untapped and unsafe wirings, andthe presence or rats, cockroaches, mosquito

Inability to recognize the presence of the problem due to:a. lack of knowledge or insight.

Inability to provide a home environment which is conduciveto health maintenance and personal development due to:

a. Lack of knowledge to the problemb. Lack of skill in carrying out measures to improve homeenvironment

Inability to make decisions with respect to taking appropriatehealth action due to:

a. Negative attitude towards the health problem.b. Failure to comprehend the nature, magnitude and scope of theproblem.c. Low salience not a felt need/ problem of the family

e. improper garbage/ refuse disposal> Their garbage disposal have poor sanitary conditions, they do not cover their

trash cans there are some flies around it and its starting to expel odorous smell.

Inability to recognize the presence of the problem due to:a. ignorance of facts


a. Failure to comprehend the nature, magnitude/ scope of the

problem

b. Low salience of the problem

c. Lack of knowledge/ insights as to alternative courses ofaction open to them.

Inability to provide a home environment which is conduciveto health maintenance and personal development due to:

a. Ignorance of importance of hygiene and sanitation

b. Ignorance of preventive measuresc. Lack of skill in carrying out measures to improve homeenvironment

f. improper drainage system


10/18

> Their drainage system have poor sanitary conditions. open / dirty wateroverflows and accumulates at their backyard.

Inability to recognize the presence of the problem due to:a. ignorance of facts


a. Failure to comprehend the nature, magnitude/ scope of theproblem

b. Low salience of the problem

c. Lack of knowledge/ insights as to alternative courses ofaction open to them.

Inability to provide a home environment which is conduciveto health maintenance and personal development due to:a. Ignorance of importance of hygiene and sanitation

b. Ignorance of preventive measures

c. Lack of skill in carrying out measures to improve homeenvironment

4. inherent personal characteristics

> short temper

Inability to recognize the presence of the problem due to:a. attitude

Inability to make decisions with respect to taking appropriateheath action due to :

a. conflicting opinions among family members/ significant othersregarding action to take

B. Presence of Health Deficit

1. Illness state, regardless of whether it is diagnosed or undiagnosed by medicalpractitioner

>There are few minor illnesses that are experiencing of those children such ascommon colds, Cough, and fever. Aside from these there are major illnesses existing in thefamily, Lola Martina had hypertension.

Inability to recognize the presence of the problem due to:a. fear of consequences of diagnosis of problem. (economic, physical/

psychological)


11/18

Inability to make decisions with respect to taking appropriate healthaction due to:

a. Failure to comprehend the nature, magnitude/ scope of the problemb. Low salience of the problemc. feeling of confusion and/ or resignation brought about by failure to break

down problems into manageable units of attack.d. Lack of knowledge/ insights on the effect of the problem.e. Fear of consequences of action

Inability to provide a home environment which is conducive to healthmaintenance and personal development due to:a. Ignorance of preventive measures

Failure to utilize community resources for health care due to:a.ignorance or lack of awreness of community resources for health careb. inaccessibility of required care/services (cost)c. lack of inadequate family resources (financial)

C. Presence of stress point and foreseable crisis

1. entrance at school> Marvin is already high school, the family need to adjust from the new

environment of their school and new things to learn.


a. Failure to comprehend the nature, magnitude and scope of theproblem.

Inability to provide a home environment which is conducive to healthmaintenance and personal development due to:

a. Inadequate family resources (financial)


12/18

VI. Scoring and Prioritization on health problemFire hazards

Criteria Computation Actual Score JustificationNature of the problem 2/3x1 .67 The problem is a health

threat because it has thepotential risk to thehealth of the family

Modifiability of theproblem

2/2x2 2 The family can fix theseproblems easily and find

solution.

Preventive potential 3/3 x 1 1 The problem needs highpreventive measurebecause can cause

accidentSalience of the problem 2/2 x 1 1 The family recognizes

the problem as seriousand needing immediate

actions

total 4.67

Fall hazards (scattered rags and broken glass)

Criteria Computation Actual Score Justification

Nature of the problem 2/3 x 1 .67 The problem is a healththreat because it has the

potential risk to thehealth of the family


2/2 x 2 2 The family can fix theseproblems easily and find

solution.

Preventive potential 3/3 x 1 1 The problem needs highpreventive measurebecause can cause

accident

Salience of the problem 2/2 x 1 1 The family recognizesthe problem as seriousand needing immediate

actions

total 4.67

Interpersonal conflicts between family members

Criteria Computation Actual Score JustificationNature of the problem 2/3 x 1 .67 It is health threatbecause of stressprovoking factors


2/2 x 2 2 The family can fix theseproblems easily and find

solution.

Preventive potential 2/3 x 1 .66 The problem needs


13/18

moderate preventivemeasure

Salience of the problem 0/2 x 1 0 The family does notrecognize the existence

of the problem

total 3.33

Inadequate living space


Nature of the problem 2/3 x 1 .67 It is health threat thatdoes not demandimmediate action


1/2 x 2 1 The family does nothave adequate

resources to solve theproblem.

Preventive potential 1/3 x 1 .33 The family does nothave adequate


Salience of the problem 1/2 x 1 .5 The family recognize theproblem but not needing

attention

total 2.5


14/18

Inadequate personal belongings/ utensils


Nature of the problem 2/3 x 1 .67 It is health threat thatdoes not demandimmediate action






Salience of the problem 1/2 x1 .5 The family recognize theproblem but not needing

attention

total 2.5

Lack of food storage facilities


Nature of the problem 2/3 x 1 .67 It is health threat that

does not demandimmediate action






Salience of the problem 1/2 x 1 .5 The family recognize the

problem but not needingattention

total 2.5

Presence of breeding places of insects and rodents


Nature of the problem 2/3x1 .67 The problem is a healththreat, because this

might be possible carrierof a disease.


2/2x2 2 It is easily modifiable ifgiven an immediate

attention.


15/18

Preventive potential 3/3 x 1 1 Extermination of insectsand animals will reducethe possibility of spread

of disease.

Salience of the problem 2/2 x 1 1 The family recognizes

the problem as seriousand needing immediateactions

total 4.67

Improper garbage/ refuse disposal


Nature of the problem 2/3 x 1 .67 The problem is healththreat because it has the

potential to give adisease.


2/2 x 2 2 The family can easilysolve the problem sinceit does not require mucheffort and also easily to

modifiable.

Preventive potential 3/3 x 1 1 The problem can causecommunicable disease

and vector bornedisease.


actions

total 4.67

Improper drainage system


Nature of the problem 2/3 x 1 .67 The problem is healththreat because it has the

potential to give adisease.



modifiable.

Preventive potential 3/3 x 1 1 The problem can causecommunicable disease

and vector bornedisease.



16/18

actions

total 4.67

Inherent personal characteristics ( short temper)


Nature of the problem 2/3 x 1 .67 It is a health treat



modifiable.Preventive potential 3/3 x 1 1 The problem needs

Highly Preventivepotential

Salience of the problem 0/2 x 1 0 The family does notrecognize the existence

of the problem

total 3.67

Hypertension


Nature of the problem 3/3 x 1 1 The problem is healthdeficit and requires moreimmediate intervention.


2/2 x 2 2 The resources andinformation to solve theproblem are available to

the family

Preventive potential 3/3 x 1 2 The problem easilylessen if they takes

medication, but if theyignored it get worse

Salience of the problem 2/2 x1 1 The problem haveimmediate attention

because its affect thehealth

total 5

Entrance at school


Nature of the problem 1/3 x 1 .33 The problem is forseablecrisis


2/2 x 2 2 The resources andinformation to solve theproblem are available to


17/18

the family

Preventive potential 3/3 x 1 1 The problem needsHighly Preventive

potential

Salience of the problem 1/2 x 1 .5 The family recognize the

problem but not needingattention

total 3.83


18/18

VII. The Prioritized Health Problem

The list of health condition or problems ranked according to priorities is presented:

1. Hypertension- 52. Fall hazards (scattered rags and broken glass)- 4.673. Presence of breeding places of insects and rodents- 4.674. Improper drainage system- 4.675. Improper garbage/ refuse disposal- 4.676. Fire hazards- 4.677. Entrance at school 3.838. Inherent personal characteristics ( short temper)- 3.679. Interpersonal conflicts between family members- 3.3310.Lack of food storage facilities- 2.511.Inadequate personal belongings/ utensils- 2.512.Inadequate living space-2.5

X. Conclusion

I therefore conclude, nursing process is a effective way to define or give the proper way of

solving a problem and these process have five major steps, these are assessment, diagnosis, planning,

implementation and evaluation. Through nursing process provide a systemic method of determining the

health problem of the family, devising a care plan to address those problems, implementing the plan and

evaluating the plan effectiveness. Through nursing process I have identified the different problems in the

family of Melicio Rayray and Victoria Rayray. And I also identified the various health threats and stress

point or foreseeable crisis of the family. And I also rendered nursing care to their family.

Through family nursing care plan, the members will be equip with some knowledge about health

and know how to perform their responsibilities in maintaining their family and their awareness to the

different health threats that can affect their daily living.

XI. References Public health nursing in the Philippines Community health nursing book( maglaya book)

family case cha (1)

Documents