Family Case Cha (1)
-
Upload
jheiczhietoot-kibas -
Category
Documents
-
view
220 -
download
0
Transcript of 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
-
7/28/2019 Family Case Cha (1)
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:
-
7/28/2019 Family Case Cha (1)
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
-
7/28/2019 Family Case Cha (1)
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
-
7/28/2019 Family Case Cha (1)
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
-
7/28/2019 Family Case Cha (1)
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
-
7/28/2019 Family Case Cha (1)
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. stress- provoking 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.
-
7/28/2019 Family Case Cha (1)
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)
-
7/28/2019 Family Case Cha (1)
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
Inability to make decisions with respect to taking appropriatehealth action due to:
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
-
7/28/2019 Family Case Cha (1)
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
Inability to make decisions with respect to taking appropriatehealth action due to:
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)
-
7/28/2019 Family Case Cha (1)
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.
Inability to make decisions with respect to taking appropriatehealth action due to:
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)
-
7/28/2019 Family Case Cha (1)
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
Modifiability of theproblem
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
Modifiability of theproblem
2/2 x 2 2 The family can fix theseproblems easily and find
solution.
Preventive potential 2/3 x 1 .66 The problem needs
-
7/28/2019 Family Case Cha (1)
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
Criteria Computation Actual Score Justification
Nature of the problem 2/3 x 1 .67 It is health threat thatdoes not demandimmediate action
Modifiability of theproblem
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
resources to solve theproblem.
Salience of the problem 1/2 x 1 .5 The family recognize theproblem but not needing
attention
total 2.5
-
7/28/2019 Family Case Cha (1)
14/18
Inadequate personal belongings/ utensils
Criteria Computation Actual Score Justification
Nature of the problem 2/3 x 1 .67 It is health threat thatdoes not demandimmediate action
Modifiability of theproblem
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
resources to solve theproblem.
Salience of the problem 1/2 x1 .5 The family recognize theproblem but not needing
attention
total 2.5
Lack of food storage facilities
Criteria Computation Actual Score Justification
Nature of the problem 2/3 x 1 .67 It is health threat that
does not demandimmediate action
Modifiability of theproblem
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
resources to solve theproblem.
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
Criteria Computation Actual Score Justification
Nature of the problem 2/3x1 .67 The problem is a healththreat, because this
might be possible carrierof a disease.
Modifiability of theproblem
2/2x2 2 It is easily modifiable ifgiven an immediate
attention.
-
7/28/2019 Family Case Cha (1)
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
Criteria Computation Actual Score Justification
Nature of the problem 2/3 x 1 .67 The problem is healththreat because it has the
potential to give adisease.
Modifiability of theproblem
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.
Salience of the problem 2/2 x 1 1 The family recognizesthe problem as seriousand needing immediate
actions
total 4.67
Improper drainage system
Criteria Computation Actual Score Justification
Nature of the problem 2/3 x 1 .67 The problem is healththreat because it has the
potential to give adisease.
Modifiability of theproblem
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.
Salience of the problem 2/2 x 1 1 The family recognizesthe problem as seriousand needing immediate
-
7/28/2019 Family Case Cha (1)
16/18
actions
total 4.67
Inherent personal characteristics ( short temper)
Criteria Computation Actual Score Justification
Nature of the problem 2/3 x 1 .67 It is a health treat
Modifiability of theproblem
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 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
Criteria Computation Actual Score Justification
Nature of the problem 3/3 x 1 1 The problem is healthdeficit and requires moreimmediate intervention.
Modifiability of theproblem
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
Criteria Computation Actual Score Justification
Nature of the problem 1/3 x 1 .33 The problem is forseablecrisis
Modifiability of theproblem
2/2 x 2 2 The resources andinformation to solve theproblem are available to
-
7/28/2019 Family Case Cha (1)
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
-
7/28/2019 Family Case Cha (1)
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)