III. Methods of Data Gathering

III. Methods of Data Gathering

1. Health assessment of each family member2. Observation3. Interview4. Review of records/reports & laboratory results5. Assessment of home & environment6. Tools used in family assessment: genogram, ecomap, initialdatabase, family assessment guide7. Health status of each family member8. Values & practices on health promotion

I. FAMILY ASSESSMENT Initial Data Basea. Family structure, characteristics and dynamics1. Members of the household and relationship to the head of the family2. Demographic data age, civil status, position in the family3. Place of residence- whether living with the family or elsewhere4. Type of family structure5.Dominant family members in terms of decision making especially in matters of health care6. General family relationship /dynamics

b. Socio-economic and cultural characteristicsIncome, occupation, place of work (of each member)Educational attainment of each memberEthnic background and religious affiliationSignificant others and other roles they play in the familys lifeRelationship of the family to the larger community (membership in organizations)Income Family income : ________ .Source : salary ________ , saving ________ , investment ________ .Others ________ .Contribution of working members :Member : ________ , Amount : ________ (JD, $ & SH ) Are expenses greater , less than or equal to income : ________ Who plans how the money is spent ?

c. Home and environmentInformation on housing and sanitation facilities which includes:Housing agency, sleeping arrangements, food storage, cooking facilities, water supply, source, ownership, potability, presence of accident hazards, toilet, garbage disposalAvailability of social, health , communication and transportation facilities in the community.Space : Adequate : ________, Inadequate : ________Furniture : Adequate : ________ , Inadequate : ________Accident hazards : ________Neighborhood : ________Residential : ________ . Industrial : ________ . Rural : ________ .Urban : ________ . Suburban : ________. Other : ________ . Condition of dwellings and streets :

Accessibility of :Play area : Yes ________ . No ________Health facilities ( List ) : Yes ________ . No________Mosques , Churches : Yes________ . No ________Schools : Yes ________ . No ________ Public transportation ? Type ? ________Family's method of transportation :________Neighborhood health hazard : ________Family's perception of safety in the neighborhood ?

d. Health status of each memberPast /current significant illnessBeliefs/practices about healthNutritional and development statusDecision making on which or whom to seek advice regarding healthFamily health practice :Immunization status of each family member :Self exam ( breast , testicular , .. etc ) Preventive exams ( dental , colon/rectal ) :Names of physician / date of last appointment and next scheduled appointment for each family member :Medication : is any family member taken any medication ? Yes: ------. No : ------ .

If yes ( including over the counter drugs ) :Name of the drug _______ .How often taken : ______.Drug action ________ .Side effects : ________ .Date of prescription : ________ .Number of refills : ___ . Physician : ________ .Pharmacist : ________ .Treatment prescribed for family members :Level of compliance with prescribed medication and treatments :

FAMILY NUTRTIONAL-METABOLIC PATTERN :Observation about kitchen and mealtimes :Who does the grocery shopping ?Who does the cooking ?Therapeutic diets :Observation of family member of nutritional 24-hrs food/fluid intake : Break fast , Lunch , Dinner , Snacks Analyze if diet provides nutrients ?How is food stored ?Water supply :Municipal , Well , Other.

e. Health Values and Practices on Promotion and MaintenancePreventive aspects- immunization statusAdequate rest and sleep, exercise, relaxation activitiesStreet management activities, utilization of health care facilities

FAMILY HEALTH PERCEPTION HEALTH MANAGEMENT PATTERN :Reason for visit :Family's perception of their level of health :Medical diagnosis of each family member :Familial disease ( heart , cancer , stroke , anemia , .. etc )History of past significant illness and accident of each family member :Risk factors ( tobacco , alcohol , obesity , lack exercise ) :

FAMILY ACTIVITY SLEEP-REST PATTERN :Which family member sleep alone ?What type of bed does each have ?What are the usual hours of sleep ?Bedtime , arising , rest periods for adult and children ?Are they any disturbances in family sleep pattern ?

FAMILY ACTIVITY-EXERCISE PATTERN :Adults leisure ________ . Children leisure ________ .Shared family activities ________ .Type of activities required for family roles : ________________ .Adults : ________ . Children : ________ .Describe pace of family life :Fast : ________. Moderate : ________ . Slow : ________.

FAMILY VALUE AND BELIEF PATTERN ?Ethnic background ________ . Influence on health behavior . Religious affiliation ________ . Degree of family involvement ________ .Influences on health behavior :Family's definition of health :Health beliefs and attitudes :Folk medicine : Use of non-traditional healing methods :Acceptance / non-acceptance of help from community agencies ?

Family care plan:FAMILY COGNITIVE / PERCEPTION PATTERN :Educational level , What is the highest grade completed ?Adults : ________ Children : ________Members of the family with learning or developmental disabilities ?Decision making : Who make the decisions ? Give examples :FAMILY ELIMINATION PATTERN :Compliance with garbage regulations ?Yes ________ . No ________ . If no , explain ?Rodents ?Yes ________ . No ________ .Insects ?Yes ________ . No ________ .Toilet facilities ?Yes ________ . No ________ .FAMILY SEXUALITY-REPRODUCTION PATTERN :Sexual relationships :Family planning :Sex education of children :Family care plan:FAMILY COPING STRESS TOLERANCE PATTERN :How has the family managed in previous situation of illness or crises ?Own resources ________ . Extended family : ________ .Other relatives ________ . Friends ________ . Neighborhood ________ .Significant others ________ . Health professional ________. Other ________ .Caregiver's perception of their ability to deal with crises :Client perception of caregiver's / family ability to deal with demands of care :Family care plan:Family care plan:Financing health care :Health insurances : ________ .Private insurances : ________ .Own finance : ________ . Family nursing diagnosis:Examples for family nursing diagnosis:Family Processes, Dysfunctional: Alcoholism ( substance abuse ).Family Processes, Interrupted.Family Processes, Readiness for Enhanced.Family coping, ineffective.Family coping, potential for growth.

Family nursing diagnosis:Examples for family nursing diagnosis:Parental role conflict.Parent/infant/child attachment, altered, risk for.Parenting, altered.Parenting, altered, risk for.Role performance, alteredSocial interaction, impaired.Social isolation.

IV. Typology of Nursing Problems in Family Nursing Practice

1. 1st level assessment:identify health threats, foreseeablecrisis, health deficits & wellness potential/state

2. 2nd level assessment:determining familys ability to performthe family health tasks on each health threat, healthdeficit, foreseeable crisis or wellness potential

V. Statement of a Family Health Nursing Problem- health problem andcause/ contributing factors or health condition and factors related with non-performance of family health tasks

VI. Developing the Care Plan1. Priority Setting : Criteria2. Defining/Setting Goals/Objectives3. Specifying Intervention Plan4. Developing the evaluation plan, specifying methods/tools

VII. Categories of nursing interventions in family nursing practiceinclude:1. Human becoming: Methods/Processes2. Competency-based teaching3. Motivation-support for behavior chang3e/lifestyle modification

VIII. Categories of health care strategies and intervention1. Preventive2. Curative3. Rehabilitative4. Facilitative5. Facilitation6. Direct

IX. Evaluation1. Qualitative & quantitative data for evaluation2. Methods & sources of evaluative data3. Steps in evaluation4. Evaluation criteria5. Evaluation in Family nursing practice

X. Records in Family Health Nursing Practice1. Importance & uses2. Types of records& reports

LEVELS OF PREVENTION:1ST LEVEL2ND LEVEL3RD LEVEL 4. tools for measuring and analyzing community health problems; and 5. application of principles of management and organization in the delivery of health services to the community

iii. Basic Concepts and Principles of Community Health Nursing1. The family is the unit of care; the community is the patient and there are four levels of clientele in community health nursing. 2. The goal of improving community health is realized through multidisciplinary effort. 3. The community health nurse works with and not for the individual patient, family, group or community. The latter are active partners, not passive recipients of care.

4. The practice of community health nursing is affected by changes in society in general and by developments in the health field in particular. 5. Community health nursing is part of the community health system, which in turn is part of the larger human services system.

iv. Roles of the Nurse in Caring for Communities and Population Groups

v. Brief History of Community Health/Public Health Nursing Practice in the PhilippinesFirst level assessmentI.Presence of wellness condition Stated as potential or readiness- a clinical nursing judgment about a client in transition from a specific level of wellness or capability to a higher level .Potential for enhanced capability for 1.healthy lifestyle2. Health maintenance/health management3. Parenting4. Breastfeeding5. Spiritual being6. Others , specifyFirst level assessmentWellness potentialIs a nursing judgment on wellness state or condition based on clients performance, current competencies or clinical data but no explicit expression of client desire.

First level assessmentReadiness for enhanced wellness state is a nursing judgment on wellness or state condition based on client competencies or performance, clinical data and explicit expression of desire to achieve a higher level of state or function in a specific area on health promotion and maintenance.1.healthy lifestyle2. Health maintenance/health management3. Parenting4. Breastfeeding5. Spiritual being6. Others , specify

First level assessmentPresence of health threatsConditions that are conducive to disease and accident , or may result to failure to maintain wellness or realize health potential.Presence of risk factors of specific diseases- e.g. Lifestyle diseases, metabolic syndromeThreat of cross infection from a communicable disease caseFamily size beyond what family resources can provide