Chapter I INTRODUCTION

“The family is the nucleus of civilization.”
-Ariel and Will Durant: Wisdomquotes.com

The 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 the development, and progress of the community through active involvement and self – responsibilities of each constituent. It is composed of persons, male and female, being molded to be as one, working hand in hand to maintain a good atmosphere among the family members. A nucleus controls the functions of the entire cell and can be thought as the “command center” of the cell. The nucleus as well has different components which are all needed in order for it and the cell to function well, same as with the “commander” or the head of the family and the members who has different functions within the family. The impression or status of each family will always affect the status of the community as a whole. Community health nursing is a response to the health needs of the people. It does not focus on a particular class or family. It is comprehensive and general in approach. Community health service is not episodic as it requires continuous observation and monitoring of the community as a whole. Promotion and preservation of the health of its different clients

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(individual, family, group or community) is the primary goal of community health nursing. The community is a group of people sharing geographic boundaries and/or values and interests. (Maglaya, 2004) No two communities are alike. A nurse exposed in the community learns how to interact and adapt to different kinds of people. The family is considered as the basic unit of care in the community health nursing. It is in the family where a member develops his health values, beliefs and practices. The family is a major influence in the health behaviors of an individual. With this, it is important that families in a community are aware of the things and practices pertaining to their health. It is apt to say that community health nursing has a big role in the nursing education. It is in the community where the student nurse learns nursing apart from the hospital setting as she was exposed to different level of orientation. It is in the community where the saying “nursing is an art” can be applied as a student nurse tries to give quality service using the available resources in the health center. ` Conducting a family case study is a means by which student nurse

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

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student nurse as she was given the opportunity to share their skills, knowledge and time to alleviate and uplift the living condition of a family. The family that was chosen by the student nurse is a picture of the majority of the family here in our country: a family living in a poor environmental condition without enough resources and lacks knowledge on vital health information and experiences other socio-economic related problems. Though tiring as it is, reaching out to this family and mingling with them makes the student nurse feel the sense of fulfillment as she share her knowledge, skill and time to aid in uplifting the condition of the family.

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Chapter II OBJECTIVES OF THE STUDY

This chapter presents the general and specific objectives of this family case study. Setting objectives provides direction for planning a family nursing intervention. It facilitates motivation for the client and the nurse by providing a sense of achievement. (Kozier, Erb et. al., 2004).

General Objectives: At the end of the student nurse-family relationship, the adopted family will be able to improve their health status and become self-reliant in maintaining their health through appropriate interventions in a given time frame.

Specific Objectives After 1 month of home visits and student nurse-family interaction, the family should be able to: • • Established rapport and trust with the student nurse. Give pertinent and factual information during surveys and interviews • • Participate actively during home visits and assessment interviews Identify actual and potential problems which may be a hindrance in attaining optimum health.

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Categorize the identified health problems as health threat, health deficit or foreseeable crisis through the assistance of their studentnurse.

Prioritize the identified family health nursing problems with the assistance of their student nurse.

Plan possible solutions or nursing actions to the prioritized health problems.

Generate interventions considering the student nurses’ capabilities, community and the family’s resources.

• • •

Carry out the planned interventions together with the student nurse Perform the health teachings taught by the student nurse Evaluate the effectiveness of the intervention using the set objectives as a basis, and

Evaluate changes in condition after giving interventions.

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low stress.). although the length of time in which the family remains in this form varies even within the same society. Upper Labay. In nuclear families. Family Structure. A nuclear type is a typical type of family composed of a father. Level (Grade 4) Elem. General Santos City. a mother and child/children. and Dynamics Name Mr. The nuclear family can be a nurturing environment in which to raise children as long as there is love. They have started living their since June of 2009.Chapter III INITIAL DATABASE A. time spent with children. Level (Grade 3) Elem Grad (Grade 6) Elem. V Mrs. V Child AV Child BV Child CV Child DV Age 30 29 11 10 7 5 Sex Male Civil Married Position in the Family Father Mother (Respondent) Eldest Child Second Child Third Child Fourth Child Occupation Farmer Housewife Student Student Student Student Educational Attainment Elem. This type of family structure is found in almost all societies. Level (Grade 3) Elem. They were a 6 . and a stable economic environment. 2004. emotional support. Level (Grade 5) Elem. both adults are the biological or adoptive parents of their children (Jay C. Level (Grade 1) Female Married Male Female Male Female Child Child Child Child The Family V is considered as a nuclear type of family. The V family resides in Purok Daanbanwang. Characteristics.

B. V since of course believing it is her duty as the mother. They consult each other in terms of planning and budgeting for their family. Out of Mr. feeding the right food and caring for the sick member. shoes and slippers comes in. 7 . Mr. V does not work. She makes sure that she will comply with the appropriate regimen when certain health issues arise. V earns about Php 6. V is more dominant. most of it goes to the family’s budget for food. The education of the children is free and they can walk from their house to the school so only some school supplies are being bought. V’s earnings. V’s farming. When problem arises. in terms of matter concerning health Mrs. They have been in Nurallah. But then.000. they make sure that both of them will handle and solve the problem. She has greater awareness concerning health matters compared to Mr. Mrs. V go hand in hand in terms of decision-making.family whose resident is always changing. she is in charge of the house and in taking care of the children. Since Mrs. V and Mrs. Usually. V budgets the money in terms of food. there is nothing to be left for the miscellaneous expense. Socio-Economic and Cultural Characteristics The V family’s main source of income is coming from Mr. These health matters include immunization. They discuss matters concerning their children’s schooling financially and also with regards to the emotional problems or aspects within the family. education and miscellaneous where clothes. Mr. South Cotabato for 5 years and in Malungon for 3 years.00 a month.

All of them are affiliates of Protestantism. which is situated far away from the family’s house. Mrs.With Mr. V works as a farmer. Mrs. Mr. thus. Mrs. the significant others in their lives are their relatives and some neighbors. the family strives hard to accommodate everything they need for them to live. 000. He seldom goes home but rather stays in the farm. V also confirmed how helpful and welcoming her neighbors are with them. they can be considered poor. V doesn’t work and stays in their house. V’s monthly income. 8 . Significant others are called such due to their own role in one’s life. prepare food.00 and when divided among the 6 members. V is about Php 6. The total monthly income of Mr. They usually run to their relatives if they face hardships and problems. Mrs. V mentioned that they do not go to church anymore since they have lived in Purok Daanbanwang for the reason that of the distance they have to travel from their place to the church. They typically borrow money from their relatives.00. sweep the yard and make the house clean. he works from 3 am until 8 pm everyday. According to NEDA. 000. each individual should at least have Php 2768. They are the ones very close to a person or group of persons. V also informed the student nurse that they do not have any financial assets at hand in case of emergency.60 when the total monthly income of the family is divided among the total family members. For family V. it is only Php 1. She is the typical housewife where in you can see her wash clothes.

V did not know the exact measurement of their house. The house only has 2 windows and can sustain the adequate ventilation needed by the family. 9 .The family has yet to participate in community activities since they are new in the place. In order for the house to be considered as adequate. though. meters away from their house. the total floor area should be divided among the total members of the family and each should at least have 3. There is also a shallow well built within the river where the family gets their water source for drinking if they get lazy in getting water from the faucet. parties and carnivals.5 m2. The children. Home and Environment The house is made of wood. C. Her husband knows it yet he was not there during the interview. mostly bamboo. Mrs. they usually partake in community activities. go to Purok Daanbanwang Elementary School. Mrs. The V Family barely enjoys the community resources since the community itself lacks resources. But way back in Nurallah. The father is usually in their farm while the mother is in the house doing household chores. V told the student nurse that their house is usually “presko” since it is beside the river and the air goes to and fro freely inside the house. The family uses the river as their means of water source in washing their clothes. These activities include fiesta.

There is 10 . They usually urinate and remove bowels anywhere near their house. with no bed at all. In terms of cooking facilities the family is equip with pots. V Family has no comfort room. it is far from their house. The V Family has only one appliance which is the radio powered by batteries since the place has no electrical supply yet. They put their water in a big container with cover. V uses wood and charcoal in cooking. V. They usually don’t go and get water from the faucet in the purok since. The river is the family’s main source of water. and knives. The foods that they usually eat are fish and vegetables. Mrs. They use “banig” in sleeping. according to Mrs. In terms of garbage disposal. according to Mrs. V. She cooks inside the house at the back portion. The drainage system of the family is an open type where in the drainage flows anywhere and is continuous. Mr. They wash their clothes and gets their drinking water supply there. and Mrs V. She is the one who prepares the food. they either bury or burn their garbage. “sandok”. together with the children. The family uses plastic plates and stainless spoons in eating. sleep in one room. When it comes to storing their food. The one is the sala/dining room and the other is the bedroom. they are still new in the community and has no enough budget for it yet. It is dirty and has a stinky smell. They have not yet built their own comfort room since. They usually don’t sterilize their drinking water supply. they just cover it with a plate.The house has 2 rooms.

Mrs. V said that her husband is about 5’4 tall and weighs about 55 kilograms. Her BMI reveals normal weight with a value of 23. Mr.4. Health Assessment of Each Family Member D1. A since he was in their farm during the interview.some rice grains noted. they usually walk kilometers. When they go to their farm or any purok within Upper Labay. PAST AND PRESENT ILLNESS 1. The family has one chicken and a dog. Mrs. Mrs. His BMI reveals normal weight with a value of 20. He drinks alcohol rarely since they have no budget for that. V – The student nurse has never met Mr. There is no obstruction present at the drainage system since it is open and flows anywhere. B. He is not a smoker. She is 5 feet and 3 inches and weighs 60 kilograms. V. When she was still 4 years old. There are vegetables planted near the house. She has also not completed immunizations. They ride on a jeepney or truck in going to the city proper. V told the student nurse that her husband has no genetic or hereditary illness known. Mrs. she experienced chicken pox. She has no complaints as of the present time and has not taken any medications 11 . chronic. or infectious diseases as of the present time. Health Assessment on Each Member A. told us that she thinks her husband has never undergone immunizations at all since it was not that important before.8. V – She has no degenerative. The family does not own any transportation facilities. D. however.

Uses herbal plants. He has not completed immunizations. Child AV – has no any degenerative. V who drinks alcohol rarely. The family is not using family planning anymore. Child DV – has no any degenerative. D. or infectious diseases as of the present time. She has complete immunizations. she would just drink paracetamol for fever and mefenamic acid for pain or treat wounds with crushed plants coming from their backyard. Child BV –has no any degenerative. She is 4 feet and 7 inch tall and weighs 36. E. He is 4 feet and 10 inches and weighs 38 kilograms. She is 3 feet and 11 inches tall and weighs 17 kilograms. chronic. She appears thin.5 kilograms. from their backyard 12 . Health Perception-health management patterns • With no known vices like smoking and drinking except for Mr. At times of illness. Child BV –has no any degenerative. He likes to eat vegetables and fish. though not approved by the DOH. F. or infectious diseases as of the present time. or infectious diseases as of the present time. He is 4 feet and weighs 33 kilograms. This child has many allergies and there are rashes still seen on her legs. or infectious diseases as of the present time. chronic. C.as of the moment. He has not completed immunizations. chronic. She has not completed immunizations. FAMILY ASSESSMENT BASED ON FUNCTIONAL HEALTH PATTERN 1. chronic. • • Was able to recognize the importance of having a healthy well-being.

• They usually sleep at around 9 in the evening and wake up at around 4 to 5 in the morning. 6. Sleep-rest pattern • Family usually has 7-8 hours of uninterrupted sleep according to the mother. every other day with no difficulty in defecating noted. V.2. 4. • Family preferred to stay at home and take a nap if they have free time while their children play with other children in the community after class. Activity-exercise pattern • “Dili nami makaexercise kay daghan mi trabaho labi na pagbuntag” verbalized by the mother. V 3. • The family members defecate everyday and some. Elimination pattern • • Eliminates everyday with an average frequency of urine: 5 times According to Mrs. • They also take a nap at free time. 5. fish and vegetables Children eat junk foods whenever they were given money Children have poor appetite according to Mrs. all of the family members have no difficulty in voiding. Nutritional-metabolic pattern • • • • Do not take any food supplements or vitamins Daily food intake is mainly rice. Cognitive-perceptual pattern 13 .

9. 8. place and is able to identify people and significant others by their first names.• Was oriented to time. Roles and relationship • Family members have an open communication and able to discuss their problems according to the mother. Verbal pattern and spontaneity normal • • Memory intact No sensory defects 7. Retaliates as soon as he can and was able to rationalize. Coping Stress • Gains strength in the “assurance and guarantee” provided by family members. Perceived situations (health deficits) to be very stressful but remain passive about things and condition. 14 . • Was able to respond accordingly and correctly to questions. Self-perception/self-concept • • Showed apprehension and worry towards unspecific consequences. Sexual reproductive • • Both parents are still in the reproductive age The parents are separated as of the moment since the father is in their farm and the mother is in the house 10.

and walking are their ways of exercise. they were not able to sustain sufficient supplies of medication or articles which they would need related to their health care needs. The children are either in school or are playing with other children in the community. All the children in the family were dewormed last March 2008. They sleep early and wake up early. the usual time of sleeping is 9pm and they wake up at around 4 to 5am. Is certain that the Divine providence would protect them from any unidentified and possibilities of harm. The mother usually does the household works and talks with the neighbors during free time. because of financial constraints made them ignores any major health problems that may arise. The children in the family has not all completed their immunization. They often use alternative medicines or herbal medicines for treating their illness and habitually self-medicate if OTC medications are available. Values. The family has adequate rest and sleep. The mother recognizes the importance of health in the family. Mrs. The father is in the farm.  Does not go anymore to church since they are situated far away from the place of worship they attend E. doing the household chores.11. Expressed great belief and faith in God. Habits. however. The family 15 . V stated that farming. Practices on Health Promotion. Furthermore. Values/ Beliefs Pattern  The family is Protestant in faith. Maintenance and Disease Prevention.

Mrs. V said that she had no choice but to use these plants for the reason that the barangay health center is far away from their home. But if the symptoms manifested by the family member become severe. they immediately go to the health center or to the hospital. They occasionally use herbal plants lodged near the house in treating diseases or symptoms in the family since their transfer from Nurallah.believes in the power of herbal plants. 16 .

He is 30 years old. Mrs. She did not continue schooling due to financial constraints. Family History Family V is composed of 6 members Mr. Mrs. Database of the Respondent. Mr. Mr. He was able to go to school up to grade 3 year level. V is the father. V as the mother. Activities of Daily Living which could be an indicative for the present health status of the family as it continues to influence the each of the family member. She has 2 siblings. Sarangani Province. child BV is 10 years old. Upper Labay. Instead she helped her parents in doing household chores and in looking money for their household 17 . Family Tree. BV. child CV is 7 years old and child DV is 5 years old. his wife is 29 years old. After that he did not continue schooling in order to help his parents look for money for their household expenses. Her father is a farmer and her mother is a housewife. V was born and grew up in Malungon. V. V was born and grew up in Purok Daanbanwang. He has 9 siblings and he is the eldest. V is the head of the family. General Santos City. His father was a farmer and his mother was a housewife.Chapter IV FAMILY BACKGROUND This chapter illustrates the family background of the study which includes. Child AV. She was able to go to school and graduated elementary school. CV and DV are the kids. General Household Data. He is a B’laan. Mrs. children AV. as the eldest son is 11 years old.

they got married. V and Mrs. OF CHILDREN : EDUCATIONAL ATTAINMENT: Elementary Graduate ESTIMATED MONTHLY INCOME: none NAME OF HUSBAND: Mr. V 18 . V met in Malungon. South Cotabato and stayed there for another 5 years and came back Upper Labay just this June of 2009 Data Base of the Respondent The respondent upon interview is the mother in the family. They become a couple and after 3 months. then transferred to Upper Labay for 6 months. Sarangani Province through friends of friends. NAME AGE GENDER ADDRESS : : : : Mrs. They again transferred to Nurallah. V 29 years old Female Purok Daanbanwang. Sarangani Province Protestant Housewife Married Filipino 4 NO. They resided in Malungon for 3 years. Upper Labay.Mr. General Santos City BIRTH PLACE RELIGION OCCUPATION CIVIL STATUS NATIONALITY : : : : : Malungon.

Status INC INC INC INC INC COM NS NA NA NA N N N 19 . level F Elem Grad M Elem.B. level Religion Protestant Protestant Protestant Protestant Protestant Protestant Positio n in the Family Father Mother 1st Child 2nd Child 3rd Child 4th Child Imm. Total No. e Attainment x M Elem. V Child AV Child BV Child CV C. List of Household Members Members Mr. of Children: 2 2. level F F F Elem. level Elem. V Mrs. Family Tree Mr. General Household Data 1. V Child AV Child BV Child CV Child DV Status Married Married Child Child Child Child Occupation Farmer Housewife Student Student Student Student S Educ. level Elem. V Mrs.

They are independent in moving about and using their musculoskeletal system. etc. Therapeutic Competence Includes all of the procedures or treatments prescribed for the care of illness such as giving medications. However. The observations are analyzed to see occurrence of health problems or negative attitudes and behavior. They are sentient of their financial difficulties. using appliances. It includes an assessment on how the family handles various stressors.Chapter V FAMILY COPING INDEX This chapter depicts the actual observation of the family behavior and practices in contrast to the ideal family attitude and behavior. The parents are 3 aware on what to do if a member fells ill. The parents are aware of their lapses in therapeutic competence. dressing. exercise. The members are all able to move 5 without assistance and difficulty. walking. Every member has no noted disabilities or disparities in moving and/or doing their ADL. they cannot There are no abnormalities in the physical independence of the family members. CRITERIA IDEAL ACTUAL Rating JUSTIFICATION 1. which is the primary reason for not having or following the 20 . 2. to get out of bed. to take care of daily grooming. Physical Independenc e Is concerned with ability to move about. due to financial problems and distance of the health center. They do their activities of daily living without aid.

4. they use herbal plants. health issues are overlooked. Understanding the general pattern of development of newborn baby and basic needs of infants for physical care. Yet due to financial problems. Concerned with family action in relation to maintaining family nutrition. Yes they take a bath everyday but their source of water.relaxation. Even though aware of hygiene’s importance. The mother is 2 knowledgeable on salient health issues and responsibilities. securing adequate rest and relaxation for family members. Application of Principles of General Hygiene The family sleeps 2 well and eats nutritious food everyday. carrying out accepted preventive measures (immunizations. medical appraisal. But their source of water is not healthy at all. This could be detrimental to the lives of the members especially the children. 21 . appropriate procedure or treatment. those plants are not approved by the DOH. having appliances and even enough clothes for the children. Knowledge of Health Condition Concerned with the particular health condition that is the occasion for care such as knowledge of the disease or inability to understand communicability of diseases and mode of transmission. eating habits and maintenance of healthy lifestyle are not taken into consideration that much. she does not regard it as important at all. Although. diets. 3. safe home-making in relation to storing Though the mother recognizes pertinent health issues. the family does not practice good hygienic skills. etc. special provide enough and/or appropriate interventions. They do not practice sterilization nor healthy habits in food storage and preparation.

Health Attitudes of The parents are 1 concerned about the health of the members of the family yet they do not participate actively in maintaining optimum health due to financial constraints. Willingness to meet reasonable The family lives harmoniously at home. and public health measures. 5. want to protect their children from any harm but then. and to plan for happy and fruitful living. They see stress just like any other family does. as much as possible. Emotional Competence Has to do with the maturity and integrity with which the members of the family are able to meet the usual stresses and problems of life. 22 . 6. Also. Parents. The parents take responsibility for the children. including preventive services. they really see to it that they would discuss each concern in a calm manner.and preparing food). The family are 5 competent enough emotionally. the family lacks information regarding healthy lifestyle and healthful ways toward improvement of life. Even though conflicts arise. The development of the individual’s responsibilities and decision. care of illness. They discipline them and teach them the morals of life. they lack money and information for them to carry out the right health care for the family Concerned with the way the family feels about health care in general. The degree to which individuals accept the necessary disciplines imposed by one’s family and culture.

screening. Their food storage is unsanitary. Their house is also located near a creek. the ways in which they make decisions affecting the family. There are presence of insects. rodents and other vectors. Also their house is in poor condition. sometimes insects and other 23 . because of the presence of pests and accident hazards in their community. The family members get along with one another. privacy. 7. and the ways in which they manage the family budget. 8. Each has his or her own part or role in the family. system. The family’s 2 house space is not good enough for the family. the degree to which they support one another and do things as family. especially with regards to their interrelationship with others. facilities of cooking. the community and work environment as its affect family health. They cook their food outside their house wherein they just use earthly pot and used wood as Others respect individual relationships of each member of the family. The children are not yet open for suggestion to decision-making since they are still young and difficult to comprehend their current situations. level of community (deteriorated neighborhood. The parents discuss decision. to accept adversity with fortitude. presence of social There is high 3 concern within the family. The condition of the house such as pressure of accident hazards. to consider the needs of others as well as one’s own. Family Living Concerned with the interpersonal or group aspect of family life. that they can possibly acquire serious diseases. which is well respected. Decisionmaking is shared among its members except on young member. Though it is covered with cloth. Concerned with home. the degree of respect and affection.making. Physical Environment The house environment is not fitted for them especially for the children.obligations. plumbing.

Bottles of liquor and decomposing woods were noted as well. Also a nail attached on the wood on inverted position was noted. They live in a place wherein it’s not congested but then the distances between their neighbors are not that so far from each other small animals could crawl inside the dish organizer.. Also. transportation of schools and availability. They cannot go to the health center since they have to walk kilometers just to get there. 9.hazards. the cloth that they used was dirty. both in health and education. The school is the only community facility the family uses. The storage of water has a cover. The mother is 3 aware of the available resources in the community. fuel. Use of Community Facilities Degree of the family use and awareness of the available community facilities for education and welfare. Having a eartly pot near the house is really a fire hazard because some of the coal fire might come in contact with their bamboo wall and the nails attached to wood gives the possibility that some of their family members might stepped into it. But they cannot utilize the health facilities since it is far from their house 24 . pests). but it is still unsanitary due to the presence of dirt on the outside of the container.

Inability to provide a home roof. The mother usually cooks at the environment conducive to health back of the house using wood and maintenance and personal charcoal. It is mainly made up of bamboo and nipa as its A. the family nursing problem and the nursing diagnosis. b. Negative attitude towards the health problem. health deficits. Failure to see benefits of Puro kahoy na siya ug nipa ug mga investment in home patay na dahon sa saging. as a health threat. Inadequate family Subjective data: resources. Inability to make decisions with sa budget. ikaon na lang namo diba” due to: a. The problems identified are categorized into presence of wellness state. specifically The mother verbalized “Kaning financial constrains/limited among balay dugay na ni siya. Ang among ipahimo ug respect to taking appropriate action balay. Gibuhat financial resources. Table 4. c. Low salience of the problem 25 . development due to: a. Typology of Nursing Problems identified in Family X Cues or Data Family Nursing Problems Objective data: I. and magnitude of the problem. health threats.Chapter VI TYPOLOGY OF NURSING PROBLEM This chapter discusses about the problem that were identified during assessment and interview with the family. It includes the cues/data. Accident hazards specifically fire The house of Family V is a hazard. ni siya sa pamilya sa akoang bana. Mao ra jud ni among makaya kay siyempre kulang B. galuto sa may likod. bungalow style of house. foreseeable crisis and stress points. Failure to comprehend the nature. scope. Dira ko environment improvement. b.

Wala man mi a. Inaccesability if appropriate resources for care specifically financial constraints Objective data: V. Family size beyond what family resources can adequately provide as a health threat. a. Mga kinahanglan nila. Negative attitude ug langaw” towards health problem c. Low salience of the problem. Isda ug mga gulay dira sa kilid among sud-an pirmi. Inability to make decisions with respect to taking appropriate health action due to: a. Ang among pagkaon ginatama tama lang para sa amua. Daghan lagi kayo b. Luoy kayo. Unsanitary food handling as a The hands of the children are presence of health threat. A. “Gamay ra jud ang income intawon.Objective data: The income of the family is about Php 3000 per month. butanganan na lain. Inability to make decisions with Subjective data: respect to taking appropriate Mother verbalized “Ay mga health action due to: tamad na sila manghugas ug kamot. Wala tay mahimo kay gahi man jud ug b. unclean when they ate they meal. Inaccesability of appropriate resources for care such as financial constraints. A.” II. Objective data: III. Low salience of the problem. Di na gain mi kapalit sa mga sanina sa bata.” health problem Objective data: IV. There are five members in the family Subjective data: Mother verbalized. Inability to make decisions with Subjective data: respect to taking appropriate Mother verbalized “Dira ra man health action due to: namo na ginabutang. Negative attitude towards ulo. Poor home condition specifically The family usually stores their lack of food storage facilities as a food by covering it with plate and health threat leaves it in the table A. They just throw it disposal as a health threat 26 . Poor environmental sanitation The family’s drainage is an specifically improper drainage open type.

They just defecate and void disposal as a health threat anywhere. Near the river is a carabao taking a bath and women washing clothes. Negative attitude towards kanang walay tao” health problem c. Layo man gud kaayo ang gripo diri sa amua” C. Negative attitude towards health problem d. Low salience of the problem. are noted A. Poor environmental sanitation specifically polluted water supply as a health threat A. Inability to recognize presence of condition or problem due to: a. Wala na namo ginasterilize. A. Ok naman na siya. b. Negative attitude towards health problem Subjective data: Mother verbalized “Dira ra man namo pud namo na ginalabay” Objective data: VI. Rice grains beside the house. VII. Inability to make decisions with respect to taking appropriate health action due to: a. b. Inaccesability if appropriate resources for care specifically financial constraints Objective data: The family gets their water source in the man-made shallow well in the river. Poor environmental sanitation The family has no comfort specifically unsanitary waste room. Inaccesability if appropriate resources for care specifically financial constraints Subjective data: Mother verbalized “Dira mi sa B. Failure to utilize community resources for health care due to: 27 . Low salience of the problem. Lack of knowledge Inability to make decisions with respect to taking appropriate health action due to: a. galibang b. Wala a. Dra ra mi gaihi. balon gakuha ug tubig.anywhere. Inability to make decisions with Subjective data: respect to taking appropriate Mother verbalized “Mao jud na health action due to: karon kay wala pa mi kahimo. Low salience of the problem. pay kwarta.

Inability to make decisions with Mother verbalized “Isa ra lagi respect to taking appropriate ang nakakumpleto sa bakuna ba. Inaccesability if appropriate resources for care specifically financial constraints B. Layo health action due to: pa jud ang center. Lack of immunization status Not all children have completed specially of children as a health their immunizations. threat Subjective data: A. Inaccessibility of required service due to physical inaccessibility (location of facility) 28 .” a. Failure to utilize community resources for health care due to: a.a. Inaccessibility of required service due to physical inaccessibility (location of facility) Objective data: VII.

Criteria Computation 1. This could be done if the family will be very alert in watching out especially if they are cooking since the house could catch fire anytime.33 29 . The only way to solve this problem is to renovate the house. The family size cannot be trimmed down to smaller size The problem may be prevented but the family size 0. Nature of the 2/3 x 1 problem 2. Preventive potential 2/3 x 1 0. The problem could be moderately prevented.5 Total Score: 2. thus it needs money. Criteria Computation 1. as a health threat. It includes a computation on how priorities were shown with their corresponding justification. I.67 0 Justification This problem is a health threat The problem could not be modified at all. The problem. compared with the other problems does not need immediate attention since it requires time and money. Nature of the 2/3 x 1 problem 2. Modifiability of 0/2 x 2 the problem 3. Modifiability of 1/2 x 2 the problem Score 0.67 1 Justification This problem is a health threat The problem is partially modifiable. Preventive potential 1/3 x 1 Score 0. Salience 1/2 x 1 0.67 4.Chapter VII PRIORITIZING PROBLEMS This chapter shows the setting of priorities of family health problems that has been identified. Family size beyond what family resources can adequately provide as a health threat. 3. Accident hazards specifically fire hazard.84 II.

Poor home condition specifically lack of food storage facilities as a health threat Criteria Computation 1. Salience 1/2 x 1 Total Score: 0. The problem is not perceived as a problem at all by the family. Unsanitary food handling as a presence of health threat. III. Criteria Computation 1.5 2. Preventive 3/3 x 1 potential 4. Salience 1/2 x 1 1 0.4.67 1 Justification This problem is a health threat This problem is partially modifiable since the family lacks resources specifically in the financial aspect. Preventive 1/3 x 1 potential 4.17 IV. If the family receives the right health teaching. Modifiability of 1/2 x 2 the problem Score 0. Modifiability of 2/2 x 2 the problem Score 0.5 Total Score: 4. The problem is not needing immediate attention according to the family 3. attitude can be changed for the better The problem can be prevented if the family is educated on the importance of hand washing The problem is not perceived as a problem requiring immediate attention according to the family since there are other health problems more important 3. Nature of the 2/3 x 1 problem 2. Nature of the 2/3 x 1 problem 2. However.5 30 . appropriate health teachings may correct this problem The problem is low in preventive potential since there is lack of appropriate resources that could solve this.67 2 Justification This problem is a health threat The condition can be highly modifiable. Salience 0/2 x 1 Total Score: 0 1 cannot be trimmed down.33 0.

Modifiability of 2/2 x 2 the problem 3. Preventive 2/3 x 1 potential 4. This is highly preventable if the family has learned the importance of having a clean drainage.5 3. Nature of the 2/3 x 1 problem 2. Salience 1/2 x 1 Total Score: Score 0. Modifiability of 1/2 x 2 the problem 3. This can be highly preventable if the family had prioritized in building a toilet According to the family. the problem does not need immediate attention 0.67 0. it plays not much importance in their life 0.5 2. The problem is preventive because there are ways and 1 31 .67 2 Justification This problem is a health threat The problem is easily modifiable by teaching the family the importance of having a proper drainage. Nature of the 2/3 x 1 problem 2. Preventive 3/3 x 1 potential Score 0. With regards to the family’s perception.67 0. Poor environmental sanitation specifically polluted water supply as a health threat Criteria Computation 1.V. Salience 1/2 x 1 Total Score: Score 0. Poor environmental sanitation specifically unsanitary waste disposal as a health threat Criteria Computation 1.67 1 Justification This problem is a health threat The problem is moderately modifiable since this problem can only be solved with money.84 VI. Poor environmental sanitation specifically improper drainage disposal as a health threat Criteria Computation 1. Nature of the 2/3 x 1 problem 2.67 2 Justification This problem is a health threat The problem is highly modifiable since it could be solved if the family knows the importance of sterilization.84 VII. Preventive 2/3 x 1 potential 4. Modifiability of 2/2 x 2 the problem 3.

VIII. Nature of the 2/3 x 1 problem 2.67 1 Justification This problem is a health threat The problem is moderately modifiable since there are available resources such as in the health center yet the family cannot easil go to the health center because of its long distance from Daan Banwang The problem is moderately preventive since the family could have had immunization way back in Malungon but also due to negative attitude and financial constraint. The family knows how important immunization is specially for the children 3. with accordance to the family’s perception. Modifiability of 1/2 x 2 the problem Score 0. Lack of immunization status specially of children as a health threat Criteria Computation 1. the family did not seem to mind at all.67 4. Preventive 2/3 x 1 potential 0. Salience 2/2 x 1 Total Score: 1 3. Salience 1/2 x 1 Total Score: 0.4.17 resources present in the community where in the family can have a clean water supply The problem. is not much important.5 4.34 32 .

Chapter VIII NURSING CARE PLAN This chapter shows the identified and prioritized problems in a ranking order.50 1 33 . as a health threat. This chapter also presents the family care plan formulated by the student nurse together with the family.34 2. Poor home condition specifically lack of food storage facilities as a health threat Family size beyond what family resources can adequately provide as a health threat.84 2. Score 4.17 3. Poor environmental sanitation specifically polluted water supply as a health threat Poor environmental sanitation specifically improper drainage disposal as a health threat Lack of immunization status specially of children as a health threat Poor environmental sanitation specifically unsanitary waste disposal as a health threat Accident hazards specifically fire hazard. Problem List Problems Unsanitary food handling as a presence of health threat.84 2.84 3.17 4.

pail and clean towel After 1 day of community exposure. water. the family has able to: Employ hands finger before during meals clean and nails and eating Specifically: • • >Demonstrate proper hand washing Discuss the technique importance and need for hand washing >Inform the Demonstrat family about e proper communicable Specifically: • Discuss the importance and need for hand washing Demonstrate proper hand • 34 . CUES ANALYSIS OF THE PROBLEM INTERVENTION PLAN OBJECTIVES NSG. INTERVENTIONS RATIONALE METHOD RESOURCES REQUIRED EXPECTED OUTCOME Subjective data: Mother verbalized “Ay mga tamad na sila manghugas ug kamot. the family will be able to: Employ hands finger before during meals clean and nails and eating >Assess the family’s ideas on food handling and hand washing >Discuss with the family the importance and need for hand washing > To obtain how much the family knows on these issues >To educate the family about proper hand washing > To show the proper hand washing technique and for better understanding on it > To make the family aware of the diseases H O M E V I S I T >Manpower resources such as time and effort. Wala tay mahimo kay gahi man jud ug ulo. >Physical and chemical resources such as soap.” Inability to make decisions with respect to taking appropriate health action due to: • Low salience of the problem.FAMILY NURSING CARE PLAN Problem# 1 Unsanitary food handling as a presence of health threat. • Negative attitude Objective towards data: health The hands problem of the children are unclean when they ate they meal. After 1 day of community exposure.

. 35 .Dirty and long finger nails noted hand washing techniques diseases especially the ones transmitted if hand washing is not reinforced >Explore the family’s reaction about the health teachings given. washing techniques > To measure the understanding of the health teachings presented. they are prone of.

Mr. EVALUATION AND RECOMMENDATION Presented in this case study is the different characteristics and health condition of family V. Summary and Evaluation The Family V is considered as a nuclear type of family. The V family’s main source of income is coming from Mr. she is in charge of the house and in taking care of the children.000. The V family resides in Purok Daanbanwang. home and environmental factors. the family strives hard to accommodate everything they need for them to 36 . V does not work. Since Mrs. mostly bamboo. This case study presents the family structure. V earns about Php 6. Her husband knows it yet he was not there during the interview.5 m2. the total floor area should be divided among the total members of the family and each should at least have 3.00 a month. V’s farming. a mother and child/children. General Santos City. With Mr. socio – economic and cultural factors. health assessment of each member. A nuclear type is a typical type of family composed of a father. Mrs. They have started living their since June of 2009. V did not know the exact measurement of their house. The house only has 2 windows and can sustain the adequate ventilation needed by the family. Upper Labay. V’s monthly income. In order for the house to be considered as adequate.Chapter IX SUMMARY. It also contains data about identified problems on the living condition of the family. Their house is made of wood.

00 and when divided among the 6 members. The drainage system of the family is an open type where in the drainage flows anywhere and is continuous. V Family has no comfort room. 37 . The total monthly income of Mr. V is about Php 6. V mentioned that they do not go to church anymore since they have lived in Purok Daanbanwang for the reason that of the distance they have to travel from their place to the church. though. it is only Php 1. According to NEDA. They usually don’t sterilize their drinking water supply. The river is the family’s main source of water.live. they can be considered poor. 000. thus. Mrs. go to Purok Daanbanwang Elementary School. They typically borrow money from their relatives.60 when the total monthly income of the family is divided among the total family members. The V Family barely enjoys the community resources since the community itself lacks resources. each individual should at least have Php 2768. They wash their clothes and gets their drinking water supply there. They usually urinate and remove bowels anywhere near their house. The family has yet to participate in community activities since they are new in the place. The father is usually in their farm while the mother is in the house doing household chores.00. 000. The children. They put their water in a big container with cover. All of them are affiliates of Protestantism. V also informed the student nurse that they do not have any financial assets at hand in case of emergency. Mrs.

The objectives of identifying family nursing problems were only partially achieved due to security reasons for the part of the student nurse. Recommendations The student nurse have identified and prioritized problems and needs with the family. A nursing care plan then is formulated to address the different problems identified. Nevertheless. the student nurse as an agent has helped the family through motivation and support to change their lifestyle and improve their health status. many problems were identified such as health threats which include fire hazards. and improper drainage system as well as health threats which are improper personal practice as improper hygiene. poor home and environmental sanitation. the family has chances to improve their health condition. the family is now equipped with fair knowledge which they could use anytime as the need arises. The student nurse have also created a care plan on how to deliver the 38 . Hence. they are willing to submit themselves for the impartation of information and basic knowledge regarding family health. They are cooperative and participative to the different issues and interventions they are confronted. There still have that ability to meet the desired characteristics in their structure and maximize their health potential of optimum wellness. With this situation and family condition.The V family is identified to have plenty of environmental problems in which it is evident that they practice poor environmental sanitation. Together with the family. Although the allotted time for the student nurse was not enough to attend to all those problems.

and proper and regular hand washing. • They must also reorganize their cooking practices in terms of food preparation and handling as well as keeping their kitchen utensils in a covered storage to avoid getting it contaminated by insects or pests. • The family should also maintain proper hygiene such as taking a bath regularly. • The family should be aware that organizations in the community are open and present for their problems to be addressed properly. brushing of teeth frequently. • The family must also be educated and follow the proper preparation of herbal medicines as it was presented during the mother’s class.best nursing care for the family to address their needs. they should also cover their food storage. The following below are propositions and commendations recognized by both the student nurse and family: • The V family should maintain a healthy and clean environment. • The family should also be advised to not wait for the ailment to become severe before seeking medical help. trimming their nails. frequent changing of clean clothes especially when come in contact with filthy objects or experienced wetness of the back. • The V family should persevere to perform proper waste segregation and disposal of their garbage as it was presented during the mother’s class. In addition to that. refraining from walking barefooted. They must clean their surroundings to avoid the presence of vectors of diseases. 39 .

• They should be encouraged to verbalize their concerns with regard to the community so that resolutions can be made. 40 .

Philippines:2007 Maglaya. et. Manila: Educational Publishing House. 10th ed. Published: 6/23/2004.BIBLIOGRAPHY Books Cuevas. Nursing Practice in the Community. http://www. Internet Sources Jay C.htm 41 .about. Marikina City: Argonauta Corp. 1st ed. Public Health Nursing in the Philippines. F.com http://psychology. 2005. al. htm http://psychology.buzzle. 2004..about.com/editorials/6-23-200455793.com/od/theoriesofpersonality/a/psychosocial.com/od/theoriesofpersonality/ss/psychosexualdev. Concepts and Guidelines in COPAR. A. Untalan. A.asp http://wisdomquotes.

5 kgs 33 kgs 17 kgs NS N N N N N N Members Mr V Mrs V AV BV CV DV II. Sources of Income: Occupation: Farming Estimated Monthly Income: P6. List of household members: B-Day (mm/dd/yyyy) Occupation Farmer.College of Nursing Barangay/ Purok: Daanbanwang.APPENDICES APPENDIX A BARANGAY HEALTH PROFILE Department of Health Notre Dame of Dadiangas University. 000 42 . 11-14-79 10-09-80 07-11-98 10-19-99 04-16-02 05-23-05 ECONOMIC DATA A. Upper Labay. Status INC INC INC INC COM Deworming Date 2008 2008 2009 2009 Weight 56 kgs 50 kgs 38 kgs 36. Husband son son son daughter Imm. Housewife Student Student Student Student Sex M F M F M F Eductl Attainment Grade 3 Elem Grad Grade 5 Grade 4 Grade 3 Grade 1 Religion Protestant Protestant Protestant Protestant Protestant Protestant Rel. Total number of children: 4 B. General Santos City PERSONAL DATA Name of respondent: Mrs V I. B-Day: 12/17/1973 Status: M Household No. Educational Attainment: Grade 6 GENERAL HOUSEHOLD DATA A. to Resp.

43 . Immediate Sources of Medical Care: BHW C. Pills D. Lactating: No F. colds and fever. Home: Herbal ( ) Vegetable ( x) None ( ) MEDICAL HEALTH DATA A. Pregnancy: No E.B. Source of Drinking Water Supply: Shallow well C. Animal Raising: chicken G. Land 1. Transportation Facilities: Owned ( X ) Rented or Others( ) H.taka B. Family Planning: Continuous. Type: Plain ( X ) Rolling ( ) C. Water: Bought ( ) Free (x ) III. Owned ( ) Rented ( ) Tenanted ( X ) 2. Disable member of the family: None IV. of Hectares: ____. Household Appliances: radio F. Garbage Disposal: Burying and/or Burning E. Herbal e.g Mayana and Kataka. Type of Housing: Concrete ( ) Ordinary ( X ) Rented ( ) Scrap ( ) E. Toilet facilities: Owned ( ) Shared ( ) None ( X ) Anywhere B. if land is farmed: corn D. Common diseases/ Commen Treatment: cough. Products. Death in the Family: None G. Other pertinent observations/informations like presence of personality disturbances: None H. Drainage: none D. ENVIRONMENTAL DATA A. No.

APPENDIX B FAMILY HEALTH DATA CARD INDICATOR FAMILY PLANNING PRENATAL IMMUNIZATION NUTRITION WATER GARBAGE DISPOSAL TOILET ALCOHOLISM SMOKING THIRD QUARTER OOOOOO OOOOOO OOOOOO OOOOOO OOOOOO OOOOOO OOOOOO OOOOOO OOOOOO QUARTER FOURTH QUARTER OOOOOO OOOOOO OOOOOO OOOOOO OOOOOO OOOOOO OOOOOO OOOOOO OOOOOO 44 .

Mao ning inyong balay?” Client “Maayong buntag sad. Dali sulod mo oi. Amua ni siya. Rationale The opening can be the most important part of the interview because what is said and done at that time sets the tone for the remainder of the interview.APPENDIX C Process Recording This appendix represents the course of interaction between the student and the family during each phase of interview. Purpose: 1. Pwede mabal-an unsa inyong pangalan?” “Ay hello diay Ma’am Emie. To be able to interpret or analyze the answers given by the respondent 3. To document pertinent data and how they responded to questions that were raised Orientation Phase Student Nurse “Maayong buntag diay Ma’am” (Waves and smiles) “Salamat Ma’am. To be able to have a specific data on how the interview was conducted 2. Establishing rapport is a process of creating goodwill “O. The purposes of the opening are to establish rapport and orient the interviewee.” (Smiles) “Ahh. Nursing student sa NDDU. Ako diay si Mylene Ma’am. Bag-o ra jud mi diri. Ako diay si Emie. Tong June lang mi ngbalhin diri” The student nurse verified if the respondent 45 .” Remarks The student nurse greeted the respondent and the respondent welcomed the student nurse in their house. It also includes the reactions of the family or how they respond on the questions that were lift during the entire interview.

The student in a nonjudgmental ko mag-interview Walay problema. Siyempre importante gud na naa mi mabal-an sa sakit sakit.” duration of mi mga November their stay in na. Aha “Ang akong bana of the begin with a man pud inyong naa man sa bukid community. It can “Ahh. and a sila mukaon” friendly manner. Pasalamat gani mi naa mo diri karon para mutabang namo. Giving recognition. greeting (“Good pamilya?” gud nag-uma. nurse told the understanding. Lisod daw ang suga. Pwede “Okey ra kaayo uy. Mga December the daw mi community. Acknowledgment may be with or “Salamat kaayo “Hala. self-introduction Ginaadtuan lang (“Good morning! namo sa mga bata.was a member and trust. an Kanang kamo man Hehe” respondent on efftort the client has gud ang akong her purpose made. I’m a nursing Ang mga bata naa student”) man sa eskwelahan accompanied by kay nay klase. “Ay ma’am. Pero challenge na siya sa amua eh. magculmination” “Lagi daw ma’am. of a change in sa inyuha? Maayo gani ni. informed the behaviour.” “Ay wala nay problema gang. Kanang manghangyo ko sa inyong cooperation ma’am ha. Dalia ra man The student without ma’am ha. a inig udto kay diri to handshake. Dapat lang jud mucooperate mi eh” (Smiles) The respondent approves of the student nurse’s purpose and acknowledged her presence. Mubalik suga diri. nurse way. nonverbal gestures Unya pato taod2 such as smile. Didto morning Sir!”) or na siya gapuyo jud. Lingaw man pud na siya (Client and SN laughs). 46 . ma’am?” interview. Kanang pud diay noh. or a napili na iadopt na for coming contribution to family. maginterview eh? Wala baya the time (Barbara Kozier) interview. Mao ba. Okey ra and the communication. hantod October mi Matulog pud mo diri respondent verbal or nonverbal.

Lagi. October 9 ko nya November 14 na siya. Education is an important aspect in every human life especially now that job hiring could be Respondent was proud to be a family planning follower. 4 tanan among mga anak. Unsaon ta man Respondent blames poverty for their lack of education. Maayo gani ma’am nainform mo ug ing-ana Kanang ma’am mangutana ko kung unsa inyong nahuman sa eskwela? 47 . si BV 10. Remarks Rationale Demographic data was given completely. Lisod na baya kinabuhi ron. 29 nako. Ahh. Akong bana kay 30. Wala baya sila diri kay nageskwela. Unsa pud mga Pangalan sa inyong anak ug ilang mga bday? Client Yata. Si BV kay October 1999. Elementary graduate ko. Si AV July 1998 na siya. Gafamily planning man jud gud mi tong una pa sa Malungon pa mi. Naa man pud gud health center didto sa Malungon ug Nurallah. akong bana kay hantod grade 3 lang. Ikaw lang akong interbyuhon.Working Phase Student Nurse Ay kanang ma’am unsa inyong apelyido? Sige lang ma’am. Si Child AV 11. Unsa napud inyong edad ug sa inyong bana? Kanus-a pud inyong mga bday? Okey ra ma’am uy. Ay sige. Si CV April 2002 unya si DV May 2005. Kanang. si CV 7 unya si DV 5. Wala baya akong bana diri ay. Hehe. Lagi ma’am uy. Layo layo pud ilahang mga agwat noh. Nagsunod sunod lang ang 2 ka una pero after ana nagpills nako.

Kaning among balay dugay na ni siya. Mao ra jud ni among makaya kay siyempre kulang sa budget. si CV grade 3. O. Unsa pa mga lain ninyong ginakwaan para income? Kanang pila pud inyong maincome sa usa ka bulan? Mga Php6. very difficult if you lack education. Ang among ipahimo ug balay. Puro kahoy na siya ug nipa ug mga patay na dahon sa saging. 48 . Gamay ra jud ang income intawon. Respondent put on much emphasis on financial issues.lisod kaayo ang kinabuhi.000 pud. Wala nay lain. Poverty is an issue in every Filipino family since it is the major factor that affects their way of living. Nag-ingon ka ma’am na nagauma imong bana. Kamo ra jud diri sa mga bata ma’am? Bale balay jud ni ninyo? She was able to express her concerns about the household. si BV grade 4. Due to financial constraints. the family has not able to provide an adequate and a safe house for the family. Si AV grade 5. si DV maggrade 1. Dira ko galuto sa may likod. Respondent was glad the children have a chance in education. Gibuhat ni siya sa pamilya sa akoang bana. Di na gain mi kapalit sa mga sanina sa bata. Ang mga bata ma’am? Mga bata maayo man kay nay eskwelahan diri. Mga kinahanglan nila. Kami ra jud diri. including the environment. ikaon na lang namo diba Ay mao ra jud na. akong bana tu-a sa bukid.

Ang among pagkaon ginatama tama lang para sa amua. Layo man gud kaayo ang gripo diri sa amua. Drainiage disposal is an important factor since vectors or insects may hover and affect their health. Respondent explains how they manage their drainage disposal Respondent shows how they put their left overs. Dira ra man namo na ginabutang. 49 . The respondent explained how they manage with their elimination even without a toilet facility. Daghan lagi kayo ug langaw Ay daghan pud. Daghan kaayo mga langaw? Mga lamok? Respondent explains that although there are many mosquitoes in the place. galibang kanang walay tao Dira mi sa balon gakuha ug tubig. aha ninyo ginalabay? Kanang butangan sa inyong pagkaon na wala nahurot? Dira ra man namo pud namo na ginalabay. The family has not yet build a toilet facility since they were new to the place and have no budget for it. they have protection from it. She also explained their ways of getting water for drinking. Ok naman na siya. Isda ug mga gulay dira sa kilid among sudan pirmi. (Points at the ground beside the house). Wala na namo ginasterilize. Wala man mi butanganan na lain. Wala pay kwarta. Kanang inyuhang banyo? Ug kung asa mo gakuha ug tubig? Mao jud na karon kay wala pa mi kahimo. Pero naa man mi mosquitero. Ang inyong mga lamaw ma’am o mga hugaw gikan sa kusina.Luoy kayo. Dra ra mi gaihi.

Ang na ginatanom? herbal naa sa ilalom. Parehas ng ilang paghugas o paggamit ug tsinelas? Kanang bisyo ma’am? Knowing the ways of health helps the student nurse what to educate the family and what kind of improvement on health they need. Balik ra ko.” Respondent points out that the health center is quite far from their place. Ay maayo jud. Wala jud bisyo akong bana. Remarks The respondent appreciated our presence and was open Rationale Expressing gratitude makes the respondent feel that they did something good. Respondent shows the student nurse their mini vegetable garden and that they have herbal plants around. Giving 50 . Ay mga tamad na sila manghugas ug kamot. Client Walay problema. Having a vegetable and herbal garden helps the family in terms of healthy food and also disease management Termination Phase Student Nurse Ay ma’am salamat kaayo ma’am ha. Naa pud ba moy Naa. Kanang diri sa panimalay ma’am unsa pud ng ugali sa mga bata na makaapekto sa ilang lawas. No disturbances were found. Salamat jus kaayo. Respondent feels proud of her husband not having vices. Mga mga gulay o herbal kangkong. Wala tay mahimo kay gahi man jud ug ulo. Adto lang gud diri. Sa panahon namo dili man pud na uso gud. Balik balik mo ha.Kanang sa bakuna sa mga bata ma’am? Isa ra lagi ang nakakumpleto sa bakuna ba. Suroy suroy pud mo ba. Immunization is an important protection and prevention of some diseases. Respondent shows that she disapproves of the children’s behavior but feels she can’t do anything about it. Layo pa jud ang center. Mga asunting. Didto o.

or a contribution to communication. Acknowledgment may be with or without understanding.in answering all the questions. 51 . of a change in behaviour. in a nonjudgmental way. an efftort the client has made. recognition. verbal or nonverbal.

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