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“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
(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
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.
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.
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.
They have started living their since June of 2009.Chapter III INITIAL DATABASE A. Level (Grade 3) Elem Grad (Grade 6) Elem. The nuclear family can be a nurturing environment in which to raise children as long as there is love. The V family resides in Purok Daanbanwang. Level (Grade 3) Elem. low stress. 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. and Dynamics Name Mr. and a stable economic environment. a mother and child/children. V Mrs. This type of family structure is found in almost all societies. They were a 6 . Upper Labay. emotional support. time spent with children. Characteristics. 2004. Level (Grade 1) Female Married Male Female Male Female Child Child Child Child The Family V is considered as a nuclear type of family. both adults are the biological or adoptive parents of their children (Jay C. Level (Grade 4) Elem. Level (Grade 5) Elem. Family Structure. In nuclear families. General Santos City.). A nuclear type is a typical type of family composed of a father. although the length of time in which the family remains in this form varies even within the same society.
She makes sure that she will comply with the appropriate regimen when certain health issues arise. They consult each other in terms of planning and budgeting for their family. South Cotabato for 5 years and in Malungon for 3 years. shoes and slippers comes in. When problem arises. Socio-Economic and Cultural Characteristics The V family’s main source of income is coming from Mr. V and Mrs.00 a month. V since of course believing it is her duty as the mother. in terms of matter concerning health Mrs. V earns about Php 6. she is in charge of the house and in taking care of the children. V go hand in hand in terms of decision-making.000. Since Mrs. Mr. Out of Mr. She has greater awareness concerning health matters compared to Mr. Mr. 7 . most of it goes to the family’s budget for food. V does not work. Usually. they make sure that both of them will handle and solve the problem. Mrs. V is more dominant. They have been in Nurallah. V budgets the money in terms of food. education and miscellaneous where clothes. They discuss matters concerning their children’s schooling financially and also with regards to the emotional problems or aspects within the family. there is nothing to be left for the miscellaneous expense. 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. These health matters include immunization. V’s earnings. But then.family whose resident is always changing. V’s farming. feeding the right food and caring for the sick member. B.
For family V. thus. V is about Php 6. the significant others in their lives are their relatives and some neighbors. each individual should at least have Php 2768. Mrs. Mr. V works as a farmer. They usually run to their relatives if they face hardships and problems. 8 .00 and when divided among the 6 members. She is the typical housewife where in you can see her wash clothes. 000. Mrs. sweep the yard and make the house clean. it is only Php 1. According to NEDA. 000.00. They are the ones very close to a person or group of persons. Mrs. All of them are affiliates of Protestantism. Mrs. V doesn’t work and stays in their house. prepare food. 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. Significant others are called such due to their own role in one’s life. they can be considered poor. The total monthly income of Mr. he works from 3 am until 8 pm everyday.60 when the total monthly income of the family is divided among the total family members.With Mr. which is situated far away from the family’s house. V also informed the student nurse that they do not have any financial assets at hand in case of emergency. V also confirmed how helpful and welcoming her neighbors are with them. He seldom goes home but rather stays in the farm. V’s monthly income. the family strives hard to accommodate everything they need for them to live. They typically borrow money from their relatives.
The house only has 2 windows and can sustain the adequate ventilation needed by the family. V did not know the exact measurement of their house. they usually partake in community activities. 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. 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. Home and Environment The house is made of wood. The family uses the river as their means of water source in washing their clothes. The children. 9 .5 m2. mostly bamboo. parties and carnivals. In order for the house to be considered as adequate. C. Her husband knows it yet he was not there during the interview. These activities include fiesta.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. meters away from their house. go to Purok Daanbanwang Elementary School. The V Family barely enjoys the community resources since the community itself lacks resources. Mrs. though. Mrs. But way back in Nurallah.
they just cover it with a plate. and knives. When it comes to storing their food. In terms of cooking facilities the family is equip with pots. V. and Mrs V. It is dirty and has a stinky smell. V Family has no comfort room. The V Family has only one appliance which is the radio powered by batteries since the place has no electrical supply yet. according to Mrs. Mr. they are still new in the community and has no enough budget for it yet. “sandok”. it is far from their house. They wash their clothes and gets their drinking water supply there. They usually urinate and remove bowels anywhere near their house. they either bury or burn their garbage. sleep in one room. They usually don’t sterilize their drinking water supply. The foods that they usually eat are fish and vegetables. The drainage system of the family is an open type where in the drainage flows anywhere and is continuous. They usually don’t go and get water from the faucet in the purok since. She is the one who prepares the food. Mrs. The river is the family’s main source of water. The one is the sala/dining room and the other is the bedroom. V. V uses wood and charcoal in cooking. She cooks inside the house at the back portion. together with the children. The family uses plastic plates and stainless spoons in eating. according to Mrs. They have not yet built their own comfort room since. They use “banig” in sleeping. with no bed at all.The house has 2 rooms. They put their water in a big container with cover. In terms of garbage disposal. There is 10 .
They ride on a jeepney or truck in going to the city proper. V – She has no degenerative. told us that she thinks her husband has never undergone immunizations at all since it was not that important before. Mrs. they usually walk kilometers. She has also not completed immunizations. Mrs. V. chronic. V told the student nurse that her husband has no genetic or hereditary illness known. Health Assessment on Each Member A. There is no obstruction present at the drainage system since it is open and flows anywhere. The family has one chicken and a dog. He drinks alcohol rarely since they have no budget for that. His BMI reveals normal weight with a value of 20. A since he was in their farm during the interview. Her BMI reveals normal weight with a value of 23. V – The student nurse has never met Mr. V said that her husband is about 5’4 tall and weighs about 55 kilograms. He is not a smoker. The family does not own any transportation facilities.4. She has no complaints as of the present time and has not taken any medications 11 .some rice grains noted. Mr.8. B. she experienced chicken pox. There are vegetables planted near the house. PAST AND PRESENT ILLNESS 1. however. or infectious diseases as of the present time. Mrs. When she was still 4 years old. Health Assessment of Each Family Member D1. When they go to their farm or any purok within Upper Labay. Mrs. She is 5 feet and 3 inches and weighs 60 kilograms. D.
• • Was able to recognize the importance of having a healthy well-being. D. though not approved by the DOH. chronic. from their backyard 12 . or infectious diseases as of the present time. she would just drink paracetamol for fever and mefenamic acid for pain or treat wounds with crushed plants coming from their backyard. She has complete immunizations. chronic. F. Uses herbal plants. She is 4 feet and 7 inch tall and weighs 36. He is 4 feet and weighs 33 kilograms. The family is not using family planning anymore.5 kilograms. Child BV –has no any degenerative. FAMILY ASSESSMENT BASED ON FUNCTIONAL HEALTH PATTERN 1. Child DV – has no any degenerative. He likes to eat vegetables and fish. Child BV –has no any degenerative. or infectious diseases as of the present time. She has not completed immunizations. or infectious diseases as of the present time. or infectious diseases as of the present time. C. This child has many allergies and there are rashes still seen on her legs. chronic. He has not completed immunizations. She is 3 feet and 11 inches tall and weighs 17 kilograms. At times of illness. Child AV – has no any degenerative. V who drinks alcohol rarely. He is 4 feet and 10 inches and weighs 38 kilograms. She appears thin. He has not completed immunizations. Health Perception-health management patterns • With no known vices like smoking and drinking except for Mr. chronic. E.as of the moment.
V 3. fish and vegetables Children eat junk foods whenever they were given money Children have poor appetite according to Mrs. • The family members defecate everyday and some. 6. • They usually sleep at around 9 in the evening and wake up at around 4 to 5 in the morning. Nutritional-metabolic pattern • • • • Do not take any food supplements or vitamins Daily food intake is mainly rice. 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. all of the family members have no difficulty in voiding. • They also take a nap at free time. V. every other day with no difficulty in defecating noted. Cognitive-perceptual pattern 13 . Activity-exercise pattern • “Dili nami makaexercise kay daghan mi trabaho labi na pagbuntag” verbalized by the mother. 5.2. Sleep-rest pattern • Family usually has 7-8 hours of uninterrupted sleep according to the mother. Elimination pattern • • Eliminates everyday with an average frequency of urine: 5 times According to Mrs.
9. Coping Stress • Gains strength in the “assurance and guarantee” provided by family members. 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. Roles and relationship • Family members have an open communication and able to discuss their problems according to the mother. • Was able to respond accordingly and correctly to questions. 14 . Perceived situations (health deficits) to be very stressful but remain passive about things and condition. place and is able to identify people and significant others by their first names.• Was oriented to time. Self-perception/self-concept • • Showed apprehension and worry towards unspecific consequences. 8. Retaliates as soon as he can and was able to rationalize. Verbal pattern and spontaneity normal • • Memory intact No sensory defects 7.
however. The family has adequate rest and sleep. The children are either in school or are playing with other children in the community. Is certain that the Divine providence would protect them from any unidentified and possibilities of harm. They often use alternative medicines or herbal medicines for treating their illness and habitually self-medicate if OTC medications are available. The mother usually does the household works and talks with the neighbors during free time. Habits. V stated that farming. and walking are their ways of exercise. The father is in the farm. Furthermore. they were not able to sustain sufficient supplies of medication or articles which they would need related to their health care needs. They sleep early and wake up early. the usual time of sleeping is 9pm and they wake up at around 4 to 5am. doing the household chores. All the children in the family were dewormed last March 2008. The mother recognizes the importance of health in the family. Values/ Beliefs Pattern The family is Protestant in faith. The children in the family has not all completed their immunization. Does not go anymore to church since they are situated far away from the place of worship they attend E. Practices on Health Promotion. The family 15 . because of financial constraints made them ignores any major health problems that may arise. Values. Maintenance and Disease Prevention. Expressed great belief and faith in God. Mrs.11.
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. Mrs. 16 . They occasionally use herbal plants lodged near the house in treating diseases or symptoms in the family since their transfer from Nurallah. But if the symptoms manifested by the family member become severe.believes in the power of herbal plants. they immediately go to the health center or to the hospital.
V. children AV. Mr. Mrs. He has 9 siblings and he is the eldest. child BV is 10 years old. Child AV. General Household Data. She was able to go to school and graduated elementary school. His father was a farmer and his mother was a housewife. Instead she helped her parents in doing household chores and in looking money for their household 17 . child CV is 7 years old and child DV is 5 years old. his wife is 29 years old. He is 30 years old. Family History Family V is composed of 6 members Mr. Upper Labay. He was able to go to school up to grade 3 year level. General Santos City. V as the mother. She did not continue schooling due to financial constraints. as the eldest son is 11 years old. V is the head of the family. After that he did not continue schooling in order to help his parents look for money for their household expenses. V is the father. BV. Sarangani Province. Mrs. Mrs. 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.Chapter IV FAMILY BACKGROUND This chapter illustrates the family background of the study which includes. She has 2 siblings. He is a B’laan. Her father is a farmer and her mother is a housewife. V was born and grew up in Malungon. Database of the Respondent. Family Tree. V was born and grew up in Purok Daanbanwang. Mr. CV and DV are the kids.
Sarangani Province Protestant Housewife Married Filipino 4 NO. They become a couple and after 3 months. they got married. OF CHILDREN : EDUCATIONAL ATTAINMENT: Elementary Graduate ESTIMATED MONTHLY INCOME: none NAME OF HUSBAND: Mr. V and Mrs. 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. V 29 years old Female Purok Daanbanwang. They again transferred to Nurallah.Mr. then transferred to Upper Labay for 6 months. They resided in Malungon for 3 years. NAME AGE GENDER ADDRESS : : : : Mrs. V 18 . Upper Labay. V met in Malungon. Sarangani Province through friends of friends. General Santos City BIRTH PLACE RELIGION OCCUPATION CIVIL STATUS NATIONALITY : : : : : Malungon.
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 F Elem Grad M Elem. V Mrs.B. V Mrs. level Elem. V Child AV Child BV Child CV C. e Attainment x M Elem. 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. Family Tree Mr. Status INC INC INC INC INC COM NS NA NA NA N N N 19 . of Children: 2 2. level F F F Elem. level Elem. General Household Data 1. List of Household Members Members Mr.
they cannot There are no abnormalities in the physical independence of the family members. Every member has no noted disabilities or disparities in moving and/or doing their ADL. Therapeutic Competence Includes all of the procedures or treatments prescribed for the care of illness such as giving medications. etc. to get out of bed. to take care of daily grooming. Physical Independenc e Is concerned with ability to move about. They are sentient of their financial difficulties. walking. The members are all able to move 5 without assistance and difficulty. They are independent in moving about and using their musculoskeletal system. CRITERIA IDEAL ACTUAL Rating JUSTIFICATION 1. dressing.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. which is the primary reason for not having or following the 20 . It includes an assessment on how the family handles various stressors. The parents are 3 aware on what to do if a member fells ill. The parents are aware of their lapses in therapeutic competence. They do their activities of daily living without aid. due to financial problems and distance of the health center. exercise. using appliances. 2. However. The observations are analyzed to see occurrence of health problems or negative attitudes and behavior.
eating habits and maintenance of healthy lifestyle are not taken into consideration that much. those plants are not approved by the DOH. health issues are overlooked. 4. appropriate procedure or treatment. Although. They do not practice sterilization nor healthy habits in food storage and preparation. the family does not practice good hygienic skills. medical appraisal. Concerned with family action in relation to maintaining family nutrition. securing adequate rest and relaxation for family members. 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. Understanding the general pattern of development of newborn baby and basic needs of infants for physical care. Application of Principles of General Hygiene The family sleeps 2 well and eats nutritious food everyday. But their source of water is not healthy at all. Yet due to financial problems. Yes they take a bath everyday but their source of water. 3. carrying out accepted preventive measures (immunizations. having appliances and even enough clothes for the children. 21 .relaxation. they use herbal plants. special provide enough and/or appropriate interventions. she does not regard it as important at all. safe home-making in relation to storing Though the mother recognizes pertinent health issues. etc. This could be detrimental to the lives of the members especially the children. Even though aware of hygiene’s importance. The mother is 2 knowledgeable on salient health issues and responsibilities. diets.
and preparing food). They discipline them and teach them the morals of life. and public health measures. 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. Also. Parents. care of illness. The development of the individual’s responsibilities and decision. 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. 6. The parents take responsibility for the children. 5. the family lacks information regarding healthy lifestyle and healthful ways toward improvement of life. they really see to it that they would discuss each concern in a calm manner. Even though conflicts arise. They see stress just like any other family does. The degree to which individuals accept the necessary disciplines imposed by one’s family and culture. 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. want to protect their children from any harm but then. and to plan for happy and fruitful living. as much as possible. The family are 5 competent enough emotionally. 22 . Willingness to meet reasonable The family lives harmoniously at home. including preventive services.
to consider the needs of others as well as one’s own. Their food storage is unsanitary. The family members get along with one another. the degree to which they support one another and do things as family. privacy. especially with regards to their interrelationship with others. 7. that they can possibly acquire serious diseases. because of the presence of pests and accident hazards in their community. the community and work environment as its affect family health. screening. Also their house is in poor condition. The children are not yet open for suggestion to decision-making since they are still young and difficult to comprehend their current situations. presence of social There is high 3 concern within the family. level of community (deteriorated neighborhood. which is well respected. Physical Environment The house environment is not fitted for them especially for the children.making. The parents discuss decision. Each has his or her own part or role in the family. The condition of the house such as pressure of accident hazards. Family Living Concerned with the interpersonal or group aspect of family life. 8. rodents and other vectors. Concerned with home. system. The family’s 2 house space is not good enough for the family.obligations. There are presence of insects. facilities of cooking. sometimes insects and other 23 . the degree of respect and affection. and the ways in which they manage the family budget. Though it is covered with cloth. 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. Their house is also located near a creek. Decisionmaking is shared among its members except on young member. to accept adversity with fortitude. plumbing. the ways in which they make decisions affecting the family.
Bottles of liquor and decomposing woods were noted as well. fuel. transportation of schools and availability. pests).. 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. The storage of water has a cover. But they cannot utilize the health facilities since it is far from their house 24 . The mother is 3 aware of the available resources in the community. the cloth that they used was dirty. Also. They cannot go to the health center since they have to walk kilometers just to get there. Also a nail attached on the wood on inverted position was noted. but it is still unsanitary due to the presence of dirt on the outside of the container. Use of Community Facilities Degree of the family use and awareness of the available community facilities for education and welfare. The school is the only community facility the family uses.hazards. both in health and education. 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. 9.
Accident hazards specifically fire The house of Family V is a hazard. as a health threat. Mao ra jud ni among makaya kay siyempre kulang B. scope. Ang among ipahimo ug respect to taking appropriate action balay. specifically The mother verbalized “Kaning financial constrains/limited among balay dugay na ni siya. The mother usually cooks at the environment conducive to health back of the house using wood and maintenance and personal charcoal. development due to: a. Gibuhat financial resources. Table 4. It is mainly made up of bamboo and nipa as its A. health threats. The problems identified are categorized into presence of wellness state. galuto sa may likod. It includes the cues/data. Low salience of the problem 25 . Failure to comprehend the nature. Inability to provide a home roof. Inadequate family Subjective data: resources. bungalow style of house. and magnitude of the problem. Negative attitude towards the health problem. b. b. Typology of Nursing Problems identified in Family X Cues or Data Family Nursing Problems Objective data: I. Failure to see benefits of Puro kahoy na siya ug nipa ug mga investment in home patay na dahon sa saging. Dira ko environment improvement. health deficits.Chapter VI TYPOLOGY OF NURSING PROBLEM This chapter discusses about the problem that were identified during assessment and interview with the family. the family nursing problem and the nursing diagnosis. ikaon na lang namo diba” due to: a. foreseeable crisis and stress points. ni siya sa pamilya sa akoang bana. Inability to make decisions with sa budget. c.
Di na gain mi kapalit sa mga sanina sa bata. “Gamay ra jud ang income intawon. Ang among pagkaon ginatama tama lang para sa amua. Luoy kayo. Family size beyond what family resources can adequately provide as a health threat.” health problem Objective data: IV. Low salience of the problem. A.” II. There are five members in the family Subjective data: Mother verbalized. Daghan lagi kayo b. They just throw it disposal as a health threat 26 . Mga kinahanglan nila. Negative attitude towards ulo. Unsanitary food handling as a The hands of the children are presence of health threat. unclean when they ate they meal. Negative attitude ug langaw” towards health problem c. Isda ug mga gulay dira sa kilid among sud-an pirmi. Objective data: III. a. 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. butanganan na lain.Objective data: The income of the family is about Php 3000 per month. Inaccesability if appropriate resources for care specifically financial constraints Objective data: V. Low salience of the problem. Inaccesability of appropriate resources for care such as financial constraints. Wala tay mahimo kay gahi man jud ug b. 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. Inability to make decisions with Subjective data: respect to taking appropriate Mother verbalized “Dira ra man health action due to: namo na ginabutang. Wala man mi a. Poor environmental sanitation The family’s drainage is an specifically improper drainage open type. Inability to make decisions with respect to taking appropriate health action due to: a. A.
b. Wala a. Wala na namo ginasterilize.anywhere. Poor environmental sanitation specifically polluted water supply as a health threat A. Lack of knowledge Inability to make decisions with respect to taking appropriate health action due to: a. galibang b. Inability to make decisions with respect to taking appropriate health action due to: a. Negative attitude towards kanang walay tao” health problem c. 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. pay kwarta. Inaccesability if appropriate resources for care specifically financial constraints Subjective data: Mother verbalized “Dira mi sa B. are noted A. Failure to utilize community resources for health care due to: 27 . Low salience of the problem. VII. Dra ra mi gaihi. Inability to recognize presence of condition or problem due to: a. Negative attitude towards health problem Subjective data: Mother verbalized “Dira ra man namo pud namo na ginalabay” Objective data: VI. Low salience of the problem. Near the river is a carabao taking a bath and women washing clothes. 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. Ok naman na siya. Poor environmental sanitation The family has no comfort specifically unsanitary waste room. Rice grains beside the house. Negative attitude towards health problem d. A. Layo man gud kaayo ang gripo diri sa amua” C. They just defecate and void disposal as a health threat anywhere. balon gakuha ug tubig. Low salience of the problem.
threat Subjective data: A. Inaccessibility of required service due to physical inaccessibility (location of facility) 28 . Lack of immunization status Not all children have completed specially of children as a health their immunizations.a. Failure to utilize community resources for health care due to: a.” a. Layo health action due to: pa jud ang center. Inaccessibility of required service due to physical inaccessibility (location of facility) Objective data: VII. 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.
The problem could be moderately prevented.84 II. Nature of the 2/3 x 1 problem 2. Preventive potential 1/3 x 1 Score 0. The only way to solve this problem is to renovate the house.67 1 Justification This problem is a health threat The problem is partially modifiable.67 4. 3. Modifiability of 1/2 x 2 the problem Score 0. It includes a computation on how priorities were shown with their corresponding justification. Modifiability of 0/2 x 2 the problem 3. Criteria Computation 1. The family size cannot be trimmed down to smaller size The problem may be prevented but the family size 0. Salience 1/2 x 1 0. The problem.Chapter VII PRIORITIZING PROBLEMS This chapter shows the setting of priorities of family health problems that has been identified. I. 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. Preventive potential 2/3 x 1 0.33 29 . Accident hazards specifically fire hazard. thus it needs money. Family size beyond what family resources can adequately provide as a health threat. compared with the other problems does not need immediate attention since it requires time and money. as a health threat.5 Total Score: 2. Criteria Computation 1. Nature of the 2/3 x 1 problem 2.67 0 Justification This problem is a health threat The problem could not be modified at all.
Nature of the 2/3 x 1 problem 2. Preventive 3/3 x 1 potential 4.5 Total Score: 4. The problem is not needing immediate attention according to the family 3. Nature of the 2/3 x 1 problem 2. The problem is not perceived as a problem at all by the family.5 2. Salience 0/2 x 1 Total Score: 0 1 cannot be trimmed down. 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.17 IV. Unsanitary food handling as a presence of health threat. III. If the family receives the right health teaching. Preventive 1/3 x 1 potential 4. Salience 1/2 x 1 Total Score: 0.67 1 Justification This problem is a health threat This problem is partially modifiable since the family lacks resources specifically in the financial aspect. Salience 1/2 x 1 1 0. 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 3.4.5 30 .67 2 Justification This problem is a health threat The condition can be highly modifiable.33 0. Modifiability of 1/2 x 2 the problem Score 0. However. Criteria Computation 1. Modifiability of 2/2 x 2 the problem Score 0. Poor home condition specifically lack of food storage facilities as a health threat Criteria Computation 1.
Poor environmental sanitation specifically polluted water supply as a health threat Criteria Computation 1.V. This is highly preventable if the family has learned the importance of having a clean drainage. Nature of the 2/3 x 1 problem 2. Nature of the 2/3 x 1 problem 2.67 0. The problem is preventive because there are ways and 1 31 . Modifiability of 2/2 x 2 the problem 3. Preventive 2/3 x 1 potential 4. Poor environmental sanitation specifically improper drainage disposal as a health threat Criteria Computation 1. Modifiability of 2/2 x 2 the problem 3. Preventive 3/3 x 1 potential Score 0.5 2. Nature of the 2/3 x 1 problem 2. This can be highly preventable if the family had prioritized in building a toilet According to the family. Preventive 2/3 x 1 potential 4.84 VI. it plays not much importance in their life 0.67 0. Modifiability of 1/2 x 2 the problem 3. With regards to the family’s perception. the problem does not need immediate attention 0.5 3.84 VII. Salience 1/2 x 1 Total Score: Score 0.67 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. 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.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.
Preventive 2/3 x 1 potential 0.5 4. Lack of immunization status specially of children as a health threat Criteria Computation 1.67 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. Salience 2/2 x 1 Total Score: 1 3. with accordance to the family’s perception. Modifiability of 1/2 x 2 the problem Score 0. VIII.34 32 . is not much important. the family did not seem to mind at all.17 resources present in the community where in the family can have a clean water supply The problem. Salience 1/2 x 1 Total Score: 0. Nature of the 2/3 x 1 problem 2.67 4.4.
17 3. 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. This chapter also presents the family care plan formulated by the student nurse together with the family.50 1 33 .84 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.Chapter VIII NURSING CARE PLAN This chapter shows the identified and prioritized problems in a ranking order.84 2. Problem List Problems Unsanitary food handling as a presence of health threat. Score 4.17 4. as a health threat.34 2.
INTERVENTIONS RATIONALE METHOD RESOURCES REQUIRED EXPECTED OUTCOME Subjective data: Mother verbalized “Ay mga tamad na sila manghugas ug kamot. After 1 day of community exposure. • Negative attitude Objective towards data: health The hands problem of the children are unclean when they ate they meal. pail and clean towel After 1 day of community exposure.” Inability to make decisions with respect to taking appropriate health action due to: • Low salience of the problem. 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. water. CUES ANALYSIS OF THE PROBLEM INTERVENTION PLAN OBJECTIVES NSG. >Physical and chemical resources such as soap.FAMILY NURSING CARE PLAN Problem# 1 Unsanitary food handling as a presence of health threat. 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 .
washing techniques > To measure the understanding of the health teachings presented..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. 35 . they are prone of.
Upper Labay.5 m2. V’s farming. A nuclear type is a typical type of family composed of a father. The V family resides in Purok Daanbanwang. In order for the house to be considered as adequate. EVALUATION AND RECOMMENDATION Presented in this case study is the different characteristics and health condition of family V. V earns about Php 6. home and environmental factors. Her husband knows it yet he was not there during the interview. socio – economic and cultural factors. It also contains data about identified problems on the living condition of the family. They have started living their since June of 2009. the family strives hard to accommodate everything they need for them to 36 . The V family’s main source of income is coming from Mr. mostly bamboo. the total floor area should be divided among the total members of the family and each should at least have 3. Since Mrs. Mr. V’s monthly income.Chapter IX SUMMARY. V does not work. Their house is made of wood. she is in charge of the house and in taking care of the children. This case study presents the family structure. General Santos City. The house only has 2 windows and can sustain the adequate ventilation needed by the family. a mother and child/children. Mrs. V did not know the exact measurement of their house.00 a month. Summary and Evaluation The Family V is considered as a nuclear type of family. health assessment of each member.000. With Mr.
The father is usually in their farm while the mother is in the house doing household chores. They usually don’t sterilize their drinking water supply. The drainage system of the family is an open type where in the drainage flows anywhere and is continuous. They put their water in a big container with cover. thus. 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. 000. though. The children. All of them are affiliates of Protestantism. Mrs. According to NEDA. it is only Php 1. 000. go to Purok Daanbanwang Elementary School. They typically borrow money from their relatives.live.60 when the total monthly income of the family is divided among the total family members.00 and when divided among the 6 members. They wash their clothes and gets their drinking water supply there. they can be considered poor. V also informed the student nurse that they do not have any financial assets at hand in case of emergency. The V Family barely enjoys the community resources since the community itself lacks resources. V Family has no comfort room. The river is the family’s main source of water. Mrs. They usually urinate and remove bowels anywhere near their house. each individual should at least have Php 2768. The family has yet to participate in community activities since they are new in the place. 37 . The total monthly income of Mr.00. V is about Php 6.
poor home and environmental sanitation. and improper drainage system as well as health threats which are improper personal practice as improper hygiene. the family is now equipped with fair knowledge which they could use anytime as the need arises. With this situation and family condition. Together with the family. Although the allotted time for the student nurse was not enough to attend to all those problems. Nevertheless. the student nurse as an agent has helped the family through motivation and support to change their lifestyle and improve their health status.The V family is identified to have plenty of environmental problems in which it is evident that they practice poor environmental sanitation. Hence. Recommendations The student nurse have identified and prioritized problems and needs with the family. the family has chances to improve their health condition. The objectives of identifying family nursing problems were only partially achieved due to security reasons for the part of the student nurse. they are willing to submit themselves for the impartation of information and basic knowledge regarding family health. A nursing care plan then is formulated to address the different problems identified. The student nurse have also created a care plan on how to deliver the 38 . There still have that ability to meet the desired characteristics in their structure and maximize their health potential of optimum wellness. They are cooperative and participative to the different issues and interventions they are confronted. many problems were identified such as health threats which include fire hazards.
refraining from walking barefooted. brushing of teeth frequently. and proper and regular hand washing. they should also cover their food storage. frequent changing of clean clothes especially when come in contact with filthy objects or experienced wetness of the back. • 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. trimming their nails. • The family should be aware that organizations in the community are open and present for their problems to be addressed properly. They must clean their surroundings to avoid the presence of vectors of diseases. • The family should also maintain proper hygiene such as taking a bath regularly. • The V family should persevere to perform proper waste segregation and disposal of their garbage as it was presented during the mother’s class. 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 must also be educated and follow the proper preparation of herbal medicines as it was presented during the mother’s class. In addition to that. • The family should also be advised to not wait for the ailment to become severe before seeking medical help.best nursing care for the family to address their needs. 39 .
• They should be encouraged to verbalize their concerns with regard to the community so that resolutions can be made. 40 .
Philippines:2007 Maglaya. htm http://psychology. al.com/od/theoriesofpersonality/a/psychosocial. Untalan.com http://psychology. http://www. Published: 6/23/2004. 1st ed. Marikina City: Argonauta Corp. F. Manila: Educational Publishing House.about.BIBLIOGRAPHY Books Cuevas.buzzle.asp http://wisdomquotes. et. A. Concepts and Guidelines in COPAR.com/od/theoriesofpersonality/ss/psychosexualdev..about. 2004. 10th ed. Internet Sources Jay C. Nursing Practice in the Community. A. Public Health Nursing in the Philippines. 2005.com/editorials/6-23-200455793.htm 41 .
List of household members: B-Day (mm/dd/yyyy) Occupation Farmer.APPENDICES APPENDIX A BARANGAY HEALTH PROFILE Department of Health Notre Dame of Dadiangas University. Total number of children: 4 B. Educational Attainment: Grade 6 GENERAL HOUSEHOLD DATA A. Upper Labay. Sources of Income: Occupation: Farming Estimated Monthly Income: P6. 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. Husband son son son daughter Imm. Status INC INC INC INC COM Deworming Date 2008 2008 2009 2009 Weight 56 kgs 50 kgs 38 kgs 36. to Resp. 11-14-79 10-09-80 07-11-98 10-19-99 04-16-02 05-23-05 ECONOMIC DATA A. 000 42 . General Santos City PERSONAL DATA Name of respondent: Mrs V I.5 kgs 33 kgs 17 kgs NS N N N N N N Members Mr V Mrs V AV BV CV DV II.College of Nursing Barangay/ Purok: Daanbanwang. B-Day: 12/17/1973 Status: M Household No.
g Mayana and Kataka. Herbal e. Source of Drinking Water Supply: Shallow well C. Garbage Disposal: Burying and/or Burning E. Home: Herbal ( ) Vegetable ( x) None ( ) MEDICAL HEALTH DATA A. Other pertinent observations/informations like presence of personality disturbances: None H. Drainage: none D. Death in the Family: None G. Disable member of the family: None IV. of Hectares: ____. if land is farmed: corn D. Pills D. 43 .B. Water: Bought ( ) Free (x ) III.taka B. Household Appliances: radio F. Type of Housing: Concrete ( ) Ordinary ( X ) Rented ( ) Scrap ( ) E. Lactating: No F. Land 1. Pregnancy: No E. Family Planning: Continuous. Toilet facilities: Owned ( ) Shared ( ) None ( X ) Anywhere B. Products. Immediate Sources of Medical Care: BHW C. Transportation Facilities: Owned ( X ) Rented or Others( ) H. colds and fever. No. Animal Raising: chicken G. Owned ( ) Rented ( ) Tenanted ( X ) 2. Common diseases/ Commen Treatment: cough. Type: Plain ( X ) Rolling ( ) C. ENVIRONMENTAL DATA A.
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 .
Tong June lang mi ngbalhin diri” The student nurse verified if the respondent 45 . Ako diay si Emie.APPENDIX C Process Recording This appendix represents the course of interaction between the student and the family during each phase of interview. The purposes of the opening are to establish rapport and orient the interviewee. Bag-o ra jud mi diri. Purpose: 1. To be able to have a specific data on how the interview was conducted 2. Pwede mabal-an unsa inyong pangalan?” “Ay hello diay Ma’am Emie.” (Smiles) “Ahh. 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. Mao ning inyong balay?” Client “Maayong buntag sad. Nursing student sa NDDU. It also includes the reactions of the family or how they respond on the questions that were lift during the entire interview. 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. To be able to interpret or analyze the answers given by the respondent 3. Establishing rapport is a process of creating goodwill “O.” Remarks The student nurse greeted the respondent and the respondent welcomed the student nurse in their house. Amua ni siya. Ako diay si Mylene Ma’am. Dali sulod mo oi.
greeting (“Good pamilya?” gud nag-uma. Dalia ra man The student without ma’am ha. maginterview eh? Wala baya the time (Barbara Kozier) interview. Didto morning Sir!”) or na siya gapuyo jud. Mao ba. The student in a nonjudgmental ko mag-interview Walay problema. Acknowledgment may be with or “Salamat kaayo “Hala. “Ay ma’am. Lisod daw ang suga. Lingaw man pud na siya (Client and SN laughs). or a napili na iadopt na for coming contribution to family. Mga December the daw mi community. magculmination” “Lagi daw ma’am. an Kanang kamo man Hehe” respondent on efftort the client has gud ang akong her purpose made. Dapat lang jud mucooperate mi eh” (Smiles) The respondent approves of the student nurse’s purpose and acknowledged her presence. nonverbal gestures Unya pato taod2 such as smile. ma’am?” interview. Okey ra and the communication. and a sila mukaon” friendly manner. I’m a nursing Ang mga bata naa student”) man sa eskwelahan accompanied by kay nay klase.” duration of mi mga November their stay in na. Mubalik suga diri. Pero challenge na siya sa amua eh. Kanang manghangyo ko sa inyong cooperation ma’am ha. Pasalamat gani mi naa mo diri karon para mutabang namo. nurse told the understanding.” “Ay wala nay problema gang. Giving recognition. of a change in sa inyuha? Maayo gani ni. hantod October mi Matulog pud mo diri respondent verbal or nonverbal. 46 . nurse way. a inig udto kay diri to handshake. informed the behaviour. Kanang pud diay noh. self-introduction Ginaadtuan lang (“Good morning! namo sa mga bata. Siyempre importante gud na naa mi mabal-an sa sakit sakit. Pwede “Okey ra kaayo uy. Aha “Ang akong bana of the begin with a man pud inyong naa man sa bukid community. It can “Ahh.was a member and trust.
Wala baya akong bana diri ay. Unsa napud inyong edad ug sa inyong bana? Kanus-a pud inyong mga bday? Okey ra ma’am uy. Unsa pud mga Pangalan sa inyong anak ug ilang mga bday? Client Yata. Kanang. Ahh. Ay sige. Maayo gani ma’am nainform mo ug ing-ana Kanang ma’am mangutana ko kung unsa inyong nahuman sa eskwela? 47 . si BV 10. Lisod na baya kinabuhi ron. October 9 ko nya November 14 na siya. Layo layo pud ilahang mga agwat noh. 4 tanan among mga anak. si CV 7 unya si DV 5. akong bana kay hantod grade 3 lang. Si AV July 1998 na siya. Gafamily planning man jud gud mi tong una pa sa Malungon pa mi. Si BV kay October 1999. Akong bana kay 30. Naa man pud gud health center didto sa Malungon ug Nurallah. Ikaw lang akong interbyuhon. Wala baya sila diri kay nageskwela. Lagi ma’am uy. Elementary graduate ko. Nagsunod sunod lang ang 2 ka una pero after ana nagpills nako. 29 nako. Si CV April 2002 unya si DV May 2005. 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. Si Child AV 11. Hehe. Remarks Rationale Demographic data was given completely.Working Phase Student Nurse Ay kanang ma’am unsa inyong apelyido? Sige lang ma’am. Lagi. Unsaon ta man Respondent blames poverty for their lack of education.
Ang among ipahimo ug balay. Respondent was glad the children have a chance in education. Di na gain mi kapalit sa mga sanina sa bata. akong bana tu-a sa bukid. Kami ra jud diri.lisod kaayo ang kinabuhi. very difficult if you lack education. Wala nay lain. the family has not able to provide an adequate and a safe house for the family. Gibuhat ni siya sa pamilya sa akoang bana. Nag-ingon ka ma’am na nagauma imong bana. Si AV grade 5. Gamay ra jud ang income intawon. si CV grade 3. Unsa pa mga lain ninyong ginakwaan para income? Kanang pila pud inyong maincome sa usa ka bulan? Mga Php6. O. Kaning among balay dugay na ni siya. si BV grade 4. 48 . Kamo ra jud diri sa mga bata ma’am? Bale balay jud ni ninyo? She was able to express her concerns about the household. Puro kahoy na siya ug nipa ug mga patay na dahon sa saging. Due to financial constraints. Mga kinahanglan nila. Mao ra jud ni among makaya kay siyempre kulang sa budget. si DV maggrade 1.000 pud. Dira ko galuto sa may likod. including the environment. Ang mga bata ma’am? Mga bata maayo man kay nay eskwelahan diri. ikaon na lang namo diba Ay mao ra jud na. Poverty is an issue in every Filipino family since it is the major factor that affects their way of living. Respondent put on much emphasis on financial issues.
Drainiage disposal is an important factor since vectors or insects may hover and affect their health. Daghan kaayo mga langaw? Mga lamok? Respondent explains that although there are many mosquitoes in the place. Daghan lagi kayo ug langaw Ay daghan pud. The family has not yet build a toilet facility since they were new to the place and have no budget for it. Pero naa man mi mosquitero. Dira ra man namo na ginabutang. Wala pay kwarta. Respondent explains how they manage their drainage disposal Respondent shows how they put their left overs. Wala na namo ginasterilize. (Points at the ground beside the house). they have protection from it. galibang kanang walay tao Dira mi sa balon gakuha ug tubig. Isda ug mga gulay dira sa kilid among sudan pirmi. Kanang inyuhang banyo? Ug kung asa mo gakuha ug tubig? Mao jud na karon kay wala pa mi kahimo. Dra ra mi gaihi. Ok naman na siya. Ang among pagkaon ginatama tama lang para sa amua. 49 .Luoy kayo. Wala man mi butanganan na lain. Ang inyong mga lamaw ma’am o mga hugaw gikan sa kusina. She also explained their ways of getting water for drinking. aha ninyo ginalabay? Kanang butangan sa inyong pagkaon na wala nahurot? Dira ra man namo pud namo na ginalabay. The respondent explained how they manage with their elimination even without a toilet facility. Layo man gud kaayo ang gripo diri sa amua.
Layo pa jud ang center. Mga asunting. 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. 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. Didto o. Balik ra ko. No disturbances were found. Suroy suroy pud mo ba. Sa panahon namo dili man pud na uso gud. Respondent feels proud of her husband not having vices. Ay mga tamad na sila manghugas ug kamot.” Respondent points out that the health center is quite far from their place. Client Walay problema. 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 balik mo ha. Kanang diri sa panimalay ma’am unsa pud ng ugali sa mga bata na makaapekto sa ilang lawas. Salamat jus kaayo. Wala jud bisyo akong bana. Naa pud ba moy Naa. Wala tay mahimo kay gahi man jud ug ulo.Kanang sa bakuna sa mga bata ma’am? Isa ra lagi ang nakakumpleto sa bakuna ba. Ay maayo jud. Adto lang gud diri. Remarks The respondent appreciated our presence and was open Rationale Expressing gratitude makes the respondent feel that they did something good. Mga mga gulay o herbal kangkong. Ang na ginatanom? herbal naa sa ilalom. Giving 50 . Respondent shows the student nurse their mini vegetable garden and that they have herbal plants around.
in a nonjudgmental way. an efftort the client has made. of a change in behaviour.in answering all the questions. recognition. 51 . verbal or nonverbal. Acknowledgment may be with or without understanding. or a contribution to communication.
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