Table of Contents

I. Introduction II. Acknowledgement III. Biographical Data A. Family Structure and Characteristics B. Biological and Socio-cultural Factors C. Environmental Factors D. Health and Medical History E. Type of Family Structure IV. Activities of Daily Living A. Sleeping Pattern B. Eating Pattern C. Leisure Time Activities V. First Level of Assessment VI. Second Level of Assessment VII. Scales of Ranking Family Health Problems VIII. Ranking OF the Identified Health Problems IX. Cues and Data X. Family Nursing Care Plan XI. Learning Experience XII. Conclusion

I. Introduction

As health advocates in the society, we are obliged to maintain or restore the optimum health of the people within the community and that aim we have as actively participating student nurses of this generation, we adhere to the problems of our family, which is the basic unit of the society and the most important component of our country. We met the family for the first time last January 15, 2010 at San Roque Seaside, Lapasan, Cagayan de Oro City. Their geographical location is readily accessible because you don’t to ride a “trisikad” in order for you to locate the place; instead, we took a walk in order for to reach the place. The Head of the Family is Mr. Eusebio Agbong, a 48 year old original resident of Barangay Lapasan. He is living together with his wife, Mrs. Flordeliza Agbong, 39 year old native from Talakag, Bukidnon and his five children. The head of the Family is a security guard from the Sagittarius Agency and currently working at Gusa, Mindanao Tracking Corporation and earns at approximately Php 7,000 per month regardless with the expenses at home and daily needs. The husband seldom drinks and smoke because of his night duty shift while Flordeliza is a plain housewife who’s focus is to take care of the children especially their youngest son who always acquires such illnesses. As the real aim of the nursing profession, which is to give care to the people, takes place, we took it as a stepping stone in helping the family in making them realize the essence of a simple yet healthy life through many ways of living. We are also responsible for giving our family the importance of prioritizing such health problems whether a health deficit or threat in order to give specific actions for us, together with the cooperation of the family, to achieve, solve, reduce and/or completely eliminate the different kinds of problems through establishing a good foundation of prioritizing actions and care to promote, prevent or keep the family away from the occurrence of various diseases.

II. Acknowledgement

As health providers of this society, we ought to give our all in order to help the people in this community achieve their main goal--- the health yet joyful life. A big and unending thanks to our Clinical Instructor, Ms. Doreen Grace Contreras, RN, who brought our ideas and our clinical experiences into more productive yet helpful to all the people in the community because through hr funfilled way of teaching, we are able to inculcate in our minds and most especially to our hearts the importance of helping family in a certain community to achieve their optimum health which is predominantly the aim of this project. She enhanced our capabilities in giving care to the people who needed the most out of it. In addition, we can’t also forget the endless effort of the Health Care provider residing at San Juan Lapasan Health Center as well as to the Barangay Health Workers and most especially to the Public Health Nurse of the Barangay, MR. Rex Ranile, RN, who taught us how to give importance to the families especially to those indigent people. The said action will never be attained without the courage and selfless effort of my group mates: Lyra, Riezel, Crystal, Irish, Hannah and Jairus, who took this challenge seriously and did it without any hesitations to help a family who needed much care from us trough the sleepless nights that we had, and the money, time, and effort that we exerted, shared and sacrificed, the project became possible that I can say, it all worth it. We would never forget the big help of our Almighty God, the creator of all living and non-living things and who provided all the resources that we need in order to give the necessary care to our chosen family. He miraculously made things possible through giving us knowledge, the abilities and the resources that we need. He helped us in many ways and we undoubtly appreciate it and we give Him all our praises. In accordance to the vision of the Department of Health in the Philippines: “The Leader of Health in all Filipinos in the Philippines”, we, in the least that we did, contributed to its vision through giving our willingness and determination to devout ourselves in giving care to our Filipino countrymen and someday, as we go on with our chosen profession, we will be able to give care also to all the people in the world not just Filipinos regardless with their gender, creed, color and race. Because through this vision that is within us, we would be able to help in the progress of the over-all health of our country and to the world.

III. Biographical Data

NURSING ASSESSMENT: QUESTIONAIRRE AND DATA SHEET

A. FAMILY STRUCTURE AND CHARACTERISTICS HEAD OF THE FAMILY AGBONG Last Name ADDRESS: SEASIDE SAN ROQUE, LAPASAN, CAGAYAN DE ORO CITY EUSEBIO First Name 48 Age

MEMBERS OF THE FAMILY NAME AGE SEX CIVIL STATUS Flordeliza Agbong Marlon Agbong Candy Agbong Cindy Agbong Mary Agbong Aldren 2 Single 5th child Son Jane 8 F Single 4th child Daughter 16 F Single 3 child
rd

POSITION IN FAMILY Wife

RELATIONSHIP

PLACE RESIDENCE Seaside, Roque, Lapazan Seaside, Roque, Lapazan

OF

THE TO THE FAMILY Wife

39

F

Married

San

18

M

Single

Eldest Son Son

San

17

F

Single

2nd child

Daughter

Seaside, Roque, Lapazan

San

Daughter

Seaside, Roque, Lapazan Seaside, Roque, Lapazan Seaside,

San

San

San

Agbong

Roque, Lapazan

B. BIOLOGICAL AND SOCIO-CULTURAL FACTORS 1. What is the family’s source of income? • The family’s source of income is from the husband only. The husband works as a security guard at Gusa, Mindanao Tracking Corporation from the Sagittarius Agency. He works about an average of 8 hours/day. His monthly income averages Php 7,000 per month. 2. What is their ethnic background? Their religious affiliation? • When it comes to their ethnic background, the husband is purely Kagay-anon while the wife is from Talakag, Bukidnon. They are currently residing at San Roque Seaside, Lapasan Cagayan de Oro City. The rest of the members of the family speak Visayan. They are “Philippinista” but their first born son separately goes to church at United Christian Church of the Philippines (UCCP). 3. Who are the family’s significant others? What roles do they play in the family’s life? • The family’s significant others are their in-laws, siblings of the husband and their children who lived next to their home. The role of their significant others is to help them in times of need just like emotional and most especially during financial problems. 4. Does the family participate in the activities of the community? If yes what are these activities. If no, what are the reasons why they do not participate? • Yes, family participates in the activities of the community like feeding programs; outreach programs and community clean up of the environment. C. ENVIRONMENTAL FACTORS 1. Housing a. Is the family’s living space adequate for their number? • The family’s living space is inadequate for their number. It has one room in near their kitchen for the couple and small portion upstairs

for their five children. All the children sleep together in one room including the 2 year old boy. b. Is their furniture adequate for them? Is it enough for their needs? • The family’s furniture is enough for their needs. They have one table, small cabinet for their TV and DVD and small sofa for their visitors but their kitchen utensils do not sustain their needs. c. Are their insects and rodents in their house? • Their house has a plenty of insects such as flies, rats, ants, especially mosquitoes. Mosquitoes are present day and night. Rats is as big as small cats but they don’t do any precautionary measures in order to eliminate or even reduce these rodents. d. Are their accident hazards in and around the house? If yes, please enumerate. • The house is made of light materials. They cooked their foods inside the house using liquefied petroleum gas (LPG) but sometimes if they ran out of LPG, they used to cook their food inside the house using the “kahoy” located in the ground beside the wall. This can cause fire and considered as hazardous to well being of all the members of the family. The wirings are too close to each other that might result to a short circuit that will eventually lead to fir The house is always affected by flood due to its location and structure since their house is not elevated, thus, causes the water to go inside and flood their things inside. e. What are their cooking utensils? What is their storage? • Their cooking utensils include only of one small frying pan and pots. They use plastic ware for their food. They don’t have enough storage for their utensils because some utensils are just place in the anywhere. In addition, they have poor food storage because they don’t have the refrigerator, thus, their food must be all consumed in order for the food not to become spoiled. f. What is their water supply? Where is the source? Is it potable? • They do not have their own water supply. The source of their drinking water is from the Cagayan de Oro Water District (COWD), government own free for the residents in their place. They wake up

early and gather some water and store it in the plastic container, which is slightly dirty. g. What is their toilet facility? What is its condition? Is it sanitary? • The family does have a toilet of their own but it somewhat unsanitary. It is open and located at the corner of their kitchen beside the unprotected stairs. It is water –sealed type of toilet with black dirt surrounded on it. The only barrier to their toilet from the other parts of the house is the bathroom curtains only, thus, when someone defecates, all the family members will know because they can smell the not-so-fragrant smell. h. What is the type of their garbage and refuse disposal system? Is it sanitary? • They use sack for their garbage, which is collected by the garbage truck every Tuesday. It has no cover and the flies are all around but as we go on with our assessment we found out that there are scattered trashes at the back of their house situated beside the toilet. i. Describe their drainage system. Is it sanitary? • The drainage system is closely sealed but still it is smelly and unsanitary since they do not have the willingness to clean their drainage.

2. What type of neighborhood does the family belong to? Describe. • The type of their neighborhood is like squatter’s area. They belong in a low-income level family. It is noisy, crowded and cannot accessed by vehicles especially fire trucks.

3. Are their social and health facilities in the neighborhood? If yes, please enumerate and describe each? • In terms of their social facilities, they have basketball court 30 meters away from their house. They also have a Catholic Church in

the area. As to health facilities, there is a health center which is approximately 45 meters away from their house 4. What is the family’s mean of communication and transportation? • The family has a television and a radio as a means of communication. His oldest son has a cell phone for emergency cases. Their means of transportation are jeepneys and trisikads.

D. HEALTH AND MEDICAL HISTORY 1. Medical and health history of each family member. • The children of the Agbong Family already completed their immunization as evidenced by immunization record situated at the San Roque Health Center that was provided by the Barangay Health Worker (BHW). Vaccines given were one dose of BCG, 3 doses of OPV, 3 doses of Hepa B, 1 dose of measles. The youngest son of the family, Aldren experienced hospitalization during the year 2008 because of diarrhea. There is no further passed hospitalization experienced by the children of the said family. Currently, Aldren is suffering from diarrhea but they did not consult yet any doctors because according to the mother it is not yet severe and the child is still responding effectively. 2. Value placed on disease prevention. a. Are the children immunized? What is their immunization status? • All of the five children were fully immunized because they availed the immunization program implemented by the government through their Barangay Health Center. • Here is the summary of the immunizations received by the children of the said family:

Child’s Name Marlon Agbong

DPT 

BCG 

OPV 

Hepatitis B 

Measles 

Candy Agbong Cindy

 

  

  

  

  

Agbong Mary Jane  Agbong Aldren Agbong 

b. Does the family utilize other preventive actions? If yes, what are they? • The family does not have other preventive actions.

3. What is the family’s source of medication? • The family’s source of medication is from their health center. These medications include paracetamol (biogesic) and amoxicillin. If and when that one of their family members will get severe illness they often borrow money with the siblings of the husband. 4. What are their perception of the role of the health professional and their services? What are their expectations of the services of the community health? Nurse? • They have high respect for the health professionals. They were contented with the free services given by the health workers since they were treated very well regardless of their economic status. 5. Do they have previous experience with the health professionals? If yes, were they satisfied with the results? • Yes, They have previous experience with the health professionals. It was when they consulted at the health center and their youngest son was hospitalized in NMMC. So far all health professionals they have encountered treated them well. They were satisfied of the services. E. TYPE OF FAMILY STRUCTURE Patriarchal  Single Parent  Extended  Nuclear  Matriarchal  Alternate Family

1. Dominant family members in terms of decision making, especially in health care. • The husband and wife often share the obligation of making decisions relative to health care. The father predominantly makes the decision regarding with the activities of the family. But when it comes to caring the sick family member it is the mother who take good care of them. 2. Describe the general family relationship. • As what we have observed, the family has a good, harmonious relationship. The husband does not have any vices but drinks occasionally like during fiestas and birthdays. The husband is responsible enough to provide the family’s needs while the wife is taking good care of their children.

IV. Activities for Daily Living
A. SLEEPING PATTERN 1. Are there hours for retiring and getting up?

All of the family members wake up at 5 am because they have their own chores to do and they prepare themselves for school.

2. Do the family nap during the day? • Only the mother and her youngest son can nap during the day because the husband is working while the rest are at school. They usually nap at around 2 pm of the day after house hold chores and after watching noon time show. 3. Do the members of the family sleep together? • The couple sleep together in their bed beside the kitchen while the children sleeps together also in the other room upstairs. B. EATING PATTERN 1. How many meals do the family have each day? • The family can eat three meals a day. Their meals usually consist of vegetables, sardines and dried fish. They eat snacks sometimes during afternoon. But sometimes when they are out of budget, they take their meals twice only. 2. Does anyone of the family appear over weight or under weight? Who they are? Members Eusebio (father) Flordeliza (wife) Marlon Candy Cindy Mary Jane Aldren Age 48 39 18 17 12 8 2 Weight 61 kg 52kg 48kg 39kg 26 kg 24 kg 10kg Height 160 cm 158 cm 157cm 155cm 138cm 133cm BMI 23.82 20.82 19.47 16.23 13.65 13.56 8214.87 Classification Normal Normal Normal Underweight Underweight Underweight underweight

C. LEISURE TIME ACTIVITIES 1. How does each member spend his/ her leisure hours? Is the leisure time appropriate for the sex and age group of the individual? • The father does not have leisure time because he is at work and when if it’s his off day he spent it by resting in the house. He leaves early for work and went home late. The mother does not also have

leisure time because she’s so busy doing laundry and giving care to the children. 2. Does any member have an all- consuming hobby? If yes, What affects does this on the family. • Any of the family does not have any all- consuming hobbies because they prioritized their work rather than their hobbies. 3. Does the family have any joint activity for leisure? What is it? How often do they do this limited activity? • The family’s joint activity includes attending church during Sundays and sometimes they go to the bench for fun.

V. FIRST LEVEL OF ASSESSMENT
I. Presence of Health threats, Health deficits, Foreseeable crisis/ stress points of the family.

A. Health Threats (Color the applicable vertical scrolls) Family history of hereditary diseases Specify disease/s: Hypertension Family size beyond family resources Threats of cross-infection from a communicable disease Specify disease/s: cough and colds, fever Inappropriate immunization status especially of children: Poor environmental situation Inadequate living space Inadequate personal belongings/utensils Lack of food storage Polluted water supply Presence of breeding places of insects and rodents Improper refuse disposal Improper drainage system Poor ventilation and lightning Noise pollution Unsanitary food handling and preparation Others, please specify: ____________________________ Inherent personality characteristics Short temper Others, please specify: ____________________________ Inappropriate role consumption Child assuming mother’s role Others, please specify: ____________________________ Accident hazards Broken stairs Pointed sharp objects Poison and medicines improperly kept Fire hazards Fall hazards Others, please specify: Unprotected stairs Nutritional Inadequate food intake both in quality and quantity Excessive intake of certain nutrients Faulty eating habits Others, please specify: ______________________ Stress provoking factors

Strained marital relationship Immature parents Interpersonal conflicts between family members Others, please specify: ______________________ Personal habits/practices Excessive smoking Walking barefooted Eating raw fish and meat Poor personal hygiene Self-medicated Others, please specify: ______________________ Health history that may precipitate the occurrence of a health problem Specify: Hypertension Family disunity Self-oriented behaviour Unresolved conflicts Intolerable disagreements Others, please specify: ______________________ B. Health Deficits (Enumerable and discuss briefly) • Malnutrition – The children shows signs and symptoms of malnutrition (underweight, poor skin integrity) • Diarrhea – one their children shows impending characteristics of diarrhea that predisposes him in dehydration that may alter the normal functioning of his body. Some of the manifestation are frequent defecation in just one day and watery stool. C. Stress points/foreseeable crisis situations

VI. SECOND LEVEL OF ASSESSMENT
I. Inability to recognize the presence of a problem due to: Ignorance of facts Fear of consequences of diagnosis of problem

Social (Stigma, loss of respect of peer/significant others) Economic (Cost) Physical/Psychological Attitude/Philosophy in life II. Inability to make decisions with respect to taking appropriate health actions due to: (Color applicable horizontal boxes) Failure to comprehend the nature, magnitude or scope of the problem Low salience of the problem Feeling of confusion and resignation brought about by failure to breakdown problems into manageable units of attack Lack of knowledge/insight as to alternative course of action open to them Inability to decide which action to take among the list of alternatives Conflicting opinion among members regarding action to take Ignorance of community resources for health care Fear of consequences of action Social Economic Physical/Psychological Negative attitude toward the health problem Lack of trust/confidence in health personnel/agency Misconception of erroneous information about proposed course/s of action Inability of appropriate resources of care Pregnancy, labor, puerperium Parenthood Additional member of the family Abortion Entrance at school Adolescence Loss of job Death of a member Illegitimacy Resettlement in a new community Others, please specify: ____________________________

Physical (location) Cost

III. Inability to provide nursing care to the sick, disabled, or dependent member of the family due to: (Color the applicable horizontal scrolls) Ignorance of the facts about the disease/health condition (Nature, severity, complications, prognosis, and management) Ignorance of the nature and extent of the nursing care needed Lack of necessary facilities (equipment and supplies) for care Lack of knowledge and skill in carrying out the necessary treatment/procedure/care Inadequate resources for care Responsible family member Financial Physical resources (e.g. isolation room) Failure to see benefits (especially long term ones) of investments in home environment improvement Present of physical/psychological conflicts Identify crisis/psychological conflicts Jealousy/rivalry Guilt feelings Others, please specify: ____________________________ Ignorance of preventive measures Attitude/philosophy on life Family disunity Self-oriented behavior of members Intolerable disagreements Lack of support to members in crisis Others, please specify: ____________________________

IV. Inability to utilize community resources for health due to: (Put Color Green to the applicable horizontal scrolls) Ignorance of lack of awareness of community resources for health care Failure to perceive benefits of health care/services Lack of trust/confidence in health agency/personnel Previous unpleasant experience with health worker

Fear of consequences of action Physical/psychological Financial Social Unavailability of required care/services Inaccessibility of required care/services Cost Physical Inadequate family services Manpower Financial Feelings of alienation/lack of support form from the community

Attitude/philosophy in life: Whatever Happens, Let it be.

VII. SCALES FOR RANKING FAMILY HEALTH PROBLEMS
(According to priorities)

1.

UNSANITARY TOILET COMPUTATION 2/3 (1) ACTUAL WEIGHT .67 JUSTIFICATION It is classified as health threat.

CRITERIA Nature of the Problem Modifiability of the Problem Preventive Potential Salience

2/2 (2)

2

There is a greater chance of modifying this problem.

3/3 (1)

1

Communicable diseases will be prevented if this problem will be managed well. It is identified by the family as a problem but they uttered that it doesn’t need an immediate attention.

1/2 (1)

.5

TOTAL

4.17

2.

PRESENCE OF BREEDING PLACES OF INSECTS AND RODENTS COMPUTATION 2/3 (1) ACTUAL WEIGHT .67 JUSTIFICATION The existing problem is categorized as a health threat to 2/2 (2) 2 the members of the family. Modifiability of the problem is possible because there are lots of ways to prevent the occurrence of 3/3 (1) 1 such diseases. Prevention of communicable diseases is easily achieved through proper precautionary measurement and most especially Salience 1/2 (1) .5 by cleaning their surroundings. They knew that the problem is existing problem but does not require immediate actions. TOTAL 4.17

CRITERIA Nature of the Problem Modifiability of the Problem Preventive Potential

3.

MALNUTRITION

CRITERIA Nature of the Problem Modifiability of the Problem Preventive Potential

COMPUTATION 3/3 (1)

ACTUAL WEIGHT 1

JUSTIFICATION The problem identified is classified as health threat.

2/2 (2)

2

Modifying this problem is possible through effective ways in achieving the ideal BMI. The emergence of various diseases may be prevented if each of the family members if the existing problem is given an attention. None of the family members knew that some of them were malnourished.

3/3 (1)

1

Salience

0/2 (1)

0

TOTAL

4

4.

IMPROPER GARBAGE DISPOSAL COMPUTATION 2/3 (1) ACTUAL WEIGHT .67 JUSTIFICATION Characterized as a health deficit.

CRITERIA Nature of the Problem Modifiability of the Problem Preventive Potential Salience

2/2 (2)

2

Preventive measurements are readily available in order to put action to this problem. The possibility of the spread of many infections is readily available. They have knowledge about the problem but according to the mother it doesn’t require urgent actions.

2/3 (1)

.67

1/2 (1)

.5

TOTAL

3.84

5.

FAMILY HISTORY OF SPECIFIC CONDITION (HYPERTENSION) COMPUTATION 1/3 (1) ACTUAL WEIGHT .33 JUSTIFICATION Classified as Health threat

CRITERIA Nature of the Problem

Modifiability of the Problem Preventive Potential Salience

2/2 (2)

2

Problem is modifiable through a healthy lifestyle.

3/3 (1)

1

Problem like hypertension can be prevented if this problem given action. They knew that they have a family history of hypertension but they uttered that it doesn’t need immediate action.

1/2 (1)

.5

TOTAL

3.83

6.

INADEQUATE LIVING SPACE COMPUTATION 2/3 (1) ACTUAL WEIGHT .67 JUSTIFICATION It classified as health threat.

CRITERIA Nature of the Problem Modifiability of the Problem Preventive Potential Salience

1/2 (2)

1

Cannot be easily solved due to financial problem.

3/3 (1)

1

Spread of disease can be minimized if this problem is given attention. It is a felt problem but doesn’t need immediate attention.

1/2 (1)

.5

TOTAL

3.17

7.

ACCIDENTAL HAZARDS COMPUTATION 2/3 (1) ACTUAL WEIGHT .67 JUSTIFICATION Considered as a health threat.

CRITERIA Nature of the Problem Modifiability of the Problem Preventive Potential

1/2 (2)

1

It is modifiable because the family has the option to transfer and fixed the wirings to a safer place. Accident can be prevented if problem is felt and proper action is implemented.

2/3 (1)

.67

Salience

1/2 (1)

.5

They knew that the problem is existing but according mother it does not require immediate action.

TOTAL

2.84

8. FAMILY BEYOND WHAT FAMILY RESOURCES CAN ADEQUATELY PROVIDE CRITERIA Nature of the Problem Modifiability of the Problem Preventive Potential Salience 1/2 (1) .5 2/3 (1) .67 1/2 (2) 1 It is not modifiable since the father is the only one working and his monthly salary is only php 7000 Health problems will be given attention if both parents are working. Felt problem but not given prompt attention TOTAL 9. CRITERIA Nature of the Problem Modifiability of the Problem Preventive Potential Salience 0/2 (1) 0 3/3 (1) 1 1/2 (2) 1 Family income is not enough to buy more for food storage. Food contamination can be prevented if there is adequate food storage. It is not felt as a problem. COMPUTATION 2/3 (1) 2.84 ACTUAL WEIGHT .67 JUSTIFICATION Classified as health threat COMPUTATION 2/3 (1) ACTUAL WEIGHT .67 JUSTIFICATION Considered as health threat.

LACK OF FOOD STORAGE FACILITIES

TOTAL

2.67

10.

INADEQUATE PERSONAL BELONGINGS UTENSILS COMPUACTUAL JUSTIFICATION

CRITERIA

TATION Nature of the Problem Modifiability of the Problem Preventive Potential Salience 0/2 (1) 3/3 (1) 1/2 (2) 2/3 (1)

WEIGHT .67 Considered as health threat

1

Family’s income is not enough to buy more utensils.

1

Spreading of disease can be prevented if members has each own utensils It is not felt problem.

0

TOTAL

2.67

VIII. RANKING OF THE 10 FAMILY HEALTH PROBLEMS

RANK 1

SCORE 4.17 4.17 4 3.84 3.83

FAMILY HEALTH PROBLEMS UNSANITARY TOILET PRESENCE OF BREEDING PLACES OF INSECTS AND RODENTS MALNUTRITION IMPROPER GARBAGE DISPOSAL FAMILY HISTORY OF SPECIFIC CONDITION (HYPERTENSION)

2 3 4

5 6

3.17 2.84 2.84 2.67 2.67

INADEQUATE LIVING SPACE ACCIDENTAL HAZARDS FAMILY BEYOND WHAT FAMILY RESOURCES CAN ADEQUATELY PROVIDE LACK OF FOOD STORAGE FACILITIES INADEQUATE PERSONAL BELONGINGS UTENSILS

7

IX. CUES AND DATA
CUES AND DATA FAMILY NURSING PROBLEMS

Subjective: “ usahay ikaduha rami maka kaon sa usa ka adlaw, usahay pod gani dili mi maka kaon og tarong kay wala mi sud-an, kan-on nalang amoang kaonon” as verbalized by the mother Flordeliza. Objective: 

Malnutrition
A. Inability to recognize the presence of a problem due to: Fear of consequences of diagnosis of problem as inadequate financial expenditure. B. Inability to make decisions with

The following are the malnourished members of the family: Flordeliza, 39 years old, weighing 52kg, 158cm height. Candy, 17 years old, weighing 39kg, 155cm height.

respect in taking appropriate health actions due to: Failure to comprehend the nature, magnitude or scope of the problem Lack of knowledge/ insight as

to alternative courses of  Cindy, 12 years old, weighing 26kg, 138cm height. Aldren, 2 years old, weighing 10kg, 82cm height, big stomach.     actions open to them Low salience of the problem Inability to decide which action to take among the list of alternatives Fear of consequences of action financially  Inaccessibilty of appropriate resources of care financially C. Inability to provide adequate nursing care to at risk member of the family due to: Ignorance of the facts about the health condition; child development and child care  Lack of necessary facilities for care  Lack of knowledge and skill in carrying out the necessary care  Inadequate family resources for care

Subjective: “wala paman na nahuman, temporary lang man na among gihimo nga CR” as verbalized by the father Eusebio. Objective: Dirty toilet bowl, no cover  

Unsanitary Toilet
A. Inability to recognize the presence of a problem due to: Ignorance of the facts Fear of consequences of diagnosis of problem as inadequate financial expenditure.

stinky odor

Attitudes/philosophy in life

B. Inability to make decisions with respect in taking appropriate health actions due to: Failure to comprehend the nature, magnitude or scope of the problem  Lack of knowledge/ insight as to alternative courses of actions open to them  Inability to decide which action to take among the list of alternatives  Fear of consequences of action financially  Inaccessibilty of appropriate resources of care financially

C. Inabilty to provide a home environment which conducive to health maintenance and personal development due to: Inadequate family resources financially  Failure to see benefits of investment in home environment improvement  Ignorance of importance of hygiene and sanitation  Lack of skill in carrying out measures to improve home environment  Attitude

Subjective: “ daghan kaayo lamok among balay daghan pod ilaga” as verbalized by the mother. Objective: Poorly ventilated Dimly lighted House is messy and disoriented  Presence of rats in the house as observed  Mosquito flying and biting as observed.

Presence of breeding places of insects and rodents
A. Inability to recognize the presence of a problem due to: Fear of consequences of diagnosis of problem about lack os space to organize things B. Inability to make decisions with respect in taking appropriate health actions due to: Inaccessibilty of appropriate resources of care physically C. Inabilty to provide a home environment which conducive to health maintenance and personal development due to: Inadequate family resources for care like location  Failure to see benefits of investment in home environment improvement  Ignorance of importance of hygiene and sanitation  Lack of skill in carrying out measures to improve home environment  Attitude

  

XI. LEARNING EXPERIENCE

As we are doing our project, first we thought of doing it for the sake of complying to our RLE30 requirements but as we go on with our Assessment with the family, we realize the importance of this project and how it will touch the lives of the people whom we will b helping. From that day one, we are doing our project vigorously with interest in our minds and most especially in our hearts not just for the compliance of our project but also to help the family in achieving their optimum health. Meeting different kinds of people tests our patience and our ability to socialize with them. It also measures on how we should response to their needs as a health care provider. My group mates and I observed that the people of that community craves for medical help and you can see straight to their eyes their hunger for any form of medical help. For that, I realized that the people needs a big help from medical personnel and the government must impose more programs like this that reaching families especially to the rural areas and to those people who are indigent and couldn’t afford to secure their health care needs. As a group, we are so happy that in the least that we did. We helped some of the people living in the community to ease the hunger that they felt for many years through checking their Blood Pressure and giving away essential health teachings o how to improve a healthy yet productive lifestyle.

Experiencing those thrills during our rotation becomes an eyeopener to all of us that tells all of us that the people need us, as healthcare providers in this society, to ease the pain they are suffering from and to achieve their ideal health into the maximum level.

XII. CONCLUSION

The main problems in our group are malnutrition, presence of insects and rodents and unsanitary toilet. We taught the family how to avoid these problems like eating the right food, how to clean their toilet and how to keep rodents away from the house. We learned that our family didn’t think that these are big problems which they are. It is important to notice these problems to prevent bigger problems from occurring especially that they have younger children.

Therefore, we as a group helped the family to better understand why these are health threats and health deficits. We gave them health teachings to give them information regarding the problem at hand. We learned as a group that it is important to know our family and level to them to help them understand better. In these ways, we rendered service to our family and somehow helped them from their problems.

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