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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.
A nuclear type is a typical type of family composed of a father. 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. In nuclear families. time spent with children. Level (Grade 4) Elem. both adults are the biological or adoptive parents of their children (Jay C. Level (Grade 1) Female Married Male Female Male Female Child Child Child Child The Family V is considered as a nuclear type of family. emotional support. They have started living their since June of 2009. 2004. and a stable economic environment. This type of family structure is found in almost all societies. Level (Grade 3) Elem Grad (Grade 6) Elem. General Santos City.). low stress. Level (Grade 5) Elem. a mother and child/children. V Mrs. although the length of time in which the family remains in this form varies even within the same society.Chapter III INITIAL DATABASE A. and Dynamics Name Mr. Upper Labay. Family Structure. Level (Grade 3) Elem. Characteristics. The V family resides in Purok Daanbanwang. They were a 6 . The nuclear family can be a nurturing environment in which to raise children as long as there is love.
there is nothing to be left for the miscellaneous expense. They consult each other in terms of planning and budgeting for their family. She has greater awareness concerning health matters compared to Mr. Mr. They have been in Nurallah. South Cotabato for 5 years and in Malungon for 3 years. B. V does not work. shoes and slippers comes in. Out of Mr. 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. feeding the right food and caring for the sick member. When problem arises.000. She makes sure that she will comply with the appropriate regimen when certain health issues arise. V and Mrs. she is in charge of the house and in taking care of the children.family whose resident is always changing.00 a month. Socio-Economic and Cultural Characteristics The V family’s main source of income is coming from Mr. V earns about Php 6. Since Mrs. they make sure that both of them will handle and solve the problem. V’s farming. V budgets the money in terms of food. Mr. V since of course believing it is her duty as the mother. 7 . V is more dominant. Mrs. Usually. These health matters include immunization. V go hand in hand in terms of decision-making. most of it goes to the family’s budget for food. in terms of matter concerning health Mrs. education and miscellaneous where clothes. But then. They discuss matters concerning their children’s schooling financially and also with regards to the emotional problems or aspects within the family. V’s earnings.
They are the ones very close to a person or group of persons. They usually run to their relatives if they face hardships and problems. V works as a farmer.00.00 and when divided among the 6 members. Significant others are called such due to their own role in one’s life. Mrs. They typically borrow money from their relatives. he works from 3 am until 8 pm everyday. V’s monthly income. V doesn’t work and stays in their house. Mrs. prepare food. 000. He seldom goes home but rather stays in the farm. they can be considered poor. thus. V also informed the student nurse that they do not have any financial assets at hand in case of emergency. Mrs. V mentioned that they do not go to church anymore since they have lived in Purok Daanbanwang for the reason that of the distance they have to travel from their place to the church. it is only Php 1.With Mr. According to NEDA. the family strives hard to accommodate everything they need for them to live. All of them are affiliates of Protestantism. V is about Php 6. She is the typical housewife where in you can see her wash clothes.60 when the total monthly income of the family is divided among the total family members. each individual should at least have Php 2768. 8 . For family V. Mr. Mrs. the significant others in their lives are their relatives and some neighbors. V also confirmed how helpful and welcoming her neighbors are with them. 000. The total monthly income of Mr. sweep the yard and make the house clean. which is situated far away from the family’s house.
The V Family barely enjoys the community resources since the community itself lacks resources. though. The father is usually in their farm while the mother is in the house doing household chores. Mrs. 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. These activities include fiesta. V did not know the exact measurement of their house. they usually partake in community activities. The family uses the river as their means of water source in washing their clothes. C. In order for the house to be considered as adequate. Mrs. The house only has 2 windows and can sustain the adequate ventilation needed by the family. V told the student nurse that their house is usually “presko” since it is beside the river and the air goes to and fro freely inside the house. The children. But way back in Nurallah. Her husband knows it yet he was not there during the interview. Home and Environment The house is made of wood.The family has yet to participate in community activities since they are new in the place. mostly bamboo. the total floor area should be divided among the total members of the family and each should at least have 3.5 m2. go to Purok Daanbanwang Elementary School. meters away from their house. 9 . parties and carnivals.
In terms of garbage disposal. They usually urinate and remove bowels anywhere near their house. according to Mrs. There is 10 . V Family has no comfort room. The river is the family’s main source of water. and Mrs V. They usually don’t go and get water from the faucet in the purok since. They have not yet built their own comfort room since. The one is the sala/dining room and the other is the bedroom. V uses wood and charcoal in cooking. They use “banig” in sleeping. She is the one who prepares the food. It is dirty and has a stinky smell. and knives. When it comes to storing their food. V. They put their water in a big container with cover. “sandok”. Mrs. according to Mrs. they either bury or burn their garbage. They wash their clothes and gets their drinking water supply there. it is far from their house. She cooks inside the house at the back portion.The house has 2 rooms. The V Family has only one appliance which is the radio powered by batteries since the place has no electrical supply yet. together with the children. The drainage system of the family is an open type where in the drainage flows anywhere and is continuous. In terms of cooking facilities the family is equip with pots. they just cover it with a plate. V. they are still new in the community and has no enough budget for it yet. Mr. with no bed at all. The foods that they usually eat are fish and vegetables. sleep in one room. They usually don’t sterilize their drinking water supply. The family uses plastic plates and stainless spoons in eating.
She is 5 feet and 3 inches and weighs 60 kilograms. Her BMI reveals normal weight with a value of 23. or infectious diseases as of the present time. however. told us that she thinks her husband has never undergone immunizations at all since it was not that important before. V.8. V said that her husband is about 5’4 tall and weighs about 55 kilograms.some rice grains noted. chronic. V told the student nurse that her husband has no genetic or hereditary illness known. When she was still 4 years old. Health Assessment on Each Member A. Mrs. The family has one chicken and a dog. they usually walk kilometers. Mr. she experienced chicken pox. V – She has no degenerative. The family does not own any transportation facilities. He is not a smoker.4. His BMI reveals normal weight with a value of 20. When they go to their farm or any purok within Upper Labay. A since he was in their farm during the interview. Health Assessment of Each Family Member D1. He drinks alcohol rarely since they have no budget for that. V – The student nurse has never met Mr. They ride on a jeepney or truck in going to the city proper. Mrs. There is no obstruction present at the drainage system since it is open and flows anywhere. Mrs. There are vegetables planted near the house. B. She has also not completed immunizations. PAST AND PRESENT ILLNESS 1. She has no complaints as of the present time and has not taken any medications 11 . D. Mrs.
D. He is 4 feet and weighs 33 kilograms. Health Perception-health management patterns • With no known vices like smoking and drinking except for Mr. or infectious diseases as of the present time. chronic. He has not completed immunizations. Child DV – has no any degenerative. E. • • Was able to recognize the importance of having a healthy well-being. FAMILY ASSESSMENT BASED ON FUNCTIONAL HEALTH PATTERN 1. chronic. He likes to eat vegetables and fish. She has not completed immunizations. He has not completed immunizations. C. He is 4 feet and 10 inches and weighs 38 kilograms. she would just drink paracetamol for fever and mefenamic acid for pain or treat wounds with crushed plants coming from their backyard. At times of illness. V who drinks alcohol rarely. Uses herbal plants. chronic. from their backyard 12 . She is 3 feet and 11 inches tall and weighs 17 kilograms.as of the moment. Child BV –has no any degenerative. or infectious diseases as of the present time. or infectious diseases as of the present time. chronic. This child has many allergies and there are rashes still seen on her legs. though not approved by the DOH. Child AV – has no any degenerative. The family is not using family planning anymore. Child BV –has no any degenerative. She appears thin. or infectious diseases as of the present time. She has complete immunizations. F. She is 4 feet and 7 inch tall and weighs 36.5 kilograms.
all of the family members have no difficulty in voiding. 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. every other day with no difficulty in defecating noted. Activity-exercise pattern • “Dili nami makaexercise kay daghan mi trabaho labi na pagbuntag” verbalized by the mother. • They also take a nap at free time. • 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. Sleep-rest pattern • Family usually has 7-8 hours of uninterrupted sleep according to the mother. V. Cognitive-perceptual pattern 13 . 6. 4. 5. • They usually sleep at around 9 in the evening and wake up at around 4 to 5 in the morning.2. Nutritional-metabolic pattern • • • • Do not take any food supplements or vitamins Daily food intake is mainly rice. Elimination pattern • • Eliminates everyday with an average frequency of urine: 5 times According to Mrs. V 3.
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. 8.• Was oriented to time. Retaliates as soon as he can and was able to rationalize. 9. Verbal pattern and spontaneity normal • • Memory intact No sensory defects 7. Self-perception/self-concept • • Showed apprehension and worry towards unspecific consequences. place and is able to identify people and significant others by their first names. Roles and relationship • Family members have an open communication and able to discuss their problems according to the mother. Coping Stress • Gains strength in the “assurance and guarantee” provided by family members. • Was able to respond accordingly and correctly to questions. Perceived situations (health deficits) to be very stressful but remain passive about things and condition. 14 .
The family has adequate rest and sleep. The children in the family has not all completed their immunization. because of financial constraints made them ignores any major health problems that may arise. they were not able to sustain sufficient supplies of medication or articles which they would need related to their health care needs. All the children in the family were dewormed last March 2008. The mother usually does the household works and talks with the neighbors during free time. Is certain that the Divine providence would protect them from any unidentified and possibilities of harm.11. The father is in the farm. The family 15 . Does not go anymore to church since they are situated far away from the place of worship they attend E. and walking are their ways of exercise. Values. the usual time of sleeping is 9pm and they wake up at around 4 to 5am. Furthermore. They sleep early and wake up early. V stated that farming. Mrs. Practices on Health Promotion. doing the household chores. The mother recognizes the importance of health in the family. The children are either in school or are playing with other children in the community. Values/ Beliefs Pattern The family is Protestant in faith. They often use alternative medicines or herbal medicines for treating their illness and habitually self-medicate if OTC medications are available. however. Habits. Expressed great belief and faith in God. Maintenance and Disease Prevention.
they immediately go to the health center or to the hospital.believes in the power of herbal plants. But if the symptoms manifested by the family member become severe. 16 . Mrs. They occasionally use herbal plants lodged near the house in treating diseases or symptoms in the family since their transfer from Nurallah. 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.
General Santos City. She did not continue schooling due to financial constraints. his wife is 29 years old. BV. He is 30 years old. CV and DV are the kids. She has 2 siblings. Instead she helped her parents in doing household chores and in looking money for their household 17 . Her father is a farmer and her mother is a housewife. Mrs.Chapter IV FAMILY BACKGROUND This chapter illustrates the family background of the study which includes. 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. Family Tree. Sarangani Province. Child AV. V as the mother. He is a B’laan. child BV is 10 years old. Mrs. His father was a farmer and his mother was a housewife. He has 9 siblings and he is the eldest. children AV. He was able to go to school up to grade 3 year level. She was able to go to school and graduated elementary school. Mrs. Family History Family V is composed of 6 members Mr. Database of the Respondent. V. General Household Data. Mr. as the eldest son is 11 years old. V was born and grew up in Purok Daanbanwang. V is the head of the family. V was born and grew up in Malungon. Mr. child CV is 7 years old and child DV is 5 years old. V is the father. After that he did not continue schooling in order to help his parents look for money for their household expenses. Upper Labay.
OF CHILDREN : EDUCATIONAL ATTAINMENT: Elementary Graduate ESTIMATED MONTHLY INCOME: none NAME OF HUSBAND: Mr. Upper Labay. V 18 . They become a couple and after 3 months. V met in Malungon. They resided in Malungon for 3 years. NAME AGE GENDER ADDRESS : : : : Mrs. then transferred to Upper Labay for 6 months. they got married. 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. Sarangani Province Protestant Housewife Married Filipino 4 NO. General Santos City BIRTH PLACE RELIGION OCCUPATION CIVIL STATUS NATIONALITY : : : : : Malungon. Sarangani Province through friends of friends. V 29 years old Female Purok Daanbanwang. They again transferred to Nurallah.Mr.
level Elem. V Mrs. General Household Data 1. List of Household Members Members Mr. e Attainment x M Elem. V Mrs. Total No. of Children: 2 2.B. Status INC INC INC INC INC COM NS NA NA NA N N N 19 . level F F F Elem. Family Tree Mr. level Religion Protestant Protestant Protestant Protestant Protestant Protestant Positio n in the Family Father Mother 1st Child 2nd Child 3rd Child 4th Child Imm. V Child AV Child BV Child CV C. level F Elem Grad M Elem. level Elem. 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.
to get out of bed. The members are all able to move 5 without assistance and difficulty. using appliances. CRITERIA IDEAL ACTUAL Rating JUSTIFICATION 1. Physical Independenc e Is concerned with ability to move about. dressing. The parents are aware of their lapses in therapeutic competence. They are independent in moving about and using their musculoskeletal system. Every member has no noted disabilities or disparities in moving and/or doing their ADL. exercise. to take care of daily grooming. 2. due to financial problems and distance of the health center. They are sentient of their financial difficulties. They do their activities of daily living without aid. which is the primary reason for not having or following the 20 . However. Therapeutic Competence Includes all of the procedures or treatments prescribed for the care of illness such as giving medications.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. It includes an assessment on how the family handles various stressors. etc. walking. The observations are analyzed to see occurrence of health problems or negative attitudes and behavior. they cannot There are no abnormalities in the physical independence of the family members. The parents are 3 aware on what to do if a member fells ill.
those plants are not approved by the DOH. But their source of water is not healthy at all. 3. 21 . Even though aware of hygiene’s importance. diets. Understanding the general pattern of development of newborn baby and basic needs of infants for physical care. The mother is 2 knowledgeable on salient health issues and responsibilities. special provide enough and/or appropriate interventions. they use herbal plants. 4. etc. she does not regard it as important at all. Yet due to financial problems. securing adequate rest and relaxation for family members. eating habits and maintenance of healthy lifestyle are not taken into consideration that much. They do not practice sterilization nor healthy habits in food storage and preparation. health issues are overlooked. 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. the family does not practice good hygienic skills. Concerned with family action in relation to maintaining family nutrition. medical appraisal. Yes they take a bath everyday but their source of water. This could be detrimental to the lives of the members especially the children. carrying out accepted preventive measures (immunizations. appropriate procedure or treatment. safe home-making in relation to storing Though the mother recognizes pertinent health issues. Although. having appliances and even enough clothes for the children. Application of Principles of General Hygiene The family sleeps 2 well and eats nutritious food everyday.relaxation.
They discipline them and teach them the morals of life. They see stress just like any other family does. 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. Willingness to meet reasonable The family lives harmoniously at home. they really see to it that they would discuss each concern in a calm manner. Also. 5. including preventive services. The development of the individual’s responsibilities and decision.and preparing food). The parents take responsibility for the children. The family are 5 competent enough emotionally. The degree to which individuals accept the necessary disciplines imposed by one’s family and culture. 22 . and public health measures. 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. Even though conflicts arise. and to plan for happy and fruitful living. 6. care of illness. the family lacks information regarding healthy lifestyle and healthful ways toward improvement of life. Parents. 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. want to protect their children from any harm but then. as much as possible.
system.obligations. The condition of the house such as pressure of accident hazards. Each has his or her own part or role in the family. Though it is covered with cloth. that they can possibly acquire serious diseases.making. the ways in which they make decisions affecting the family. The children are not yet open for suggestion to decision-making since they are still young and difficult to comprehend their current situations. Their food storage is unsanitary. which is well respected. 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. plumbing. Also their house is in poor condition. Family Living Concerned with the interpersonal or group aspect of family life. to consider the needs of others as well as one’s own. The family’s 2 house space is not good enough for the family. screening. Physical Environment The house environment is not fitted for them especially for the children. especially with regards to their interrelationship with others. Concerned with home. facilities of cooking. 8. the community and work environment as its affect family health. Their house is also located near a creek. sometimes insects and other 23 . rodents and other vectors. level of community (deteriorated neighborhood. The parents discuss decision. Decisionmaking is shared among its members except on young member. the degree of respect and affection. privacy. to accept adversity with fortitude. 7. presence of social There is high 3 concern within the family. because of the presence of pests and accident hazards in their community. and the ways in which they manage the family budget. the degree to which they support one another and do things as family. The family members get along with one another. There are presence of insects.
both in health and education. 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. 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. but it is still unsanitary due to the presence of dirt on the outside of the container. Also. The mother is 3 aware of the available resources in the community. But they cannot utilize the health facilities since it is far from their house 24 . The school is the only community facility the family uses. pests). Bottles of liquor and decomposing woods were noted as well. transportation of schools and availability. Also a nail attached on the wood on inverted position was noted. The storage of water has a cover. Use of Community Facilities Degree of the family use and awareness of the available community facilities for education and welfare. 9.hazards.. fuel. the cloth that they used was dirty. They cannot go to the health center since they have to walk kilometers just to get there.
Ang among ipahimo ug respect to taking appropriate action balay. ni siya sa pamilya sa akoang bana. foreseeable crisis and stress points. Mao ra jud ni among makaya kay siyempre kulang B. Inability to make decisions with sa budget. Low salience of the problem 25 .Chapter VI TYPOLOGY OF NURSING PROBLEM This chapter discusses about the problem that were identified during assessment and interview with the family. as a health threat. Typology of Nursing Problems identified in Family X Cues or Data Family Nursing Problems Objective data: I. Table 4. b. galuto sa may likod. specifically The mother verbalized “Kaning financial constrains/limited among balay dugay na ni siya. Negative attitude towards the health problem. scope. It is mainly made up of bamboo and nipa as its A. b. development due to: a. the family nursing problem and the nursing diagnosis. Gibuhat financial resources. Accident hazards specifically fire The house of Family V is a hazard. Dira ko environment improvement. Failure to see benefits of Puro kahoy na siya ug nipa ug mga investment in home patay na dahon sa saging. Inadequate family Subjective data: resources. c. Inability to provide a home roof. health deficits. Failure to comprehend the nature. health threats. The problems identified are categorized into presence of wellness state. It includes the cues/data. bungalow style of house. The mother usually cooks at the environment conducive to health back of the house using wood and maintenance and personal charcoal. ikaon na lang namo diba” due to: a. and magnitude of the problem.
” II. a. 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. Daghan lagi kayo b. Objective data: III. 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. Family size beyond what family resources can adequately provide as a health threat. Inability to make decisions with respect to taking appropriate health action due to: a. Negative attitude ug langaw” towards health problem c. They just throw it disposal as a health threat 26 . There are five members in the family Subjective data: Mother verbalized. Di na gain mi kapalit sa mga sanina sa bata. Negative attitude towards ulo. Isda ug mga gulay dira sa kilid among sud-an pirmi. Luoy kayo.” health problem Objective data: IV. Inaccesability if appropriate resources for care specifically financial constraints Objective data: V. Wala man mi a. “Gamay ra jud ang income intawon. unclean when they ate they meal. butanganan na lain. Mga kinahanglan nila. A. Poor environmental sanitation The family’s drainage is an specifically improper drainage open type. Low salience of the problem. Unsanitary food handling as a The hands of the children are presence of health threat. Wala tay mahimo kay gahi man jud ug b. Low salience of the problem. Inability to make decisions with Subjective data: respect to taking appropriate Mother verbalized “Dira ra man health action due to: namo na ginabutang. Inaccesability of appropriate resources for care such as financial constraints. A. Ang among pagkaon ginatama tama lang para sa amua.Objective data: The income of the family is about Php 3000 per month.
Inability to recognize presence of condition or problem due to: a. Low salience of the problem. Dra ra mi gaihi. Near the river is a carabao taking a bath and women washing clothes. Poor environmental sanitation The family has no comfort specifically unsanitary waste room. Inaccesability if appropriate resources for care specifically financial constraints Subjective data: Mother verbalized “Dira mi sa B. pay kwarta. b. VII. Ok naman na siya. Low salience of the problem. Inability to make decisions with respect to taking appropriate health action due to: a. 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. b. A. They just defecate and void disposal as a health threat anywhere. Layo man gud kaayo ang gripo diri sa amua” C. Lack of knowledge Inability to make decisions with respect to taking appropriate health action due to: a. Rice grains beside the house. are noted A.anywhere. Negative attitude towards kanang walay tao” health problem c. Negative attitude towards health problem Subjective data: Mother verbalized “Dira ra man namo pud namo na ginalabay” Objective data: VI. Wala a. galibang b. Low salience of the problem. Wala na namo ginasterilize. Poor environmental sanitation specifically polluted water supply as a health threat A. balon gakuha ug tubig. Failure to utilize community resources for health care due to: 27 . 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. Negative attitude towards health problem d.
Lack of immunization status Not all children have completed specially of children as a health their immunizations. Inaccessibility of required service due to physical inaccessibility (location of facility) Objective data: VII.” a. Inaccessibility of required service due to physical inaccessibility (location of facility) 28 . threat Subjective data: A. Inaccesability if appropriate resources for care specifically financial constraints B.a. Inability to make decisions with Mother verbalized “Isa ra lagi respect to taking appropriate ang nakakumpleto sa bakuna ba. Failure to utilize community resources for health care due to: a. Layo health action due to: pa jud ang center.
It includes a computation on how priorities were shown with their corresponding justification.67 0 Justification This problem is a health threat The problem could not be modified at all. The problem could be moderately prevented. Nature of the 2/3 x 1 problem 2. Criteria Computation 1. 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. as a health threat. Modifiability of 0/2 x 2 the problem 3.5 Total Score: 2. thus it needs money. Nature of the 2/3 x 1 problem 2. Accident hazards specifically fire hazard.33 29 . Salience 1/2 x 1 0. 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.67 4. Criteria Computation 1. The family size cannot be trimmed down to smaller size The problem may be prevented but the family size 0. Preventive potential 2/3 x 1 0. Modifiability of 1/2 x 2 the problem Score 0.Chapter VII PRIORITIZING PROBLEMS This chapter shows the setting of priorities of family health problems that has been identified. The problem. I. Family size beyond what family resources can adequately provide as a health threat. Preventive potential 1/3 x 1 Score 0. compared with the other problems does not need immediate attention since it requires time and money. 3.84 II.
The problem is not perceived as a problem at all by the family. 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. If the family receives the right health teaching. 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 3.5 2. Modifiability of 2/2 x 2 the problem Score 0. Salience 1/2 x 1 1 0.4.5 Total Score: 4.33 0. Preventive 3/3 x 1 potential 4.5 30 . The problem is not needing immediate attention according to the family 3. Preventive 1/3 x 1 potential 4. Poor home condition specifically lack of food storage facilities as a health threat Criteria Computation 1.67 2 Justification This problem is a health threat The condition can be highly modifiable. III.67 1 Justification This problem is a health threat This problem is partially modifiable since the family lacks resources specifically in the financial aspect. Nature of the 2/3 x 1 problem 2. Salience 0/2 x 1 Total Score: 0 1 cannot be trimmed down. Modifiability of 1/2 x 2 the problem Score 0. Unsanitary food handling as a presence of health threat. Criteria Computation 1. However. Salience 1/2 x 1 Total Score: 0. Nature of the 2/3 x 1 problem 2.17 IV.
it plays not much importance in their life 0. Poor environmental sanitation specifically unsanitary waste disposal as a health threat Criteria Computation 1. Modifiability of 2/2 x 2 the problem 3.67 1 Justification This problem is a health threat The problem is moderately modifiable since this problem can only be solved with money. 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. Poor environmental sanitation specifically polluted water supply as a health threat Criteria Computation 1.67 2 Justification This problem is a health threat The problem is easily modifiable by teaching the family the importance of having a proper drainage.67 0.V. This is highly preventable if the family has learned the importance of having a clean drainage. Poor environmental sanitation specifically improper drainage disposal as a health threat Criteria Computation 1.84 VII. Nature of the 2/3 x 1 problem 2.5 2.67 2 Justification This problem is a health threat The problem is highly modifiable since it could be solved if the family knows the importance of sterilization. Modifiability of 2/2 x 2 the problem 3.5 3. With regards to the family’s perception. The problem is preventive because there are ways and 1 31 . Salience 1/2 x 1 Total Score: Score 0. Nature of the 2/3 x 1 problem 2.67 0. Preventive 3/3 x 1 potential Score 0. Salience 1/2 x 1 Total Score: Score 0.84 VI. the problem does not need immediate attention 0. Preventive 2/3 x 1 potential 4. Nature of the 2/3 x 1 problem 2. Modifiability of 1/2 x 2 the problem 3.
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 did not seem to mind at all. Modifiability of 1/2 x 2 the problem Score 0. Lack of immunization status specially of children as a health threat Criteria Computation 1. VIII. Preventive 2/3 x 1 potential 0. The family knows how important immunization is specially for the children 3. Nature of the 2/3 x 1 problem 2.34 32 .17 resources present in the community where in the family can have a clean water supply The problem. is not much important.67 4. Salience 2/2 x 1 Total Score: 1 3.5 4.4. with accordance to the family’s perception. Salience 1/2 x 1 Total Score: 0.
84 2.17 3. This chapter also presents the family care plan formulated by the student nurse together with the family. as a health threat.50 1 33 .84 3.Chapter VIII NURSING CARE PLAN This chapter shows the identified and prioritized problems in a ranking order.34 2. Problem List Problems Unsanitary food handling as a presence of health threat.17 4. Score 4.84 2. Poor home condition specifically lack of food storage facilities as a health threat Family size beyond what family resources can adequately provide as a health threat. 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.
pail and clean towel After 1 day of community exposure. >Physical and chemical resources such as soap. Wala tay mahimo kay gahi man jud ug ulo. 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. water. the family has able to: Employ hands finger before during meals clean and nails and eating Specifically: • • >Demonstrate proper hand washing Discuss the technique importance and need for hand washing >Inform the Demonstrat family about e proper communicable Specifically: • Discuss the importance and need for hand washing Demonstrate proper hand • 34 .” Inability to make decisions with respect to taking appropriate health action due to: • Low salience of the problem. CUES ANALYSIS OF THE PROBLEM INTERVENTION PLAN OBJECTIVES NSG. INTERVENTIONS RATIONALE METHOD RESOURCES REQUIRED EXPECTED OUTCOME Subjective data: Mother verbalized “Ay mga tamad na sila manghugas ug kamot. 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.FAMILY NURSING CARE PLAN Problem# 1 Unsanitary food handling as a presence of health threat.
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.. washing techniques > To measure the understanding of the health teachings presented.
home and environmental factors. Mr.Chapter IX SUMMARY. With Mr. mostly bamboo. General Santos City. V did not know the exact measurement of their house. V does not work. The V family resides in Purok Daanbanwang. A nuclear type is a typical type of family composed of a father. EVALUATION AND RECOMMENDATION Presented in this case study is the different characteristics and health condition of family V. Upper Labay. Mrs. the total floor area should be divided among the total members of the family and each should at least have 3.000. In order for the house to be considered as adequate. V earns about Php 6.00 a month. she is in charge of the house and in taking care of the children. V’s monthly income. Their house is made of wood. the family strives hard to accommodate everything they need for them to 36 .5 m2. Since Mrs. health assessment of each member. They have started living their since June of 2009. The house only has 2 windows and can sustain the adequate ventilation needed by the family. Summary and Evaluation The Family V is considered as a nuclear type of family. This case study presents the family structure. socio – economic and cultural factors. It also contains data about identified problems on the living condition of the family. The V family’s main source of income is coming from Mr. Her husband knows it yet he was not there during the interview. a mother and child/children. V’s farming.
The family has yet to participate in community activities since they are new in the place. They usually urinate and remove bowels anywhere near their house. V Family has no comfort room. They put their water in a big container with cover. 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. Mrs. V is about Php 6. They typically borrow money from their relatives. 000. The children. Mrs. 000. All of them are affiliates of Protestantism.00 and when divided among the 6 members. The father is usually in their farm while the mother is in the house doing household chores. The drainage system of the family is an open type where in the drainage flows anywhere and is continuous. The V Family barely enjoys the community resources since the community itself lacks resources. 37 . each individual should at least have Php 2768. The river is the family’s main source of water. They wash their clothes and gets their drinking water supply there. go to Purok Daanbanwang Elementary School. they can be considered poor. it is only Php 1. V also informed the student nurse that they do not have any financial assets at hand in case of emergency.00. thus. According to NEDA. The total monthly income of Mr.60 when the total monthly income of the family is divided among the total family members.live. though. They usually don’t sterilize their drinking water supply.
the student nurse as an agent has helped the family through motivation and support to change their lifestyle and improve their health status. There still have that ability to meet the desired characteristics in their structure and maximize their health potential of optimum wellness. Nevertheless. the family is now equipped with fair knowledge which they could use anytime as the need arises. the family has chances to improve their health condition. They are cooperative and participative to the different issues and interventions they are confronted. Hence. The student nurse have also created a care plan on how to deliver the 38 . many problems were identified such as health threats which include fire hazards. With this situation and family condition.The V family is identified to have plenty of environmental problems in which it is evident that they practice poor environmental sanitation. Together with the family. A nursing care plan then is formulated to address the different problems identified. Although the allotted time for the student nurse was not enough to attend to all those problems. and improper drainage system as well as health threats which are improper personal practice as improper hygiene. poor home and environmental sanitation. 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. Recommendations The student nurse have identified and prioritized problems and needs with the family.
• The family should be aware that organizations in the community are open and present for their problems to be addressed properly. • The V family should persevere to perform proper waste segregation and disposal of their garbage as it was presented during the mother’s class. frequent changing of clean clothes especially when come in contact with filthy objects or experienced wetness of the back. They must clean their surroundings to avoid the presence of vectors of diseases. • They must also reorganize their cooking practices in terms of food preparation and handling as well as keeping their kitchen utensils in a covered storage to avoid getting it contaminated by insects or pests. • The family must also be educated and follow the proper preparation of herbal medicines as it was presented during the mother’s class. refraining from walking barefooted. brushing of teeth frequently. • The family should also be advised to not wait for the ailment to become severe before seeking medical help. and proper and regular hand washing. they should also cover their food storage. The following below are propositions and commendations recognized by both the student nurse and family: • The V family should maintain a healthy and clean environment. In addition to that. trimming their nails.best nursing care for the family to address their needs. 39 . • The family should also maintain proper hygiene such as taking a bath regularly.
40 .• They should be encouraged to verbalize their concerns with regard to the community so that resolutions can be made.
htm 41 . Published: 6/23/2004.about. al.com/od/theoriesofpersonality/a/psychosocial.buzzle. Untalan. Marikina City: Argonauta Corp.BIBLIOGRAPHY Books Cuevas. Concepts and Guidelines in COPAR.com/editorials/6-23-200455793. F. A. Public Health Nursing in the Philippines.com http://psychology. Manila: Educational Publishing House. et.com/od/theoriesofpersonality/ss/psychosexualdev. A. 2005.about. 1st ed. htm http://psychology. Internet Sources Jay C. Nursing Practice in the Community. Philippines:2007 Maglaya. 10th ed. 2004..asp http://wisdomquotes. http://www.
B-Day: 12/17/1973 Status: M Household No.College of Nursing Barangay/ Purok: Daanbanwang. 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. Educational Attainment: Grade 6 GENERAL HOUSEHOLD DATA A.5 kgs 33 kgs 17 kgs NS N N N N N N Members Mr V Mrs V AV BV CV DV II. List of household members: B-Day (mm/dd/yyyy) Occupation Farmer. General Santos City PERSONAL DATA Name of respondent: Mrs V I. Total number of children: 4 B. 11-14-79 10-09-80 07-11-98 10-19-99 04-16-02 05-23-05 ECONOMIC DATA A. Husband son son son daughter Imm.APPENDICES APPENDIX A BARANGAY HEALTH PROFILE Department of Health Notre Dame of Dadiangas University. 000 42 . Status INC INC INC INC COM Deworming Date 2008 2008 2009 2009 Weight 56 kgs 50 kgs 38 kgs 36. Sources of Income: Occupation: Farming Estimated Monthly Income: P6. Upper Labay. to Resp.
Home: Herbal ( ) Vegetable ( x) None ( ) MEDICAL HEALTH DATA A. Water: Bought ( ) Free (x ) III. 43 .B. Toilet facilities: Owned ( ) Shared ( ) None ( X ) Anywhere B. ENVIRONMENTAL DATA A. No. Products. Family Planning: Continuous. Household Appliances: radio F. Common diseases/ Commen Treatment: cough. colds and fever. Type: Plain ( X ) Rolling ( ) C. Animal Raising: chicken G. Type of Housing: Concrete ( ) Ordinary ( X ) Rented ( ) Scrap ( ) E. if land is farmed: corn D. Lactating: No F. Garbage Disposal: Burying and/or Burning E. Owned ( ) Rented ( ) Tenanted ( X ) 2. Disable member of the family: None IV. Immediate Sources of Medical Care: BHW C. Other pertinent observations/informations like presence of personality disturbances: None H. Pregnancy: No E. Land 1.g Mayana and Kataka. Drainage: none D. Herbal e. Pills D. Transportation Facilities: Owned ( X ) Rented or Others( ) H.taka B. Source of Drinking Water Supply: Shallow well C. of Hectares: ____. Death in the Family: None G.
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 .
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. Tong June lang mi ngbalhin diri” The student nurse verified if the respondent 45 . Amua ni siya.” Remarks The student nurse greeted the respondent and the respondent welcomed the student nurse in their house. Ako diay si Mylene Ma’am. It also includes the reactions of the family or how they respond on the questions that were lift during the entire interview.APPENDIX C Process Recording This appendix represents the course of interaction between the student and the family during each phase of interview. To be able to have a specific data on how the interview was conducted 2. Mao ning inyong balay?” Client “Maayong buntag sad. Establishing rapport is a process of creating goodwill “O. Pwede mabal-an unsa inyong pangalan?” “Ay hello diay Ma’am Emie. 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. The purposes of the opening are to establish rapport and orient the interviewee. To be able to interpret or analyze the answers given by the respondent 3. Bag-o ra jud mi diri. Ako diay si Emie. Purpose: 1. Dali sulod mo oi. Nursing student sa NDDU.” (Smiles) “Ahh.
was a member and trust. nurse told the understanding. Aha “Ang akong bana of the begin with a man pud inyong naa man sa bukid community. Dapat lang jud mucooperate mi eh” (Smiles) The respondent approves of the student nurse’s purpose and acknowledged her presence. It can “Ahh. Pwede “Okey ra kaayo uy.” duration of mi mga November their stay in na. of a change in sa inyuha? Maayo gani ni. I’m a nursing Ang mga bata naa student”) man sa eskwelahan accompanied by kay nay klase. Lingaw man pud na siya (Client and SN laughs). 46 . Giving recognition. informed the behaviour. Pasalamat gani mi naa mo diri karon para mutabang namo. an Kanang kamo man Hehe” respondent on efftort the client has gud ang akong her purpose made. Siyempre importante gud na naa mi mabal-an sa sakit sakit. Didto morning Sir!”) or na siya gapuyo jud. Kanang manghangyo ko sa inyong cooperation ma’am ha. greeting (“Good pamilya?” gud nag-uma. or a napili na iadopt na for coming contribution to family. Kanang pud diay noh. Pero challenge na siya sa amua eh. The student in a nonjudgmental ko mag-interview Walay problema. Lisod daw ang suga. nonverbal gestures Unya pato taod2 such as smile. self-introduction Ginaadtuan lang (“Good morning! namo sa mga bata. nurse way.” “Ay wala nay problema gang. and a sila mukaon” friendly manner. Okey ra and the communication. Dalia ra man The student without ma’am ha. Mga December the daw mi community. Acknowledgment may be with or “Salamat kaayo “Hala. magculmination” “Lagi daw ma’am. a inig udto kay diri to handshake. ma’am?” interview. Mao ba. Mubalik suga diri. hantod October mi Matulog pud mo diri respondent verbal or nonverbal. maginterview eh? Wala baya the time (Barbara Kozier) interview. “Ay ma’am.
Hehe. Gafamily planning man jud gud mi tong una pa sa Malungon pa mi. akong bana kay hantod grade 3 lang. Wala baya sila diri kay nageskwela. si BV 10. Elementary graduate ko. Si BV kay October 1999. Nagsunod sunod lang ang 2 ka una pero after ana nagpills nako. Remarks Rationale Demographic data was given completely. Si CV April 2002 unya si DV May 2005. 29 nako. Unsa pud mga Pangalan sa inyong anak ug ilang mga bday? Client Yata.Working Phase Student Nurse Ay kanang ma’am unsa inyong apelyido? Sige lang ma’am. Unsaon ta man Respondent blames poverty for their lack of education. Kanang. Wala baya akong bana diri ay. 4 tanan among mga anak. Lagi ma’am uy. October 9 ko nya November 14 na siya. Ikaw lang akong interbyuhon. Ay sige. Lisod na baya kinabuhi ron. Si Child AV 11. Maayo gani ma’am nainform mo ug ing-ana Kanang ma’am mangutana ko kung unsa inyong nahuman sa eskwela? 47 . Si AV July 1998 na siya. Layo layo pud ilahang mga agwat noh. Naa man pud gud health center didto sa Malungon ug Nurallah. Lagi. Akong bana kay 30. Ahh. Unsa napud inyong edad ug sa inyong bana? Kanus-a pud inyong mga bday? Okey ra ma’am uy. si CV 7 unya si DV 5. 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.
Respondent was glad the children have a chance in education. Kaning among balay dugay na ni siya. Gamay ra jud ang income intawon.lisod kaayo ang kinabuhi. Si AV grade 5. Kami ra jud diri. O. Di na gain mi kapalit sa mga sanina sa bata. si CV grade 3. Due to financial constraints. ikaon na lang namo diba Ay mao ra jud na. Nag-ingon ka ma’am na nagauma imong bana. si BV grade 4. 48 . Unsa pa mga lain ninyong ginakwaan para income? Kanang pila pud inyong maincome sa usa ka bulan? Mga Php6. including the environment.000 pud. the family has not able to provide an adequate and a safe house for the family. Gibuhat ni siya sa pamilya sa akoang bana. akong bana tu-a sa bukid. Respondent put on much emphasis on financial issues. Dira ko galuto sa may likod. Poverty is an issue in every Filipino family since it is the major factor that affects their way of living. Puro kahoy na siya ug nipa ug mga patay na dahon sa saging. Mga kinahanglan nila. Ang mga bata ma’am? Mga bata maayo man kay nay eskwelahan diri. Wala nay lain. si DV maggrade 1. Kamo ra jud diri sa mga bata ma’am? Bale balay jud ni ninyo? She was able to express her concerns about the household. Ang among ipahimo ug balay. Mao ra jud ni among makaya kay siyempre kulang sa budget. very difficult if you lack education.
49 . Daghan lagi kayo ug langaw Ay daghan pud. Isda ug mga gulay dira sa kilid among sudan pirmi. aha ninyo ginalabay? Kanang butangan sa inyong pagkaon na wala nahurot? Dira ra man namo pud namo na ginalabay. galibang kanang walay tao Dira mi sa balon gakuha ug tubig. Ok naman na siya. they have protection from it. Pero naa man mi mosquitero. The respondent explained how they manage with their elimination even without a toilet facility. Ang inyong mga lamaw ma’am o mga hugaw gikan sa kusina. Daghan kaayo mga langaw? Mga lamok? Respondent explains that although there are many mosquitoes in the place. (Points at the ground beside the house). Kanang inyuhang banyo? Ug kung asa mo gakuha ug tubig? Mao jud na karon kay wala pa mi kahimo. Wala na namo ginasterilize. Layo man gud kaayo ang gripo diri sa amua. Dira ra man namo na ginabutang. Respondent explains how they manage their drainage disposal Respondent shows how they put their left overs. Wala man mi butanganan na lain.Luoy kayo. Wala pay kwarta. Ang among pagkaon ginatama tama lang para sa amua. Drainiage disposal is an important factor since vectors or insects may hover and affect their health. She also explained their ways of getting water for drinking. The family has not yet build a toilet facility since they were new to the place and have no budget for it. Dra ra mi gaihi.
Balik ra ko. Adto lang gud diri. Wala tay mahimo kay gahi man jud ug ulo. Respondent shows the student nurse their mini vegetable garden and that they have herbal plants around. Ay mga tamad na sila manghugas ug kamot. Immunization is an important protection and prevention of some diseases. 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. Mga mga gulay o herbal kangkong. 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. Naa pud ba moy Naa. Giving 50 . No disturbances were found. Wala jud bisyo akong bana. Ay maayo jud. Layo pa jud ang center. Suroy suroy pud mo ba. Mga asunting. Ang na ginatanom? herbal naa sa ilalom. Balik balik mo ha.Kanang sa bakuna sa mga bata ma’am? Isa ra lagi ang nakakumpleto sa bakuna ba. Didto o.” Respondent points out that the health center is quite far from their place. Salamat jus kaayo. Client Walay problema. Sa panahon namo dili man pud na uso gud. Kanang diri sa panimalay ma’am unsa pud ng ugali sa mga bata na makaapekto sa ilang lawas. Respondent shows that she disapproves of the children’s behavior but feels she can’t do anything about it. Respondent feels proud of her husband not having vices. Remarks The respondent appreciated our presence and was open Rationale Expressing gratitude makes the respondent feel that they did something good.
or a contribution to communication. an efftort the client has made. of a change in behaviour.in answering all the questions. recognition. Acknowledgment may be with or without understanding. in a nonjudgmental way. verbal or nonverbal. 51 .
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