CHAPTER I

INTRODUCTION

Community Health Nursing is the utilization of the nursing process in the different

levels of clientele-individuals, families, population groups and communities,

concerned with the promotion of health, prevention of disease and disability and

rehabilitation (Maglaya, 2004).

“The family is the nucleus of civilization.”

-Ariel and Will Durant: Wisdomquotes.com

Family as a socially recognized group (usually joined by blood, marriage,

cohabitation, or adoption) that forms an emotional connection and serves as an

economic unit of society 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.

The nucleus acts like the brain 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 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 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 behaviours

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 appropriate to say that community health nursing has a big role in the

nursing education. It is in the community where the student nurses learn

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 nurses reache

and feel 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 fulfilment 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.

In compliance to the criteria of the Primary Health Care System with the selection

of the family, particularly those who are underprivileged, is acknowledge with the

importance in the delivery of the health care services. The family that was

chosen by the student nurses 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, experiences other

socio-economic related problems such family income of below five thousand

pesos monthly, is considered poor according to Philippine Statistics Authority

(PSA) and National Statistical Coordination Board (NSCB).

With considerations on the conditions mentioned above, the student nurses

chose the C. family as the subject of our community health nursing practice. The

C. family resides at Centro, Barangay Arosip Bacnotan, La Union, which consists

of six family members. Family C. is considered as an extended type of family. An

extended type is a family that extends beyond the nuclear family, including

grandparents, aunts, uncles, and other relatives, who all live nearby or in one

household. This type of family structure is found in almost all societies especially

here in our country, although the length of time in which the family remains in this

form varies even within the same society. Mr. T. C. is the head of the family, the

eldest and a farmer. He has history of tuberculosis. Mrs. G. C. is the wife of Mr. T.

C. and has hypertension. Mrs. L. C. is the daughter of Mr. and Mrs T. C. She is

married and with 2 children. She is also hypertensive. Mr. J. C. is a janitor and

the husband of Mrs. L. C. and X. C. is the first born of Mr. J. C. and Mrs. L. C.

and she has history of asthma. Y. C. is the youngest among the family and has

scabies on her lower extremities. These conclude that the C. family is an

extended type of family. The location of the house of C. family has poor

environmental condition. According to the observations made by the student

nurses as they walk through the household and through assessment and

interview, the youngest child has scabies because the family owns 6 dogs and

they are not taking good care of them and because of the presence of breeding

sites for mosquitoes there is a high risk of having dengue among the family.

Spring is the water source of the C. family for drinking and for doing chores; the

water is not filtered or boiled before drinking which makes the C. family high risk

for diarrhea or cholera. There are also hazards present in the vicinity of the
house like hanging wires, there is no ceiling and kitchen utensils are not

organized in one place thus making the family high risk for injuries.