FAMILY HEALTH ASSESSMENT OF

IN PARTIAL FULFILLMENT OF THE COURSE NCM 63.1: COMMUNITY HEALTH

NURSING, 1-RLE PRESENTED TO THE FACULTY OF THE COLLEGE OF
NURSING, CENTRAL MINDANAO UNIVERSITY

Submitted to
PILAR V. DOMAGSANG, RN, MAN
NEDA JOY L. ESPINA, RN, MAN
EMVIE LOYD P. ITABBLE, RN, MAN
AL DUANE B. UNGAB, RN, MAN
LAL JOY L. SANCHEZ, RN

Proponents:

BS Nursing (Section Code)

(DATE)
ACKNOWLEDGEMENT
 TABLE OF CONTENTS

CLASS NAME
LIST……………………………………………………………………………. I
ACKNOWLEDGEMENT……………………………………………………………………
…. II
TABLE OF
CONTENTS……………………………………………………………………… III
LIST OF
APPENDICES……………………………………………………………………… IV

INTRODUCTION……………………………………………………………………………
…. V
BARANGAY ORGANIZATIONAL
CHART…………………………………………………. VI
PUROK ORGANIZATIONAL CHART………………………………………………………
VII
COMMUNITY
PROFILE………………………………………………………………………. 1
LOCATION AND LAND
AREA……………………………………………………….. 2

RESOURCES………………………………………………………………………….. 3
NUMBER OF FAMILY
HOUSEHOLD……………………………………………….. 4
POWER
SOURCES…………………………………………………………………… 5
COMMUNICATION
SERVICES……………………………………………………… 6
TRANSPORTAION
SERVICES……………………………………………………… 7
WATER
SUPPLY………………………………………………………………………. 8
SPOT
MAP……………………………………………………………………………………... 9
FAMILY HEALTH ASSESSMENT GUIDE…………………………………………………
10
GENERAL DATA……………………………………………………………………...
11
FAMILY DATA…………………………………………………………………………
12
FAMILY CHARACTERISTICS………………………………………………………
13
HOME AND ENVIRONMENT……………………………………………………….
14
HEALTH AND HEALTH PRACTICES……………………………………………...
15
ENVIRONMENT………………………………………………………………………
16
AWARENESS OF COMMUNITY ORGANIZATION………………………………
17
HEALTH INSURANCE……………………………………………………………….
18
LIST OF FAMILY HEALTH PROBLEM AND NATURE OF PROBLEM………………...
19
COMPUTATION AND WEIGHING OF SOCRES…………………………………………
20
FAMILY HEALTH CARE PLAN……………………………………………………………..
21
RECCOMENDATIONS……………………………………………………………………....
22
INTRODUCTION
BARANGAY ORGANIZATIONAL CHART
PUROK ORGANIZATION CHART
 COMMUNITY PROFILE
1.0 LOCATION AND LAND AREA (FROM GOOGLE MAP)
2.0 RESOURCES (WITH ILLUSTRATION AND/OR GRAPHICAL CHARTS)
3.0 NUMBER OF FAMILY HOUSEHOLD (WITH ILLUSTRATION AND/OR GRAPHICAL CHARTS)
4.0 POWER SYSTEM (WITH ILLUSTRATION AND/OR GRAPHICAL CHARTS)
5.0 COMMUNICATION SERVICES (WITH ILLUSTRATION AND/OR GRAPHICAL CHARTS)
6.0 TRANSPORTATION SERVICES (WITH ILLUSTRATION AND/OR GRAPHICAL CHARTS)
7.0 WATER SYSTEM (WITH ILLUSTRATION AND/OR GRAPHICAL CHARTS)
SPOT MAP
 FAMILY HEALTH ASSESSMENT

I. GENERAL DATA

II. FAMILY DATA

Family Member’s Chart
 III. FAMILY CHARACTERISTICS

IV. HOME AND ENVIRONMENT

IV.A. HOUSE ((WITH ILLUSTRATION AND/OR GRAPHICAL CHARTS)

IV.B. FOOD STORAGE/COOKING FACILITIES (WITH ILLUSTRATION AND/OR
GRAPHICAL CHARTS)
IV.C. WATER FACILITY (WITH ILLUSTRATION AND/OR GRAPHICAL CHARTS)
IV.D. WASTE MANAGEMENT (WITH ILLUSTRATION AND/OR GRAPHICAL
CHARTS)
IV.E. PREMISES INDICATION (WITH ILLUSTRATION AND/OR GRAPHICAL
CHARTS)
IV.F. PLANTS/VEGETATION (WITH ILLUSTRATION AND/OR GRAPHICAL
CHARTS)
Information of the herbal plants approved by DOH
Information of the herbal plants non-approved by the DOH
V. HEALTH AND HEALTH PRACTICES
Common Illnesses encountered for the last 6 months and the treatment applied
Immunization status of family members
Nutrition of child aged 0-5 years
V.A. FAMILY PLANNING
V.B. REST AND SLEEP PATTERN
Felt Family Needs
VI. ENVIRONMENT
VII. AWARENESS OF COMMUNITY ORGANIZATION
VIII. HEALTH INSURANCE
 LIST OF THE FAMILY PROBLEMS (WITH ILLUSTRATION AND/OR GRAPHICAL CHARTS)

Supporting Data/Cues Health Problems Nursing Problems

 COMPUTATION AND WEIGHING OF SCORES
(WITH ILLUSTRATION AND/OR GRAPHICAL CHARTS)
 FAMILY HEALTH CARE PLAN 1
FAMILY CODE 1:00
(WITH ILLUSTRATION AND/OR GRAPHICAL CHARTS)
 RECCOMENDATIONS
(WITH ILLUSTRATION AND/OR GRAPHICAL CHARTS)

A. TO THE FAMILY
B. TO THE COMMUNITY
C. TO THE MIDWIFE AND BHW
D. TO THE BARANGAY OFFICERS
APPENDICES
Appendix 1. FAMILY HEALTH ASSESSMENT GUIDE
Appendix 2. COMMITTEES
Appendix 3. DOCUMENTATIONS DURING INTERVENTIONS
DOCUMENTATIONS DURING CASE PRESENTATION AND CULMINATION