YR/BLK: BSNII-B Group: 4 DATE: 09-23-2021

SUBJECT: NCM 104 CHN Lec CI: Art Z. Tribunal, RN, LPT

Activity 2.1
Clienteles & Nursing Process

Group Members:
1. Madolid, Switzel 6. Paday, Mark Paulo
2. Manumbas, Romeo 7. Rait, John Michael
3. Naman, Jessa Mae 8. Robarios, Jovi
4. Novero, Marc Franzs 9. Salvador, Karen
5. Obmana, Zyra 10. Santos, Sheila May

1. Give the four levels of community and compare its difference to each other.
The four levels of community are the Individual, Family, Population Group and the
Community.
An Individual serves as the building block of the community, it makes up the family, while
the family makes up the population group and makes up the community. A nurse makes sure
that an Individual is well taken care of, it can either be prenatal to postnatal, tuberculosis,
hypertension and many more. Also, an Individual is a spiritual being so respecting their beliefs
is a must.
Family, they are the people that we interact with most of the time, we share a bond with
every member of the family that is why the health of one member can affect the whole family.
Compared to the individual level, here in family level we are now dealing with two or more
people.
Next is we have the Population Group wherein the people here shares the same
characteristics and development which can also expose them to the same health problems.
And lastly, we have the Community, this is a cluster of families put together, they share
the same traditions, interests and beliefs. Every community is unique in their own way, they
have their own communication system, religious system, economic system, education, so on
and so forth. And since communities and different from one another, we also need to adapt
and understand their ways in life not just as a person, but as a community as a whole.

2. What are the 6 functions of the family? Give an example to each function.
1. Procreation
Procreation is a general word for a family unit formed by two or more people.
Contrasted as "family of origin," which refers to the families from whom people come (from
marriage). The procreative family will develop its own set of values and dynamics. The
intergenerational continuity of a family system can help provide shelter and experience,
as they begin to build their own family of procreation.
YR/BLK: BSNII-B Group: 4 DATE: 09-23-2021
SUBJECT: NCM 104 CHN Lec CI: Art Z. Tribunal, RN, LPT

Activity 2.1
Clienteles & Nursing Process

Example: Marc was famer and Sheila was a daughter of the president, they met at
Bagasbas beach and got married. They had three childrens. Marc and Sheila with their
three children are a family of procreation.

2. Socialization of family members

People learn about social expectations and how to interact with other people
through socialization. It is during socialization that everyone learns to walk, talk, and feed
themselves, as well as behavioral rules that help them integrate into society. Family is
regarded as the most essential agent of socialization. The parents fill the position of
teaching the children how to function and care for themselves. Them as well as the other
family, teach about close relationships, group dynamics, and resource sharing. They also
give the first set of values, conventions, and beliefs, which reflects their own social status,
religion, ethnic group, and other factors.

Example: Switzel, a girl who is deaf. She grew up differently from the other girls. But she
was taught by her parents through socialization on how to sign language, read lips and
how to read books. With this it helped her to socialize with others despite the disability.

3. Status placement
The reproductive and socialization functions of the family are completely linked to
status placement in the society. The family into which one classes, has a significant impact
on the responsibilities and statuses that one would hold later in life. At birth, several
statuses are assigned, such as age, sex, and social class. Children typically adopt their
family's legal, religious, and political position. Even acquired statuses, such as marriage,
career, and education, are heavily determined by one's affiliation with a specific family.

Example: Mark Paulo was born from a billionaire family, his parents was the CEO and
founder of the largest company in the Philippines. He and his siblings will inherit his
family’s company, wealth and status.

4. Economic function
It defines “family” from an economics perspective and then details the economic
functions of the family: human capital creation, social capital creation, household
production of goods and services, economies of scale and public goods provisioning,
consumption and savings decisions, and risk-sharing and self-insurance.

Example: Jay is a hardworking father, he works at the construction but due to lack of
finance, his wife Jenna and her daughter Jessica is also working for the family. Jenna
YR/BLK: BSNII-B Group: 4 DATE: 09-23-2021
SUBJECT: NCM 104 CHN Lec CI: Art Z. Tribunal, RN, LPT

Activity 2.1
Clienteles & Nursing Process

works as a cashier while her daughter Jessica, works as a saleslady. They help each other
to survive their daily needs in their living.

5. Physical maintenance
It is expected that families will provide physical care for all members: adults,
children, and otherwise dependent individuals this includes health care, appropriate
nutrition, shelter, clothing if this does not happen then individuals could be at risk and
suffer unless society steps in to replace this function.

Example: Carlo was a father of the 3 children and a husband to his wife. He always takes
care of his family and works as a construction worker to give his family food in order to
survive and can pay rent of their house.

6. Welfare and protection

It is where the family provides companionship and meets affective, sexual, and
socioeconomic requirements for spouses or partners. Also, provides emotional fulfillment
and psychological security to the children by cultivating a sense of love and belonging.

Example: At the age of 30, Jaden has his own family. He has 2 kids and a lovable wife.
He loves his family more than he loves himself. He always makes sure that he is always
there for his family and protects them at all costs.

3. There are tasks of the family life cycle stated below. Classify each task on which stage it
belongs.
Aging Families a. Support role of middle generation
Marriage: joining of families b. Formation of identity as couple
Families as launching centers c. Renegotiation of marital relationship
Families with adolescents d. Development of increasing autonomy for adolescents
Families with young children e. Integration of children into family unit
Marriage: joining of families f. The mother and father enrolled their children in public
school in consideration of their economic status.
Families with young children g. Mark is excited to announce to his parents that they will
be having a child.
Families with adolescents h. Fatima failed to fulfill her role as a mother to her
teenage son because of her work. Her husband opened this issue and proposing for
separation.
Aging families i. Linda, a 71 widowed mother, was alone and decided to
go into a pay ward of home for the aged nearby, after her youngest child migrated in
YR/BLK: BSNII-B Group: 4 DATE: 09-23-2021
SUBJECT: NCM 104 CHN Lec CI: Art Z. Tribunal, RN, LPT

Activity 2.1
Clienteles & Nursing Process

Canada in order to live with her husband for them to raise their children in a greener
pasture.
Families as launching centers j. Roy and his wife Ciara decided to live with his parents to
adjust with their new situation when his wife recently got hired in DepEd. In addition,
they found out that Ciara is 2 months pregnant with their second child.

4. Enumerate the phases of home visit and give at least 3 highlights on each phase.
PRE-VISIT PHASE
The nurse will call or contacts the family he/she will going to visit
The nurse determines the family’s willingness for a home visit
The nurse sets as appointment with the family
IN-HOME PHASE
The nurse seeks permission to enter the family’s house
This phase consists of first, initiation or the knocking and greeting the family as well
as introducing his/her self and stating the purpose of visit and iniating some sort of
conversation to establish rapport. Second, implementation which is the application of
nursing process from the assessment down to evaluation. Third, termination is the
concluding part wherein the nurse states all the findings and observations, setting
follow-up visit, and recording the gathered data.
The nurse says goodbye to the family and leaves the house.
POST-VISIT PHASE
Documentation regarding the visit including the personal observations and feelings of
the nurse about the visit.
Planning what interventions to take based on the family’s data
Referral, if necessary, and follow-up home visits for the family.

5. Create a Genogram of a family from one of your members (preferably the on that will be
assigned on this question) using the Genogram Symbols.
GENOGRAM OF ROBARIOS FAMILY:
YR/BLK: BSNII-B Group: 4 DATE: 09-23-2021
SUBJECT: NCM 104 CHN Lec CI: Art Z. Tribunal, RN, LPT

Activity 2.1
Clienteles & Nursing Process

6. Assessment: From the samples of primary and secondary data, how can you
differentiate the two?
Primary data refers to original sources of information before it has been analyzed and is
obtained by the nurse herself. These are raw data or first-hand observations that are gathered
through observation, survey, informant interview, community forum, and focus group
discussion.
On the other hand, secondary data are sources that analyze or interpret the primary data.
These are just from the existing data sources, it may be interpretations of information, written
after the event, or gives reviews or reports. Examples include vital registries, health records
and reports, disease registries, and publications.

 In collecting primary data, we have the observation (ocular or windshield survey)

where the nurse can drive or walk in the community to observe the environmental
conditions and facilities and to also note the appearance of the people whether they’re
healthy or not. Can also be a chance to observe the environmental conditions like
cleanliness or how the houses are built, if there are available healthy foods like vegies
and up to observing the animals in the community. All of this including the places
where there can be public gatherings like health facilities, barangay halls, schools, etc.
This method helps the nurse in determining community values, beliefs, norms
priorities, concerns and power in influence structures.
 Survey is next to observation it’s done when there is no available information in the
community that can be studied so the nurse tends to find another way to contract info.
A survey is a series of questions for systematic collection of information from a sample
of individuals can be written or oral.
 Information interview is purposely talking to an informant to get information’s on the
community perceptions about health and health care.
 Community forum an open meeting of members of the community a medium to
express their views another way to gather some data and to also give some
information’s.
 Focus Group A focus group is a bit similar to a community forum the difference is it’s
a smaller group of people that have the same concerns.
Secondary data sources
 Registry of vital events act 3753 civil registration law, Philippine legislature, 1930
that requires the registration of vital events such as births, marriages and deaths.
Reliable civil registration and vital statistics provide a realistic basis for program
planning and implementation. Birth and death are sources of fertility and mortality data.
Birth should be registered 30 days from occurrence of birth and a death certificate
should be issued within 48 hours.
YR/BLK: BSNII-B Group: 4 DATE: 09-23-2021
SUBJECT: NCM 104 CHN Lec CI: Art Z. Tribunal, RN, LPT

Activity 2.1
Clienteles & Nursing Process

 Health records and reports Field Health Service Information System (FHSIS) official
recording and reporting system of the DOH and is used by the Philippine Statistics
Authority to generate health statistics. FHSIS is an essential tool in monitoring the
health status of the population at different levels.
 Disease registries is a listing of persons diagnosed with specific type of disease in a
defined population. The data collected serves as basis for monitoring, decision
making, and program management.
 Census data is a periodic governmental enumeration of the population and back then
it is usually done for every 10 years but now it is done for every 5 years to maintain
updated information used by the government and private organization in planning and
decision making.

In conclusion, the primary and secondary data sources are of course about gathering
information but the difference between the two is the primary data is more likely be done by
being present in the community and observing it personally and the information’s are all raw
and new its updated. You get to see it, hear it, make judgments, etc. I am not saying that the
secondary data is not updated I’m just saying that it’s like harvesting vegies and you know its
freshly picked that receiving one and being told that it is freshly picked. There’s a big
difference. While on the secondary data sources it’s more like of a stored information, I mean
it is easier method, it’s like keeping history so you have something to look back into. If a
problem occurred, you can dig up some information that is stored to clear things up and it is
basically connect the dots thing.

7. Diagnosis: After the nurse gathered data as basis for him/her to have the nursing
diagnosis, can you give at least 3 diagnosis from these sources.

a. NANDA (Use NANDA pocket guide hardcopy or pdf)

● Interrupted family processes; related to family role shift as evidenced by change in
communication patterns. .
● Impaired social interaction related to isolation from family as evidenced by
separation, loneliness, and lack of supervision from the family members.
● Impaired physical mobility related to decreased muscle strength and control as
evidenced by inability to control upper and lower extremities.
YR/BLK: BSNII-B Group: 4 DATE: 09-23-2021
SUBJECT: NCM 104 CHN Lec CI: Art Z. Tribunal, RN, LPT

Activity 2.1
Clienteles & Nursing Process

b. The Omaha System

Domain: environmental Domain: health-related Domain: psychosocial

behaviors

● Income ● Nutrition ● Neglect

● Residence ● physical activity ● mental health
● Sleep and rest ● role change
● healthcare
supervision

Intervention scheme: Intervention scheme: Intervention scheme:

● Finances ● Proper nutritional ● Supervision of

● Projects for intake. neglected member
cleanliness of area ● Exercise (assistance &
or residence ● Right amount sleep comfort)
Clientele: family & ● Supervision of ● Professional aid
community isolated member ● Counseling
Clientele: Family

Clientele: Family

Signs and symptoms Signs and symptoms Signs and symptoms

(individual/actual): (individual/actual): (individual/actual):

● Low income ● Lack of proper ● Mistreated or

● Unsanitized area nutrition uncared for
● Lack of exercise ● Existing mental
● & lack of proper rest health problems
● & role acceptance

c. Social Diagnosis

● Absenteeism: related to family problems manifested by separation or seclusion

from the family and from personal problems affecting the overall mental health of
a specific member.
● Alteration in family health management: related to eating a diet high in saturated
fats as evidenced by the sedentary lifestyle of the family or a specific member.
YR/BLK: BSNII-B Group: 4 DATE: 09-23-2021
SUBJECT: NCM 104 CHN Lec CI: Art Z. Tribunal, RN, LPT

Activity 2.1
Clienteles & Nursing Process

● Drug abuse: related to community substance abuse as evidenced by

overpopulation and low-income that affects the daily life of people in the
community.

8. Planning: (a.) Give the planning models and explain each. (b.) List the five steps strategy
to planning and elaborate each.
PLANNING MODELS
PATCH Model or the Planning Approach to Community Health Model is the
one that the health promotion is governed for the effectiveness in terms of health.
Community participation is essential in this type of model 'coz it is intended that the
community is present and visible to this so called health emergencies, encounters etc.
According to this model, health promotion is the process by which the population gains
more control over their own health. It entails mobilizing the community, gathering health
data, determining health priorities, developing a comprehensive intervention plan, and
assessing the process.
Local health departments can take the APEX-PH to improve their organizational
capacity and boost their leadership role in their communities. It is intended for usage by a
local health department on a voluntary basis. A good local health department will help a
community achieve locally relevant goals more effectively.
MAPP Model is a model for improving community health systems whose mission
statement is “Communities achieving improved health and quality of life by mobilizing
partnerships and taking strategic action.” The first phase of MAPP is to mobilize the
community. This phase emphasizes the preparedness and organization of a community,
one example is the arrival of covid-19 virus to some countries, while the government is
doing their roles as a public servant, supposedly there are private sectors that take effect
on this situation to deeply disseminate the facts and information to every community. The
second is to guide the community toward a share vision for long range planning. This
phase refers to the expected goals to an expected outcome to happen. Giving directions
and instructing the community, it will take a lot of discussions in order for the agreement
and action plan to happen. The third is to conduct four assessment. Conducting
assessment is relevant to this model because it tackles about the: assessing community
themes and strengths (what is the current condition of a community), local public health
system (what will be the progress of such health system to the community) community's
health status, and assessing the forces of change (what was the probable/possible
changes when this model will be implemented, does it benefit every constituents of a
community?), and others.
YR/BLK: BSNII-B Group: 4 DATE: 09-23-2021
SUBJECT: NCM 104 CHN Lec CI: Art Z. Tribunal, RN, LPT

Activity 2.1
Clienteles & Nursing Process

FIVE STEPS STRATEGY TO PLANNING

 Determine where you are. Conducting external and internal audits is necessary
in order to get acquainted or be familiarized with the community you are going to
work with and be prepared to apply the skills that you will be needing.
 Identify what is important. Align your focus to the problems in the community
that you want to address. Have your own mission and vision. Know what you want
to do in the community and what you aim for.
 Define what you must achieve. Have specific objectives for the community that
will result for its betterment once all of those objectives are achieved. Through your
objectives, it will help you and the community to resolve the existing issues.
 Determine who is in charge. This is how you will arrive to your preferred
destination. The strategies, action plans, and budgets are all part of a process that
successfully conveys how you will allocate time, human capital, and financial
resources to solve priority issues and meet set goals.
 Review. To ensure that the strategy works as intended, you should conduct formal
assessments of the process on a regular basis and refine it as needed. It is
suggested that you do this at least once every quarter.

9. Implementing: What do we do in this stage?

Implementation is the step when the family and/or nurse execute the plan of action. The
pattern of implementation is determined by the mutually agreed upon goals and objectives
and the selected course of action. When appropriate, it involves providing direct nursing care,
helping family members do what is necessary to meet health needs and problems, or referring
the family to another health worker or agency. The nurse should be conscious of possible
barriers to implementing planned strategies, which may be family-related or nurse-related.
Nurses also use their critical thinking skills and clinical knowledge to assess the procedures
to ensure they address the patient's needs appropriately and align with the team's goals. The
nurse's role therefore may be facilitate the process rather than directly implement the planned
interventions. Implementation also entails coordination of the plan with the community and
other members of the health team. This requires a common understanding of the goals,
objectives, and planned interventions among the members of the implementing group.

10. Evaluation: (a.) Define UTILITY, FEASIBILITY, PROPRIETY, and ACCURACY. (b.)
Differentiate validity and reliability.
(a.) Define UTILITY,FEASIBILITY, PROPRIETY, and ACCURACY
Utility is the value of evaluation in terms of usefulness of results. This will provide a basis
for utilizing the community health process in dealing with other community concern in the
future.communicated to the local government (barangay and municipality/city) authorities, the
evaluation result mal also promote policy change such as in budgetary allocations.
YR/BLK: BSNII-B Group: 4 DATE: 09-23-2021
SUBJECT: NCM 104 CHN Lec CI: Art Z. Tribunal, RN, LPT

Activity 2.1
Clienteles & Nursing Process

Feasibility answers the question of whether the plan for evaluation is doable or not,
considering available resource. Resources include facilities, evaluations. Data gathering for
evaluation should bring about minimal disruption everyday activities.

Propriety involves ethical and legal matters. Respect for the worth and dignity of
participants in data collection should be given credit where it is due and to show the strengths
to encourage further growth and weaknesses for remedial action, if possible.

Accuracy refers to the validity and reliability of the results of evaluation. It is the
correctness of all gathered data through correct documentation and utilizing the right
evaluation tools as well as rechecking the data in order to ensure validity and reliability.

(b.) DIFFERENTIATE VALIDITY AND RELIABILITY

Validity means that the results obtained from the evaluation satisfy the objectives or
simply, it is about the accuracy of the results.
Reliability on the other hand, is the consistency of the results from the evaluation. If the
same result can be consistently achieved by using the same methods under the same
circumstances, the measurement is considered reliable.