I.

INTRODUCTION AND OBJECTIVES

A. INTRODUCTION

It is greatly known that family is one of the most remarkable masterpieces that is
formed by love and unity. With the case scenario given, the Y family has a good
relationship within each other. The bond through connections and trust cannot be
undeniable. As this relationship evolves in a matter of time, the interaction should be
maintained wherein both communication and support systems are the key to have a
healthy family relationship.

Every year, one million children under the age of five are believed to die in
developing countries worldwide. Malnutrition is typically a contributing factor in these
deaths, which are mostly caused by five common illnesses (pneumonia, diarrhea;
malaria; measles; and dengue hemorrhagic fever). Even though effective and affordable
treatments for these common issues already exist, they have not yet reached those
most in need: the young and the poor. In 1992, the WHO-UNICEF developed Integrated
Management of Childhood Illnesses to all developing countries. The Integrated
Management of Childhood Illnesses (IMCI) is an effective strategy since it provides
curative care, nutrition, immunization, disease prevention, and health promotion. An
approach for lowering mortality and morbidity from critical sources of childhood disease.
The IMCI covers a broad spectrum of illnesses that impact young children, including
preventative and curative strategies.

In this paper, one specific case was prioritized: Pneumonia. Pneumonia is a life
threatening disease and it is also one of the most dangerous global health problems in
children, especially in those countries who are still developing. According to the annual
reports from its Department of Health (DOH) pneumonia is ranked as the number one
leading cause of death in children those ages from 1 to 4. Furthermore, the Integrated
Management of Childhood Illness (IMCI) which is developed by the World Organization
Health and the United Nations Children’s Fund, nurture a better and effective patient
management in order to lessen the rate and cases of disease in a population which is
caused by some common childhood diseases, including pneumonia. The Millennium
Development Goal 4 (MDG 4) of the United Nations objective is to lessen the cases of
diseases, especially pneumonia by two-thirds by 2015 from 1990 level. Nevertheless,
many of the developing countries are not on track to accomplish The Millennium
Development Goal 4 (MDG 4). There are many factors that hinder the achievement of
MDG 4. Including pneumonia, it remains to cause 1.4 million deaths of children annually
under the age of 5, accounting for 18% of universal mortality in this age group globally.
Around 110 per 1000 people per year is the estimated incidence rate of pneumonia in
children whose age is less than 5 years old in the Western Pacific Region.
 In relation to the study, previous results found out that there is a close
interrelation between childhood pneumonia and risk factors such as age, sex, parents’
educational level, parental smoking, number of siblings, type of cooking fuel, type of
toilet facility even the socio economic status (SES). Remarkably, the above-mentioned
studies were conducted in the hospital settings. When children develop pneumonia,
caregivers may not always take them to the hospitals, especially in the countries with
limited resources, due to some numerous reasons, for instance, financial problems, lack
of knowledge, or even poor accessibility to healthcare facilities. Data on the health care-
seeking behavior of pneumonia, specifically at the community level is needed, in order
to understand the real situation of pediatric pneumonia, but the said data are still limited.
Qualitative data was collected from 63 older and younger mothers and it revealed that
most of them recognized pneumonia and were able to describe mild and severe signs
and symptoms to explain incidence of pneumonia. Respiratory illness was attributed to
humoral imbalance, supernatural causes and “negligent” mothers. The role of the family
was important in decision-making. Rural mothers were relieved and satisfied to be able
to have quick access to low-cost medicines from Bangladesh Rural Advancement
Committee (BRAC) health volunteers, who are clearly responsible for health care
practices. An In-depth interview and focused group discussion was conducted with 23
health volunteers and after the said activity it showed that all 22 health volunteers were
able to correctly identify breathing rates and their association with pneumonia.

Records from the CHO revealed that the disease has been ranked as number
one among the top 10 leading causes of mortality in the metropolis in 2011 and 2012.
Data showed that pneumonia killed 1,115 people in Davao City from January up to
November of 2012. The CHO has yet to include data from December of 2012 as it is still
collating as of Tuesday. Although it remains the top killer disease in Davao City for two
years, the number of deaths caused by pneumonia decreased by 28 cases compared to
that of 2011 which recorded 1,143 deaths. Pneumonia is an infection of one or both
lungs which is usually caused by bacteria, viruses or fungi. However, pneumonia ranked
fourth as the top cause of mortality in the city with 1,201 cases in the five-year average
data of 2006-2010.

This case will benefit not only our group but also our nursing colleagues. By
studying the ways of a family case study and utilizing Family Coping Index,
Prioritization, and doing Family Nursing Care Plan, we will obtain new knowledge. It will
increase our awareness and expertise on nursing responsibilities in dealing with a wide
range of disorders in several settings, including not only pneumonia but also some
community-based circumstances that demand prompt response. This will allow us to
explore potential options and present the best solution with evidence.
B. OBJECTIVES

General Objectives:

At the end of the Integrated Management of Childhood Illness rotation, under the
supervision of the clinical instructor, the student nurses from BSN-2F Group 1 Subgroup
1 will gain knowledge and render appropriate intervention skills by developing a
comprehensive, substantial case study about the family's condition that will help the
situation of each member of the family. This case study will be beneficial to the
community, other student nurses, and researchers in the future.

Specific Objectives:

In this case study, the student nurses will be able to:

1. Describe the Family.

2. Define IMCI briefly.
3. Provide local, national, and global statistical reports of Pneumonia.
4. Give an overview of the Family Case Study.
5. Explain the Family Developmental Task.
6. Justify the Family Coping Index.
7. Score and justify the Prioritization of Problems
8. Formulate a Family Nursing Care Plan
9. Enumerate the Implications of the Study.