UNIVERSITY OF SAINT ANTHONY

(Dr. Santiago G. Ortega Memorial)

Iriga City

HEALTH CARE EDUCATION DEPARTMENT

NCM 104 –

Community Health Nursing

The Individual and The Family as

Clients in The Community
and Public Health Nursing

Submitted by:
Eunice B. Guevarra
BSN-2B

Submitted to:
Mr. Kenny Nino H. Tagum, RM, RN, MAN Ph.D
Clinical Instructor
 UNIVERSITY OF SAINT ANTHONY
(Dr. Santiago G. Ortega Memorial)
Iriga City

HEALTH CARE EDUCATION DEPARTMENT

1. Discuss the levels of clientele in community health nursing.

As exposed to the community as one of the health care providers on the field a
community health nursing deal with the four (4) levels of clientele. It includes the.
individual, the family, the population groups, and the community.

The first level of clientele deals with the biopsychosocial and spiritual being of an
individual as a client. Nurses aims to deliver care holistically with the end goal of
having the individual be well nourished, relates to both genders that includes equality,
and has a smooth working relationship with the family. Assisting sick individuals in
general to become healthy and healthy individuals achieve optimum wellness. It states
that nurses must deliver care holistically and that includes an individual’s spirituality and
beliefs that a community health nurse must respect. This level of clientele works with
the singularity cases of an individual with or without the consideration of the family but
to one; cases such as prenatal, postnatal, postpartum, clients suffering from diabetes or
a hypertensive patient, as long as the main focus is on one individual to help restore
the health, prevent diseases and alleviate the suffering of the patient.

The second level is the family, as the individual is the first contact of a community
health nurse of the “entry point” next to the family. Family is defined as the collection
of people who are integrated, interactive and interdependent and the basic unit of care
in community health nursing. In one’s household depending on their home situation and
orientation the nurse assumed the duty to deliver care to the family.

The third level of clientele is the population groups, population groups refers to
the group of people who shares common characteristics, exposure to the community
and the developmental stages, these includes children, women and elderly. For
example, a health teaching about the risks and management of a tuberculosis cases
corresponding to the needs of a group of people, sharing the same sentiments.

A community as a clientele refers to the overall or collectives that shares the

common values, beliefs, common interests, goals and objectives that lives through the
same social system; health system, family system, economic system, educational
system, religious system, welfare system, political system, recreational system, legal
system and communication system.
 UNIVERSITY OF SAINT ANTHONY
(Dr. Santiago G. Ortega Memorial)
Iriga City

HEALTH CARE EDUCATION DEPARTMENT

2. Describe the different types of families.     

As a community health nursing interacts with different sets of people note that we
deal with different type of people, families and their own upbringing. It requires the
nurse to work in such a flexible manner that allows the nurses to formulate different
approaches that can deliver the right care to its clients so one should be aware to such
changes in the community especially in family.

The different types of family include (1) Nuclear Family – it is defined as the
family of marriage, parenthood, or procreation. The traditional definition of a nuclear
family is a family unit that includes two married parents of opposite genders and their
biological or adopted children living in the same residence. [1] (2) Dyad family on the
other hand is consist only of the husband and wife such as newly married couples and
called “empty nesters”. (3) Extended family- consisting of three generations living in
the same household, which may include married siblings and their families and/or
grandparents. (4) Blended family is the union of both spouses with both children form
their first marriage or before the current relationship. (5) Compound families wherein
a man has more than one spouse, but only applicable to Muslim man by virtue of
Presidential Decree No. 1083 in accordance to the code of Muslim Personal Laws of the
Philippines as mandated in 1977 in respect to the part of the community. (6)
Cohabiting family or more familiar in the terminology “live-in”. It is the arrangement
of two unmarried couple. (7) Single parent – could be a result from death of a
spouse, separation or pregnancy outside of wedlock. They are more prone to greater
risks be with financial, emotional and social security that could affect the well-being of
the child. (8) LGBTQI+ families or the cohabitation of couple of the same sex in a
sexual relationship, they may have or have not children.

3. Analyze the Individual and the family as a health system.

Family in the health system is buffer system that connect the individual to the
society, families are expected to meet the needs of society, and the second is to meet
the needs of the individual family members. It starts from the interaction of the family
from a smaller unit inside the family to a larger unit of the family outside the
 UNIVERSITY OF SAINT ANTHONY
(Dr. Santiago G. Ortega Memorial)
Iriga City

HEALTH CARE EDUCATION DEPARTMENT

community. With the participation of an individual to a group of people it opens a portal

of entry to interact and be able to communicate deeper to the needs in health care of
the seeking client, we know that families are consist of individuals who are integrated,
interactive and interdependent to each other then factors that affects the need of that
group of that people will be simmered to the individual needs of that family which then
can varies depending on the suprasystems that could disrupts the acting system outside
the family. Look at it as the individual as the starting point to unveil the necessary care
the family needs.

4.  Explain why the family is the unit of service in community and public health nursing.

The family is assumed to be the basic biological, cultural, and epidemiological unit of
society. In addition, health resources are used through the family. Therefore, the family
[2]
is the basic unit of health services. From them the health of the person would first
depend on the health of the family and its affecting factors such as the home situation.
It considered ad unit of service as the illness of a family member affects the family's
total medical care, they first assumed the role of a “primary health care provider” to
restore the health of their family member then if its successful then the family health
service is effective and the individual can maintain successful family lifestyle.

5.  Decide which specific type of family nurse contact will be appropriate for a particular
family.

The clinic visit is the type of nurse-contact which takes place in a private clinic,
health center, barangay health station, rural health unit and or in an ambulatory clinic.
This type of could be appropriate to those families with resources such as
transportation advantages and the distance of the place is appropriate could be a
suitable choice for them as this type of nurse-contact requires the client to take the
initiative of visiting a professional help with willingness to start an intervention on
health care process however if the client finds hardship seeking help from client visit
then the they would have difficulty in discussing their health concerns.
 UNIVERSITY OF SAINT ANTHONY
(Dr. Santiago G. Ortega Memorial)
Iriga City

HEALTH CARE EDUCATION DEPARTMENT

A group conference targets a specific group in hopes to provide opportunities to

gave care to a group that shares the same sentiments such as screenings of newborns
or through a target family of the community. This open to opportunities that helps build
self-reliance and community awareness among society. The downside of a group
conference is that the demographic population couldn’t be met due to the unavailabity
of targeted group.

Telephone on the other hand provides an easy access and contact to the
nurse/health care worker and the family, this could be an approach that could save
both ends on other resources such as transportation fees and other risk factors for
example now in time of pandemic it lessens the risk of exposure to the virus especially
to the vulnerable groups of the community but keep in mind that not everyone can
have access to telephones and the targeted audience might be limited.

Written communication this is used to give specific information to families, such

as interaction given to parents through school children.

6.  Identify the most appropriate methods and tools in performing family health
assessment.

The three commonly used assessment methods and tools are Genogram, family
health tree, and ecomap. Genograms are used as a stool that uses symbols to outline
the family structure then with the used of genogram, we could further assess the client
using the Family health tree that could be an indicator or for the mechanism of
recording for the families medical and health histories. Ecomap for the family linkage to
it’s suprasystems about the family awareness to the community.

7. Utilize the nursing process in the care of individuals within the family and the care of
the family as a whole.

The nursing process it is a systematic, problem-solving, logical, and deliberate

process to help the family develop and strengthen their capacities to meet their health
needs and solve their health problems. Facilitates standardized nursing procedures to
achieve the goals and objectives of family health nursing. It is a logical sequence of
 UNIVERSITY OF SAINT ANTHONY
(Dr. Santiago G. Ortega Memorial)
Iriga City

HEALTH CARE EDUCATION DEPARTMENT

data collection for family health care. The five-nursing process includes the
assessment first to identify the health status of the individual member of the family
introducing the used of assessment tools such as genograms, family health tree and
ecomap. It also Involves Observation, Nursing History, Literature Review Consultation,
Interview, and Clinical History, Physical and Psychosocial History. Next is the family
nursing diagnosis, it consists of the family diagnosis based from the North American
Nursing Diagnosis Association. Planning: Involves setting priorities, setting goals and
objectives, and formulating a family health nursing care plan. Implementation: It
consists of the mobilization of resources facilitating the work environment,
implementation and documentation. Evaluation: It involves the summative and
[3]
formative evaluation of the family health nursing care plan.
 UNIVERSITY OF SAINT ANTHONY
(Dr. Santiago G. Ortega Memorial)
Iriga City

HEALTH CARE EDUCATION DEPARTMENT

REFERENCES

1. Applebury G. Definition of a Nuclear Family: Understanding the Characteristics.

LoveToKnow. Published 2021. Accessed November 2, 2021.
https://family.lovetoknow.com/definition-nuclear-family
2. Family health nursing care services in community. Nursing Guru. Published
2020. Accessed November 2, 2021.
https://www.communityhealthnursing.guru/2020/12/family-health-care-services-
in.html
3. Family health nursing care services in community. Nursing Guru. Published
2020. Accessed November 2, 2021.
https://www.communityhealthnursing.guru/2020/12/family-health-care-services-
in.html

BOOK: Community and Public Health Nursing 2nd Philippine Edition