Family Interview

I. Family Structure and Characteristics

• Who are the members of the household?
Trans: Sino sino ang mga miyembro ng pamilya? Maari niyo bang banggitin ang
pangalan?
• For the demographic data, kindly tell us the family member’s age, sex, civil status
and position in the family
Trans: Para sa data ng demograpiko, mangyaring sabihin sa amin ang edad, kasarian, at
posisyon ng miyembro sa pamilya
• Are all the members living together? If not, who are those not living in the same
house?
Trans: Lahat ba ng miyembro ay magkakasama sa bahay? Kung hindi, sino sino ang mga
miyembro na nakahiwalay ng tirahan?
• What is your family structure? (matriarchal, patriarchal, nuclear or extended)
Trans: Ano ang istraktura ng iyong pamilya? (matriarchal, patriarchal, nuclear o
extended)
• Who are the dominant family members who makes all the decisions when it comes
to health care?
Trans: Sino ang mga miyembro ng pamilya na gumagawa ng lahat ng desisyon
pagdating sa pangangalagang pangkalusugan?
• OBSERVE: General family relationship - presence of any obvious/ready observable
conflict between members; communication patterns among members.
II. Socio-economic and cultural factors
• For the family members who are working, if it is okay, will you tell us your
occupation, place of work and income?
Trans: Para sa mga miyembro ng pamilya na nagtatrabaho, kung okay lang, maari mo
bang sabihin sa amin ang iyong trabaho, lugar ng trabaho, at magkano ang kita?
• Is your income sufficient to meet your basic needs (food, clothing, shelter)
Trans: Sapat ba ang iyong kita upang matugunan ang iyong mga pangunahing
pangangailangan (pagkain, damit, tirahan)
• Who makes the decision about money and how it is spent?
Trans: Sino ang gumagawa ng desisyon tungkol sa pera at kung paano ito ginagastos?
• What is the highest educational attainment of each family member?
Trans: Ano ang pinakamataas na natamo ng bawat miyembro ng pamilya?
• Do you have another ethnic background besides Filipino? If yes, what is it?
Trans: Mayroon ba kayong ibang etnikong pinagmulan maliban sa Filipino? Kung oo,
ano ito?
• What is your religion?
Trans: Ano ang inyong relihiyon?
• Who are the family members who have significant others or spouses? Do they have
a role in the family when it comes to decision making?
 Trans: Sino-sino ang mga miyembro ng pamilya na may asawa? May papel ba sila sa
pamilya pagdating sa pagdedesisyon?
• Does your family participate in community activities?
Trans: Nakikilahok ba ang iyong pamilya sa mga aktibidad sa komunidad?

Family Age Sex Civil Position Place of Occupation Place Income Educational SO/
Member Status in Residence of Attainment Role
the work in the
family family

III. Environmental Factors

Observe the following:
1. Housing
a. Adequacy of living space
b. Sleeping arrangement.
c. Presence of insects and rodents.
d. Adequacy of the furniture
e. Food storage and cooking facilities
f. Presence of accidents hazards
g. Water supply-source, ownership, potability
h. Toilet facility-type, ownership, sanitary condition
i. Garbage/refuse disposal- type, sanitary condition
j. Drainage system- type and sanitary condition
2. Kind of neighborhood- congested, slum, etc.
3. Social and health facilities available
4. Communication and transportation
IV. Health Assessment of Each Member (Interview individually)
• Medical and Nursing Health History
o Did you have a significant illness in the past? If yes, what was your
condition?
Trans: Nagkaroon ka ba ng isang makabuluhang sakit sa nakaraan? Kung oo,
ano ang iyong naging sakit o kalagayan?
o Do you have allergies? If yes, what are those?
Trans: Mayroon ka bang allergy? Kung oo, ano ang mga iyon?
o When you are sick or have an injury, do you consult a healthcare worker for
medication or you rely on home remedies to relieve the situation?
Trans: Kapag ikaw ay may sakit o may pinsala, kumukunsulta ka ba sa isang
healthcare worker para sa gamot o umaasa ka sa mga home remedy upang
maibsan ang sitwasyon?
o Do you exercise regularly? How often?
Trans: Ikaw ba ay nag eehersisyo? Gaano kadalas?
o Do you smoke? If yes, how often?
Trans: Ikaw ba ay naninigarilyo? Gaano kadalas?
o Do you drink alcoholic drinks? If yes, how often?
Trans: Umiinom ka ba ng alak? Gaano kadalas?
o Do you visit you doctor regularly?
Trans: Madalas ka ba bumisita sa iyong doktor?
• Nutritional Assessment
o What do you usually eat in a day? Please indicate the quality and quantity of
food intake per day.
Trans: Ano ang karaniwan mong kinakain sa isang araw? Mangyaring
ipahiwatig ang kalidad at dami ng pagkain sa bawat araw.
o Do you experience problems in eating?
Trans: Nakararanas ka ba ng mga problema sa pagkain?
o Do you currently follow a strict diet or meal plan? If yes, can you tell us your
current diet plan?
Trans: Mayroon ka bang sinusunod na dyeta? Kung oo, ano ito?
o Anthropometric Data (Weight and Height)

• Current health status

o Are you experiencing any health issue in the present? (cough, fever,
headaches, body aches, etc)
Trans: Nakakaranas ka ba ng anumang isyu sa kalusugan sa kasalukuyan? (ubo,
lagnat, sakit ng ulo, pananakit ng katawan, atbp)
o Are you diagnosed with any medical condition in the present?
Trans: Na-diagnose ka ba na may anumang kondisyong medikal sa kasalukuyan?
V. Value Place on Preventive Disease
• Did you have complete immunization vaccines during your childhood? If yes, what
were the vaccines given to you? (Hepa B, Polio, BCG, etc.)
Trans: Nabigyan ka na ba ng mga nararapat na vaccine noong ikaw ay bata pa? Kung oo,
anong vaccine ang natatandaan mong naibigay saiyo?
• Have you had your current immunization vaccines? If yes, can you state what are
those? (Covid, Flu, Pneumonia, etc)
Trans: Mayroon ka na bang bakuna para sa Covid 19, Flu, Pneumonia, atbp.?
o What brand of Covid Vaccine did you get? How many doses have you
completed?
Trans: Anong klase ng Covid Vaccine ang kinuha mo? Ilang tusok na ang
nakumpleto mo?
o Have you had booster shots? How many doses?
Trans: Nakakuha ka na ba ng mga booster shot? Ilang doses?