ILOILO DOCTORS’ COLLEGE

College of Nursing
West Ave., Molo. Iloilo City

FAMILY HEALTH NURSING OUTPUT: FAMILY ASSESSMENT W/ FAMILY CARE PLAN

(with RUBRICS)

NAME: ____________CJ T. PORRAS____________________YR. & SEC.__BSN 2-B_ AREA: ____POTOTAN, ILOILO_____

CLINICAL INSTRUCTOR: ______________________________________________________________________________

III-Prioritizing Health Problems (Scaling & Computation)

CRITERIA COMPUTATION SCORE JUSTIFICATION

Specific Problem: _Hypertension
__________________________
Nature of the Problem
(please encircle)
a. Health Threat
b. Health Deficit
c. Foreseeable Crisis or
Stress Point
Modification of the
Problem
Hypertension is a health
deficit in which will cause
3/3 x 1 1 complications that requires
immediate attention and
adequate management of
one’s blood pressure.
Current knowledge,
interventions and resources
2/2 x 2 2 are available to solve the
problem of high blood
pressure or hypertension.

Preventive Potential
Increase blood pressure can
be prevented through
3/3 x 1 1 proper health management
for hypertension and taking
medication regularly.

Salience

The family perceives

2/2 x 1 1 hypertension as a serious
problem needing attention.

TOTAL SCORE 5

CRITERIA COMPUTATION SCORE JUSTIFICATION

Specific Problem: _Unhealthy
lifestyle and personal habit
Nature of the Problem
(please encircle)
d. Health Threat
e. Health Deficit
f. Foreseeable Crisis or
Stress Point
Smoking and taking alcohol
are health threat in which
2/3 x 1 2/3 may cause a major risk in
one’s health however does
not demand immediate
action.
 Modification of the
Problem The problem is partially
modifiable because
1/2 x 2 1 sometimes they forgot to
take their maintenance on
time.

Preventive Potential
Smoking is the vices of the
grandmother and it is
moderately prevented
because she smokes that
2/3 x 1 2/3 everyone can’t see her.
While drinking alcohol is for
the father, he can minimize
it but sometimes his body
wants some alcohol.

Salience
The family recognizes it as
problem. It does not seem
1/2 x 1 1/2 the problem as needing
immediate action.

TOTAL SCORE 2 5/6

CRITERIA COMPUTATION SCORE JUSTIFICATION

Specific Problem: Poor home/
environmental condition/
sanitation
Nature of the Problem It is a health threat that
(please encircle) 2/3 x 1 2/3 demand immediate action.
g. Health Threat
h. Health Deficit
i. Foreseeable Crisis or
Stress Point
Modification of the
Problem The resource and
interventions needed to
2/2 x 2 2 solve the problem are
available to the family.

Preventive Potential
Occurrence of dengue,
malaria and other
2/3 x 1 2/3 communicable diseases can
be reduced or minimized by
cleaning and disposing the
possible sites in production
of the vectors.

Salience
This problem does not need
immediate attention, just
1/2 x 1 1/2 cleaning the surrounding
every day.

TOTAL SCORE 3 5/6

IV -List of Prioritization/Ranking of Health Problems

RANK HEALTH PROBLEM CLASSIFICATION SCORE

1
Hypertension Health Deficit 5

2 Poor home/ environmental condition/

sanitation Health Threat 3 5/6

3
Unhealthy lifestyle and personal habit Health Threat 2 5/6

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V- FAMILY COPING INDEX (FCI)
Coping may be defined as dealing with problems associated with health care with reasonable success.
When the family is unable to cope with one or another aspect of health care, it may be said to have a coping
deficit. The coping index is composed of a point on the scale and a justification statement. (Pls. refer to your
handouts on (FCI). /coping capacity is rated from 1(totally unable to manage family care) to 5 (able to handle
care w/o help from community resources). Check no problem if it is not relevant. The justification consists of
statements that explain why you have rated the family as you have explained in observable facts. General
considerations include: 1.) It is the coping capacity and not the underlying problem is being rated. 2.) It is the
family and not the individual that is being rated.

SCALE:
No problem 1 – no competence 3 – moderate competence 5 – complete competence

Instruction: Please check the corresponding scale and justify. (Use your FCI guide)

No
CATEGORIES Problem 1 3 5 JUSTIFICATION

1. Physical
Independence Aside from their support system, the father is
the one who is responsible for their everyday
food and has no stable work since he is an on-
/ call driver in the village, and the mother is the
one who takes good care of everything in the
house. The children have their own role in the
house to fulfill when there is no class.

2. Therapeutic
Competence The family is complete with all the necessary
equipment’s in checking the health of everyone
such as BP apparatus, thermometer and pulse
/ oximeter. Also, with any type of medicine and
for first aid. Their first child is a student
therefor, a plus factor for taking care of their
health.

3. Knowledge of
Health Condition The family is quite knowledgeable when it
comes in detecting any signs of illness or
/ disease. They have family relatives that into
medical field therefor they have an easy access
in terms of consultation. The family is very
conscious especially to the health of everyone.

4. Application of
Principles of The mother is very conscious in terms to the
General Hygiene cleanliness of the house and its surroundings.
/ Every day she maintains the cleanliness of every
part of the house especially the comfort room.
Also, everyone practices personal hygiene.

5. Health Attitudes
The family understands and recognizes need
for medical care in illness and
/ for the usual preventive
services.

No
 CATEGORIES Problem 1 3 5 JUSTIFICATION

6. Emotional
Competence All members of the family able to maintain a
reasonable degree of emotional clam, face up to
/ illness realistically and hopefully. They consider
the needs and wishes of other family members,
of neighbor and those with whom they work
and live in making decisions upon action.

7. Family Living
Family does things together, each member acts
for the good of the family as a whole. No
/ control of children or family to totally
dependent on one another that they are being
stifled.

8. Physical
Environment House is in good repair. Materials used was all
in good quality. The environment is free from
hazardous accidents. Every household
/ maintains the cleanliness of their surroundings.
Also, well ventilated because the surrounding is
surrounded by trees. Everyone in the
community has a good relationship.

9. Use of
Community Community facilities are quite easy to access
Facilities because the community is complete with
equipment’s especially for the health of
/ everyone. Every part of the community has
assigned BHW, tanod and Kagawad in case of
emergency or other necessities.

VI – FAMILY CARE PLAN (pls see attached format)

VII - REFLECTION/INSIGHTS (pls. use the guide questions)

After conducting a family analysis and assessment using a variety of models, I'd like to think about how
I may use these tools more effectively in the future and learn more about family-centered care. In order to
identify the scope of services required for the family system, to ascertain the likelihood of compliance (the
need for monitoring and assistance), to explore choices, and to provide proposals or recommendations, it is
crucial to assess the family. The family that is assesses is health conscious. The whole family is covered under
medical insurance and adheres to annual health checkup. This family prefers homely food and the parents set
example for that. They also enjoy the relationship with neighbors and with extended family members. The
nutritional-metabolic pattern depicts characteristics of the family’s typical food and fluid consumption and
metabolism. In this particular family, all members follow a well-balanced diet. They prefer homely food which
is freshly prepared.

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