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I. Introduction

The family is a basic unit of study in many medical and social

science disciplines. Definitions of family have varied from country to
country, and also within country. The family is a basic unit of study in
many social science disciplines, such as sociology, psychology,
economics, anthropology, social psychiatry, and social work. It is also
a unit of study in the medical sciences especially in understanding the
epidemiology and the natural history of diseases (Sharma, 2013). The
family unit – principally a man and a woman living together in
harmony and peace – is and always will be the basic social
organization or unit of any society. This relationship alone provides
stability in a sexual, emotional, intellectual and social way as no other
can.

The family is the most important social unit of society. This is a

fact that everyone must learn. The family is not only the basic
societal unit. It is also the basic sexual unit, the basic child-raising
unit, the basic communication unit, and the basic all-around fun and
friendship unit (Wilson, 2013). It also forms the basic unit for family
medicine. Census definitions of family have varied from country to
country and also from census to census within country. The word
household has often been used as a replacement for family. The
UNESCO report stated that a family is a kinship unit and that even
when its members do not share a common household, the unit may
exist as a social reality. This definition may be too broad to serve the
purpose of identification of a family unit for the purpose of
assessment as a factor in variables such as health.

Family nursing is a part of the primary care provided to patients

of all ages, ranging from infant to geriatric health. Nurses assess the
health of the entire family to identify health problems and risk factors,
help develop interventions to address health concerns, and implement
the interventions to improve the health of the individual and family.
Family nurses often work with patients through their whole life cycle.
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This helps foster a strong relationship between health care provider

and patient (Peteprin, 2016). Family nursing is not as much patient-
centered care as it is centered on the care of the family unit. It also
takes a team approach to health care.

In the course of the family care assessment, it has been found

that Marcos family incurred problems regarding environmental
sanitation. Environmental Health is concerned with preventing illness
through managing the environment and by changing people's behavior
to reduce exposure to biological and non-biological agents of disease
and injury. It is concerned primarily with effects of the environment to
the health of the people. Per assessment it was found that the Marcos
family gives low attention to environmental sanitation. According to
the WHO Director-General Dr Margaret Chan "Sanitation is a
cornerstone of public health". "Improved sanitation contributes
enormously to human health and well-being, especially for girls and
women. We know that simple, achievable interventions can reduce the
risk of contracting diarrhoeal disease by a third". Ann M. Veneman,
UNICEF Executive Director said that “Nearly 40% of the world’s
population lacks access to toilets, and the dignity and safety that they
provide". “The absence of adequate sanitation has a serious impact on
health and social development, especially for children. Investments in
improving sanitation will accelerate progress towards the Millennium
Development Goals and save lives” (WHO & UNICEF, 2008).

Health problems result from the lack of sanitation facilitates,

especially among the urban poor living in overcrowded informal
settlements which is greatly affects to their health. Environmental
poor sanitation, globally an estimated 2000 under the age of five die
every day from diseases and these some 1800 deaths are linked to
water, sanitation and hygiene (United Nations International Children
Emergency Fund). In the Philippines, an estimated 25% of Filipinos
do not have improved sanitation, translating to more than 24 million
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people. (UNICEF WHO Progress on Drinking Water and Sanitation

2012).

For the clinical case, Mister M of the Marcos family was found to
be suffering from Nephrolithiasis. It is a process of forming a kidney
stone, a stone in the kidney (or lower down in the urinary tract).
Kidney stones are a common cause of blood in the urine and pain in
the abdomen, flank, or groin. Kidney stones occur in 1 in 10 people at
some time in their life. The development of the stones is typically
related to increased excretion of stone-forming components such as
calcium, oxalate, urate or cystine. The pain with kidney stones is
usually of sudden onset, very severe and colicky (intermittent), not
improved by changes in position, radiating from the back, down the
flank, and into the groin. Nausea and vomiting are common.

The incidence and prevalence of kidney stones is increasing

globally and is seen across sex, race, and age. Changes in dietary
practices may be a key driving force influencing these trends as well
as the effects of global warming.