I.

INTRODUCTION Biologic definitions of family describe mating, reproduction, and descent, and do not emphasize psychosocial aspects of partnering or parenting. Sociologists view the family as a social group usually related by blood or contract. Legal definitions of family consider the phenomena of marriage, divorce, separation, and adoption, and how they create non-biologic family configurations. Common to all definitions of family are that families are more than one person with at least one adult, and that these persons are related to one another by blood or social contract. In nursing, we use the nursing process as our problem solving approach. It enables the nurse to systematically assess and respond effectively to the situations. The process begins with a health situation. The nurse and the recipient of her services come together and the process begins. The family nursing care process is the sum of the activities jointly performed by the family and the nurse. It includes the following: ASSESSMENT: It involves the collection of data based on observation of behavior, recurrent themes, stressful and critical incidents as they relate to an individual, a family or a group situation. The interpretation of data implies a working knowledge if concepts of health, disease process, and they psychological and social determinants of an individual, family, and group behavior. DIAGNOSIS: After completing the assessment phase of family care, the nurse will be able to identify family strengths and determine the existence of any actual or potential health problems. PLANNING: It involves problem prioritization, goal and objective formulation, identification of strategies or interventions and alternatives, and writing the family nursing care plan. IMPLEMENTATION: Implementation of interventions involves the actual execution of the nursing care or client self-care regimen. Nursing interventions are based on principles of nursing care which serves as guides for the action taken. It may be: 1) Dependent when the nurse functions in relation to a medical care plan 2) Independent when the nurse performs in her own responsibility 3) Collaborative when the nurse performs in conjunction with other disciplines and the recipients of health services EVALUATION: This involves the examination of the outcome of a chosen action in terms of its success in meeting the objectives of intervention. It is an appraisal of whether or not the nursing assessment and interventions have met the recipients needs or has contributed to the solution of a problem.

A primary health care worker / nurse needs to formulate a family health care plan so as to discover and appraise health needs and problems through combining public health nursing efforts with those of other professional workers. The competence of the family and the individual to cope with their own health problems would be developed. It can also contribute to the personal and social development of individuals and families through health activities. Lastly, formulating a family health care plan brings families an understanding of non-nursing health services within or outside the agency where the nurse is working, and provides the families with the necessary information and encouragement to use resources wisely and fully. Providing care in the clients home rather than in a hospital or a clinic gives the nurse a totally different perspective, and presents a more accurate picture of the individual as part of a family and a community system. Home nursing care takes place in the clients territory, and health care planning responsibilities are shared equally by the health care provider and the client family.

During the planning phase, the nurse establishes a verbal or written contract with the family. This permits both the family and the nurse to know personal roles and responsibilities in the relationships. Empowering family members is significant to clients. With empowerment, we can not only formulate a participatory family health care plan, but also people can help themselves for a lifetime and become independent decision makers for their own health. The nurse and the family must work together collaboratively to develop a list of goals, strategies, and expected outcomes. The family prioritizes its identified needs, and a plan of care begins with the formulation of interventions or actions.

At the end of our health worker family- client relationship, decisions will be made regarding the patients need which can be met within the context of the nurse-patient relationship. The solutions often depends upon the willingness of individuals, families, and community groups to make careful decisions on whether to pursue a long course of action or to change fundamental patterns of living. To achieve the desired ends, the nurse and the family, agency, or community group must establish a relationship that permits us to work together in such a way that the best efforts of both can be put together to improve the situation. Health needs and problems will have its solution either long term or short term. Lastly, preventive measures will be implemented to minimize reaching the curative stage of treatment.

II.

INITIAL DATA BASE A. Family Structure, Characteristics, and Dynamics

Family Sampaga is currently residing at Papayew, Pudong, Kapangan. The family is composed of three members. Mr. Smith Sakiaten is considered as the head of the family while Mrs. Sabaina is considered as the light of the family which is their mother. The family is classified as a nuclear family according to structure and composition since Mrs. Sabaina is living with his two sons since they chose to stay in that place without having their own family. All her other cjhildren are living in other places.

Table 1. All members living in the household NAME OF FAMILY MEMBER 1. Sakiaten, Sabaina 2. Bian, Smith 3. Sakiaten, Arthur RELATIONSHIP TO HEAD OF FAMILY Mother Head Brother POSITION AGE DATE OF BIRTH unrecalled 11/09/64 10/10/68 GENDER MARITAL STATUS Widowed Single Single RELIGION ETHNIC GROUP Kankana ey Kankana ey Kankana ey EDUCATIONAL ATTAINMENT Highschool level ElementaryGrade 5
OCCUPATION DOMINANT DECISION MAKER

Mother Son Son

44 40

Female Male Male

Anglican Anglican Anglican

Farmer Farmer

Since Smith is the eldest among the two brothers and has the highest educational attainment, he is considered as the head of the family but most of the times the two brothers share their income together with Mrs. Sabaina. Their decision making especially to finances were talked about within the family. Money is really hard for them to produce since the two brothers are only contractual to the fields that they are working with. So sometimes they receive their food from neighborhood or nursing students who gives them food to eat. Mrs. Sabaina and his two sons have a satisfying relationship with each other. Even though they fight at times, conflicts are easily resolved. They settle their differences right away so that problems wont grow or increase in severity. Mrs. Sabaina cooks for the family. At her condition all her actions are limited only. His sons were always out to do their farming and earn for their family. They seems to have a good relationship since Mrs. Sabaina smiles oftenly. Overall, the family members interact with each other repeatedly in many contexts. They engage in flexible role relationships, are democratic, respond to change, support growth and autonomy of others, and engage in decision making that affects them. The family also has few outside friends like their neighbors. They had also relatives from other Sitios and sometimes visits them to have a small talk and help each other.

B.

Socio-economic and Cultural Characteristics

Mr. Smith and Arthur works as a farmer. Their income were not approximated or estimated because they are only contractual. Mrs. Sabaina is not employed and is only at their home. Their income is not enough to meet their monthly expenses which include food allowances. Mr. Smith is the ones who have the final say on how the money is spent since he has the highest educational attainment and eldest among the two brothers.

Table 2. Income and Expenses NAME OF EMPLOYED MEMBER Bian, Smith Sakiaten, Arthur PLACE OF WORK Kapangan kapangan APPROX. MONTHLY INCOME OTHER SOURCES -

Table 3. Monthly Budget of Expenses

Food allowances are only available if one of the brothers got money from the field they were working. They don't have any other aspects such as water and electricity to be part of their expenses since this is free for them. They don't take any medicines and buy any other clothing. They are all on the adulthood so nobody is still studying. The family is a native of the place and are all Kankanaey. They are members of the Anglican church and sometimes go to church and hear a mass. Family Sakiaten rarely maintains contacts with community groups and organizations they are only familiar with their relatives and neighborhood. They are not aware of any government and non-government agencies servicing the community.

Home and Environment The family owns house including the house near them. It includes a one bedroom which is used as a living room, kitchen, and a dining room all-in-one. They all sleep in one bedroom since it is all in one. The house is made up of wood and concrete though it needed a few repairs, it cannot be destroyed by any natural calamity such as a typhoon in low signal number. Rain water cannot also enter. There were no electricity available for them. There is sufficient ventilation since the place were near the trees and is very refreshing . The house is dirty since not all things in the house are properly arrange. Also Mrs. Sabaina's clothing and he inside of the house were dirty. Dusts are everywhere and the place were not kept cleaned. Breeding and resting sites of insects such as cockroaches, flies, and mosquitoes are present in the structure of the house because of many small spaces between the walls. They were used with their surroundings so they didn't problem much on their place's present condition. Pointed, sharp objects and medicines which are improperly

kept and the presence of steep stairs predisposes as an accident hazard since At night they only use a candle and Mrs. Sabaina used to walk barefoot and has a weak body. Also their stairs through their house doesn't have safety holders that could be a danger for them. The family stores their food primarily on plastics but sometimes leave their leftovers covered on the table or on the pot. They store their drinking water in plastics and drums. Water used in cooking is stored in plastic drums. They have their fireplace inside their house and uses woods to make fire for cooking and boiling of water. The water supply of the family comes from the spring in the mountain. They fetch water from the spring. The water is free, thus it does not add burden to the familys financial expenses. The potability of the water is not yet tested. Water-sealed type of toilet is available in the family. It is located outside of their house and is only covered with rice bags. In terms of garbage / refuse disposal, the family doesn't separates their biodegradable waste from the non-biodegradable. There were no collection of garbage, they practice incineration and burying of garbage at the back of their house. The place where they keep their garbage for collection is frequented by insects such as mosquitoes, flies, and cockroaches. The status of the drainage system is fair since it can also predispose as a breeding place of mosquitoes because sine are areas tend to be stagnant when filled with excess water. There are no sari-sari stores, beauty parlors, barber shops, and recreational facilities available near the family. Nearest neighborhood is only 5 meters away from them. Transportation available to the family includes a jeepney which operates limited. Information in their area is disseminated via word of mouth, radio, letter, and the use of mobile phones. Newspapers are not being floated in the area since it is quite far and difficult to reach. The family doesnt know of any peoples organization, government and non-government agencies servicing their area.

C.

Health Status of each Family Member

According to family developmental perspective, the family is categorized as a family , since they the two brothers are living with their mother and never had a family of their own. Mrs. Sabaina is on the retirement age and is unable to do the things that she's been normally doing, so his sons are supporting their family. According to physical assessments and diagnostic tests such as benedict's test Mrs. Sabina has hypertension, osteoporosis, and diabetes. She also had a cyst on her left foot that she believed that it was in born. The family doesn't eat regularly or eat a balance meal due to poverty. Their usual meal is rice with salt or sayote. They rarely eat meat. Most of the times student nurses or neighborhood are giving them food for them to eat. Mrs. Sabaina claims that she's drinking about three cups of water a day. The family hadnt undergone any surgical / medical procedures for the last five years. Also, no deaths occurred during the last five years. In terms of psychosocial history, Mrs. Sabaina is still seeing the positive side of life even though his husband died many years ago. Although their living in poverty she still manages to smile and continue the simplicity of life they had. She is really thankful of his sons and the people who are continuously looking on them. She doesn't reach any grade level in her life and that's the only thing she had regretted. She never learned to read and right thus she doesn't understand few things and made her confidence low.

The two brothers were not interviewed and not assessed due to conflict of time regarding their work. D. Values, Habits, Practices on Health Promotion, Maintenance, and Disease Prevention Mrs. Sabaina can't remember any vaccinations or immunizations done with her or her sons. Mrs. Sabaina and his sons doesn't go to any check ups because of lack of money. They were only assessed by volunteers and student nurses who visits them. The family doesn't visit the dentist for dental check- up. Self breast examination were not also practiced by Mrs. Sabaina as well as pap smear examinations. The family gets an average of 8-10 hours of sleep. They sleeps early in the evening and wakes up early in the morning. They usually had nap especially Mrs. Sabaina. When stressed Mrs. Sabaina usually goes for a short walk, do some works and rests for a bit. Their exercise is usually walking around their surroundings.They usually walk bare foot inside their house and sometimes outside. Mrs. Sabaina doesn't take a bath regularly, she doesn't brush nor uses shampoo to clean her hair. She uses a pin and cotton to clean her ears. Clothes were unironed and dirty because Mrs. Sabaina is no longer that strong enough to do those kinds of chores.

PHYSICAL ASSESSMENT Sakiaten, Sabaina Mrs. Sabaina has a temperature of 36.3C via the axillary route, a pulse rate of 67 bpm, a respiratory rate of 17 cpm, and a blood pressure of 170/130 mmHg. Looks, behaviors, and actions are consistent with age and sex. Her average height wasn't measured correctly due to her osteoporosis. She has a slender body stature. Body posture is slumped. She had slowed movements. Clothes used are not clean and well-pressed but uses clothes which are appropriate in color combination and with age and sex. Hair is not well combed and is only tied and braaided with a piece of clothing and nails are not well trimmed and dirty. Her level of consciousness is decreased because of her age and condition she responds to stimuli slowly. She is also oriented as to who she is, where she is. No involuntary movements, shakes, or tremors observed. Skin is generally brownish, without increased or decreased pigmentation. No pallor, jaundice, or cyanosis is also observed. It is warm, smooth, and dry to touch. Skin fold is slow because of dry skin and age. Lesions such as rashes and ecchymosis are absent. Hair is terminal in the eyebrows, eyelashes, axilla, chest, arms, and legs. A Cyst is observed at her left foot. Head is normocephalic, spherical, symmetrical, and proportionate to body size. There is no evidence of bulging, masses, or injuries. Eyes are normally symmetrical and in level with each other. There are no delays observed upon closure of eyes. Eyeballs move in parallel or conjugate direction. Pupils constrict in response to light. Pinkish palpebral conjunctiva and clear and white bulbar conjunctiva and sclera noted.

Ears have the same color with face, are proportionate with head and face, are bilaterally symmetrical (pinna is in level with the lateral canthus of the eyes) and no visible lumps or lesions were observed. Moderate flaky cerumen is present in the external auditory canal. Nose is symmetrical. There are no deformities, lesions, nor deviations. There are no occlusions or tenderness when pressure is applied. Pinkish nasal cavity is noted. There are no inflammations, swellings, exudates, or abnormal discharges. Paleness of lip color, dryness, and cracking was observed. There were no teeth observed gums are pnkish. Tongue is pinkish, located midline, is moist, and symmetrical. Ventral portion of tongue is pinkish with small or fine blood vessels. Tonsils are grade 1. Neck is symmetrical and there are no distentions or bulgings. Upon palpation, there was no enlargement or tenderness of lymph nodes. Respiratory rhythm / effort was regular). Overall chest shape is elliptical and the antero-posterior diameter is 2x smaller than the lateral of transverse diameter. Normal lung expansion was observed. Heart rhythm / quality was regular. There are no visible pulsations except at the point of maximal impulse. Capillary refill time in the fingers is 2 seconds. There is no edema noted. Abdomen has an unblemished skin with uniform color, is smooth, and no rashes. There are no scars or surgical scars present. It is flat. Bowel movement is regular defecating at least once a day. Activities of daily living such as bathing, dressing, going to the comfort room, moving in and out of the bed, and feeding are done without assistance. Genitalia is normal since the client claims that there are no masses or abnormal discharges nor lesions present

Table 4. Obstetrical Condition of Sabaina Sakiaten

ORDER OF PAST AND PRESENT PREGNANCIES NAME OF CHILD FROM THIS PREGNANCY John Luding Smith Arthur Noel Salbina Jovita PRENATAL CHECK-UPS FREQUENCY Unrecalled Unrecalled Unrecalled Unrecalled Unrecalled Unrecalled Unrecalled HOSPITAL Home Home Home Home Home Home Home alive alive alive alive alive alive alive PLACE OF DELIVERY REMARKS METHOD OF DELIVERY OB SCORE

1st 2nd 3rd

NSVD NSVD NSVD NVSD NVSD NVSD NVSD

G7T0P0A0L7

4th 5th 6th

Table
NAME OF FAMILY MEMBER PRESENT
BCG DPT

IMMUNIZATION COMPLETED
OPV
AntiMeasles

NIGHT SLEEP
Tetanus Toxoid (TT) No. of Hours and Nature

NAPS
No. of Hours

Anti- Hepa B

Wt.

Ht.
1 2 1 2 3 BD 1 2 3 B D -

1 -

2 -

3 -

B D -

1 -

2 -

3 -

4 -

5 8- 10 hours continuous 8- 10 hours continuous 8- 10 hours continuous 2 hours None None

1. Sabaina Sakiaten 2. Smith Bian 3. Arthur Sakiaten

Immunization and vaccination are unrecalled

III. RESULTS OF FIRST LEVEL ASSESSMENT

IDENTIFIED HEALTH STRENGTHS / POTENTIALS & NEEDS Absence of Health Threats Living on a quiet and away from pollution CUES: The family lives on a quiet surroundings and air is really fresh because they are on a mountain full of trees IDENTIFIED HEALTH PROBLEMS Presence of Health Threats Threat of cross infection from a communicable disease CUES: - The family owns a one-storey house with one cramped room. The room is used as their bedroom, kitchen, and living room.

No member engages in dangerous sports Steep stairs CUES: CUES: Family only works only on their chores and - There is a wooden stairs located at the job entrance door. And it has no other protective handle. Mrs. Sabaina is already old and has difficulty in moving. She also claimed that her vision is blurry. No member engages in dangerous sports Pointed, sharp objects and medicines CUES: improperly kept Family only works only on their chores and CUES: job - Knives were left scattered in the kitchen sink and on the floor since there were no cabinets inside the house. Adequate sleep Faulty eating habits CUES: CUES: The family sleeps early in the evening and - Kanayon nga asin ti sida mi, wennu has about 8 to 10 hours of sleep. sayote. Nu adda kwarta ajay panggatang mi makan wennu nu madda estudyante nga agited ti makan ajay mangan kmi ti nasiyaat, nu awan ket apa anusan mi lattan. as verbalized by Mrs. sabaina Family Unity Inadequate living space CUES: CUES: - Though they are only three in the family they - The family's house has only one room. And still decided to stay and help one another in it is all in one. They do all their activities in order to survive. The two brothers cared for just a one room. their mother much that they work for her. Small family size CUES: - The family is composed of three members: Mrs. Sabaina and his two Sons Arthur and Smith Possibly polluted water supply CUES: - The source of water were not tested and is coming from the spring or Ubbog Presence of breeding places for insects and rodents CUES: - Breeding and resting sites of insects such as cockroaches, flies, and mosquitoes are present in the structure of the house because of many small spaces between the walls. - Flies are inhabiting the comfort room owned by the family. Presence of Health DeficitsIllness states, regardless of whether it is diagnosed or undiagnosed by a medical practitioner CUES: According to the vital statistics of Mrs.

Sabaina she had a very high BP. Also from tests she had diabetes. And has osteoporosis. A cyst were also seen on her left foot. Poor Personal Hygiene CUES: Mrs. Sabaina is wearing a dirty and unironed clothes. Has untrimed and dirty finger and toe nails. She admitted that she doesn't take a bath regularly. Fire Hazards CUES: The family has a fire place inside their house which they used to cook food and boil water. Fall Hazards CUES: They have a stair on their entrance door and is made up of wood. It has no protective handle. And Mrs. Sabaina had blurry vision . Lack of food storage facilities CUES: The family use plastic containers as food storage. Leftovers were left on the table covered with plates. Unsanitary waste disposal CUES: The family incerinate their waste at the back of their house and bury it there since there were no garbage collectors on their place. Poor lighting CUES: They had no electricity therefore they only use candle at night. The place were dim if the entrance door wasn't open. Unsanitary food handling preparations CUES: Mrs. Sabaina use to cook for the family. But she prepares their food without washing her hands Lack of immunization / inadequate immunization status CUES: Mrs. Sabaina doesn't recall that her children and her had immunization before Presence of Stress points/ Foreseeable Crisis Situations: Poverty CUES: The family doesn't eat regularly. They can't by the foods that they wanted to eat and is only eating rice and salt if there were no food available Unhealthful lifestyle and personal habits/ practices: Cleaning of ears using a sharp object CUES: Mrs. Sabaina cl;aims that she uses a pin and cotton to clean her ears Unhealthful lifestyle and personal habits/ practices: Walking barefooted or inadequate footwear CUES: Mrs. Sabaina walks barefooted inside the house and spometimes outside Doesn't practice self breast examinations CUES: Mrs. Sabaina claims that she doesn't practice self breast examination

IV.

Second Level of assessment

FORMULATED FAMILY DIAGNOSIS

HEALTH PROBLEMS ACCORDING TO PRIORITY AND RELEVANT CUES

Threat of cross infection from a communicable Inability to make decisions with respect to disease taking appropriate health action due to: CUES: - The family owns a one-storey house with low salience of the problem or condition one cramped room. The room is used as their bedroom, kitchen, and living room. Inability to provide a home environment Steep stairs CUES: conducive to health maintenance and personal There is a wooden stairs located at the development due to: entrance door. And it has no other protective handle. Mrs. Sabaina is already old and has inadequate knowledge of preventive difficulty in moving. She also claimed that her measures vision is blurry. limited physical resources

Pointed, sharp objects and medicines Inability to provide a home environment conducive to improperly kept health maintenance and personal development due CUES: to: - Knives were left scattered in the kitchen sink and on the floor since there were no cabinets inside the house. Inadequate family resources, specifically: Limited physical resource

Failure to see benefits (specifically long-term ones) to investment in home environment improvement

Lack of/ inadequate knowledge of preventive measures Inability to provide a home environment conducive to Faulty eating habits CUES: health maintenance and personal development due to: - Kanayon nga asin ti sida mi, wennu inadequate family resources specifically: sayote. Nu adda kwarta ajay panggatang mi makan wennu nu madda estudyante nga agited ti makan ajay mangan kmi ti financial constraints nasiyaat, nu awan ket apa anusan mi lattan. as verbalized by Mrs. sabaina Inability to provide a home environment conducive to Inadequate living space CUES: health maintenance and personal development due - The family's house has only one room. to: And it is all in one. They do all their activities in just a one room. Inadequate family resources, specifically: Limited physical resource

Failure to see benefits (specifically long-term ones) to investment in home environment

improvement

Lack of/ inadequate knowledge of preventive measures Inability to provide a home environment Possibly polluted water supply CUES: conducive to health maintenance and personal - The source of water were not tested and development due to: is coming from the spring or Ubbog financial constraints Presence of breeding places for insects and Inability to provide a home environment rodents conducive to health maintenance and personal CUES: development due to: - Breeding and resting sites of insects such as cockroaches, flies, and inadequate knowledge of preventive mosquitoes are present in the structure measures of the house because of many small spaces between the walls. - Flies are inhabiting the comfort room owned by the family. Inability to make decisions with respect to Presence of Health Deficits Illness taking appropriate health action due to: states, regardless of whether it is diagnosed or undiagnosed by a medical practitioner cost constraints CUES: - According to the vital statistics of Mrs. Sabaina she had a very high BP. Also from tests she had diabetes. And has osteoporosis. A cyst were also seen on her left foot. inadequate measures knowledge of preventive

Poor Personal Hygiene Inability to provide a home environment CUES: conducive to health maintenance and personal Mrs. Sabaina is wearing a dirty and development due to: unironed clothes. Has untrimed and dirty finger and toe nails. She admitted that she doesn't inadequate knowledge of preventive take a bath regularly. measures Lack of inadequate knowledge of importance of hygiene and sanitation

Fire Hazards Inability to provide a home environment CUES: conducive to health maintenance and personal - The family has a fire place inside their development due to: house which they used to cook food and boil water. Inadequate family resources; financial constraints Failure to see benefits of investment in home environment improvement inadequate measures knowledge of preventive

Fall Hazards Inability to provide a home environment CUES: conducive to health maintenance and personal They have a stair on their entrance development due to: door and is made up of wood. It has no protective handle. And Mrs. Sabaina had blurry Inadequate family resources; financial

vision .

constraints Failure to see benefits of investment in home environment improvement inadequate measures knowledge of preventive

Lack of food storage facilities Inability to provide a home environment CUES: conducive to health maintenance and personal The family use plastic containers as development due to: food storage. Leftovers were left on the table covered with plates. Inadequate family resources; financial constraints Failure to see benefits of investment in home environment improvement inadequate measures knowledge of preventive

Unsanitary waste disposal Inability to provide a home environment CUES: conducive to health maintenance and personal The family incerinate their waste at development due to: the back of their house and bury it there since there were no garbage collectors on their Failure to see benefits of investment in place. home environment improvement inadequate measures knowledge of preventive

Poor lighting Inability to provide a home environment CUES: conducive to health maintenance and personal They had no electricity therefore development due to: they only use candle at night. The place were dim if the entrance door wasn't open. Inadequate family resources; financial constraints Failure to see benefits of investment in home environment improvement inadequate measures knowledge of preventive

Unsanitary food handling preparations Inability to provide a home environment CUES: conducive to health maintenance and personal Mrs. Sabaina use to cook for the development due to: family. But she prepares their food without washing her hands Failure to see benefits of investment in home environment improvement inadequate measures knowledge of preventive

Lack of inadequate knowledge importance of hygiene and sanitation

of

Lack of immunization / inadequate Inability to make decisions with respect to immunization status taking appropriate health action due to: CUES: Mrs. Sabaina doesn't recall that Failure to comprehend the nature/ her children and her had immunization before

magnitude of the problem/ conditions Low salience of the problem/ condition

Presence of Stress points/ Foreseeable Inability to provide a home environment Crisis Situations: Poverty conducive to health maintenance and personal CUES: development due to: The family doesn't eat regularly. They can't by the foods that they wanted to eat Inadequate family resources; financial and is only eating rice and salt if there were no constraints food available Unhealthful lifestyle and personal habits/ Inability to provide a home environment practices: Cleaning of ears using a sharp object conducive to health maintenance and personal CUES: development due to: Mrs. Sabaina cl;aims that she uses a pin and cotton to clean her ears Failure to see benefits of investment in home environment improvement inadequate measures knowledge of preventive

Inadequate family resources; financial constraints

Unhealthful lifestyle and personal habits/ Inability to provide a home environment practices: Walking barefooted or inadequate footwear conducive to health maintenance and personal CUES: development due to: Mrs. Sabaina walks barefooted inside the house and spometimes outside Inadequate family resources; financial constraints Failure to see benefits of investment in home environment improvement inadequate measures knowledge of preventive

Inability to provide a home environment Doesn't practice self breast examinations CUES: conducive to health maintenance and personal Mrs. Sabaina claims that she doesn't development due to: practice self breast examination inadequate measures knowledge of preventive

PRIORITIZATION OF IDENTIFIED PROBLEMS Threat of cross infection from a communicable disease CRITERIA SCORE JUSTIFICATION COMPUTATION ACTUAL SCORE

Nature of the Problem= 3 Health Threat

The family is living in just a one room wherein it is all in one. If somebody aquired a communicable disesease contact with one another would be easy This is not modifiable because the family lack financial resources to build up another room. And a lot of materials and manpower is needed to solve tgis problem

(2/3) x 1

.67

Modifiability= 2

0.5

(.5/2) x 2

0.5

current knowledge (0) family resources (0) health workers resources (.5) community resources (0) Preventive Potential= 3 0.75

gravity or severity (.75) duration (0) management initiated (0) exposure to high risk groups (0) Salience= 2 0

Since the family owns the two houses the problem is not that severe at all. Its so long that the family is living this way.

(.75/3) x 1

0.25

family identified/ verbalized the problem (0) feels perceives it as needing immediate attention (0)

The family doesn't have any perception at all regarding the problem. They don't consider this situation as a problem

(0/2) x 1

TOTAL

1.42

. Steep stairs CRITERIA SCORE JUSTIFICATION COMPUTATION ACTUAL SCORE

Nature of the Problem= 3 Health Threat

Steep stairs is a health threat since Mrs. Sabaina had blurry vision due to aging. It has no protective handling for the family iof ever their climbing up in their house The family didn't do any interventions regarding the problem. They consider it as a part of their daily life. But then health worker's can do something about the situation as well as the community resources are adequate to build a handle Its been a while since the stairs were built. This sis a danger to Mrs. Sabaina due to her eye coondition and age.

(2/3) x 1

.67

Modifiability= 2

(1/2) x 2

current knowledge (0) family resources (0) health workers resources (.5) community resources (.5) Preventive Potential= 3 1.5

(1.5/3) x 1

0.5

gravity or severity (.75) duration (0) management initiated (0) exposure to high risk groups (.75) Salience= 2 0

family identified/ verbalized the problem (0) feels perceives it as needing immediate attention (0)

The family doesn't recognize this problem as a danger to themselves.

(0/2) x 1

TOTAL

2.17

. Pointed, sharp objects and medicines improperly kept CRITERIA SCORE JUSTIFICATION COMPUTATION ACTUAL SCORE

Nature of the Problem= 3 Health Threat

Sharo objects are just scattered inside the whose. On the floor and on their table. Thus this could be a cause of accidents in the family

(2/3) x 1

0.67

Modifiability= 2

1.5

current knowledge (.5) family resources (0) health workers resources (.5) community resources (.5) Preventive Potential= 3 1.5

The family is aware of their materials inside the house and sometimes they put these things on a safe place. A proper health teaching could help solve this problem as a precaution for the family

(1.5/2) x 2

1.5

gravity or severity (.75) duration (0) management initiated (0) exposure to high risk groups (.75) Salience= 2 0

Mrs. Sabaina is at high risk. She might get into accidents anytime if this wouldn't be solve as early as possible

(1.5/3) x 1

0.5

family identified/ verbalized the problem (0) feels perceives it as needing immediate attention (0)

The family doesn't recognize the problem as a danger to themselves

(0/2) x 1

TOTAL

2.67

. Faulty eating habits CRITERIA SCORE JUSTIFICATION COMPUTATION ACTUAL SCORE

Nature of the Problem= 3 Health Threat

The family is living in poverty hus they are not eating properly and regularly

(2/3) x 1

0.67

Modifiability= 2

current knowledge (0) family resources (0) health workers resources (.5) community resources (.5) Preventive Potential= 3 2.25

The family can only eat properly if one of his sons receive their payment from farming or a health worker and neighborhood is giving them canned goods or food

(1/2) x 2

gravity or severity (.75) duration (.75) management initiated (0) exposure to high risk groups (.75) Salience= 2 1

The family still eats rice everyday. The family can't help it because they lack all the resources for financial.

(2.25/3) x 1

0.75

family identified/ verbalized the problem (1) feels perceives it as needing immediate attention (0)

Mrs. Sabaina told us the they've been suffering from the scarcity of money. But they don't sees as a very stressing problem because many are still helping them

(1/2) x 1

0.5

TOTAL

2.92

. Inadequate living space CRITERIA SCORE JUSTIFICATION COMPUTATION ACTUAL SCORE

Nature of the Problem= 3 Health Threat

The room of the house is small and spread of disease in their home is easy

(2/3) x 1

0.67

Modifiability= 2

0.5

current knowledge (.5) family resources (0) health workers resources (0) community resources (0) Preventive Potential= 3 2.25

This is not modifiable since the family has scarcity of money

(.5/2) x 2

0.25

gravity or severity (.75) duration (.75) management initiated (0) exposure to high risk groups (.75) Salience= 2 0

Mrs. Sabaina's body resistance might heve decreased now because shes on the retirement age. Since they have two houses sometimes his sons sleep an accupy the other house

(2.25/3) x 1

0.75

family identified/ verbalized the problem (0) feels perceives it as needing immediate attention (0)

The family doesn't recognize this as their problem and threat to their health

(0/2) x 1

TOTAL

1.67

. Possibly polluted water supply CRITERIA SCORE JUSTIFICATION COMPUTATION ACTUAL SCORE

Nature of the Problem= 3 Health Threat

The family's supply of water came from mountain spring. And not been tested yet.

(2/3) x 1

0.67

Modifiability= 2

current knowledge (0) family resources (0) health workers resources (0) community resources (0) Preventive Potential= 3 1.5

Its the community's responsibilty to check and test the water. Since the place is really far water supply from a water district is merely imposible.

(0/2) x 2

gravity or severity (.75) duration (0) management initiated (0) exposure to high risk groups (.75) Salience= 2 0

They didn't report any diarrhea aor parasitism due to dirty water so they consider their water to be clean

(1.5/3) x 1

0.5

family identified/ verbalized the problem (0) feels perceives it as needing immediate attention (0)

The family doesn't regognize this as a health threat and problem for their family

(0/2) x 1

TOTAL

1.17

Presence of breeding places for insects and rodents CRITERIA SCORE JUSTIFICATION Nature of the Problem= 3 Health Threat 2 The family thought s that these pests are just normal. They are all everywhere

COMPUTATION (2/3) x 1

ACTUAL SCORE 0.67

Modifiability= 2

1.5

current knowledge (0) family resources (.5) health workers resources (.5) community resources (.5) Preventive Potential= 3 1.5

There are many things or ethods to trap these pests but the family ignores them and kills them only if they harm them.

(1.5/2) x 2

1.5

gravity or severity (.75) duration (.75) management initiated (0) exposure to high risk groups (.75) Salience= 2 0

These pests could give them illnesses. They could spread bacteria and viruses anytime to the family if they were not controlled.

(1.5/3) x 1

0.5

family identified/ verbalized the problem (0) feels perceives it as needing immediate attention (0)

The family doesn' recognize these pests as problems or health threat to their family

(0/2) x 1

TOTAL

2.67

Presence of Health Deficits Illness states, regardless of whether it is diagnosed or undiagnosed by a medical practitioner CRITERIA SCORE JUSTIFICATION COMPUTATION ACTUAL SCORE Nature of the Problem= 3 Health Deficit 3 Mrs. Sabaina have an osteoporosis, hypertension and diabetes and she's not taking any medications to treat her condition (3/3) x 1 1

Modifiability= 2

current knowledge (0) family resources (0) health workers resources (.5) community resources (.5) Preventive Potential= 3 1.5

Mrs. Sabaina Doesn't do any managements to her condition thus she's just trating herself as normal. The family lack financial support so they don't go to check ups. Only health workers are assesing and giving them health teachings Its been a while since she had these conditions but there were no interventions done yet to her

(1/2) x 2

(1.5/3) x 1

0.5

gravity or severity (.75) duration (0) management initiated (0) exposure to high risk groups (.75) Salience= 2 0

She doesn't take her condition seriously and is living normal

(0/2) x 1

family identified/ verbalized the problem (0) feels perceives it as needing immediate attention (0) TOTAL 2.5

 Poor Personal Hygiene CRITERIA Nature of the Problem= 3 Health Threat

SCORE 2

JUSTIFICATION Mrs. Sabaina wears cothes that are unclean and unironed. She doesn't takes a bath everyday. Her nails are untrimmed and dirty. Also her hair is unkept. She's aware of herself but because of her age there is a kimit on her movements and ould easily get cold. The community and health worker could reinforce her and give her teachings about being clean

COMPUTATION (2/3) x 1

ACTUAL SCORE 0.67

Modifiability= 2

(2/2) x 2

current knowledge (.5) family resources (.5) health workers resources (.5) community resources (.5) Preventive Potential= 3 1.5

gravity or severity (.75) duration (0) management initiated (0) exposure to high risk groups (.75) Salience= 2 0

Mrs. Sabina's body resistance would be invaded and lowered because of her condition.

(1.5/3) x 1

.5

family identified/ verbalized the problem (0) feels perceives it as needing immediate attention (0)

She doesn't recognize this as athreat and problem to her health

(0/2) x 1

TOTAL

3.17

Fire Hazards CRITERIA Nature of the Problem= 3 Health Threat

SCORE 2

JUSTIFICATION The famil's fireplace is inside the house and the house is made up of woods. It could be a source of fire inside the house thus it is a health threat to them. Also the smoke coming from it could affect their respiratory system The family can not affort a gas range so they cook and boil water on their fireplace.

COMPUTATION (2/3) x 1

ACTUAL SCORE 0.67

Modifiability= 2

1.5

(1.5/2) x 2

1.5

current knowledge (.5) family resources (0) health workers resources (.5) community resources (.5) Preventive Potential= 3 1.5

gravity or severity (.75) duration (0) management initiated (0) exposure to high risk groups (.75) Salience= 2 0

The family were used on it. Since they were young its been a part of their daily living

(1.5/3) x 1

0.5

family identified/ verbalized the problem (0) feels perceives it as needing immediate attention (0)

The family doesn't recognize this situation as danger and threat to themselves

(0/2) x 1

TOTAL

2.67

Fall Hazards CRITERIA Nature of the Problem= 3 Health Threat SCORE 2 JUSTIFICATION The famly's been climbing their stairs to walk inside their house. But since it is made of wood and its been a while the qualtiy of the stairs might have decreased and would break anytime The family could make another stairss using woods. They should have made a replacement with a handle to prevent accidents that might happen especially to Mrs. Sabaina COMPUTATION (2/3) x 1 ACTUAL SCORE 0.67

Modifiability= 2

1.5

(1.5/2) x 2

1.5

current knowledge (.5) family resources (0) health workers resources (.5) community resources (.5) Preventive Potential= 3 1.5

gravity or severity (.75) duration (0) management initiated (0) exposure to high risk groups (.75) Salience= 2 0

The stairs wasn't yet replaced and it could break anytime. People coming into their house moght slip anytime especially at night

(1.5/3) x 1

0.5

family identified/ verbalized the problem (0) feels perceives it as needing immediate attention (0)

The family doesn't recognze this as a danger and health threat for the family

(0/2) x 1

TOTAL

2.17

. Lack of food storage facilities CRITERIA SCORE Nature of the Problem= 3 Health Threat 2 JUSTIFICATION The family's food storage are just plastic containers. They just cover their leftovers with plates. Thus pests could easily reach this places COMPUTATION (2/3) x 1 ACTUAL SCORE 0.67

Modifiability= 2

current knowledge (0) family resources (0) health workers resources (0) community resources (0) Preventive Potential= 3 1.5

The family cannot afford to buy cabinets or furnitures as their storage. They lack financial resources.

(0/2) x 2

gravity or severity (.75) duration (0) management initiated (0) exposure to high risk groups (.75) Salience= 2 0

They've been practicing this habit. And they just continue this from what they had been doing.

(1.5/3) x 1

0.5

The family soesn't recognize this as a health threat to them

(0/2) x 1

family identified/ verbalized the problem (0) feels perceives it as needing immediate attention (0) TOTAL 1.17

Unsanitary waste disposal CRITERIA SCORE Nature of the Problem= 3 Health Threat 2

JUSTIFICATION The family used to burn or bury their wastes at the back of their house. They don't practice segregation.

COMPUTATION (2/3) x 1

ACTUAL SCORE 0.67

Modifiability= 2

current knowledge (.5) family resources (.5) health workers resources (.5) community resources (.5) Preventive Potential= 3 1.5

There were no garbage collectors on their place. So they are doing this practice. But this could be solve by health teachings and making a pity privy that is meters away from home

(0/2) x 2

gravity or severity (.75) duration (0) management initiated (0) exposure to high risk groups (.75) Salience= 2 0

There were no management done to solve the problem. And this could be a threat to the health of the people who are near their garbage disposal area. It could also be a breeding site of pests

(1.5/3) x 1

0.5

The family doesn't recognize this as a health problem

(0/2) x 1

family identified/ verbalized the problem (0) feels perceives it as needing immediate attention (0) TOTAL 1.17

Poor Lighting CRITERIA Nature of the Problem= 3 Health Threat SCORE 2 JUSTIFICATION The family doesn't have elctricity. They use candle at night or lamp. And this is a health threat to them. They might experience accident at night because the surroundings is very dim The family cannot afford to buy a a bulb and pay the expences of electricity monthly so they are living in darkness at night COMPUTATION (2/3) x 1 ACTUAL SCORE 0.67

Modifiability= 2

(1/2) x 2

current knowledge (.5) family resources (0) health workers resources (0) community resources (.5) Preventive Potential= 3 1.5

gravity or severity (.75) duration (0) management initiated (0) exposure to high risk groups (.75) Salience= 2 0

Mrs. Sabaina and his sons are all growing more older. And their senses might have diminished especially their eyesight and this could be a danger to each of them

(1.5/3) x 1

0.5

family identified/ verbalized the problem (0) feels perceives it as needing immediate attention (0)

The family doesn't have any verbalized problem regarding their light

(0/2) x 1

TOTAL

2.17

. Unsanitary food handling preparations CRITERIA SCORE JUSTIFICATION Nature of the Problem= 3 Health Threat 2 Mrs. Sabaina is not washing her hands when she's preparing food. COMPUTATION (2/3) x 1 ACTUAL SCORE 0.67

Modifiability= 2

1.5

current knowledge (0) family resources (.5) health workers resources (.5) community resources (.5) Preventive Potential= 3 2.25

She's not aware that she has a dirty hand. But we could reinforce the family by teaching them the proper handwashing and proper handling of food

(1.5/2) x 2

1.5

gravity or severity (.75) duration (.75) management initiated (0) exposure to high risk groups (.75) Salience= 2 0

Mrs. Sabaina's practice were not reinforcd yet. And this could affect their health

(2.25/3) x 1

0.75

family identified/ verbalized the problem (0) feels perceives it as needing immediate attention (0)

Mrs. Sabaina just listens to what is being told to her but she doesn't implement what she had heard

(0/2) x 1

TOTAL

2.92

 Lack of immunization / inadequate immunization status CRITERIA SCORE JUSTIFICATION Nature of the Problem= 3 Health Threat 2 Mrs. Sabaina cannot recall if her children were immnized. She always tells us that her husband were the one who knows everything to their family since she told us that she didn't study She is unaware of the effects of the immunization. And scarcity of money lies within the family

COMPUTATION (2/3) x 1

ACTUAL SCORE 0.67

Modifiability= 2

(1/2) x 2

current knowledge (0) family resources (0) health workers resources (.5) community resources (.5) Preventive Potential= 3 1.5

gravity or severity (.75) duration (0) management initiated (0) exposure to high risk groups (.75) Salience= 2 0

Anytime one of the memners copuld acquire disease and if they were not immunized they might be easliy affected

(1.5/3) x 1

0.5

family identified/ verbalized the problem (0) feels perceives it as needing immediate attention (0)

Mrs. Sabaina doesn't recognize the importance of immunization

(0/2) x 1

TOTAL

2.17

 Presence of Stress points/ Foreseeable Crisis Situations: Poverty CRITERIA SCORE JUSTIFICATION COMPUTATION Nature of the Problem= 3 Health Threat 1 The family is living with poverty. And this causes their lifestyle now. (1/3) x 1

ACTUAL SCORE 0.33

Modifiability= 2

1.5

current knowledge (.5) family resources (0) health workers resources (.5) community resources (.5) Preventive Potential= 3 0.75

They know that financial resources are limited. But they still do something just to eat in a day. Some health workers , relatives. Neighbors are sharing and giving them goods

(1.5/2) x 2

1.5

gravity or severity (0) duration (0) management initiated (0) exposure to high risk groups (.75) Salience= 2 2

Their current situation is a major problem to them. This is the root of all the causes. If somebody got sick no money will be available to them

(.75/3) x 1

0.25

family identified/ verbalized the problem (1) feels perceives it as needing immediate attention (1)

They know they current situaton and they can't do anything about it. But just work to gain money

(2/2) x 1

TOTAL

3.08

Unhealthful lifestyle and personal habits/ practices: Cleaning of ears using a sharp object CRITERIA SCORE JUSTIFICATION COMPUTATION ACTUAL SCORE Nature of the Problem= 3 Health Threat 2 Mrs. Sabaina verbalized that she uses a pin and cotton to clean her ears and this could infect and irritate her ears (2/3) x 1 0.67

Modifiability= 2

current knowledge (0) family resources (0) health workers resources (.5) community resources (.5) Preventive Potential= 3 1.5

Mes. Sabaina is not aware of the dangers of the practice shes been doing

(1/2) x 2

gravity or severity (.75) duration (0) management initiated (0) exposure to high risk groups (.75) Salience= 2 0

If this would not be corrected further accidents might happen later

(1.5/3) x 1

0.5

Mrs. Sabaina doesn't see this as a danger to her health

(2/2) x 1

family identified/ verbalized the problem (0) feels perceives it as needing immediate attention (0) TOTAL 2.17

Unhealthful lifestyle and personal habits/ practices: Walking barefooted or inadequate footwear CRITERIA SCORE JUSTIFICATION COMPUTATION ACTUAL SCORE Nature of the Problem=3 Health Threat 2 Mrs Sabaina used to walk barefoot inside their house and sometimes outside. She might get into an accident because of this (2/3) x 1 0.67

Modifiability= 2

0.5

current knowledge (0) family resources (0) health workers resources (0) community resources (.5) Preventive Potential= 3 1.5

She doesn't care if she's walking barefooted. Shes been used to this practice. And also they cannot mange to buy new slippers

(.5/2) x 2

0.5

gravity or severity (.75) duration (0) management initiated (0) exposure to high risk groups (.75) Salience= 2 0

Sharp objects might be scattered around the area and this could lead to accidents to them if they are walking barefooted.

(1.5/3) x 1

0.5

family identified/ verbalized the problem (0) feels perceives it as needing immediate attention (0)

Mrs. Sabaina doesn't see this as problem or hea;th threat to her

(0/2) x 1

TOTAL

1.67

 Doesn't practice self breast examinations CRITERIA SCORE JUSTIFICATION Nature of the Problem= 3 Health Threat 2 Mrs. Sabaina doesn't know how to perform breast examination also she can't comprehend well because she is a kankanaey.

COMPUTATION (2/3) x 1

ACTUAL SCORE 0.67

Modifiability= 2

1.5

current knowledge (0) family resources (.5) health workers resources (.5) community resources (.5) Preventive Potential= 3 1.5

This could be taught to her and demonstrated to her to be able perform the examination. This doesn't need any materials or money.

(1.5/2) x 2

1.5

gravity or severity (.75) duration (0) management initiated (0) exposure to high risk groups (.75) Salience= 2 0

She's not practicing self breas examination and because of this maybe later she might develop lumps on her breast that she might not have noticed

(1.5/3) x 1

family identified/ verbalized the problem (0) feels perceives it as needing immediate attention (0)

She' snot aware of the breast examination thus she doesn't care at all

(0/2) x 1

TOTAL

2.67

List of Prioritized Problems

Problems
1. Poor Personal Hygiene 3.17

Total

2. Presence of Stress Points/ Foreseeable Crisis 3.08 Situations: Poverty 3. Faulty Eating Habits Unsanitary Food Handling Preparation 4. Pointed, sharp objects and medicines improperly kept Presence of breeding places for insects and rodents Fire hazards Unhealthful Lifestyle and personal habits practices: Doesn't practice self breast examination 5. Presence of health deficits, illness, states, regardless whether it is diagnosed or undiagnosed by a medical practitioner 6. Steep stairs Fall hazards Poor lighting Inadequate immunization/ Inadequate immunization status Unhealthful Lifestyle and personal Habits/ practices: Cleaning of ears using sharp objects 7. Unhealthful Lifestyle and personal Habits/ practices: Walking Barefooted or inadequate footwear Inadequate living space 8. Threat of cross infection from a communicable disease 9. Possibly polluted water supply Lack of food storage facilities Insanitary waste disposal 1.42 1.67 2.5 2.67 2.92

2.17

1.17

SUMMARY OF INDIVDUAL MEMBER LEARNING INSIGHTS FOR THE WHOLE PERIOD

This was my first community duty outside Baguio. At first I thought this rotation would only be tiring and demanding

BIBLIOGRAPHY Nursing Care in the Community by Joan M. Cookfair Community Health Nursing in the Philippines by Eliza V. Dizon Community-Based Nursing (An Introduction) by Melanie McEwen G&A Notes by Gregory Navarro Palma and Adrian David Oseda

V APPENDICES Summary table of schedules

September 6, 2010: DAY 1

7:15 Left school 7:20- Stopover to buy Ice (M. Roxas St. Alfonso Tabora, Baguio City) 7:25 Continue to Kapangan 8:00 Stopover at Shilan 8:25 Continue to Kapangan 9:20 Stopover at Water Refilling Station Aso Datakan Kapangan, Benguet 9:30 Arrival at Municipal Hall = Courtesy Call 10:00 Finished courtesy call, continue to Tadayan 10:50 Arrived in Tadayan 12:20 Ocular Survey 3:00 Reached Amasi 4:30 Arrived back in Staff house 7:30 Dinner 10:30 Sleeping Time

September 7, 2010: DAY 2

5:30 Wake Up time 7:00 Breakfast 7:45 Went to Kagawad Teofilos House, Hataw Kapangan Practice 9:30 Return to Staff House 10:30 Went to Papayew Elementary School. Beautified the Herbarium 1:00 Return to Staff House 2:15 Left Tadayan, Kapangan 5:10 Arrived in Baguio

September 13, 2010: DAY 3

6: 00 Arrived at waiting area at SLU Gate 2 7: 00 7: 30 Departure time 7: 45 Bought ice 7: 50 Continued the travel

8: 30 Stop Over at Shillan 11: 00 Arrived at Pudong, Kapangan 11: 10 Started to fix and arrange the staff house and cook food for lunch 12: 00 1: 00 Lunch Time 1: 00 1: 30 Visited the wake of Mr. Alon Paclos 1: 00 7: 00 Homevists for each sitios Time of arrival per sitio 6: 00 Cantao 6: 30 Tadayan Proper 6: 45 - Tayawan 7: 00 Papayew Conduct acetic acid and Benedict's tests Met up with community folks and updated progress notes

7: 25 -Am- asie 7: 30 8: 30 Dinner 8: 30 9: 30 ARAS 9: 10 Lights off

September 14, 2010: DAY 4

4: 00 5: 00 Waking up time 5: 30 Preparing of breakfast by the cooking comittee 6: 00 7: 00 Breakfast 8: 00 - Departure from staff and start of trip to Tuplac 8: 30 Assisted in the vaccination of Alexix Pellitan 8: 30 10: 30 Travelling time from Staff house to Tuplac Arrival to Tuplac 10: 40 Started to gather data Spot mapping of Tuplac BMI- School Vaccinations Height and Weight monitoring 12: 00 1: 00 Lunch at Tuplac

1: 00 2: 00 Continued with the homevisit 2: 30 5: 30 Travelling time back at the staff households 5: 30 Preparation of dinner 7: 30 8: 30 Dinner 8: 30 9: 00 ARAS/ LECTURE 9: 10 Lights Off

September 15, 2010: DAY 5

6: 00 Waking up of the cooking comitee 7: 00- Breakfast 8: 00 Left the staff house 8: 05 Arrived at Kagawad Teofilo's house 8: 10 Planned activities for the farewell program for next week Practiced HATAW Role Play Health teachings Games 12: 00 Went Back to staff house 12: 05 Pepared Lunch 1: 00 Lunch time 2: 00 3: 00- Packed and prepared for our departure of the area 3: 05 Departure of the area 5: 30 Arrived at Baguio

FAMILY HEALTH CARE PLAN Health Problem: Poor Personal Hygiene Family Diagnosis: Inability to provide a home environment conducive to health maintenance and personal development due to: inadequate knowledge of preventive measures Lack of inadequate knowledge of importance of hygiene and sanitation

Goals Objectives

and

Interventions Measures and Rationale, Method of Contact and Teaching Strategies

Resources Needed Available to Family Not Available to Family but Needed

Results of Evaluation

Goal:

After nursing intervention, the possibility of transmission of microorganism or simply acquiring of a certain disease will be minimized or prevented.
Objectives:

Discuss with Mrs. Sabaina the nature, cause and even the signs and symptoms of possible diseases that he can acquire; (2) explore with him the ways of implementing measures to maintain personal hygiene especially among the
members (3) explore with him the ways of implementing certain types of sanitation measures and maximizing resources.

Time and effort of both the nurse and\the family themselves.

Visual aids and materials needed to improve personal hygiene practices and home sanitation.

Fully met if: was

The family able to:

1.Implement appropriate measures regarding personal hygiene 2. Was able to maintain cleanliness and doesn't forgot what they had learned

Partially met if:

After nursing intervention,

Mrs. Sabaina will: correct its wrong notion about doing an appropriate personal hygiene; (2) implement the agreed-upon measures in order to improve his personal hygiene within himself at home; and (3) to be able to recognize beginning cases of simple hygiene measures that they can adapt easily

The family able to:

was

1. Recognize this as a health threat

Not met if was

The family able to:

1. Doesn't follow or implement what they had learned 2. Still ignores what has been taught to them and continues the way they are living

Legend:

Church The family goes to church sometimes if they feel like hearing a mass Money The family had scarcity of money and is living with poverty. They have no earnings Hospital The hospital in the area is far from them. And they don't go to a regular check ups eventhough they had illnesses Neighborhood Their neighbors are helping them in terms of food and other things. Relatives Mrs. Sabaina's Children are in different place and had their own family. They don't see oftenly. Sometimes her other relatives are visiting her since their sitio is near from them. Sometimes they had chit chat's and also help each other Food The family doesn't eat regularly or eat a balanced diet due to poverty. Health workers sometimes give them food as well as their neighborhood Work Mrs. Sabaina doesn't work anymore because she's on her retirement age and condition. Her son are working as contractual and is not regularly receiving payment

ECO MAP

Documentation

Figure 1 The Cyst that was assessed and observed to the left foot of Mrs. Sabaina

Figure 2: While conducting an interview with Mrs. Sabaina