A Family Case Study (Malacabibi, Solana Cagayan) RLE 2C

Prepared by:
Jennifer Aggabao Rosalina Rosete Leslie Nonato Mark Louie Duran

Submitted to:
Mrs. Annabel Lee Daoala, RPT, MSN (Clinical Instructor)

INTRODUCTION
Monday morning, May 7, the community student nurses were looking for families to assess here in Malaccabibi, Solana. On our way to Zone 3, a house caught our attention. The structure of the house is made up of combined nipa, bamboo, concrete, and wood. Their surrounding is dirty and is not suitable for living. We also observed that their comfort room was just covered with sacks. Mrs. H, a 20- year old client, was the one who entertained us. She was not well groomed and walks barefooted. Her clothes were dirty and ragged. Upon arriving to their house, we saw her cooking while carrying her 7-month-old child. We asked her if we could interview her and she easily agreed. We started the interview by asking the history of Malaccabibi. She answered that Malaccabibi was then known to be the last zone in Dassun. They decided to separate it because Dassun was already a large barangay and they named it Malaccabibi because it was known to have large and several kabibe in that area. Their type of family is extended and is composed of 10 members. The mother is the breadwinner since her husband died 8 years ago. The family is Roman Catholic and was able to attend mass twice in a month. Their primary source of income is farming. The mother and her three children are the ones responsible for this. They are able to earn 500-700 pesos in a week since they only act as tenants. They usually harvest corn.

COMMUNITY ASSESSMENT FORM

NAME OF COMMUNITY ASSESSED: Zone 3, Malacabibi, Solana Cagayan DATE ASSESSED: May 2, 2012 ASSESSED BY: RLE 2C Name of Household Highest Member Age Gender Civil Status Educational Attainment A.G 48 Female Married Grade 6 R. G 29 Male Single Grade 6 J.R.G 22 Male Married Grade 6 M.G 11 Female Single Grade 6 E.G 9 Male Single Grade 6 H.G. 20 Female Married High school J.G 1 Male Single J.M.G 7 months Female Single G.G 1 Female single Type of family: COMMUNITY SUBSYSTEM A. PHYSICAL ENVIRONMENT 1. Land use: Agricultural Pasteur land Residential Industrial Others, specify 2. Type of soil ( ) loam Nuclear x Extended

Religion Roman Catholic Roman Catholic Roman Catholic Roman Catholic Roman Catholic Roman Catholic Roman Catholic Roman Catholic Roman Catholic

I.

( ) clay

( ) sandy

(x) others

3. Boundary maintenance ( ) river ( ) mountain ( ) field (x) highway ( ) hills ( ) others, specify

4. Real network (state type (graveled , asphalted , concrete) and length of roads/streets existing in the barangay). 5. Housing and zooming a. What is the age of the house/s? 10 years

b. Construction materials used? ( ) nipa/ bamboo ( ) wood ( ) concrete (x) mixed c. Are all most neighbor houses similar in size/ architecture? No d. General state of repair/ disrepair ( broken stairs, doors, windows, walls) e. Common neighborhood hangouts (stores, schoolyard, churchyard, etc.) house f. Along with people, what animals do you see on the streets? Name them. Dogs, pig, Carabao chicken

B. HEALTH AND SOCIAL SERVICES Facility used Location Services offered Characteristics of users

Brgy. Health center Zone 3 Malacabibi

Medical assistance Blood Pressure Monitoring

C. ECONOMICS 1. Sources of income Name of HH member A.G R.G J.R.G H.G Main Income from Place of work occupation main job Other Income from sources of other income sources

Farming

500-700 pesos

Malacabibi, Solana

2. House hold income/annum (please check) P 1,000 below P2, 000-3,999 x P1, 000-1,999 P4, 000-4,999 3. Agricultural products raised by the family Rice Corn Beans D. SAFETY AND TRANSFORMATION x 1. Sanitation Water source: Water storage: bottles Toilet system: Garbage disposal: Communal pit Open dumping Drainage disposal: open well x pump well river drum/can plastic containers none tobacco root crops others, specify P5, 000-5,999 P6, 000 above

peanuts mongo

elevated tanks Earthen jar flush type

___x___water-sealed

individual pit wrap and throw

burning

Open blind x none 2. What type of transformation/s is available in the community? Please name these, indicate frequency of trips coming in and getting out of barangay. Jeep E. COMMUNICATION 1. Formal communication channels __Newspaper __x__ Radio __x___ TV postal service telephone service others, specify

2. Informal communication channels Bulletin boards TV radio Newsletter ___x___word of mouth others specify 3. Are there community meetings to discuss community concerns? How often? Yes, once a month 4. Are there specific gathering places where information is shared? What is this? Yes, in Barangay Hall II. GENERAL HEALTH PARCTICES 1. Where do you seek medical assistance for simple illness? Private hospital/ clinic ___x___rural health center District hospital CHN worker Self-medication 2. Reasons for choosing the place for consultation. ___x___Accessible ___x___free of charge Others, specify effective/dependable services 3. Where do you usually seek medical assistance for complicated illness? Private hospital/ clinic District hospital ___x___Provincial hospital Others, specify 4. Reason for choosing the place of consultation. Accessible Charges responsible rate Others, specify rural health center CHN worker Self-medication

free of charge ___x___effective/dependable services

5. Where do you usually buy/get your supply of medicine? Barangay Health Center, Stores

III.

Second Level of Assessment

CUES/DATA FAMILY NURSING PROBLEMS A. Possible Infection and they are prone to diseases related to poor sanitation 1. Inability to provide a home environment conducive to health maintenance and personal development due to: a. Inadequate knowledge of importance of hygiene and sanitation. b. Inadequate knowledge of preventive measures. c. Lack of skill in carrying out measures to improve home environment

The surroundings are dirty and not suitable for living. The family members are not washing their hands before and after eating They are also not well groomed.

Broken stairs There were pointed/sharp objects inside and outside of the house that are improperly kept. Knife Fall hazards Stairs without handle.

A. Possible Injury and Accident 1. Inability to make decisions with respect to taking appropriate health action due to inadequate knowledge as to alternative courses of action open to them.

The house is not enough to accommodate all the family members. Family has ten members with a weekly income of 500- 700 Php. Family lives in one-room house with a dimension of 3 meters by 3 meters

A. Family size beyond what family resources can adequately provide 1. Inability to make decisions with respect to taking appropriate actions due to conflicting opinions among family members B. Inadequate living space

IV.

PRIORITY SETTING

A. Poor Sanitation specifically on unsanitary waste disposal Criteria Computation Actual Justification Score 1. Nature of the Problem 2/3 x 1 2/3 It is a health threat. 2. Modifiability of the Problem 2/2 x 2 2 The problem is easily modifiable since the nurses resources are available; they can educate the family regarding proper ways of sanitation. Susceptibility to possible diseases and infections can be prevented if poor sanitation is eliminated. 1 The family recognizes it as a problem that needs immediate action.

1 3. Preventive Potential 3/3 x 1

4. Salience of the Problem

2/2 x 1

Total Score

4 2/3

A. Accident Hazards specifically fire hazards and broken stairs

Criteria 1. Nature of the Problem 2. Modifiability of the Problem Computation 2/3 x 1 Actual Justification Score 2/3 It is a health threat.

2/2 x 2

Current knowledge, interventions and resources are available to solve the problem. It is highly preventable since the required resources are available. It is not a felt problem.

3. Preventive Potential 4. Salience of the Problem Total Score

3/3 x 1

0/2 x 1

3 2/3

B. Inadequate Living Space

Criteria 1. Nature of the Problem 2. Modifiability of the Problem 3. Preventive Potential 4. Salience of the Problem Total Score Computation 2/3 x 1 Actual Justification Score 2/3 It is a health threat.

1/2 x 2

Increasing the living space will require quite a financial expenditure. Increasing the living space will allow more facilities to be utilized. It is not a felt problem.

3/3 x 1

0/2 x 1

0 2 2/3

C. Presence of stress points in parenthood

Criteria 1. Nature of the Problem 2. Modifiability of the Problem Computation 1/3 x 1 Actual Justification Score 1/3 It is a foreseeable crisis.

2/2 x 2

The resources and interventions needed to solve the problem are available to the family. Proper parenting skills promote the well-being of each family member It is not a felt problem.

3. Preventive Potential 4. Salience of the Problem Total Score

3/3 x 1

1 0

0/2 x 1 3 1/3

Family size beyond what family resources can adequately provide

Criteria 1. Nature of the Problem 2/2 x 2 2. Modifiability of the Problem 2 Interventions and resources are available to solve the problem. Computation 2/3 x 1 Actual Justification Score 2/3 It is a health threat.

3/3 x 1 3. Preventive Potential

The available family resources can be utilized to encourage growth promoting experiences for members. It is not a felt problem.

0/2 x 1

4. Salience of the Problem Total Score 3 2/3

HEALTH PROBLEM

FAMILY NURSING PROBLEM

FAMILY NURSING CARE PLAN GOAL OF OBJECTIVE OF CARE CARE

1. Poor home/environmental condition/ sanitation: Inadequate living space. Unsanitary waste disposal.

Inability to provide a home environment conclusive to health maintenance and personal development due to inadequate family resources specifically financial constraints/ limited financial resources and lack of/ inadequate knowledge of preventive measures.

After nursing intervention, the family will take the necessary measures to properly maintain/ manage to improve the familys environment and good/ proper sanitation.

After nursing interventions, the family will: a. Identify necessary actions to improve their living. b. Change their behavior regarding their health. c. Practice proper segregation of waste disposal between biodegradabl e and nonbiodegradabl e.

INTERVENTION PLAN NURSING INTERVENTIONS METHODS OF NURSE FAMILY CONTACT A. Discuss with the Home visit family the strategies to improve their living. B. Guide the family in implementing the strategies. C. Motivate the family to maintain healthy living. D. Encourage the member of the family to activity participate in every house hold chores.

RESOURCES REQUIRED

Materials resources visual aids for the health education. Human resources effort of the nurse in discussing health education with the family. Financial resources money for the materials needed for the visual aids and for transportati on of the nurse.

HEALTH PROBLEM

FAMILY NURSING PROBLEM

FAMILY NURSING CARE PLAN GOAL OF CARE OBJECTIVE OF CARE NURSING INTERVENTIONS 1. Broaden the knowledge of the family on the hazards a. Discuss the consequences of failure to the appropriate activity on the problem. 2. Discuss with the family the cases of action open to them

1. Accident Inability to recognize the hazards presence of the condition specifically on or problem due to: fire hazard and a. Lack or inadequate broken stairs. knowledge. b. Denial about existence or severity as a result of fear of consequences of diagnosis of problem, specifically: a. Physical consequences.

After nursing intervention the family will gain knowledge on the presents of the considered problem.

After interventions the family will: a. Can determine the presents of hazards. b. Can enumerate various ways to prevent injury. c. Will seeks a method appropriate for them.

INTERVENTION PLAN METHODS OF NURSE FAMILY CONTACT Home visit

RESOURCES REQUIRED Materials needed: visual aids, Time and effort to the nurse and the family. Expenses for the teaching aids and transportation of the nurse.

HEALTH PROBLEM

FAMILY NURSING PROBLEM

GOAL OF CARE

FAMILY NURSING CARE PLAN OBJECTIVE OF CARE

2. Family size beyond what family resources can adequately provide.

Inability to make After nursing After the nursing decisions with respect to intervention, the family intervention, the family : taking appropriate action will decide an c. Can innumerate due to inaccessibility of appropriate action(s) to the appropriate appropriate resources, maintain family size. ways of specially financial maintaining the inaccessibility. size of the family. d. Will select a method most appropriate for them. e. Will consult the student nurse after delivery for guidance on the method chosen.

INTERVENTION PLAN NURSING METHODS OF NURSE INTERVENTIONS FAMILY CONTACT 3. Analyze with the Home visit following the critical issues related with inadequate resources to accommodate the whole family. 4. Discuss with family size the alternative courses of action. 5. Analyze with the family possible consequences of each method to encourage better decision making on the best option given to the family.

RESOURCES REQUIRED Human resources time and effort of both the nurse and the family. Financial resources money for the nurse transport.