A Typology of Nursing Problems in Family

Nursing Practice
First Level Assessment

I. Presence of Wellness Condition-stated as potential or Readiness-a clinical or nursing judgment about a clien
a higher level. Wellness potential is a nursing judgment on wellness state or condition based on clients perform
explicit expression of desire to achieve a higher level of state or function in a specific area on health promotion

A. Potential for Enhanced Capability for:

1. Healthy lifestyle-e.g. nutrition/diet, exercise/activity

2. Healthy maintenance/health management

3. Parenting

4. Breastfeeding

5. Spiritual well-being-process of clients developing/unfolding of mystery through harmonious interconne

(NANDA 2001)

6. Others. Specify.

B. Readiness for Enhanced Capability for:

1. Healthy lifestyle

2. Health maintenance/health management

3. Parenting

4. Breastfeeding

5. Spiritual well-being

6. Others. Specify.

II. Presence of Health Threats-conditions that are conducive to disease and accident, or may result to failure to
this are the following:

A. Presence of risk factors of specific diseases (e.g. lifestyle diseases, metabolic syndrome)
B. Threat of cross infection from communicable disease case

C. Family size beyond what family resources can adequately provide

D. Accident hazards specify.

1. Broken chairs

2. Pointed /sharp objects, poisons and medicines improperly kept

3. Fire hazards

4. Fall hazards

5. Others specify.

E. Faulty/unhealthful nutritional/eating habits or feeding techniques/practices. Specify.

1. Inadequate food intake both in quality and quantity

2. Excessive intake of certain nutrients

3. Faulty eating habits

4. Ineffective breastfeeding

5. Faulty feeding techniques

F. Stress Provoking Factors. Specify.

1. Strained marital relationship

2. Strained parent-sibling relationship

3. Interpersonal conflicts between family members

4. Care-giving burden

G. Poor Home/Environmental Condition/Sanitation. Specify.

1. Inadequate living space

2. Lack of food storage facilities

 3. Polluted water supply

4. Presence of breeding or resting sights of vectors of diseases

5. Improper garbage/refuse disposal

6. Unsanitary waste disposal

7. Improper drainage system

8. Poor lightning and ventilation

9. Noise pollution

10. Air pollution

H. Unsanitary Food Handling and Preparation

I. Unhealthy Lifestyle and Personal Habits/Practices. Specify.

1. Alcohol drinking

2. Cigarette/tobacco smoking

3. Walking barefooted or inadequate footwear

4. Eating raw meat or fish

5. Poor personal hygiene

6. Self medication/substance abuse

7. Sexual promiscuity

8. Engaging in dangerous sports

9. Inadequate rest or sleep

10. Lack of /inadequate exercise/physical activity

11. Lack of/relaxation activities

12. Non use of self-protection measures (e.g. non use of bed nets in malaria and filariasis endemic areas).
J. Inherent Personal Characteristics-e.g. poor impulse control

K. Health History, which may Participate/Induce the Occurrence of Health Deficit, e.g. previous history of diffi

L. Inappropriate Role Assumption- e.g. child assuming mothers role, father not assuming his role.

M. Lack of Immunization/Inadequate Immunization Status Specially of Children

N. Family Disunity-e.g.

1. Self-oriented behavior of member(s)

2. Unresolved conflicts of member(s)

3. Intolerable disagreement

O. Others. Specify._________

III. Presence of health deficits-instances of failure in health maintenance.

Examples include:

A. Illness states, regardless of whether it is diagnosed or undiagnosed by medical practitioner.

B. Failure to thrive/develop according to normal rate

C. Disability-whether congenital or arising from illness; transient/temporary (e.g. aphasia or temporary paralysi
diabetes, blindness from measles, lameness from polio)

IV. Presence of stress points/foreseeable crisis situations-anticipated periods of unusual demand on the indiv
Examples of this include:

A. Marriage

B. Pregnancy, labor, puerperium

C. Parenthood

D. Additional member-e.g. newborn, lodger

E. Abortion

F. Entrance at school

G. Adolescence
H. Divorce or separation

I. Menopause

J. Loss of job

K. Hospitalization of a family member

L. Death of a member

M. Resettlement in a new community

N. Illegitimacy

O. Others, specify.___________

Second-Level Assessment

I. Inability to recognize the presence of the condition or problem due to:

A. Lack of or inadequate knowledge

B. Denial about its existence or severity as a result of fear of consequences of diagnosis of problem, specifically

1. Social-stigma, loss of respect of peer/significant others

2. Economic/cost implications

3. Physical consequences

4. Emotional/psychological issues/concerns

C. Attitude/Philosophy in life, which hinders recognition/acceptance of a problem

D. Others. Specify _________

II. Inability to make decisions with respect to taking appropriate health action due to:

A. Failure to comprehend the nature/magnitude of the problem/condition

B. Low salience of the problem/condition

C. Feeling of confusion, helplessness and/or resignation brought about by perceive magnitude/severity of the s
manageable units of attack.

D. Lack of/inadequate knowledge/insight as to alternative courses of action open to them

E. Inability to decide which action to take from among a list of alternatives

F. Conflicting opinions among family members/significant others regarding action to take.

G. Lack of/inadequate knowledge of community resources for care

H. Fear of consequences of action, specifically:

1. Social consequences

2. Economic consequences

3. Physical consequences

4. Emotional/psychological consequences

I. Negative attitude towards the health condition or problem-by negative attitude is meant one that interferes wi

J. In accessibility of appropriate resources for care, specifically:

1. Physical Inaccessibility

2. Costs constraints or economic/financial inaccessibility

K. Lack of trust/confidence in the health personnel/agency

L. Misconceptions or erroneous information about proposed course(s) of action

M. Others specify._________

III. Inability to provide adequate nursing care to the sick, disabled, dependent or vulnerable/at risk mem

A. Lack of/inadequate knowledge about the disease/health condition (nature, severity, complications, prognosis

B. Lack of/inadequate knowledge about child development and care

C. Lack of/inadequate knowledge of the nature or extent of nursing care needed

D. Lack of the necessary facilities, equipment and supplies of care

E. Lack of/inadequate knowledge or skill in carrying out the necessary intervention or treatment/procedure of c
program).

F. Inadequate family resources of care specifically:

1. Absence of responsible member

2. Financial constraints

3. Limitation of luck/lack of physical resources

G. Significant persons unexpressed feelings (e.g. hostility/anger, guilt, fear/anxiety, despair, rejection) which hi

H. Philosophy in life which negates/hinder caring for the sick, disabled, dependent, vulnerable/at risk member

I. Members preoccupation with on concerns/interests

J. Prolonged disease or disabilities, which exhaust supportive capacity of family members.

K. Altered role performance, specify.

1. Role denials or ambivalence

2. Role strain

3. Role dissatisfaction

4. Role conflict

5. Role confusion

6. Role overload

L. Others. Specify._________

IV. Inability to provide a home environment conducive to health maintenance and personal development

A. Inadequate family resources specifically:

1. Financial constraints/limited financial resources

2. Limited physical resources-e.i. lack of space to construct facility

B. Failure to see benefits (specifically long term ones) of investments in home environment improvement

C. Lack of/inadequate knowledge of importance of hygiene and sanitation

D. Lack of/inadequate knowledge of preventive measures

E. Lack of skill in carrying out measures to improve home environment

F. Ineffective communication pattern within the family

G. Lack of supportive relationship among family members

H. Negative attitudes/philosophy in life which is not conducive to health maintenance and personal developmen

I. Lack of/inadequate competencies in relating to each other for mutual growth and maturation (e.g. reduced abi
members as a result of familys preoccupation with current problem or condition.

J. Others specify._________

V. Failure to utilize community resources for health care due to:

A. Lack of/inadequate knowledge of community resources for health care

B. Failure to perceive the benefits of health care/services

C. Lack of trust/confidence in the agency/personnel

D. Previous unpleasant experience with health worker

E. Fear of consequences of action (preventive, diagnostic, therapeutic, rehabilitative) specifically :

1. Physical/psychological consequences

2. Financial consequences

3. Social consequences

F. Unavailability of required care/services

G. Inaccessibility of required services due to:

1. Cost constrains

2. Physical inaccessibility

H. Lack of or inadequate family resources, specifically

 1. Manpower resources, e.g. baby sitter

2. Financial resources, cost of medicines prescribe

I. Feeling of alienation to/lack of support from the community, e.g. stigma due to mental illness, AIDS, etc.

J. Negative attitude/ philosophy in life which hinders effective/maximum utilization of community resources fo

K. Others, specify __________