COLEGIO SAN AGUSTIN-BACOLOD

COLLEGE OF NURSING

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Family Case Study

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SUBMITTED BY:

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SUBMITTED TO:

DATE SUBMITTED:
 CHAPTER I

INTRODUCTION

The family is the smallest unit of the society and the natural fundamental core of the

community and consequently, it is considered as the primordial recipient of the nursing effort,

which is contributory to the development, and progress of the community through

active involvement and self – responsibilities of each constituent. It is composed of persons,

male and female, being molded to be as one, working hand in hand to maintain a good

atmosphere among the family members .A nucleus controls the functions of the entire cell and

can be thought as the “command center” of the cell. The nucleus as well has different

components which are all needed in order for it and the cell to function well, same as with the

“commander” or the head of the family and the members who has different functions within the

family. The impression or status of each family will always affect the status of the community as

a whole. Community health nursing is a response to the health needs of the people. It does not

focus on a particular class or family.

Comprehensive and general in approach. Community health service is notepisodic as it requires

continuous observation and monitoring of the

communityas a whole. Promotion and preservation of the health of its different clients

(individual, family, group or community) is the primary goal of community health nursing .The

community is a group of people sharing geographic boundaries and/or values and interests.

(Maglaya, 2004) No two communities are alike. A nurse exposed in the community learns how

to interact and adapt to different kinds of people. The family is considered as the basic unit of

care in the community health nursing. It is in the family where a member develops his health
values, beliefs and practices. The family is a major influence in the health behaviors of an

individual. With this, it is important that families in a community are aware of the things and

practices pertaining to their health. It is apt to say that community health nursing has a big role in

the nursing education. It is in the community where the student nurse learns nursing apart from

the hospital setting as she was exposed to different level of orientation. It is in the community

where the saying “nursing is an art” can be applied as a student nurse tries to give quality service

using the available resources in the health center.

Conducting a family case study is a means by which student nursereaches and feels the

community through its basic structure – the family. It is a tool in determining the health status of

a family through assessment and critical inspection. Through this, health related problems are

identified, thus giving the student nurse a hint on where to act and how to intervene. It is also a

meanstowards improving the health of the community people, making them moreproductive. To

come up with a family case study gives a sense of fulfillment to a

Student nurse as she was given the opportunity to share their skills, knowledge and time to

alleviate and uplift the living condition of a family. The family that was chosen by the student

nurse is a picture of the majority of the family here in our country: a family living in a poor

environmentalcondition without enough resources and lacks knowledge on vital healthinformatio

n and experiences other socio-economic related problems. Thoughtiring as it is, reaching out to

this family and mingling with them makes the student nurse feel the sense of fulfillment as she

share her knowledge, skill and time to aid in uplifting the condition of the family.
 CHAPTER II

OBJECTIVES OF THE STUDY

This chapter presents the general and specific objectives of this family case

study. Setting objectives provides direction for planning a

familyn u r s i n g i n t e r v e n t i o n . I t f a c i l i t a t e s m o t i v a t i o n f o r t h e c l i e n t a n d t h e

n u r s e b y providing a sense of achievement. (Kozier, Erb et. al., 2004)

General Objectives:
At the end of the student nurse-family relationship, adopted family will be

able to improve their health status and become self-reliant in maintaining their

health through appropriate interventions in a given frame.

Specific Objectives:
After 3 days of home visits and student nurse-family interaction, the family should be

able to:

 Establish rapport and trust with the student nurse.

 Give pertinent and factual information during surveys and interviews.

 Participate actively during home visits and assessment interviews.

 Identify actual and potential problems which may be a hindrance in attaining optimum

health.

 Categorize the identified health problems as health threat, health deficit or foreseeable

crisis through the assistance of their student-nurse.

 Evaluate changes in condition after giving interventions.

 CHAPTER III

A. Initial Data Base

a. Family Structure, Characteristics and Dynamics

Initials of Sex Birthday Age Civil Educational Occupation Relation to

the Family Status Attainment the head of
members the family

R.F M 29 Single Undergraduate Tricikad Husband

(high school) driver
J.G F 26 Single Undergraduate Housewife Wife
(elementary)
E.G F 8 Single Grade 2 ------ Daughter

R.G M 2 Single ------ ------ Son

J.G M 3 Single ------ ------ Son

The F. Family is a nuclear type of family consist of the father Mr. R.F who is a tricikad

driver. Mrs. J.G a full time housewife but also have part time job who leases one of their room in

order to support their daily needs and their 8 year old eldest daughter E.G who is currently in

grade 2. R.G their middle child who is 3 years old and J.G their youngest who is 2 years old now.

Mr. and Mrs. F. don’t have a hard time in terms of decision making because each of them

consider each other’s opinion first before deciding their final decisions especially when it comes

to health matters. The father is the head of the family and the bread winner of the family while

the mother takes care of the household and also do part-time job to help support their family’s

daily needs and took good care of their 3 children

 b. Socio-Economic and Cultural Characteristics

Lack of educational attainment seems to be the hindrance for finding a good job to Mr. R.F.

He never finished his high school and was obliged to work as a tricikad driver with an income

250 pesos a day. While Mrs. J.G only finishes grade 5 and decided to stay home to take care of

their first child.

The approximately monthly income of Mr. R.F is only 7,500pesos just enough to pay

their electricity bill, food, milk allowance and transportation expenses. But Mrs. J.G also help

her husband in order to provide their daily needs her monthly income 300pesos which also help

for the school expenses for their eldest daughter. Most of the time, the budget for health

maintenance is being sacrifice and not giving full attention due to lack of money. According to

Mrs. J.G, she spends 200 pesos per day to meet their daily needs.

The family is basically from Bacolod City. They are forced to transfer their house to

Purok Sagrado because the land that they are staying at is not their own property so they have no

choice but to move out. The family is not a member of any social association in the community

nor an active member of the Catholic Church.

c. Home and Environment

The family lives in under privileged area in Brgy. Estefania, Bacolod City. Their

establishment is composed of light materials. The floor is almost 6 sq. meters. The family is

resting together peacefully in a wooden bed foam located near the entrance door which is also

their receiving area. They usually sleep very early at around 8pm and wake up at around 6am.

The house is not well ventilated and there is inadequate lighting. Breeding sites for mosquitoes,

flies, cockroaches and rodents are unavoided due to open drainage and poor environmental
sanitation. Their toilet facility is located inside their house which they share with all the family

members. There is no water supply in the area so Mr. R.F is oblige to fetch water 20 meters away

from their house and cost 20pesos per container. Mrs. E.G buys their foods stuffs in the market

and store it in the uncovered cabinet leaving it susceptible to germs and bacteria. She usually

cooks vegetables and fish dishes. Their garbage is collected twice a week by DPS truck.

Tricikad roam around as their medium of transportation while cellular phones for

communication is accessible. Carinderias and mini-market also seeable with the neighborhood.

The general surroundings of the family is unhygienic and drainage system is open and

near to the houses. Only wooden walls separate them from their neighbors and electrical

connections are tangled and dangerous.

d. Health Status of each family Member

Mrs. E.G have a history of asthma and doesn’t have any medication maintenance, her asthma

only arises when she do strenuous work, when her asthma arises she relaxes herself and take her

time until her breathing will return will completely return again to normal. Her middle child R.G

genetically acquire this, if he got fever immediately arises because R.G is only 3 years old he

can’t handle to relax himself and breath normally so when they arises, they have to go to health

center for nebulization. Her first child is completely fit, so far she doesn’t have trouble I her

health status. While her youngest child is vulnerable in acquiring diseases last month she stated

that her youngest child had experience chicken pox but it was only few spots and recently it was

gone. Among her 3 children according her, her youngest child has low immune system, every

month or week he has fever or cough. Her second child had a history also of UTI luckily he

overcome it. So, so far Mrs. E.G avoided to cook foods high in sodium.
 Her second and youngest child does drink milk but sometimes she feeds them small

amount of solid foods like mashed vegetables and rice soup to help lessen their milk expenses.

They don’t take up any kinds of vitamins to boost their health because according to her they can

have them with the foods they eat.

After a long day of work her husband Mr. R.F sometimes complains of severe pain on his

body, knees and hands maybe a sign of rheumatism and over fatigue. The family doesn’t use

herbal medicine and goes to the health center when needed arises.

e. Values, Habits, Practices on Health Promotion, Maintenance and Disease

Prevention

The family sleeps early to have enough rest and energy for the next day. They sometimes

watch movies together as a form or relaxation or go outside of the community to have some

fresh air.

The family does not use bed nets at night but uses mosquito repellant (katol) to

protect them from mosquito and insects while they are sleeping. Their 3 children has

completed all the immunization required.

Every month at their community there is Pa-Bingo held as form of their relaxation

and entertainment.
TYPOLOOGY OF NURSING HEALTH PROBLEMS
Cues/Data
Subjective: “Gin hilanat sya,
tapos nag gwa dayon ang iya
sulalob pero dutay lang”
A 2 year old child with fever
and chicken pox
Subjective: “Damo gid tanga
bala biskan diin lang, may
mga ilaga man nga kama
dalagko ga labay labay, tapos
kung aga damo langaw”
Objective: “the waste are
gathered and disposed at the
back of the house near their
bathroom”
FAMILY COPING INDEX (Family Nursing Diagnosis)
Family Nursing Diagnosis (Family Coping Index by Freeman and Heinrich, 1981)
Normal Standard
A healthy child must be free
from diseases or illness like
fever, cough, rashes and the
like.
A healthy home must be free
from rodents and pest, it is
clean well ventilated and free
from threats.
A healthy home must have a
proper garbage disposal
available.
Family Heath Care
Chicken pox as a health
threat
1. Inability to provide
adequate nursing care
to the dependent
member with chicken
pox and fever due to:
 Lack of knowledge
of disease condition
and management.
Presence of vectors and
rodents as a health threats
1. Inability to recognize
threat due to lack of
knowledge about the
condition.
2. Inability to provide
home conducive to
health maintenance
and personal
development due to
ignorance in
preventive measures.
Lack of knowledge and
awareness on how to dispose
garbage properly.
INITIAL FAMILY COPING INDEX
This presents the initial coping capacity of the adoptive family using Family Coping Index as a

tool in rating the underlying problem, and it is the diagnosed to record family rather than individual

coping capacity. In community health nursing, the family cannot be seen only as a factor that affects

health; rather, the family is the patient

Legend:
5 – Complete Competence 3 – Moderate Competence 1 – No Competence

Area Rate Justification

1. Physical independence: 3 Both husband and wife are capable of performing

This category is concerned
with the ability to move about
to get out of bed, to take care
of daily grooming, walking
and other things which
involves the daily activities.
the activities of daily living. The husband is a
tricikad driver so his wife who is a plain
housewife takes good care and does the daily
grooming of their three children.

2. Therapeutic Competence: 3 Family’s diet depends on their budget and

This category includes all the
procedures or treatment
prescribed for the care of ill,
such as giving medication,
dressings, exercise and
relaxation, special diets.
availability of foods in the carinderia. They eat 3
meals a day. Their usual diet are vegetable and
fish. If there’s time after they wake up they go
out and have some walk as a form of their
exercise. Of one member of the family is sick
they first self-medicate it or otherwise go to the
quack doctor to have”hilot or luy-a” and if not
healed, they will go to the health center for
consultation. Their three children were fully
immunize.

3. Knowledge of Health 3 The family has some knowledge of the disease

Condition: condition such as caring its member with fever
This system is concerned with and was able to buy medicine the doctor
the particular health condition prescribed.
that is the occasion of care.

4. Application of the principles 3 The family sometimes bought cooked foods at

of General Hygiene:
This is concerned with the
family action in relation to
maintaining family nutrition,
securing adequate rest and
relaxation for family
the carinderia for their meal but the mother
usually cooked their own food. Their usual diet
are vegetable and fish, were they can get enough
vitamins and minerals. They relaxes through
watching movies together and go outside the
community to get some fresh air their children
 members, carrying out
accepted preventive measures,
such as immunization.
5. Health Attitudes:
This category is concerned
with the way the family feels
about health care in general,
including preventive services,
care of illness and public
health measures.
6. Emotional Competence:
This category has to do with
the maturity and integrity
with which the members of
the family are able to meet the
usual stresses and problems of
life, and to plan for happy and
fruitful living.
7. Family Living:
This category is concerned
largely with the interpersonal
with the interpersonal or
group aspects of family life –
how well the members of the
family get along with one
another, the ways in which
they take decisions affecting
the family as a whole.
8. Physical Environment:
This is concerned with the
home, the community and the
work environment as it affects
family health.
9. Use of Community
Facilities:
Generally keeps
appointments. Follows
through referrals. Tells others
about Health Department
services.
has completed all the immunization required by
the health center.
3 The family feels that health care is very
important because for them “health is wealth”
they don’t take up vitamins but they eat
nutritious foods, they also attend programs about
health in the community for them to be aware of
and also they avail services the health center
offered.
3 If there’s a problem both husband and wife have
some time to talk to each other they rationalized
things they’ve done then eventually arguments
stops and problems were solved.
3 The wife takes good care of her husband and
three children. The head of the family is the
father. The most dominant in terms of decision
making is the mother but even the mother is
dominant on decision making the father’s
suggestion is still accepted or sometimes
followed.
1 The family lives in a house which is composed of
bamboo, not cemented floors and a galvanized
roofs. Their kitchen where they cooked their
foods is easy for the children to climb of, and
when they wash their dishes the floor becomes
wet which makes it slippery. The father works as
a tricikad driver which makes him more exposed
to pollution which may harm his health.
3 They have knowledge about the services in the
health center and they were able to available free
services like free immunization and free
consultation.
PRIORITIZING HEALTH PROBLEMS (Identify at least 3 prioritized problems stated to the typology
of Nursing Problems)
1.

Criteria Computation Score Justification

Nature of the Problem

Modifiability of the
Problem

Preventive Potential

Salience of the
Problem

Family Nursing Problems According to Priority

FAMILY CARE PLAN (for the three (3) identified problems)

Priority Problem # 1

Health Family Goal of Objectives Intervention Plan

Problem Nursing Care of Care
Problem Nursing Method of Resources
Intervention Family Required
Contact

EVALUATION
FINAL FAMILY COPING INDEX
This presents the final coping capability of the adopted family on the identified areas for assessment after
3 days of Nurse-Family Interaction. The impact of the nursing management to the family based on the
identified nursing problems and the recommendation of the student nurse for the family to finally deal
with the problems in their own personal capability and discovers the facility of the community in the
attainment of the more enhanced health related measures.
Area Rate Justification

1. Physical
independence:
This category is
concerned with the
ability to move about
to get out of bed, to
take care of daily
grooming, walking
and other things
which involves the
daily activities.

2. Therapeutic
Competence:
This category includes
all the procedures or
treatment prescribed
for the care of ill, such
as giving medication,
dressings, exercise
and relaxation, special
diets.

3. Knowledge of Health
Condition:
This system is
concerned with the
particular health
condition that is the
occasion of care.

4. Application of the
principles of General
Hygiene:
This is concerned with
the family action in
relation to
maintaining family
nutrition, securing
adequate rest and
relaxation for family
members, carrying out
 accepted preventive
measures, such as
immunization.
5. Health Attitudes:
This category is
concerned with the
way the family feels
about health care in
general, including
preventive services,
care of illness and
public health
measures.

6. Emotional
Competence:
This category has to
do with the maturity
and integrity with
which the members of
the family are able to
meet the usual stresses
and problems of life,
and to plan for happy
and fruitful living.

7. Family Living:
This category is
concerned largely
with the interpersonal
with the interpersonal
or group aspects of
family life – how well
the members of the
family get along with
one another, the ways
in which they take
decisions affecting the
family as a whole.

8. Physical
Environment:
This is concerned with
the home, the
community and the
work environment as
 it affects family
health.

9. Use of Community
Facilities:
Generally keeps
appointments.
Follows through
referrals. Tells others
about Health
Department services.

RECOMMENDATION

REFERENCES
http:www.gp-training.net/training/tools/famcase.htm