A typology of Nursing Problems in Family Nursing Problem

First Level Assessment 1. Presence of Wellness Condition stated as potential or Readiness a clinical or nursing judgement about a client in transition from a specific level of wellness or capability in a higher level. Wellness potential is a nursing judgement on wellness state or condition based on clients performance, current competencies, or performance, clinical data or explicit expression of desire to achieve a higher level of state of function in a specific area on health promotion and maintenance. Examples of this are the following: A. Potential for Enhanced Capability for: 1. Healthy Lifestyle ex 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 interconnectedness that comes from inner strength/sacred source God (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 2. Presence of Health Threats conditions that are conducive to disease and accident, or may result to failure to maintain wellness or realize health potential Examples of this are the following: A. Presence of risk factors of specific diseases ex. Lifestyle disease, metabolic syndromes) 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 charts 2. Pointed sharp objects, poisons and medicines improperly kept 3. Fire hazards 4. Fall hazards 5. Others specify E. Faulty/un healthful/nutritional/eating habits or feeding techniques practices specify 1. Inadequate food intake both in quality and quantity 2. Excessive food intake of certain nutrients 3. Faulty eating habits 4. Ineffective breastfeeding 5. Faulty feeding techniques F. Stress provoking factors specify: a. Strained marital relationship b. Strained parent-sibling relationship c. Interpersonal conflicts between family members d. 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: a. Alcohol drinking b. Cigarette tobacco smoking c. Walking barefooted or inadequate footwear d. Eating raw meat or fish e. Poor personal hygiene f. Self medication substance abuse g. Sexuality promiscuity h. Engaging in dangerous sports i. Inadequate rest or sleep j. Lack of relaxation activities k. Lack of inadequate exercise/physical activity l. Non use of self protection measure (non use of bed nets in malaria and filariasis endemic areas) J. Inherent Personal Characteristics ex poor impulse control K. Health History which may Participate/Induce the Occurrence of Health Deficit ex. Previous history of difficult labor L. Inappropriate Role Assumption ex child assuming mothers role, father not assuming his role M. Lack of Immunization/Inadequate Immunization Status Specialty of Children N. Family Disunity ex 1. Self oriented behaviour of members 2. Unresolved conflicts of members 3. Intolerable disagreements 4. Oters, specify 3. 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 in thrive develop according to normal rate C. Disability whether congenital or arising from illness: transient/temporary (e.g. aphasia or temporary paralysis after a CVA) or permanent (e.g. leg amputation secondary to diabetes, blindness from measles, lameness from polio) 4. Presence of stress points/foreseeable crisis situation anticipated periods of unusual demand on the individual or family in terms of adjustment family resources. Examples of this include: A. Marriage B. Pregnancy, labor, puerperium C. Parentlhood 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, speify________________

Second level assessment 1. Inability to recognize the presence of the condition or problem due to: A. Lack or inadequate knowledge B. Denial about its existence or severity as a result of fear of consequences of diagnosis of problems Specifically: 1. Social-stigma, loss of respect of peer significant other 2. Economic/cicalost implications 3. Physical consequences 4. Emotional/psychological issues/concern 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 situation or problem i.e. failure to breakdown problems into manageable units of attach 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. Four consequences of action, specifically: 1. Social consequences 2. Economic consequences 3. Physical consequences 4. Emotional/psychological consequences I. Negative attitude towards the health conditions or problem by negative attitude is meant one that interferes with rational decision-making J. In accessibility of appropriate resources for care, specifically: 1. Physical accessibility 2. Costs constraints or economic/financial inaccessibility K. Lack of trust/confidence in the health personnel/agency L. Misconception or erroneous information about proposed courses of action M. Others specify III. inability to provide adequate nursing care to the sick, disabled, dependent or vulnerable/at risk, member of the family, due t A. Lack of/inadequate knowledge about the disease/health condition (nature, severity, complications, prognosis and management) B. Lack of / inadequate knowledge of the nature or extent of nursing care needed C. Lack of the necessary facilities, equipment and supplies of care D. Lack of/inadequate knowledge about child development and care E. Lack of /inadequate knowledge or skill in carrying out the necessary intervention or treatment procedure of care i.e. complex therapeutic regimen or healthy lifestyle program) F. Inadequate family resources of care specifically: 1. Absence of responsible member 2. Financial constraints 3. Limitation of lack/lack of physical resources

G. Significant persons unexpressed feelings (ex hostility/anger, guilt, fear/anxiety, despair, rejection)which his/her capacities to provide care H. Philosophy in life which negates/hinder caring for the sick, disabled, dependent, vulnerable/at risk member I. Members preoccupation with no concern/interest 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 IV. inability to provide a home environment conducive to health maintenance and personal development due to: A. Inadequate family resources specifically: 1. Financial constraints/limited financial resources 2. Limited physical resources i.e lack of space to construct facility B. Failure to see benefits (specifically long term ones) of investment 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 members G. Lack of supportive relationship among family members H. Negative attitudes/philosophy in life which is not conducive to health maintenance and personal development I. Lack of inadequate competencies in relating to each other for mutual growth and maturation ex reduced ability to meet the physical and psychological needs of other 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/service 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) specificall 1. physical/psychological consequences 2, financial consequences