1st level assessment 1. Health strengths Typology Potential for enhanced capability for: a.

Adequate living space Cues

b. Adequate water supply for all washing purposes including bathing.

c. Sufficient food storage

S> Ay ayos met ta tag-gaysa kami ti kwarto, ngem agkakwarto kami keni apok. O> Each room measures 10 square meters with adequately sized bed for one person. The living room measures 2 x 3 meters. The kitchen and dining room is measured as one approximately 3x5 meters. The store which is located near the house approximately measures 2x3 meters. S> Agapo ta ubbogtuloy tuloy met isu nga uray awan ti drum mi. O> Pipelines going to the comfort room and in the kitchen were seen during the visit. S> "Ada met jay ref mi ijay store, nu saan mi maibos, kaluban mi lattan itta lamisaan." O> During the 2nd visit, left-over foods were seen the table with plate cover.

Readiness for enhanced capability for: a. Minimal stress-provoking factor: smooth interpersonal relationship between and among family members, occasional conflicts occur but are immediately resolved. b. Complete immunization of children S> "Agap-apa kami met nu paminsan ngem nu mapagtungtungan ket mayaten."

c. Appropriate role assumption

d. Adequate rest and sleep

e. Occasional drinking of alcohol

f. No smoking member of the family

S> "Nakumpleton met jay apok na ni Kyla jay bakuna na." O> " No history of serious diseases such as polio, tubercolosis and diphtheria. S>"Jay anak ko kenni asawak ti agtrabtrabaho ijay, (pertaining to farm) siyak ket ittoy store laeng." O> During the home visit, Mr. Samson and Mr. Leo Jose were not there since they were at work. Mrs. Josefa stays in their sari-sari store most of the time since she was discharged from the hospital because of hypertension. S> "Alas-otso matmaturog kamin tapos alas kwatro kami nga bumangbangon tani agtrabaho da pay gamin." S> "Agpaminsan da laeng nga uminom ti arak (pertaining to Mr. Samson and Mr. Leo Jose). Handa nga masango ngamin kinanayon da jay trabaho." S> "Han da met nga agsigsigarilyo." O> No history of smoking-induced illnesses in the family members.

g. 2. Health threats Typology a. Excessive intake of certain nutrients and lack of intake of some important nutrients Cues S> "Manmanu kami nga agsida ti karne ken fish, ngamin ti sidsidaen mi ket vegetables a na makita itta garden mi ken ittoy asideg balay mi." O> radish, carrots and cabbage were seen in the garden while sayote was seen beside their house S> "Agininom kami diretso itta ubbog, pati pagluto mi ket itta mi met laeng nga al-alan, ipaburuk ku met bassit para keni Kyla ta ubing." O> Pipelines going to the comfort room and in the kitchen were seen during the visit. S> "Adu a ti ngilaw ittoy, ngem awan met ti lamuk." O> Flies were seen in their home and in their store during the interview. Sacks of chicken dung is also seen in front of their store and this attract flies. S> "Hankami nga inaldaw nga agdigos ta nalamin, ngerm agtoothbrush kami met ti 2 nga beses ti maysa nga aldaw." O> Slightly unclean clothes were worn by Mrs. Josefa during the interview S> "Hanmi nga masangon a ta ununaen mi pay ti trabaho. Jay ag garden sa ket exercisen O> They consider their works as their exercise. O> Since Mrs. Josefa has hypertension, Leo and Kyla can also have it S> "Purpuuran mi nga kinanayon ti basura mi ta awan ti mangkulkulekta. Medyo adayo itoy balay ti pagpurpuuran mi. S> "Wen, nagalis (pertaining to the stairs going to the store) lallalo na nu agtudo. O> There are stairs inside their house and it's made up of wood and has no railings. There are also stairs going to the store which is made up of stones and is slippery when it rains. S> "Itak lang kusina nga ikabkabil dagijay kutsilyo ken nakacellophane jay agas ko nga pang high blood." O> knives were scattered in the dirty kitchen with no cover O> Kyla, who was Mrs. Josefa's grandaughter was observed to be walking barefooted outside

b. Unsafe water for drinking and cooking

c. Presence of breeding or resting sites of insects

d. Poor personal hygiene by some members of the family

e. Inadequate exercise of most members of the family

f. Presence of family history of hypertension g. Improper garbage disposal

h. Hazardous path beside the house and fall hazard on the stairs

i. Pointed or sharp objects and medicines improperly kept

j. Walking barefoot by some members of the family

k. poor ventilation

their store. S>"Hanku nga iluklukat dagijay bintana tani nalamin, ken hanak met nga kinanayon itoy balay ta apapan kami ijay store ken awan mabati ditoy. O> There are 4 windows in the house but these were closed, and it's not adequate to promote good ventilation

3. Health Deficit Typology Illness state whether it is diagnosed or undiagnosed by a doctor: >Hypertension Cues S> Karkarwar ko lang ijay ospital 3 days ago ngamin na high blood ak ngem hanak met na stroke. Maululawak met lang nu maminsan ken sumaksakit ittoy ko." (massaging her nape area) O> blood pressure taken as 160/100

2nd level assessment Identified Health Problems 1. Excessive intake of certain nutrients and lack of intake of some important nutrients Formulated Family Diagnosis Inability to make decisions with respect to taking appropriate health action related to inadequate knowledge as to alternative courses of action open to them Inability to provide a home environment conducive to health maintenance and personal development related to inadequate knowledge of preventive measures Inability to provide a home environment conducive to health maintenance and personal development related to inadequate skill in carrying out measures to improve home environment Inability to provide a home environment conducive to health maintenance and personal development related to inadequate knowledge of importance of personal hygiene and sanitation. Inability to recognize the presence of the condition or problem related to inadequate knowledge regarding the importance of adequate and regular exercises. Inability to recognize the presence of the condition or problem related to inadequate knowledge regarding the predisposing factor of hypertension Inability to provide a home environment conducive to health maintenance and personal

2. Unsafe water for drinking and cooking

3. Presence of breeding or resting sites of insects

4. Poor personal hygiene by some members of the family

5. Inadequate exercise of most members of the family

6. Presence of family history of hypertension

7. Improper garbage disposal

8. Hazardous path beside the house and fall hazard on the stairs

9. Pointed or sharp objects and medicines improperly kept

10. Walking barefoot by some members of the family

11. Poor ventilation

12. Illness state whether it is diagnosed or undiagnosed by a doctor: >Hypertension

development related to inadequate knowledge of the effects of burning Inability to provide a home environment conducive to health maintenance and personal development related to inadequate knowledge of preventive measures and inadequate skill in carrying out measures to improve home environment. Inability to provide a home environment conducive to health maintenance and personal development related to inadequate knowledge of preventive measures to improve home environment Inability to recognize the presence of the condition or problem related to inadequate knowledge regarding the importance of wearing slippers inside and outside the house Inability to provide a home environment conducive to health maintenance and personal development related to failure to see the benefits of home environment improvement specifically utilizing the windows for adequate ventilation Inability to provide adequate nursing care to the sick family member related to inadequate knowledge about the disease or health condition and philosophy in life that it is part of aging

Health Potentials 1. Adequate living space

Identified Family Diagnoses Ability to provide a home environment conducive to health maintenance and personal development due to ability to see benefits of investment in home environment improvement. >Ability to provide a home environment conducive to health maintenance and personal development due to ability to see benefits of investment in home environment improvement. >Ability to utilize community resources for health care due to availability of required service or resources. Ability to provide a home environment conducive to health maintenance and personal development due to ability to see benefits of investment in home environment improvement. Ability to provide a home environment conducive to health maintenance and personal development due to effective communication patterns within the family and presence of

2. Adequate water supply for all washing purposes including bathing.

3. Sufficient food storage

4. Minimal stress-provoking factor: smooth interpersonal relationship between and among family members, occasional conflicts occur but are immediately resolved.

5. Complete immunization of children

6. Appropriate role assumption

7. Adequate rest and sleep

8. Occasional drinking of alcohol

9. No smoking member of the family

supportive relationship among family members. Ability to provide adequate care to the at-risk members of the family due to adequate knowledge about child development and care. Ability to provide a home environment conducive to health maintenance and personal development due to effective communication patterns within the family and supportive relationship among family members. Ability to recognize the benefits of the action due to ability to attitudes in life that promote the performance of the appropriate action. Ability to recognize the benefits of the action due to appropriate attitude in life which hinders the performance of the action. Ability to provide a home environment conducive to health maintenance and personal development due to appropriate attitude in life which hinders the performance of the action.

PRIORITIZATION OF HEALTH PROBLEMS 1. Excessive intake of certain nutrients and lack of intake of some important nutrients
Criteria Nature Problem of Justification classified as health threat because it does not to be attended right away. However, if this problem will not be addressed, this will lead to actual problem state. Modifiability the Problem of The problem is considered to be PARTIALLY 1.5 / 2 x2 MODIFIABLE justification: a) current knowledge, technology and interventions to manage the problem are present like eating chicken and pork b) The community where the family lives has no stores that sells chicken and pork meat at an affordable price. c) The family have money to buy chicken and pork meat. The family does not have also the adequate knowledge, financial and attitudes in solving the problem. d) Barangay health clinics and the midwife are present in their community to help them by giving health educations. Preventive Potential The problem has a MODERATE PREVENTIVE 2.25/ 3 x 1 POTENTIAL because of the following .75 because of the following 1.5 Computation Actual Score 0. 67

the It is scored as such because the problem is 2/3x 1

justifications: a) Excessive intake of vegetable like cabbage and "sayote" occurs for how many years. However the family members do not still manifest serious signs and symptoms of diseases related to imbalance nutrition. b) The family already is practicing the imbalanced dietary intake for a long time period. and they still doing it without appropriate actions c) The management instituted by the family was to eat meat sometimes. d) All of the members of the family are at risk for having diseases due to lack of nutrients Salience of the The family perceived this as a problem but does 1/ 2 x 1 Problem Total score: not need immediate attention 3.42 0.5

2. Unsafe water for drinking and cooking

Criteria Nature Problem of Justification classified as health threat because unsafe water for drinking and cooking may cause various diseases such as ameobiasis, gastroenteritis and cholera Modifiability the Problem of The problem is considered to be PARTIALLY 1.5 / 2 x2 MODIFIABLE justification: a) Current knowledge, technology and interventions are present to maintain potability of drinking water b) The community where the family lives has no stores near them which sells gallons of mineral water. c) The family has also resources in maintaining the cleanliness of their drinking water such as pots for boiling water. d) Barangay health clinics and the midwife are present in their community to help them by giving health educations. Preventive Potential The problem has a MODERATE PREVENTIVE 1.5/ 3 x 1 POTENTIAL justifications: a) The problem is not that severe and can be managed by interventions because of the following 0.5 because of the following 1.5 Computation Actual Score 0. 67

the It is scored as such because the problem is 2/3x 1

b) The family drinks directly from the faucet on a long period of time and still c) The management instituted by the family was to boil the water for only 5 minutes which is incorrectly done d) no family member do not have any serious illness pertaining to unsafe water Salience of the The family doesn't perceive it as a problem or 0/ 2 x 1 Problem Total score: does not need change. 2.67 0

3. Presence of breeding or resting sites of insects

Criteria Nature Problem Modifiability the Problem of of Justification since insects such as files can be a carrier of particular diseases. The problem is considered to be PARTIALLY 1/ 2 x2 MODIFIABLE justification: a) Current knowledge, technology and interventions are available to prevent breeding or resting sites of insects b) The community where the family lives has no interventions to decrease the number of flies c) The family also do not have resources in preventing flies from entering homes because there garden is just near them, where flies can breed. d) Barangay health clinics and the midwife are present in their community to help them by giving health educations. Preventive Potential The problem has a LOW of PREVENTIVE 0.75/ 3 x 1 the following 0.25 POTENTIAL justifications: a) The problem is not that severe and can be managed by interventions b) The presence of flies in the community occurs for how many year now c) There were no interventions done to address the problem d) The family do not experience certain diseases caused by flies. Salience of the The family doesn't perceive it as a problem or 0/ 2 x 1 Problem Total score: does not need change. 1.92 0 because because of the following 1 Computation Actual Score 0. 67

the The problem is classified as a health threat, 2/3x 1

4. Poor personal hygiene by some members of the family

Criteria Nature Problem Modifiability the Problem of of Justification because it can cause microorganisms to enter the body causing diseases The problem is considered to be EASILY 2/ 2 x2 MODIFIABLE justification: a) Current knowledge, technology and interventions are available to improve personal hygiene. The student nurses are also willing to render hygiene b) The community where the family lives has continuous water which can be used in improving personal hygiene c) The family has the resources because Mrs. Josefa sells toiletries such as shampoo and soap d) Barangay health clinics and the midwife are present in their community to help them by giving health educations Preventive Potential The problem has a MODERATE PREVENTIVE 2.25/ 3 x 1 POTENTIAL justifications: a) The problem is not that severe and can be managed by interventions b) The problem occurs for just one day because they take a bath every other day c) There were no interventions done to address the problem because of the cold weather d) The family especially the girls are at risk for having diseases such as urinary tract infection Salience of the The family doesn't perceive it as a problem or 0/ 2 x 1 Problem Total score: does not need change. 3.42 0 because of the following 0.75 health education regarding personal because of the following 2 Computation Actual Score 0. 67

the The problem is classified as a health threat 2/3x 1

5. Inadequate exercise of most members of the family

Criteria Nature Problem Modifiability the Problem of of Justification because if not addressed it can predispose to certain diseases like heart diseases and obesity. The problem is considered to be EASILY 2/ 2 x2 MODIFIABLE because of the following 2 Computation Actual Score 0. 67

the The problem is classified as a health threat 2/3x 1

justification: a) Current knowledge, are available technology to manage and the interventions

problem. Student nurses are also willing to encourage the family to have a regular exercise. b) The community where the family lives has a wide yard for them to run, jog, and do aerobic exercises. c) The family has enough energy to do certain exercises especially Mrs. Josefa d) Barangay health clinics and the midwife are present in their community to help them by giving health educations Preventive Potential The problem has a LOW of PREVENTIVE 0.75/ 3 x 1 the following 0.25 POTENTIAL justifications: a) The problem is not that severe and can be managed by interventions b) The family does not practice regular exercise for how many years already. c) There were no interventions done to address the problem d) The problem does not give the family serious diseases and this was not the main cause of Mrs. Josefa's hypertension. Salience of the The family doesn't perceive it as a problem or 0/ 2 x 1 Problem Total score: does not need change. 2.92 0 because

6. Presence of family history of hypertension

Criteria Nature Problem Modifiability the Problem of of Justification threat since it does not need to be attended immediately. The problem is considered of to the be NOT 0.5/ 2 x2 0.5 MODIFIABLE justification: a) The are no current knowledge, technology and interventions available to manage the problem since you cannot change the gene of a person. Hypertension is innate in the family. b) The community lacks fruits and vegetables to prevent hypertension. c) The family also has no resources in preventing hypertension. because following Computation Actual Score 0. 67

the The health problem is considered as health 2/3x 1

d) Barangay health clinics and the midwife are present in their community to help them by giving health educations Preventive Potential The problem has a MODERATE PREVENTIVE 1.5/ 3 x 1 POTENTIAL justifications: a) The problem is not that severe because no family member other than Mrs. Josefa have it yet. b) This problem cannot be prevented because it is hereditary. c) There were no interventions done to address the problem d) Mr. Leo Jose is vulnerable of having hypertension because of his age and increase intake of vegetables that's high in sodium. Salience of the The family doesn't perceive it as a problem or 0/ 2 x 1 Problem Total score: does not need change. 1.92 0 because of the following 0.75

7. Improper garbage disposal

Criteria Nature Problem Modifiability the Problem of of Justification cause diseases The problem is considered to be PARTIALLY 1/ 2 x2 MODIFIABLE justification: a) current knowledge, are available technology to manage and the interventions problem b) community resources are not available because there were no garbage collectors to bring the garbage to a dumpsite every week c) family resources are available by doing proper segregation d) Health workers do not address this problem Preventive Potential The problem has a LOW of PREVENTIVE 0.75/ 3 x 1 the following 0.25 POTENTIAL justifications: a) The problem is severe because there's no other way to dispose garbage other than burning b) The family practices burning of garbage for how many years already. c) There were no interventions done to address the problem because because of the following 1 Computation Actual Score 0. 67

the It is considered as health threat because it can 2/3x 1

d) All family members are vulnerable in having diseases such as lung cancer because of 0 1.92 continuous burning of garbage. Salience of the The family doesn't perceive it as a problem or 0/ 2 x 1 Problem Total score: does not need change.

8. Hazardous path beside the house and fall hazard on the stairs
Criteria Nature Problem of Justification threat since it does not need to be attended right away. However, if this problem will not be addressed, this will lead to actual problem state. Modifiability the Problem of The problem is considered of to the be NOT 0.5/ 2 x2 0.5 MODIFIABLE justification: a) current knowledge, are available technology to manage and the interventions problem b) community resources are not available c) The family has no resources to solve the problem d) Health workers do not address this problem Preventive Potential The problem has a MODERATE PREVENTIVE 1.5/ 3 x 1 POTENTIAL justifications: a) The problem is not that severe because the stairs outside is only slippery when it rains and the family wear boots when going out. b) It did not cause any injury in the past. c) There were no interventions done to address the problem d) Kyla who is only 3 years old is at risk for fall because of being playful. Salience of the The family doesn't perceive it as a problem or 0/ 2 x 1 Problem Total score: does not need change. 1.67 0 because of the following 0.5 because following Computation Actual Score 0. 67

the The health problem is considered as health 2/3x 1

9. Pointed or sharp objects and medicines improperly kept

Criteria Nature Problem Modifiability of of Justification be attended immediately The problem is considered to be NOT 0.5/ 2 x2 0.5 Computation Actual Score 0. 67

the It is a health threat because it doesn't need to 2/3x 1

the Problem

MODIFIABLE justification: a) current

because knowledge, are

of

the

following and the

technology to manage

interventions problem

available

b) community resources are not available c) The family has no resources to solve the problem d) Health workers do not address this problem Preventive Potential The problem has a MODERATE PREVENTIVE 1.5/ 3 x 1 POTENTIAL justifications: a) It's not that severe because no family member was harmed from scattered knives on the kitchen b) It did not cause any injury in the past. c) The family did not do anything to solve the problem d) Kyla who is only 3 years old is at risk for playing with improperly kept sharp objects Salience of the The family doesn't perceive it as a problem or 0/ 2 x 1 Problem Total score: does not need change. 1.67 0 because of the following 0.5

10. Walking barefoot by some members of the family

Criteria Nature Problem Modifiability the Problem of of Justification be attended immediately The problem is considered to be PARTIALLY 1.5/ 2 x2 MODIFIABLE justification: a) current knowledge, are available technology to manage and the interventions problem b) community resources are available because they sell slippers c) The family has also resources to solve the problem because each has slippers to wear d) Health workers do not address this problem Preventive Potential The problem has a HIGH of PREVENTIVE 3/ 3 x 1 the following 1 POTENTIAL justifications: a) It's not that severe because no family member got a disease because of walking barefooted because because of the following 1.5 Computation Actual Score 0. 67

the It is a health threat because it doesn't need to 2/3x 1

b) It occurs for long periods of time now for Kyla because when she plays she doesn't like to wear slippers. c) Mrs. Josefa always reminds Kyla to wear her slippers whenever she goes out to play. d) Kyla can get hookworms because of walking barefooted Salience of the The family doesn't perceive it as a problem or 0/ 2 x 1 Problem Total score: does not need change. 3.17 0

11. Poor ventilation

Criteria Nature Problem Modifiability the Problem of of Justification lead to certain diseases The problem is considered to be PARTIALLY 1/ 2 x2 MODIFIABLE justification: a) current knowledge, are available technology to manage and the interventions problem b) community resources are available c) Family resources are not available d) Health workers do not address this problem Preventive Potential The problem has a NOT of PREVENTIVE 0.75/ 3 x 1 the following 0.25 POTENTIAL justifications: a) Problem is not severe because there's interventions which can be done b) It is occurring for how many years now c) The family prefers to close the windows due to the abundant flies and cold weather. d) This problem does not cause serious diseases to the family Salience of the It is scored as such because the family does not 0/ 2 x 1 Problem Total score: identify it as problem. 1.92 0 because because of the following 1 Computation Actual Score 0. 67

the It is considered as health threat because it can 2/3x 1

12. Illness state whether it is diagnosed or undiagnosed by a doctor: Hypertension

Criteria Nature Problem of Justification Josefa experiences dizziness and her blood pressure is 160/200 mmHg. Computation Actual Score 1

the The problem is classified as health deficit. Mrs. 3/3x 1

Modifiability the Problem

of

The problem is considered to be HIGHLY 2/ 2 x2 MODIFIABLE justification: a) current knowledge, are available technology to manage and the interventions problem b) Community resources are available such as stores that sell garlic, tomatoes and cabbage which can lower blood pressure c) Family resources are available such as medicines that lowers blood pressure. This is patient's stock. d) Mrs. Josefa was hospitalized in Abatan because of hypertension and the doctor prescribed her medications that helps in lowering blood pressure (She does not know the name of the medications.) Doctors and nurses are available in a certain hospital in Abatan that addresses the problem. because of the following

Preventive Potential

The problem has a MODERATE PREVENTIVE 1.5/ 3 x 1 POTENTIAL justifications: a) Problem is not severe because Mrs. Josefa always take her maintenance drugs. b) It is occurring for how many years now c) Mrs. Josefa is taking her medications on a regular basis and does not miss a dose. d) The problem does not still cause to more severe diseases. because of the following

0.5

Salience of the The family member is aware that it is a problem 2/ 2 x 1 Problem Total score: and needs immediate attention

1 4.5

LIST OF PRIORITIZED PROBLEMS

PRIORITIZED PROBLEMS

SCORE

1. Illness state whether it is diagnosed or undiagnosed by a doctor: Hypertension

4.5

2. Excessive intake of certain nutrients and lack 3.42 of intake of some important nutrients 3. Poor personal hygiene by some members of 3.42 the family 4. Walking barefoot by some members of the 3.17 family 5. Inadequate exercise of most members of the 2.92 family 6. Unsafe water for drinking and cooking insects 8. Presence of family history of hypertension 9. Improper garbage disposal 10. Poor ventilation hazard on the stairs 12. Pointed/Sharp objects improperly kept 1.67 1.92 1.92 1.92 2.67 7. Presence of breeding or resting sites of 1.92

11. Hazardous path beside the house and fall 1.67