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To provide a basis for estimating the nursing needs of a particular

Health Care Need

A family health care need is present when:

1. The family has a health problem with which they are unable to cope.
2. There is a reasonable likelihood that nursing will make a difference in
the in the familys ability to cope.

Relation to Coping Nursing Need:

COPING may be defined as dealing with problems associated with
health care with reasonable success.
When the family is unable to cope with one or another aspect of health
care, it may be said to have a coping deficit

Direction for Scaling

Two parts of the Coping index:
1. A point on the scale
2. A justification statement
The scale enables you to place the family in relation to their ability to
cope with the nine areas of family nursing at the time observed and as
you would expect it to be in 3 months or at the time of discharge if
nursing care were provided. Coping capacity is rated from 1 (totally
unable to manage this aspect of family care) to 5 (able to handle this
aspect of care without help from community sources). Check no
problem if the particular category is not relevant to the situation.
The justification consists of brief statement or phrases that explain
why you have rated the family as you have.

General Considerations

1. It is the coping capacity and not the underlying problem that is being
2. It is the family and not the individual that is being rated.
3. Rating should be done after 2-3 home visits when the nurse is more
acquainted with the family.
4. The scale is as follows:
o 0-2 or no competence
o 3-5 coping in some fashion but poorly
o 6-8 moderately competent
o 9 fairly competent
5. Justification- a brief statement that explains why you have rated the
family as you have. These statements should be expressed in terms of
behavior of observable facts. Example: Family nutrition includes basic
4 rather than good diet.
6. Terminal rating is done at the end of the given period of time. This
enables the nurse to see progress the family has made in their
competence; whether the prognosis was reasonable; and whether the
family needs further nursing service and where emphasis should be

Scaling Cues

The following descriptive statements are cues to help you as you rate
family coping. They are limited to three points 1 or no competence,
3 for moderate competence and 5 for complete competence.

Areas to Be Assessed

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 Departments services