TABLE OF CONTENTS

I. INTRODUCTION

II. OBJECTIVES

III. NARRATIVE REPORT

IV. RECORDS AND REPORTS

V. RECOMMENDATION

VI. BIOGRAPHY

VII. PROBLEMS IDENTIFIED ACCORDING TO PRIORITY

VIII. FAMILY CARE PLAN

I. Introduction

The community is an important part of a person's life, technically it is defined as a social

group determined by geographic boundaries and or common values and interest where its
members know and interact with each other, functions with in a particular structure and exhibits
and creates norms, values and social interactions. By the definition alone, a community is
fundamental in forming a persons values and beliefs. It is where he learns and interacts. It is
often said that nobody is an island and nobody stands alone, a community is also a place where
you can find refuge when you are in need. Through the community, a person can learn different
lessons that are essential in life. Community health nursing is important mainly because its focus
is on the prevention of disease and promotion of health, but in order to do this we must not only
venture into the community, we should also get to know the people who are living in it and they
are none other than the family.

The family is one of the strongest influence that a person can find. It is where he first
learns, interacts and feel accepted. As popularly defined, the family is the basic unit of the
society, without the family, the society's social structure would be in disarray. In order to assess
the family correctly we must know them well. A family, though it may not be as big as a
community has also its own structure and complexities. The most popular kind of family is the
nuclear family. It is usually composed of the parents and the children but here in our country as
tightly knit as we are with our families the other kind of family which is the extended family is
also very common. It is also usually composed of the parents and the children but this time
grandparents or other relatives can also be found living in the same household. As the society
and people progress more and more kinds of families are also included in the list. The types of
families in today's society includes single-parent family, adolescent family wherein the parents
are still in the adolescent stage, foster family and Gay and Lesbian Family. These are just some
of the recent types of families but one can see the evolution of the society.

Community Health Nursing as defined by Ruth Freeman is a service rendered by a

professional nurse and community groups, families and individuals at home, health centers,
clinics, schools, places of work for the promotion of health, prevention of illness, care of the sick
at home and rehabilitation. Community Health Nursing is very important due to the fact that it
promotes health in the individual and family level. Though this diseases can be avoided and
proper health teaching and education can be given to the people. Through CHN we can have the
knowledge of the different subsystems that are present in the community, we can also know the
factors that would make the community a health place to live. CHN is also very important in
terms of awakening the students view of the society and its problems, through CHN students can
be made aware of the different social, political and health issues that are present in the country.
They can experience first hand the hardships of the common people and they can understand the
sentiments of their countrymen who are not as fortunate compared to them. CHN does not only
allow the students to see the negative side of things, it also allows them to see the positive and
the optimism of the people. Despite the hardships and the poverty that we are experiencing,
people in the community are still thankful for the blessings that they continue to receive even
though how small those blessings may be. Students can also see that people are still ready to help
each other in times of need and crises.

The Family Case Study is an important tool in delivering efficient care to the client
because it helps the nurse assess the family's health status, the current or potential health
problems and it also helps the nurse in finding solutions to the identified problems. It is a
systematic way for the nurse to prioritize the problems as well as the solutions. It is also a tool
for the student to have an in-depth knowledge of the family and its condition, in knowing the
family the nurse will also know the community and its other inhabitants.
II. Objectives

A. General Objectives

After two days of nurse-client interaction the student nurse will be able to:

• Apply the knowledge learned in assessing family health status and prioritizing of the
family health problems for promotion of health and disease prevention.

B. Specific Objectives

After two days of nurse-client interaction the student nurse will be able to:

• Assess the condition of the family

• Determine and prioritize the family health problems

• Formulate nursing care plan of the prioritized problem

• Conduct health teaching to promote health and wellness

III. Narrative Report

A. Family Structure and Characteristics

The family has six members: The father, two children and three grandchildren. The father
Mr. Edgardo Samulde is 63 years old and is a rice and sugarcane miller, he is the head of the
family and he works hand in hand with his two daughters to meet the family's needs. Mrs. Mercy
Samulde has already passed away last Sept. 29, 2009 leaving Mr. Edgardo Samulde, their two
daughters and three grandchildren at home. Originally they have seven children but five of them
are not living in the house or are abroad. The family has a very close relationship with one
another and has good and open communication.

The eldest of the two daughters is Ms. Bebelyn 36 years old, is a college graduate at one
of the schools in Bacolod, she is already married and currently residing in Manila but is at home
for already several months to take care of Mrs. Samulde when she was still alive, she is still
unable to go back to Manila because she is looking after their father. The other daughter is Ms.
Marites 32 years old, also a college graduate and also married. She has one daughter named
Princess who is three years old and is also a resident of the house. The other grandchildren are
Miracle, she is studying at St. Michael's School and is 14 years old and Miggy who is studying
at Calvary School and is 9 years old. They grandchildren has a very good relationship with one
another, whenever Ms. Marites is doing something the older children often take care of Princess.

My clients have their own house situated near the mother of Mrs. Mercy Samulde. Mr.
Edgardo Samulde is a high school graduate and so is Mrs. Mercy Samulde. My client's
relationship with her father, sister, nieces and nephew is generally good. They help one another
in the chores and they know their roles and functions in the family. When it comes to health
matters they often consult the doctor in the Rural Health Unit in the town proper. They are very
sensitive when it comes to their health and they depend very much on the services of the doctor.

B. Socioeconomic and Cultural Factors

As mentioned earlier Mr. Samulde is a rice and sugarcane miller, he also owns trucks and
domestic animals, he is a High school graduate and he works for the family. Ms. Bebelyn and
Ms. Marites are however without a job and is dependent on their father and their respective
husbands, they are in charged on the upkeep of the house. The family also has a sari-sari store
which is another source of income for them. The income of the family is sufficient to meet the
needs of each of its members. The children also has no problem in terms of their schooling
because they are enrolled in good schools and the tuitions are paid for by their respective parents
who are abroad or in Manila. As I have observed the family is the only family in the community
who owns a private vehicle (Multicab).
Mr. Edgardo Samulde is active in the community and was in fact one of the kagawads
before, however his daughters are not as active and they are often just in the house and keep to
themselves. This is due mainly to the fact that they have just returned to Canroma a couple of
months ago after years of being away from home.

C. Environmental Factors

The environenment is a detrimental factor in the health of the family, by assessing the
environment around the family and the community the nurse can then assess the potential
hazards to the clients. My client is very particular when it comes to their surrounding, the front
yard is always clean and free of any garbage. Inside the house they have adequate furnitures, the
house is also adorned with different decors coming from several countries that the children has
worked on. They also have a lot of family pictures. Unlike some in the community who get their
water from the nearby artesian well, the family has their own artesian well in their backyard and
that is there primary source of water. Their backyard is a bit unruly because they have a lot of
plants in their and it is a bit congested, it is also where you can find the toilet which is made up
of concrete and is separated from the house, it is a manual flush toilet and it is generally clean
and sanitary.

The community is spacious and the houses have moderate proximity with another, they
are also near the “kampo” and mosquitoes and flies are often a problem. Most of the houses are
made with concrete but a fair number of houses are also made of wood or a mixture of both.

As to different services in the community such as health facilities, they do not avail of it
very much since they go to Bacolod City for check up whenever they are sick. My client's
communication facilities are adequate because even though they don't have landlines they own
cellphones, they also have a television set and radio. My client also knows how to use the
internet and makes use of it in the town proper whenever the need arise.

They have their own vehicle at home so transportation is no problem for them, however
they still ensue the services of the tricycle whenever they need to go to the town proper. Even if
they have their own vehicle they also still make use of the jeepneys and bus to go to Bacolod or
La Carlota.

D. Health Assessment of each member

A person cannot function properly if he is unhealthy, that is why health is a very

important aspect of one's life. We must always do our best to achieve the optimal health possible.
Through health, we can do our responsibilities with ease, it can also enable us to live our life
fully. If we are healthy, we can be productive productive citizens and be of help to our family and
our society.

In line with this, it is very important to assess the family's health status because through
proper assessment we can determine health problems and the steps on how to address them.
During our community exposures we, the student nurses are given the chance to interact with our
clients, we are also given the chance to observe their health practices and interview them about
it. Health management in the family is done by using simple remedies. They also believe in
alternative and contemporary medicine such as “hilot”, herbal plants and liniments. Self-
medication is observed in the family and they go to the doctor whenever the condition has
worsened or persisted for a time.

Mr. Samulde is a fairly healthy adult. He is still very active in work and is often out of the
house. However he has one major health threat: he is a smoker, he started smoking when he was
still young.

Ms. Marites and Bebelyn are also healthy adults, they practice good personal hygiene and
are active in terms of taking care of the house and the family. They only get minor illnesses such
as fever, cough and colds.

Miracle and Miggy are also healthy, they are active children in school and at home.
Princess is also generally health although she has a condition called G6PD. Through the proper
care of her mother Ms. Marites, she is not suffering from any complications and her condition,
food intake and medicines are carefully monitored.

The family's diet generally consist of rice and a viand which is often vegetables. They eat
an average of three meals a day, not including the in between meals.

IV. Records and Reports

1. Home Visit Records

2. Health teaching

V. Recommendation

Trust and cooperation is very important in conducting this study. Through the interaction
I had with my client I was able to acquire information that helped me identify and prioritize the
problems of the family. Through the knowledge that I have acquired I was also able to think of
ways to minimize, if not, solve them.

As to the family involved in the study, family members (especially adults) should further
take note of the following:

• Adults in the house must encourage the head of the household to cease smoking as this
may affect the over all health status of every member of the household especially the
children.

• Environmental sanitation must always be done in the backyard in order to avoid further
proliferation of rodents and insects' breeding places.

• Parent should continue monitoring the youngest child in the house especially in her
intake of food and medication to avoid complication due to G6PD

• Balanced diet must always be observed

• Proper lighting and ventilation must be observed especially in the back portion of the
house so as to avoid accidents and further health problems
Smoking of Cigarette

Criteria
1. Nature of the Problem 2/3 x 1 2/3
Health Threat
2. Modifiability of the 1/2 x 2 1
Problem
Partially Modifiable
3. Preventive Potential 3/3 x 1 1
High
4. Salience 1/2 x 1 1/2
A problem not needing
immediate attention
Total 3 1/6

Presence of breeding places of insects and rodents

Criteria
1. Nature of the Problem 2/3 x 1 2/3
Health threat
2. Modifiability of the 2/2 x2 2
Problem
Easily Modifiable
3. Preventive Potential 3/3 x 1 1
High
4. Salience 1/2 x 1 1/2
A problem not needing
immediate attention
Total 4 1/6

Death of a Member

Criteria
1. Nature of the Problem 1/3 x 1 1/3
Foreseeable crisis
2. Modifiability of the 0 0
Problem
Not modifiable
3. Preventive Potential 1/3 x 1 1/3
Low
4. Salience 0 0
 Not perceived as a problem
Total 2/3

Poor lighting and Ventilation

Criteria
1. Nature of the Problem 2/3 x 1 2/3
Health Threat
2. Modifiability of the 1/2x 2 1
Problem
Partially Modifiable
3. Preventive Potential 2/3 x 1 2/3
Moderate
4. Salience 0 0
Not perceived as a problem
Total 2 1/3

Family History of Cancer

Criteria
1. Nature of the Problem 2/3 x 1 2/3
Health Threat
2. Modifiability of the 1/2x 2 1
Problem
Partially Modifiable
3. Preventive Potential 3/3 x 1 1
High
4. Salience 1/ 2 x 1 1/2
A problem not needing
immediate attention
Total 3 1/6
Prioritized Problem: Presence of breeding places of insects and rodents

Criteria Computatio Justification Method Resources Required

n
1. Nature of 2/3 x 1 = 2/3 It is a health threat -Family - Time and effort of
the Problem needing proper Interview student nurse
management so that
Health future problems can
threat be minimized, if not - Assistance from
eradicated. the following:
2. 2/2 x2 = 2 The resources and - Home Visit
Modifiabilit interventions needed
y of the to solve the problem - Clinical instructor
Problem are available to the
family
Easily - Practicing clinical
Modifiable -Health instructor
Teaching
3. Preventive 3/3 x 1 = 1 The possible
Potential diseases arising form - Family members
rodents and insects
High can be eliminated if
interventions can be
done as early as
possible
4. Salience 1/2 x 1 = 1/2 The family see it as a
problem, they often
A problem mention it to the
not needing nurse however
immediate household members
attention are often

Total 4 1/6
Family Case
Study

Prepared By:
Charmaigne Anne B. Bajada
BSN3D

Submitted To:
Ms. Deborah Tejam