I.

Introduction

Family, as defined by Encarta, is a group of people who are closely

related by birth, marriage or adoption, functioning as a single household, and
usually consisting of parents and their children. While on the other hand, a
family case analysis is a determination of the nature of a problem occurring
in families and implying some possible solutions about the problem, and to
analyze some observable cases of that particular family, who may be in need
of medical intervention and attention. And so, as student public health
nurses currently taking up HECA-101A, our assignment is to conduct family
case analyses on families residing in several Barangays in Olongapo City.

We were assigned to hold a family case analysis to one of the families

living in Old Cabalan, Olongapo City. As early as 8:00 in the morning, a day
so wet because of the rain brought by typhoon Hannah, the group, amidst
the bad weather, has decided to continue the trip down to Old Cabalan. The
trip will not mean an enjoyable one! Though can be tagged as an “enjoyable
journey” through adventures waiting for us – and we guess these may
include wet steep streets of slop 45◦, houses to look for, and the selection of
the right home for the right family case analysis.

And our guess was right, as we arrived at our destination, Sir Serano
introduced as to some Barangay staff, present there at Old Cabalan
Barangay hall. To look for the house of the right family is our first main task.
Old Cabalan is not just a four-cornered room-sized barangay. To find the right
family is not an easy task, but how lucky we are that as we walked to the
mountainous terrain of Old Cabalan, we found a humbled home consisting of
a hospitable family who are willing to cooperate for the task that we are
going to render.

II. Family Structure and Organization

Family Name: Omagap Family
Address: #2186 Narra Lane, Purok II Old Cabalan, Olongapo City

Family Data:
Length of residency: 1987
Family Size: 11

Religion:
Husband: Iglesia ni Cristo
Wife: Iglesia ni Cristo

Place of Origin:
Husband: Ilo-ilo
Wife: Leyte

Type of Family Structure: Patriarchal, Extended

General Family Relationship/Dynamic:

Criteria Yes No
1. Observable conflicts between Family Members
a. Wife Husband Beating √
b. Frequent quarreling √
c. Child abuse √
2. Characteristics of Communication
a. Open communication among family members √
b. Swearing or use of insults when talking to each
other √

The chart below represents the Family Structure of Mr. Omagap’s family.

Ag Se Civil Educational
Name e x Status Position Attainment Occupation
Construction
Ricardo 2nd year High Worker/
Omagap 49 M Married Father school Painter
Leoncia 1st year High Laundry
Omagap 45 F Married Mother school Woman
Leorilyn 4th year High Factory
Omagap 23 F Married Eldest school Worker
Richard Construction
Omagap 22 M Single 2nd Eldest 6th Grade Worker
 Mark Ron 1st year High
Omagap 21 M Single 3rd Eldest school
Maria Mae 2nd year High
Omagap 19 F Single 4th Eldest school
Maria Rica Live - 1st year High
Omagap 17 F in 5th Eldest school
Greggy Construction
Omagap 16 M Single 6th Eldest 6th Grade Worker
Dennis
Omagap 14 M Single 7th Eldest 6th Grade Snack Vendor
Mary Omagap 13 F Single 8th Eldest 6th Grade
Christian
Omagap 12 M Single Youngest 6th Grade
Jody Omagap 1 F Single Grandchild

The Omagap family, as any other basic unit of the society, is lead by a
responsible father personified by Mr. Ricardo Omagap. By definition, this
large family composed of twelve members, can be classified as patriarchal
for the main existing fact that most of the matters relating to the conclusive
judgment of the family such as health decisions, and everyday life decisions
are vested upon more to the authority of the father.

Mr. Ricardo and Mrs. Leonicia, at the age of 49 and 45 respectively, are
already grandparents to the child of their fifth sibling – Maria Rica Omagap,
17 – whose live-in partner does not live in the same residential address of
the family. But this situation could be tagged as “Extended”. It also fits the
criteria of an extended family, and can be classified under this category.
Maria Rica and her daughter Jody Omagap still reside in the home of the
Omagaps. Adding more spaces and seeking for support. While on the other
hand, the eldest sibling of the Omagap family, Lerylin, was already married
and that they have separated themselves from the family.

Although Mang Ricardo heads a family of many members, this large

number has not impeded the formation of a peaceful and organized family.
No observable conflict among family members, and that there are no
impaired communications nor there any communication – isolated cases
evident in some members. These were observed at the date and time of the
home visit.
III. Socioeconomic and Cultural factors

Monthly Family Income Source

Husband: Php 220 Wife: Php 300

Others: 2nd Eldest: Php 220, 6th Eldest: Php 220, 7th Eldest: Php 100

Total:
Below Php 5,000

Felt Family Needs:

1. Trabaho/ dagdag na kita
2. Gamot
3. Pagkain
4. Bahay

Though Mang Ricardo heads a family of twelve members including him,

this large number has not impeded the formation of a peaceful and
organized family. It is pretty obvious that because of the low education
attainment of all members, this unfortunate fate has resulted in a problem of
not having enough financial support for the family. And that the loss of a
permanent job for the legal-age members of the family is the main
consequence of that previous problem. As indicated in the table under the
topic family structure, characteristics and dynamics, only five members of
the family have their own jobs. Unfortunately, Leorilyn, the eldest sibling of
the family has already separated and now working as a factory worker for
her family. But even these jobs could not be considered as “jobs” for they are
not permanent; for they could not earn enough money to support the
physiological and basic needs of the family. Approximately, the average
monthly income of the family changes form less than or equal to Php 8,000
to less than or equal to Php 10,000. Mrs. Leoncia only earns Php 300/ week
from her laundry. Mang Ricardo on the other hand should earn Php 5280/
month if, and only if, he is a regular construction worker. The same is true
with his two sons. Unfortunately, this is not what is happening. The truth is,
they’re just few of the victims of the “not so good” system in the Philippines.

Financial resources problem is getting serious. It has resulted in chain

problems vested upon the loss of a job. “…gusto ko talaga number one ang
trabaho”, uttered by Mang Ricardo as we asked him about the top ten needs
of the family, a very smart answer to a question which most people would
definitely put financial needs on the number one spot. “Kung may trabaho
ka, magkakaroon ka ng pera at kung ano pa ang gugustuhin mo”, he
concluded.

IV. Home and Environmental Factors

House: Others: Caretaker

Type of Housing Material: Mixed

What appliances are owned by the family?
Television, Radio, Cellular phone

Type of Garbage Disposal: Collected

Type of Toilet Facility: Water sealed

Type of drainage system: Open

Source of Water Supply: Shared

Source of Drinking Water: Tap Water

Food Storage: Covered

Is there presence of breeding sites for Pests? Yes

What Common household pest is present in the household?

Cockroach, Rats, Lizards, Ants

Where does the family keep their pets? Household

Are there accident hazards present? Yes, stairs; whole structure of the house.

Kind of Neighborhood Urban

Social and Healthy Facilities Brgy. Center, Basketball Court,
Available Plaza
Facilities Jeepneys

Awareness of Community Organization

Are you aware of existing organizations in your community? No

Are you a member of any of these organizations? No

Name community members whom you think are able to lead the people

1. Kagawad Alba
2. Purok Leader
3. Manugang

As defined in Dorland’s Dictionary, 28th Edition, an environment is the

sum total of al conditions and elements which make up the surroundings and
influence the development and actions of an individual. Making this
definition as basis, the student public health nurses therefore foresee that
home and environmental factors reflects and greatly affects the health
condition of an individual and family living on a certain area.

The humble home of the Omagap family is located at # 2186 Nara

Lane, Purok II, Old Cabalan, Olongapo City. They have been residing at this
mixed type house structure made mostly of wood for almost twenty years.
Although they do not own the house and lot, and are named as caretakers, it
has been home to them for quite some time. A television, a radio and a
mobile phone are the appliances that they own which serve as their source
of leisure and fun when there are household chores to accomplish. As a
productive family, continuous waste disposal is frequent. They have
appropriate garbage receptacles and that garbage is being collected during
Wednesdays and Saturdays by garbage collectors. Their toilet facility is not
located inside the house. A water sealed toilet, no lighting and scarce
toiletries are all to be seen inside. Their drainage system is open, meaning to
say that the wastes which are being disposed by the family is directly open
to the external environment for there are no pipes conducting the wastes to
the proper disposal area. The water they are using for their daily use are not
owned by them, they are sharing water from their neighbor who is
subscribing to Subic water Inc. and like any other family living in that area,
they are using tap water as their daily source of drinking water. Despite the
fact that their home appliances are only a television, a radio and a mobile
phone, they have no appropriate means of food storage like a refrigerator.
Their only means of food storage are disposable plastic containers and
sometimes, they don’t even have a chance to store their food because they
just prepare food that is enough for the family in the span of a day. Pests
such as cockroaches, rats, lizards and ants obviously cannot be avoided, but
they have their cats to fight these health threatening pests. A lactating bitch
of nine puppies, named Punying, is present and has found a place beneath
the steep staircase of the house. The external environment is filled with a
small farm, some greenery and oxygen giving trees which is good for the
health. The sidewalks in the community are clean but are occasionally
present with dog feces and there are proper receptacles of garbage. The
neighborhood is very friendly to the family, and they have said that some of
them have helped during their times of shortcomings. The barangay health
center is just a few blocks away from the Omagap family’s home and a
doctor is present in the center only once a week, which may not be sufficient
to handle the health problems of the residents of Old Cabalan.

As student Public health nurses, assessment plats a big role in the

family case analysis for us to determine if some factors may be health
threatening. Accident hazards are present in their environment because of
the location of their house is on the foot of the mountain, which may be
prone to landslides and their house being old, materials are continuously
aging making the house’s foundation weak.
V. Health Assessment

Family Dietary Habits

Your Diet usually composes of?

Breakfast: Sinangag, Pandesal, Tuyo, Kape

Lunch: Talbos, Malunggay, Kanin
Supper: Same in Lunch sometimes

Family Health History

Name of Family Member Health History

Ricardo Omagap TB, Kidney Stone
Jody Omagap Bronchopneumonia

Health and Health Practices

Common Illness encountered for the last six months and treatment rendered
Illness Treatment
Colds Medicines; Herbal Medicines
Fever

Who do you consult for health related problems? Nurse

For problems other than health who do you consult? Relatives

Immunization Status of the Family

Family Member Type of Immunization
All family Members Complete Immunization

Do your family members have enough?

1. Rest and Sleep? Yes
If yes, how many hours/night? 8 hours

2. Exercise? Yes
If yes, what type of exercise? Lakad-lakad lang

3. Relaxation Activities? Yes

4. Stress Management activities? Yes

A. Present Illness

Name Problem Belief Medical Remarks

Attendance
Ricardo Untreated Prolonged Partial He had undergone
Omagap Tuberculosi Cough treatment but is was
s discontinued due to
economic problem
Jody Asthma, Allergies Partial Due to weather changes
Omagap cough and and from time to time, she
colds weather experience cough and
condition cold and wasn’t able to
cure well because of
lack of knowledge

B. Past Ilness

Name Problem Belief Medical Remarks

Attendance
Jody Bronchopneumoni Neglected With Treated
Omagap a perspiratio
n at the
back
Ricardo Kidney stone From salty With treated
Omagap Foods

C. Infant Feeding

All children experienced breastfeeding and also given milk through

bottle feeding when their mother is not around

D. Immunization Status

According to Ricardo, all of his children had completed the vaccines

during their infancy from the Barangay Health Center

VI. Awareness of Community Organization

As Iglesia ni Cristo members, the Omagap family isn’t aware of any

existing community organizations. They have told us that the reason that
they are not aware because organizations have a political influence which is
not allowed in their sect. although they have nothing against other
organizations, they just want to protect what they believe in. that is why, if
ever they are aware of any organizations, they would definitely not become a
member of it. But they are aware of the projects existing in their community,
but not of the organizations that have provided them.

VII. Values Attitudes, Beliefs and Practices

 As we approached the family, Mary, the second youngest welcomed us
with warmth and respect. Their father, Ricardo, accepted and cooperated
with us without hesitation. He even made us felt comfortable which shows
the hospitality of the Filipinos.

The members of the family are all Iglesia ni Cristo. They go to their
church twice a week and they are very religious. Their faith to God is the only
thing that they can be proud of. They also value education but because of
indigence, they can’t send all their children to school.

When one of the family members got sick, they don’t go to quack
doctors because it is against their religion. And because of poverty, they
can’t afford to go to doctors for check-up. They will just go to the ministers of
their church and will pray for the sick. They also use herbal medicine to cure
their illness.

Maybe because of an existing fact that the Omagap family has

acquired the values and traditions of becoming an Iglesia ni Cristo, a religion
which on the perception of many people has lived the strict compliance of
rules set by the most high authority of their church for the benefits of their
general members, one could almost say that this family is really a religious
unit of the society.

They knew the meaning of the word “samahan” (organization). They

knew that there are certain “samahan” existing in their barangay. Ask if they
knew the functions and purposes of the said organizations, they will give you
the sure yes! Ask for the specific names of those organizations, they will give
you an innocent answer, as if organizations were not existent. But ask if they
are affiliated with such organizations and that they are attending their
programs and activities, they will give you a very simple answer – “Bawal po
sa amin! May bahid po kasi ng pulitika ang mga samahan!” a proof of values
capacitated by the family.

VIII. Family Health Problem

Problem First Level Second level Assessment

Assessment
1. Cough and Cold Health Threat Failure to utilize community
resources for health due to lack
of or inadequate family
resources, specifically financial
resources such as cost of
medicine prescribed
2. Untreated Health Deficit Failure to utilize community
Tuberculosis resources for health due to lack
of or inadequate family
resources, specifically financial
resources such as cost of
medicine prescribed

3. Threat of cross Health Threat Inability to recognize the

infection from a presence of the condition or
communicable problem due to lack of or
disease case inadequate knowledge

4. Family size Health Threat Failure to utilize community

beyond what resources for health due to lack
family resources of or inadequate family
can adequately resources, specifically financial
provide resources such as cost of
medicine prescribed

5. Accident Health Threat Inability to provide a home/

hazards (fall environment conducive to health
hazards) maintenance and personal
development due to lack of
inadequate knowledge of
preventive measures and
inadequate family resources
specifically financial constraints/
limited financial resources
6. inadequate food Health Threat Failure to utilize community
intake both in resources for health due to lack
quality and of or inadequate family
quantity resources, specifically financial
resources such as cost of
medicine prescribed

7. Family eating Health Threat Failure to utilize community

habits resources for health due to lack
of or inadequate family
resources, specifically financial
resources such as cost of
medicine prescribed
8. Poor home/ Health Threat Inability to provide a home/
environmental environment conducive to health
condition/ maintenance and personal
sanitation development due to lack of skill
specifically in carrying out measures to
inadequate improve home environment and
living space inadequate family resources
specifically financial constraints/
limited financial resources.

9. Unhealthy Health Threat Inability to recognize the

lifestyle and presence of the condition or
personal habits/ problem due to attitude/
practices philosophy in life which hinders
specifically recognition/ acceptance of a
cigarette problem
smoking
10.Loss of Job Foreseeable Crisis Inability to make decisions with
respect to having appropriate
action due to feeling of
confusion, helplessness and/or
resignation brought about by
perceived magnitude/ severity of
the situation / problem

IX. Physical Assessment

Name: Ricardo Omagap

Age: 49 years old
Vital Signs: BP: 120/70 mmHg RR: 16cpm PR: 63 bpm Temp: 36.4 ° C
Skin: dry and wrinkled skin, brown complexion
Scalp: no infection or infestation
Hair: presence of alophecia, thin, smooth
Eyes: symmetrical, pinkish conjunctiva, normal ocular movement
Ears: symmetrical, color is same as facial skin, cerumen is dry
Nose: symmetrical, moist mucosa, presence of colds
Mouth: presence of cavities, incomplete number of teeth, dry oral mucosa,
brownish lips
Throat: no inflammation of tonsil and throat
Neck: neck muscles are equal in strength
Heart: heart sounds are audible with the use of stethoscope
Lungs: no adventitious sound
Extremities: body parts are proportioned with one another, no abnormalities

Name: Leonicia Omagap

Age: 45 years old
Vital Signs: BP: 130/90 mmHg RR: 15 cpm PR: 64 bpm Temp: 36.5° C
Skin: dry and wrinkled skin, brown in complexion
Scalp: presence of infestation
Hair: dry, thin
Eyes: symmetrical, pinkish conjunctiva, normal ocular movement
Ears: symmetrical, color is same as facial skin, cerumen is dry
Nose: symmetrical, no discharge, moist mucosa
Mouth: presence of cavities, dry oral mucosa
Throat: no inflammation of tonsil and throat
Neck: neck muscles are equal in strength
Heart: heart sounds are audible with stethoscope
Lungs: no adventitious sound
Extremities: body parts are in proportion with one another, no abnormalities

Name: Richard Omagap

Age: 22 years old
Vital Signs: BP: 120/80 mmHg RR: 17 cpm PR: 62 bpm Temp: 36.8° C
Skin: brown complexion
Scalp: no infection or infestation
Hair: dry
Eyes: symmetrical, pale conjunctiva, normal ocular movement
Ears: symmetrical, color is same as facial skin, dry cerumen
Nose: symmetrical, no discharge, moist mucosa
Mouth: presence of cavities
Throat: no inflammation of tonsil and throat
Neck: neck muscles are equal in strength
Heart: heart sounds are audible with the use of stethoscope
Lungs: no adventitious sound
Extremities: body parts are proportion with one another, no abnormalities

Name: Mark Ron Omagap

Age: 21 years old
Vital Signs: BP: 110/70 mmHg RR: 16 cpm PR: 62 cpm Temp: 36.7° C
Skin: brown complexion
Scalp: presence of infestation, dandruff
Hair: dry
Eyes: symmetrical, pinkish conjunctiva, normal ocular movement
Ears: symmetrical, color is same with facial skin, cerumen is dry
Nose: symmetrical, no discharge, moist mucosa
Mouth: presence of cavities
Throat: no inflammation of tonsil and throat
Neck: neck muscles are equal in strength
Heart: heart sounds are audible with the use of stethoscope
Lungs: no adventitious sound
Extremities: body parts are in proportion with one another, no abnormalities

Name: Maria May Omagap

Age: 19 years old
Vital Signs: BP: 100/70 mmHg RR: 17 pm PR: 75bpm Temp: 36.5° C
Skin: brown complexion
Scalp: no infection or infestation
Hair: dry
Eyes: symmetrical pinkish conjunctiva, normal ocular movement
Ears: symmetrical, color is same as facial skin, cerumen is dry
Nose: symmetrical, no discharge, moist mucosa
Mouth: presence of cavities
Throat: no inflammation of tonsils and throat
Neck: neck muscles are equal in strength
Heart: heart sounds are audible with stethoscope
Lungs: no adventitious sound
Extremities: body parts are in proportion with one another, no abnormalities

Name: Maria Rica Omapag

Age: 17 years old
Vital Signs: BP: 100/700 mmHg RR: 16 cpm PR: 74 bpm Temp: 36.4° C
Skin: brown complexion
Scalp: presence of infestation
Hair: dry
Eyes: symmetrical, pinkish conjunctiva, normal ocular movement
Ears: symmetrical, color same as facial skin, cerumen is dry
Nose: symmetrical, no discharge, moist mucosa
Mouth: presence of cavities, incomplete number of teeth
Throat: no inflammation of tonsils and throat
Neck: neck muscles are equal in strength
Heart: heart sounds are audible with the use of stethoscope
Lungs: no adventitious sound
Extremities: body parts are in proportion with one another, no abnormalities

Name: Dennis Omagap

Age: 14 years old
Vital Signs: BP: R110/70 mmHg RR: 17 cpm PR: 74 bpm Temp: 36.6° C
Skin: brown complexion
Scalp: presence of itchiness and lesion
Hair: dry
Eyes: symmetrical, pinkish conjunctiva, normal ocular movement
Ears: symmetrical, color is same as facial skin, cerumen is dry
Nose: symmetrical, no discharge, moist mucosa
Mouth: oral mucosa is moist and pink
Throat: no inflammation of tonsil and throat
Neck: neck muscles are equal in strength
Heart: heart sounds are audible with the use of stethoscope
Lungs: no adventitious sound
Extremities: body parts are in proportion with one another, no abnormalities

Name: Mary Omagap

Age: 13 years old
Vital Signs: BP: 110/70 mmHg RR: 17 cpm PR: 86 bpm Temp: 36.6° C
Skin: fair complexion, smooth
Scalp: presence of infestation
Hair: dry
Eyes: symmetrical, pinkish conjunctiva, normal ocular movement
Ears: symmetrical, color is same as facial skin, cerumen is dry
Nose: symmetrical, no discharge, moist mucosa
Mouth: presence of cavities
Throat: no inflammation of tonsil and throat
Neck: neck muscles are equal in strength
Heart: heart sounds are audible with the use of stethoscope
Lungs: no adventitious sound
Extremities: body parts are in proportion with one another, no abnormalities

Name: Christian Omagap

Age: 12 years old
Vital Signs: BP: 90/60 mmHg RR: 16 cpm PR: 58 bpm Temp: 36.4 ° C
Skin: brown complexion
Scalp: presence of infestation
Hair: smooth
Eyes: symmetrical, pinkish conjunctiva, normal ocular movement
Ears: symmetrical, color is same as facial skin, cerumen is dry
Nose: symmetrical, no discharge, moist mucosa
Mouth: presence of cavities, incomplete number of teeth
Throat: no inflammation of tonsil and throat
Neck: neck muscles are equal in strength
Heart: heart sounds are audible with the use of stethoscope
Lungs: no adventitious sound
Extremities: body parts are in proportion with one another, no abnormalities

X. Family Health Problem Prioritization

Accident Hazards (e.g. Fall Hazards)

Criteria Computation Total Score Justification
Nature of the 2/3 x 1 2/3 It is a health threat
Problem
Modifiability of 2/2 x 2 2 There are
the Problem interventions to
solve the problem.
Preventive 3/3 x 1 1 They can utilize
Potential preventive measures
to avoid this at
home.
Salience of the 0/2 x 1 0 The family do not
Problem see this as a problem
Total = 3 2/3

Threat of cross-infection from a communicable disease

Criteria Computation Total Score Justification
Nature of the 2/3 x 1 2/3 It is a health threat
Problem
Modifiability of 1/2 x 2 1 They can practice
the Problem health measures to
prevent the spread of
communicable
disease.
Preventive 2/3 x 1 2/3 There are
Potential interventions to
prevent the problem.
Salience of the 2/2 x 1 1 They recognize it as
Problem a problem that does
not need an
immediate attention
Total = 3 1/3

Inadequate food intake both in quantity and quality

Criteria Computation Total Score Justification
Nature of the 2/3 x 1 2/3 It is a health threat
Problem
Modifiability of ½x2 1 They can provide
the Problem somehow but still
lack.
Preventive 2/3 x 1 2/3 It can be prevented
Potential somehow but
resources are
limited.
Salience of the 2/2 x1 1 The family sees it as
Problem a problem that
requires immediate
attention.
Total = 3 1/3

Cigarette/Tobacco Smoking
Criteria Computation Total Score Justification
Nature of the 2/3 x 1 2/3 It is a health threat
Problem
Modifiability of 2/2 x 2 1 There are
the Problem interventions to
solve the problem.
Preventive 2/3 x 1 2/3 Smoking can be
Potential prevented even little
by little.
Salience of the 0/2 x 1 0 The father does not
Problem perceive it as a
problem.
Total = 3 1/3

Family Size beyond what family resource can adequately provide

Criteria Computation Total Score Justification
Nature of the 2/3 x 1 2/3 It is a health threat
Problem
Modifiability of 1/2 x 2 1 There are still more
the Problem alternative for food
sources that are
considered cheap but
nutritious.
Preventive 1/3 x 1 1/3 They cannot have a
Potential stable job.
Salience of the 2/2 x 1 1 The family perceives
Problem it as a problem
needing attention
Total = 3

Presence of Stress points / Foreseeable Crisis Situations - Loss of Job

Criteria Computation Total Score Justification
Nature of the 1/3 x 1 1/3 It is a foreseeable
Problem crisis.
Modifiability of 1/2 x 2 1 They can only apply
the Problem jobs that are
contractual.
Preventive 2/3 x 1 2/3 They cannot acquire
Potential a stable job because
of low educational
attainment.
Salience of the 2/2 x 1 1 The family perceives
Problem it as problem that
requires immediate
attention.
Total = 3

Poor environmental sanitation e.g. inadequate living space

Criteria Computation Total Score Justification
Nature of the 2/3 x 1 2/3 It is a health threat
Problem
Modifiability of 1/2 x 2 1 Some interventions
the Problem are available to solve
the problem.
Preventive 2/3 x 1 2/3 They have a big
Potential family size so it is
hard to prevent.
Salience of the 0/2 x 1 0 The family does not
Problem perceive it as
problem.
Total = 2 1/3