CENTRAL PHILIPPINE UNIVERSITY

COLLEGE OF NURSING

A Family Case Study

In Partial Fulfillment in related Learning Experience

Presented to:
Prof. Nenit S. Soldevilla
Clinical Instructor

Presented by:

Parto, Fanny Jane

Pasaquian, Kathryn
Pasaquian, Kimberly
Pasomanero, Anjeala
Pendilla, Dyza
Pendon, Regine
Perez, Frances Joei
Picana, Ledor
Pielago, Stephanie
Pillado, Kriziah

BSN – 2G
 Family Case Study

I. Initial Data Base

a. Family Structure Characteristics and Dynamic
Name Sex Age Members of the Household (Relationship
to the head of the Family)

Yakub Bakil Male Not mentioned Father (Head of the Family)

Sarfaina Bakil Female 14 Daughter

Nasri Bakil Male 3 Son

The Bakil Family is a typical nuclear type of a family consisting of the father, Mr. Yakub, who is a fisherman, the mother who is a full time housewife and their nine
children that includes Sarfaina, the eldest among them. The family was living at Eleven Islands, Zamboanga Peninsula.
Mr. Yakub has a hard time in terms of decision making whether to prioritize his children or their needs. Sarfaina tends to be responsible because of their life status. She
always cares for her siblings, especially to her 3 years old brother.
b. Socio-economic and Cultural Characteristics
Mr. Yakub had a hard time to get their daily needs because he works as a fisherman and their income depends on climate and how many fishes he gets. He experienced
discouragement because his three thousand pesos capital for agar-agar/seaweeds went to waste due to heat or el nino. Since Mr. Yakub has no stable income, they can’t even
afford to buy milk for their youngest child and their health was not given priority due to lack of money. Sarfaina and her siblings always find alternative ways to have money to
meet their needs to survive. They have a hard time going to school because they have to wait for their father to arrive and sell the fish for twenty-five pesos per tie. After they
finished their classes, they went to the nearby store to buy rice, coffee and sugar with the money they earned on selling the fishes. When their father has low income, they look for
“Kahanga”, a kind of shell on shore but they only got nine pieces of shells due to the high tied and they sell it in town for twenty pesos. Sarfaina as the eldest daughter already
knew their life situation since she was a child. She is 14 years of age however; she is still a grade four student because she stopped her school for four years when she was in third
grade. Their family are not a member of any social organization in the community nor an active member of catholic church.
 c. Home and Environment
The Bakil Family resides in one of Zamboanga’s Eleven Islands. The Family suffers from the absence of electricity, source of fresh water, schools and health centers.
Depends on one lamp as their source of light at night. Their house is made of nipa hut and light materials. There are breeding sites for mosquitos, flies and cockroaches. The supply
of water and water is adequate for them, they need to go to the mainland to get fresh water from the natural spring which they use for drinking and bathing. The overall
surrounding of the family is unhygienic and they are too expose to heat.
d. Health Status of each Family Member
Not stated
e. Values, Habits, Practices on Health Promotion, Maintenance and Disease Prevention
Their water supply which they use for bathing and drinking is brown in color and with the presence of moss. The food they consume is mostly “kamote kahoy” also known
as cassava. The children only drink coffee and water mixed with sugar since they can’t afford to buy milk.

II. First Level Assessment

a. Family size beyond what family resources can adequately provide – Health threat
b. Accident hazards
i. Fire hazards
ii. Fall hazards
iii. Transportation hazard
c. Faulty / unhealthy nutritional / eating habits or feeding techniques / practices - Health threat
i. Inadequate food intake both in quality and quantity
ii. Faulty eating habits
iii. Ineffective breastfeeding
d. Poor home / environmental condition/ sanitation - Health threat
i. inadequate living space
ii. lack of food storage facilities
iii. polluted water supply
iv. presence of breeding or resting sites of vectors of diseases
 v. improper garbage / refuse disposal
vi. unsanitary waste disposal
vii. poor lightning and ventilation
e. Unsanitary food handling and preparation - Health threat
i. Poor personal hygiene
f. Lack of immunization / inadequate immunization status specially of children - Health threat

III. Second Level Assessment

a. Family size beyond what family resources can adequately provide
i. Inability to provide a home environment conducive to health maintenance and personal development due to:
1. Inadequate family resources, specifically:
2. financial constraints / limited financial resources
b. Accident hazards
i. Inability to recognize the presence of the condition or problem due to:
1. Limited financial resources
c. Faulty / unhealthy nutritional / eating habits or feeding techniques / practices

i. Inability to recognize and understand the presence of a problem due to lack of :

1. Knowledge about the possible health impacts of their unhealthy habits and poor sanitary condition.

2. Family resources specifically the availability of basic necessities.

3. Knowledge of preventive measures Inability to make decisions with respect to taking appropriate health action due to:

d. Poor home / environmental condition/ sanitation

i. Inability to recognize the presence of the condition or problem due to:
1. Denial about its existence or severity as a result of fear of consequences of diagnosis of problem, specifically:
a. economic / cost implications
 ii. Inability to provide a home environment conducive to health maintenance and personal development due to:
1. Inadequate family resources, specifically:
2. financial constraints / limited financial resources
e. Unsanitary food handling and preparation
i. Inability to recognize the presence of the condition or problem due to:
1. Denial about its existence or severity as a result of fear of consequences of diagnosis of problem, specifically:
a. economic / cost implications

2. Attitude / philosophy in life which hinders recognition / acceptance of a problem

f. Unhealthy lifestyle and personal habits/practices such as poor hygiene and non-use of self-protection measures
i. Inability to provide a home environment conducive to health maintenance and personal development due to:
1. Inadequate family resources, specifically:
2. financial constraints / limited financial resources
IV. Family Coping Index

AREA SCALE JUSTIFICATION

Physical independence 5 There are no abnormalities in the family members' physical independence. There are no evident disabilities or disparities in each member's
ability to move and/or perform their ADL.

Therapeutic competence 3 The parents are aware of their therapeutic deficits. They are aware of their financial issues, which is the fundamental cause for not having or
following the proper process or treatment, having adequate appliances, and even enough clothes for the children.

Knowledge of health 3 Despite the fact that the father is aware of significant health issues, he does not consider them to be important. This could have a negative
condition impact on the members' lives, particularly the children.

Application of principles of 1 The family lacks proper hygiene practices. Yes, they take a bath every day, but just two dipper per family member, and their source of
general hygiene water, eating habits, and maintaining a healthy lifestyle are not carefully considered as much as they should be.

Health attitudes 1 Parents want to safeguard their children from damage as much as possible, but many lack the financial and information resources to provide
proper health care for their families.

Emotional competence 5 The family bravely face all the difficulties that they have encountered in their way of living. They stand still and keep going especially for
Sarfaina who never thought about giving up in school despite of their situation.

Family living 3 Each family member respect their individual relationship with one another. Decisions are mostly done by the father, which is respected by
all the family members. The family’s budget are quite insufficient that made the children needs to sell fishes which is given by their father
to be able to earn money for their allowance and go to school.

Physical environment 1 The house is in poor condition. It is made of light materials that might easily be blown by winds and destroyed by storms given that they
live in an island. They are prone to different hazards that might put their lives in danger. Their water storage is unsanitary because it came
from a small cave wherein the water that they fetch there is contaminated and a lot of moss where floating in the water. They have no
comfort rooms, they just take a bath outside just beside their house. The water they used for bath is also the same water for drinking that
might affect their health condition. Food storage is also scarce because all they have is kamoteng kahoy or cassava and they barely eat rice.

Use of community facilities 1 The island has no electricity and school. To be able to go to school, the children needs to paddle the boat for a couple of hours just to reach
their town where their school is located. And when nighttime comes, they are having a hard time studying because there is no electricity and
they only share one lamp. They also don’t have health centers which is necessary to check their health conditions and other medical
concerns.
V. Problem Prioritization

I. Family size beyond what family resources can adequately provide

Criteria Computation Score Justification
Nature of the condition or problem presented 2/3 x 1 0.67 This problem is a health threat.
Modifiability of the condition/problem 1/2 x 2 2 This problem is easily modifiable because it is lack of budget,
food(rice) water, household necessities and especially their
transportation.
Preventive potential 2/3 x 1 0.67 This can be prevented moderately because the family are living
beside the sea, they can find fish or seafood to eat and even sell later
on.
Salience 2/2 x 1 1 This problem needs an immediate help and attention since
their income can’t sustain of what they need and the living
space is inadequate to live, since it is far from mainland

Total score 3.34

II. Accident hazards such as fire hazards, pointed/sharp objects, and fall hazards
Criteria Computation Score Justification
Nature of the condition or problem presented 2/3 x 1 0.67 This problem is a health threat.

Modifiability of the condition/problem 1/2 x 2 1 The problem is defined as partially modifiable because they do
not have enough money, but this can still be renovated or
reconstructed when enough budget is provided.

Preventive potential 1/3 x 1 0.33 This problem has low preventive potential. Since they do not
have electricity, they just use one kerosene as their source of
light every evening when they study on the floor which can
possibly cause fire when mishandled. Knowing that their house
is made of just wood and leaves, this is highly hazardous.
 Salience 1/2 x 1 1 This problem does not need immediate attention because they
are adaptive to the environment and home they have. They are
careful enough to handle things like this but it is still
dangerous in the future and cause a great danger to them.

Total score 3

III. Faulty / unhealthy nutritional / eating habits or feeding techniques / practices such as inadequate food intake, faulty eating habits, and ineffective breastfeeding.
Criteria Computation Score Justification
Nature of the condition or problem presented 2/3 x 1 0.67 This problem is a health threat.

Modifiability of the condition/problem ½x2 1 This problem is partially modifiable because this problem
arose due to lack of budget, thus this can be solved with money.

Preventive potential 2/3 x 1 0.67 This can be prevented moderately since the family has access
to the sea where they can find fish or seafood to eat.

Salience 2/2 x 1 1 This problem needs immediate attention since it makes the
family members vulnerable to diseases and it is an everyday
practice. Food/water are mostly contaminated. They could not
acquire enough nutrients for growth and protection.

Total score 3.34

IV. Poor home/ environmental condition/ sanitation

Criteria Computation Score Justification
Nature of the condition or problem presented 2/3 x 1 0.67 This problem is a health threat.
Modifiability of the condition/problem ½x2 1 This problem can be partially modified because their
 environment could be changed, but not easily because of their
financial status.
Preventive potential 2/3 x 1 0.67 Despite being far, this can be moderately prevented when they
establish better materials and sanitation for their home.
Salience 2/2 x 1 1 This problem needs immediate attention because poor home
conditions could affect the overall well-being of a person most
especially in terms of health.
Total score 3.34

V. Unsanitary food handling and preparation

Criteria Computation Score Justification
Nature of the condition or problem presented 2/3 x 1 1.33 This problem is a health threat.

Modifiability of the condition/problem ½x2 1 The problem is defined as partially modifiable because the
family is aware of the problem. They know some ways of
disinfecting their utensils. More to that, they also do hand
washing although their water is not clean.
Preventive potential 1/3 x 1 0.33 The problem has low preventive potential because of limited
financial resources.
Salience 2/2 x 1 1 The problem is needing immediate action because it can
contribute to the risk of developing some illnesses and other
health problems.
Total score 3.67

VI. Unhealthy lifestyle and personal habits/practices such as poor hygiene and non-use of self-protection measures.

Criteria Computation Score Justification

Nature of the condition or problem 2/3 x 1 1.33 This problem is a health threat.
presented
 Modifiability of the condition/problem ½x2 1 The problem is partially modifiable since it could be fixed
through health teaching about hygiene education and proper
nutrition.

Preventive potential 1/3 x 1 0.33 The problem has low preventive potential because of limited
financial resources.

Salience 2/2 x 1 1 The problem is needing immediate action.

Total score 3.67

VI. Family Nursing Care Plan

Problem List
Problem Score

Family size beyond what family resources can adequately provide 3.34

Accident hazards such as fire hazards, pointed/sharp objects, and fall hazards 3.0

Poor home/ environmental condition/ sanitation 3.34

Unhealthy lifestyle and personal habits/practices such as poor hygiene and non-use of 3.67
self-protection measures.

Faulty / unhealthy nutritional / eating habits or feeding techniques / practices such as 3.67
inadequate food intake, faulty eating habits, and ineffective breastfeeding.

Unsanitary food handling and preparation 3.0

 Family Nursing Care Plan
Problem #1 Faulty / unhealthy nutritional / eating habits or feeding techniques / practices such as inadequate food intake, faulty eating habits, and ineffective breastfeeding.

Cues Health Family Nursing Objectives of Care Rationale Intervention Resources Method of Evaluation
Problem Problem Measures Required Nurse-Family
Contact

Subjective data: Faulty / Inability to recognize After 2 weeks of the Healthy 1. Proper Visual aids Home visits MET – After 2
“Asukal lang maam, unhealthy and understand the nursing intervention, nutritional education about for health weeks of nursing
chaka mainit na tubig” nutritional / presence of a problem the family will be able practices promote nutritional diet teaching intervention, the
eating habits due to lack of : to improve their prevention of and intake. family was able to
“Walang pambili ng or feeding nutritional intake and disease, have enough
gatas ang pamilya. Kung techniques / a. Knowledge about diet by the following: improvement, 2. Providing knowledge
the possible health Family and
hindi kape, tubig na may practices such maintenance and appropriate general nurse efforts regarding the proper
asukal ang iniinom ng as inadequate impacts of their a. Having enough thus, achieve the check-up for the food intake and
unhealthy habits and to address
mga bata” food intake, knowledge in the overall wellness whole family about the problem sanitation.
faulty eating poor sanitary proper food intake of the family. their health status. Demonstrating and
“Kadalasan kasi, habits, and condition. and sanitation performing effective
kamoteng kahoy ang ineffective 3. Guide the family breastfeeding was
b. Family resources b. Demonstrate and
kanilang kinakain” breastfeeding. in making also achieved for the
specifically the perform effective decisions with wellness of the
availability of basic breastfeeding
“ ‘Yan (tubig) lang ang respect to taking children. In
necessities.
maiinom naming maam, appropriate health addition, they also
kahit may lumot” c. Sufficient action. have sufficient
c. Knowledge of
awareness of the awareness in the
preventive measures
Objective Data: family in the 4. Proper sanitation appropriate eating
• Most of the appropriate eating of utensils used for habits and feeding
children looked habits and feeding eating. techniques with the
skinny. techniques proper health
• Their drinking teachings that was
water has moss and provided.
dirt, and an
unpleasant smell is
also present.
• Their food is
prepared on the
floor.
Problem #2 Unhealthy lifestyle and personal habits/practices such as poor hygiene and non-use of self-protection measures.

Cues Health Family Nursing Objectives of Care Rationale Intervention Resources Method of Evaluation
Problem Problem Measures Required Nurse-
Family
Contact

Subjective Data: Unhealthy Inability to After two weeks of A lifestyle Establish rapport, clean Money Home visit After two weeks they
lifestyle and provide a home nursing intervention, that is clean surroundings and health Partially met their
"Wala talaga dito na tubig personal environment the family will be and has teaching on having a Manpower nursing intervention.
Ma’am,meron lang tubig kong habits/practic conducive to able to improve their sufficient good hygiene practice The family was able to
es such as
umuulan maam, pero kong health living conditions by food Materials Improve their living
poor hygiene
walang ulan maam, kailangan and non-use
maintenance and having the following: storage to Educate the family to conditions by boiling
talagang kumuha ng tubig kasi of self- personal a. To improve supplement find a way to make an Source of the water before
wala naman kaming iinumin dito protection development due their proper nutrients improvised water filter drinking consuming it. The
maam" measures.. to: sanitation on water family was able to make
Inadequate family their drinking Educate the family an improvised water
"Yan din po iinumin namin resources, water regarding their proper filter with the use of
Ma’am kahit ganyan, wala kasi specifically: b. To improve sanitation on their sand, coal, stone and
kaming magagawa maam " financial their personal drinking water grass which then
constraints/limited hygiene improved their personal
"Kong sa inyo maam, madumi financial c. To improve Assess the family to hygiene by bathe
sa amin hindi sanay na kami resources. their innovate their canoe for regularly with a
mag inom na ganyan" transportation safety transportation sufficient amount of
access water to prevent the risk
Objective Data: d. To improve Assess the level of of any diseases. They
• Consumption of mucky their food understanding of the improved their canoe by
water intake family regarding to the fixing it using durable
• Poor sanitation problem by discussing materials. The family
• They take quick bath's to the problem to the was able to know the
conserve water family side effects of
• The canoe they use for consuming too much
transportation has holes in Discuss and educate sugar as an alternative
it the family that drinking for milk for the baby
• They use coffee and sugar of sugar is bad for the and to control the sugar
as an alternative for milk child’s health intake for their children.
• Lack of food supply