COMMUNITY HEALTH NURSING
Initial Data Base
A. Family Structure, Characteristics, and Dynamics
- Table 1. Types of family, dominant family members, name, sex, age, civil status, position in the family, place
and type of residence, and general family relationships and dynamics.
B. Socio-economic and cultural characteristics
- Table 2.1. Decision maker for allocation of money, occupation, place of work, income, and other sources of
income.
- Table 2.2. Basic Necessities
- Table 2.3 Monthly Expenses
- Table 2.4. Educational Attainment
- Table 2.5. Ethnicity Background and Religious Affiliation
- Table 2.7. Relationship of the Family to a Larger Community
C. Home and Environment
- Table 3.1. Adequacy of Living Space
- Table 3.2. Sleeping Arrangement
- Table 3.3. Presence of Breeding or Resting Sites of Vectors of Disease Like Mosquitos, Roaches, Flies,
Rodents, Etc.
- Table 3.4. Presence of Accident Hazards
- Table 3.5. Food Storage and Cooking Facilities
- Table 3.5. Food Storage and Cooking Facilities
- Table 3.6. Water Supply
- Table 3.7. Main Source of Water Supply
- Table 3.8. Distance of the Septic Tank from the Source of Water Supply (in meters if ground water)
- Table 3.9. Toilet Facility
- Table 3.10. Garbage/ Refuse Disposal
- Table 3.11. Drainage System
- Table 3.12. Animal Excreta
- Table 3.13. Household Waste
- Table 3.14. Kind of Neighborhood
- Table 3.15. Social and Health Facilities Available
- Table 3.16. Communication and Transportation Facilities
- Table 3.17. Participation of Community Activities
- Table 3.18. Recreational Activities/ Sports Activities
D. Health Status of each Family Member
Medical
- Table 4.1. Hospitalization
- Table 4.2. Consultation
- Table 4.3. Childhood Illnesses
- Table 4.4. Surgical History
- Table 4.5. Injuries/Accidents
- Table 4.6. OB/GYN History
- Table 4.8. Beliefs and Practices
Nutritional Assessment
- Table 5.1. Nutritional Assessment
- Table 5.2. Three-Day Diet Recall Meal
- Table 5.3.1 Risk Factors Assessment Form
Physical Assessment
- Table 6.1 Physical Assessment Form
E. Values, Habits, Practices on Health Promotion, Maintenance and Disease Prevention
- Table 7.1. Immunization Status (1 y/o and below & pregnant mother)
- Table 7.2. Smoking (Cigarette Consumption)
- Table 7.3. Alcohol Intake
- Table 7.4 Brushing of Teeth
- Table 7.5. Taking a Bath
- Table 7.6. Adequacy of Rest and Sleep, Exercise, Protective Measures, Relaxation and Stress Management
- Table 7.7. Preventive and Promotive Health Services
FAMILY COPING INDEX (After assessing the FAMILY)
- Provide a basis for estimating the nursing needs of a particular family.
- Rating is 1 (No Competence), 3 (Moderate Competence), 5 (Complete Competence)
- Coping capacity is rated not the problem
- It is the family and not the individual that is being rated.
- Rating is done after initial visits (2-3 visits) and another FCI at the end to evaluate the family.
- 9 areas to be assessed:
Physical Independence
Therapeutic Competence
Knowledge of Health Conditions
Application of the Principles of General Hygiene
Health Attitudes
Emotional Competence
Family Living
Physical Environment
Use of Community Facilities
FAMILY NURSING DIAGNOSIS
1st Level Assessment
- Presence of Health Threats, Health Deficits, and Foreseeable Crisis or Stress Point in the Family
A. Health Threats – conditions that are conductive to disease, accident or failure to realize one’s health potential.
1. Health history of specific condition/disease. Eg. Family history of diabetes.
2. Threat of cross infection from a communicable disease case.
3. Family size beyond what family resources can adequately provide.
4. Accident hazards
Broken stairs
Pointed/sharp objects, poisons and medicines improperly
Fire hazards
Fall hazard
5. Nutritional
Inadequate food intake both in quantity and quality
Excessive intake of certain nutrients
Faulty eating habits
6. Stress provoking factors
Strained marital relationships
Strained parent sibling relationship
Interpersonal conflict between family members
7. Poor environmental sanitation
Inadequate living space
Inadequate personal belongings and interests
Lack of food storage facilities
Polluted water supply
Presence of breeding places of insects and rodents
Improper garbage/ refuse disposal
Unsanitary drainage system
Poor lighting and ventilation
Noise pollution
Air pollution
8. Unsanitary food handling
9. Personal habits/practices
Frequent drinking of alcohol
Excessive smoking
Walking barefooted
Eating raw meat/fish
Poor personal hygiene
Self-medication
Use of dangerous drugs and narcotics
Sexual promiscuity
10. Inherent personal characteristics eg. Short temper
11. Health history which may precipitate/induce the occurrence of health deficit eg, previous history of difficult
labor.
12. Inappropriate role assumption eg. Child assuming mother’s role: father not assuming his role.
13. Lack of immunization/inadequate immunization status especially of children
14. Family disunity
Self-oriented behavior of member’s
Unresolved conflict of members
Intolerable disagreements
15. Others
B. Health Deficits – instances of failure in human maintenance
1. illness states, regardless whether it is diagnosed or undiagnosed by medical practitioner
2. failure to thrive/develop according to normal rate
3. disability arising from illness, whether transient/temporary (eg. Aphasia or temporary paralysis after CVA. Leg
amputation secondary to diabetes
C. Stress Points/Foreseeable Crisis Situations anticipated periods of unusual demand on the individual or family in
terms of adjustment/family resources.
1. Marriage
2. Pregnancy, labor, puerperium
3. Parenthood
4. Additional members-newborn, lodge
5. Abortion
6. Entrance at school
7. Adolescence
8. Loss of job
9. Death of a member
10. Resettlement in a new community
11. Illegitimacy
12. Others
2nd Level Assessment (Prudent Analysis)
How the Family address or consider the assessed problem in relation to their perception.
I. Inability to recognize the presence of a problem due to:
II. Inability to make decisions with respect to taking appropriate health action due to:
Inability to provide adequate nursing care to the sick disabled, dependent, or vulnerable/at risk members of the family
due to:
IV. Failure to utilize community resources for health care due to:
V. Inability to provide a home environment conducive to health maintenance and personal development due to:
Priority Setting (Determine the sequence in dealing with identified family needs and problems)
- Factors to consider:
Family Safety – life threatening situation is given top priority.
Family Perception – most urgent and or important.
Practicality – Nurse looks into existing resources and constraints together with the family.
- Crisis for determining priorities among health condition or problems
Nature of Condition or Problem Presented (Health Threats, HD, FC) – Nurse is the RATER
Modifiability – probability of success through intervention – Nurse and HW are the RATER
Preventive Potential – nature and magnitude of future problems that can be minimized or totally
prevented if intervention is done on the condition – Nurse is the Rater
Salience – family’s perception and evaluation of the condition or problem in terms of seriousness
and urgency of attention needed or family readiness. We let them recognize the problem. Nurse is
the Rater
- Scale – Weight and Score
Nature – 3,2,1,0 – 1
Modifiability – 2,1,0 – 2
Preventive Potential – 3,2,1 – 1
Salience – 2,1,0 – 1
- Divide the score by the highest possible score and multiply the weight.
- Highest score is 5
