Exploring Health Problems in The Household: The Case of Family A

EXPLORING HEALTH PROBLEMS IN THE HOUSEHOLD:
THE CASE OF FAMILY A.
A capstone project
presented to
the faculty of the Senior High School
Congressional Integrated High School
City of Dasmariñas, Cavite
In partial fulfillment
of the requirements for graduation
KADYMARS G. JABONERO
SIMON TIMOTHY SECRETARIO
April 2018
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Republic of the Philippines

Department of Education
Region IV-A (CALABARZON)
City Schools Division of Dasmariñas
CONGRESSIONAL INTEGRATED HIGH SCHOOL
Via Verde Village, San Agustin II, City of Dasmariñas, Cavite
 (046) 973-2534
Senior High School

APPROVAL SHEET
This capstone project entitled “EXPLORING HEALTH PROBLEMS IN THE

HOUSEHOLD: THE CASE OF FAMILY A.” prepared and submitted by KADYMARS G.
JABONERO and SIMON TIMOTHY SECRETARIO, has been reviewed and recommended
as a partial fulfillment of the requirements for graduation in Congressional Integrated High School.
JEFFREY A. LUCERO, MPMG, MAEd, MAN, RN, CSE, SHNC, CHNS, FNP, FRIN, FRIEdr, FIIER
Research Adviser
Date: April 3, 2018
Accepted and recommended by the class adviser and the subject group head for Science,
Technology, Engineering, and Mathematics (STEM) following a successful oral presentation on
22 March 2018.
MARIAN S. PENALES, MSc, LPT ADELMA S. TOPACIO, MAT, LPT

Class Adviser Subject Group Head
Date: April 3, 2018 Date: April 3, 2018
Accepted and approved in partial fulfillment of the requirements for graduation.
JOSEFINA A. BRIÑAS, MAEd, LPT

Principal IV
Date: April 3, 2018
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ACKNOWLEDGEMENT
The researchers would like to express their deepest gratitude and appreciation to the
following people who made the completion of this study possible.
First of all, they would like to express their sincere gratitude to the expertise of Professor
Jeffrey A. Lucero, their beloved research adviser who was very helpful and offered invaluable
assistance, guidance and support for them to fully understand and finish the study. He has
imparted sufficient knowledge for them to learn and he always ensure that they understand
everything before they apply the information in their research study;
To Mrs. Josefina A. Briñas, for allowing the research to be conducted and for being
supportive to the congressionalians on striving for excellence;
To Mrs. Marian S. Penales, STEM 12-1 adviser, for the guidance and motherly care that
paved the way for inspiring the researchers to be better each day;
To the supportive families of the researchers, who were always there to support and always
give encouragement to do their task better for supporting them in their financial constraints in
paying all the cost required to finish the paper;
To the friends and classmates of the researchers, who always guided them on their task and
provided the researchers pieces of information on what are the things they should do to make this
research;
Most of all, God, for His wisdom, guidance and love to finish this task on time.
KADYMARS G. JABONERO
SIMON TIMOTHY SECRETARIO
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TABLE OF CONTENTS
Page
APPROVAL SHEET ...................................................................................................................... ii
ACKNOWLEDGEMENTS ............................................................................................................ ii
LIST OF APPENDICES .............................................................................................................. viii
LIST OF FIGURES .................................................................................................................... viiii
LIST OF TABLES ......................................................................................................................... ix
ABSTRACT .................................................................................................................................... x
Chapter I: THE PROBLEM AND ITS BACKGROUND ...................................................... 11

Introduction ............................................................................................................................... 11
Statement of the Problem .......................................................................................................... 12
Scope and Delimitation of the Study ........................................................................................ 12
Significance of the Study .......................................................................................................... 13
Chapter II THEORETICAL FRAMEWORK ......................................................................... 14

Related Literature...................................................................................................................... 14
Family………………………………………………………………………………………14
Functions of the Family………………………………………………………………….....15
Health Tasks of the Family…………………………………………………………………16
Family Health Assessment……….…………………………………………………………16
Family as Health Support System……...……………………………………………………16
Related Studies.......................................................................................................................... 21
Synthesis of RRL ...................................................................................................................... 24
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Theoretical Framework ............................................................................................................. 26
Conceptual Framework ............................................................................................................. 26
Definition of Terms................................................................................................................... 28
Chapter III METHODOLOGY................................................................................................. 28

Research Design........................................................................................................................ 29
The Sample ................................................................................Error! Bookmark not defined.
Research Instrument.................................................................................................................. 30
Data Gathering Procedure ......................................................................................................... 31
Data Analysis ............................................................................................................................ 32
Chapter IV RESULTS AND DISCUSSION............................................................................. 34

Profile of the Key Informant’s Household................................................................................ 34
Family Health Assessment tool .................................................................................. 34
Gordon’s Functional Assessment ............................................................................... 40
The Health Related Problems Present in the Household .......................................................... 34
Inability to Take Vitamins .....................................................Error! Bookmark not defined.
Unsanitary Water Supply ...................................................................................................... 46
Unsanitary Drinking Water ................................................................................................... 47
Poor Outdoor Environmental Condition ............................................................................... 48
Poor Indoor Environmental Condition.................................................................................. 49
Proposed Interventions for the Identified Health Related Problems of the Household ............ 50
Care Plan for Inability to Take Vitamins .............................................................................. 51
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Care Plan for Unsanitary Water Supply................................................................................ 51
Care Plan for Unsanitary Drinking Water ............................................................................ 53
Care Plan for Poor Outdoor Environmental Condition......................................................... 54
Care Plan for Poor Indoor Environmental Condition ........................................................... 55
Chapter V SUMMARY, CONCLUSIONS, AND RECOMMENDATIONS ........................ 55

Summary ................................................................................................................................... 56
Conclusion ................................................................................................................................ 58
Recommendation ...................................................................................................................... 61
REFERENCES ............................................................................................................................ 64
APPENDICES ............................................................................................................................. 65
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LIST OF APPENDICES
Appendix Page
A Transcript of the Interview…………………………………………… 66
B Research Instruments………………………………………………… 69
C Twenty Health Related Problems……………………………………. 73
D Ishikawa Diagram……………………………………………………. 83
E Certification of the English Critic……………………………………. 88
F Curriculum Vitae of Kadymars G. Jabonero…………………………. 89
G Curriculum Vitae of Simon Timothy Secretario……………………… 90
H Documentation…………………...……………………………………… 91
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LIST OF FIGURES
Figure Page
1 The Assessment Phase in Family Health Nursing Practice:

The Critical Thinking Approach………………………………… 26
2 The Conceptual Framework…………………………………………….. 27
3 The Phases of The Data Gathering……………………………………… 31
4 Data Gathering …………………...……………………………………… 91
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LIST OF TABLES
Table Page
1 Prioritizing Health Problems…………………………………………….. 34
2 Demographic Data of the Household…………………………………..... 35
3 Top Five Priority Health Problem……………………………………….. 45
4 Inability to take Vitamins ……………………………………………….. 46
5 Poor Home Sanitation: Unsanitary Water Supply ………………………. 47
6 Poor Home Sanitation: Unsanitary Drinking Water …………………….. 48
7 Poor Outdoor Environmental Condition ………………………………… 49
8 Poor Indoor Environmental Condition ………………………………….. 50
9 Care Plan for Inability to take Vitamins ………………………..……….. 51
10 Care Plan for Poor Home Sanitation: Unsanitary Water Supply ………... 52
11 Care Plan for Poor Home Sanitation: Unsanitary Drinking Water ……….. 53
12 Care Plan for Poor Outdoor Environmental Condition ………………….. 54
13 Care Plan for Poor Indoor Environmental Condition…………………….. 55
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EXPLORING HEALTH PROBLEMS IN THE HOUSEHOLD:

THE CASE OF FAMILY A.
1 SIMON TIMOTHY SECRETARIO and KADYMARS G. JABONERO

2JEFFREY A. LUCERO, MPMG, MAEd, MAN, BScN, AHScEd, CSE, RN, SHC, FRIN, FRIEdr, FIIER
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Researchers, 2Research Adviser
Congressional Integrated High School
ABSTRACT
Every family, considering their profile and specific condition, have potential and existing health
related problems that are a must to be resolved. That is why this study entitled “Family Health
Assessment: The Case of Family A” was conducted. This study aimed to assess the health of a
family living in the community of South Crest Village, San Agustin II, Dasmariñas, Cavite. This
further examines and acquires an in depth understanding and investigation with regards to the
family’s views and actions when dealing with these health related problems as well as life
struggles. The researchers aimed to identify health related problems and to carefully formulate an
intervention well suited for these problems. Through the interference of the researchers, the family
was able to resolve these health problems and gain a positive outlook towards healthy living and
problem facing. This study is a qualitative case study since it is an in-depth and detailed evaluation
of the health problems of the family. This study seeks to further study the family’s current status
in terms of health by identifying and addressing these health problems. The key informants of this
study is a family consisting five family members: a couple with three children. Gordon’s Health
Functional Assessment and Family Health Assessment Tool were used by the researchers to attain
the profile of the family itself. The data gathering procedure conducted by the researchers was an
audio recorded interview where open-ended questions were asked. These data gathered were then
analysed through transcription and thematic analysis. The prioritized problems identified in the
household are: Inability to take vitamins; Unsanitary water supply; Unsanitary drinking water;
Poor outdoor environmental condition; and Poor indoor environmental condition. These five
health related problems were then attended by the researchers with the appropriate interventions
to be made created through a care plan.
Keywords: Nursing Care Plan, Family Health Assessment, Gordon’s Functional Assessment
Type of Research: Case Study
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Chapter I:
THE PROBLEM AND ITS BACKGROUND
Introduction
Family is the basic unit of a community. According to Cherlin (2008), it is composed of a
male and a female being molded to be as one, working hand in hand to have a good atmosphere
among the family members. Family usually consists of parents and their children, live in the same
household, share a common emotional bond, and perform certain interrelated social tasks.
According to Allender and Spradley (2008), family is a source of emotional support, comfort,
warmth, nurturing, protection and as well as security.
Every family is unique. Healthcare providers like nurses that are exposed to the community
learn how to interact and adapt to the different kind of people living in a community. It is in the
family who develop health values, beliefs and practices. Family influences the health and activities
of their member (Chen, Shiao, & Gau, 2007). With this, it is important that families in the
community are aware of the things and practices pertaining to their health.
The aim of this research was to apply the knowledge of family health nursing through case
a study. Conducting a case study is a way where researchers improve and apply all the concepts.
It is a tool in determining the health status of family through assessment and critical inspection
because of this, health related problems are identified which gives an indication to researchers on
how to intervene just to give a holistic care and improve the deficiency. (McLeod, 2008).
The researchers had chosen one household among the clients that they have interviewed
and monitored during the process of community health assessment. The family that was chosen is
a picture of the majority of the family here in our country: a family living in a poor environmental
condition without enough resources and lack of knowledge on vital health information and also
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experiences socio – economic related problems. Tiring as it is but reaching out to this family and
mingling with them makes the researcher feel the sense of fulfillment as they share knowledge,
skills and time to support in uplifting the condition of family. Also, it enabled the researchers from
STEM 12-1 in Congressional National High School, to identify the health problems that subsist in
the family and formulated a plan on how to intervene and provide holistic care to address such
family’s health status through critical evaluation.
Statement of the Problem
Generally, the study attempted to assess the health of the chosen family which is the case of
Family A, resident in South Crest Village Dasmariñas City.
Specifically, the study aimed to answer the following questions:
1. What is the profile of the key informants using the following assessment tools:
a. Family Health Assessment Tool and
b. Gordon’s Functional Assessment?
2. What are the health-related problems present in the household?
3. What are the interventions that could be done to address the identified health related
problems in the household?
Scope and Delimitation of the Study
This study focused on determining and evaluating the health problems only on one family,
specifically the Family A. The health problems’ objective and subjective cues were determined in
all 20 health problems discovered to be present in the family yet only 5 main problems were further
discussed with regards to its causes and solutions. The responses of the family were not limited
making their statements all valid and all a source of further analyzation. Furthermore, the solutions
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they have been doing to resolve these health problems were only the solutions they have been
practicing on their household alone. The health problems and ways of coping of the neighbors of
Family A were not included in this study. Also, health problems in the community as a whole were
disregarded by the researchers and focused only on the health problems of Family A alone.
Significance of the Study
The results of this study can benefit families by knowing the common health problems
encountered in a family, and the correct ways of coping with them. It was lead them to a wider
perspective in terms of family health problems and thus, proper knowledge was imparted.
Furthermore, the results of this study contributed to the information of the health authorities in the
community where the family belongs that lead in attending to their community’s family health
problems. In addition, the family that was studied now had a better chance of having their health
problems attended and resolved properly with the assistance of the health authorities.
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Chapter II
THEORETICAL FRAMEWORK
This chapter showed how did the researchers come up with the proper theoretical
framework and it was because of the read literatures and studies by the researchers which helped
to determine how the research would be done.
2.1 Related Literature
Family
Family is defined as a fundamental social group in society typically consisting of one or two
parents and their children. There are two or more people who share goals and values, have long-
term commitments to one another and reside usually in the same dwelling. (Blessing, 2017).
According to study.com they reveal a point that the family is the primary way to raise children.
The family introduces people to cultural norms, social behavior, education, group interactions,
morals, and pretty much everything else that we can think of. The family also enforces cultural
and social rules and morals by teaching the principle that every action has consequences; break a
rule, get grounded.
The traditional family were consisting of a father, mother and children as the standard family.
However, there are variety changes in family units, some very different from the standard of the
1950s. Today, children are also often raised in single parent homes, by grandparents or by
homosexual parents. Some families opt to have no children, or cannot have children due to some
medical or emotional barrier. The idea that parents and children make a family is a basic definition
In the study of Shyamm (2009), she presented six characteristics of a family: (1) Every family
is a social system. (2) Every family has an own cultural values and rules. (3) It is the first social
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group to which the individual is exposed. (4) Every family has a structure. (5) Every family have
certain basic function and last (6) Every family moves through stages in its life cycle.
According to the work of scholars Max Weber, Alan Macfarlane, Steven Ozment, Jack
Goody and Peter Laslett, the huge transformation that led to modern marriage in Western
democracies was "fueled by the religio-cultural value system provided by elements of Judaism,
early Christianity, Roman Catholic canon law and the Protestant Reformation”(Maglaya, 2004).
The term "nuclear family" is commonly used, especially in the United States of America, to
refer to conjugal families. A "conjugal" family includes only the husband, the wife, and unmarried
children who are not of age. Sociologists distinguish between conjugal families (relatively
independent of the kindred of the parents and of other families in general) and nuclear families
(which maintain relatively close ties with their kindred). Other family structures, such as blended
parents, single parents, and domestic partnerships have begun to challenge the normality of the
nuclear family.
Function of The Family
For Ano et.al (2015), affection, love, care and an emotional support will provide the family
a security, identity, affiliation, socialization and control. Ano emphasizes that family is also a sense
of belonging and of history and place. They have their rituals for rejoicing and grieving and even
in systems for earning money, supporting partners and children. Lastly, the family individual roles
such as sharing of labor and chores are required to keep the family running.
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Health Tasks of The Family
Clinical Application for Community Health Nursing (NUR 417) presents the health tasks of
the family in the presentation Lecture 3 Family Assessment. First health task is recognizing
interruptions of health or development. Second is seeking health care. Third is managing health
and non- health crises. Fourth is providing nursing care to the sick, disabled and dependent member
of the family. Fifth is maintaining a home environment conductive to good health and personal
development and last, maintaining a reciprocal relationship with the community and health and
institutions.
Family Health Assessment
This involves a set of actions by which the status of a family as client, its ability to maintain
itself as a system and functioning unit, and its ability to maintain wellness, prevent, control, or
resolve problems in order to achieve health and well-being among its members are measured.
(Haliyash, 2010) Assessing family health in a systematic fashion require four theories as health-
support system: (1) Family Systems Theory (2) Developmental theory (3) Interactionist Theory
and (4) Structural-Functional Theory.
Family as Health-Support System
The idea of Family Systems Theory is that the family is a living social system in which
different factors are affecting its whole self and the members in it. The family’s pattern is circular
and not linear. This means that the members of the family are having an interrelation and
interdependence relationship towards one another that helps each other to achieve the specific
function and goals, may it be individually or as a family. (Salonen, M., Kurki, Järvenpää, &
Tarkka, 2008)
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As an overall meaning for the family systems theory, it is the interconnectedness and
interdependence of the family that makes it as a system, when one factor affect a member of the
family, it would ripple to other members and affecting the whole family. It is when the family
would work together for it to achieve a specific goal like the good development of the whole
family. They had to work together like a system in order to achieve it. The thing that may happen
to a member affects the other members of the family. (Friedman 1992; in Oommen, Rantanen,
Kaunonen, & Tarka, 2011)
Another theory for family health is the developmental theory that has the following
assumptions (1) family changes occur according to internal or external resources, (2)
developmental tasks are goals worked rather than specific job, (3) each family is unique in nature,
and (4) family may arrive at similar developmental levels through different process. (Hill, R. &
Hanse, D.A. 1978; in Doherty, LaRossa, Schumm, & Steinmetz, (2009)
This theory implies that the family may have different interaction to different factors like
internal and external. Internal being the ability of the family as a whole like the knowledge of the
members, the resources – may it be financial or manpower, and behavioral norms.External being
the things that the society or governement may give in order for the health of the family to improve
like the technologies, services, and skills that can be learned. This factors affects the totality of the
developmental process of the family. Other factors like the things that always happen between
them like the death of a family member may affect the development of the whole family or any
crisis that may occur during the development.
Third theory for family health is the interactionist theory, it has the following assumptions
(1) complex sets of symbols having common meaning are acquire through symbolic environment,
(2) Individuals evaluates and assign meaning for symbols, (3) Individuals are actors and reactors,
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(4) Individual are born to a dynamic society, and (5) Individual learn from culture and become the
society. (Aldous, J. 1990 in; White & Klein, 2008)
The first idea implies that the member of the family learns the different ways of a family
members, like for example a kid who was born in a hygienic family would have a symbol or idea
that the proper way of eating is that you should wash your hands first and that you should always
wash your hand however, a kid who was not born in that kind of family may have different
implication as to what should be done in order to be clean. The learning of proper way is acquire
by the members of the family by the way they see it.
The second idea implies that the members of the family is the one who assess what they
see meaning, the family members may have different perspective about the certain cases they see
at home, like for example when they grew up in an environment that is all unsanitary, they may
clai, that is sanitary because it is how they have been living all their life.
The third idea is that everything they see would be reacted over and over again and when
it is something that is not conducive to health, they would still do it no matter what it is. They
would have repitition on what they are doing.
The fourth idea implies that just because they have been born in that kind of family does
not mean they have an static environment meaning, their environment would result to a change
that may change their way of living as well as perspective.
Lastly, the idea implies that what they see in the environment and society is what they
consider as a norm and results to a continuous action. This means that when the community
practices good segregation of trashes, they would have similar action and it may ripple to another
family and result to an environment conducive to healthy living.

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The last theory is the Structural-Functional Theory which has these assumptions (1)
Family is a social system with a function, (2) Family is a small group possessing features of a
small group, (3) It serves individual and society and (4) Individual act in terms of learned behavior
at the time or family socialization prcess. (Friedman 1992; in Oommen, Rantanen, Kaunonen, &
Tarka, 2011)
This theory implies that the family is a single unit and it specifies the characteristics such
as member roles, family forms, power structure, communication process and value system. This
means that each assumption about the family would identify how the family works as a whole. It
serves as a guide on the answer about who the family follows, or what does the family believes in
when it comes to health, or what kind of norms do they do.
In connection to family health, this theory was used in order to develop a nursing care plan
for the problems that were found in order to achieve an optimum health status of the family. This
healthy status of the family is not just the absence of disease or infirmity is should be the complete
physical, mental and social well-being of the family. (World Health Organization, 2006). A certain
assessment was done in order for the objectification of the problems. These problems were
assessed by two levels.
The health status of the family was assessed on the first level, which were divided into four
main categories (1) presence of wellness condition, (2) presence of health threats, (3) presence of
health deficits and (4) presence of stress points/ foreseeable crisis. After that, the health of the
family was further assessed according to their ability to do something about the health problem
that was categorized into five. The following are the categorization of the second level of
assessment (1) Inability to recognize the presence of the condition or problem, (2) Inability to
make decision with respect to taking appropriate health action, (3) Inability to provide adequate
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nursing care to the sick, disabled, dependent or vulnerable/at-risk member of the family, (4)
Inability to provide a home environment conducive to health maintenance and personal
development and (5) Failure to utilize community resources for health care.
These are all developed by Maglaya & Bailon-Reyes in 1978 and was further reviewed and
updated by Maglaya from 1994 untill the latest which was in 2009. The first level assessment is
finding the health problem while on the second level assessment is finding the cause of the
problems as to why it exist in the family.
It can be notice in the list of categories that the family, as a whole, would have a problem
if one family member shows the kind of attitude, perspective or infirmity on himself/herself.
Relating it to Family Systems Theory, the health status of a family member affects the health status
of the family, meaning they are all interrelated to one another that when an anomaly on a member
happens the whole family is affected.
From the four theories, the family as health support systems was made by (Manciaux &
Belsey, 2009) Which was categorized into four parts (1)Family as a Unit of Health, (2)Family as
a Unit of Care, (3) Helping Families towards Health Promotion, and (4) Supporting Family Health
They claim that the family is a unit of health because the interaction between the members
of it are interrelated to one another making them as a unit of health. They further support it by
putting an example that the family works as one in a way that the health outcome of a member is
a responsibility of another member, for example a family would help on creating a home
environment conducive to health and personal development of the member. Another claim of the
two authors is that the family is a unit of care meaning that when someone has an infirmity, the
job of the family is to take care of the person and make sure that the person gets back to healthy
state. In that way, the family is a unit of care to one another. Third function of the family as a
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support system is by promoting the healthful living; this means that the member shall do activities
or set norms that would promote healthful living. An example of that is the constant reminder to
the kids of washing their hands before eating or telling them not to eat junk foods or telling them
to eat vegetables. All of this is a function of the family on ensuring the promotion of health in the
family. Last function of the family is supporting family health, this involves from supporting it
financially and supporting it by work force. This ranges from the ability of the parents to provide
the right amount of money during emergencies or providing nutritious food to the family to the
ability of the family members to be there during emergency or witnessing the happenings in the
member’s life from the birthday up to their adolescence.
All of this shows that the family is system in which the family have interdependence and
interrelatedness in order to attain the optimum healthy state of one another through helping one
another by promoting, preventing, curing and rehabilitating the healthy state if ever needed.
2.2. Related Studies
The strengths-based family assessment is planned to achieve Comprehensive Functional
Family Assessment goals. In completing a strengths-based assessment, Cowger and Snively (2002)
suggest that there are guidelines to help the family identify meaningful and functional strengths.
(1) Give preeminence to the children and families’ understanding of the facts. The children and
family’s definition of the situation and the meaning that they give the situation are the central focus
for the assessment. (2) Believe the children and family to the degree possible. Fundamental to the
strengths-based model is that the clients are ultimately trustworthy. This is somewhat difficult to
deal with in a situation where the social worker is in fact investigating allegations.
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Felix (2016) identified existing health conditions and ranked according to degree of
prioritization, from greatest to least on the family that he studied namely (1) presence of breeding
or resting sites of vectors of diseases; (2) presence of risk factors of specific disease;(3) Inadequate
living space.
In the study of Blanco (2016) reveals that the family P cannot provide adequate resources for
their needs because of their low income. They couldn’t even afford to buy a refrigerator to keep
their food fresh. The family member, especially the children are susceptible to the disease that the
rats, mosquitoes, and cockroaches may harbor because of the scattered garbage outside their house.
Fire hazards in their home shows because cooking facilities are improperly kept outside the house
and their house is made up of wood.
The environment affects our health in a variety of ways. The interaction between human
health and the environment had been extensively studied and environmental risks had been proven
to significantly impact human health, either directly by exposing people to harmful agents, or
indirectly, by disrupting life-sustaining ecosystems (World Health Organization, 2009). The health
of a family could be identified in the house and environment that they live in. Safe water and clean
air, healthy workplaces, safe houses, communities and roads all contribute to good health.
Meanwhile people in employment are healthier, particularly those who have more control over
their working conditions. In housing congestion, according to Gateshead Council, a standard
number requirement of bedrooms is calculated for each household in accordance with its age, sex,
and marital status composition and the relationship of the members to one another. However, it
does not have a direct physical effect to one’s health, poor living conditions can serve as a
mechanism of social stratification, affecting children’s wellbeing and resulting in the
intergenerational transmission of social inequality (Solari and Mare, 2012). In addition, houses in
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the community which has been built with strong structural materials such as concrete and cement
indicates that there is a small probability of a health hazard to happen casually due to its resistance
to fire, wind, water, and even decomposition; unlike light materials like wood which breaks and
decay easily (Portland Cement Association, n.d.). Unlike, light construction materials such as
engineered woods, cement and concrete has less health risk for they don’t use bonding agents
which compose of chemicals such as formaldehyde and is emitted into air. Thus, results to a lower
health risk. Not only the housing congestion and materials affect family health. General
environmental sanitation also has a huge impact to health. According to World Health
Organization (2015), inadequate sanitation is a major cause of disease worldwide and improving
sanitation was known to have a significant beneficial impact on health both in households and
across communities. General sanitation includes the source of water supply of the household. The
finding is that the water contamination and the distance from where the household get their water
plays a major role on the health of the families, it specifically pertained to the gastrointestinal
infections that the water supply may have an effect on (Gorham, Yoo, Garabed, Mouhaman, &
Lee1, 2017). Transfer of diseases among the people living in a sanitary environment is signficantly
lower as well a the generation of certain infection (Mara, Lane, Scott, & Trouba, 2010).
Not only the environmental condition affects the family health but social factors too.
Greater support from families, friends and communities were linked to better health (World Health
Organization). McGibbin et al. (2008) examined the relation of individuals’ participation and
illness characteristics. They found out an association of depression and restricted participation
cutting across age ranges. They noted that while they are unable to find out whether depression
leads to restriction, or restriction to depression, that the key informants face their struggle with
illness in a culture that limits the participation of individuals with mental illness. According to
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Heibutzki, (2010) negative emotion such as sadness, if not addressed, affects physical well-being,
as well as emotional well-being. Failure to cope adequately with sadness imposes higher stress on
the body, which can result in autoimmune diseases, heart problems, and a greater tendency toward
self-harming behavior.
In line with these is the socioeconomic and educational factor. Having an educational
attainment or education was linked to health outcomes. According to Virginia Commonwealth
University Center on Society and Health (2014), a 25 year old in US without high school diploma
would die nine years earlier than those with college degrees. Also, those with college degrees tends
to practice more healthy behaviors like getting regular exercise, refraining from cigarettes or
getting timely check-ups, immunizations or screenings (Exploring the Social Determinants of
Health: Education and Health, 2011). Employment of a person was strongly linked to health
outcomes of a person. Having a job can help a person provide the necessary needs of his/her family,
as well as, his/her well-being. Employment is necessary for obtaining the adequate economic
resources in order to provide the right amount of physiological needs of the person. On the other
hand, unemployment of a person was strongly linked to poorer health (Waddel & Burton, 2006).
However, it is not the only determinant of health, factors like re-employment and the amount of
wages that was taken into account (Waddel & Burton, 2006).
Synthesis
This family health assessment the cases of family A was the chosen client by the researchers
using convenience sampling in South Crest Village San Agustin 2 Dasmariñas City, Cavite. The
family was being observed prior to the home visit that was conducted by the researchers to identify
the health-related problem. The health problems’ objective and subjective cues will be determined
in all 20 health problems discovered to be present in the family yet only 5 main problems will be
25
further discussed with regards to its causes and solutions. Those identified problems were used in
prioritization and would be planned to have its intervention through making a care plan. The
responses of the family will not be limited making their statements all valid and all a source of
further analyzation. Furthermore, the solutions they have been doing to resolve these health
problems will only be the solutions they have been practicing on their household alone. Lastly the
family’s ability to maintain wellness, prevent, control, or resolve problems in order to achieve
health and well-being among its members were also measured. Figley and McCubbin (2012) states
that family crisis should be an opportunity for family interventionists to promote family well-
being.
26
Theoretical Framework
 Recognize Need to Use Data based on Evidence

 Ensure Accuracy and Reliability of Data
 Check for Inconsistencies
 Complete Missing Information
DATA COLLECTION DATA ANALYSIS HEALTH CONDITIONS/

Framework: Use an Organized PROBLEMS AAND
 Sort Data
Comprehensive Approach to
FAMILY NURSING
Assessment  Cluster/Group Related Data
DIAGNOSES
First-level – Data on Status/  Distinguish Relevant from First – level Assessment:
Condition of: Irrelevant Data Define the Health Conditions/
 Family/ Household Health Problem (categorized
Members  Identify Patterns (e.g.,
Home and Environment
as wellness states, health
function, behavior,
deficits, health threats,
Second level – Data on Family’s lifestyle) foreseeable crises or stress
Assumption of Health Tasks on each  Relate family data to points)
Health Condition/Problem identified
in first – level assessment relevant clinical data and
Second – level Assessment:
research findings.
Methods/ Sources: Define the Family Nursing
First – level Assessment:  Compare Patterns with Problems/ Diagnoses as
 Health Status of Family/ Norms or Standards Statements of:
Household Member:
o Health Assessment  Interpret Results
Family’s Inability to Perform
o Laboratory/ Diagnostic  Make Inferences/ Draw
Test Results Health Tasks on each Health
o Records/ Reports Conclusion Condition/ Problem specifying
 Home and Environment the Barriers to Performance or
o Observation/ Ocular Reasons for Non –
Survey Performance of Family Health
o Interview
o Laboratory/ Diagnostic Tasks
Test Results
o Records/ Reports
Second – level Assessment
 In – depth interview on
Realities/ Perceptions about
attitude towards Assumption/
Performance on Health Tasks
 Observation: Relate Verbal with

Non – verbal Cues
Continuous Data Validation/Update for Adequacy of

Evidence to Support Diagnosis
Figure 1. The Assessment Phase in Family Health Nursing Practice: The Critical Thinking Approach
27
Conceptual Framework
INPUT PROCES OUTPU
SSS T
1.Assessment done
on the Family A.
2.The existing and
potential health Data Gathering
problems of the
family which Survey Health Care Plan for the
may be a Collection of Data
hindrance in Family of A.
attaining Analysis and
optimum health Interpretation of Data
3.Prioritize family
health problem
and develop care
plan for the
family
4.Intervention suited
for the family to
address their
family health
concerns
Figure 2: The conceptual framework (Figure 2) shows the input, process and output of the study.
The input is basically the needed information for the study; (1) Assessment done on the Family A.
(2) The existing and potential health problems of the family which may be a hindrance in attaining
optimum health (3) Prioritize family health problem and develop care plan for the family. (4)
Intervention suited for the family to address their family health concerns. The processes are the
survey, collection of other data and analysis and interpretation of data. Thus, the output will be the
Prioritize Family Health Problem and Care Plan for the Family.
28
Definition of Terms
Family A. Family A pertains to the family which was the participant of the study.
Convenience Sampling. Convenience Sampling is the sampling technique used by the researchers
to attain the sample.
Interview. Interview is the data gathering procedure done by the researchers to identify the
existing health problems of the family and their ways of coping up with them.
Neutral Voice. Neutral voice is the manner of interpreting data done to the participants’ responses
for effective and objective qualitative data.
Interventions. Interventions are the main courses of actions of the researchers, inclined to the
health care plan made, to attend to the family’s health problems.
Gordon’s Functional Assessment. Gordon’s Functional Assessment is the research instrument
utilized by the researchers to understand the current health status of the family.
Family Health Assessment Tool. Family Health Assessment tool is the research instrument
utilized by the researchers to examine the household of the family.
Survey. Survey is the method of data gathering used by the researchers to attain data for the Family
Assessment Tool.
Health Problems. Health Problems are the problems that the researchers will identify and attend
to.
Key Informant. Key informant is the head of the family who directly answered the inquiries of
the researchers.
29
Chapter III
METHODOLOGY
This chapter includes the research method and procedure and time and place of the study.
The research method and procedure include research design, research participants/ respondents
and sampling techniques, research tools, data gathering and data analysis procedure.
Research Design
This study was a qualitative research. This study was a qualitative case study since it is an
in-depth and detailed evaluation of the health problems of a family. This was descriptive-
qualitative research making it effective in describing what these health problems are, what are their
signs and symptoms, and how the family copes with these health problems. This study sought to
further study the family’s current status in terms of health by identifying and eradicating these
health problems. This aided the researchers to further evaluate and examine the key informants’
household in formulating an intervention that effectively provided immediate attention to the
family’s health related problems. Having this kind of research design, the researchers were able to
thoroughly indulge themselves to the living of the family paving the way to gather the most
accurate pieces of information possible in terms of understanding health related issues of Family
A.
The Sample
The key informants of the study were the Aller family. This family, Family A, was chosen
out of ten (10) households assessed by the researchers because of the family’s accessibility,
availability, and convenience. This family had all its 5 family members a participant of the study.
The family is located in the Sparrow St. in South Crest Village, San Agustin II, Dasmariñas,
Cavite. Convenience non-probability sampling was done by the researchers to come up in having
30
this family as the family to be further examined because this study will be more accurate if the
family to be assessed is accessible and voluntarily participating. According to Etikan (2016), this
is sampling technique where the researchers choose a sample of subjects/units from a population
which are useful especially when randomization is impossible like when the population is very
large. Also, there are only two proponents in this study making their resources, time, and workforce
limited which makes this sampling technique perfect for the nature of this research. This family
was chosen not only because of its convenience to the researchers but also because they are the
family that has the highest level of urgency in terms of the number and severity in health problems.
Research Instrument
This family case study adopted the Gordon’s Functional Assessment and made use of the
Family Health Assessment Tool (Lucero, 2017). The Family Health Assessment tool aims to
further examine the household of the family in terms of the following: profile of the head of the
family and each of the member of the family and their relationship to him/her, age, civil status;
their home; drinking water supply; kitchen; waste disposal; domestic animals; and the community
in general. The adopted version of the Gordon’s Functional Assessment used was the basis of
thoroughly understanding the health status of each family member. On the other hand, Gordon’s
Functional Health Patterns Assessment includes inquiries with regards to the following: health
perception and management pattern; nutritional-metabolic pattern; elimination pattern; activity-
exercise pattern; sleep-rest pattern; cognitive-perceptual pattern; self-perception/self-concept
pattern; role-relationship pattern; sexuality-reproductive pattern; coping/stress-tolerance pattern;
and value/belief pattern of the household.

31
Data Gathering Procedure
Use the Analyze the

Consent from
possible ways data to come
key figures of
of gathering up with the
the research
the data problems
Figure 3. The phases of the data gathering
The gathering of data done is through a survey guided by the Family Health Assessment
Tool itself and interview method guided by the Gordon’s Functional Assessment where the
participants of the study will be given open-ended questions. The questions prepared by the
researchers with regards to the Gordon’s Functional Assessment were first validated before it was
used for data gathering for accurate answers to be acquired from the key informants and to make
sure that the questions to be asked will supply sufficient information to conduct the said
assessment. On the other hand, a copy of the Family Health Assessment Tool was obtained by the
researchers from a registered nurse which was used to examine the household of the family. Even
before preparing these data gathering prerequisites, the confirmation and approval of the family to
participate voluntarily in this study was given to the researchers. As the researchers conduct the
said assessments through interview, their responses were then recorded and transcribed
accordingly. Interviewing is the data gathering procedure done for it will gather raw and reliable
data direct from each family members. Although it is time consuming, the researchers had very
credible results. In addition to this, objective cues were identified by the researchers by observing
and scanning the household and the family itself. From these, health related problems were then
32
identified. These identified health problems were then hierarchized in terms of the level of
prioritization through proper scoring.
Data Analysis
The data gathered from the interviews regarding the Family Health Assessment Tool and
Gordon’s Functional Assessment Tool were then analyzed and evaluated. These evaluations lead
to the concrete profile of the family household and the identification of the health-related problems
of the family. After this, the researchers identified five (5) health related problems to be prioritized.
The evaluation of the prioritized health problems was done by creating a Nursing Care Plan which
consists of the following: Assessment, Diagnosis, Planning, Intervention and Evaluation itself.
These prioritized health related problems were further discussed. The assessment part consists of
the subjective and objective cues of that health-related problem. The diagnosis part includes the
problem itself and its typology. The planning part was the long-term or short-term SMART
(Specific, Measurable, Attainable, Realistic, and Time-Bounded) goals of the researchers to
resolve the health-related problem. The intervention part was the step-by-step procedure to
accomplish the plan created. And only then the researchers could evaluate the interventions created
for the five (5) prioritized health related problem whether the goal is met or not and at the same
time to identify if the interventions were effective or not. However, all the responses of the key
informants throughout the process were not interpreted but perhaps explained through a neutral
voice maintaining its credibility and objectivity.

33
Table 1. Prioritizing Health Problems
Criteria Weight
Nature or condition of the problem
Scale: Wellness state (3)
Health deficit (3) 1
Health threat (2)
Foreseeable crisis (1)
Modifiability of the Problem
Scale: Easily modifiable (2)
2
Partially modifiable (1)
Not modifiable (0)
Preventive Potential
Scale: High (3)
1
Moderate (2)
Low (1)
Salience of the Problem
Scale: Need immediate attention (2)\
1
Does not need immediate attention (1)
Not perceived as a problem (0)
This table shows the weight of the way of prioritization of the problem. It start on the nature
of the problem, the modifiability of the problem, preventive potential of the problem and the
salience of the problem. The nature is what kind of the problem is it. The modifiability is how the
household can modify the problem with the help of the nursing care plan concerning their current
resources. The preventive potential is how able the family can prevent the diagnosed problem
concerning their current resources. The salience is how does the family sees the problem, whether
they do see it as a problem or not.

34
Chapter IV
RESULTS AND DISCUSSION
This chapter illustrates the family background of the study which includes, Database of the
Respondent, Family Values and Practices, General Household Data, Activities of Daily Living
which could be an indicative for the present health status of the family as it continues to influence
the each of the family member as well as the identified health problems together with the
intervention or care plan.
The Profile of the Key Informant’s Household
Table 2. Profile of household
Civil Position in Educational

Name Age Sex Occupation
Status the Family Attainment
Mr. 35 Male Single Father Security High School
A guard Undergraduate
Ms. 36 Female Single Mother Housewife High School
F (Respondent) Undergraduate
Child 10 Female Child Eldest Child/ Student Elem. Level
G.F Daughter (Grade 5)
Child 7 Male Child Second Child/ Student Elem. Level
G.A Son (Grade 3)
Child 1 Female Child Third Child/ Not Not Applicable
J.G.A Daughter Applicable
Family Structure, Characteristics, and Dynamics
The Family A, as any other basic unit of the society, is considered as a nuclear type of
family. A nuclear type is a typical type of family composed of a father, a mother and child/children.
This type of family structure is found in almost all societies, although the length of time in which
the family remains in this form varies even within the same society.
35
The nuclear family can be a nurturing environment in which to raise children as long as
there is love, time spent with children, emotional support, low stress, and a stable economic
environment. In nuclear families, both adults are the biological or adoptive parents of their children
(Jay, 2004).
The A Family resides in South Crest Village San Agustin 2, Dasmariñas City, Cavite. They
lived there since 2007.
Ms. F is superior in the household in terms of decision making while Mr. A provides the
financial needs. But both consult each other in terms of caring their children. They discuss matters
concerning their children’s schooling financially and also with regards to the emotional problems
or aspects within the family. When problem arises, they make sure that both of them will handle
and solve the problem. But then, in terms of matter concerning health, Ms. F is more dominant.
She makes sure that she will comply with the appropriate regimen when certain health issues arise.
She has greater awareness concerning health matters compared to Mr. A since of course believing
it is her duty as the mother. Also, Ms. F’s Aunt supports their family’s shortage in water supply
and electricity.
Socio-Economic and Cultural Characteristics
The A family’s main source of income is coming from Mr. A’s work which is security
guard. Mr. A earns about Php 3,000.00 a month. Since Ms. F does not work, she is in charge of
the house and in taking care of the children. Ms. F budgets the money in terms of food, education
and miscellaneous where clothes, shoes and slippers comes in. Out of Mr. A’s earnings, most of it
goes to the family’s budget for food. The education of the children is free and they can walk from
36
their house to the school so only some school supplies are being bought. Usually, there is nothing
to be left for the miscellaneous expense.
With Mr. A’s monthly income, the family strives hard to accommodate everything they
need for them to live. According to NEDA, each individual should at least have Php 2768.60 when
the total monthly income of the family is divided among the total family members. The total
monthly income of Mr. A is about Php 3, 000.00 and when divided among the 5 members, it is
only Php 600.00, thus, they can be considered poor. Ms. F also informed the researchers that they
do not have any financial assets at hand in case of emergency. They typically borrow money from
their relatives.
Mr. A works as a security guard, he works from 3 am until 8 pm every day. Ms. F doesn’t
work and stays in their house. She is the typical housewife where in you can see her wash clothes,
prepare food, sweep the yard and make the house clean.
All of them are affiliates of Roman Catholic. Ms. F mentioned that they seldom go to
church since they have lived in South Crest Village San Agustin 2 for the reason that they have no
time and the distance they have to travel from their place to the church is somewhat far away.
Significant others are called such due to their own role in one’s life. They are the ones very
close to a person or group of persons. For family A, the significant others in their lives are the aunt
of Ms. F living just beside their house and some neighbors which resides within the vicinity area.
They usually run to Ms. F’s Aunt if they face hardships and problems. Ms. F also confirmed how
helpful and welcoming her neighbors are with them. Their neighbors on the left side of their house
is the source of their electricity. They contribute 200.00 pesos for electric bill. While their
37
neighbors on the right side of their house help them with water supply wherein they contribute
190.00 pesos for water bill.
The family participates in the community activities such as celebrating fiesta and watching
different affairs such as basketball competition.
Home and Environment
The house of Family A is rent-free made of light construction materials such as galvanized
iron sheets and mostly plywood. Ms. F does not know the exact measurement of their house. Her
husband knows it yet he was not there during the interview. In order for the house to be considered
as adequate, the total floor area should be divided among the total members of the family and each
should at least have 2 x 1 meters.
The house only has 1 window located at the back of their house. As for adequacy of
ventilation, the total window area should be at least 10% of the total floor area. Since it only has 1
window for the entire house, that means it cannot sustain the adequate ventilation needed by the
family, but Mrs. F told the researchers that the air goes to and fro-freely inside the house since it
was lied beside the creek that has a river beside it.
The house has only one room which served as their sala/dining room, kitchen and bedroom
but with no bed at all. According to the National Building Code of the Philippines (2000) the
minimum size of room required for human habituation individually is 3.5 square meters (adult)
and 1.5 square meters (child). Mr. A and Ms. F, together with the children, sleep in one room.
They use “banig” in sleeping.

38
The Family A has only one appliance which is the electric fan since the place has limited
electrical supply that came from their neighbor.
Ms. A uses wood and charcoal in cooking. She is the one who prepares the food. She cooks
inside the house at the back portion. The foods that they usually eat are instant noodles and canned
goods. The family uses plastic plates and stainless spoons in eating. When it comes to storing their
food, they just cover it with a plate. In terms of cooking facilities the family is equip with pots,
“sandok”, and knives that stored in one dish cabinet.
The family’s main source of water was coming from their neighbor. They wash their
clothes and gets their drinking water supply there. They put their water in big jars and pail without
cover. They get water directly from the faucet and they usually don’t sterilize their drinking water
supply.
The Family A has a comfort room built at the back of their house. It has a small hole inside
it. They usually urinate and remove bowels there. The toilet type is open pit privy which is once
they finished removing their waste, they will get it and throw it either on the creek or dig out to
bury it. According to Ms. F, they have lack the ability to renovate their own comfort room since
they do not have enough money and enough budget for it yet.
In terms of garbage disposal, they either bury or burn their garbage or send their garbage
through garbage collection. There was no drainage system provided and let it flows anywhere near
the creek. There were some rice grains noted. There is no obstruction present at the drainage system
since it is open and flows anywhere.
The family does not own any transportation facilities. They just walk or ride on a jeepney
whenever they going out.

39
The family has 2 kinds of domestic animals namely the dogs and chickens. There are 24
numbers of chicken and 2 dogs mentioned by Ms. F.
Health Status of Each Family Member
The researchers met Mr. A on the second home visit but he was busy that time fixing
something on their house, so Ms. F again volunteered to be the interviewee. Ms. F, however, told
us that her husband once experienced having hemorrhoids known as “almoranas” when he was
working in a construction. His major role there was to carry heavy cements and metals that is why
got that illness. But according to Ms. F, “Sinabihan ko na yun, di naman daw niya pinapansin,
tigas ng ulo, kayang kaya naman daw niya, sabi ko ipahinga niya eh ayaw naman rin niya
magpaawat, mas magkakasakit lang daw pag nagpadoktor pa” Her husband condition did not last
long for they treated it early in time by applying some cream as was advised by Ms. F’s Aunt.
Also, her husband has never undergone immunizations at all since it was not that important before.
Ms. F said that her husband is about 5’4 tall and weighs about 55 kilograms. His BMI reveals
normal weight with a value of 20.8. Ms. F told the researchers that her husband has no genetic or
hereditary illness known. He is not a smoker, but he drinks alcohol rarely especially when he is in
his day-off.
Ms. F on the other hand stated that she has no degenerative, chronic, or infectious diseases
as of the present time. She has also not completed immunizations. When she was still pregnant to
her third child, she intake ferrous sulfate that was given by the Barangay Health Center. Ms. F
was 5 feet by 3 inches and weighs 60 kilograms. Her BMI reveals normal weight with a value of
23.4. She has no complaints as of the present time and has not taken any medications as of the
40
moment. At times of illness, she would just drink paracetamol for fever and mefenamic acid for
pain or treat wounds.
Mr. A and Ms. F children have also their individual medical history and past illness. Child
G. F. has a congenital heart disease as verbalized by Ms. F“Wala kasi kami pampadoktor sa kanya
at mahal din mga gamot na kailangan niya kaya di na namin siya napapainom ng mga gamot
tapos noodles lang nakakain kasi wala pera madalas eh bawal sa kanya yun” This chronic disease
of her once made her life at risk when she experienced convulsion and got unconscious for half
hours in the middle of the night. Ms. F got panicked of what happened and so what she did was
throwing a water on the face of her daughter. But nothing happened. After half hours of being
unconscious, Child G.F woke up and asked for water to drink. The morning after the incident, Ms.
F asked for help to her aunt and they brought Child G.F on the hospital and that why they
discovered that Child G.F has congenital heart disease.
Child G.A, the second child of Mr. A and Ms. F has an asthma. They went to Barangay
Health Center to use nebulizer once when his asthma attacks. Child G.A seldom attacked by his
asthma as stated by his mother.
Lastly their youngest child J.A, who has no any degenerative, chronic, or infectious
diseases as of the present time. She has complete immunizations. Ms. F mentioned that “tiki-tiki”
is the medicine intake by her daughter. She is 3 feet and 11 inches tall and weighs 17 kilograms.
She appears thin. This child has many rashes seen on her legs.
Family Assessment Based on Gordon’s Functional Health Pattern
Health Perception-health management patterns

41
The family A was free from diseases and no known vices like smoking and drinking except
for Mr. A who drinks alcohol rarely. They also able to recognize the importance of having a healthy
well-being.
Nutritional-metabolic pattern
The Family A does not have any healthy lifestyle practices and they seldom take any food
supplements or vitamins. Their family daily food intake is mainly rice, instant noodles and canned
goods. Children eat junk foods whenever they were given money. Children have poor appetite
according to Ms. F.
Elimination pattern
The Family eliminates everyday with an average frequency of urine: 2-3 times. According
to Ms. F, all of the family members have no difficulty in voiding. The family members defecate
everyday and some, every other day with no difficulty in defecating noted.
Activity-exercise pattern
Family preferred to stay at home and take a nap if they have free time while their children
play with other children in the community after class.
Sleep-rest pattern
The Family A usually has 7-8 hours of uninterrupted sleep according to the mother. They
usually sleep at around 9 in the evening and wake up at around 4 to 5 in the morning. They also
take a nap at free time.
Cognitive-perceptual pattern
42
The family A was oriented to time, place and is able to identify people and significant
others by their first names and also able to respond accordingly and correctly to questions. Verbal
pattern and spontaneity were normally observed as well as memory intact and also no observed
sensory defects.
Self-perception/self-concept
The Family A perceived situations (health deficits) to be very stressful but remain passive
about things and condition of each member’s past illness.
Roles and relationship
The Family members have an open communication and able to discuss their problems
according to the mother.
Sexual reproductive
Both parents are still in the reproductive age but Ms. F mentioned verbalized “Ay naku
wala na kong time, tama na tong tatlo. Wala na ngang makain eh”
Coping Stress
The Family A especially the parents go hand in hand in terms of decision making since
their children were still young. They gains strength in the “assurance and guarantee” provided by
family members.
Values/ Beliefs Pattern
The family is Roman Catholic in faith but does not go anymore to church since they are
situated far away from the place of worship they attend.

43
Values, Habits, Practices on Health Promotion, Maintenance and Disease Prevention.
The children in the family has not all completed their immunization. Only the youngest
child undergo complete immunization since according to Ms. F statement, the Barangay Health
workers round on their Barangay to give immunization to the infants that was also part of the
program of barangay San Agustin 2.
The family A does not have healthy lifestyle practices. The mother stated it depends on the
amount of money what they were going to eat as manifested by “Eh kung anong meron, kakainin.
Hanggang mga noodles at delata lang kaya ng budget namin”.
In terms of adequate rest and sleep, Ms. F mentioned that they sleep early once their
favorite tv shows ended and wake up early because the work of his husband. It was manifested by
Mrs. F. verbalization. “Maaga kami natutulog. Minsan ng gabi, minsan 8 ng gabi. Maaga rin kamin
nagigising. Minsan 4 ng madaling araw minsan 7 ng umaga dipende sa gising nitong maliit at
trabaho ni mister”
For the Family A, Ms. F waking up her husband and children and start doing the household
chores, and walking are their ways of exercise. The mother usually does the household works and
talks with the neighbors during free time. The children are either in school or are playing with
other children in the community.
The mother recognizes the importance of health in the family, however, because of
financial constraints made them ignores any major health problems that may arise. Furthermore,
they were not able to sustain sufficient supplies of medication or articles which they would need
related to their health care needs. They often use alternative medicines or herbal medicines for
44
treating their illness and habitually self-medicate if medications are available. The family believes
in the power of herbal plants. They occasionally use herbal plants lodged near the house in treating
diseases or symptoms in the family since she had no choice but to use these plants for the reason
and the best way for this family in barangay health center is far away from their home. But if the
symptoms manifested by the family member become severe, they immediately go to the health
center or to the hospital.
The Health-Related Problems Present in the Household
The Family House Assessment Tool and Gordon’s Health Assessment of the family that
lives in South Crest Village was used to determine their different health problems, etiology, and
signs and symptoms. The researchers have identified 20 different health problems and derived top
five health problems with the help of following criteria: Nature of the Problem, Modifiability of
the Problem, Preventive Potential of the Problem, and Salience of the Problem. These problems
were scored (see complete scoring on Appendix) to identify the problems that should be highly
prioritized. The first five problems are the top five problems arranged in chronological order based
on their ranking with respect to their scores of prioritizations.
Table 3. The table shows the top five priority health problems with the scores and its rank
No. PROBLEMS IDENTIFIED Score Rank
1 Inability to take medicine 11 1
2 Poor Home Sanitation: Unsanitary Water Supply 11 1
3 Poor Home Sanitation: Unsanitary Drinking Water 11 1
4 Poor Outdoor Environmental Condition 11 1
5 Poor Indoor Environment Condition 11 1

45
Out of twenty health problems identified in the case of family A, these top five with the
scores of 11 and all got rank 1 were utilized to the appropriate care plan needed for the family. In
the study of Blessing (2017), he revealed that there are ten (10) common family health problem
and out of those 10, these five also belongs to the rank of 9th, 5th, 3rd and 6th respectively.
Inability to Take Vitamins
Inability to utilize community resources for health care related to inadequate knowledge of
community resources for health care in taking vitamins as manifested by the absence of vitamins
and food supplements and the key informant’s verbalization “Wala naman ata kasi minsan
vitamins yung center kaya di kami nahingi, tsaka wala rin panahon kasi lagi nasa trabaho asawa
ko tapos ako naman lagi nasa bahay, pag wala siya pasok pahinga lang siya dito”.
Table 4. Inability to take Vitamins

Actual
Criteria Computation Justification
Score
1. Nature of the Not taking Vitamins lessens health

(2)1 2
Problem improvement, making it a health threat.
Supply of Vitamins is free and available
2. Modifiability of
(2)2 4 making this health-related problem easily
the Problem
modifiable.
3. Preventive Vitamins intake can easily be promoted
Potential (3)1 3 making the preventive potential of this health-
related problem high.
It needs immediate attention for the children

4. Salience of the
(2)1 2 of the family protected from diseases that are
Problem
prominent in their household
Total Score: 11
46
This health-related problem, inability to take vitamins, is a health threat that has the highest
level of modifiability considering the vitamins’ availability and accessibility. It has a high
preventive potential for proper promotion and practice could lead to habitual vitamin intake. It also
has a high salience for it must be immediately resolved for future health problems to be prevented.
Poor Home Sanitation: Unsanitary Water Supply
development related to lack of inadequate knowledge of importance of hygiene and sanitation in
terms of water supply as manifested by the sponge beside pails with stagnant polluted water that
serves as a water for cleaning plates and the key informant’s verbalization “Diyan na kami
naghuhugas ng plato, nababa naman yung dumi sa ilalim kaya pwede pa panghugas hugas, para
tipid na rin kasi mahal tubig”.
Table 5. Poor Home Sanitation: Unsanitary Water Supply

Actual
Score
1. Nature of the Having an unsanitary water supply is a threat

(2)1 2
Problem to family’s health.
Easily modifiable since waters in their pails
2. Modifiability of
(2)2 4 can be renewed and replaced with clean water
the Problem
to store.
3. Preventive
Potential It has high preventive potential for its effects
(3)1 3
can be prevented easily.
It needs immediate attention for this

4. Salience of the
(2)1 2 unsanitary water supplies are their medium in
Problem
cleaning plates, etc.
Total Score: 11
47
This health-related problem, unsanitary water supply, is a health threat that has the highest
level of modifiability considering the low level of difficulty in providing a sanitary water supply.
It has a high preventive potential for its effects could be easily prevented when a sanitary water
supply is provided. It also has a high salience for it must be immediately resolved for future health
problems related to water sanitation be prevented.
Poor Home Sanitation: Unsanitary Drinking Water
development related to inadequate family resources, specifically financial constraints/limited
financial resources as manifested by the absence of drinking water containers and the key
informant’s verbalization “Wala kami pambili ng purified at mineral kaya tubig gripo lang iniinom
namin, pagkaigib, iintay lang ilang minuto tas pwede na inumin yun”.
Table 6. Poor Home Sanitation: Unsanitary Drinking Water

Actual
Score
1. Nature of the Unsanitary drinking water is a health threat

(2)1 2
Unsanitary drinking water is easily
2. Modifiability of modifiable since practices of purifying
(2)2 4
the Problem water can be taught and water stations are
available.
3. Preventive Preventive Potential is high since only one
Potential (3)1 3 source of water is needed to fix and
resolutions that can be done are many.
The problem needs immediate attention

4. Salience of the
(2)1 2 since all family members drink water
Problem
obtained directly from a faucet.
Total Score: 11
48
This health-related problem, unsanitary drinking water, is a health threat that has the
highest level of modifiability considering the availability of purified water stations and several
ways of making water potable. It has a high preventive potential for its effects could be easily
prevented when a sanitary drinking water is provided. It also has a high salience for it must be
immediately resolved for all the family members’ health are at stake every time they drink.
Poor Outdoor Environmental Condition
development related to lack of/inadequate knowledge of preventive measures as manifested by the
presence of pile of garbage with no segregation, wood and metal scattered, and pails with stagnant
water, and the key informant’s verbalization “May mga nakakalat na kahoy kahoy diyan pati bakal
di namin tinatapon kasi baka mabenta pa, diyan din namin tinatabi mga basura, inaayos lang
naming sila pag nagkokolekta na ng basura, di naman kami mapapano niyan”.
Table 7. Poor Outdoor Environmental Condition

Actual
Score
Unsanitary surroundings is a threat to
1. Nature of the
(2)1 2 family’s health for health hazards can be
Problem
aggravated.
It has an easy modifiability since regular
2. Modifiability of
(2)2 4 cleaning and sanitation can solve this health
the Problem
threat caused by health hazards.
3. Preventive It can be prevented since this problem can be
Potential (3)1 3 eradicated by just promoting cleanliness and
orderliness.
4. Salience of the It needs immediate attention for these hazards
(2)1 2
Problem could lead to health deficits soon.
Total Score: 11
49
This health-related problem, poor outdoor environmental condition, is a health threat that
has the highest level of modifiability considering the low level of difficulty in improving the
cleanliness of the family’s outdoor environment. It has a high preventive potential for its risks can
be eradicated once proper sanitation is practiced in the surroundings of their house. It also has a
high salience for it must be immediately resolved for different health related hazards not to become
disasters.
Poor Indoor Environmental Condition
Inability to provide home environment conducive to health maintenance and personal
development related to inadequate knowledge of the importance of hygiene and sanitation as
manifested by the presence of trashes and dust in the living room and the key informant’s
verbalization “Tuwing gabi lang kami nagwawalis para isahang linisan na lang, bago matulog
kasi madudumihan lang ulit”.
Table 8. Poor Indoor Environmental Condition

Actual
Score
A poor indoor environment could lead to
1. Nature of the
(2)1 2 health deficits making this health-related
Problem
problem a health threat.
This problem is easily modifiable for
2. Modifiability of
(2)2 4 regular and proper cleaning is enough to
the Problem
resolve it.
3. Preventive It has high preventive potential since proper
Potential (3)1 3 education of hygiene and sanitation could
prevent this health-related problem.
4. Salience of the This needs an immediate attention for it
(2)1 2
Problem could lead to health diseases.
Total Score: 11
50
This health-related problem, poor indoor environment, is a health threat that has the highest
level of modifiability considering the low level of difficulty in maintaining the cleanliness and
orderliness on the indoor setting. It has a high preventive potential for its effects could be easily
prevented when proper and regular cleaning is practiced by the family. It also has a high salience
for it must be immediately resolved for future health problems caused by poor indoor
environmental may eventually be present.
Proposed Interventions for the Identified Health Related Problems of the Household
In addressing the top five prioritized health problems that the researchers have identified,
care plans were completed that will provide holistic care for the client. A care plan flows from
each patient’s unique list of diagnoses and should be organized by the individual’s specific needs
(RN Central, 2003). The care plan includes the following components such as (1) the assessment
where physical, emotional, sexual, psychosocial, cultural, spiritual/transpersonal, cognitive,
functional, age related, economic and environmental condition of the client are assessed, and these
may be subjective and objective; (2) the diagnosis where the healthcare provider identify and
diagnose the problems to be addressed and prioritized; (3) intervention, made by the researcher
and should provide evidence based care to the client or family member.
Along with the care plan are the Ishikawa or Fishbone Diagram, a visualization tool for
categorizing the potential causes of each problems in order to identify its root causes (Rouse,
2015). The care plans of each problems were arranged in chronological order based on their
ranking with respect to their scores of prioritizations.

Care Plan for Inability to Take Vitamins
Table 9. Care Plan for Inability to Take Vitamins

Assessment Diagnosis Planning Intervention
Subjective: Inability to utilize At the end of the 1-week- The researchers will aim to
“Wala naman community resources intervention, the following achieve the goal set by
ata kasi minsan for health care related objectives must be performing the following:
vitamins yung to inadequate accomplished: Prepare a brochure
center kaya di knowledge of  All of the members of regarding the importance
kami nahingi, community resources the family will be of taking vitamins and the
tsaka wala rin for health care in given a brochure medicines and services
panahon kasi taking vitamins as regarding the offered by the nearest
lagi nasa manifested by the importance of taking barangay health center.
trabaho asawa absence of vitamins vitamins and the  Prepare a Five (5) Item
ko tapos ako and food supplements medicines and services questionnaire
naman lagi nasa and the key offered by the nearest regarding the
bahay, pag wala informant’s barangay health center. importance of taking
siya pasok verbalization “Wala  At least 2 members of vitamins and the
pahinga lang naman ata kasi the family will be medicines and services
siya dito”. minsan vitamins yung addressed in a one-on- offered by the nearest
Objective: center kaya di kami one discussion of the barangay health
 Absence of nahingi, tsaka wala contents of the center.
vitamins rin panahon kasi lagi brochure.  One-on-one discussion
 Absence of nasa trabaho asawa  At least 2 members of with at least 2
any food ko tapos ako naman the family will provide members of the family
supplements lagi nasa bahay, pag an evaluation about the regarding the
wala siya pasok discussion at least 4 brochure.
pahinga lang siya out of 5.  Conduct an evaluation
dito”.
This health-related problem, inability to take vitamins, was a health threat which was
mainly caused by inadequate knowledge of community health resources for health care in taking
vitamins. This is why the main objective of this nursing care plan was to educate the family with
regards to the health resources offered by the community health centers as well as the importance
of taking vitamins through the use of educative brochures. The family then answered a
questionnaire to measure the level of their learning and eventually provide an evaluation of the
nursing care plan done.

52
Care Plan for Unsanitary Water Supply
Table 10. Care Plan for Poor Home Sanitation: Unsanitary Water Supply
Subjective: Inability to provide a At the end of the 1-week- The researchers will aim to
“Diyan na kami home environment intervention, the achieve the goal set by
naghuhugas ng conducive to health following objectives must performing the following:
plato, nababa maintenance and be accomplished:  Prepare a brochure
naman yung dumi personal development  All of the members of regarding the
sa ilalim kaya with relate to lack of the family will be importance of sanitary
pwede pa inadequate knowledge given a brochure water supply,
panghugas hugas, of importance of regarding the specifically the
para tipid na rin hygiene and sanitation importance of sanitary knowledge regarding
kasi mahal tubig”. in terms of water water supply, water contamination
Objective: supply as manifested specifically the and effective ways to
 Presence by the sponge beside knowledge regarding save water.
of pails pails with stagnant water contamination  Prepare a Five (5) Item
with polluted water that and effective ways to questionnaire regarding
contamina serves as a water for save water. the importance of
ted water cleaning plates and the  At least 2 members of sanitary water supply,
 Presence key informant’s the family will be specifically the
of verbalization “Diyan addressed in a one-on- knowledge regarding
unwashed na kami naghuhugas one discussion of the water contamination
dishes ng plato, nababa contents of the and effective ways to
beside the naman yung dumi sa brochure. save water.
pails ilalim kaya pwede pa  At least 2 members of  One-on-one discussion
 Presence panghugas hugas, the family will with at least 2 members
of sponge para tipid na rin kasi provide an evaluation of the family regarding
mahal tubig”. about the discussion the brochure.
at least 4 out of 5.  Conduct an evaluation
This health-related problem, unsanitary water supply, was a health threat which was mainly
caused by inadequate knowledge of importance of hygiene and sanitation. This is why the main
objective of this nursing care plan was to educate the family with regards to water contamination
and effective ways to store water. The family then answered a questionnaire to measure the level
of their learning and eventually provide an evaluation of the nursing care plan done.
53
Care Plan for Unsanitary Drinking Water
Table 11. Care Plan for Poor Home Sanitation: Unsanitary Drinking Water
“Wala kami home environment intervention, the following achieve the goal set by
pambili ng conducive to health objectives must be performing the following:
purified at maintenance and accomplished:  Prepare a brochure
mineral kaya personal development  All of the members of regarding the importance
tubig gripo with relate to the family will be of sanitary drinking water,
lang iniinom inadequate family given a brochure specifically the importance
namin, resources, specifically regarding the of having a sanitary water
pagkaigib, financial importance of sanitary source and container and
iintay lang constraints/limited drinking water, knowing ways to make
ilang minuto financial resources as specifically the water potable.
tas pwede na manifested by the importance of having a  Prepare a Five (5) Item
inumin yun” absence of drinking sanitary water source questionnaire regarding
water containers and and container and the importance of sanitary
Objective: presence of open pails knowing ways to make drinking water,
 Absence of with drinking glasses, water potable. specifically the importance
Drinking and the key  At least 2 members of of having a sanitary water
Water informant’s the family will be source and container and
Containers verbalization “Wala addressed in a one-on- knowing ways to make
 Presence of kami pambili ng one discussion of the water potable.
Pails with purified at mineral contents of the  One-on-one discussion
Water kaya tubig gripo lang brochure. with at least 2 members of
 Drinking iniinom namin,  At least 2 members of the family regarding the
Glasses pagkaigib, iintay lang the family will provide brochure.
beside the ilang minuto tas an evaluation about the  Conduct an evaluation
Pails pwede na inumin discussion at least 4
yun”. out of 5.
This health-related problem, unsanitary drinking water, was a health threat which was
mainly caused by inadequate family resources, specifically financial constraints. This is why the
main objective of this nursing care plan was to educate the family with regards to ways on how to
make water from sink or faucet potable as well as the importance of sanitary drinking water and
container. The family was then answered a questionnaire to measure the level of their learning and
eventually provide an evaluation of the nursing care plan done.

54
Care Plan for Poor Outdoor Environmental Condition
Table 12. Care Plan for Poor Outdoor Environmental Condition

“May mga nakakalat home environment intervention, the achieve the goal set by
na kahoy kahoy diyan conducive to health following objectives must performing the following:
pati bakal di namin maintenance and be accomplished:  Prepare a brochure
tinatapon kasi baka personal development  All of the members of regarding the
mabenta pa, diyan din due to lack the family will be importance of outdoor
namin tinatabi mga of/inadequate given a brochure hygiene and sanitation,
basura, inaayos lang knowledge of regarding the specifically the
naming sila pag preventive measures as importance of outdoor importance of proper
nagkokolekta na ng manifested by the hygiene and waste disposal, dangers
basura, di naman kami presence of pile of sanitation, of stagnant water, and
mapapano niyan” garbages, scattered specifically the proper wood and metal
pieces of wood and importance of proper storing.
Objective: scrap metals, and pails waste disposal,  Prepare a Five (5) Item
 Pile of of stagnant water and dangers of stagnant questionnaire regarding
Garbage with verbalized by “May water, and proper the importance of
no segregation mga nakakalat na wood and metal outdoor hygiene and
beside the kahoy kahoy diyan pati storing. sanitation, specifically
house bakal di namin  At least 2 members of the importance of
 Wood and tinatapon kasi baka the family will be proper waste disposal,
metals mabenta pa, diyan din addressed in a one-on- dangers of stagnant
scattered on namin tinatabi mga one discussion of the water, and proper wood
the lot of the basura, inaayos lang contents of the and metal storing.
house naming sila pag brochure.  One-on-one discussion
 Pails with nagkokolekta na ng  At least 2 members of with at least 2 members
stagnant water basura, di naman kami the family will of the family regarding
placed in front mapapano niyan”. provide an evaluation the brochure.
of the house about the discussion  Conduct an evaluation
at least 4 out of 5.
This health-related problem, poor outdoor environmental condition, was a health threat
which was mainly caused by inadequate knowledge of preventive measures. This is why the main
objective of this nursing care plan was to educate the family with regards to proper storage of scrap
metals and wood as well as proper waste segregation and risks of having stagnant water. The
family was then answered a questionnaire to measure the level of their learning and eventually
provide an evaluation of the nursing care plan done.

55
Care Plan for Poor Indoor Environmental Condition
Table 13. Care Plan for Poor Indoor Environmental Condition

Subjective: Inability to provide At the end of the 1-week- The researchers will aim to
“Tuwing gabi home environment intervention, the following achieve the goal set by
lang kami conducive to health objectives must be performing the following:
nagwawalis para maintenance and accomplished:  Prepare a brochure
isahang linisan na personal  All of the members of regarding the
lang, bago development due the family will be importance of indoor
matulog kasito inadequate given a brochure hygiene and sanitation,
madudumihan knowledge of the regarding the specifically the
lang ulit”. importance of importance of indoor importance of regular
hygiene and hygiene and sanitation, indoor cleaning of trash
Objective: sanitation as specifically the and dust.
 Presence manifested by the importance of regular  Prepare a Five (5) Item
of trash all presence of trashes indoor cleaning of questionnaire regarding
over the and dust in the trash and dust. the importance of
house living room and the  At least 2 members of indoor hygiene and
 Presence key informant’s the family will be sanitation, specifically
of dust all verbalization addressed in a one-on- the importance of
over the “Tuwing gabi lang one discussion of the regular indoor cleaning
house kami nagwawalis contents of the of trash and dust.
 Absence para isahang brochure.  One-on-one discussion
of Broom linisan na lang,  At least 2 members of with at least 2 members
and bago matulog kasi the family will provide of the family regarding
Dustpan madudumihan lang an evaluation about the brochure.
ulit”. the discussion at least  Conduct an evaluation
4 out of 5.
This health-related problem, poor indoor environmental condition, was a health threat
which was mainly caused by inadequate knowledge of importance of hygiene and sanitation. This
is why the main objective of this nursing care plan was to educate the family with regards to proper
and regular indoor cleaning of trash and dust. The family was then answered a questionnaire to
measure the level of their learning and eventually provide an evaluation of the nursing care plan
done.
56
Chapter V
SUMMARY, CONCLUSIONS, AND RECOMMENDATIONS
Presented in this case study is the distinctive characteristics and health condition of family
A. This case study presented the family structure, socio – economic and cultural factors, home and
environmental factors, health assessment of each member. It also contains data about identified
problems on the living condition of the family and its corresponding interventions.
Summary
The Family A is considered as a nuclear type of family. A nuclear type is a typical type of
family composed of a father, a mother and child/children. The A family resides in the Sparrow St.
in South Crest Village, San Agustin II, Dasmariñas, Cavite. They have started living there since
2007.
Their house is made of wood and galvanized iron sheets. Ms. F did not know the exact
measurement of their house. Her husband, Mr. A, knows it yet he was not there during the
interview. In order for the house to be considered as adequate, the total floor area should be divided
among the total members of the family and each should at least have 3.5 m2. The house only has
1 window that cannot sustain the adequate ventilation needed by the family.
The A family’s main source of income is coming from Mr. A’s occupation as a security
guard. Mr. A earns about Php 3,000.00 a month. Since Ms. F does not work, she is in charge of
the house and in taking care of the children and the budgeting of money in terms of food, education
and miscellaneous. With Mr. A’s monthly income, the family strives hard to accommodate
everything they need for them to live. According to NEDA, each individual should at least have
Php 2768.60 when the total monthly income of the family is divided among the total family
members. The total monthly income of Mr. V is about Php 3, 000.00 and when divided among the
57
5 members, it is only Php 600.00, thus, they can be considered poor. Ms. F also informed the
researchers that they do not have any financial assets at hand in case of emergency. They typically
borrow money from their relatives.
All of them are affiliates of Roman Catholicism. Ms. F mentioned that they seldom go to
church ever since they have lived in South Crest Village San Agustin II for the reason that they
have no time for its distance from their house is somewhat faraway. The family participates in
community activities such as celebrating fiesta and watching different affairs such as basketball
competitions.
The A Family enjoys the community resources since the community itself are active in
conducting activities for the community. The children, though, go to Purok Daanbanwang
Elementary School. The father is usually in a mosque working as a security guard while the mother
is in the house doing household chores.
Their neighbors on the left side of their house is the source of their electricity while their
neighbors on the right side of their house help them with water supply. The A Family contribute
Php 190.00 for water supply. They wash their clothes and gets their drinking water supply there.
They put their water in a pails often without cover. They do not sterilize or purify their drinking
water supply.
A Family has no proper comfort room. They usually urinate and remove bowels in their
Open Pit Privy improvised comfort room. The drainage system of the family is an open type where
in the drainage flows anywhere and is continuous.
The A family is identified to have plenty of environmental problems in which it is evident
that they practice poor environmental sanitation. With this situation and family condition, many
58
problems were identified such as health threats which include fire hazards, poor home and
environmental sanitation, and improper drainage system as well as health threats which are
improper personal practice as improper hygiene. A nursing care plan was then formulated to
address the different problems identified.
Nevertheless, the family has chances to improve their health condition. There still have
that ability to meet the desired characteristics in their structure and maximize their health potential
of optimum wellness. They are mostly cooperative and participative to the different issues and
interventions they are confronted. Hence, they are willing to submit themselves for the impartation
of information and basic knowledge regarding family health.
The objectives of identifying family health related problems were achieved due to the
compliance and cooperation of the A Family. Together with the family, the researchers as an agent
has helped the family through motivation and support to change their lifestyle and improve their
health status. Although the allotted time for the researchers was not enough to attend to all those
twenty (20) health related problems, the family is now equipped with fair knowledge which they
could use anytime as the need arises.
Conclusion
This study “Family Health Assessment: The Case of Family A” is a qualitative case study that
formulated conclusions answering the research problems of this study.
The A Family consists of 5 family members where the father, Mr. A, is the only one
working that has a monthly income of Php 3,000.00. This amount of income implies that the A
Family is to be considered poor. On the other hand, Ms. F, although has no occupation, she is
dominant in terms of decision making and household duties. Their aunt and neighbors play a big
59
role in their way of living in terms of water, electricity, and financial support. Their household are
made up of light materials that consists only one room for sleeping, cooking, and dining. All of
the family members have a medical history of acquiring diseases except Ms. F for she stated that
she did not acquired any disease yet. Immunization of the family members are incomplete. They
have no stable lifestyle due to insufficient resources yet recognizes health as a must.
The researchers identified twenty (20) health related problems present in the A Family.
However, the researchers come up with five (5) health related problems to be prioritized through
proper scoring and its corresponding justifications. These five-prioritized health related problems
are namely: inability to take vitamins; unsanitary water supply; unsanitary drinking water; poor
outdoor environmental condition; and poor indoor environmental condition respectively. These
are the health-related problems where interventions were made.
The interventions were mainly imparting knowledge and proper education about the
following: medicines and services offered by barangay health center including the importance
of taking vitamins; importance of sanitary water supply, information regarding water
contamination, and proper effective ways of saving water; importance of sanitary drinking
water source and container, and knowing ways to make water potable; importance of outdoor
hygiene and sanitation, specifically the importance of proper waste disposal, dangers of
stagnant water, and proper wood and metal storing; and importance of indoor hygiene and
sanitation and regular indoor cleaning of dust and trash respectively. These interventions were
concluded by the researchers to be effective in eradicating or lessening the prioritized health
related problems.
60
Recommendation
The researchers have identified and prioritized problems and needs with the family. The
researchers have also created a care plan on how to deliver the best nursing care for the family to
address their needs. The following below are propositions and commendations recognized by both
the researchers and family after the interventions were conducted:
The family should be aware that organizations in the community are open and present for their
problems to be addressed properly, specifically the availability of medicines such as vitamins in
the nearby barangay health center.
They must enclose all storage of water to avoid pollution through contamination to maintain a
sanitary water supply.
The family must promote proper ways of saving water considering hygiene and sanitation.
The family must realize what danger using polluted water can cause to the health of its family
members and what makes a water polluted.
The family should secure a safe, sanitary and closed drinking water storage for all of its
members.
The A family must remember the importance of sanitary drinking water in a household and
practice ways in making tap water potable.
The A family should maintain a healthy and clean environment. They must clean their
surroundings to avoid the presence of vectors of diseases.
The A family should persevere to perform proper waste segregation, scrap metal and wood
storage, and disposal of their garbage as it was presented during the intervention.
They should be encouraged to regularly clean the dust and trashes inside their house on a daily
basis realizing the health problems it could bring.

61
The family must also be educated on the importance of hygiene and sanitation in all situations
for this issue is prominent in the interventions made considering that Family A have a very low
level of cleanliness in many aspects.
The future researchers should seek resources and develop a more comprehensive manner
and consider the following recommendations of the researchers of this study:
Conduct data gathering for at least 3 consecutive days for the data to be accurate for some
situations may only happen by chance or coincidence.
Conduct an interview not only in the key informant, the head of the family, but also the other
members to thoroughly understand the living of the family in each of their perspectives.
Make sure that the visiting in this family occurs in a time where the family is complete and not
preoccupied.
Attempt to have an access inside the house to further examine the household and to gather a
wider variety of possible or existing health related problems.
Gather pieces of information also with the neighbors of the family to be assessed that have a
built relationship with them for the study to have a different point of view with regards to the
household of the family.
The other families are recommended utilize family case studies like this as an advantage
of foreseeing possible health related problems that may arise in the family and perform the
following ways of preparation or resolution:
Gather information in conducted family health case studies to know the common health related
problems that are faced by other families.
Be educated on the appropriate plans to be formulated in order to attain development and
improvement with regards to a particular health related problem.

62
Prevent the common health related problems evident on other families from affecting their
household by learning the precautions
Discover different intervention that are effectively performed on the other families and utilize
it when a similar health related problem existed.
Gather pieces of information also with the neighbors of the family to be assessed that have a
built relationship with them for the study to have a different point of view with regards to the
household of the family.
The local health authorities related to Family A are recommended to perform the following
activities to strengthen the health foundation of families in the community:
Inform all the household in the community of the offered medicines and health services of the
barangay health center and provide a list of it if possible.
Constantly promote the cleanliness and sanitation of the surroundings of each household in the
community.
Discover the common health related problems of the community and provide an appropriate
intervention for these for the common good of the community.

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APPENDICES
66
APPENDIX A
TRANSCRIPT OF THE INTERVIEW
Researcher 1: Magandang araw po Nay ! Mga researchers po kami mula sa Congre Grade 12
students po. Pwede po ba namin kayong mainterview? May mga katanungan lang po kaming
itatanong niyo and mostly about sa Health po ng Family niyo. Pwede po ba?
Respondent: Para saan ba’ yan?
Researcher 2: Para po sa Research po namin. Pananaliksik po dito po sa South Crest Village.
Respondent: Ah O sige pasok kayo. Maliit lang bahay namin dito nalang tayo sa labas at masikip
diyan sa loob, magulo pa. Neng paabot nga ng suklay.
Researchers 1: Ayan sige po umpisahan ko na po yung pagtatanong. Bali po irerecord po namin
itong pag uusap po natin para po sa accuracy ng data po namin ok lang po.
Respondent: Sige sige.
Researchers 2: Ay Nay bali habang tinatanong po kayo ni Kady, Kukuhanan ko po kayo ng vital
signs ayos lang po ba?
Respondent: Ok. sige. O Joy behave ka lang huh. Wag malikot kay ibbp ako ni Kuya.
Researchers 1: Ayan sige po. So bali sa unang katanungan po, kamusta naman po ang kalusugan
niyo po ngayon? May kakaiba po ba kayong nararamdaman or anything na nafefeel na sakit?
Respondent: Hahaha. Pasaway. Edi kung may sakit ka dapat nasa doktor. Hindi, okay lang. Pang
bata ba wala kayo?
Researchers 1: Ahmm, nakakapag bisita pa po ba kayo sa doctor?
Respondent: Hindi na ako nagpapadoktor. Wala naman akong nararamdaman eh
Researchers 1: Dito po sa health center ninyo?
Respondent: Ayan kapag may mga sakit yung bata. Bata lang. Siyempre unahin mo muna bata
eh. Eto (baby Joy) ano naman to eh every meron sila diyan sa center pang bata.
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Researchers 1: Opo
Respondent: Pero pag matanda ka, hindi mo na iniisip yun. Unang-una bata eh, Diba Joy?
Researchers 1: Wala po kayong ano, kahit nararamdaman lang po?
Respondent: Napapagod. *laugh* Naubo. Malamig kasi.
Researchers 1: Ah napapagod. Ano pong iniinom niyo po kapag napapagod po kayo o may
iniinom po ba kayo?
Respondent: Meron akong ferrous. Ferrous na ano vitamins.
Researchers 1: Ah vitamins.
Respondent: Bigay sakin yun ng auntie ko. Paano wala naman ata kasi minsan vitamins yung
center kaya di kami nahingi,
Researchers 1: Ah talaga po?
Respondent: Oo, tsaka wala rin panahon kasi lagi nasa trabaho asawa ko tapos ako naman lagi
nasa bahay, pag wala siya pasok pahinga lang siya dito.
Researchers 1: Ah ok po. Ay, nay umiinom po ba?
Respondent: Hindi.
Researchers 1: Naninigarilyo po?
Respondent: Naku, kulang na nga sa pamilya mo. Magbibisyo pa.
Researchers 2: Tama Mommy. Sana lahat ng mommy ganyan.
Researchers 1: Tama. Hand up para kay Nanay.
Respondent: Neng magbihis ka na at malelate ka na.
Researchers 1: Saan po napasok si Neneng?
Respondent: Diyan sa tirona.
Researchers 1: May service po?

68
Respondent: Nilalakad lang nila yan kasi malapit nga lang, wala naman mangayari sa kanilang
masama, lakad lang naman.
Researchers 1: Kung ire rate niyo po yung kalusugan niyo. 1 yung lowest at 10 ang highest, gaano
po kaya masasabi niyo na healthy kayo pati po yung buong pamilya niyo?
Respondent: Di ko madescribe. Dapat perfect para walang sakit diba?
Researchers 1: Healthy na healthy po ba?
Respondent: Syempre naman. Kailangan eh. Syempre kapag may sakit ka, apektado bata eh.
Kawawa naman. Tulad niyan. *turo sa panganay na anak* may sakit sa puso yan. Butas puso niyan
eh.
Researchers 1: Talaga po?
Respondent: Oo. Two years old siya ng ma detect naming butas puso niya.
Researchers 1: Ano pong ginawa niyo noong nalaman niyo pong butas yung puso niya?
Respondent: Syempre, natakot. Kinabahan. Wala kasi kami pampadoktor sa kanya at mahal din
mga gamot na kailangan niya kaya di na namin siya napapainom ng mga gamot tapos noodles lang
nakakain kasi wala pera madalas.
Researchers 1: Ano po? Instant Noodles?
Respondent: Oo, instant noodles. Eh bawal sa kanya yun sabi ng auntie ko.
69
APPENDIX B
RESEARCH INSTRUMENTS
GORDON’S FUCNTIONAL HEALTH ASSESSMENT

Health Perception/ Health Management Pattern
1. How is your Health?

2. Do you regularly visit a doctor within a year? Copy of medical reports if any?
3. Are you under medication? Is it prescription or over the counter drugs? What are those
medicines?
4. Do you use tobacco?
5. Do you drink Alcohol? What type of Alcohol?
6. In a scale of 1-10, 1 being not healthy and 10 as healthy, how would you rate your health
status?
7. How often do you visit the doctor within a year?
8. How many medication drugs do you take?
9. How many sticks or packs of cigarettes do you consume?
10. How many bottles of alcohol? How often?
Nutritional Metabollic
1. Did you lose or gain weight in the last six months?

2. How would you describe your appetite?
3. What are the foods that you enjoy? Don’t enjoy?
4. Do you restrict yourself from eating something? What are those? Why did you restrict
yourself?
5. Did your doctor, if there is any, restrict you from eating any food? What are those? Why
did you restrict yourself?
6. Do you drink water every day? Are there any other fluids that you drink?
7. What kind of food do you eat ever day? Could you describe it?
8. What is the amount of weight you gain or lose?
9. In a scale of 1-5, 1 being the poor and 5 being the good, how would you describe your
appetite?
10. How much water do you drink every day?
11. How much food do you think to eat every day?
Elimination Pattern
1. How can you describe your usual bowel movement?

2. Can you describe your stool? The color? The size? The smell?
3. Do you take any medication that may have an effect on your bowel movement? What is it?
4. Can you describe the consistency of your urine? The color? The smell?
5. How often is your bowel movement?
6. How often do you urinate?
70
Activity-Exercise Pattern
1. Do you have an exercise pattern?

2. Describe your usual leisure activities?
3. What do you usually do in your spare time and what sport do you participate in?
4. How often do you follow your exercise pattern?
5. How many times do you perform your exercise in the span of a week?
6. How often do you experience your difficulty in breathing?
Cognitive-Perceptual Pattern
1. Describe your pain tolerance, decision making and knowledge level?

2. Hearing difficulty/Hearing aid?
3. Any change in memory lately?
4. How do you define tasty food?
5. Any problems with your vision? If any, do you consult it to your doctor?
6. How do you choose your decisions? What factors influence you in decision making?
7. How do you understand things best? Do you prefer for visual or audio aids?
8. If there are any, what are your difficulties in learning?
9. How often do you make good decisions in your life?
10. How many languages do you speak?
11. How many times do you have your routine eye exam?
12. What is your eye grade?
Sleep-Rest Pattern
1. Describe your sleep routine?

2. Sleep on set problems? Aids? Dreams (Nightmares)? Early awakening?
3. How many hours do you sleep?
4. How long do you rest still?
Self-Perception/Self-Concept Pattern
1. How do you describe yourself? Most of the time, feel good (not so good) about self?
2. Things frequently make you angry? Annoyed? Fearful? Anxious?
3. Do you feel good about yourself?
4. Are you contented to your present body image?
5. In what situation have you ever felt despair?
6. For you, what are your talents? Are you willing to show it to others?
7. Nervous (5) or relaxed (1): rate from 1 to 5.
8. Assertive (5) or passive (1): rate from 1 to 5.
9. In the scale of 1-10, rate your confidence level?
Role-Relationship
1. Things generally go well at word? (school)?

71
2. Who do you live with?

3. Describe the environment in which you grew up.
4. If any what is your major role in the family?
5. Do you belong to any social group?
6. How do you interact with others?
7. How often do you feel lonely?
8. In a scale of 1-10, how extraneous the activities your work requires you to do?
9. How many are you in the family?
10. In a scale of 1-10, how satisfied are you in your family?
Sexuality-Reproductive Pattern
1. Are you satisfied with your sexual/ reproductive practice? Why or why not?
2. When appropriate: Use of contraceptives/ Problems?
3. Do you experience difficulties in your sexual capabilities?
4. Are you satisfied with your sexual relationship?
Girls:
5. How may times have you given birth?

6. How many times you already got pregnant?
7. When do you have your first menstruation period?
Boys:
8. How frequent do you engage in reproductive practices?

9. When did you have your first ejaculation?
Coping With Stress/ Tolerance Pattern
1. How do you handle stress?

2. How does your friends and family comfort you during the days that are you stressed?
3. How do you cope with stress, if you do not feel like sharing it to your friends and family?
4. In a scale of 1-10, rate your level of coping with stress?
5. What is your estimated time before you can move on from something that gives you stress?
Value-Belief Pattern
1. What is your religion?

2. Are there any practices in your religion that would ask you to eat something or prohibits
you from eating something? What are those foods?
3. How important your health is to you?
4. Do you care about your health?
5. How often do you follow those practices?
6. If being healthful is important, how much do you invest on the health status?
72
73
APPENDIX C.
TWENTY PROBLEMS, ETIOLOGY, SIGNS AND SYMPTOMS (PESS)
1. Inability to utilize community resources for health care related to inadequate knowledge of
Actual
Score
1. Nature of the Not taking Vitamins lessens health
(2)1 2
Problem improvement, making it a health threat.
Supply of Vitamins is free and available
2. Modifiability of
(2)2 4 making this health related problem easily
the Problem
modifiable.
3. Preventive Vitamins intake can easily be promoted
Potential (3)1 3 making the preventive potential of this health
related problem high.
It needs immediate attention for the children
4. Salience of the
(2)1 2 of the family protected from diseases that are
Problem
prominent in their household
Total Score: 11
2. Inability to provide adequate nursing care to the at-risk member of the family related to
inadequate family resources for care, specifically financial constraints on congenital heart disease
as manifested by the absence of medicines and medical certificates and presence of instant noodles
as food supply, and the key informant’s verbalization “Wala kasi kami pampadoktor sa kanya at
mahal din mga gamot na kailangan niya kaya di na namin siya napapainom tas noodles lang
nakakain kasi wala pera madalas eh bawal sa kanya yun”
Actual
Score
The problem of having a family member who
1. Nature of the
(3)1 3 has congenital heart disease is perceived as a
Problem
health deficit.
It notates partial modifiability because the
2. Modifiability of
(1)2 2 effects of it can be lessen or treated but
the Problem
cannot be truly eradicated.
3. Preventive It has low preventive potential since this
Potential (1)1 1 disease cannot be eradicated from occurring
but can be treated.
4. Salience of the This needs an immediate attention since the
(2)1 2
Problem effects may be fatal.
Total Score: 8
74
3. Inability to provide adequate nursing care to the dependent member of the family related to
inadequate family resources for care specifically financial constraints as manifested by the absence
of food for infants and the key informant’s verbalization “Wala kami pambili ng mga cerelac at
biscuit kaya breastfeed lang ginagawa ko para tipid, wala rin kami panggastos eh”
Actual
Score
Breast milk alone as a food source for more
1. Nature of the
(2)1 2 than 6 months could harm babies making it a
Problem
health threat.
It is easily modifiable since enough infant
2. Modifiability of
(2)2 4 food supply is enough to solve this health
the Problem
related problem.
Breastfeeding is a good practice and must not
3. Preventive
be prevented since its good for their health as
Potential (3)1 3
well as their finances.
It is not need immediate attention for the baby

4. Salience of the
(1)1 1 is at good health condition.
Problem
Total Score: 10
4. Inability to provide a home environment conducive to health maintenance and personal

development related to lack of inadequate knowledge of importance of hygiene and sanitation in
terms of water supply as manifested by the sponge beside pails with stagnant polluted water that
Actual
Score
Having an unsanitary water supply is a threat
1. Nature of the
(2)1 2 to family’s health.
Problem
Easily modifiable since waters in their pails
2. Modifiability of
(2)2 4 can be renewed and replaced with clean water
the Problem
to store.
3. Preventive
It has high preventive potential for its effects
Potential (3)1 3
can be prevented easily.
It needs immediate attention for this
4. Salience of the
(2)1 2 unsanitary water supplies are their medium in
Problem
cleaning plates, etc.
Total Score: 11
75

development related to inadequate family resources, specifically financial constraints/limited
financial resources as manifested by the absence of drinking water containers and the key
informant’s verbalization “Wala kami pambili ng purified at mineral kaya tubig gripo lang iniinom
namin, pagkaigib, iintay lang ilang minuto tas pwede na inumin yun”.
Actual
Score
1. Nature of the Unsanitary drinking water is a health threat
(2)1 2
Unsanitary drinking water is easily
2. Modifiability of modifiable since practices of purifying
(2)2 4
the Problem water can be taught and water stations are
available.
Preventive Potential is high since only one
3. Preventive
source of water is needed to fix and
Potential (3)1 3
resolutions that can be done are many.
The problem needs immediate attention

4. Salience of the since all family members drink water
(2)1 2
Problem obtained directly from a faucet.
Total Score: 11

development related to lack of/inadequate knowledge of importance of hygiene and sanitation on
drying clothes as manifested by the presence of dried clothes eposed to unsanitary dusts and
garbage and the key informant’s verbalization “Wala, magtatali tali lang kami jan tas sasampay
na namin jan.”
Actual
Score
1. Nature of the Unsanitary Drying of clothes is a threat to
(2)1 2
Problem family’s health.
It is a partially modifiable since they can dry
2. Modifiability of
(1)2 2 clothes inside their house, but their house
the Problem
lacks in available of space.
It has high preventive potential since they
3. Preventive
have a neighbor close to them to dry their
Potential (3)1 3
clothes and they can also just clean their
drying place.
It does not need an immediate attention since
4. Salience of the
(2)1 1 the problem cannot lead to immediate health
Problem
problems.
Total Score: 8
76

development related to lack of/inadequate knowledge of preventive measures as manifested by the
presence of pile of garbage with no segregation, wood and metal scattered, and pails with stagnant
water, and the key informant’s verbalization “May mga nakakalat na kahoy kahoy diyan pati bakal
di namin tinatapon kasi baka mabenta pa, diyan din namin tinatabi mga basura, inaayos lang
naming sila pag nagkokolekta na ng basura, di naman kami mapapano niyan”.
Actual
Score
1. Nature of the Unsanitary surroundings is a threat to family’s
(2)1 2
Problem health for health hazards can be aggravated.
It has an easy modifiability since regular
2. Modifiability of
(2)2 4 cleaning and sanitation can solve this health
the Problem
threat caused by health hazards.
3. Preventive It can be prevented since this problem can be
Potential (3)1 3 eradicated by just promoting cleanliness and
orderliness.
4. Salience of the It needs immediate attention for these hazards
(2)1 2
Problem could lead to health deficits soon.
Total Score: 11
8. Inability to provide home environment conducive to health maintenance and personal

development related to Inadequate family resources such as having no bathrooms as manifested
by the bathroom covered with plywood and galvanized iron sheets located at the back of their
house and the key informant’s verbalization “Nakikiligo kami diyan sa kabilang bahay. Minsan
kina Auntie.”
Actual
Score
1. Nature of the Sharing bathrooms is a threat to health when
(2)1 2
Problem done in a regular basis.
It is partially modifiable since they do not
2. Modifiability of
(1)2 2 have their own bathroom but can take a bath
the Problem
without sharing bathrooms.
It cannot be prevented completely for it has
3. Preventive
low preventive potential. The family will
Potential (1)1 1
always tend to share bathrooms because they
don’t have one.
It does not need an immediate attention for its
4. Salience of the
(1)1 1 effects are minimum but must not be
Problem
disregarded.
Total Score: 6
77
9. Inability to provide adequate nursing care to the sick member of the family related to inadequate
family resources for care, specifically limitations/lack of physical resources manifested by the
presence of only one room for dinner,sleeping, and eating and the key informant’s verbalization
“May mga ubo’t sipon kami ngaun. Hawa hawa kami kasi lagi naman kami magkakatabi at
magkakasama kasi isang kwarto lang buong bahay namin”.
Actual
Score
1. Nature of the Cough and colds that are frequent are
(3)1 3
Problem considered a health deficit.
It can be treated with medications but is hard
2. Modifiability of to eradicate due to absence of patient isolation
(1)2 2
the Problem making the disease to easily spread in the
family.
It is partially moderate in preventive potential
3. Preventive
since their exposure to cough and colds
Potential (2)1 2
causing environment is unavoidable or
controlled.
It needs immediate attention since pneumonia
4. Salience of the
(2)1 2 or other serious health problems may be
Problem
present.
Total Score: 9
10. Inability to provide a home/ environment conducive to health maintenance and personal
development related to financial constraints manifested by the absence of materials for barricading
and the key informant’s verbalization “Yang mga nasa babang yan (turo sa mga bahay sa baba)
madalas niyang kinakalkal mga gamit namin dito, hindi naman kami makagawa ng harang kasi
wala kami pera.” Their house is located near the slope of the river. There are also houses below
them.
Actual
Score
1. Nature of the Having a house which is prone to theft may
(1)1 1
Problem lead to a crisis that may affect their living.
The house can be locked at times but cannot
2. Modifiability of
(1)2 2 be totally safe because of low quality house
the Problem
materials.
3. Preventive It has low preventive potential because of the
Potential (1)1 1 house location which is near to possible
intruders and to a cliff.
This needs an immediate attention since the
4. Salience of the
(2)1 2 problem has many threats to occur many
Problem
times already.
Total Score: 6
78
development related to financial constraints manifested by the absence of toilet place and materials
and the key informant’s verbalization “Gusto ko nga magkaroon ng maayos na cr kaso di naman
namin kaya, magastos kasi, pagkain nga lang hirap na, kaya ayun nagtiyatiyaga kami sa cr naming
iyan”
Actual
Score
Open Pit Privy is a health threat since the
1. Nature of the
(2)1 2 illnesses could arise in this type of toilet
Problem
system.
The problem is partially modifiable since
2. Modifiability of sanitation in this type of toilet system can be
(1)2 2
the Problem practiced but not totally change the toilet
system.
3. Preventive Open pit privy has low preventive potential
Potential (1)1 1 since they cannot afford to have a better toilet
system.
This needs immediate attention since diseases
4. Salience of the
(2)1 2 can be created with this unsanitary toilet
Problem
system.
Total Score: 7
development related to inadequate knowledge of the importance of hygiene and sanitation as
manifested by the presence of trashes and dust in the living room and the key informant’s
verbalization “Tuwing gabi lang kami nagwawalis para isahang linisan na lang, bago matulog kasi
madudumihan lang ulit”.
Actual
Score
A poor indoor environment could lead to
1. Nature of the
(2)1 2 health deficits making this health related
Problem
problem a health threat.
This problem is easily modifiable for
2. Modifiability of
(2)2 4 regular and proper cleaning is enough to
the Problem
resolve it.
3. Preventive It has high preventive potential since proper
Potential (3)1 3 education of hygiene and sanitation could
prevent this health related problem.
4. Salience of the This needs an immediate attention for it
(2)1 2
Problem could lead to health diseases.
Total Score: 11
79
development related to inadequate family resources specifically limited physical resources as
manifested by the absence of space for kitchen and the key informant’s verbalization “Isang kwarto
lang kasi lahat, kaya kasama na rin namin kusina namin, kung kaya lang namin mapalawak yung
bahay para medyo hiwalay hiwalay mga sala kusina matagal na namin ginawa” The house of
Family A is a bungalow style of house mainly made up of woods and galvanized iron sheets. The
mother usually using wood and charcoal.
Actual
Score
Accident Hazards is a foreseeable crisis for it
1. Nature of the
(1)1 1 can lead to destruction of home and scarcity of
Problem
resources.
It is partially modifiable since old materials
2. Modifiability of
(1)2 2 can be replaced but not the whole itself due to
the Problem
lack of resources.
3. Preventive It has a moderate preventive potential since
Potential (2)1 2 these are only hazards and not a current
problem but must not be disregarded.
4. Salience of the It needs immediate attention since disasters
(2)1 2
Problem can come without further notice.
Total Score: 7
14. Inability to make decisions with respect to taking appropriate health action related to
inaccessibility of appropriate resources for care, specifically cost constraints or financial
inaccessibility manifested by the presence of instant noodles and canned sardines and the key
informant’s verbalization “Eh kung anong meron, kakainin. Hanggang mga noodles at delata lang
kaya ng budget namin”. Their Family income is worth P3000 a month and they barely cook for it
is costly for them to do so.
Actual
Score
1. Nature of the Bad family eating habits is a threat to family’s
(2)1 2
Problem health.
2. Modifiability of It is partially modifiable since what they eat
(1)2 2
the Problem only depends on their available resources.
3. Preventive
It has a low preventive potential for having
Potential (1)1 1
low financial resources to buy healthy foods.
It needs immediate attention since health
4. Salience of the
(2)1 2 impacts that are fatal can occur in the long run
Problem
because of their family diet.
Total Score: 7
80
development related to lack of skill in carrying out measures to improve home environment and
inadequate family resources specifically inadequate living space as manifested by “Ayan ito lang
yung aming bahay. Dito na lahat kwarto,kusina,sala lahat na. Eh wala pang pera eh. Tsaka na
pag may pera, eh kaso yung pera kulang pang pangkain at gastusin dito sa bahay araw-araw”.
The house of Family A is composed of single room where all of their kitchen,sala and even their
bed are located on it. inappropriate to the number of their family size.
Actual
Score
1. Nature of the Inadequate living space can lead to a
(1)1 1
Problem foreseeable crisis one day.
It is partially modifiable because they cannot
2. Modifiability of
(1)2 2 afford to expand the house, but the space can
the Problem
be budgeted.
3. Preventive
It has low preventive potential since they
Potential (1)1 1
cannot avail to have a larger living space.
It must be attended immediately since their
4. Salience of the
(2)1 2 living space is not appropriate for the
Problem
numbers of the family members.
Total Score: 6
development related to lack of skill in carrying out measures to improve home environment as
manifested by “Isa inaasthma, kailangan magpanebulize kasi sobra ang ubo sa gabi , pinapainom
ko na lang ng tubig.” The Family A has a family member with asthma due to polluted environment
and subsequent cough and colds. Presence of dust and bed in the floor in the house.
Actual
Score
1. Nature of the The problem of having a family member who
(3)1 3
Problem has asthma is perceived as a health deficit.
2. Modifiability of It can be partially modifiable modification
(1)2 2
the Problem since it can be solved by nebulization.
3. Preventive It has high preventive potential since the
Potential (3)1 3 availability of medical medicine and attention
is good.
4. Salience of the It needs immediate attention because asthma
(2)1 2
Problem attacks every night to the child.
Total Score: 10
17. Inability to recognize the presence of the condition or problem related to attitude or philosophy
in life which hinders recognition or acceptance of a problem on hemorrhoids as manifested by
81
“Sinabihan ko na yun, di naman daw niya pinapansin, tigas ng ulo, kayang kaya naman daw niya,
sabi ko ipahinga niya eh ayaw naman rin niya magpaawat, mas magkakasakit lang daw pag
nagpadoktor pa” The Family A have a family member who was once diagnosed with hemorrhoids
for he is a former construction worker facing extraneous activities because of his principles.
Actual
Score
The problem of having a family member who
1. Nature of the
(3)1 3 has hemorrhoids is perceived as a health
Problem
deficit.
It is partially modifiable since rest and
2. Modifiability of
(1)2 2 avoiding of carrying heavy objects leads only
the Problem
are required.
3. Preventive It has low preventive potential because only
Potential (2)1 2 the father itself can perform extraneous tasks
in the family.
4. Salience of the It does not need an immediate attention since
(2)1 2
Problem this deficit is simply a past health history.
Total Score: 9
18. Inability to make decisions with respect to taking appropriate health action due to
misconceptions or erroneous information about proposed courses of action in seizures as
manifested by “Di ko na alam gagawin ko pag naulit ulit yun, binabasa ko na lang mukha niya
kasi natirik na mata niya nun tas hilot hilot lang, ganun diba” The Family A has a family member
who experienced convulsion when having a fever aggravated by a heart disease.
Actual
Score
1. Nature of the The problem of having a family member who
(3)1 3
Problem has seizure is perceived as a health deficit.
2. Modifiability of It is partially modifiable since its occurrence
(1)2 2
the Problem are seldom and medications are available.
3. Preventive It has a moderate preventive potential since
Potential (2)1 2 this can be prevented but it can be heighted by
the environment.
4. Salience of the It needs an immediate attention since it is side
(2)1 2
Problem effect of having a seizure of the child
Total Score: 9
19. Failure to utilize community resources for health due to lack of/inadequate knowledge of
community resources for health care manifested by the absence of medical certificates and key
informant’s verbalization “Mahal kasi magpacheck up kaya napunta lang kami sa center para
manghingi minsan ng gamot”. The family is not aware that free check-ups are also available in
the barangay health center.
82
Actual
Score
Health threat because the absence of regular
1. Nature of the
(2)1 2 check-up in the family may lead to a health
Problem
deficit unconsciously.
This can be modified by simply imparting
2. Modifiability of
(2)2 4 education regarding the services that health
the Problem
centers offer.
3. Preventive This has high preventive potential since once
Potential (3)1 3 the family is educated, regular check-up will
be possible.
This does not need immediate attention
because even though they are not aware of the
4. Salience of the free check-up they are aware of the free
(1)1 2
Problem medicines. Therefore, this can me a matter to
discuss after prioritizing the other health
problems.
Total Score: 10
20. Inability to make decisions with respect to having appropriate health action due to failure to
comprehend the nature/magnitude of the problem manifested by the 3km distance from their house
and the school and the verbalization of the client “Diyan lang naman sa Tirona. Nilalakad lang
nila yan kasi malapit nga lang, wala naman mangayari sa kanilang masama, lakad lang naman.”
The mother does not understand that the distance of the school could cause respiratory problems,
accidents, and over fatigue for the children.
Actual
Score
1. Nature of the Remote school of children is a health threat
(2)1 3
Problem for the family.
This partially modifiable since they can
2. Modifiability of
(1)2 2 transfer the children to nearby school but still
the Problem
depends on their resources.
3. Preventive It has low preventive potential since the
Potential (1)1 1 family will choose the school for it is
convenient financially.
This must be attached immediately since long
4. Salience of the
(2)1 2 duration of walking daily can lead to fatigue,
Problem
cough etc.
Total Score: 7
83
APPENDIX D.
ISHIKAWA DIAGRAM
1. Inability to utilize community resources for health care related to inadequate knowledge of
Absence of Vitamins
Inability to
seek and
produce
INABILITY TO TAKE VITAMINS
Unavailability of Lack of
Time to Spare Awareness
Absence of People Poor Education of the

to Produce Services Offered by the
Vitamins Barangay
84

development with relate to lack of inadequate knowledge of importance of hygiene and sanitation
in terms of water supply as manifested by the sponge beside pails with stagnant polluted water that
Improper Water
Storage (Open Pail)
High
Contamination
Potential
UNSANITARY WATER SUPPLY
Over Saving of
Water due to Lack of Education
Financial
Constraints
Unhygienic Misconception about Water

Reusing of Water Pollutants
85

development with relate to inadequate family resources, specifically financial constraints/limited
financial resources as manifested by the absence of drinking water containers and presence of open
pails with drinking glasses, and the key informant’s verbalization “Wala kami pambili ng purified
at mineral kaya tubig gripo lang iniinom namin, pagkaigib, iintay lang ilang minuto tas pwede na
inumin yun”.
Improper Drinking Water

Storage
(Open Pail)
High
Contamination
Potential
UNSANITARY DRINKING WATER SUPPLY
Presence of Pails
with Drinking Lack of Education
Glasses
Drinking Water Lack of Knowledge of the

Directly from Importance of Sanitary Drinking
Faucet Water
86
4. Inability to provide a home environment conducive to health maintenance and personal development
with relate to lack of/inadequate knowledge of preventive measures as manifested by the presence of pile
of garbage with no segregation, wood and metal scattered, and pails with stagnant water, and the key
informant’s verbalization “May mga nakakalat na kahoy kahoy diyan pati bakal di namin tinatapon kasi
baka mabenta pa, diyan din namin tinatabi mga basura, inaayos lang naming sila pag nagkokolekta na ng
basura, di naman kami mapapano niyan”.
Presence of Breeding
Site for Vectors of
Diseases
Pails with
Stagnant Water
POOR OUTDOOR ENVIRONMENTAL CONDITION
Potential Breeding
Sites for Vectors of Accident Hazard
Diseases
Improper Waste Improper Storing of Scrap

Disposal Metal and Wood
87

development due to inadequate knowledge of the importance of hygiene and sanitation as
manifested by the presence of trashes and dust in the living room, and the absence of broom and
dustpan in the living room, and the key informant’s verbalization “Tuwing gabi lang kami
nagwawalis para isahang linisan na lang, bago matulog kasi madudumihan lang ulit”.
Lack of Knowledge of the

Importance Hygiene and
Sanitation
Low
Educational
Attainment
POOR INDOOR ENVIRONMENTAL CONDITION
Improper Practice Presence of

of Cleaning Trashes and
Dust
Behaviour in Unsanitary Environment of

Hygiene and the House
Sanitation
88
APPENDIX E.
CERTIFICATION OF THE ENGLISH CRITIC
Republic of the Philippines

Department of Education
Region IV-A (CALABARZON)
City Schools Division of Dasmariñas
CONGRESSIONAL INTEGRATED HIGH SCHOOL

Via Verde Village, San Agustin II, City of Dasmariñas, Cavite
 (046) 973-2534
Senior High School
CERTIFICATION
TO WHOM IT MAY CONCERN:
This is to certify that the research manuscript entitled: Exploring Health

Problems in the Household: The Case of Family A. has been read and edited by the
undersigned as the English critic.
ELOISA ROSEL- ESPEÑA, MAT, LPT

English Critic
Contact Number: (0932)546-5694
Date Signed: April 3, 2018
Noted:
JEFFREY A. LUCERO, MPMG, MAEd, MAN, RN, CSE, SHNC, FRIN, FRIEdr, FIIER
Capstone Project Teacher
89
APPENDIX F.
CURRICULUM VITAE OF KADYMARS G. JABONERO
Kadymars Galinato Jabonero was born on July 15,
1998 in Dasmariñas, Cavite. She finished her primary
education at Salitran Elementary School with flying colors.
She is studying in Congressional Integrated High school taking
up Science, Technology, Engineering and Mathematics
(STEM) strand. She is now in her grade 12 and is part of the
pioneer batch of K-12 program that will graduate on April 5, 2018. She is currently the President
of Sipnayan Society, one of the Club Organization in her school. She was also a former team leader
and member of Disaster Risk Reduction Management “Rehabilitation Team” wherein their team
was responsible to conduct different health awareness programs and medical mission at her school.
Prior to that, she plans to pursue medical field in college and aspire to be an allied health
professional in the future.
Aside from being an academic achiever, she is also a servant of God. She is part and
belongs to performing team of Whitelight Ministry in Church of God Dasmariñas.

90
APPENDIX G.
CURRICULUM VITAE OF SIMON TIMOTHY SECRETARIO
Simon Timothy Secretario is currently a student and is
approaching his legal age on April 25th in the year 2018. He is
a part of the pioneer graduates of K-12 program and is
graduating on April 5, 2018. He was born and raised in the City
of Parañaque. He finished his elementary education and his
Junior High School in Golden Achievers Academy of
Parañaque. He is the First Honor of his school from grade 7 to grade 10. He is a versatile student
fond of participating at the utmost way in different school activities, both curricular and extra-
curricular. He is a consistent honor student and known by his teachers and mentors as an indeed
good student. He does not stresses himself with regards to his studies for he knows that he got
nothing to prove yet something to improve. His ability on research is not at its peak and is actually
just beginning to be nurtured and developed fully. He is willing to learn and opens his mind for all
future opportunities and improvements.

91
APPENDIX H.
DOCUMENTATION
Figure 4: Data Gathering

Exploring Health Problems in The Household: The Case of Family A

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EXPLORING HEALTH PROBLEMS IN THE HOUSEHOLD:

THE CASE OF FAMILY A.

Republic of the Philippines

Senior High School

This capstone project entitled “EXPLORING HEALTH PROBLEMS IN THE

Date: April 3, 2018

MARIAN S. PENALES, MSc, LPT ADELMA S. TOPACIO, MAT, LPT

Accepted and approved in partial fulfillment of the requirements for graduation.

JOSEFINA A. BRIÑAS, MAEd, LPT

following people who made the completion of this study possible.

everything before they apply the information in their research study;

supportive to the congressionalians on striving for excellence;

paying all the cost required to finish the paper;

SIMON TIMOTHY SECRETARIO

APPROVAL SHEET ...................................................................................................................... ii

LIST OF APPENDICES .............................................................................................................. viii

LIST OF FIGURES .................................................................................................................... viiii

LIST OF TABLES ......................................................................................................................... ix

Chapter I: THE PROBLEM AND ITS BACKGROUND ...................................................... 11

Statement of the Problem .......................................................................................................... 12

Scope and Delimitation of the Study ........................................................................................ 12

Significance of the Study .......................................................................................................... 13

Chapter II THEORETICAL FRAMEWORK ......................................................................... 14

Functions of the Family………………………………………………………………….....15

Health Tasks of the Family…………………………………………………………………16

Family Health Assessment……….…………………………………………………………16

Family as Health Support System……...……………………………………………………16

Synthesis of RRL ...................................................................................................................... 24

Theoretical Framework ............................................................................................................. 26

Conceptual Framework ............................................................................................................. 26

Chapter III METHODOLOGY................................................................................................. 28

The Sample ................................................................................Error! Bookmark not defined.

Data Gathering Procedure ......................................................................................................... 31

Data Analysis ............................................................................................................................ 32

Chapter IV RESULTS AND DISCUSSION............................................................................. 34

Family Health Assessment tool .................................................................................. 34

Gordon’s Functional Assessment ............................................................................... 40

The Health Related Problems Present in the Household .......................................................... 34

Inability to Take Vitamins .....................................................Error! Bookmark not defined.

Unsanitary Water Supply ...................................................................................................... 46

Unsanitary Drinking Water ................................................................................................... 47

Poor Outdoor Environmental Condition ............................................................................... 48

Poor Indoor Environmental Condition.................................................................................. 49

Care Plan for Inability to Take Vitamins .............................................................................. 51

Care Plan for Unsanitary Water Supply................................................................................ 51

Care Plan for Unsanitary Drinking Water ............................................................................ 53

Care Plan for Poor Outdoor Environmental Condition......................................................... 54

Care Plan for Poor Indoor Environmental Condition ........................................................... 55

Chapter V SUMMARY, CONCLUSIONS, AND RECOMMENDATIONS ........................ 55

A Transcript of the Interview…………………………………………… 66

C Twenty Health Related Problems……………………………………. 73

E Certification of the English Critic……………………………………. 88

F Curriculum Vitae of Kadymars G. Jabonero…………………………. 89

G Curriculum Vitae of Simon Timothy Secretario……………………… 90

1 The Assessment Phase in Family Health Nursing Practice:

2 The Conceptual Framework…………………………………………….. 27

3 The Phases of The Data Gathering……………………………………… 31

4 Data Gathering …………………...……………………………………… 91

1 Prioritizing Health Problems…………………………………………….. 34

2 Demographic Data of the Household…………………………………..... 35

3 Top Five Priority Health Problem……………………………………….. 45

4 Inability to take Vitamins ……………………………………………….. 46

5 Poor Home Sanitation: Unsanitary Water Supply ………………………. 47