NCM 104 – FAMILY NURSING PROCESS

FAMILY HEALTH ASSESSMENT

- 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
1) TOOLS FOR ASSESSMENT: ITHC
- Initial Data Base FSEHV
o Family Structure Characteristics and Dynamics.
 Members of the household and relationship to the head of the
family
 Demographic data
 Place of residence of each member
 Type of family structure (matriarchal or patriarchal,
nuclear or extended)
 Dominant family members in terms of decision-making
 General family relationships or dynamics
o Socio-economic and Cultural Characteristics
 Income and expenses
 Occupation and place of work of each member
 Adequacy to meet basic needs
 Who makes decision about family expenditure
 Educational attainment of each member
 Ethnic background and religious affiliation
 Significant others
 Relationship of the family to a larger community
o Home Environment
 Housing
 Adequacy of living space ◦ Sleeping arrangement ◦
Presence of breeding or resting sites of vectors of
diseases ◦ Presence of accident hazards ◦ Food storage
 and cooking facilities ◦ Water supply ◦ Toilet facility ◦
Garbage disposal ◦ Drainage system
 Kind of neighborhood
 Social and health facilities available
 Communication and transportation facilities available
o Health Status of each Family Member
 Medical history indicating current or past significant illnesses or
beliefs and practices conducive to health and illness
 Nutritional assessment (anthropometric data, dietary history,
eating/feeding habits/practices)
 Developmental assessment
 Risk factor assessment indicating presence of major and
contributing modifiable risk factors for specific lifestyle diseases
 Physical assessment indicating presence of illness state/s
 Results of laboratory/diagnostic and other screening procedures
supportive of assessment findings
o Values, Habits, Practices on Health Promotion, Maintenance and
Disease Prevention
 Immunization status
 Healthy lifestyle practices
 Adequacy of:
 Rest and sleep
 Exercise/activities
 Use of protective measures
 Use of promotive-preventive health services
- Typology of Nursing Problems in Family Nursing Practice
o tool used to facilitate the process of defining family nursing problems,
classification system, and has been used by nursing students,
community health nurse practitioners and educators
o ASSESSMENTS:
 First Level Assessment (1)
 The process whereby existing and potential health
conditions or problems of the family are determined.
  It relates what health problems exist and will exist.
 Categories: WTDF
o Wellness State
o Health Threats
o Health Deficits
o Foreseeable Crisis
 First Level Assessment (2)
 Presence of Wellness Condition
o A clinical judgement about a client in transition
from a specific level of wellness or capability to a
higher level.
 Presence of Health Threats
o Conditions that are conducive to disease and
accident, or may result to failure to maintain
wellness or realize health potential
 First Level Assessment (3)
 Presence of Health Deficits
o Instances of failure in health maintenance
 Presence of Foreseeable Crisis
o Anticipated periods of unusual demand on the
individual or family in terms of adjustment/family
resources
 Second Level Assessment (1)
 the nature or type of nursing problems that the family
encounters in performing the health tasks with respect to
a given health condition or problem, and the etiology or
barriers to the families’ assumption of these tasks.
 Second Level Assessment (2)
 the family recognizes the existence of the condition or
problem. If the family does not recognize the presence of
the condition or problem, explore the reasons why.
 If the family recognizes the presence of the condition or
problem, determine if something has been done to
 maintain the wellness state or resolve the problem. If the
family has not done anything about it, determine the
reasons why. If the family has done something about the
problem or condition, determine if the solution is effective.
o LEVELS:
 First Level
 Wellness condition (3) - Health Deficits (3)
 Health Threats (2) - Foreseeable Crisis (1)
 Second Level
 Inability to recognize the presence of the condition or the
problem
 Inability to make decisions with respect to taking
appropriate health action
 Inability to provide adequate care to the sick, disabled,
dependent, or vulnerable/at-risk member of the family
 Inability to provide home environment conducive to health
maintenance and personal development
 Failure to utilize community resources for health
- Family Health Task
o Health task differ in degrees from family to family.
o TASK – is a function, but work or labor overtures assigned or
demanded of the person
o 5 Family Health Tasks (maintaining a reciprocal relationship with the
community and its institution) RHHDC
 Recognizing interruptions of health development
 Managing health and non-health crisis
 Maintaining a home environment conducive to health
maintenance
 Making decisions about seeking health care/ to take action
 Providing care to all members of the family
- Family Coping Index
o The objective of this indicator is to present bench mark for appropriate
nursing needs of a particular family, thus family coping index.
 o The family coping index is measured with the following scores:
 1 – No competence
 3 – Moderate Competence
 5 – Complete competence
2) FAMILY DATA ANALYSIS:
- TYPES: SEHV
o Socio-Economic and Cultural Characteristics
 Income and expenses
 Occupation, place of work and income of each working
member
 Adequacy to meet basic necessities (food, clothing,
shelter)
 Who makes decision about money and how it is spent
 Educational Attainment of each Member
 Ethnic Background and Religious Affiliation
 Significant others-role (s) they play in family’s life
 Relationship of the family to larger community
o Home Environment
 Housing
 Adequacy of living space
 Sleeping in arrangement
 Presence of breathing or resting sites of vector of
diseases
 Presence of accident hazard
 Food storage and cooking facilities
 Water supply-source, ownership, pot ability
 Toilet facilities-type, ownership, sanitary condition
 Garbage/refuse disposal-type, sanitary condition
 Drainage System-type, sanitary condition
 Kind of Neighborhood, e.g. congested, slum etc.
 Social and Health facilities available
 Communication and transportation facilities available
o Family Health Status
  Medical Nursing history indicating current or past significant
illnesses or beliefs and practices conducive to health and illness
 Nutritional assessment (especially for vulnerable or at risk
members)
 Anthropometric data
 dietary history specifying quality and quantity of food or
nutrient per day
 Eating/ feeding habits/ practices
 Developmental assessment of infant, toddlers and preschoolers
 Risk factor assessment indicating presence of major and
contributing modifiable risk factors for specific lifestyle diseases
 Physical Assessment indicating presence of illness state/s
(diagnosed or undiagnosed by medical practitioners)
 Results of laboratory/diagnostic and other screening
procedures supportive of assessment findings
o Family Values and Health Practices
 Values, Habits, Practices on Health Promotion, Maintenance
and Disease Prevention. Examples include:
 Immunization status of family members
 Healthy lifestyle practices. Specify.
 Adequacy of:
o Rest and sleep
o Exercise/activities
o Use of protective measure
o Relaxation and other stress management activities
 Use of promotive-preventive health services