implementation or practice sessions centered on providing the families guided experiences or opportunities to carry out or practice the competencies/skills learned, The last component focused on evaluation activities which developed the families’ capabilities to ‘specify "What happened?"; "What were missing?"; and, "What to do next?" Research findings showed that these four components of the motivation-support intervention significantly improved the families’ competencies on early casefinding, prompt/appropriate treatment, use of _ self-protection measures and environmental manipulation to eliminate the breeding and resting sites of the mosquito-vector of malaria. Fleury’s model of wellness motivation was adapted using the motivation-support intervention, Families were guided thru the behavior change process: from constructing the intention to initiate/sustain the change to translating the intention into actions, and lastly to integrate the actions/change into existing lifestyle. Appendix C specifies the nursing interventions to facilitate the families’ movement through each stage. Chapter 18 describes in detail the family empowerment process and ‘outcomes based on an intervention research on malaria control done in Danglas, Abra Province from 1997 to 1999. Criteria for Selecting tho Type of Nurse-Family Contact Effectivity, efficiency, and appropriateness are major criteria for selecting the type of family-nurse contact. While the home visit is expensive in terms of time, effort, and logistics for the nurse, it is an ‘effective and appropriate type of family-nurse contact if the objectives and outcomes of care require accurate appraisal of family relationships, home Gnd environment, and family competencies (i.e. the best opportunity to ‘observe actual care given by family members). ‘The clinic or office conference is less expensive for the nurse and provides the opportunity to use equipment that cannot be taken to the home. In some cases, the other team members in the clinic may be Consulted or called in to provide additional service. The clinic or office Conference also emphasizes to the family the importance of empowerment and assuming responsibility for self-help. ‘The telephone conference may be effective, efficient and appropriate if the objectives and outcomes of care require immediate access to data, given problems on distance or travel time. Such data include monitoring of health status or progress during the acute phase of “anillness state, change in schedule of visitor family decision, and updates on outcomes or responses to care or treatment. 107‘The written communication is another less time-consuming option for the nurse in instances when there are a large number of families Needing follow-up on top of problems of distance and travel time. If the family is motivated and independent enough such that the nurse can use the advantage of placing responsibility for action on the family, a letter, note (as reminder, follow-up on medication/treatment or update on Progress or referral) and leariing materials are appropriate, effective and efficient options. A school visit or conference is done to work with the family and school authorities on how to appraise the degree of vulnerability of and work out interventions to help children and adolescents. ‘on specific health risks, hazards or adjustment problems. An industrial plant or job site visit is done when the nurse and the family need to make an accurate assessment of health risks or hazards, and work with ‘employer or supervisor on what can be done to improve on provisions for health and safety of workers. DEVELOPING THE EVALUATION PLAN ‘The evaluation plan specifies how the nurse will determine changes in health status, condition, or situation and achievement of the outcomes of care (goals and objectives). The plan includes crteria/indicators, evaluation methodsitools and sources of evaluation data. These ‘components of the evaluation plan are discussed extensively in Chapter 17. AN ILLUSTRATION OF A FAMILY NURSING CARE PLAN Table § shows the family nursing care plan based on the first five health conditions or problems in the list of priorities. It specifically illustrates the goals and objectives of nursing care and the intervention plan which includes nursing measures to be done, the methods of nurse. family contact, and the resources required, Note that the nursing care plan addresses the etiology of the family nursing problems or the barriers to the family’s performance of the health tasks. Ideally, the family nursing care plan is written as part of the family service and progress record or the FSPR (See Appendix E). It contains the sociodemographic data of the family, the assessment of the home and environment, the problem sheet containing the list of health conditions and family nursing problems with their corresponding supporting data/cues, the nursing care plan and the follow-up or progress notes. See Appendix D for Guidelines on Charting Nursing Care, Progress Notes and Client Responses/Outcomes. The other problems on the home and the environment shall be taken up with depth, with @ care plan formulated, after the nurse has taken the ‘opportunity to do second-level assessment on each heath condition or problem. 108‘you sed punod eu0 32091 72 Aq wuBlon s.ouny oseonul o Aouabe wou, soupisisse iejeipyequoweyddns re1ojaeyog syelpoueyuy “eosBop 16:4 03 e04Bop puoces woy snes euonianu s,euny exouduy, ‘uojAryoR [eUULeL ‘Bun Jo W/Biam Apjaam jo wdEIDS "xouabe 1g van sounprsse Keypmueweyscns Poo} 0 Aanuenb pu punt eIeP 10 UONEION “yeu vod eu fa voles oo} Jo wnowe pue pun, Busyoeds ep poo :Burpios0y p96n 0a 01 Bupa 0 BPONN ES) ainjeuBs 5 980N _sSuise 9P10 1 oxaeUbis ——arrreubs 8 040 ‘ameuBs 80.064 ~| ————————————_ —— we oy es L9vULNOD bung {apie pue euns Jo uossiap wf uo paseq 10) you! Jed hep Ajuse} 940 jeuOINPPE "BU JO 8229 OY) IPA OWN SEVICES ape Ka ven 19d 8910U 40 USIP QUO ‘Bury jo 0209 ‘9ye) yn oy s6u)Q8 10pI0 105 UOREXEIOA pus eineia| Jo ¥oam 1 sunoy omy jEUOMPEE popoou 1 ‘eoppe pus woueBesnooue 10) Kvep 20u0 earn eu 82 0 vossiued 'VORBNAGUCD 205 ekep 219 seInBa! * eo Fo: @ w rs1e10]uIEyFIGURE 3. SAMPLE TWO-WAY REFERRAL FORM* (Letterhead of Referring Agency specifying Name, Address and Telephone Number) Name of Agency to Which Referral is Made: —— Address:. Date: ——_______ Name of Patient/Family Head: ————<—_______—— Age: Sex, Civil Status:__ Occupation: Reason for Referral/Services Requested: ‘Signature of Referring Personnel and Designation Name of Patient/Family Head: Services Done/Findings/Recommendations: ~ Signature and Designation (See back page for instructions) 110A Objective: : ‘Set-up a referral system that facilitates access to services and information by client/family and agencies. Instructions: t (back page) ‘Two-Way Referral Form The personnel of the referring agency (e.g., barangay station: R.H.U,) fills up the first half of the form providing pertinent data as indicated (\e., case summary and reason for referral or services requested. ‘The clientfamily brings the referral form to the agency where referral is made to avail of the services needed. ‘The personnel of the agency to which referral is made fills up the ‘second half of the form, specifying the services rendered/findings ‘and recommendations, and sends back the form to the referring ‘agency through the client/family. The clienvfamily brings back to the referring agency (e.9., barangay station; R.H.U.) the duly accomplished second half of the form for decision, action or information. 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