PFC MATRIX

COMMUNITY-
COMPONENTS PATIENT-CENTERED FAMILY-FOCUSED
ORIENTED
Relevant Hx and PE Family Genogram (on a Six building blocks of
separate sheet) health
DATA Psychosocial issues APGAR 1 Score Social determinants of
health
SCREEM
Clinical features

ANALYSIS Psychosocial issues

Bioethical issues

DIAGNOSIS

MANAGEMENT Non-medical treatment

/
Medical Management
INTERVENTION

* 6 Building Blocks of Health (WHO): i) service delivery, ii) health workforce, iii) health
information systems, iv) access to essential medicines, v) financing, vi) leadership /
governance

COMPONENTS PATIENT CENTERED FAMILY FOCUSED COMMUNITY ORIENTED

DATA Relevant History and PE; Family History Social determinants of health;
Psychosocial issues Family Assessment Six building blocks of health;
Tools, Family Systems Work history; Endemicity
Assessment

ANALYSIS Salient clinical features, Salient features of the Salient features of the
psychosocial, bioethical family dynamics and/or assessments on the SDH and
issues family systems Health system
assessment

DIAGNOSIS/ Medical diagnosis (ICD-10) May mention barriers to May mention barriers to care /
CONCLUSION / Psychosocial diagnosis care/ those things those enabling to care
ASSUMPTION enabling to care

MANAGEMENT/ Treatment: Non-medical and Family intervention to COPC-based

INTERVENTIONS Medical Management address both medical and Addressing the issues identified
Medical and Individual psychosocial issues (existing and proposed)
psychosocial intervention identified
Family GENOGRAM / Family MAP

FAMILY ___________________
DATE _____________________
ADDRESS _________________

II

III

Legend:

Family APGAR 1 QUESTIONNAIRE

ALMOST SOME OF HARDLY

ALWAYS THE TIME EVER

I am satisfied that I can turn to my family for help when

something is troubling me

I am satisfied with the way my family talks over things

with me and shares problems with me

I am satisfied that my family accepts and supports my

wishes to take a new activities and directions

I am satisfied with the way my family expresses affection

and responds to my emotions

I am satisfied with the way my family and I share time

together

TOTAL

LEGEND:
Highly Functional. 8-10
Moderately Dysfunctional 4-7
Severely Dysfunctional 0-3
FAMILY APGAR PART 2 QUESTIONNAIRE

Who lives in your home? How do you get along?

Name Relationship Age Gender Well Fairly Poor

SCREEM

PARAMETER STRENGTH WEAKNESS

SOCIAL

CULTURAL

RELIGIOUS

EDUCATIONAL

ECONOMIC

MEDICAL

FAMILY ECOMAP

SCHOOL CHURCH

WORK HEALTH CARE

FRIENDS RELATIVES

Legend:
________ Positive
_ _ _ _ _ _ Tenuous

~~~~~~~~ Stressful