o

MAGLAYA COPY current or past significant illnesses or beliefs and practices conducive

to health illness
INITIAL DATA BASE FOR FAMILY NURSING PRACTICE o
Nutritional assessment
▪
● Anthropometric data: Measures of nutritional status of children,
Family structure, Characteristics, and Dynamics
o weight, height, mid-upper arm circumference: Risk assessment measures of
Members of the household and relationship to the head of the family
o obesity: body mass index, waist circumference, waist hip ratio
Demographic data – age, sex, civil status, position in the family
▪
o Dietary history specifying quality and quantity of food/nutrient intake
Place of residence of each member – whether living with the family
per day
or elsewhere
▪
o Eating/ feeding habits/ practices
Type of family structure – e.g. matriarchal or patriarchal, nuclear or
o
Developmental assessments of infants, toddlers, and preschoolers –
extended
o e.g., Metro Manila
Dominant family members in terms of decision-making, especially in
o
Risk factor assessment indicating presence of major and contributing
matters of health care
o modifiable risk factors for specific lifestyles, cigarette smoking, elevated blood
General family relationship/dynamics – presence of any readily
lipids, obesity, diabetes mellitus, inadequate fiber intake, stress, alcohol drinking
observable conflict between members; characteristics communication patterns
and other substance abuse
among members
o
● Physical assessment indicating presence of illness state/s
Socio-economic and Cultural Characteristics
o
o Results of laboratory/diagnostic and other screening procedures
Income and Expenses
▪ supportive of assessment findings
Occupation, place of work and income of each working members
●
▪ Values, Habits, Practices on Health Promotion, Maintenance and
Adequacy to meet basic necessities
▪ Disease Prevention
Who makes decisions about money and how it is spent
o
o Immunization status of family members
Educational attainment of each other
o
o Healthy lifestyle practices. Specify
Ethnic background and religious affiliation
o
o Adequacy of:
Significant Others – role(s) they play in family’s life
▪
o rest and sleep
Relationship of the family to larger community – Nature and extent
▪
exercise
of participation of the family in community activities
▪
● use of protective measures- e.g. adequate footwear in parasite-
Home and Environment
o infested areas;
Housing
▪
▪ relaxation and other stress management activities
Adequacy of living peace
o
▪ Use of Promotive-preventive health services
Sleeping arrangement
▪
Presence of breeding or resting sites of vectors of diseases
▪ A TYPOLOGY OF NURSING PROBLEMS IN FAMILY NURSING PRACTICE
Presence of accidents hazards
●
▪ FIRST-LEVEL ASSESSMENT
Food storage and cooking facilities
o
▪ Presence of Wellness Condition – stated as Potential or Readiness- a
Water supply – source, ownership, portability
▪ clinical or nursing judgment about a client in transition from a specific level of
Toilet facility – type, ownership, sanitary condition
▪ wellness or capability to a higher level. Wellness potential is a nursing judgment on
Drainage system – type, sanitary condition
o wellness state or condition based on client’s performance, current competencies or
Kind of neighborhood, e.g. congested, slum, etc.
o clinical data but no explicit expression of client desire. Readiness for enhanced
Social and health facilities available
o wellness state is a nursing judgment on wellness state or condition based on
Communication and transportation facilities available
● client’s current competencies or performance, clinical data explicit expression of
Health Status of each Family MemberMedical and nursing history
desire to achieve a higher level of state or function in specific area on health
indicating
promotion and maintenance.
▪
Potential for Enhanced Capability for:
● ●
Healthy lifestyle – e.g. nutrition/diet, exercise/ activity Improper drainage system
● ●
Health Maintenance Poor ventilation
● ●
Parenting Noise pollution
● ●
Breastfeeding Air pollution
● ▪
Spiritual Well-being – process of a client’s unfolding of mystery Unsanitary food handling and preparation
▪
through harmonious interconnectedness that comes from inner strength/sacred Unhealthful lifestyles and personal habits-
●
source/GOD (NANDA 2001) Alcohol drinking
● ●
Others, Cigarette smoking
▪ ●
Readiness for Enhanced Capability for: Inadequate footwear
● ●
Healthy Lifestyle Eating raw meat
● ●
Health Maintenance Poor personal hygiene
● ●
Parenting Self-medication
● ●
Breastfeeding Sexual promiscuity
● ●
Spiritual Well-being Engaging in dangerous sports
● ●
Others, Inadequate rest
o ●
Presence of Health Threats – conditions that are conducive to Lack of inadequate exercise
●
disease, accident or failure to realize one’s health potential. Lack of relaxation activities
▪ ●
Family history of hereditary condition, e.g. diabetes Non-use of self protection measures
▪ ▪
Threat of cross infection from a communicable disease case Inherent personal characteristics – e.g. poor impulse control
▪ ▪
Family size beyond what family resources can adequately provide Health history which induce the occurrence of a health deficit, e.g.
▪
Accidental hazards previous history of difficult labor
● ▪
Broken stairs Inappropriate role assumption – e.g. child assuming mother's role,
●
Sharp objects, poison, and medicines improperly kept father not assuming his role
● ▪
Fire hazards Lack of immunization/ inadequate immunization status specially of
▪
Faulty nutritional habits or feeding practices. children
● ▪
Inadequate food intake both in quality & quantity Family disunity
● ●
Excessive intake of certain nutrients Self-oriented behavior of member(s)
● ●
Faulty eating habits Unresolved conflicts of member(s)
● ●
Ineffective breastfeeding Intolerable disagreement
● ●
Faulty feeding practices Other
▪ ▪
Stress-provoking factors – Other
● o
Strained marital relationship Presence of Health Deficits – instances of failure in health
●
Strained parent-sibling relationship maintenance.
● ▪
Interpersonal conflicts between family members Illness states, regardless of whether it is diagnosed or by medical
●
Care-giving burden practitioner
▪ ▪
Poor home condition Failure to thrive/ develop according to normal rate
● ▪
Inadequate living space Disability – whether congenital or arising from illness; temporary
● o
Lack of food storage facilities Presence of stress Points/ Foreseeable Crisis Situations – anticipated
●
Polluted water supply periods of unusual demand of the individual or family in terms of family resources.
● ▪
Presence of breeding sites of vectors of disease Marriage
● ▪
Improper garbage Menopause
● ▪
Unsanitary waste disposal Pregnancy
▪ ●
Loss of job Physical consequences
▪ ●
Parenthood Emotional/psychological consequences
▪ ▪
Hospitalization of a family member Negative attitude towards the health condition o problem – by
▪
Additional member negative attitude is meant one that interferes with rational decision making
▪ ▪
Abortion Inaccessibility of appropriate resources for care, specifically:
▪ ●
Death of a manner Physical inaccessibility
▪ ●
Entrance at school in a new community Cost constraints or economic/financial inaccessibility
▪ ▪
Resettlement Lack of trust/confidence in the health personnel/agency
▪ ▪
Adolescence Misconceptions or erroneous information about proposed course(s)
▪
Divorce of action
▪ ▪
Illegitimacy Others, specify ______________________
● o
Second Level Assessment Inability to provide adequate nursing care to the sick, disabled,
o
Inability to recognize the presence of the condition or problem due dependent or vulnerable /at-risk member of the family due to:
▪
to: Lack of/inadequate knowledge about the disease/health condition
▪
Lack of or inadequate knowledge (nature, severity, complications, prognosis and management);
▪ ▪
Denial about its existence or severity as a result of fear of Lack of/inadequate knowledge about child development and care
▪
consequences of diagnosis of problem, specifically: Lack of/ inadequate knowledge of the nature and extent of nursing
●
Social-stigma, loss of respect of peer/significant others care needed
● ▪
Economic/cost implications Lack of the necessary facilities, equipment and supplies of care
● ▪
Physical consequences Lack of or inadequate knowledge and skill in carrying out the
●
Emotional/psychological issues/concerns necessary interventions/treatment/procedure/care (e.g. complex therapeutic
▪
Attitude/philosophy in life which hinders recognition/acceptance of a regimen or healthy lifestyle program)
▪
problem Inadequate family resources for care, specifically:
▪ ●
Others, specify: _______________________ Absence of responsible member
o ●
Inability to make decisions with respect to taking appropriate health Financial constraints
●
action due to: Limitations/lack of physical resources –e.g. isolation room
▪ ▪
Failure to comprehend the nature/magnitude of the Significant person’s unexpressed feelings (e.g., hostility/anger, guilt,

problem/condition fear/anxiety, despair, rejection) which disable his/her capacities to provide care.
▪ ▪
Low salience of the problem/condition Philosophy in life which negates/hinder caring for the sick, disabled,
▪
Feeling of confusion, helplessness and/or resignation brought about dependent, vulnerable/at-risk member
▪
by perceived magnitude/severity of the situation or problem, i.e., failure to break Member’s preoccupation with own concerns/interests
▪
down problems into manageable units of attack Prolonged disease or disability progression which exhausts
▪
Lack of/inadequate knowledge/insight as to alternative courses of supportive capacity of family members
▪
action open to them Altered role performance – specify:
▪ ●
Inability to decide which action to take from among a list of Role denial o ambivalence
●
alternatives Role strain
▪ ●
Conflicting opinions among family members/significant others Role dissatisfaction
●
regarding action to take Role conflict
▪ ●
Lack of/inadequate knowledge of community resources for care Role confusion
▪ ●
Fear of consequences of action, specifically: Role overload
● ▪
Social consequences Others, specify _________________________
●
Economic consequences
o ▪
Inability to provide a home environment conducive to health Others, specify _________________________

maintenance and personal development due to:

▪
Inadequate family resources, specifically:
●
Financial constraints/limited financial resources
●
Limited physical resources – e.g. lack of space to construct facility
▪
Failure to see benefits (specifically long-term ones of investment in

home environment improvement

▪
Lack of/inadequate knowledge of importance of hygiene and

sanitation
▪
Lack of/inadequate knowledge of preventive measures
▪
Lack of skill in carrying out measures to improve home environment
▪
Effective communication patterns within the family
▪
Lack of supportive relationship among family members
▪
Negative attitude/philosophy in life which is not conducive to health

maintenance and personal development.

▪
Lack of/inadequate competencies in relating to each other for mutual

growth and maturation (e.g. reduced ability to meet the physical and psychological

needs of other members as a result of family’s preoccupation with current problem

or condition)
▪
Others, specify ______________________
o
Failure to utilize community resources for health care due to:
▪
Lack of/inadequate knowledge of community resources for health

care
▪
Failure to perceive the benefits of health care/services
▪
Lack of trust/confidence in the agency/personnel
▪
Previous unpleasant experience with health worker
▪
Fear of consequences of action (preventive, diagnostic, therapeutic

rehabilitative), specifically:
●
Physical/psychological consequences
●
Financial consequences
●
Social consequences – e.g., loss of esteem of peer/significant others
▪
Unavailability of required care/service
▪
Inaccessibility of required care/service due to:
●
Cost constraints
●
Physical inaccessibility, i.e., location of facility
▪
Lack of or inadequate family resources, specifically:
●
Manpower resources – e.g. baby sitter
●
Financial resources – e.g. cost of medicine prescribed
▪
Feeling of alienation to/lack of support from the community, e.g.,

stigma due to mental illness, AIDS, etc.

▪
Negative attitude/philosophy in life which hinders

effective/maximum utilization of community resources for health care