Lack of inadequate family resources: Manpower and Financial resources

Criteria Score Justification

1, Nature of the problem

This crisis is regarded as
foreseeable because, if it persists,
1 the family's primary provider
×1=0.33
Forseeable Crisis 3 might pass away and more issues
might arise.

2. Modifiability
Due to some family members'
1 unwillingness to cooperate and
Partially modifiable ×2=1
2 their resistance to change, it is
only partially changeable.

3. Preventive/ potential
It is moderately
preventive/potential because, if we
2 take action to address the issue, we
Moderately ×1=0.66
3 may be able to stop or prevent the
future issues the family will
encounter.

4. Salience o f the problem

Problem needing an urgent 2 Due to their complaints on

×1=1 their financial situation, this issue
attention 2
requires urgent attention.

Total: 2.99
 Illness states regardless of wether it is diagnosed or undiagnosed by medical practitioner
Criteria Score Justification

1, Nature of the problem

Due to Mrs. Guererro and his
3 son's illnesses, it is seen as a
×1=1
Health Deficit 3 health deficiency.

2. Modifiability
The client does not care about
what is happening to her body as
0 long as she is earning money to
Not modifiable × 2=0
2 provide food for her family, hence
it is regarded to be unmodifiable.

3. Preventive/ potential
It is highly preventive
because if we take action to
3 address this issue, we can stop
High ×1=1
3 some future problems that the
family may have.

4. Salience of the problem

Because they were in agony
2 and lacked access to medications,
Problem needing an urgent ×1=1
2 the family understood that this was
attention a problem that needed to be
addressed immediately.

Total: 3
 Inadequate food intake both quantity and quality
Criteria Score Justification

1. Nature of the problem

Because eating too little food
can lead to health issues, it is
2 viewed as a health deficit. It might
×1=0.66
Health deficit 3 also make it harder for the family
to work or to think effectively.

2. Modifiability
We emphasized to them the
significance of consuming
1 nutritious foods for their families,
Partially modifiable ×2=1
2 and it seems that they understand
it therefore it is
partially modifiable.

3. Preventive/ potential It is regarded as

moderately preventive/potential
since there is a good probability
2 that their illnesses won't worsen
Moderately ×1=0.66
3 and that they will develop
immunity if they follow the advice
we gave them about eating
nutritious foods.

4. Salience of the problem

Mrs. Guerrero is doing her
best to provide food for her family
2 so they may eat, but the income
Problem needing an urgent ×1=1
2 they have is insufficient, thus the
attention family recognized this as a
problem needing urgent action.

Total: 3.66
 Criteria Score Justification

1, Nature of the problem

This crisis is regarded as
foreseeable because, if it persists,
1 the family's primary provider
×1=0.33
Forseeable Crisis 3 might pass away and more issues
might arise.

5. Modifiability
Due to some family members'
1 unwillingness to cooperate and
Partially modifiable ×2=1
2 their resistance to change, it is
only partially changeable.

6. Preventive/ potential
It is moderately
preventive/potential because, if we
2 take action to address the issue, we
Moderately ×1=0.66
3 may be able to stop or prevent the
future issues the family will
encounter.

7. Salience of the problem

2 Due to their complaints on

×1=1 their financial situation, this issue
2
requires urgent attention.

Total: 2.99
 Lack of inadequate family resources: Manpower and Financial resources
Criteria Score Justification

1, Nature of the problem

This crisis is regarded as
foreseeable because, if it persists,
1 the family's primary provider
×1=0.33
Forseeable Crisis 3 might pass away and more issues
might arise.

8. Modifiability
Due to some family members'
1 unwillingness to cooperate and
Partially modifiable ×2=1
2 their resistance to change, it is
only partially changeable.

9. Preventive/ potential
It is moderately
preventive/potential because, if we
2 take action to address the issue, we
Moderately ×1=0.66
3 may be able to stop or prevent the
future issues the family will
encounter.

10. Salience of the problem

2 Due to their complaints on

×1=1 their financial situation, this issue
2
requires urgent attention.

Total: 2.99
1. HEALTH PERCEPTION AND HEALTH MANAGEMENT PATTERN.

Father E doesn't want to undergo dialysis because he believes that it will not prolong his life.
His last physical examination was taken 2 years ago and he doesn't have any post-operative
history. Father E is not vaccinated against COVax but is immunized against pneumonia while his
wife is completely vaccinated.

The most crucial thing we can do to protect ourselves and our children against illness is to be
vaccinated. Every year, they avert up to 3 million fatalities worldwide. Your immune system learns
from vaccinations how to produce antibodies that shield you from disease. Your immune system
will acquire this information much more safely through immunization than by contracting the
illnesses and undergoing treatment. Once your immune system is trained to combat a disease, it
can frequently keep you healthy for years (NHS UK, 2019).

2. NUTRITION AND METABOLISM PATTERN

Father E wants to eat beans and likes to eat internal organs of animals such as the liver,
intestine, etc. Due to Father E’s choices of food, mother Y chooses to cook it and both of them will
have it. However, foods like these are not allowed for both of them to eat because they contain a
lot of sodium that might worsen their condition, especially Father E’s health condition.
Nonetheless, father E and his family don't have any food allergies

Some health issues from CKD may be avoided or delayed by eating the proper foods and
avoiding those high in sodium, potassium, and phosphorus. The effectiveness of your kidney
disease therapies may also be influenced by what you eat and drink. People with advanced CKD
should know how calories, lipids, protein, and liquids impact the body. ( Gluba-Brzózka A,
Franczyk B, Rysz J., 2017, )

3. ELIMINATION PATTERN

The family mentioned that Father E's urine is yellowish to dark yellow about 5 bottles of 500ml
in a day. According to mother Y, Father E urinates from time to time and it causes the “arinola” to
his bedside. Recently, Father E experienced difficulty in elimination and it takes 11 days for him to
have fecal withdrawal. Additionally, Mother Y has mentioned that she does not feel any problems
with urination and defecation.

Having days with low or high urine output is common. The typical number of bathroom visits
from morning to night is around seven, however, this number can vary greatly depending on how
much you drink each day and what you consume. In terms of frequency of urination, what is typical
for one person may not be for another. Your bladder, which retains urine, has a capacity that can
range from 350 ml to 600 ml (1.5 cups to 2.5 cups) ( Petar Bajic,  2021)

4. ACTIVITY AND EXERCISE PATTERN

According to the family, Father E can no longer do exercise since he is bedridden because
of the inflammation of his joints while Mother Y is the one that is in charge of doing household
chores and considers it as exercise. The family doesn't have any breathing problems.

Use it or lose it is a common belief, particularly for those with kidney illness. Losing
muscular mass and power by spending too much time in bed or sitting still will make it more
difficult to perform daily tasks. If you continue to do nothing except sit around, you risk losing the
ability to move independently and developing a disability. Getting moving will help you stay active
and maintain or perhaps build strength. Regular exercisers who are on dialysis say they sleep
better, have more energy and muscle power, and are better able to get things done in their daily
life (Michael P, 2021).

5. COGNITION AND PERCEPTION PATTERN 

Upon interviewing, no difficulty in speech and memory was observed. The family was able to
answer questions that were being asked of them. Some questions that require recalling events
take a few seconds before getting a response but it is normal because the students usually ask
about their past life

Age-related changes in the brain, injuries like strokes or traumatic brain injuries, mood
disorders like depression, substance use disorders like addiction, and diseases like Alzheimer's
disease can all have an impact on brain health. While there are some things that cannot be
changed that affect brain health, there are many lifestyle adjustments that could have an impact
(National Institute on Aging, 2020).

6. SLEEP AND REST PATTERN 

They often sleep between 8 and 9 in the evening and have a total of 10 hours of sleep.
Mother Y chooses to spend the night on the sofa next to Father E's bed since the family only has
one room and she wants to be close to and watch over Father E. According to   father E, She
usually sleeps but unintentionally wakes up and falls asleep again out of concern. Also, the family
gets up at around 6 in the morning.

Your physical and emotional health is directly impacted by how well you sleep. Various sleep-
related mechanisms support optimal brain function and sustain overall wellness. Sleep is essential
for healthy development and growth in kids and teenagers. Lack of sleep not only makes you feel
weary but also raises your risk for a variety of illnesses and health issues. Obesity, heart disease,
high blood pressure, diabetes, and stroke are a few of these. Your physical safety is also in danger
if you don't get enough sleep. ( Heather W, 2022 ).

7. SELF-PERCEPTION AND SELF-CONCEPT PATTERN

Mother Y still has good personal hygiene. However, Father E is bedridden due to that, Mother
Y bed baths the upper extremities of her husband and does a tepid sponge bath on his lower
extremities.

The results showed that while sit-to-stand was the only physically functioning component that
was objectively evaluated and associated with planned physical activity, physical self-perceptions
(activity, coordination, endurance, and flexibility) were connected with self-reported planned and
incidental physical activity.

Similar to this, more falls, general self-esteem, self-perceptions of general and domain-specific
physical attributes (strength and flexibility), and knee strength were linked to fear of falling.
Additionally, there were correlations between some of the objectively evaluated physical
functioning measures and physical self-perceptions (Myrla S, 2017).
8. ROLES AND RELATIONSHIP PATTERN 

Since there are only two people living together, Father E is the one who makes decisions on
his health and within the household. Mother Y stated that her role in their house is taking care of
Father E and all of the house chores are done by her. While Father E makes the decisions when it
comes to his health and within the household wherein their two children are living separately from
them. She added also that if she gets hospitalized at an unexpected time, her daughter who lives
in Area C, which is Daughter A, will take charge to look after Father E. Mother Y is very thankful to
their children because of their cooperation when they need financial support since they do not
have any source of income. On the other hand, Father E always refused to undergo dialysis
because some of his friends who had the same health condition as him died because of dialysis. 

The most recent, thorough research shows that marriage has a positive impact on some
health-related outcomes.

According to this research, being married enhances some aspects of mental health, lowers the
need for some expensive medical services (like nursing home care), and increases the likelihood
of having health insurance. Additionally, a growing body of research indicates that having married
parents when you were young is linked to greater adult health.

Marriage has conflicting consequences on health behaviors, sometimes leading to healthier

ones (reduced heavy drinking) and sometimes to less healthy ones (weight gain).

Rigorous research on the consequences of marriage has largely remained ignored for other
important health outcomes, particularly measurements of particular physical health issues.
( Robert W, 2007 )

9. SEXUALITY AND REPRODUCTION PATTERN

The family is no longer sexually active due to the condition of Father E and because of old age.
Additionally, because of their advanced age and lack of family development planning, they are
unable to have any more children.

After age 50, there are a variety of changes that occur in sexuality. The reduction in sexual
frequency is the most obvious alteration (Lindau et al., 2007; Mercer et al., 2013). Lower sexual
frequency is mostly caused by deteriorating physical health and sexual function, as well as by
ageism or other unfavorable ideas (i.e., later-life sex as a redundant or pointless activity); apart
from difficulties brought on by a lack of a ( sexual ) partner (DeLamater, 2012; Erens et al., 2019;
Gore-Gorszewska, 2020; Waite & Das, 2010).

10. COPING AND STRESS TOLERANCE PATTERN

According to Father E, whenever he feels stressed, he turns on the television to relax, or

sometimes he chooses to sleep. At times he is crying because a lot of doubts in his life about his
condition are running inside his head. From the point of view of Mother Y, who's taking care of
Father E, when she is stressed, she is taking a nap to relax and at times she is listening to the
radio. Occasionally, she is leaving Father E when they are fighting just to relieve her anger and to
calm herself down.

In order to cope, you typically have to accept or tolerate unpleasant situations or truths while
attempting to maintain a healthy sense of self and emotional balance. Coping happens when there
are believed to be stressful life adjustments. Losing a loved one or a job are two examples of
unpleasant life changes that are frequently linked to psychological stress. But every shift
necessitates some form of adaptation. Even good things like getting married or having kids can
cause stress. Too many changes in a short period of time can give us the impression that we are
powerless over what happens. Low self-esteem is a result of this perspective, which may also play
a role in the emergence of anxiety or depression (Cleveland Clinic,  2020).

11. VALUES AND BELIEF PATTERN

According to Father E and Mother Y, they have been Roman Catholic since back then. They
always pray to God because they believe that God can provide and help them to overcome their
struggles in life.

   Everyone has values, but each person has a unique set of values that are influenced by their
culture, personal upbringing, life experiences, and a variety of other factors. Personal values are
defined as "broad desirable goals that motivate people's actions and serve as guiding principles in
their lives" (Sagiv et al., 2017).

    Core beliefs are described as basic, unchanging, unquestionable, and universal ideas that
people have about themselves, other people, the world, and/or the future. We utilize our beliefs to
inform how we perceive the world (Beck JS, 2011)