PFC MATRIX

FAMILY MEDICINE 2023

FM CLERK LACSON, SHEILA

 PATIENT-CENTERED FAMILY-FOCUSED COMMUNITY-BASED
Patient J.P. The patient lives with his The patient has
44 y/o wife and two sons. formed friendships
with churchmates, he
Male
is comforted that he
Married Family structure: can turn to them
D Filipino Nuclear family anytime, the same
A Roman Catholic goes with his
T neighbors
Biñan, Laguna Family life cycle:
A Garbage is collected
October 16, 2023 Family with young children 1x a week
Location of the house
CC: ”Lower back pain“ is not flood prone
area
Informant: Patient
Reliability: 85%
 PATIENT-CENTERED
1 week PTC
the patient noted lower back
→
pain
→
intermittent
→
cramping in character
D pain scale: 5/10
→
no other associated symptoms
A goes with his
no swelling, no stiffness, no
T decreased joint motion, no
A fracture, no sprain, no edema,
no loss of muscle mass, no
muscle spasm
no medications taken
no consultation done
FAMILY-FOCUSED
The patient lives with his
wife and two sons.
Family structure:
Nuclear family
Family life cycle:
Family with young children
COMMUNITY-BASED
The patient has
formed friendships
with churchmates, he
is comforted that he
can turn to them
anytime, the same
neighbors
Garbage is collected
1x a week
Location of the house
is not flood prone
area
 PATIENT-CENTERED FAMILY-FOCUSED COMMUNITY-BASED
Few hours PTC The patient lives with his The patient has
the patient noted lower back wife and two sons. formed friendships
→
pain with churchmates, he
→
intermittent is comforted that he
→
cramping in character Family structure: can turn to them
D pain scale: 5/10 Nuclear family anytime, the same
→
no other associated symptoms
A goes with his
no swelling, no stiffness, no
T decreased joint motion, no neighbors
Family life cycle:
A fracture, no sprain, no edema, Garbage is collected
Family with young children 1x a week
no loss of muscle mass, no
muscle spasm Location of the house
hence, consultation is not flood prone
area
 PATIENT-CENTERED FAMILY-FOCUSED COMMUNITY-BASED
Past Medical History The patient lives with his The patient has
(-) HPN (-) Kidney Disease
(-) DM (-) Thyroid Disease wife and two sons. formed friendships
(-) Cardiac Disease (-) PTB with churchmates, he
(-) CVD (-) COVID-19
(-) Hospitalization is comforted that he
(-) Bronchial Asthma Family structure:
(-) Atopic Dermatitis (-) Blood can turn to them
D Transfusion Nuclear family anytime, the same
Immunization History
A (+) Influenza, 2015 (-) Pneumo 23 (1) goes with his
T (-) PCV (1) (-) Tdap (3bq10yrs) neighbors
(-) HepaB (2) (+) COVID-19 (2) Family life cycle:
A (-) HepaA (2) Moderna, no Garbage is collected
(-) Zoster (1) booster Family with young children 1x a week
Family Medical History
(-) Bronchial
Location of the house
(+) Lung CA, paternal
(+) Nephrolithiasis, Asthma is not flood prone
brother (-) PTB area
(-) HPN (-) Atopic
(-) DM Dermatitis
(-) Cardiac Disease (-) Thyroid Disease
(-) CVD (-) Covid-19
 PATIENT-CENTERED FAMILY-FOCUSED COMMUNITY-BASED
Personal/Social History The patient lives with his The patient has
non smoker, wife and two sons. formed friendships
non alcoholic beverage drinker with churchmates, he
denies illicit drug use is comforted that he
allergic to chicken, seafoods Family structure: can turn to them
D no allergy to medications Nuclear family anytime, the same
A prefer to eat vegetables, pork, goes with his
eats 3 meals per day neighbors
T Family life cycle:
usually walks about 30 minutes
A Garbage is collected
at least every morning Family with young children 1x a week
patient is construction worker
no recent travel history Location of the house
family in the same household is not flood prone
do not exibit the same area
symptoms
 PATIENT-CENTERED
Environmental History
He and his family lives in
their owned house, bungalow
type, with two bedrooms
house is well ventilated with
D two windows
A water source is from Laguna
T water and drinks mineral
A water
garbage is collected once a
week by garbage truck from
the City government
house is not prone to floods
with no pets at home
FAMILY-FOCUSED
The patient lives with his
wife and two sons.
Family structure:
Nuclear family
Family life cycle:
Family with young children
COMMUNITY-BASED
The patient has
formed friendships
with churchmates, he
is comforted that he
can turn to them
anytime, the same
goes with his
neighbors
Garbage is collected
1x a week
Location of the house
is not flood prone
area
 REVIEW OF SYSTEMS
(-) generalized weakness, (-) weight loss,
General
(-) night sweats

(-) hyperpigmentation, (-) rashes, (-) bruises, (-) jaundice,

Skin
(-) wounds, (-) scars, (-) pruritus
D
A (-) eye pain, (-) neck mass, (-) trauma, (-) dysgeusia,
T HEENT (-) oral sores, (-) sore throat, (-) odynophagia,
A (-) hoarsness, (-) dysphagia

Cardiovascular (-) shortness of breath, (-) palpitations, (-) orthopnea

(-) heat or cold intolerance, (-) polydypsia, (-) polyuria,

Endocrine
(-) nocturia, (-) decrease in appetite
 REVIEW OF SYSTEMS
Hematologic (-) easy bruising, (-) gum bleeding, (-) easy bleeding

(-) abdominal pain, (-) nausea/vomiting, (-) diarrhea, (-)

Gastrointestinal change in bowel habits, (-) constipation, (-) blood in stools,
(-) change in stool size/caliber, (-) hematemesis
D
A (-) oliguria, (-) frequent urination at night, (-) increased
Genitourinary
T thirst, (-) hematuria, (-) dark yellow urine
A
(-) seizures, (-) loss of consciousness, (-) paralysis, (-)
Neurologic
tremors, (-) involuntary movements
 PATIENT-CENTERED FAMILY-FOCUSED COMMUNITY-BASED
General survey: The patient lives with his The patient has
conscious, coherent, not in wife and two sons. formed friendships
cardiorespiratory distress with churchmates, he
is comforted that he
Vital signs: Family structure: can turn to them
D BP: 100/60mmHg, HR: 79bpm, Nuclear family anytime, the same
A RR: 19cpm, T: 37.1C, O2: 98% RA goes with his
T Weight 80.6kg Ht: 170 cm neighbors
Family life cycle:
A BMI 27.8kg/m2 overweight Garbage is collected
Family with young children 1x a week
Skin: warm to touch, good skin Location of the house
turgor, no active lesion is not flood prone
area
HEENT: head is normocephalic, no
palpable mass, anicteric sclerae,
pink palpebral conjunctiva
 PATIENT-CENTERED
HEENT: no nasoaural discharge,
no tonsillopharyngeal
congestion, no
cervicolymphadenopathy
D Chest and Lungs:
A Symmetrical chest expansion, no
T retractions, normal breath
A sounds, no crackles, no wheezes
Abdomen:
Flabby, no pulsations seen,
normoactive bowel sounds, soft,
non tender, no palpable mass
FAMILY-FOCUSED
The patient lives with his
wife and two sons.
Family structure:
Nuclear family
Family life cycle:
Family with young children
COMMUNITY-BASED
The patient has
formed friendships
with churchmates, he
is comforted that he
can turn to them
anytime, the same
goes with his
neighbors
Garbage is collected
1x a week
Location of the house
is not flood prone
area
 PATIENT-CENTERED FAMILY-FOCUSED COMMUNITY-BASED
Extremities: The patient lives with his The patient has
No gross deformities, no wife and two sons. formed friendships
cyanosis, no edema, CRT<2-3 with churchmates, he
seconds, full equal pulses is comforted that he
Family structure: can turn to them
D Neurologic Examination: Nuclear family anytime, the same
A Mental Status: Oriented goes with his
T Cranial Nerves: neighbors
Family life cycle:
A Garbage is collected
CN I: not tested Family with young children 1x a week
CN II: Pupils reactive to light
Location of the house
CN III, IV, VI: Intact extraocular is not flood prone
muscles area
CN VII: No facial asymmetry
 PATIENT-CENTERED FAMILY-FOCUSED COMMUNITY-BASED
CN VIII: able to hear The patient lives with his The patient has
CN IX,X: Swallowing subjectively wife and two sons. formed friendships
unimpaired with churchmates, he
CN XI: Can shrug shoulders is comforted that he
Family structure: can turn to them
symmetrically
D CN XII: Tongue symmetrical Nuclear family anytime, the same
A protrusion goes with his
T neighbors
Family life cycle:
A Garbage is collected
Family with young children 1x a week
Location of the house
is not flood prone
area
 PATIENT-CENTERED FAMILY-FOCUSED COMMUNITY-BASED
Mini mental status exam: The patient lives with his The patient has
wife and two sons. formed friendships
Orientation: 5/5
with churchmates, he
Registration: 5/5 is comforted that he
Attention: 5/5 Family structure: can turn to them
D Recall: 3/3 Nuclear family anytime, the same
A Language: 5/5 goes with his
T Copying: 3/3 neighbors
Family life cycle:
A Garbage is collected
Family with young children 1x a week
Location of the house
is not flood prone
area
 FAMILY GENOGRAM
PALO FAMILY
BINAN LAGUNA
I OCT 16, 2023

○ Rose
Informant: Patient
Jose
63 76 Reliability: 85%
D Legends:
A ○ Lung CA
✬ Nephrolithiasis
T
A II
✬
June Janice

↗️
51 48
Adrea
41

III
Justin John
6 2
 PATIENT-CENTERED FAMILY-FOCUSED COMMUNITY-BASED
Salient features: Family APGAR: Patient lives in
44-year-old male 10/10 Highly a community
(+) lower back pain,
intermittent, cramping in functional family easily
character, pain scale 5/10 accessible to
D lifts heavy sacks of cement,
A
Family SCREEM RES: nearby
sand, gravel or other building
T materials Adequate family healthcare
A resources facilities
 DIFFERENTIAL DIAGNOSES

MUSCULOSKELETAL STRAIN GRADE I

D Muscle strain, muscle pull, or even a muscle tear means that

A
there is damage to a muscle or the tendons attached to it. This
T
type of injury can happen if you put too much pressure on
A
muscles, whether you’re doing normal daily activities, lifting
something heavy, working out, or playing a sport.
 DIFFERENTIAL DIAGNOSES

MUSCULOSKELETAL STRAIN GRADE I

RULE IN RULE OUT

D
no swelling
A 44-year-old male no stiffness
T (+) lower back pain, no decreased joint motion
no fracture
A intermittent, cramping in no sprains
character, pain scale 5/10 no edema
no loss of muscles mass
lifts heavy sacks of
no muscle spasm
cement, sand, gravel or no lower back tenderness upon deep
other building materials palpation
 DIFFERENTIAL DIAGNOSES

LUMBOSACRAL RADICULOPATHY

D Lumbosacral radiculopathy is a term used to describe a pain

A
syndrome caused by compression or irritation of nerve roots in
T
the lower back. It can be caused by lumbar disc herniation,
A
degeneration of the spinal vertebra, and narrowing of the
foramen from which the nerves exit the spinal canal.
 DIFFERENTIAL DIAGNOSES

LUMBOSACRAL RADICULOPATHY

RULE IN RULE OUT

D
no swelling
A 44-year-old male no stiffness
T (+) lower back pain, no decreased joint motion
no fracture
A intermittent, cramping in no sprains
character, pain scale 5/10 no edema
no loss of muscles mass
lifts heavy sacks of
no muscle spasm
cement, sand, gravel or no lower back tenderness upon deep
other building materials palpation
 DIFFERENTIAL DIAGNOSES

OSTEOARTHRITIS

D Osteoarthritis is the most common joint disease. Characterized by

A hyaline articular cartilage loss. Initially present in a focal and non-
T uniform manner, progressing with increased thickness and
A sclerosis of the subchondral bone, osteophyte outgrwoth,
stretching of the joint capsule, and weakness of muscles
surrounding the joint - all of which ultimately lead to joint failure.
 DIFFERENTIAL DIAGNOSES

OSTEOARTHRITIS

RULE IN RULE OUT

D
no swelling
A 44-year-old male no stiffness
T (+) lower back pain, no decreased joint motion
no fracture
A intermittent, cramping in no sprains
character, pain scale 5/10 no edema
no loss of muscles mass
lifts heavy sacks of
no muscle spasm
cement, sand, gravel or no lower back tenderness upon deep
other building materials palpation
 FAMILY APGAR I

APGAR Ako’y nasisiyahan 2 1 0

Nakakaasa ako ng tulong mula sa aking pamilya sa oras ng

Adaptation
pangangailangan

D
Nakikipagtalakayan sa akin ang aking pamilya tungkol sa
A Partnership
mga problema

T Growth Tinatanggap at sinusuportahan ako ng aking pamilya

A
Ipinadadama ng akin pamilya ang kanilang pagmamahal at
Affection
pag unawa sa aking damdamin

Resolve Ang aking pamilya ay nagkakaroon ng panahon sa isa’t isa

TOTAL 10/10

Interpretation HIGHLY FUNCTIONAL

 FAMILY APGAR II

Sino ang nakatira sa inyong tahanan? Paano ang inyong relasyon?

D Relasyon Di
A Pangalan sa Edad Kasarian Mabuti gaanong Di mabuti
pasyente mabuti
T
A
Andrea Asawa 41 F

Justin Anak 6 M

John Anak 2 M
 SCREEM

SCREEM Resource Pathology

Family has a good relationship with

Social
neighbors

D
Family practices the Filipino culture of
A Culture
strong family ties and helping each other

T The family regularly prays and go to church

Religion on Sundays. Their faith in God gives them
A strength and hope

Patient claims that they have enough

Economic No emergency funds
savings for their daily need

Patient claims that he understands his

Education
condition and its management

The family lives nearby a local health

Medical
center. They are able to utilize its benefits.
 SCREEM-RES

Resources 3 2 1 0

Social

Ang bawat isa ay natutulungan sa aming

D pamilya
A
Natutulungan kami ng aming mga kaibigan
T at kasamahan sa komunidad

A
Cultural

Ang aming kultura ay napapatatag ng loob

ng aming pamilya

Ang kultura ng pagtutulungan at

pagmamalasakit sa aming komunidad ay
nakakatulong sa aming pamilya
 SCREEM-RES

Resources 3 2 1 0

Religion

Ang aming pananampalataya at relihiyon ay

D nakakatulong sa aming pamilya

A Natutulungan kami ng aming mga

T kasamahan sa simbahan o grupong
reluhiyoso
A
Economic

Sapatang naipong pera ng aming pamilya

para sa aming mga pangangailangan

Sapat ang kinikita ng aming pamilya para sa

aming pangangailangan
 SCREEM-RES
Resources 3 2 1 0

Educational

Sapat ang aming edukasyon/kaalaman

upang maintindihan ang mga impormasyon
D tungkol sa sakit

A Sapat ang aming edukasyon/kaalaman para

maalagaan ang may sakit
T
A Medical

Madaling makakuha ng tulong medical sa

aming komunidad

Natutulungan kami ng mga duktor, nars, at

health workers

SCREEM RES SCORE: 14 INTERPRETATION: Adequate family resources

 PATIENT-CENTERED FAMILY-FOCUSED COMMUNITY-BASED
Family structure: Nuclear Patient is able to
Assessment: family utilize the health
Family life cycle: Family service offered by
with young children their barangay
D
A
Musculoskeletal Family APGAR: 10/10 Highly like free
medications
functional family
T
A
Strain, Lower Family SCREEM-RES:
back Adequate family
resources
Smilkstein’s family:
Adaptation
Trajectory of illness:
Stage I: Onset of illness
 PATIENT-CENTERED FAMILY-FOCUSED COMMUNITY-BASED
CEA DONE Other family members should: Patient must fully
Diet: as tolerated Know the time of proper utilize the services
Laboratory: for Urinalysis offered by the local
medication intake of the
Medications: health center
patient Patient must avail
Start:
D Practice preventive free vaccinations
A 1. Paracetamol + Orphenadrine
Citrate 650mg/50mg Q8 PRN for measure against from the local health
T center
A pain musculoskeletal strain
Patient can also
Advice: SUPPORT AND TAKE PART
save money by
Use proper body formation when TO A HEALTHIER LIFESTYLE availing the free
picking up objects medications offered
Avoid lifting heavy objects by the health center
Do leg and back straightening
exercises
 THANK
YOU!
DEPARTMENT OF FAMILY AND COMMUNITY MEDICINE
OCTOBER ROTATOR 2023