II.

INITIAL DATA BASE FOR FAMILY NURSING PRACTICE

A. FAMILY STRUCTURE AND CHARACTERISTICS

o Dominant family members in terms of decision-making in matters of health care

o Characteristic communication pattern among members of the family

B. SOCIO-ECONOMIC AND CULTURAL FACTORS

o Who makes the decision about the money and how it is spent?

o What is the participation of the family in community activities?

D. HEALTH STATUS

Name Past significant illness Beliefs and practices

conductive to illness

NUTRITIONAL ASSESSMENT

Name Age WT HT BMI Nutritional Dietary Eating

kg/m2 status history habits/practice
s
E. FAMILY APGAR

ADAPTATION

o How have family members aided each other in time of need?

o In what way have family members received help or assistance from friends and

community agencies?

PARTNERSHIP

o How do family members communicate with each other about such matters as vacations,
finances, medical care, large purchases and personal problems?

GROWTH

o How have family members changed during the past years?

o How has this change been accepted by family members?

 o In what ways have family members aided each other in growing or developing
independent lifestyle?

o How have family members reacted to your desires for change?

AFFECTION

o How have family members of your family responded to emotional expressions such as
affection, love, sorrow or anger?

RESOLVE

o How do members of your family share time, space and money?

 G. FAMILY COPING INDEX

Coping Area Definition Rate Justification

Physical
Independence This category is concerned
with the ability to move
about to get out of bed, to
take care of daily grooming,
walking and other things
which involves the daily
activities.
Therapeutic
competence This category includes all
the procedures or treatment
prescribed for the care of
the ill, such as giving
medication, dressings,
exercise and relaxation, and
special diets.

Knowledge of
health This system is concerned
condition with the particular health
conditions that is the
occasion of care.
Health
attitudes This category is concerned
with the way the family feels
about health care in
general, including
preventive services, care of
illness and public health
measures.

Emotional
competence This category has to do with
the maturity and integrity
with which the members of
the family are able to meet
the usual stresses and
problems of life, and to plan
for happy and fruitful living.
Family living
This category is concerned
largely with the
interpersonal or group
aspects of family life– how
well the members of the
family get along with one
another, the ways in which
they take decisions affecting
the family as a whole.

Physical
environment This is concerned with the
home, the community and
the work environment as it
affects family
health.
Use of
community Generally keeps
resources appointments.Follows
through referrals. Tells
others about Health
services.

TOTAL SCORE
Interpretation

III. TYPOLOGY

A TYPOLOGY OF NURSING PROBLEMS IN FAMILY NURSING PRACTICE

A. First-Level Assessment

I. Presence of health threats, health deficits and foreseeable crisis or stress points in

the family

A. Health Threats – conditions that are conducive to disease, accident or failure to realize

one’s health potential. Examples of these are the following:

1. Health history of specific condition/disease – NONE

2. Threat of cross infection from a communicable disease case

3. Family size beyond what family resources can adequately provide

4. Accident hazards – e.g.,

a. Broken stairs

b. Pointed/sharp objects, poisons and medicines improperly kept

c. Fire hazards

d. Fall hazards

5. Nutritional – e.g.,
 a. Inadequate food intake both in quantity and quality

b. Excessive intake of certain nutrients

c. Faulty eating habits

6. Stress-provoking factors – e.g.,

a. Strained marital relationship

b. Strained parent-sibling relationship

c. Interpersonal conflicts between family members

7. Poor environment sanitation – e.g.,

a. Inadequate living space

b. Inadequate personal belongings/utensils

c. Lack of food storage facilities

d. Polluted water supply

e. Presence of breeding places of insects and rodents

f. Improper garbage/refuse disposal

g. Unsanitary waste disposal

h. Improper drainage system

i. Poor lighting and ventilation

j. Noise pollution

k. Air pollution

8. Unsanitary food handling and preparation

9. Personal habits/practices – e.g.,

a. Frequent drinking of alcohol

b. Excessive smoking

c. Walking barefooted
 d. Eating raw meat/fish

e. Poor personal hygiene

f. Self-medication

g. Use of dangerous drugs/narcotics

h. Sexual promiscuity

i. Engaging in dangerous sports

10.Inherent personal characteristics – e.g. short temper

11. Health history which may precipitate/induce the occurrence of a health deficit, e.g.

previous history of difficult labor

12.Inappropriate role assumption – e.g. child assuming mother’s role; father not

assuming his role

13.Lack of immunization/ inadequate immunization status specially children

14.Family disunity – e.g.,

a. Self-oriented behaviour of member(s)

b. Unresolved conflicts of member(s)

c. Intolerable disagreements

15.Others, specify ____________________________________________

B. Health Deficits – instances of failure in health maintenance

Example include:

1. Illness states, regardless whether it is diagnosed or undiagnosed by medical

practitioner

2. Failure to thrive/develop according to normal rate

3. Disability arising from illness, whether transient/temporary (e.g. aphasia or

temporary paralysis after a CVA) or permanent (e.g. leg amputation secondary to

diabetes, blindness from measles, lameness from polio)

C. Stress Points/Foreseeable Crisis Situations – anticipated periods of unusual demand

on the individual or family in terms of adjustment/family resources. Examples of these

Include:

1. Marriage

2. Pregnancy, labor, puerperium

3. Parenthood

4. Additional member – e.g. newborn, lodger

5. Abortion

6. Entrance at school

7. Adolescence

8. Loss of job

9. Death of a member

10.Resettlement in a new community

11. Illegitimacy

12.Others, specify ____________________________________________

B. Second-Level Assessment

II.Inability to recognize the presence of a problem due to:

A. Ignorance of Facts

B. Fear of Consequences of Diagnosis of problem - e.g.

1) Social stigma, loss of respect of peer/significant others

2) Economic - cost

3) Physical/Psychological

C. Attitude/philosophy in life

D. Others, specify ____________________________________________

III. Inability to make decisions with respect to taking appropriate health action due to:

A. Failure to comprehend the nature, magnitude/scope of the problem

B. Low salience of the problem

C. Feeling of confusion and/or resignation brought about by failure to break down

problems into manageable units of attack

D. Lack of knowledge/insight as to alternative courses of action open to them

E. Inability to decide which action to take from among a list of alternatives

F. Conflicting opinions among family members/significant others regarding action to take

G. Ignorance of Community resources for care

H. Fear of consequences of action - e.g.

a. Social

b. Economic

c. Physical / psychological

I. Negative attitude towards the health problem - By negative attitude is meant one that

interferes with rational decision making

J. Inaccessibility of appropriate resources of care

a. Physical location
 b. Cost

K. Lack of trust/confidence in the health personnel/agency

L. Misconceptions or erroneous information about proposed course(s) of action

M. Others; specify __________________________________

a. Physical location

b. Cost

K. Lack of trust/confidence in the health personnel/agency

L. Misconceptions or erroneous information about proposed course(s) of action

M. Others; specify __________________________________

IV. Inability to provide adequate nursing care to the sick disabled, dependent or
vulnerable/at risk member of the family due to:

A. Ignorance of facts about the disease/health condition (nature, severity, complications,

prognosis, and management); child development and child care

B. Ignorance of the nature and extent of nursing care needed

C. Lack of the necessary facilities (equipment and supplies) for care

D. Lack of knowledge and skill in carrying out the necessary treatment/procedure/care

E. Inadequate family resources for care

a. Responsible member

b. Financial

c. Physical resources - e.g. isolation room

F. Negative attitude towards the sick, disabled, dependent, vulnerable/at-risk member

G. Attitude/philosophy in life

H. Members’ preoccupation with own concerns/interests

I. Others, specify __________________________

V. Inability to provide a home environment which is conducive to health maintenance and

personal development due to:

A. Inadequate family resources

a. Financial

b. Physical - e.g., lack of space to construct facility

B. Failure to see benefits (especially long term ones) of investment in home environment

Improvement

C. Ignorance of the importance of hygiene and sanitation

D. Ignorance of preventive measures

E. Lack of skill in carrying out measures to improve home environment

F. Ineffective communication patterns

G. Attitude/philosophy in life

H. Others, specify _____________________________________

VI. Failure to utilize community resources for health care due to:

A. Ignorance or lack of awareness of community resources for health care

B. Failure to perceive the benefits of health care/services

C. Lack of trust/confidence in the agency/personnel

D. Previous unpleasant experience with health worker

E. Fear of consequences of action (preventive, diagnostic, therapeutic, rehabilitative)

a. physical/psychological

b. Financial

c. Social - e.g., loss of esteem of peer/significant others

 F. Unavailability of required care/service

G. Inaccessibility of required care/service

a. Cost

b. Physical - location

H. Lack of or inadequate family resources

a. Manpower - e.g., baby sitter

b. Financial - e.g., cost of medicine prescribed

I. Feeling of alienation to/lack of support from the community, e.g., mental illness

J. Attitude/philosophy in life

K. Others, specify ___________________________________

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