ASSESSMENT DATABASE IN FAMILY NURSING PRACTICE

A. Family structure, characteristics and dynamics/relational patterns

1. members of the household: birthdate, sex, civil status, position in the family and relationship to the
head of the family
2. socio-demographic data of members not currently living in the household but with major role in
resource generation and use
3. type of family structure and form
4. dominant family members in terms of decision making
5. family dynamics, communication patterns and interpersonal relationships

B. Socio-economic and cultural characteristics

1. income and expenses
a. occupation, place of work and income of each of the working member
b. adequacy to meet basic necessities
c. who makes decisions about money and how it is spent
2. educational attainment of each member
3. ethnic background and religious affiliation
4. family traditions, events or practices affecting member's health or family functioning
5. significant others
6. relationship of the family to larger community – nature and extent of participation of the family in
community activities

C. Home and Environment

1. Housing
a. adequacy of living space
b. sleeping arrangement
c. presence of breeding or resting sites of vectors of diseases
d. presence of accident and fire hazards
e. food storage and cooking facilities
f. water supply
g. toilet facility
h. garbage/refuse disposal – type, sanitary condition
i. drainage system – type, sanitary condition
2. kind of neighborhood
3. social and health facilities available
4. communication and transportation facilities available

D. Health status of each Family Member

1. medical and nursing history indicating current or past significant illnesses or beliefs and practices
conducive to health and illness
2. nutritional assessment
a. anthropometric data : measures of nutritional status of children – weight, height, mid-upper arm
circumference, BMI ( weight in kgs divided by height in meters² )
b. dietary history specifying quality and quantity of food/nutrient intake per day
c. eating/feeding habits/practices
3. risk factor assessment indicating of major and contributing modifiable risk factors for specific
lifestyle diseases
4. physical assessment indicating presence of illness state/s
5. results of laboratory/diagnostic and other screening procedures supportive of assessment findings

E. Values, Habits, Practices on Health Promotion, Maintenance and Disease Prevention

1. immunization status of family members
2. healthy lifestyle practices
3. adequacy of:
a. rest and sleep
b. exercise/activities
c. use of protective measures
d. relaxation and other stress management activities
4. use of promotive-preventive health practices ( maternal and child health supervision ) and use of
healthy lifestyle related services
TYPOLOGY OF NURSING PROBLEMS IN FAMILY NURSING PRACTICE

FIRST LEVEL ASSESSMENT

1. Presence of health threats
 conditions that are conducive to disease and accident or may result in failure to maintain
wellness or realize health potential
a. presence of risk factors of specific diseases
b. threat of cross infection from a communicable disease case
c. family size beyond what family resources can adequately provide
d. accident/fire hazards
e. faulty/unhealthful nutritional/eating habits or feeding techniques or practices
f. stress-provoking factors
g. poor home/environmental condition/sanitation – inadequate living space, lack of food storage
facilities, polluted water supply, presence of breeding sites or resting sites of vectors of diseases
( mosquitoes, flies, roaches ), improper refuse/garbage disposal, unsanitary waste disposal, improper
drainage system, poor lighting and ventilation, noise pollution, air pollution
h. unsanitary food handling and preparation
I. unhealthful lifestyle and personal habits/practices – alcohol drinking, cigarette/tobacco smoking,
walking barefooted or inadequate footwear, eating raw meat or fish, poor personal hygiene, self-
medication/substance abuse, sexual promiscuity, engaging in dangerous sports, inadequate rest or sleep,
lack of/inadequate exercise/physical activity, lack of/inadequate relaxation activities
j. inherent personal characteristics
k. health history which may participate/ induce the occurrence of a health deficit
l. inappropriate role assumption
m. lack of immunization especially of children
n. family disunity
o. others: pls specify

2. presence of health deficits

 instances of failure in health maintenance
a. illness states regardless of whether it is diagnosed or undiagnosed by medical practitioner
b. failure to thrive/develop according to normal rate
c. disability – whether congenital or arising from illness; transient/temporary ( temporary paralysis after
CVA ), or permanent ( leg amputation secondary to DM, blindness from measles, lameness from polio )

3. presence of stress points/foreseeable crisis situations

 anticipated periods of unusual demand on the individual or family in terms of adjustment/family
resources; transitions ( passage from one life phase, condition or status to another )
a. marriage
b. pregnancy, labor, puerperium
c. parenthood
d. additional member – newborn, lodger
e. abortion
f. entrance at school
g. adolescence
h. divorce or separation
I. menopause
j. chronic illness
k. loss of job
l. hospitalization of a family member
m. death of a member
n. resettlement in a new community
o. illegitimacy
SECOND LEVEL ASSESSMENT

I. Inability to recognize the presence of the condition or problem due to:

A. Lack or inadequate knowledge
B. Denial about its existence or severity as a result of fear of consequences of diagnosis of problem,
specifically:
1. Social-stigma, loss of respect of peer/significant others
2. Economic/cost implications
3. Physical consequences
4. Emotional/psychological issues/concerns
C. Attitude/philosophy in life which hinders recognition/acceptance of a problem
D. Others, specify __________________

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

A. Failure to comprehend the nature/magnitude of the problem/condition

B. Low salience of the problem/condition
C. Feeling of confusion, helplessness and/or resignation brought about by perceived magnitude/severity of
the situation or problem, i.e., failure to break down problems into manageable units of attack
D. Lack of/inadequate 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. Lack of/inadequate knowledge of community resources for care
H. Fear of consequences of action, specifically:
1. Social consequences
2. Economic consequences
3. Physical consequences
4. Emotional/psychological consequences
I. Negative attitude towards the health condition or problem – By negative attitude is meant one that
interferes with rational decision making
J. Inaccessibility of appropriate resources for care, specifically:
1. Physical inaccessibility
2. Cost constraints or economic/financial inaccessibility
K. Lack of trust/confidence in the health personnel/agency
L. Misconceptions or erroneous information about proposed course(s) of action
M. Others, specify _________________

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

A. Lack of/inadequate knowledge about the disease/health condition (nature, severity, complications,
prognosis and management)
B. Lack of/inadequate knowledge about child development and care
C. Lack of/inadequate knowledge of the nature and extent of nursing care needed
D. Lack of the necessary facilities, equipment and supplies for care
E. Lack of or inadequate knowledge and skill in carrying out the necessary
interventions/treatment/procedure/care
F. Inadequate family resources for care, specifically:
1. Absence of responsible member
2. Financial constraints
3. Limitations/lack of physical resources
G. Significant person’s unexpressed feelings which affect his capacity to provide care
H. Philosophy in life which negates/hinder caring for the sick, disabled, dependent, vulnerable/at-risk
member
I. Member’s preoccupation with own concerns/interests
J. Prolonged disease or disability progression which exhausts supportive capacity of family members
K. Altered role performance – specify:
1. Role denial or ambivalence
2. Role strain
3. Role dissatisfaction
4. Role conflict
5. Role confusion
 6. Role overload
L. Others, specify ____________________

IV. Inability to provide a home environment conducive to health maintenance and personal
development due to:

A. Inadequate family resources, specifically:

1. Financial constraints/limited financial resources
2. Limited physical resources
B. Failure to see benefits of investment in home environment improvement
C. Lack of/inadequate knowledge of importance of hygiene and sanitation
D. Lack of/inadequate knowledge of preventive measures
E. Lack of skill in carrying out measures to improve home environment
F. Ineffective communication patterns within the family
G. Lack of supportive relationship among family members
H. Negative attitude/philosophy in life which is not conducive to health maintenance and personal
development
I. Lack of/inadequate competencies in relating to each other for mutual growth and maturation
J. Others, specify _____________________

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

A. Lack of/inadequate knowledge 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, specifically:
 Physical/psychological consequences
 Financial consequences
 Social consequences
F. Unavailability of required care/service
G. Inaccessibility of required care/service due to:
 Cost constraints
 Physical inaccessibility
H. Lack of or inadequate family resources, specifically:
 Manpower resources
 Financial resources
I. Feeling of alienation to/lack of support from the community
J. Negative attitude/philosophy in life which hinders effective/maximum utilization of community
resources for health care
K. Others, specify _________________