Republic of the Philippines

Central Mindanao University

College of Nursing
University town, Musuan, Maramag,
Bukidnon
College of Nursing

A FAMILY CASE STUDY

In partial fulfilment of the subject

CARE OF CLIENTS WITH PROBLEMS IN INFLAMMATION,

IMMUNOLOGIC RESPONSE, PERCEPTION AND COORDINATION

(NCM 64.1)

Submitted to:

Dr. Ellen Gay Intong RN

Submitted by:

Baya, Aika C.

Borres, Mary Joy C.

Escobia, Blessie P.

Felimon, Mary Freyah

Laride, Kyle Lorenz B.

Luza, Nicole Hope L.

Mangubat, Yzrah Duffnee Dezz P.

Olano, Jomar Ray B.

Palma, Dechy Lyn B.

Taguiam, Jessa D.
 December 2017

ACKNOWLEDGEMENT

The study has provided our group opportunities to know the

different problems and needs of the family in order for them to develop
more in terms of their environment and especially with their health status.
But all of these could not be done without the help of those significant
people that help us throughout the study.

The students would like to extend their profound gratitude to the

following people who have generously shared their help in the completion
of this study

First and foremost, God Almighty for giving us a chance to live and
experience this opportunity. Thank you for making all things possible, for
giving us all we needed, and for making us earn insights in this way
knowing the worth of our life. For giving us unending intelligence and
strength to finish every task to facilitate and is dedicated for us to finish.
For His guidance and safety which He gives every day, for all the blessings
that He has showered upon us, and for giving us the strength to pursue
everything.

To our loving parents, thank you so much for helping us with your
prayers, for allowing us to be exposed in the community, and for helping
us with our needs especially financial matters.

To our assigned clinical instructor Dr. Ellen Gay Intong RN, who is
never weary of providing us encouragement and guidance all throughout
the making of this study. She has always been accessible and
approachable every time when we are in need of help. We were indebted
for the encouragement you contributed us every time we feel dispirited
especially for the outcome of our activities, for the patience, for
understanding our dissimilarities, for the disquiet, and for the supervision
you offered us. We appreciate it and it inspires us more to continue and
pursue and we are happy and blessed to have you as our clinical
instructor. We thank you also for allowing us to ride with you in your car
for us to be with the area at right time and keeping us always safe.

To the barangay health workers at Panadtalan Health Center

Maramag Bukidnon, for their warm welcome and for extending their help
and assistance if we needed to.

Lastly we would like to thank our classmates and for our group. For
the support and friendship, for the team building in our programs and
activities and working altogether to make this case study a successful one.

BACKGROUND OF THE STUDY

The proponents’ case study focuses on patients who are at risk with
problems in perception, coordination, immunologic and inflammatory
processes.

The patient’s case assessment provides the appropriate series of

interventions and support to the said patient. It is a process that gains a
greater understanding of the patient’s history and needs. This assessment
is culturally sensitive, individualized and developed in partnership with
the patient’s family member for the progression of interventions given to
the patient.

The proponents were assigned to look out for a patient at risk at

Brgy. Panadtalan, Maramag Bukidnon. They targeted a patient at Purok-
6A and 6B with the advice given to us by the Barangay Health Workers
(BHWs) who are known in their barangay as patient who is at risk with
problems in perception, coordination, immunologic and inflammatory
processes. As per observed and examined, hypertension and diabetes
mellitus were taken into account. The proponents’ assessment focuses on
the problem they have diagnosed, a diagnosis in line with their field of
expertise.

Introduction

Family is a basic unit of study in many medical and social science

disciplines. Definitions of family have varied from country to country, and
also within country. The family is a basic unit of study in many social
science disciplines, such as sociology, psychology, economics,
anthropology, social psychiatry, and social work. It is also a unit of study
in the medical sciences especially in understanding the epidemiology and
the natural history of diseases (Sharma, 2013). The family unit –
principally a man and a woman living together in harmony and peace – is
and always will be the basic social organization or unit of any society.

The family is the most important social unit of society. This is a fact
that everyone must learn. The family is not only the basic societal unit.
It is also the basic sexual unit, the basic child-raising unit, the basic
communication unit, and the basic all-around fun and friendship unit
(Wilson, 2013). It also forms the basic unit for family medicine. Census
definitions of family have varied from country to country and also from
census to census within country. The word household has often been used
as a replacement for family. The UNESCO report stated that a family is a
kinship unit and that even when its members do not share a common
household, the unit may exist as a social reality. This definition may be
too broad to serve the purpose of identification of a family unit for the
purpose of assessment as a factor in variables such as health.

Family nursing is a part of the primary care provided to patients of

all ages, ranging from infant to geriatric health. Nurses assess the health
of the entire family to identify health problems and risk factors, help
develop interventions to address health concerns, and implement the
interventions to improve the health of the individual and family. Family
nurses often work with patients through their whole life cycle. This helps
foster a strong relationship between health care provider and patient
(Peteprin, 2016). Family nursing is not as much patient-centered care as
it is centered on the care of the family unit. It also takes a team approach
to health care.

In the course of the family care assessment, it has been found that
Adarna family incurred problems regarding environmental sanitation.
Environmental Health is concerned with preventing illness through
managing the environment and by changing people's behavior to reduce
exposure to biological and non-biological agents of disease and injury. It
is concerned primarily with effects of the environment to the health of the
people. Per assessment it was found that the Adarna family gives low
attention to environmental sanitation. According to the WHO Director-
General Dr. Margaret Chan "Sanitation is a cornerstone of public health".
"Improved sanitation contributes enormously to human health and well-
being, especially for girls and women. We know that simple, achievable
interventions can reduce the risk of contracting diarrhoeal disease by a
third". Ann M. Veneman, UNICEF Executive Director said that “Nearly 40%
of the world’s population lacks access to toilets, and the dignity and safety
that they provide". “The absence of adequate sanitation has a serious
impact on health and social development, especially for children.
Investments in improving sanitation will accelerate progress towards the
Millennium Development Goals and save lives” (WHO & UNICEF, 2008).

Health problems result from the lack of sanitation facilitates,

especially among the urban poor living in overcrowded informal
settlements which is greatly affects to their health. Environmental poor
sanitation, globally an estimated 2000 under the age of five die every day
from diseases and these some 1800 deaths are linked to water, sanitation
and hygiene (United Nations International Children Emergency Fund). In
the Philippines, an estimated 25% of Filipinos do not have improved
sanitation, translating to more than 24 million people. (UNICEF WHO
Progress on Drinking Water and Sanitation 2012).

For the clinical case, Mrs. E of the Adarna family was found to be
suffering from Hypertension and Diabetes Mellitus Type II. Hypertension
and Diabetes Mellitus are chronic medical conditions that frequently
coexist. Having diabetes can increase risk of developing hypertension and
other cardiovascular problems, because diabetes adversely affects the
arteries. The combination of hypertension and diabetes can be lethal, and
together they can increase the risk of a heart attack or stroke.

THEORETICAL FRAMEWORK
 I. Theoretical Framework

Figure II.1

a. Florence Nightingale

The first theory we used was Florence Nightingale’s Environmental theory

she defined Nursing as “the act of utilizing the environment of the patient to assist
him in his recovery”. She linked health with five environmental factors; pure or
fresh air, pure water, efficient drainage, cleanliness and light, especially the
sunlight. This theory was applied in order to assess the following environmental
factors that needs to be improved to minimize the possibility of worsening the
patient’s condition. Nightingale said that a healthy environment is essential for
healing. Since our chosen patient has a poor immunity which makes him prone
to diseases and infections and these things are usually acquired from the
environment. We focused on altering the patient’s environment in order to help
her attain optimum state of wellness.

Our role in a patient's recovery is to alter the environment in order to

gradually create the optimal conditions for the patient's body to heal itself. This
would mean minimal noise and in other cases could mean a specific diet. All of
these areas can be manipulated to help the patient meet her health goals and