NCM_104 - CHN
resources; choose to live together as an extended family.
Community Health Nursing
Family
• Basic unit in society, and is shaped by all forces surround it.
• Is a unit of interacting persons bound by ties of blood, marriage
or adoption.
Concept of Family
• Constitute a single household, interacts with each other in their
respective familial roles and create and maintain a common
culture.
• Two or more people who live in the same household (usually),
share a common emotional bond, and perform certain
interrelated social tasks.
• An organization or social institution with continuity (past,
present, and future). In which there are certain behaviors in
common that affect each other.
Family Code - Filipino Family based on the Philippine
Constitution, with focus on religious, legal, and cultural aspects
of the definition of family.
Section 1 - The state recognizes the Filipino family as the
foundation of the nation.
Section 2 - Marriage, as an inviolable social institution, is the
foundation of family and shall be protected by the state.
Section 3 - The state shall defend
• The right of spouses to found a family in accordance with their
religious convictions and the demands of responsible
parenthood.
• The right of children to assistance including proper care and
nutrition, and special protection from all forms of
neglect, abuse, cruelty, exploitation and other
conditions prejudicial to their development.
• The right of the family to a family living wage income.
• The right of families or family associations to participate in the
planning and implementation of policies and programs of
that affect them.
Section 4 - The family has the duty to care for its elderly
members but the state may also do so through just programs of
social security.
Types of Family - They change overtime as a consequence of
birth, death, migration, separation and growth of family
members.
Structure
Nuclear - a father, a mother with child/children living together but
apart from both sets of parents and other relatives.
Extended - composed of two or more nuclear families
economically and socially related to each other.
Multigenerational, including married brothers and sisters, and
the families.
Single Parent - divorced or separated, unmarried or widowed
male or female with at least one child.
Blended/Reconstituted - a combination of two families with
children from both families and sometimes children of the newly
married couple. It is also a remarriage with children from
previous marriage.
Communal - more than one monogamous couple sharing
Cohabitation/Live-In - unmarried couple living together.
Dyad - husband and wife or other couple living alone
without children.
Gay/Lesbian - homosexual couple living together with or
without children.
No-Kin - a group of at least two people sharing a
relationship and exchange support who have no legal or
blood tie to each other.
Foster - substitute family for children whose parents are
unable to care for them.
Functional Type
• Family of Procreation - refers to the family you yourself
created.
• Family of Orientation - refers to the family where you
came from.
Decisions in the Family (Authority)
• Patriarchal - full authority on the father or any male
member of the family e.g. eldest son, grandfather.
• Matriarchal - full authority of the mother or any female
member of the family, e.g. eldest sister, grandmother.
• Egalitarian - husband and wife exercise a more or less
amount of authority, father and mother decides.
• Democratic - everybody is involve in decision making.
• Matricentric - the mother decides/takes charge in
absence of the father (e.g. father is working overseas).
• Patricentric - the father decides/ takes charge in
absence of the mother.
Descent
• Patrilineal – Affiliates a person with a group of relatives
who are related to him though his father.
• Bilateral - both parents.
• Matrilineal - related through mother.
Residence
• Patrilocal - family resides / stays with / near domicile of
the parents of the husband.
• Matrilocal - live near the domicile of the parents of the
wife.
Family Centered Nursing Approach
Family as the context
• primary focus is on the health and development of an
individual member existing within a specific
environment (i.e., the client’s family)
Family as the client
• family is the foreground.
• Individuals are in the background.
• focus is concentrated on each and every individual as
they affect the whole family.
Family as a system
Family as a component of society
• family is seen as one of many institutions in society, along
with health, educational, religious, or economic institution.
Development Stages (Duvall & Miller, 1990)
Family Nursing Process - a dynamic systematic
organized method of critically thinking about the family.
Nursing Process includes Assessment, Nursing
Diagnosis, Planning, Implementation, & Evaluation.

Stage 1 - Marriage & the Family — Involves merging of values

brought into the relationship from the families of orientation.

Stage 2 - Early Childbearing Family — Birth or adoption of a

first child which requires economic and social role changes.

Stage 3 - Family with Pre-School Children — Children at this

stage demand a great deal of time related to growth and
development needs and safety considerations.

Stage 4 - Family with School Age Children — Parents

prepare their children to function in a complex world while
maintaining their marriage relationship.

Stage 5 - Family with Adolescent Children — Allows the

adolescents more freedom and prepare them for their own life
as technology advances-gap between generations increases
Stage 6 - The Launching Center Family — Stage when
children leave to set their own household-appears to represent
the breaking of the family
Stage 7 - Family of Middle Years — Period from empty nest
to retirement
Stage 8 - Family in Retirement Older Age — Final Stage of
family development. Time for travel, hobbies, relaxation.
Typology of Problems in Family Health (Second Level)
I. Inability to recognize the presence of the condition
II. Inability to make decisions with respect to taking
appropriate health action
III. Inability to provide adequate care to the sick, disabled,
dependent, or vulnerable/at-risk member of the family
IV. Inability to provide home environment conducive to
health maintenance and personal development
V. Failure to utilize community resources for health

Stage 9 - Period from Retirement to Death of Both Spouses

Health Task - differ in degrees from family to family

Task - is a function, but with work or labor overtures assigned

or demanded of the person

Eight Family Tasks (Duvall & Miller)

* Physical Maintenance - provides food shelter, clothing, and

health care to its members

* Socialization of Family - involves preparation of children to
live in the community
* Allocation of Resources - determines which family needs will
be met and their order of priority
* Maintenance of Order - integrating family values and
enforcing common regulations for all family members
* Division of Labor - who will fulfill certain roles
* Reproduction, Recruitment, and Release of Family Member
* Placement of members into larger society - selecting
community activities such as church, school, politics that
correlate with the family beliefs and values
* Maintenance of motivation and morale - created when
members serve as support people to each other
1. Nature of the condition or problem presented
• categorized into wellness, health threat, health deficit
and foreseeable crisis.
2. Modifiability of the condition or problem
• probability of success in enhancing the wellness state,
minimizing, alleviating or totally eradicating the problem
through eradication
3. Preventive potential
• refers to the nature and magnitude of future problems
that can be minimized or totally prevented if intervention
is done on the condition or problem under consideration
4. Salience
refers to family’s perception and evaluation of the
condition or problem in terms of seriousness and urgency
of attention needed or family readiness.
Family Nursing Care Plan Types of Family Nurse Contact
- systematically minimize or eliminate the identified health and family
nursing problems through explicit formulated outcomes of care and — Clinic Visit —
chosen set of interventions, resources and evaluation criteria, • easy for the nurse
standards, methods and tools. • can see many people in a short period of time
• Medical equipment and supplies are available for the
Categories of Intervention assessment and treatment of patients

1. Promotive - the process of enabling people to increase control — Home Visit —

over, and to improve, their health
2. Preventive - prevent disability
3. Curative - practices that treat patients with the intent of curing
them, not just reducing their pain or stress
4. Rehabilitative - maximize the remaining capabilities and
functions of an already disabled patient
• Best way of performing family centered care.
• refers to meeting the needs of the people at their door
steps
• the nurse is able to see the home environment and with
other family members as well
— Group Conference / Family Discussion —
• involves the whole family and can be done at home,
clinic, school or workplace.

— Written Communication —
• an official and effective method of communication, done
by writing something and passed to others.
• it includes orders, instructions, circular letter,
newspaper, book etc.

Family Health Care Researches

Related Literature - Studies, inquiries, or investigations

Tools of Public Health Nurse
Bag Technique - a tool by which the nurse, during her visit will
enable her to perform a nursing procedure with ease and deftness, to
save time and effort
already conducted to which the present proposed study is
relate or has some bearing or similarity
Evidence-based Practice (EBP) - any practice that relies on
scientific evidence for guidance and decision-making
Inter-Professional Care in the Community

Public Health Bag - an essential and indispensable equipment of a

public health nurse which she has to carry along during her home
visits. It contains basic medication and articles which are necessary
for giving care.

Contents
• Paper lining • Extra paper for making waste bag
• Plastic/linen lining • Apron
• Hand towel • Soap in a soap dish
• Thermometers • Sterile dressing
• 2 pairs of Scissors (surgical and bandage)
• 2 pairs of forceps (curved and straight)
• Disposable syringes with needles (g. 23 & 25)
• Hypodermic needles (g. 19, 22, 23, 25)
• Cotton balls
• Cord clamp • Solutions of:
• Micropore plaster • Betadine
• Tape measure. • 70% alcohol
• 1 pair of sterile gloves • Zephiran Solution
• Baby’s scale • Hydrogen Peroxide
• Alcohol lamp • Spirit of ammonia
• 2 test tubes • Opthalmic Ointment
• Test tube holders • Acetic Acid
Republic Act 7160 (Local Government Code)
• This Code establishes the system and defines powers of
provincial, city, municipal and barangay governments in the
Philippines.
• It provides for a more responsive local government structure
instituted through a system of decentralization whereby Local
Government Units are delegated more powers, authority,
responsibilities and resources.

Government Organizations

> DSWD
> Republic of the Philippines Commission on Population
> National Nutrition Council

Non Governmental Organizations

> Socio-Civic Organizations

> Religious Organization

> School