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INTRODUCTION
Family is the fundamental unit of society which is entitled for the protection of
state and also the society. One of the primary functions of the family is to produce and
reproduce persons—biologically and socially. Thus, one's experience of one's family
shifts over time.
From the perspective of children, the family is a family of orientation: the family
serves to locate children socially and plays a major role in their enculturation and
socialization. From the point of view of the parent(s), the family is a family of
procreation, the goal of which is to produce and enculturate and socialize children.
However, producing children is not the only function of the family; in societies with a
sexual division of labor, marriage, and the resulting relationship between two people, is
necessary for the formation of an economically productive household.
In a traditional Filipino family, the father is considered the head and the provider
of the family while the mother takes responsibility of the domestic needs and in charge of
the emotional growth and values formation of the children. Children see their mothers as
soft and calm, while they regard their fathers as strong and the most eminent figure in the
family. Another particular trait of Filipinos is their strong respect for elders. Children are
taught from birth how to say “po” and “opo” to teach them as early as possible how to
properly respect their elders. These words are used to show respect to people of older
level. Upon arriving home, conservative families expect children to practice the kissing
of hands or touching their parents' or elder family members’ hand to their foreheads with
the words “mano po” as a sort of greeting.
When Filipinos get sick, they usually find an excuse to evade a visit to the doctor
and rely on other people’s advice instead. One common excuse is financial constraint.
Thus, they find the health opinions of experts in the magazines and newspapers very
useful according to Cabral (2009).
Victoria is a 3rd class municipality in the province of Tarlac, Philippines.
According to the latest census, it has a population of 57,085 people in 10,535 households.
The municipality is located in the Province of Tarlac, geographically located in the
central part of Luzon. The municipality has a total land area of 11,150 hectares, of which
a large portion is used for agricultural activities.
Victoria is politically subdivided into 26 barangays. One of its barangay is
Batang-batang and it is one of the smallest rural areas of Victoria in terms of land area,
about 168. 40 hectares, but its active agricultural activities have contributed and made an
impact on the developmental growth of the town. Comprised by 1, 245 people, some 252
households are engaged with agricultural/ farming activities: 76 households in crop
production; 53 HH heads in livestock production; and, 16 households in agricultural
services. Around 52 household heads depend on their contractual wages, 20 household
heads rely on their regular salaries, while 30 household heads are unemployed. At least
94 household heads have undergone livelihood training.
II.OBJECTIVES:
Nurse Centered
General Objective
To promote health education and to have a good working relationship with the
members of the family
Specific Objectives
1. To identify the health problems within the family
2. To establish rapport to the family
3. To apply effectively the nursing process during the entire home visit
4. To improve skills in the assessment process
Family Centered
General Objective
To enhance the current health status of the family and prevent the occurrence of
diseases through health teachings.
Specific Objectives
1. To impart knowledge regarding their health through health teachings
2. To broaden their knowledge about their health conditions and to encourage
them seek medical advice
3. To be able for them to realize the importance of having a healthy lifestyle and
environment
Observations:
The Collado family is considered an extended type of family because Mr. and
Mrs. Collado have with them their youngest child. Mr. Celestino Collado, 75 years old, is
the head of the family, making the family patriarchal. He is a farmer in their barangay.
Mrs. Dominga Collado, the wife of Mr. Collado is 73 years old. She spends her time
caring for her grandson and grand daughter. They have 4 children but the youngest was
the one with them who is Elena Gracia. Elena is 31 years old. She tooks all the chores in
the house and also responsible for taking care of her children. Elena has a husband who is
Arnold Gracia. Arnold is a part time farmer in their barangay. He also takes care of their
children when he is not working. They had 3 children namely; Jay Ann, 3 years old,
James, 2 years old and Jay, who is 5 months old.
Mr. Collado is the one also decides about all the problem matters of each family
member and this kind of family is patriarchal. They have harmonious relationship to each
other and the younger members of the family have respect to their brother and sister.
There are no noticeable conflicts between members.
Norms:
There is three basic family systems of the nuclear family which is consists of a
husband, wife, and children; the polygamous family which consists of a husband or wife
and several spouses and their children; In the Philippine setting, the head of the family is
the one who decides regarding on certain situations that the family encounters.
The extended type best describes the Filipino family. A harmonious relationship
among each member must be observed. (Maternal and child care nursing, Vol. 1, 2nd
Edition, Authors: Marcia London, Patricia Ladewig, Jane Ball and Ruth Bindler)
Analysis:
OBSERVATION
Norms:
A person’s educational attainment is considered to be the highest level (grade or
degree) of education they have completed. Education also plays a role in income. Median
earnings increase with each level of education. As conveyed in the chart, the highest
degrees, professional and doctoral degrees, make the highest weekly earnings while those
without a high school diploma are financially penalized. Higher levels of education are
associated with better economic and psychological outcomes Education plays a major
role in skill sets for acquiring jobs, as well as specific qualities that stratify people with
higher SES from lower SES. Annette Lareau(2009) speaks on the idea of concerted
cultivation, where middle class parents take an active role in their children’s education
and development by using controlled organized activities and fostering a sense of
entitlement through encouraged discussion. Laureau argues that families with lower
income do not participate in this movement, causing their children to have a sense of
constraint. A division in education attainment is thus born out of these two differences in
child rearing. In theory, lower income families have children who do not succeed to the
levels of the middle income children, who feel entitled, are argumentative, and better
prepared for adult life.
Majority of the Filipinos are Catholics. The Filipinos believe in only one GOD
who is Almighty and omnipotent. Religious practices show concern and love for one’s
neighbors. Among Catholics, the Ten Commandments set the standard of behavior. They
keep images of saints at home and every church has a patron saint.
Analysis:
Mr. Collado and his son-in-law are farmers they earn ₱500 each every month and
their salary is not enough to meet the basic needs of each of the family members.
Sometimes they just lend money from their relatives when in need. The family manages
this problem by planting vegetables on their backyard and they also have several chikens
in their backyard. Despite their financial problem, the family still manages to live
peaceful life. All members of the family are Roman Catholics but are not active
according to Elena.
Interpretation of results:
Not overcrowded: TFA is greater than the TSR (total space requirement)
Overcrowded: TSA is greater than TFA
Computations:
Total Floor Area (TFA) =6.92 x 5.86 = 40.55 m2
Total Space Requirement (TSR) = (4) (3.0) + (3) (1.5) = 16.5 m2
VENTILATION:
STANDARD: (Concepts and Guidelines in COPAR, 1ST Edition, 2005 by Untalan)
20% - Satisfactory
18 - 19 % - fair
Below 18 % - poor
Collado House TFA = \40.55sq. m
Collado House Total No. of windows: 3
Formula:
Ventilation= TWO / TFA x 100
TWO: total area of windows by multiplying their length to their width.
TFA: total floor area
Computations:
WO (window openings)
W1= 2.18 m x 1.2 = 2.616
W2= 2.18 m x 1.2 = 2.616
W3= = 2.18 m x 1.2 = 2.616
7.848 m2
Ventilation = TWO/TFA x 100
= 7.848 m2 /40.55sq. m x 100
= 0.143 x 100
= 19.35%
Analysis:
19.35 %< 20% is poor
The result of the total ventilation of the Collado family is poor. There is
occurrence of serious health threat in them especially they have a 5 months old baby.
Norms:
A healthy home is well ventilated, free of pests, toxics, and dangerous gases; dry;
clean; comfortable; and affordable. Good construction and maintenance practices can
achieve these conditions, even in an older home.
Comfortable homes make it unlikely that individuals will unknowingly take
actions that can harm their health. For example, excess cold may cause people to use
stoves and ovens for heating, leading to chronic and perhaps acute exposure to carbon
monoxide. Humidifiers may be installed to relieve an excessively dry environment,
creating extra moisture that can contribute to molds and foster the growth of dust mites,
both of which are asthma triggers.
The Total Space Requirement for an adult is 3 sq. m. and 1.5 sq. m. for a child.
The shelter must be a concrete, made up of woods that are strong enough and the lot has
been own by the owner. The family members must be has proper places in the room
while sleeping and not over crowded. There is no presence of accidental hazards, clean
water storage and proper food handling. The kitchen must be far away from the comfort
room at least 10 to 15 meters away.
(www.healthhouse.org)
Analysis:
Generally, the house of the Collado family is not well kept. Their things are not
properly placed as it should be. Their clothes are scattered everywhere at the house. The
family lacks adequate storage for food and for their kitchen fascilities. Their open
drainage is a threat of breeding sites of vectors of diseases. Accident hazards such as fire
and injury from sharp materials is present especially to children. They do not manage
their garbage properly even though it is being collected.
asked some question and she did cooperate. She said that her mother has Diabetes and
suffers from rheumatism and arthritis. The head of the family is chain smoker, he
consumes one pack of cigarettes per day. He also suffers from arthritis. Her husband,
Arnold also smokes one pack of cigarette per day. Her first and second child eats poorly
and they are still taking milk using bottles she added. And her youngest child is breastfed
and eats some other foods like biscuits With regards to their food intake habits they
usually eat rice and viand which they buy from the sari-sari store.
Body Mass Index (BMI) – BMI is calculated using the formula below:
Adult: children:
BMI = Weight in Kgs BMI= Weight in Kgs
Height in meters2 Height in cm2
Norms:
The Department of Education through the Health and Nutrition Center said that the
normal BMI of adults is 18.5-24.9, underweight adults is below 18.5, overweight adults
are 25-29.9 and for obese person is equal and above 30. Body Mass index is a reliable
Norms:
Studies of health practices among Filipino suggest that people
originally from rural areas in the Philippines are more knowledgeable regarding home
remedies, traditional healing techniques, and super natural ailments, whereas those from
urban areas rely more in medical intervention and over the counter drugs. However, in
both urban and rural areas, a variety of indigenous folk practices and modern health care
systems are utilized simultaneously. Among the traditional forms of self-medication are
certain oils or ointments, which serve as “cure-alls” in relaxing, heating and comforting
the muscles or providing relief for dizziness, colds, headaches, sore throats, and so forth.
(Montepio/1986/1987:Vans 1991)
Analysis: The family is not that aware of the health problems that may arise due to their
lifestyle habits like lack of adequate rest and exercise. On the other hand, they are aware
that completing immunizations means prevention of diseases.
Poor Sanitation
Smoking
Accident Hazard
Malnutrition
Diabetes
INTERVENTION PLAN
Nursing Methods Resources
HEALTH FAMILY GOALS OBJECTIVES
Interventions of Nurse Required
PROBLEM NURSING EVALUATION
family
PROBLEM/S
contact
Poor sanitation Inability to After proper After proper Demonstrate the Home Time and
(health threat) provide a home nursing nursing following: Visit effort of the
environment that interventions interventions 1)discuss with health care
is conducive in the family will the family the family the provider and
maintaining take the should adhered importance of the family
health and necessary the following: environmental Expenses for
personal actions to sanitation to teaching aids
1) should
development due improve and their health and
know
to: maintain the 2)utilize health transportation
the
1) inadequate sanitation of measures of the student
importa
financial their involving the nurse
nce of
resources immediate manipulation or
clean
and lack surroundings elimination of
potable
of space to thr ffg:
construct a)physical threat
water
facility to health are
supply
2) ignorance eliminated by
and
on the improving on
proper
importanc fascilities at
waste
e of home
disposal
proper b)psychological
hygiene 2) throw threat by
and waste working closely
sanitation material with the family
3) lack of s to improve
knowledg properly communication
e
regarding 3) clean
preventive surroun
measures dings to
eliminat
e
breedin
g sites
of pests
4) take a
bath
once or
twice a
day
INTERVENTION PLAN
Nursing Methods Resources
HEALTH FAMILY GOALS OBJECTIVES Interventions of Nurse Required
PROBLEM NURSING family EVALUATION
PROBLEM/S contact
Malnutrition 1)inability to After proper After proper 1)monitor VS Home
(health deficit) make nursing nursing and perform Visit Time and
decisions with interventions, interventions, physical effort of the
respect to the family will the family assessment health care
taking alleviate members will: 2) weighed the provider and
appropriate malnutrition 1)be able to children and the family
health due to and have take nutritious computed their Expenses for
lack of taking healthy foods BMI teaching aids
nutritious condition 2)be able to 3)discuss about and
foods and not maintain the the ffg: transportation
eating at the regular dietary a)the of the student
right time patter at the importance of nurse
2)inability to right time taking nutritious Paraphernalia
provide 3)understand food such as
nursing care to about the fruits and
malnourish importance of vegetables
family nutritious foods b)the condition
member due to 4)avoid to take of being
lack of unsanitary or malnourish and
knowledge non nutritious its effect
among the foods 4)instruct them
members to eat in proper
dietary pattern,
eat 3 times a
day at the right
time
5) promote
health teachings
such as the
proper hand
washing before
and after eating
INTERVENTION PLAN
Nursing Methods Resources
HEALTH FAMILY GOALS OBJECTIVES
Interventions of Nurse Required
PROBLEM NURSING EVALUATION
family
PROBLEM/S
contact
Diabetes Inability to do After proper After proper Demonstrate the Home Time and
(health deficit) the activities nursing nursing ffg: Visit effort of the
that may interventions, interventions, 1)provide health care
prevent the the family will the family information of provider and
occurrence of know the members will how such the family
the importance of be able to: activities like Expenses for
complications the betterment 1)understand of eating verity of teaching aids
of the problem of the disease the taught foods is bad and
measures to 2) giving health transportation
minimize the teachings on of the student
problem how to prevent nurse
2)avoid the complications
intake of sweet Encouraging the
foods that may mother and
contribute to of father to do
having high activities like
blood sugar exercising and
30seek medical have enough
advice when rest and sleep to
complications minimize the
occur problem
INTERVENTION PLAN
Nursing Methods Resources
HEALTH FAMILY GOALS OBJECTIVES
Interventions of Nurse Required
PROBLEM NURSING EVALUATION
family
PROBLEM/S
contact
Improper drainage Inability to After proper After proper Demonstrate the Home Time and
system provide a nursing nursing ffg: Visit effort of the
(health threat) home interventions, interventions, 1)cleaning the health care
environment the family will the family will open canal daily provider and
conducive to be able to: be able to: to stop breeding the family
health 1)recognize the 1)Demonstrate sites Expenses for
maintenance presence of the the ffg: 2)replacing all teaching aids
and personal problem by a) cleaning the the materials and
development doing a specific open canal that can be transportation
due to ignoring action such as daily possible of the student
the problem cleaning the b)avoiding breeding sites of nurse
open canal and throwing waste insects such as
avoiding on it open tires with
throwing waste stagnant water
on it
3) Proper
arranging of
home materials
such as
containers
having stock
water to
maintain a clean
surrounding.
INTERVENTION PLAN
Nursing Methods Resources
HEALTH FAMILY GOALS OBJECTIVES
Interventions of Nurse Required
PROBLEM NURSING EVALUATION
family
PROBLEM/S
contact
Smoking Inability to After proper After proper Demonstrate Home Time and
(health threat) refuse to nursing nursing the ffg: Visit effort of the
smoking of the interventions, interventions, 1encourage the health care
head of the the father will the father will father not to provider and
family that may be able to: be able to: smoke because the family
lead to serious 1) realize that 1)realize the smoking is not Expenses for
problems such smiking is very importance of only dangerous teaching aids
as TB, cancer. dangerous to not smoking for him but also and
Emphysema,and him for those who transportation
other heart takes the second of the student
ailments hand smoke nurse
2)teaching the
father the
proper mouth
hygiene
INTERVENTION PLAN
Nursing Methods Resources
HEALTH FAMILY GOALS OBJECTIVES
Interventions of Nurse Required
PROBLEM NURSING EVALUATION
family
PROBLEM/S
contact
Poor personal hygiene Inability to After proper After proper Demonstrate the Home Time and
among the maintain a nursing nursing ffg: Visit effort of the
children good hygiene interventions, interventions, 1)discuss to the health care
family the
(health threat) due to: the family will the father will provider and
importance of
1) lack of be able to: be able to: maintaining the family
good hygiene
assistance of 1)take the 1)demonstrate Expenses for
2)helping the
the mother necessary the proper way mother in teaching aids
bathing the
2)lack of action to of bathing the and
children
knowledge in improve and children 3)instructing the transportation
mother the
maintaining maintaingood 2) maintain the of the student
proper way in
good hygiene hygiene among cleanliness of maintaining the nurse
cleanliness of
3) the children the children
her children
paraphernalias
VI. Conclusion
The family cooperated well during interventions with the student nurse and we have a good working relationship. The family
in return responded well to the interventions done to them. The family are now knowledgeable with the problems in their home and to
themselves because of the student nurse who imparted knowledge to them.
VII. Recommendations
The student nurses exposed in the community play an important role in the life of a family. They will be the ones who will lead
the path towards the family’s improvement in terms of health.
As a student nurse, I recommend the following to the Collado family:
1.) The family must be conscious about their health.
2.) The family must give more attention to their hygiene.
3.) The family must know how to have a good and healthy environment in order to prevent the occurrence of diseases that
may trigger their health.
A. Books
B. Websites
http://www.livinginthephilippines.com/style12.html
Wikepedia.org
www. Census.gov.ph
www.google.com
www.healthhouse.org