Chapter I

INTRODUCTION

“The family is the nucleus of civilization.”

-Ariel and Will Durant: Wisdomquotes.com

The family is the smallest unit of the society and the natural fundamental

core of the community and consequently, it is considered as the primordial

recipient of the nursing effort, which is contributory to the development, and

progress of the community through active involvement and self – responsibilities

of each constituent. It is composed of persons, male and female, being molded to

be as one, working hand in hand to maintain a good atmosphere among the

family members.

A nucleus controls the functions of the entire cell and can be thought as

the “command center” of the cell. The nucleus as well has different components

which are all needed in order for it and the cell to function well, same as with the

“commander” or the head of the family and the members who has different

functions within the family.

The impression or status of each family will always affect the status of the

community as a whole. Community health nursing is a response to the health

needs of the people. It does not focus on a particular class or family. It is

comprehensive and general in approach. Community health service is not

episodic as it requires continuous observation and monitoring of the community

as a whole. Promotion and preservation of the health of its different clients

1
(individual, family, group or community) is the primary goal of community health

nursing.

The community is a group of people sharing geographic boundaries

and/or values and interests. (Maglaya, 2004) No two communities are alike. A

nurse exposed in the community learns how to interact and adapt to different

kinds of people. The family is considered as the basic unit of care in the

community health nursing. It is in the family where a member develops his

health values, beliefs and practices. The family is a major influence in the

health behaviors of an individual. With this, it is important that families in a

community are aware of the things and practices pertaining to their health.

It is apt to say that community health nursing has a big role in the

nursing education. It is in the community where the student nurse learns

nursing apart from the hospital setting as she was exposed to different level of

orientation. It is in the community where the saying “nursing is an art” can be

applied as a student nurse tries to give quality service using the available

resources in the health center.

` Conducting a family case study is a means by which student nurse

reaches and feels the community through its basic structure – the family. It is a

tool in determining the health status of a family through assessment and critical

inspection. Through this, health related problems are identified, thus giving the

student nurse a hint on where to act and how to intervene. It is also a means

towards improving the health of the community people, making them more

productive. To come up with a family case study gives a sense of fulfillment to a

2
student nurse as she was given the opportunity to share their skills, knowledge

and time to alleviate and uplift the living condition of a family.

The family that was chosen by the student nurse is a picture of the

majority of the family here in our country: a family living in a poor environmental

condition without enough resources and lacks knowledge on vital health

information and experiences other socio-economic related problems. Though

tiring as it is, reaching out to this family and mingling with them makes the

student nurse feel the sense of fulfillment as she share her knowledge, skill and

time to aid in uplifting the condition of the family.

3
 Chapter II

OBJECTIVES OF THE STUDY

This chapter presents the general and specific objectives of this

family case study. Setting objectives provides direction for planning a family

nursing intervention. It facilitates motivation for the client and the nurse by

providing a sense of achievement. (Kozier, Erb et. al., 2004).

General Objectives:

At the end of the student nurse-family relationship, the adopted

family will be able to improve their health status and become self-reliant in

maintaining their health through appropriate interventions in a given time frame.

Specific Objectives

After 1 month of home visits and student nurse-family interaction, the

family should be able to:

• Established rapport and trust with the student nurse.

• Give pertinent and factual information during surveys and

interviews

• Participate actively during home visits and assessment interviews

• Identify actual and potential problems which may be a hindrance in

attaining optimum health.

4
• Categorize the identified health problems as health threat, health

deficit or foreseeable crisis through the assistance of their student-

nurse.

• Prioritize the identified family health nursing problems with the

assistance of their student nurse.

• Plan possible solutions or nursing actions to the prioritized health

problems.

• Generate interventions considering the student nurses’ capabilities,

community and the family’s resources.

• Carry out the planned interventions together with the student nurse

• Perform the health teachings taught by the student nurse

• Evaluate the effectiveness of the intervention using the set

objectives as a basis, and

• Evaluate changes in condition after giving interventions.

5
 Chapter III

INITIAL DATABASE

A. Family Structure, Characteristics, and Dynamics

Position in Educational
Name Age Sex Civil Occupation
the Family Attainment
Mr. 30 Male Married Father Farmer Elem. Level
V (Grade 3)
Mrs. 29 Female Married Mother Housewife Elem Grad
V (Respondent) (Grade 6)
Child 11 Male Child Eldest Child Student Elem. Level
AV (Grade 5)
Child 10 Female Child Second Child Student Elem. Level
BV (Grade 4)
Child 7 Male Child Third Child Student Elem. Level
CV (Grade 3)
Child 5 Female Child Fourth Child Student Elem. Level
DV (Grade 1)

The Family V is considered as a nuclear type of family. A nuclear type is a

typical type of family composed of a father, a mother and child/children. This type

of family structure is found in almost all societies, although the length of time in

which the family remains in this form varies even within the same society.

The nuclear family can be a nurturing environment in which to raise

children as long as there is love, time spent with children, emotional support, low

stress, and a stable economic environment. In nuclear families, both adults are

the biological or adoptive parents of their children (Jay C, 2004,).

The V family resides in Purok Daanbanwang, Upper Labay, General

Santos City. They have started living their since June of 2009. They were a

6
family whose resident is always changing. They have been in Nurallah, South

Cotabato for 5 years and in Malungon for 3 years.

Mr. V and Mrs. V go hand in hand in terms of decision-making. They

consult each other in terms of planning and budgeting for their family. They

discuss matters concerning their children’s schooling financially and also with

regards to the emotional problems or aspects within the family. When problem

arises, they make sure that both of them will handle and solve the problem. But

then, in terms of matter concerning health Mrs. V is more dominant. She makes

sure that she will comply with the appropriate regimen when certain health issues

arise. She has greater awareness concerning health matters compared to Mr. V

since of course believing it is her duty as the mother. These health matters

include immunization, feeding the right food and caring for the sick member.

B. Socio-Economic and Cultural Characteristics

The V family’s main source of income is coming from Mr. V’s farming. Mr.

V earns about Php 6,000.00 a month. Since Mrs. V does not work, she is in

charge of the house and in taking care of the children. Mrs. V budgets the money

in terms of food, education and miscellaneous where clothes, shoes and slippers

comes in. Out of Mr. V’s earnings, most of it goes to the family’s budget for food.

The education of the children is free and they can walk from their house to the

school so only some school supplies are being bought. Usually, there is nothing

to be left for the miscellaneous expense.

7
 With Mr. V’s monthly income, the family strives hard to accommodate

everything they need for them to live. According to NEDA, each individual should

at least have Php 2768.60 when the total monthly income of the family is divided

among the total family members. The total monthly income of Mr. V is about Php

6, 000.00 and when divided among the 6 members, it is only Php 1, 000.00, thus,

they can be considered poor. Mrs. V also informed the student nurse that they do

not have any financial assets at hand in case of emergency. They typically

borrow money from their relatives.

Mr. V works as a farmer, he works from 3 am until 8 pm everyday. He

seldom goes home but rather stays in the farm, which is situated far away from

the family’s house. Mrs. V doesn’t work and stays in their house. She is the

typical housewife where in you can see her wash clothes, prepare food, sweep

the yard and make the house clean.

All of them are affiliates of Protestantism. Mrs. V mentioned that they do

not go to church anymore since they have lived in Purok Daanbanwang for the

reason that of the distance they have to travel from their place to the church.

Significant others are called such due to their own role in one’s life. They

are the ones very close to a person or group of persons. For family V, the

significant others in their lives are their relatives and some neighbors. They

usually run to their relatives if they face hardships and problems. Mrs. V also

confirmed how helpful and welcoming her neighbors are with them.

8
 The family has yet to participate in community activities since they are

new in the place. But way back in Nurallah, they usually partake in community

activities. These activities include fiesta, parties and carnivals.

The V Family barely enjoys the community resources since the community

itself lacks resources. The children, though, go to Purok Daanbanwang

Elementary School. The father is usually in their farm while the mother is in the

house doing household chores. The family uses the river as their means of water

source in washing their clothes. There is also a shallow well built within the river

where the family gets their water source for drinking if they get lazy in getting

water from the faucet, meters away from their house.

C. Home and Environment

The house is made of wood, mostly bamboo. Mrs. V did not know the

exact measurement of their house. Her husband knows it yet he was not there

during the interview. In order for the house to be considered as adequate, the

total floor area should be divided among the total members of the family and

each should at least have 3.5 m2.

The house only has 2 windows and can sustain the adequate ventilation

needed by the family. Mrs. V told the student nurse that their house is usually

“presko” since it is beside the river and the air goes to and fro freely inside the

house.

9
 The house has 2 rooms. The one is the sala/dining room and the other is

the bedroom, with no bed at all. Mr. and Mrs V, together with the children, sleep

in one room. They use “banig” in sleeping.

The V Family has only one appliance which is the radio powered by

batteries since the place has no electrical supply yet. In terms of garbage

disposal, they either bury or burn their garbage.

Mrs. V uses wood and charcoal in cooking. She is the one who prepares

the food. She cooks inside the house at the back portion. The foods that they

usually eat are fish and vegetables. The family uses plastic plates and stainless

spoons in eating. When it comes to storing their food, they just cover it with a

plate. In terms of cooking facilities the family is equip with pots, “sandok”, and

knives.

The river is the family’s main source of water. They wash their clothes and

gets their drinking water supply there. They put their water in a big container with

cover. They usually don’t go and get water from the faucet in the purok since,

according to Mrs. V, it is far from their house. They usually don’t sterilize their

drinking water supply.

V Family has no comfort room. They usually urinate and remove bowels

anywhere near their house. They have not yet built their own comfort room since,

according to Mrs. V, they are still new in the community and has no enough

budget for it yet.

The drainage system of the family is an open type where in the drainage

flows anywhere and is continuous. It is dirty and has a stinky smell. There is

10
some rice grains noted. There is no obstruction present at the drainage system

since it is open and flows anywhere.

The family does not own any transportation facilities. They ride on a

jeepney or truck in going to the city proper. When they go to their farm or any

purok within Upper Labay, they usually walk kilometers.

The family has one chicken and a dog. There are vegetables planted near

the house.

D. Health Assessment of Each Family Member

D1. PAST AND PRESENT ILLNESS

1. Health Assessment on Each Member

A. Mr. V – The student nurse has never met Mr. A since he was in their farm

during the interview. Mrs. V, however, told us that she thinks her husband has

never undergone immunizations at all since it was not that important before.

Mrs. V said that her husband is about 5’4 tall and weighs about 55 kilograms.

His BMI reveals normal weight with a value of 20.8. Mrs. V told the student

nurse that her husband has no genetic or hereditary illness known. He is not a

smoker. He drinks alcohol rarely since they have no budget for that.

B. Mrs. V – She has no degenerative, chronic, or infectious diseases as of

the present time. She has also not completed immunizations. When she was

still 4 years old, she experienced chicken pox. She is 5 feet and 3 inches and

weighs 60 kilograms. Her BMI reveals normal weight with a value of 23.4. She

has no complaints as of the present time and has not taken any medications

11
 as of the moment. At times of illness, she would just drink paracetamol for

fever and mefenamic acid for pain or treat wounds with crushed plants coming

from their backyard. The family is not using family planning anymore.

C. Child AV – has no any degenerative, chronic, or infectious diseases as of

the present time. He has not completed immunizations. He is 4 feet and 10

inches and weighs 38 kilograms. He likes to eat vegetables and fish.

D. Child BV –has no any degenerative, chronic, or infectious diseases as of

the present time. She has not completed immunizations. She is 4 feet and 7

inch tall and weighs 36.5 kilograms.

E. Child BV –has no any degenerative, chronic, or infectious diseases as of

the present time. He has not completed immunizations. He is 4 feet and

weighs 33 kilograms.

F. Child DV – has no any degenerative, chronic, or infectious diseases as of

the present time. She has complete immunizations. She is 3 feet and 11

inches tall and weighs 17 kilograms. She appears thin. This child has many

allergies and there are rashes still seen on her legs.

FAMILY ASSESSMENT BASED ON FUNCTIONAL HEALTH PATTERN

1. Health Perception-health management patterns

• With no known vices like smoking and drinking except for Mr. V who

drinks alcohol rarely.

• Was able to recognize the importance of having a healthy well-being.

• Uses herbal plants, though not approved by the DOH, from their backyard

12
2. Nutritional-metabolic pattern

• Do not take any food supplements or vitamins

• Daily food intake is mainly rice, fish and vegetables

• Children eat junk foods whenever they were given money

• Children have poor appetite according to Mrs. V

3. Elimination pattern

• Eliminates everyday with an average frequency of urine: 5 times

• According to Mrs. V, all of the family members have no difficulty in

voiding.

• The family members defecate everyday and some, every other day

with no difficulty in defecating noted.

4. Activity-exercise pattern

• “Dili nami makaexercise kay daghan mi trabaho labi na pagbuntag”

verbalized by the mother.

• Family preferred to stay at home and take a nap if they have free time

while their children play with other children in the community after class.

5. Sleep-rest pattern

• Family usually has 7-8 hours of uninterrupted sleep according to the

mother.

• They usually sleep at around 9 in the evening and wake up at around 4 to

5 in the morning.

• They also take a nap at free time.

6. Cognitive-perceptual pattern

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 • Was oriented to time, place and is able to identify people and significant

others by their first names.

• Was able to respond accordingly and correctly to questions. Retaliates as

soon as he can and was able to rationalize. Verbal pattern and

spontaneity normal

• Memory intact

• No sensory defects

7. Self-perception/self-concept

• Showed apprehension and worry towards unspecific consequences.

• Perceived situations (health deficits) to be very stressful but remain

passive about things and condition.

8. Roles and relationship

• Family members have an open communication and able to discuss their

problems according to the mother.

9. Sexual reproductive

• Both parents are still in the reproductive age

• The parents are separated as of the moment since the father is in their

farm and the mother is in the house

10. Coping Stress

• Gains strength in the “assurance and guarantee” provided by family

members.

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11. Values/ Beliefs Pattern

 The family is Protestant in faith. Expressed great belief and faith in God. Is

certain that the Divine providence would protect them from any

unidentified and possibilities of harm.

 Does not go anymore to church since they are situated far away from the

place of worship they attend

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

Prevention.

The children in the family has not all completed their immunization. All the

children in the family were dewormed last March 2008.

The family has adequate rest and sleep. They sleep early and wake up

early, the usual time of sleeping is 9pm and they wake up at around 4 to 5am.

Mrs. V stated that farming, doing the household chores, and walking are their

ways of exercise. The father is in the farm. The mother usually does the

household works and talks with the neighbors during free time. The children are

either in school or are playing with other children in the community.

The mother recognizes the importance of health in the family, however,

because of financial constraints made them ignores any major health problems

that may arise. Furthermore, they were not able to sustain sufficient supplies of

medication or articles which they would need related to their health care needs.

They often use alternative medicines or herbal medicines for treating their illness

and habitually self-medicate if OTC medications are available. The family

15
believes in the power of herbal plants. They occasionally use herbal plants

lodged near the house in treating diseases or symptoms in the family since their

transfer from Nurallah. Mrs. V said that she had no choice but to use these plants

for the reason that the barangay health center is far away from their home. But if

the symptoms manifested by the family member become severe, they

immediately go to the health center or to the hospital.

16
 Chapter IV

FAMILY BACKGROUND

This chapter illustrates the family background of the study which includes,

Database of the Respondent, Family Tree, General Household Data, Activities of

Daily Living which could be an indicative for the present health status of the

family as it continues to influence the each of the family member.

Family History

Family V is composed of 6 members Mr. V is the father, Mrs. V as the

mother, children AV, BV, CV and DV are the kids. Mr. V is the head of the family.

He is 30 years old. Mrs. V, his wife is 29 years old. Child AV, as the eldest son is

11 years old, child BV is 10 years old, child CV is 7 years old and child DV is 5

years old.

Mr. V was born and grew up in Purok Daanbanwang, Upper Labay,

General Santos City. His father was a farmer and his mother was a housewife.

He has 9 siblings and he is the eldest. He is a B’laan. He was able to go to

school up to grade 3 year level. After that he did not continue schooling in order

to help his parents look for money for their household expenses.

Mrs. V was born and grew up in Malungon, Sarangani Province. Her

father is a farmer and her mother is a housewife. She has 2 siblings. She was

able to go to school and graduated elementary school. She did not continue

schooling due to financial constraints. Instead she helped her parents in doing

household chores and in looking money for their household

17
 Mr. V and Mrs. V met in Malungon, Sarangani Province through friends of

friends. They become a couple and after 3 months, they got married. They

resided in Malungon for 3 years, then transferred to Upper Labay for 6 months.

They again transferred to Nurallah, South Cotabato and stayed there for another

5 years and came back Upper Labay just this June of 2009

Data Base of the Respondent

The respondent upon interview is the mother in the family.

NAME : Mrs. V

AGE : 29 years old

GENDER : Female

ADDRESS : Purok Daanbanwang, Upper Labay, General

Santos City

BIRTH PLACE : Malungon, Sarangani Province

RELIGION : Protestant

OCCUPATION : Housewife

CIVIL STATUS : Married

NATIONALITY : Filipino

NO. OF CHILDREN : 4

EDUCATIONAL ATTAINMENT: Elementary Graduate

ESTIMATED MONTHLY INCOME: none

NAME OF HUSBAND: Mr. V

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B. Family Tree

Mr. Mrs.
V V

Child Child Child

AV BV CV

C. General Household Data

1. Total No. of Children: 2

2. List of Household Members

S Positio
Educ. Imm.
Members Status Occupation e Religion n in the NS
Attainment Status
x Family
Mr. V Married Farmer M Elem. level Protestant Father INC NA
Mrs. V Married Housewife F Elem Grad Protestant Mother INC NA
Child AV Child Student M Elem. level Protestant 1st INC NA
Child
Child BV Child Student F Elem. level Protestant 2nd INC N
Child
Child CV Child Student F Elem. level Protestant 3rd INC N
Child
Child DV Child Student F Elem. level Protestant 4th COM N
Child

19
 Chapter V

FAMILY COPING INDEX

This chapter depicts the actual observation of the family behavior and

practices in contrast to the ideal family attitude and behavior. It includes an

assessment on how the family handles various stressors. The observations are

analyzed to see occurrence of health problems or negative attitudes and

behavior.

Rating
CRITERIA IDEAL ACTUAL JUSTIFICATION

The members are

1. Physical Is concerned with all able to move 5 There are no
Independenc ability to move without abnormalities in the
e about, to get out of assistance and physical independence
bed, to take care of difficulty. They do of the family members.
daily grooming, their activities of Every member has no
walking, etc. daily living without noted disabilities or
aid. They are disparities in moving
independent in and/or doing their
moving about and ADL.
using their
musculoskeletal
system.

2. Includes all of the The parents are 3 The parents are aware
Therapeutic procedures or aware on what to of their lapses in
Competence treatments do if a member therapeutic
prescribed for the fells ill. However, competence. They are
care of illness such due to financial sentient of their
as giving problems and financial difficulties,
medications, using distance of the which is the primary
appliances, health center, reason for not having
dressing, exercise, they cannot or following the

20
 relaxation, special provide enough appropriate procedure
diets, etc. and/or or treatment, having
appropriate appliances and even
interventions. enough clothes for the
Although, they children.
use herbal plants,
those plants are
not approved by
the DOH.

3. Concerned with the The mother is 2 Though the mother

Knowledge particular health knowledgeable on recognizes pertinent
of Health condition that is the salient health health issues, she
Condition occasion for care issues and does not regard it as
such as knowledge responsibilities. important at all. This
of the disease or Yet due to could be detrimental to
inability to financial the lives of the
understand problems, health members especially
communicability of issues are the children.
diseases and mode overlooked.
of transmission.
Understanding the
general pattern of
development of
newborn baby and
basic needs of
infants for physical
care.

4. Concerned with The family sleeps 2 Even though aware of

Application family action in well and eats hygiene’s importance,
of Principles relation to nutritious food the family does not
of General maintaining family everyday. But practice good hygienic
Hygiene nutrition, securing their source of skills. Yes they take a
adequate rest and water is not bath everyday but their
relaxation for family healthy at all. source of water, eating
members, carrying They do not habits and
out accepted practice maintenance of
preventive sterilization nor healthy lifestyle are
measures healthy habits in not taken into
(immunizations, food storage and consideration that
medical appraisal, preparation. much.
safe home-making
in relation to storing

21
 and preparing of
food).

5. Health Concerned with the The parents are 1 Parents, as much as

Attitudes way the family feels concerned about possible, want to
about health care in the health of the protect their children
general, including members of the from any harm but
preventive services, family yet they do then, they lack money
care of illness, and not participate and information for
public health actively in them to carry out the
measures. maintaining right health care for
optimum health the family
due to financial
constraints. Also,
the family lacks
information
regarding healthy
lifestyle and
healthful ways
toward
improvement of
life.

6. Emotional Has to do with the The family are 5 The family lives
Competence maturity and competent harmoniously at home.
integrity with which enough Even though conflicts
the members of the emotionally. They arise, they really see
family are able to see stress just to it that they would
meet the usual like any other discuss each concern
stresses and family does. The in a calm manner.
problems of life, and parents take
to plan for happy responsibility for
and fruitful living. the children. They
The degree to which discipline them
individuals accept and teach them
the necessary the morals of life.
disciplines imposed
by one’s family and
culture. The
development of the
individual’s
responsibilities and
decision.
Willingness to meet
reasonable

22
 obligations, to
accept adversity
with fortitude, to
consider the needs
of others as well as
one’s own.

7. Family Concerned with the There is high 3 Others respect

Living interpersonal or concern within the individual relationships
group aspect of family, especially of each member of the
family life. The with regards to family. Decision-
family members get their making is shared
along with one interrelationship among its members
another, the ways in with others. The except on young
which they make parents discuss member. Each has his
decisions affecting decision- making. or her own part or role
the family, the in the family, which is
degree to which The children are well respected.
they support one not yet open for
another and do suggestion to
things as family, the decision-making
degree of respect since they are still
and affection, and young and difficult
the ways in which to comprehend
they manage the their current
family budget. situations.

8. Physical Concerned with The family’s 2 The house

Environment home, the house space is environment is not
community and not good enough fitted for them
work environment for the family. especially for the
as its affect family There are children, because of
health. The presence of the presence of pests
condition of the insects, rodents and accident hazards
house such as and other vectors. in their community.
pressure of accident Their house is Also their house is in
hazards, screening, also located near poor condition, that
plumbing, system, a creek. They they can possibly
facilities of cooking, cook their food acquire serious
privacy, level of outside their diseases. Their food
community house wherein storage is unsanitary.
(deteriorated they just use Though it is covered
neighborhood, earthly pot and with cloth, sometimes
presence of social used wood as insects and other

23
 hazards, pests), fuel. Also a nail small animals could
transportation of attached on the crawl inside the dish
schools and wood on inverted organizer. Also, the
availability. position was cloth that they used
noted. Bottles of was dirty. The storage
liquor and of water has a cover,
decomposing but it is still unsanitary
woods were due to the presence of
noted as well. dirt on the outside of
They live in a the container.
place wherein it’s Having a eartly pot
not congested but near the house is
then the really a fire hazard
distances because some of the
between their coal fire might come in
neighbors are not contact with their
that so far from bamboo wall and the
each other nails attached to wood
gives the possibility
that some of their
family members might
stepped into it,.

9. Use of Degree of the family The mother is 3 The school is the only
Community use and awareness aware of the community facility the
Facilities of the available available family uses. They
community facilities resources in the cannot go to the health
for education and community, both center since they have
welfare. in health and to walk kilometers just
education. But to get there.
they cannot utilize
the health
facilities since it is
far from their
house

24
 Chapter VI

TYPOLOGY OF NURSING PROBLEM

This chapter discusses about the problem that were identified during

assessment and interview with the family. It includes the cues/data, the family

nursing problem and the nursing diagnosis. The problems identified are

categorized into presence of wellness state, health deficits, health threats,

foreseeable crisis and stress points.

Table 4. Typology of Nursing Problems identified in Family X

Cues or Data Family Nursing Problems

Objective data: I. Accident hazards specifically fire

The house of Family V is a hazard, as a health threat.
bungalow style of house. It is mainly
made up of bamboo and nipa as its A. Inability to provide a home
roof. The mother usually cooks at the environment conducive to health
back of the house using wood and maintenance and personal
charcoal. development due to:
a. Inadequate family
Subjective data: resources; specifically
The mother verbalized “Kaning financial constrains/limited
among balay dugay na ni siya. Gibuhat financial resources.
ni siya sa pamilya sa akoang bana. b. Failure to see benefits of
Puro kahoy na siya ug nipa ug mga investment in home
patay na dahon sa saging. Dira ko environment improvement.
galuto sa may likod. Mao ra jud ni
among makaya kay siyempre kulang B. Inability to make decisions with
sa budget. Ang among ipahimo ug respect to taking appropriate action
balay, ikaon na lang namo diba” due to:
a. Failure to comprehend the
nature, scope, and
magnitude of the problem.
b. Negative attitude towards
the health problem.
c. Low salience of the
problem

25
Objective data:
The income of the family is
about Php 3000 per month. There are
five members in the family
Subjective data:
Mother verbalized, “Gamay ra
jud ang income intawon. Di na gain mi
kapalit sa mga sanina sa bata. Mga
kinahanglan nila. Luoy kayo. Ang
among pagkaon ginatama tama lang
para sa amua. Isda ug mga gulay dira
sa kilid among sud-an pirmi.”
II. Family size beyond what family
resources can adequately provide
as a health threat.
A. Inability to make decisions with
respect to taking appropriate
health action due to:
a. Inaccesability of
appropriate resources for
care such as financial
constraints.

Objective data: III. Unsanitary food handling as a

The hands of the children are presence of health threat.
unclean when they ate they meal.
A. Inability to make decisions with
Subjective data: respect to taking appropriate
Mother verbalized “Ay mga health action due to:
tamad na sila manghugas ug kamot. a. Low salience of the problem.
Wala tay mahimo kay gahi man jud ug b. Negative attitude towards
ulo.” health problem

Objective data: IV. Poor home condition specifically

The family usually stores their lack of food storage facilities as a
food by covering it with plate and health threat
leaves it in the table
A. Inability to make decisions with
Subjective data: respect to taking appropriate
Mother verbalized “Dira ra man health action due to:
namo na ginabutang. Wala man mi a. Low salience of the problem.
butanganan na lain. Daghan lagi kayo b. Negative attitude
ug langaw” towards health problem
c. Inaccesability if
appropriate resources for
care specifically financial
constraints

Objective data: V. Poor environmental sanitation

The family’s drainage is an specifically improper drainage
open type. They just throw it disposal as a health threat

26
anywhere. Rice grains are noted
beside the house.
Subjective data:
Mother verbalized “Dira ra man
namo pud namo na ginalabay”
Objective data: VI. Poor environmental sanitation
The family has no comfort specifically
room. They just defecate and void disposal as a health threat
anywhere.
A. Inability to make decisions with
Subjective data:
Mother verbalized “Mao jud na
karon kay wala pa mi kahimo. Wala
pay kwarta. Dra ra mi gaihi, galibang
kanang walay tao”
Objective data:
The family gets their water
source in the man-made shallow well
in the river. Near the river is a carabao
taking a bath and women washing
clothes.
Subjective data:
Mother verbalized “Dira mi sa B.
balon gakuha ug tubig. Wala na namo
ginasterilize. Ok naman na siya. Layo
man gud kaayo ang gripo diri sa
amua”
A. Inability to make decisions with
respect to taking appropriate
health action due to:
a. Low salience of the problem.
b. Negative attitude towards
health problem
unsanitary waste
respect to taking appropriate
health action due to:
a. Low salience of the problem.
b. Negative attitude towards
health problem
c. Inaccesability if appropriate
resources for care
specifically financial
constraints
VII. Poor environmental sanitation
specifically polluted water supply as
a health threat
A. Inability to recognize presence of
condition or problem due to:
a. Lack of knowledge
Inability to make decisions with
respect to taking appropriate
health action due to:
a. Low salience of the problem.
b. Negative attitude towards
health problem
d. Inaccesability if appropriate
resources for care
specifically financial
constraints
C. Failure to utilize community
resources for health care due to:
27
 a. Inaccessibility of required
service due to physical
inaccessibility (location of
facility)

Objective data: VII. Lack of immunization status

Not all children have completed specially of children as a health
their immunizations. threat

Subjective data: A. Inability to make decisions with

Mother verbalized “Isa ra lagi
ang nakakumpleto sa bakuna ba. Layo
pa jud ang center.”
respect to taking appropriate
health action due to:
a. Inaccesability if
appropriate resources for
care specifically financial
constraints

B. Failure to utilize community

resources for health care due to:
a. Inaccessibility of required
service due to physical
inaccessibility (location of
facility)

28
 Chapter VII

PRIORITIZING PROBLEMS

This chapter shows the setting of priorities of family health problems that

has been identified. It includes a computation on how priorities were shown with

their corresponding justification.

I. Accident hazards specifically fire hazard, as a health threat.

Criteria Computation Score Justification
1. Nature of the 2/3 x 1 0.67 This problem is a health threat
problem
2. Modifiability of 1/2 x 2 1 The problem is partially
the problem modifiable. The only way to
solve this problem is to
renovate the house, thus it
needs money.
3. Preventive 2/3 x 1 0.67 The problem could be
potential moderately prevented. This
could be done if the family will
be very alert in watching out
especially if they are cooking
since the house could catch
fire anytime.
4. Salience 1/2 x 1 0.5 The problem, compared with
the other problems does not
need immediate attention
since it requires time and
money.
Total Score: 2.84

II. Family size beyond what family resources can adequately provide as a
health threat.
Criteria Computation Score Justification
1. Nature of the 2/3 x 1 0.67 This problem is a health threat
problem
2. Modifiability of 0/2 x 2 0 The problem could not be
the problem modified at all. The family size
cannot be trimmed down to
smaller size
3. Preventive 1/3 x 1 0.33 The problem may be
potential prevented but the family size

29
 cannot be trimmed down.
4. Salience 0/2 x 1 0 The problem is not perceived
as a problem at all by the
family.
Total Score: 1

III. Unsanitary food handling as a presence of health threat.

Criteria Computation Score Justification
1. Nature of the 2/3 x 1 0.67 This problem is a health threat
problem
2. Modifiability of 2/2 x 2 2 The condition can be highly
the problem modifiable. If the family
receives the right health
teaching, attitude can be
changed for the better
3. Preventive 3/3 x 1 1 The problem can be prevented
potential if the family is educated on the
importance of hand washing
4. Salience 1/2 x 1 0.5 The problem is not perceived
as a problem requiring
immediate attention according
to the family since there are
other health problems more
important
Total Score: 4.17

IV. Poor home condition specifically lack of food storage facilities as a

health threat
Criteria Computation Score Justification
1. Nature of the 2/3 x 1 0.67 This problem is a health threat
problem
2. Modifiability of 1/2 x 2 1 This problem is partially
the problem modifiable since the family
lacks resources specifically in
the financial aspect. However,
appropriate health teachings
may correct this problem
3. Preventive 1/3 x 1 0.33 The problem is low in
potential preventive potential since
there is lack of appropriate
resources that could solve this.
4. Salience 1/2 x 1 0.5 The problem is not needing
immediate attention according
to the family
Total Score: 2.5

30
V. Poor environmental sanitation specifically improper drainage disposal
as a health threat
Criteria Computation Score Justification
1. Nature of the 2/3 x 1 0.67 This problem is a health threat
problem
2. Modifiability of 2/2 x 2 2 The problem is easily
the problem modifiable by teaching the
family the importance of
having a proper drainage.
3. Preventive 2/3 x 1 0.67 This is highly preventable if the
potential family has learned the
importance of having a clean
drainage.
4. Salience 1/2 x 1 0.5 With regards to the family’s
perception, the problem does
not need immediate attention
Total Score: 3.84

VI. Poor environmental sanitation specifically unsanitary waste disposal as

a health threat
Criteria Computation Score Justification
1. Nature of the 2/3 x 1 0.67 This problem is a health threat
problem
2. Modifiability of 1/2 x 2 1 The problem is moderately
the problem modifiable since this problem
can only be solved with
money.
3. Preventive 2/3 x 1 0.67 This can be highly preventable
potential if the family had prioritized in
building a toilet
4. Salience 1/2 x 1 0.5 According to the family, it plays
not much importance in their
life
Total Score: 2.84

VII. Poor environmental sanitation specifically polluted water supply as a

health threat
Criteria Computation Score Justification
1. Nature of the 2/3 x 1 0.67 This problem is a health threat
problem
2. Modifiability of 2/2 x 2 2 The problem is highly
the problem modifiable since it could be
solved if the family knows the
importance of sterilization.
3. Preventive 3/3 x 1 1 The problem is preventive
potential because there are ways and

31
 resources present in the
community where in the family
can have a clean water supply
4. Salience 1/2 x 1 0.5 The problem, with accordance
to the family’s perception, is
not much important.
Total Score: 4.17

VIII. Lack of immunization status specially of children as a health threat

Criteria Computation Score Justification
1. Nature of the 2/3 x 1 0.67 This problem is a health threat
problem
2. Modifiability of 1/2 x 2 1 The problem is moderately
the problem modifiable since there are
available resources such as in
the health center yet the family
cannot easil go to the health
center because of its long
distance from Daan Banwang
3. Preventive 2/3 x 1 0.67 The problem is moderately
potential preventive since the family
could have had immunization
way back in Malungon but also
due to negative attitude and
financial constraint, the family
did not seem to mind at all.
4. Salience 2/2 x 1 1 The family knows how
important immunization is
specially for the children
Total Score: 3.34

32
 Chapter VIII

NURSING CARE PLAN

This chapter shows the identified and prioritized problems in a ranking

order. This chapter also presents the family care plan formulated by the student

nurse together with the family.

Problem List

Problems Score
Unsanitary food handling as a
presence of health threat.
4.17
Poor environmental sanitation
specifically polluted water supply as a 4.17
health threat
Poor environmental sanitation
specifically improper drainage 3.84
disposal as a health threat
Lack of immunization status specially
of children as a health threat
3.34
Poor environmental sanitation
specifically unsanitary waste disposal 2.84
as a health threat
Accident hazards specifically fire
hazard, as a health threat.
2.84
Poor home condition specifically lack
of food storage facilities as a health 2.50
threat
Family size beyond what family
resources can adequately provide as 1
a health threat.

33
 FAMILY NURSING CARE PLAN

Problem# 1 Unsanitary food handling as a presence of health threat.

INTERVENTION PLAN
ANALYSIS OF THE
CUES OBJECTIVES RESOURCES
PROBLEM NSG. INTERVENTIONS RATIONALE METHOD EXPECTED OUTCOME
REQUIRED
Subjective Inability to After 1 day of >Assess the > To obtain H >Manpower After 1 day of
data: make community family’s ideas how much the O resources community
Mother decisions exposure, the on food family knows M such as exposure, the
verbalized with respect family will be handling and on these E time and family has able
“Ay mga to taking able to: hand washing issues effort. to:
tamad naappropriate V
sila health action Employ clean >Discuss with >To educate I >Physical Employ clean
manghugas due to: hands and the family the the family S and hands and
ug kamot. • Low finger nails importance and about proper I chemical finger nails
Wala tay salience before and need for hand hand washing T resources before and
mahimo kay of the during eating washing such as during eating
gahi man problem. meals soap, water, meals
jud ug ulo.” • Negative >Demonstrate > To show the pail and
attitude Specifically: proper hand proper hand clean towel Specifically:
Objective towards washing washing
data: health • Discuss the technique technique and • Discuss the
The hands problem importance for better importance
of the and need for understanding and need for
children are hand on it hand
unclean washing washing
when they >Inform the > To make the
ate they • Demonstrat family about family aware of • Demonstrate
meal. e proper communicable the diseases proper hand

34
 hand diseases they are prone washing
- Dirty and washing especially the of. techniques
long finger techniques ones
nails noted transmitted if
hand washing
is not
reinforced

>Explore the > To measure

family’s the
reaction about understanding
the health of the health
teachings teachings
given. presented.

35
 Chapter IX

SUMMARY, EVALUATION AND RECOMMENDATION

Presented in this case study is the different characteristics and health

condition of family V. This case study presents the family structure, socio –

economic and cultural factors, home and environmental factors, health

assessment of each member. It also contains data about identified problems on

the living condition of the family.

Summary and Evaluation

The Family V is considered as a nuclear type of family. A nuclear type is a

typical type of family composed of a father, a mother and child/children. The V

family resides in Purok Daanbanwang, Upper Labay, General Santos City. They

have started living their since June of 2009.

Their house is made of wood, mostly bamboo. Mrs. V did not know the

exact measurement of their house. Her husband knows it yet he was not there

during the interview. In order for the house to be considered as adequate, the

total floor area should be divided among the total members of the family and

each should at least have 3.5 m2. The house only has 2 windows and can sustain

the adequate ventilation needed by the family.

The V family’s main source of income is coming from Mr. V’s farming. Mr.

V earns about Php 6,000.00 a month. Since Mrs. V does not work, she is in

charge of the house and in taking care of the children. With Mr. V’s monthly

income, the family strives hard to accommodate everything they need for them to

36
live. According to NEDA, each individual should at least have Php 2768.60 when

the total monthly income of the family is divided among the total family members.

The total monthly income of Mr. V is about Php 6, 000.00 and when divided

among the 6 members, it is only Php 1, 000.00, thus, they can be considered

poor. Mrs. V also informed the student nurse that they do not have any financial

assets at hand in case of emergency. They typically borrow money from their

relatives.

All of them are affiliates of Protestantism. Mrs. V mentioned that they do

not go to church anymore since they have lived in Purok Daanbanwang for the

reason that of the distance they have to travel from their place to the church. The

family has yet to participate in community activities since they are new in the

place.

The V Family barely enjoys the community resources since the community

itself lacks resources. The children, though, go to Purok Daanbanwang

Elementary School. The father is usually in their farm while the mother is in the

house doing household chores.

The river is the family’s main source of water. They wash their clothes and

gets their drinking water supply there. They put their water in a big container with

cover. They usually don’t sterilize their drinking water supply.

V Family has no comfort room. They usually urinate and remove bowels

anywhere near their house. The drainage system of the family is an open type

where in the drainage flows anywhere and is continuous.

37
 The V family is identified to have plenty of environmental problems in

which it is evident that they practice poor environmental sanitation. With this

situation and family condition, many problems were identified such as health

threats which include fire hazards, poor home and environmental sanitation, and

improper drainage system as well as health threats which are improper personal

practice as improper hygiene. A nursing care plan then is formulated to address

the different problems identified.

Nevertheless, the family has chances to improve their health condition.

There still have that ability to meet the desired characteristics in their structure

and maximize their health potential of optimum wellness. They are cooperative

and participative to the different issues and interventions they are confronted.

Hence, they are willing to submit themselves for the impartation of information

and basic knowledge regarding family health.

The objectives of identifying family nursing problems were only partially

achieved due to security reasons for the part of the student nurse. Together with

the family, the student nurse as an agent has helped the family through

motivation and support to change their lifestyle and improve their health status.

Although the allotted time for the student nurse was not enough to attend to all

those problems, the family is now equipped with fair knowledge which they could

use anytime as the need arises.

Recommendations

The student nurse have identified and prioritized problems and needs with

the family. The student nurse have also created a care plan on how to deliver the

38
best nursing care for the family to address their needs. The following below are

propositions and commendations recognized by both the student nurse and

family:

• The V family should maintain a healthy and clean environment. They must

clean their surroundings to avoid the presence of vectors of diseases.

• The family should also maintain proper hygiene such as taking a bath

regularly, trimming their nails, frequent changing of clean clothes especially

when come in contact with filthy objects or experienced wetness of the back,

refraining from walking barefooted, brushing of teeth frequently, and proper

and regular hand washing.

• They must also reorganize their cooking practices in terms of food

preparation and handling as well as keeping their kitchen utensils in a

covered storage to avoid getting it contaminated by insects or pests. In

addition to that, they should also cover their food storage.

• The family should also be advised to not wait for the ailment to become

severe before seeking medical help.

• The family must also be educated and follow the proper preparation of

herbal medicines as it was presented during the mother’s class.

• The V family should persevere to perform proper waste segregation and

disposal of their garbage as it was presented during the mother’s class.

• The family should be aware that organizations in the community are open

and present for their problems to be addressed properly.

39
• They should be encouraged to verbalize their concerns with regard to the

community so that resolutions can be made.

40
 BIBLIOGRAPHY

Books

Cuevas, F. et. al. Public Health Nursing in the Philippines. 10th ed.
Philippines:2007

Maglaya, A. Nursing Practice in the Community. Marikina City: Argonauta

Corp., 2004.

Untalan, A. Concepts and Guidelines in COPAR. 1st ed. Manila:

Educational Publishing House, 2005.

Internet Sources

Jay C. Published: 6/23/2004. http://www.buzzle.com/editorials/6-23-2004-

55793.asp

http://wisdomquotes.com

http://psychology.about.com/od/theoriesofpersonality/ss/psychosexualdev.
htm

http://psychology.about.com/od/theoriesofpersonality/a/psychosocial.htm

41
 APPENDICES

APPENDIX A

BARANGAY HEALTH PROFILE

Department of Health
Notre Dame of Dadiangas University- College of Nursing

Barangay/ Purok: Daanbanwang, Upper Labay, General Santos City Household No.

PERSONAL DATA
Name of respondent: Mrs V B-Day: 12/17/1973 Status: M Educational Attainment: Grade 6

I. GENERAL HOUSEHOLD DATA

A. Total number of children: 4
B. List of household members:

Members B-Day Occupation Sex Eductl Religion Rel. to Imm. Deworming Weight NS
(mm/dd/yyyy) Attainment Resp. Status Date
Mr V 11-14-79 Farmer, M Grade 3 Protestant Husband - - 56 kgs N
Mrs V 10-09-80 Housewife F Elem Grad Protestant INC - 50 kgs N
AV 07-11-98 Student M Grade 5 Protestant son INC 2008 38 kgs N
BV 10-19-99 Student F Grade 4 Protestant son INC 2008 36.5 N
kgs
CV 04-16-02 Student M Grade 3 Protestant son INC 2009 33 kgs N
DV 05-23-05 Student F Grade 1 Protestant daughter COM 2009 17 kgs N

II. ECONOMIC DATA

A. Sources of Income: Occupation: Farming
Estimated Monthly Income: P6, 000

42
 B. Land 1. Owned ( ) Rented ( ) Tenanted ( X ) 2. No. of Hectares: ____. Type: Plain ( X ) Rolling ( )
C. Products, if land is farmed: corn
D. Type of Housing: Concrete ( ) Ordinary ( X ) Rented ( ) Scrap ( )
E. Household Appliances: radio
F. Animal Raising: chicken
G. Transportation Facilities: Owned ( X ) Rented or Others( )
H. Water: Bought ( ) Free (x )

III. ENVIRONMENTAL DATA

A. Toilet facilities: Owned ( ) Shared ( ) None ( X )
Anywhere
B. Source of Drinking Water Supply: Shallow well
C. Drainage: none
D. Garbage Disposal: Burying and/or Burning
E. Home: Herbal ( ) Vegetable ( x) None ( )

IV. MEDICAL HEALTH DATA

A. Common diseases/ Commen Treatment: cough, colds and fever; Herbal e.g Mayana and Kataka- taka
B. Immediate Sources of Medical Care: BHW
C. Family Planning: Continuous; Pills
D. Pregnancy: No
E. Lactating: No
F. Death in the Family: None
G. Other pertinent observations/informations like presence of personality disturbances: None
H. Disable member of the family: None

43
 APPENDIX B

FAMILY HEALTH DATA CARD

QUARTER
INDICATOR THIRD QUARTER FOURTH QUARTER

FAMILY PLANNING OOOOOO OOOOOO

PRENATAL OOOOOO OOOOOO
IMMUNIZATION OOOOOO OOOOOO
NUTRITION OOOOOO OOOOOO
WATER OOOOOO OOOOOO
GARBAGE DISPOSAL OOOOOO OOOOOO
TOILET OOOOOO OOOOOO
ALCOHOLISM OOOOOO OOOOOO
SMOKING OOOOOO OOOOOO

44
 APPENDIX C

Process Recording

This appendix represents the course of interaction between the student

and the family during each phase of interview. It also includes the reactions of

the family or how they respond on the questions that were lift during the entire

interview.

Purpose:

1. To be able to have a specific data on how the interview was conducted

2. To be able to interpret or analyze the answers given by the respondent

3. To document pertinent data and how they responded to questions that

were raised

Orientation Phase

Student Nurse Client Remarks Rationale

“Maayong buntag “Maayong buntag The student The opening can be
diay Ma’am” sad. Dali sulod mo nurse greeted the most important
(Waves and oi.” (Smiles) the part of the interview
smiles) respondent because what is
and the said and done at
“Salamat Ma’am. “Ahh. Ako diay si respondent that time sets the
Ako diay si Mylene Emie.” welcomed the tone for the
Ma’am. Nursing student nurse remainder of the
student sa NDDU. in their house. interview. The
Pwede mabal-an purposes of the
unsa inyong opening are to
pangalan?” establish rapport
and orient the
“Ay hello diay “O. Amua ni siya. The student interviewee.
Ma’am Emie. Mao Bag-o ra jud mi diri. nurse verified Establishing rapport
ning inyong Tong June lang mi if the is a process of
balay?” ngbalhin diri” respondent creating goodwill

45
 was a member and trust. It can
“Ahh. Mao ba. Aha “Ang akong bana of the begin with a
man pud inyong naa man sa bukid community. greeting (“Good
pamilya?” gud nag-uma. Didto morning Sir!”) or
na siya gapuyo jud. self-introduction
Ginaadtuan lang (“Good morning!
namo sa mga bata. I’m a nursing
Ang mga bata naa student”)
man sa eskwelahan accompanied by
kay nay klase. nonverbal gestures
Unya pato taod2 such as smile, a
inig udto kay diri to handshake, and a
sila mukaon” friendly manner.
Giving recognition,
“Ay ma’am. Pwede “Okey ra kaayo uy. The student in a nonjudgmental
ko mag-interview Walay problema. nurse way, of a change in
sa inyuha? Maayo gani ni. informed the behaviour, an
Kanang kamo man Hehe” respondent on efftort the client has
gud ang akong her purpose made, or a
napili na iadopt na for coming contribution to
family. Okey ra and the communication.
ma’am?” interview. Acknowledgment
may be with or
“Salamat kaayo “Hala. Dalia ra man The student without
ma’am ha. Kanang pud diay noh. nurse told the understanding,
hantod October mi Matulog pud mo diri respondent verbal or nonverbal.
maginterview eh? Wala baya the time (Barbara Kozier)
interview. Mubalik suga diri.” duration of
mi mga November their stay in
na. Mga December the
daw mi community.
magculmination”

“Lagi daw ma’am. “Ay wala nay The

Lisod daw ang problema gang. respondent
suga. Pero Pasalamat gani mi approves of
challenge na siya naa mo diri karon the student
sa amua eh. para mutabang nurse’s
Lingaw man pud namo. Siyempre purpose and
na siya (Client and importante gud na acknowledged
SN laughs). naa mi mabal-an sa her presence.
Kanang sakit sakit. Dapat
manghangyo ko sa lang jud
inyong cooperation mucooperate mi
ma’am ha.” eh” (Smiles)

46
Working Phase

Student Nurse Client Remarks Rationale

Ay kanang ma’am Yata. Wala baya
unsa inyong akong bana diri ay.
apelyido?

Sige lang ma’am. Ay sige. 29 nako. Demographic

Ikaw lang akong Akong bana kay 30. data was
interbyuhon. Unsa October 9 ko nya given
napud inyong edad November 14 na completely.
ug sa inyong siya. 4 tanan
bana? Kanus-a among mga anak.
pud inyong mga Wala baya sila diri
bday? kay nageskwela.

Okey ra ma’am uy. Si Child AV 11, si

Hehe. Kanang. BV 10, si CV 7
Unsa pud mga unya si DV 5. Si AV
Pangalan sa July 1998 na siya.
inyong anak ug Si BV kay October
ilang mga bday? 1999. Si CV April
2002 unya si DV
May 2005.

Ahh. Layo layo Gafamily planning Respondent

pud ilahang mga man jud gud mi was proud to
agwat noh. tong una pa sa be a family
Malungon pa mi. planning
Nagsunod sunod follower.
lang ang 2 ka una
pero after ana
nagpills nako. Lisod
na baya kinabuhi
ron.

Lagi ma’am uy. Lagi. Naa man pud

Maayo gani ma’am gud health center
nainform mo ug didto sa Malungon
ing-ana ug Nurallah.

Kanang ma’am Elementary Respondent Education is an

mangutana ko graduate ko, akong blames important aspect in
kung unsa inyong bana kay hantod poverty for every human life
nahuman sa grade 3 lang. their lack of especially now that
eskwela? Unsaon ta man education. job hiring could be

47
 lisod kaayo ang very difficult if you
kinabuhi. lack education.

Ang mga bata Mga bata maayo Respondent

ma’am? man kay nay was glad the
eskwelahan diri. Si children have
AV grade 5, si BV a chance in
grade 4, si CV education.
grade 3, si DV
maggrade 1.

Kamo ra jud diri sa O. akong bana tu-a She was able Due to financial
mga bata ma’am? sa bukid. Kami ra to express her constraints, the
Bale balay jud ni jud diri. Kaning concerns family has not able
ninyo? among balay dugay about the to provide an
na ni siya. Gibuhat household, adequate and a
ni siya sa pamilya including the safe house for the
sa akoang bana. environment. family.
Puro kahoy na siya
ug nipa ug mga
patay na dahon sa
saging. Dira ko
galuto sa may likod.
Mao ra jud ni
among makaya kay
siyempre kulang sa
budget. Ang among
ipahimo ug balay,
ikaon na lang namo
diba

Nag-ingon ka Ay mao ra jud na.

ma’am na naga- Wala nay lain.
uma imong bana.
Unsa pa mga lain
ninyong
ginakwaan para
income?

Kanang pila pud Mga Php6,000 pud. Respondent Poverty is an issue

inyong maincome Gamay ra jud ang put on much in every Filipino
sa usa ka bulan? income intawon. Di emphasis on family since it is the
na gain mi kapalit financial major factor that
sa mga sanina sa issues. affects their way of
bata. Mga living.
kinahanglan nila.

48
 Luoy kayo. Ang
among pagkaon
ginatama tama lang
para sa amua. Isda
ug mga gulay dira
sa kilid among sud-
an pirmi.

Kanang inyuhang Mao jud na karon The The family has not
banyo? Ug kung kay wala pa mi respondent yet build a toilet
asa mo gakuha ug kahimo. Wala pay explained how facility since they
tubig? kwarta. Dra ra mi they manage were new to the
gaihi, galibang with their place and have no
kanang walay tao elimination budget for it.
even without a
Dira mi sa balon toilet facility.
gakuha ug tubig. She also
Wala na namo explained their
ginasterilize. Ok ways of
naman na siya. getting water
Layo man gud for drinking.
kaayo ang gripo diri
sa amua.

Ang inyong mga Dira ra man namo Respondent Drainiage disposal

lamaw ma’am o pud namo na explains how is an important
mga hugaw gikan ginalabay. (Points they manage factor since vectors
sa kusina, aha at the ground their drainage or insects may
ninyo ginalabay? beside the house). disposal hover and affect
their health.
Kanang butangan Dira ra man namo Respondent
sa inyong pagkaon na ginabutang. shows how
na wala nahurot? Wala man mi they put their
butanganan na lain. left overs.
Daghan lagi kayo
ug langaw

Daghan kaayo Ay daghan pud. Respondent

mga langaw? Mga Pero naa man mi explains that
lamok? mosquitero. although there
are many
mosquitoes in
the place, they
have
protection
from it.

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Kanang sa bakuna Isa ra lagi ang Respondent Immunization is an
sa mga bata nakakumpleto sa points out that important protection
ma’am? bakuna ba. Layo pa the health and prevention of
jud ang center. Sa center is quite some diseases.
panahon namo dili far from their
man pud na uso place.
gud.

Kanang diri sa Ay mga tamad na Respondent Knowing the ways

panimalay ma’am sila manghugas ug shows that of health helps the
unsa pud ng ugali kamot. Wala tay she student nurse what
sa mga bata na mahimo kay gahi disapproves of to educate the
makaapekto sa man jud ug ulo.” the children’s family and what
ilang lawas. behavior but kind of
Parehas ng ilang feels she can’t improvement on
paghugas o do anything health they need.
paggamit ug about it.
tsinelas?

Kanang bisyo Ay maayo jud. Respondent No disturbances

ma’am? Wala jud bisyo feels proud of were found.
akong bana. her husband
not having
vices.

Naa pud ba moy Naa. Didto o. Mga Respondent Having a vegetable

mga gulay o herbal kangkong. Ang shows the and herbal garden
na ginatanom? herbal naa sa student nurse helps the family in
ilalom. Mga their mini terms of healthy
asunting. vegetable food and also
garden and disease
that they have management
herbal plants
around.

Termination Phase

Student Nurse Client Remarks Rationale

Ay ma’am salamat Walay problema. The Expressing
kaayo ma’am ha. Adto lang gud diri. respondent gratitude makes the
Balik ra ko. Balik balik mo ha. appreciated respondent feel that
Salamat jus kaayo. Suroy suroy pud our presence they did something
mo ba. and was open good. Giving

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in answering recognition, in a
all the nonjudgmental
questions. way, of a change in
behaviour, an
efftort the client has
made, or a
contribution to
communication.
Acknowledgment
may be with or
without
understanding,
verbal or nonverbal.

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