FAMILY HEALTH NURSING PROCESS

a systematic approach of solving an existing problem/meeting the needs of family

• R apport
• A ssessment
• P lanning
• I ntervention
• E valuation

1. RAPPORT
• Trust building
• Knowing your client
• Adjusting to the situation and environment
• RESPECT
2. ASSESSMENT
• Data Gathering: tools or instruments used during survey:
• Interview
• Observation
• Questionnaires-mostly patronized & used in CHN
• Records & Reports available
• Consolidation or Collation: collecting back the questionnaires, tabulate and summarize
• Validation: uses statistical approaches
• Statistical Approaches:
1. Central Tendencies: 3 M’s
• Mean=average
• Median=range (Highest – Lowest Score)
• Mode=frequency of occurrence of a variable, used if there’s too many variable occur
2. Standard Deviation: used if there are too many variables available to be treated which is seldom used in CHN
• SD=√ Σ (x-x) n-1
• Σ=summation of
• x=variables available
• x=mean (given special attention)
• n=# of existing variables
3. Percentile (%) Method: most commonly used in CHN by adding all cores then multiply by 100
• Presentation of Data
1. Table/Chart
2. Graph:
• Pie
• Bar-2 variables only
• Line
• Polygon-connecting the results
• Histograph-2 or more variables & appear adjacent to each other
• TYPOLOGY OF NURSING PROBLEMS
1. First Level Assessment: to determine problems of family Sources of Problems using IDB
• Family: use of Initial Data Base (IDB)
• Nature: Health Deficit (HD), Health Threat (HT), Foreseeable Crisis (FC)
• USE OF INITIAL DATA BASE (IDB):
1. Family Chart Structure:
• Nuclear -Father, mother, children
• Extended (3rd generation)-Relatives staying with the family
• Multi-generational extended-“apo sa tuhod” or “apo sa talampakan”
• Dyad -Husband & wife only (childless couple)
• Blended -widow married another widow & have children
• Gay -Same sex living together
• Matriarchal -Mother is the decision maker
• Patriarchal -Father is the decision maker
• Communal -different families forming a community
2. Socio-economic: poverty level, educational attainment & nature of occupation of members of the family (sources of income)
3. Socio-cultural: different nature of religion
4. Home environment: assessment according to ES, treatment of garbage, preparation of food, availability of toilet, water & food sanitation, sources of diseases
5. Medical history: history of certain disease, family member with disease
6. Resources available in community for use by the family:
• 5 Generalized M’s in resources available in community:
• Man/Manpower
• Money
• Machine
• Materials
• Methods
• DEFINE THE PROBLEM AFTER IDENTIFYING IT
• ACCORDING TO NATURE
• Health Deficit (HD)
• if identified problem is an abnormality, illness or disease, there’s a gap/difference between normal status (ideal, desirable, expected) & actual status (the outcome/result/problem encountered on that actual day)
• Health Threat (HT)
• any condition or situation which will be conducive to health alteration, health interference & health disturbance.
• Foreseeable Crisis (FC)
• stress points, anything which is anticipated/ expected to become a problem
3. PLANNING
• Four (4) Standard Steps:
• Prioritization -start if there are multiple identified problems
• Formulation of objectives -planning a procedure will start here if there is only one problem
• Developing strategies of action
• Formulation of evaluation tools for the identified strategy developed
4. INTERVENTION
• Is the capacity to provide management
• Is the professional phase of nursing process
• Is the time when the PHN executes the standard function of an RN
• Three (3) Standard Functions of RN:
• Dependent-giving of medicines
• Independent-monitor, assess, provide, educate
• Interdependent-referrals
5. EVALUATION
• Three (3) Things to be evaluated: SPO
1. Structure of program & activity -what articles, equipments, supplies are utilized
2. Process utilized -steps used
3. Outcome of activity -results can be:
• Desirable -to be implemented, advocated, strengthen
• Undesirable -to be avoided
• Two (2) Aspects to be evaluated in the Outcome:
• Quality -characteristic or kind of outcome; no numerical value, not measurable
• Quantity -from the word “quantum”, with numerical value, measurable