Transcript Document
The Family Health Nursing Process
Cristina Marie Manzano, RN, RM, MAN
Assistant Professor II, School of Nursing
Global City Innovative College
Nursing Process in Family Health
Reflect sequential progress, interdependent and overlapping
in their execution
Sequence of Activities in FHN
Establishes a working relationship with the client
Conducts an initial assessment
Categorizes Health Problems
Determine the nature and extent of the family’s performance of
the health tasks on each of the health problems
Determine priorities among the list of health problems
Ranks health problems according to priorities.
Decides on what problems to tackle in the order of
immediacy/urgency
Defines nursing objectives in realistic measurable terms
Plans approaches, strategies of action
Implements the nursing care plan
Evaluates the effectiveness of the interventions
Re-defines nursing problems and re-formulates
Initial Data Base for Family Nursing Practice
Family Structures, Characteristics & Dynamics
Members of the household and
relationship to the head of the family
Demographic Data or Rank in the family
Place of residence of each member
Type of family structure and government
Dominant family members in terms of
decision making in matters of health care
General family relationship/ dynamics
Socio-Economic & Cultural Factors
Income and Expenses
Educational attainment of each
member
Ethnic Background and
Religious Affiliation
Significant Others
Relationship of the family to
larger community
Home and Environment
Housing
Kind of neighborhood
Social & Health facilities available
Communication & Transportation Facilities Available
Health Status of Each Family Members
Medical & Nursing history
Nutritional Assessment
Developmental Assessment
Risk Factor Assessment
Physical Assessment
Results of Diagnostic or
Laboratory Tests
Values, Habits, Practices on Health Promotion,
Maintenance and Disease Prevention
Immunization
Healthy lifestyle practices
Adequacy of rest and sleep,
exercise and use of protective
measures
Use of promotive-preventive
health services
Typology of Nursing Problems
FIRST LEVEL ASSESSMENT
1.Wellness Condition
Wellness Potential
A nursing judgment on wellness state or
condition based on client’s performance,
current competencies or clinical data
BUT NO explicit expression of client
desire.
Readiness for Enhanced Wellness
A nursing judgment on wellness state or
condition based on client’s performance,
clinical data and explicit expression of
desire to achieve a higher level of state or
function in a specific area on health
promotion and maintenance.
FIRST LEVEL ASSESSMENT
2. Health Threats
Family history
Threat of infection
Family size beyond what family can
adequately provide
Accident Hazards
Faulty/unhealthy eating habits
Stress provoking factors
Poor home/environment condition
Unsanitary food handling and
preparation
Unhealthy lifestyle and personal
habits/practices
FIRST LEVEL ASSESSMENT
Health Threats
Unhealthful lifestyles
Physical inactivity
Inadequate relaxation
techniques
Non-use of self protection
methods
Inherent personal characteristics
Health history which induce the
occurrence of a health deficit
Inappropriate role assumption
Lack of immunization
FIRST LEVEL ASSESSMENT
3. Health Deficits
Illness states
Failure to thrive/develop
according to normal rate
Disability
FIRST LEVEL ASSESSMENT
4. Foreseeable Crisis Situations
Marriage
Pregnancy
Parenthood
Abortion
Adolescence
Loss of Job
Death of a member
Divorce
SECOND LEVEL ASSESMENT
Inability to recognize the presence of a problem
Inability to make decisions with respect to
taking appropriate health action
Inability to provide adequate nursing care to the
sick disabled, dependent or vulnerable/ at risk
member of the family
Inability to provide a home environment which
is conducive to health maintenance and
personal development
Failure to utilize community resources for
health care
Criteria in Different Priorities
Nature of the Problem
Presented
Categorized whether a Health
Threat, Health Deficit or
Foreseeable Crisis
Modifiability of the Problem
Refers to the probability of success
in minimizing alleviating or totally
eradicating the problem through
health intervention
Criteria in Different Priorities
Preventive Potential
Refers to the nature and magnitude
of the future problem that can be
minimized or totally prevented if
intervention is done in the
problem.
Salience
Refers to the family perception &
evaluation of the problem in terms
seriousness & urgency of attention
needed.
SCALE FOR RANKING FAMILY HEALTH PROBLEMS
ACCORDING TO PRIORITIES
Criteria
Weight
1.Nature of the problem
presented
Scale:
Wellness state
Health Threat
Health Deficit
Foreseeable Crisis
1
3
3
2
1
SCALE FOR RANKING FAMILY HEALTH PROBLEMS
ACCORDING TO PRIORITIES
Criteria
2.Modifiability of the
Problem
Scale:
Easily modifiable
Partially modifiable
Not modifiable
Weight
2
2
1
0
SCALE FOR RANKING FAMILY HEALTH PROBLEMS
ACCORDING TO PRIORITIES
Criteria
3. PreventivePotential
Scale:
High
Moderate
Low
Weight
1
3
2
1
SCALE FOR RANKING FAMILY HEALTH PROBLEMS
ACCORDING TO PRIORITIES
Criteria
4. Salience
Scale:
A serious problem,
immediate attention
A problem but not
needing immediate
attention
Not a felt need /
problem
Weight
1
2
1
0
SCORING
1. Decide on a score for each of the criteria.
2. Divide the score by the highest possible score and multiply by the
weight.
Score
----------------- X Weight
Highest Score
3. Sum up the scores for all the criteria. The highest score is 5,
equivalent to the total weight.
The higher the score (near 5 and above) of a given problem, the
more likely it is taken as a PRIORITY.
With the available scores, the nurse then RANKS health problems
accordingly.
Example
Cues/Data
Family Nursing Problem
37 year old mother of seven at 21
Possible Complicated
weeks AOG, with BP of 140/90
and slight pedal edema
Mother verbalized, “…I did not
have problems during my previous
pregnancies, and even with my
present pregnancy… it just
happened that I passed by the
health center on my way to my inlaws… so I thought of dropping by
the clinic… but actually I feel
alright, I don’t think I have to
worry.
Pregnancy
Inability to recognize presence
of a possible complication of
pregnancy due to lack of
knowledge
Inability to provide adequate
nursing care to a pregnant
member due to lack of
knowledge on the nature and
management of health condition
Failure to utilize community
resources for health care
Possible Pre-eclampsia
Criteria
Computation
Actual
Score
Nature of the
Problem
3/3 x 1
1
The problem is a health deficit and
requires more immediate intervention
Modifiability
of the
Problem
2/2 x 2
2
The resources and interventions needed
to solve the problem are available
Justification
Preventive
Potential
3/3 x 1
1
Possibility of complications during labor
and delivery and occurrence
odabnormalities in the infant are
prevented if pre-eclampsia is eliminated
as early as possible
Salience of
the Problem
0/2 x 1
0
The family doesn’t recognize the
existence of the problem
Total Score
4