INITIAL DATABASE FOR FAMILY ASSESSMENT

Family Name: DR’s Family

A. FAMILY STRUCTURE, CHARACTERISTICS AND DYNAMICS
Demographic Data:
Household No.: 12
FAMILY MEMBER’S CHART

RELATIONSHIP
MEMBER OF THE CIVIL POSITION IN THE
TO THE HEAD AGE SEX
HOUSEHOLD STATUS FAMILY
OF THE FAMILY
Father/Husband/Fath
LODR Father 57 Male Married
er in law
Wife/ Mother/Mother
LETDR Mother 49 Female Married
in law
R.D.R son 38 Male Single Eldest child/sibling

K. D.R daughter 29 Female Cohabitation 3rd child/sibling

L.D.R son 28 Male Single 4th child/sibling

C.D.R son 24 Male Single 5th child/sibling

H.D.R son 19 Male Single 6th child/sibling

J.L Son in law 28 Male Cohabitation Son in law

L.K.D.R Grandson 8 Male Single Grandson

V.K.D.R Grandson 4 Male Single Grandson

C.L.D.R Grandson 2 Male Single Grandson

D.S Daughter in law 27 Female Cohabitation Daughter in law

Interpretation:
The family is composed of father, mother, their sons and daughter, daughter in law and
son in law and also their grandsons in total there are 12 members of family living together. The ages
are from 4 years to 57 years old. LODR and LETDR is married and they 5 sons and 1 daughter. The
second son of LODR and LETDR is now working in South Korea and KDR their 1st daughter is living
with them with her three sons and husband.
 DOMINANT
PLACE OF TYPE OF FAMILY GENERAL
MEMBER OF THE RESIDENCE OF FAMILY MEMBERS IN FAMILY
HOUSEHOLD EACH MEMBER STRUCTURE TERMS OF RELATIONSHIP
OF THE FAMILY DECISION OF DYNAMICS
MAKING
Patriarchal/
LODR Pasig Extended Quiet
Family
Patriarchal/
LETDR Pasig Extended Kind
Family
Patriarchal/
R.D.R Pasig Extended Quiet
Family
Patriarchal/
K.D.R Pasig Extended Talkative
Family
Patriarchal/
L.D.R Pasig Jolly
extended
Patriarchal/
C.D.R Pasig Quiet
extended
Patriarchal/
H.D.R Pasig Jolly
extended
Patriarchal/
J.L Pasig Naughty
extended
Patriarchal/
L.K.D.R Pasig Bubbly
extended
Patriarchal/
V.K.D.R Pasig Shy type
extended
Patriarchal/
C.L.D.R Pasig Bubbly
extended
Patriarchal/
D.S Pasig Quiet
Extended

Interpretation

The family is headed by the father and the children are ranging from ages 19-38 who are
adolescents and on middle adulthood. While the grandsons of the head of the family ranging from
ages 2-8. There were 12 members of the family living together. The live-in partners of the children of
the head of the family are also living with them causing the type of the family to be extended. The
aforesaid family size is quite big and causes some misunderstanding but they settle it with good
communication to each other. There were 9 Males and 3 females and most of the male members are
quiet. Dominant family member in terms of decision making is the mother and the father.

B. SOCIO-ECONOMIC AND CULTURAL CHARACTERISTICS

INCOME AND EXPENSES

WHO
MEMBER OF THE INCOME OF ADEQUACY
MAKES
HOUSEHOLD PLACE OF EACH TO MEET
OCCUPATION DECISION
WORK WORKING BASIC
S ABOUT
MEMBER NECESSITIES
MONEY

LODR TPMO Pasig 13,500 Adequate

LETDR IPM Enforcer Pasig 14,000 Adequate

R.D.R IPM Enforcer Pasig 14,000 Adequate

K.D.R none none none none

L.D.R IPM Enforcer Pasig 14,000 Adequate

C.D.R IPM Pasig 13,500 Adequate

H.D.R IPM Pasig 13,500 Adequate

J.L. Delivery Man Pasig 12,000 Adequate

L.K.D.R Student Pasig None

None
V.K.D.R None None None
None
C.L.D.R None None None None

D.S Sales Lady Ugong 14,000 Adequate

The monthly family income is adequate and all of the members who are earning are deciding
regarding the money and their expenses. Most of the family members are IPM and IPM Enforcer. All
of the family members are working in Pasig.
C. HOME ENVIRONMENT:
A. Is your lot owned? Yes ( ) No ( )
B. Is your house owned? Yes( ) No ( )
C. Adequacy of living space
Number of rooms: ( ) 1 room ( ) 2 rooms ( ) 3 rooms
Number of person/s per room: 4 (Specify)
D. Type of Housing materials:
Wood ( ) Mixed ( )
Concrete ( ) Makeshift ( )
Others, specify ( ) _______________
E. Is this living space adequate? Yes ( ) No ( )
F. Ventilation ( ) Well ventilated ( ) poorly ventilated
G. Number of windows per household
( )1 ( )2 ( )3 ( ) None
H. What are the appliances owned by the family?
Answers: television, gas stove.

I. Types of Garbage disposal

_____ ____ Collected _________ Burning
_________ Waste segregation _________ Burying
_________ Feeding of animals _________ Throw in the river/ sewer
_________ Open dumping _________ Others, specify
J. Type of waste disposal
______ ___ Flush _________ water - sealed
_________ Wrap and throw _________ Others, specify

K. Type of drainage: _____ ____ Open _________ Close

L. Source of water supply
______ ___ Owned _________ Shared
_________ Bought _________ Others, specify

M. Drinking water storage

_________ Refrigerated _____ ____ Covered
_________ Uncovered
N. Containers used
_____ ____ Plastic Pitchers _________ Jar, clay pots
_________ Bottles _________ Others, specify

O. Food storage/ cooking facilities

____ _____ Covered _________ Uncovered
_________ Refrigerated _____ ____ Cabinet
_____ ____ Stove _________ Pots, pan etc.

COMMON HOUSEHOLD PETS FOUND AT HOME:

P. Are there breeding sites of insects, rodents, etc. present? _____ ____ Yes _________No
Q. Pets/animals kept in the yard/home? Answer: Cat
R. Are there accident hazard present? _____ ____ Yes _________No

D. HEATH OF EACH MEMBER

NUTRITIONAL RISK FACTOR

ASSESSMENT ASSESSMENT
MEMBER OF MEDICAL AND PRESENT EATING
THE NURSING ILLNESS HABITS
HOUSEHOLD HISTORY DIETARY
AND
HISTORY
PRACTICE
S
Pritong
tilapia,
Using of
tinolang
LODR Mild stroke Hypertension utensils and
manok,
bare hands
kamatis na
may itlog
Chicken Using of
Smoke
LETDR Cough and cold Asthma noodles, utensils and
(4sticks/day)
tuyo, itlog bare hands
Noodles, Using of
R.D.R Flu sardinas, utensils and
bare hands
Sinigang,
Using of
Mumps, cough pritong
L. D.R utensils and
and cold tilapia at
bare hands
itlog
Itlog, Using of
K.D. R Flu sardinas utensils and
bare hands
 Adobong Using of
C.D.R Cough manok. itlog utensils and
bare hands
Sinigang, Using of
H.D.R Flu, colds tortang utensils and
talong bare hands
Spricy Using of
J.L Cellulitis sardines, utensils and
itlog bare hands
Toyo, asin Using of
L.K.D.R Fever, cough kanin utensils and
bare hands
Toyo, itlog Using of
Diarrhea,
V.K.D.R utensils and
vomiting
bare hands
Itlog, Using of
C.L.D.R Fever sardinas, utensils and
toyo bare hands
Fried fish, Using of
D.S Colds chicken,por utensils and
knoodles bare hands

Most of the health problems of the members of the family in the past is flu. The mother is not
taking her asthma as a serious problem since she is still smoking and serves as a risk factor
regarding her health. Same as the hypertension of the father, he does not perceive his health
condition as a problem that is the reason why he does not continue his medications. The family
frequently have fried foods as their meal and only eats twice a day.

E. VALUE, HABITS, PRACTICES ON HEALTH PROMOTION, MAINTAINANCE AND DIESEASE

PREVENTION

MEMBER OF THE IMMUNIZATION STATUS HEALTHY LIFESTYLE

HOUSEHOLD OF FAMILY MEMBERS PRACTICES

LODR Complete Walking, jogging

Walking, eating, cooking, managing
LETDR Complete
finances
R.D.R Complete Bathing, eating, using cellphone

K.D. R Complete House work, laundry,

L.D.R Complete Walking, running, eating

C.D.R Complete Using cellphone, lifting,

H.D.R Complete Walking, lifting, bathing, eating

 J.L Unrecalled Lifting delivers, walking, running

L.K.D.R Complete Using computer, walking

V.K.D.R Complete Playing, running

C.L.D.R Complete Running, playing, watching

D.S Complete Talking, walking, standing, eating

Legend: ADL- Activity of Daily Living

Adequacy of:

RELAXATION AND
USE OF
MEMBER OF THE REST/ EXERCISE/ OTHER STRESS
PROTECTIVE
HOUSEHOLD SLEEP ACTIVITIES MANAGEMENT
MEASURES
ACTIVITIES
Sleep, watching T.V.
Walking,
LODR 8 Polo, vest, raincoat singing on karaoke,
jogging
eating
Walking,
eating, Watching T.V., Listen
Jogging pants, long
LETDR 8 cooking, to radio, smoking and
sleeves, raincoat
managing talking to neighbour
finances
Bathing,
Sleeping, watching
R.D.R 10 eating, using slippers, shorts
It’s showtime
cellphone
watching T.V.,
House work, browsing social
K.D.R 8 Shorts, slippers
laundry, media, sleeping,
walking outside
Walking,
Sleep, watching
L.D.R 8 running, Jogging pants
probinsyano
eating
Using Sleep, using
Jogging pants long
C.D.R 8 cellphone, Facebook and other
sleeves
lifting, social media sites.
Walking, Sleep, browsing
Jogging pants, long
lifting, social media
H.D.R 7-8 sleeves, shoes,
bathing, accounts such as
raincoat
eating Facebook, Instagram
Lifting
Watching news,
J.L 8 delivers, Jacket, shoes, pants
listening to the music
walking,
 running

Using
Playing computer
L.K.D.R 7 computer, Slippers, shirts
games
walking
Playing, Playing on cellphone
V.K.D.R 8 Slippers
running games
Running, Playing with cats and
C.L.D.R 10 playing, Slippers, shirts neighbors watching
watching cartoons.
Talking,
Watching news on
walking,
D.S 8 Jacket, shoes T.V, Playing
standing,
application games.
eating

The family members of the household have enough sleep that enables them to do their
activities with full energy.

The immunizations of the members of the family are almost complete except with J.L. who
doesn’t have Oral polio vaccine. They have protective measures and has enough stress management
outlet. This outlet allows them to have a good relationship with each other and settle their struggles in
proper manner. Their activities in daily living serves as their physical exercise that helps them to be
fit.