NURSING

ASSESSMENT IN
FAMILY NURSING
PRACTICE
DEFINITION AND
CONCEPTS
 FAMILY
Two or more individuals coming from the
same or different kinship groups who are
involved in a continuous living arrangement,
usually residing in the same household,
experiencing common emotional bonds, and
sharing certain obligations toward each
other and toward others.
 FAMILY HEALTH
 A condition including the promotion and
maintenance of physical,
r mental, spiritual,
and social health for the family unit and for
individual family members.
 FAMILY
PROCESS
The ongoing interaction between family
members through which r they accomplish
their instrumental and expressive tasks. The
nursing process considers the family, not the
individual, as the unit of care.
 FAMILY CENTERED
NURSING
Nursing that considersr health of the family
as a unit in addition to the health of
individual family members.
 FAMILY HEALTH
NURSING
A nursing aspect of organized family health
care services which are directed or focused
on family as the unit care
r
with health as the
goal. It is thus synthesis of nursing care and
health care. It helps to develop self care
abilities of the family and promote, protect
and maintain its health.
 STEPS IN FAMILY
NURSING
1.
2.
ASSESSMENT:
Data collection methods and tools
Initial data baser for Family Nursing
Practice
3. Data analysis
4. Nursing Diagnoses: Family Nursing
Problems
DATA COLLECTION
METHOD AND
TOOLS
 DATA COLLECTION
The process of identifying the types or kinds
of data needed.
Primary source:
- obtained directly
de from the client
Secondary source:
- obtained through family or significant
others; incase of children, critically ill, or
mentally unstable patients.
 DATA COLLECTION
METHODS
1. Observation
- Date collected using the sensory
capacities.
2. Physical Examination
de
- Done through inspection,
palpation, percussion, auscultation,
measurement of specific body parts and
reviewing the body systems.
 DATA COLLECTION
METHODS
3. Interview
- Completing the health history of
each family member. The health history
determines currentde health status based
on significant past health history.
4. Record Review
- Reviewing existing records and
reports pertinent to the client.
 DATA COLLECTION
METHODS
5. Laboratory/ Diagnostic tests
- Performing laboratory tests,
diagnostic procedures or other tests of
integrity and functions
de carried out by the
nurse herself and/or other health
workers.
 5 TYPES OF DATA
FOR FAMILY
NURSING
ASSESSMENT;
INITIAL DATABASE
A. FAMILY STRUCTURE,
CHARACTERISTICS, AND
DYNAMICS
1. Members of the household and
relationship to the head of the family
2. Demographic data
3. Place of residence of each member
A. FAMILY STRUCTURE,
CHARACTERISTICS, AND
DYNAMICS
4. General family relationships or
dynamics
5. graphic data
6. Place of residence of each member
 B. SOCIO-ECONOMIC
AND CULTURAL
• CHARACTERISTICS
Income and expenses
- Occupation and place of work of
each member
- Adequacy to meet basic needs
- Who makes decision about family
expenditure
• Educational attainment of each member
B. SOCIO-ECONOMIC
AND CULTURAL
CHARACTERISTICS
• Ethnic background and religious
affiliation
• Significant others and the role they
play in the family
• Relationship of the family to a larger
community
C. HOME AND
ENVIRONMENT
• Housing
- Adequacy of living space
- Sleeping arrangement
- Water supply
• Kind of neighborhood
• Social and health facilities available
• Communication and transportation
facilities available
D. HEALTH STATUS OF
EACH MEMBER
- Includes current and past significant
illness; beliefs and practices conducive to
health and illness; nutritional and
developmental status; physical assessment
findings and significant results of
Laboratory tests.
E. VALUES, PRACTICES ON
HEALTH PROMOTION,
MAINTENANCE, AND
• Immunization status
DISEASE PREVENTION
• Healthy lifestyle
practices
• Adequacy of:
• Rest and sleep
• Exercise/activities
• Use of protective
measures
DATA ANALYSIS
 Nursing
Diagnoses:
Family Nursing Problems
First level Assessment
The process of determining
existing and potential health
conditions or problems of the
family. These health
conditions are categorized as:
 I. Presence of Wellness
Condition
Stated as “Potential” or “Readiness”; a nursing
judgment about a client in transition from a specific
level of wellness or capability to a higher level.
Wellness potential is a nursing judgment on wellness
state or condition based on client’s performance,
current competencies, or performance, clinical data or
explicit expression of desire to achieve a higher level of
state or function in a specific area on health promotion
and maintenance.
 Potential & Readiness
for Enhanced Capability
for:
-Healthy lifestyle
-Healthy maintenance/health management
-Parenting
-Breastfeeding
-Spiritual well-being-process of client’s
developing/unfolding
 II. Presence of Health
Threats
Are conditions that are conducive to
disease and accident, or may result
to failure to maintain wellness or
realize health potential.
 -Presence of risk factors of specific diseases
-Threat of cross infection from communicable
disease case
-Family size beyond what family resources can
adequately provide
-Accident hazards
 Faulty / unhealthful
nutritional / eating habits
or feeding techniques /
practices.
Stress Provoking
Factors.
 Poor Home /
Environmental
Condition /
Sanitation
Unsanitary Food
Handling and
Preparation
Unhealthy Lifestyle
and Personal
Habits/Practices.
Inherent Personal
Characteristics
 Health History,
which may
Participate/Induce
the Occurrence of
Health Deficit
 Inappropriate
Role Assumption
 Lack of
Immunization/
Inadequate
Immunization Status
Especially of
Children
Family Disunity
 III. Presence of
health deficits
These are instances of failure
in health maintenance.
 Illness states,
regardless of whether
it is diagnosed or
undiagnosed by
medical practitioner.
 Failure to thrive/
develop according
to normal rate
Disability
IV. Presence of stress
points/foreseeable
crisis situations
Are anticipated periods of unusual
demand on the individual or family
in terms of adjustment/family
resources.
 Marriage
Pregnancy, labor, puerperium
Parenthood
Additional member
Abortion
Entrance at school
Adolescence
Divorce or separation
Menopause
Loss of job
Hospitalization of a family member
Death of a member
Resettlement in a new community
Illegitimacy
 Second-Level
Assessment
Second level assessment identifies the nature
or type of nursing problems the family
experiences in the performance of their
health tasks with respect to a certain health
condition or health problem.
 I. Inability to
recognize the
presence of the
condition or
problem due to:
 Lack of or inadequate
knowledge
Denial about its existence or
severity as a result of fear of
consequences of diagnosis of
problem
Attitude/Philosophy in life, which
hinders recognition/acceptance
of a problem
 II. Inability to make
decisions with respect
to taking appropriate
health action due to:
Failure to comprehend the nature/magnitude
of the problem/condition
Low salience of the problem/condition
Feeling of confusion, helplessness and/or
resignation brought about by perceive
magnitude/severity of the situation or
problem
Lack of/inadequate knowledge/insight as to
alternative courses of action open to them
 Inability to decide which action to
take from among a list of alternatives
Conflicting opinions among family
members/significant others regarding
action to take.
Lack of/inadequate knowledge of
community resources for care
Fear of consequences of action
 Negative attitude towards the health
condition or problem-by negative
attitude is meant one that interferes with
rational decision-making.
In accessibility of appropriate resources
for care
Lack of trust / confidence in the health
personnel / agency
Misconceptions or erroneous
information about proposed course(s) of
action
 III. Inability to provide
adequate nursing care to
the sick, disabled,
dependent or vulnerable/at
risk member of the family
 Lack of / inadequate knowledge about the
disease/health condition
Lack of / inadequate knowledge about child
development and care
Lack of / inadequate knowledge of the nature
or extent of nursing care needed
Lack of the necessary facilities, equipment and
supplies of care
Lack of / inadequate knowledge or skill in
carrying out the necessary intervention or
treatment / procedure of care
 Inadequate family resources of care
Significant persons unexpressed feelings
Philosophy in life which negates / hinder
caring for the sick, disabled, dependent,
vulnerable / at risk member
Member’s preoccupation with on concerns /
interests
Prolonged disease or disabilities, which
exhaust supportive capacity of family members.
Altered role performance
IV. Inability to provide
a home environment
conducive to health
maintenance and
personal development
Inadequate family resources specifically:
Failure to see benefits of investments in
home environment improvement
Lack of / inadequate knowledge of
importance of hygiene and sanitation
Lack of / inadequate knowledge of
preventive measures
Lack of skill in carrying out measures to
improve home environment
Ineffective communication pattern within
the family
Lack of supportive relationship among
family members
Negative attitudes/philosophy in life which
is not conducive to health
Lack of adequate competencies in relating
to each other for mutual growth and
maturation maintenance and personal
development
V. Failure to utilize
community
resources for
health care
 Lack of/inadequate knowledge of community
resources for health care
Failure to perceive the benefits of health care/
services
Lack of trust/confidence in the agency/personnel
Previous unpleasant experience with health
worker
Fear of consequences of action
Unavailability of required care/services
Inaccessibility of required services
Lack of or inadequate family
resources
Feeling of alienation to/lack of
support from the community
Negative attitude / philosophy in life
which hinders effective / maximum
utilization of community resources
for health care