ntroduction

"Health is a right, not a privilege a saying that strongly correlates to Community

health nursing in such a way that it focuses on the welfare of everybody. But what is
really the true essence of Community health nursing or CHN? According to the
American Nurse Association, Community health nursing practice promotes and
preserves the health of populations by integrating the skills and knowledge relevant to
both nursing and public health. The practice is comprehensive and general, and is not
limited to a particular age or diagnostic group; it is continual, and is not limited to
episodic care. While community health nursing practice includes nursing directed to
individuals, families and groups, the dominant responsibility is to the population as a
whole (Maglaya, 2004, 1997).
Basing on the definition, we could site that the main goal of Community Health
Nursing is the promotion and preservation of health of the whole population that is
intertwined with the other preventive services and programs by the department. t
reaches out to communities that have difficulty in getting the necessary health care
provided by the community. This action would be made possible through the
cooperation of the city health office and barangay health units. We could also draw out
that the nature of the practice is comprehensive, general, continual and not episodic. n
Community health nursing, the different levels of clientele being dealt with are the
individual, families, population aggregate and the population as a whole.
Community health nursing is a specialized practice (Maglaya, 2004, 1997). t
requires a diverse skill and knowledge base on the nursing theories. Also, when doing
community health nursing a lot of versatility and adaptability and knowledge of all
nursing procedures are required especially when dealing with a lot of patient under
compromised and difficult situations. t also uses other fields and other branches of
science such as psychology, sociology, the natural sciences, etc.
Through Community Health Nursing, the Primary Health Care (PHC) will be
provided. Primary health care is defined by WHO and UNCEF (1978) as an "essential
health care based on scientifically sound and socially acceptable methods and
technology made universally accessible to individuals in the community through their full
participation and at a cost that the community can afford to maintain at every stage of
their development in the spirit of self-reliance and self-determination. ts concepts are
premised on people's right and health (Maglaya, 2004, 1997). With Community health
nursing, poverty and insufficient distribution, which are the two major reasons for
people's failure to access essential health care, will be answered.
Part of our learning as second year student nurses of Ateneo is our exposure in
the community in lieu to our Primary Health Care. n this exposure, theories thought in
the class would come to its practical application after months of rigorous lecture. The
students were grouped into four and were assigned to different areas. The group was
assigned to Purok 1 of Brgy. Biao Joaquin, Calinan district, Davao City.
The night before our community a feeling of nervousness and excitement rushed
upon the group and as the day came and arrived at the area, the group was exposed to
a completely different and unknown environment. Scorching heat welcomed us when
the group took foot on the grounds of Biao Joaquin, eventually mud glazed our shoes
as each of us were introduced to our prospect family of study. Though the walk was far
and tiresome, the breath taking views, the fresh air and the hospitality of the family took
away all those things. The houses they reside in were expected for these types of
houses are common in the community but still some houses are unusual for such type
of living.
During the last day of the exposure we selected a family from our group for the
case presentation. The group met the Agcoaile family. The proponents of this case
presentation interviewed the family to assess and know the possible and actual
problems, and help the family to cope with their difficulties. So basing on this interview
the proponents of this case presentation chose the family because of the many
underlying problems.






Acknowledgement

The proponents of this case presentation, Group 4 of section 2A, would like to
extend their gratitude to the following groups and particular people who have
contributed to the completion of this study.
First of all, the proponents of this case presentation would like to offer the praises
and thanks to their primary source of inspiration and life, none other than our Almighty
Father. Thank You for the strength and the courage imparted upon the members to
make it through the hectic week and still do the best of their abilities. For giving the
members wisdom to finish the case presentation, the group lifts the fruits of their hard-
earned achievements for Your glory. For without You, we are nothing.
For the respective families of each member for the finances and emotional
support shown, the members of the group would like to convey their gratification. Thank
you for giving the members of the group the opportunity to have such an enriching
experience as men and women of God through the major curriculum of Ateneo de
Davao University, College of Nursing.
The proponents would also like to thank their clinical instructors for this rotation,
Mrs. Apple Alvarez, R.N., M.N., for her guidance and tips on how to go about the
proponents' first community duty in Biao Joaquin. To Mrs. Alvarez, the members of
Group 4 would like to extend their thanks for parting your knowledge and for the
patience and lively personality that inspires the entire group to be invigorated despite
the very warm weather and long walks.
The group's first rotation could have been quite harder if not for the
friendly spirits of the people in Purok 1, Biao Joaquin, specifically to the hospitable and
cooperative families designated to each member of the group. t was due to their utmost
patience and participation that the humbled members of the group were able to finish
this requirement and apply the theories they have acquired inside the classroom in real-
life setting as student nurses.
The members would also want to thank the other groups and 2A in
general for the undying support and love shown. The first rotation couldn't have been
more enjoyable without you.
ast but definitely not the least; the proponents would like to extend their delight
to their group mates. This case presentation would not have been possible without the
joint effort of the members of Group 4. Thank you for the professionalism, hard work
thru almost sleepless nights, creative juices and true solidarity that formulated this work,
thank you so much.


























Objectives

After our Community Nursing Exposure at Purok 1 Biao Joaquin, Calinan District,
Davao City, the group will be able to:
General:
Present an all-inclusive family case study regarding the Agcoaile Family
being the center of our nursing care.
Specific:
1. Do an ocular survey on the designated area.
2. Thoroughly assess pertinent information about the family through an
interview to formulate the nitial Data Base.
3. Gather data in the nitial Data Base and cite the problem areas of the
family for the first level assessment.
4. Classify cited health problems as to whether they are health deficits,
health threats, and/or foreseeable crises.
5. Formulate the second level of assessment.
6. Rate the level of the family's coping ability in the different coping areas of
the Family Coping ndex.
7. Plan specific health teachings about the recognized health problems of the
family.
8. Conduct a Metro Manila Development Screening Test on one of the
children in the community.
9. Make a drug study in relation to the family's need.
10. Update the family about the various DOH Barangay Health Programs and
explain to the family the benefits of availing these services.
11. Evaluate the outcome of the Community Exposure and make
recommendations.






InitiaI Data Base
nitial Data Base is the gathered information regarding the clientele, in this
situation the family lifestyle. t is a way of assessing their health problems and health
needs thus family nursing practice is applied.
FILY STRUCTURE D CHRCTERISTICS

ame Birthday
e
(years)
Sex
Position in
the famiIy
RoIes in
the famiIy
CiviI
Status

Jimmy
.aoiIe

uust
3, 1969

42



Father

Head

arried

i.heIIe
.aoiIe

ovembe
r 26,
1978

33

F

other

Wife

arried

en.he
.aoiIe

June 8,
2004

7

F

Dauhter

ChiId

ChiId
John PauI
.aoiIe

5riI 14,
2005
6 Son ChiId ChiId
e.heIIen
.aoiIe
Se5temb
er 22,
2007
4 F Dauhter ChiId ChiId
e.ah
.aoiIe
JuIy 24,
2009
2 F Dauhter ChiId ChiId
Justine
.aoiIe
June
12,2011
3
month
s
Son ChiId ChiId

Place of residence of each member:
All of the members of the family Agcaoile reside in Purok 1A Biao Joaquin Calinan
Davao City.

%5e of famil structure:
a.) According to membership Nuclear: They don`t have any relatives living in their house,
only the members oI the Iamily reside in the household.
b.) According to authority Matriarchal: It is Michelle who does the decision making
including matters oI health care.
c.) According to residence Patrilocal: The Iamily lives near the home oI the Iather`s parents.

Regarding matters oI health care, it is Michelle who decides dominantly in the Iamily.
She is also the one who takes care oI the Iamily while her husband is not at home. In
addition, there were no observed problems during the time oI interview. The Iamily have a
strong relationship.



CLnCC8AM
ctivities of dail living:
Sleeping Pattern
According to Mrs. Michelle, the Iamily usually sleeps at around 9:00 pm especially Ior
Michelle and Jimmy since they get tired Irom the day`s activities. According to Michelle, the
usual duration oI their sleep is Irom 5-6 hours. They usually wake up at around 5 am because
they have to go to work and at the same time prepare the children as they go to school. Since
there is an inIant present in the household, Mrs. Michelle needs to wake up in the middle oI the
night.
ating Pattern
The Iamily eats three times a day. Their usual meals consist oI rice, eggs, noodles,
vegetables, and Iish. When they have enough money, they are able to buy meat suck as pork or
chicken in the nearest market in their location. The Iamily, particularly Michelle, said that the
Iood that they have is just enough to support their Iamily.
eisure Time Activities
eisure time only happens Ior both parents when they are not working. Michelle spends
her Iree time sleeping and also watching the kids. She also considers doing household chores as a
good way to spend her Iree time. For Jimmy, when he has Iree time, he also sleeps or spends
time with his children. For the children, iI they do not have classes, they usually spend their Iree
time playing with their Iriends within the community. They also watch television together as
their source oI entertainment, together with their parents.






SOCIO-ECONOMIC ND CUL%URL FC%ORS
Members Occupation
Place oI
Work
Monthly
Income
ducational
Attainment
thnic
Background
Religious
AIIliation
Jimmy
Security
Guard
PWU,
Matina
P7,500
College
evel
Dabawenyo
Roman
Catholic
Michelle HousewiIe House N/A
Highschool
level
Dabawenyo
Roman
Catholic
Menche Student N/A N/A Grade 2 Dabawenyo
Roman
Catholic
John
Paul
Student N/A N/A Grade 1 Dabawenyo
Roman
Catholic
Mecah
Not yet in
school
N/A N/A N/A Dabawenyo
Roman
Catholic
Justine
Not yet in
schoool
N/A N/A N/A Dabawenyo
Roman
Catholic

Income and penses

Family Income
Father P7,500/month

Family`s monthly budget:
Rice P27- P38 /kilo (5 kilos enough Ior 2 weeks)
gg- P6.00/pc (more or less 30 per month)
Dried Fish P60/kilo (2 kilos enough Ior one week)
Fish P70/kilo
Water P90/month
lectricity P150/month

As the Iinancer oI the Agcaoile Iamily, Mr. Jimmy works at Philippine Women`s
University as a Security Guard. His income per month is P7,500. Mrs. Michelle stays at home
and does the household jobs, watches the children and prepares meals Ior them. She is the one
who makes decision about the money and how it is spent. She also decides on what meals to
prepare and what is to be bought in the market. ven in this system, her husband is open to such
decisions made by Mrs. Michelle. According to Mrs. Michelle, the income which her husband
earns per months is somehow enough to support the Iamily.


C ENVIRONMEN%L FC%ORS
Housing
The Iamily resides in a house with inadequate living space. Wood is the main material
used Ior the building oI their house and there are two entrances that can be Iound. One entrance
is located at the Iront, and another entrance is located at the back.
The house only consists oI two areas; one room is Ior their sleeping area, while the
other one is Ior their dining area. All the Iamily members sleep on the Iloor inside their bedroom.
When they eat, they usually eat on the Iloor. They don`t use their dining table ecept when there
are any special occasions.
The Iloor is relatively clean as well as the limited Iurniture like the bench, dining table,
radio, and their television which can be Iound inside their house. It was obvious that the Iamily
owns very Iew things and Iurniture. In Iact, there were no beds present inside the house.
There are also presence oI insects and rodents inside the house. Rats, cockroaches and
lizards are sometimes present according to Mrs. Michelle. During the day, it was observed that
Ilies Ireely come in and out oI the house. BeIore they go to sleep, they light a katol to prevent
mosquitoes Irom coming near them.
Upon observation, clothes are jam-packed in one corner oI their bedroom.. Their source
oI light is placed at the center oI the house. Their kitchen is located outside the house, where the
materials Ior cooking are placed in one corner, without any proper storage Ior it. Also, their toilet
Iacility is an open pit, with no proper drainage. Because oI this, stench is really strong and bad.
lectrical wires are also Iound hanging inside the house and this may possibly cause electrical
hazard to the Iamily.
The Iamily doesn`t have storage Ior their Iood. II there are leItovers, they just leave it
inside the cooking pot. They also don`t have a reIrigerator to store their Iood or their raw meat.
Their water source comes Irom the reservoir, where they use it Ior washing the dishes and the
clothes, Ior taking a bath, and Ior drinking purposes. With regards to their garbage, they usually
burn it. But there are times that their garbage is collected by the barangay patrol.
ind oI Neighborhood
The neighbourhood is very much wide in terms oI land area at the same time no sign
oI congestion is seen. We could also observe how clean and nature Iriendly the kind oI
environment that they had.
Social Health Services available
The Iamily`s house as well as the community is near to the barangay health center. So
when there are times oI emergency, the health center is easily accessible to all the people living
in the community.
Communication and Transportation Iacilities available
As means oI communication, the Iamily uses a mobile phone powered by Smart. For the
Iamily`s transport, they usually walk going to their destination and at times ride a motorcycle
which costs them 30 pesos Ior the whole trip.



D HEL%H SSESSMEN% OF ECH MEMER
4 Medical History oI each member
1.) Jimmy- has asthma
2.) Michelle- had severe cough
3.) Menche- had mumps
4.) John Paul- had high Iever
5.) Mechellen- had coughs and colds
6.) Mecah- had Iever
7.) Justine- had cough
Although Mr. Jimmy has asthma, Fortunately, His kids didn`t inherit his sickness.
Mrs. Michelle buys medications at the nearest pharmacy or in the barangay health
center. The Iamily also uses herbal medicines like agundi.

4 'alue place on prevention oI disease
According to Mrs. Michelle, all oI her children have their complete immunization at the
barangay health center. However, they don`t Iully utilize the other preventive services. They just
go to the health center when one oI the Iamily members gets sick. Also, Mrs. Michelle
verbalized that they`d rather go Ior the generic medicines than the original because it is much
cheaper and it just gives the same eIIect.
4 Source oI Medical Care
Whenever one oI the Iamily members get sick, Mrs. Michelle is always the one who
takes care oI them. The Southern Philippines Medi
cal Center and the Barangay Health Center are their main sources oI Medical Care. Mrs.
Michelle also attends seminars at the Biao gym whenever there are conduction oI seminars and
whenever she has her Iree time. So Iar, Iamily planning, cooking and women related seminars
are the ones which she has attended.
4 Perception oI the role oI health proIessional and their services
They respect and believe that they can help them in improving their health. They believe
that health care proIessionals are helpIul and they do their best to help members oI the Iamily
improve the levels oI health. They are also thankIul Ior the presence oI the student nurses
because they learn Irom us and at the same time, they see our work as a very respectable
proIession.

st
Level ssessment

1. Presence oI Wellness Condition
A. Potential Ior nhanced Capability Ior:
1. Healthy iIestyle
The Iamily`s diet consists mainly oI rice, egg, Iried chicken, noodles and
sometimes Iish and vegetables. With these, their meals apparently don`t have enough
nutrition necessary Ior their daily requirements most especially Ior the growing children.
Their kind oI liIestyle is more oI the laid back type since they don`t live in the urbane
setting Iull oI hassle and bustles. Jimmy spends more time at work and doesn`t have time
to do proper eercise and quality time with the Iamily. The kids go to school during the
day and come back in the aIternoon though sometimes they skip classes and stay at home.
2. Health Maintenance/ Health Management
The kids don`t have complete immunizations. The immunizations available in
Barangay Health Center are Iree oI charge and they must grab the opportunity to
complete the immunizations.
3. Parenting
The children are raised well by their parents. The Iather is the bread winner by
working as a security guard. Their mother takes care oI the children and attends to their
needs. The chores are distributed in the house; each member has their own responsibility
to attend to.


4. BreastIeeding
Michelle, the mother, stated that all oI the Iive children were breast Ied. She was advised
to do so because oI many beneIits that the child may acquire.
5. Spiritual Well-Being
All oI them were baptized including the youngest child. Their religion is catholic and
they do not go to mass every Sunday.
B. Readiness Ior nhanced Capability Ior:
1. Healthy iIestyle
'Makakaon man pud mi day sa kada adlaw tulo ka beses pero kay usahay lang mi
makakaon og karne. 'Ang among ginakaon kay itlog, gulay kung naay ma-harvest, noodles,
isda, ug manok , pirmi-pirmi na pud namo n ginakaon kay mao lang na among mapalit., as
verbalized by the mother, Michelle. vidently, Michelle wants to have a liIestyle diIIerent Irom
theirs but cannot do so due to Iinancial constraints.
2. Health Maintenance/ Health Management
Because oI the advices given to them, they are starting to visit the Barangay Healh
Center because they already know that lots oI privileges are awaits Ior them.
3. Parenting
' Ginadisiplina man pud nako akong mga anak kay mutuo jud ko kanang iagi lang sa
tarong na istorya. 'Pag bunalan man gud nimo morebelde nag samot. ' Ako pud silang
ginatudluan og maayong pamatasan labaw na kanang respeto sa mga tigulang.
4. BreastIeeding
'Gipatutoy man pud nako akoang tanan na anak pwera lang pag muabt na sila ug 5 months.
As verbalized by Michelle.
5. Spiritual Well-Being
'Napabunyagan man nako tanan akong anak apil napud tong akoang kinamaghuran. 'ung
panguntan-on nimo amoang pagtuo, mutuo jud mi sa Ginoo maski di mi gasimba kada Domingo
jud naa gihapon mi paglaom na tubagon niya amoang panginahanglan. Para sa amo maskin asa
ka pwede makaampo sa ginoo.
II. Health Threat
a) Family size beyond what Iamily resources can provide.
Mr. Jimmy, a security guard, has an income oI P7500 monthly. The Iamily is suIIering
Irom inadequacy oI money due to their ecessive debt. Considering that they are 7 in the Iamily
and Michelle has no job, they have inadequacy oI Iood supply thus the Iamily has no enough
nutrition to maintain.
b) Accident hazards
The back oI their house is slippery because it is not composed oI cement but purely soils.
ven iI it is not raining, the soil is wet because they do their laundry at the back oI their house.
Their house has no stairs and when we were about to enter their house, we must take a big step to
enter their house. Their means oI cooking, which is by woods, poses a danger since many
Ilammable objects surround the area where they cook.

c) Poor home/ environmental condition/ sanitation
The Iamily house has an inadequate living space. This was evident because they live on
the same room. They are 7 in the Iamily and their house is too small Ior all oI them. In relation,
the Iamily`s home has a lack oI Iood storage meaning they don`t buy ecess but buys Iood only
during meal time. Presence oI mosquitoes is also Iound in the house. Clothes are scattered
thereIore, there is no closet Ior clothes.
d) Unhealthy liIestyle and personal habits/ practices
The Iather engages in smoking. This could Iurther aIIect his health condition speciIically his
asthma.
III. Health DeIicits
Mr. Jimmy has asthma but he is still smoking because he is already addicted. The bad
thing is that despite his present health condition, he is still into vices.
I'. Foreseeable Crisis/Stress Points
Michelle has a 3 months old baby and when the baby will grow up, maybe the other
children will stop their schooling because presently their Iinancial resources are not enough.

nd
Level of ssessment
I. Inability to recognize the presence oI the condition or problem due to lack oI/or
inadequate knowledge. ack oI attitude/ philosophy in liIe which hinders recognition/
acceptance oI a problem by denying about the problems eistence or severity as a result
oI Iear oI consequences oI diagnosis oI the problem, speciIically due to economic/ cost
implications like ecess debt Ior the Iamily size is beyond their resources can adequately
provide thus the children don`t receive allowance regularly.
II. Inability to make decisions with respect to taking appropriate action due to low salience
oI the problem. The Iather is still smoking even though he knows that he is suIIering
Irom asthma.
III. Inability to provide adequate nursing care to the sick, disabled, dependent or vulnerable/
at-risk member oI the Iamily due to lack oI inadequate knowledge oI the nature and
etent oI nursing care needed because most oI them had respiratory problems.
ack oI the necessary Iacilities, equipment and supplies Ior care Ior the Iather to
accommodate and treat his sickness due to inadequate Iamily resources Ior care
speciIically due to Iinancial constraints Ior the Iather has no Iied income proven when
the mother verbalized that 'di-kaigo ang sweldo niya para sa tibu-ok pamilya.
I'. Inability to provide a home environment conducive to health maintenance and personal
development due to inadequate Iamily resources speciIically due to Iinancial constraints
that`s why the entrance to their kitchen and bedroom have no stairs. The bedroom itselI
does not have enough space to accommodate each oI the Iamily members.
ack oI skill in carrying out measures to improve home environment thus providing
entrance to the house by insects and animals such as chicken, clothes are scattered, and
animal stench is evident.
ack oI inadequate knowledge oI preventive measures such as the possibility oI a Iire
hazard Ior they cook within close proimity to the house.
Failure to see beneIits (speciIically long term ones) oI investment in home environment
improvement and lack oI/ inadequate knowledge oI importance oI hygiene and sanitation
Ior they lack Iood storage Iacilities Ior the mother said 'Ginabutang lang sa Tupperware
ang sobra na pagkain. Minsan kay makigamit lang mi sa reI ng akoang pinsan.
I'. Inaccessibility oI required care/ service due to lack oI Iinancial resources.

Famil Co5ing Index

COPING RE R%ING 1US%IFIC%ION HEL%H %ECHING
FINL
R%ING
FINL
1US%IFIC%ION
1. Physical
Independence
5

The Agcaoile Iamily
consists oI 7 members: the
parents, their 5 children.
Mr. Jimmy usually goes
out to work and Mrs.
Michelle is leIt in the
house to take care oI the
household and children.
Although Mrs. Michelle is
spending time in caring oI
Justine and Mecah, her
other children are
independent. They can go
to school and take a bath
by their own. The older
siblings help their mother

In order to maintain
this status, the Iamily
must properly take
care oI their body by
reIraining Irom too
much stress, having
enough rest,
perIorming daily
eercises and eating
nutritious Iood to
maintain or enhance
their optimum health.
They should also pay
attention to the most
vulnerable members
oI the Iamily who are
5

The Iamily was still able to show their
competence in this coping area. All
members can independently do their
activities oI daily living. As Ior Justine
and Mecah the Iamily still continues to
provide their needswithout delay or
interruption.
in taking care oI the
young ones and the
household chores. Justin
and Mecah is still
dependent on the mother.
ven though they are still
dependent on their parents
and siblings, they still
receives the necessary
care without interruption
or undue delay.

Justine and Mecah
2. Therapeutic
Independence
3

The Iamily is providing
some medication and
treatment whenever they
have illness. Jimmy, the
Iather, has asthma.
However, he only takes
his medication whenever
there would be an asthma
attack, they do not
InIorm the Iamily
that it is important to
comply with the
given prescription oI
their physician. It is
important too to
educate the Iamily
regarding the use oI
herbal drugs,
particularly lagundi.
3

The Iamily still doesn`t Iully comply
with the prescribed drugs oI the
physician due to the Iact that they have
no adequate Iinancial resources.
maintain the medication
prescribed by the
physician. The mother
said that they also use
herbal drugs, speciIically
lagundi, Ior cough.
et them know that
herbal drugs can have
interactions with
other drugs.
3. nowledge
oI Health
Condition
3

The Iamily has an idea
about the health
conditions oI each Iamily
member. However, the
Iamily members don`t
Iully grasp the Iull
meaning oI the disease.
The Iamily members don`t
know much about the
mechanism oI asthma.
The mother also inIormed
us that she does not buy
generic Salbutamol in the
Botika ng Barangay.
Rather, she buys 'entolin
Correct the belieI oI
the mother that
generic drugs are less
eIIective compared to
branded ones.
3
The mother still chooses to buy branded
drugs since she still thinks that generic
drugs are not eIIective.
because she thinks that the
branded drug is more
eIIective than the generic
ones.
4. Application
oI Personal
and General
Hygiene
3

Although their children
have complete
immunization, the parents
let their children to play
outside bareIoot which
can be potential source oI
inIection. They do not
wash hands beIore and
aIter they eat meals. The
children also urinate
beside the house. ven
though vegetables and
dried Iish are healthy, the
Iamily is unable to
provide daily nutritional
requirement. They have
insuIIicient protein intake

ducate the Iamily on
the importance oI
handwashing in
reducing the number
oI microorganisms on
their hands and
preventing the
transIer oI diseases.
et them know the
importance oI
wearing slippers
since the Ieet are
usually in contact
with the ground.
Parents should also
be taught that they
should train their
3

The children still go outside without
using slippers. The mother was also not
able to Iully educate her children with
regards to not urinating anywhere. The
Iamily is still unable to provide the daily
nutritional requirement since the Ioods
that they eat are still the same.

and eating too much dried
Iish can cause kidney-
related problems.

children not to
urinate anywhere.
Also, inIorm them
that proper nutrition
does not mean eating
vegetables everyday,
it entails the balance,
variety and
moderation oI eating
Iood.
5. Attitude towards
Health Care
3 The Iamily
understands and
recognizes the need
Ior medical care in
illness and Ior the
usual preventive
services. They
display Iull trust on
their local health
Iacility and also to
their nearby
hospitals. Also, we
can see that they
trust any health care
personnel
InIorm the Iamily oI
the new services
oIIered by the
health agencies
present in their area.
mphasize the role
oI health care
services to their
health by giving out
situations that will
make them
understand the
importance oI
health care services
such as the role oI
which in the
prevention and early
detection oI some
3 1hey are fully aware
abouL Lhe capablllLles
of Lhelr local healLh
personnel and also Lo
Lhelr nearby healLh
faclllLy
diseases. Also,
inIorm them that
every part oI the
body is important
Ior its proper
Iunctioning, thus,
no part oI the body
should be taken Ior
granted.
6. motional
Competence
3 Both the Mother
and Father and are
the ones making
decisions in the
Iamily. During hard
times they are able
to handle things
with a degree oI
emotional calmness
and maturity. They
are able to discuss
their conIlicts
properly and calmly
whenever there are
disagreements
among the Iamily
members.
Commend the
Iamily Ior Iacing
their problems and
making responsible
decisions. Also,
encourage them to
continue their
emotional maturity
in Iacing their
troubles or conIlicts
Ior this will help
them maintain a
healthy Iamily
relationship
3 The Iamily
maintains their
maturity in dealing
with problems. The
Iather respects the
decision oI the
mother, and vice
versa. When there
are problems, they
talk about it in order
to work things out.

7. Family iving
Patterns
3 As we have seen,
the Iamily lives in
happy, simple liIe
and remained
bonded. The parents
did a good job in
disciplining their
ncourage the
Iamily to maintain
the healthy
relationship that
they have with one
another. InIorm
them on the eIIects
3
The children remain
to be respectIul and
obedient to their
parents. They get
along with each
children. But, as a
normal Iamily, they
also have habits that
do not cohere with
other Iamily
members. As they
said ' Ah, wala
man. Kung naa man
fud ma suko pagka
ugma wala man
problema.` All
members get along
as long Iast.
oI interpersonal
relationships on
their health such as
projecting a
glowing Ieature
when their heart and
social relationships
are healthy.
Commend the
parents Ior doing a
good job in
disciplining their
children.
other well. In
addition to that, the
Iamily has a good
relationship with
their neighbours.
But, sometimes
have problems
around their Iamily.
8. Physical
nvironment
3 The house is small
Ior the size oI the
Iamily. The Iamily
has 7 members and
the living space is
not suIIicient. They
may have bedrooms
but they do not have
a bed. Moreover,
they do not have a
proper toilet Iacility.
They have outside
their house and they
use a sack to
provide privacy.
The kitchen is not
properly
maintained. Some
parts oI the house
are disorganized.
InIorm the Iamily
that it is important
to check their house
Ior necessary
repairs. Also,
inIorm them that
saIety measures
should be taken
especially when
going upstairs in
order to avoid
accidents like
Ialling. Teach them
to clean their
surroundings to
eliminate possible
breeding sites oI
insects.
3 It was observed that
the Iamily did not
make the necessary
repairs in their
house which can be
a cause oI
accidental hazards
in the house
There are Presence
oI mosquito, lizard,
Ilies and rats outside
their house. Despite
oI these
imperIections in
their house, they
were still able to
keep some areas in
their house clean.
They also said that
their neighborhood
is saIe.
9. Use oI
community Iacilities
3 The Iamily is aware
oI the presence oI
community
resources Ior health,
education and
welIare. The Iamily
is open to teachings
and suggestions
when it comes to
health. They are
aware oI
government
programs too.
Further inIorm them
on the activities,
schedules and
services oIIered by
the health center Ior
them to be aware
and visit their health
center. They should
also avail the
membership
(Philhealth) and
pension (SSS) so as
to sustain their
health care needs
and other Iuture
necessities
3 1hey are parLlclpaLlve
abouL Lhlngs LhaL
Lhey know ls
beneflclal Lo Lhem
1hey fully use Lhelr
local faclllLy as Lhelr
own advanLage












Prioritization of the Problem
ccident hazards: fall hazards- absence of stairs in front of the house
Criteria Com5utation
ctual
Score
1ustification
Nature of the
Problem
x
It is a health threat. It may cause
untoward consequences to the
Iamily.
Modifiabilit of the
Problem
x
The problem is easily modiIiable
because the resources Ior the
modiIication oI the new stairs are
available. Furthermore, the Iather
has knowledge in building the
new stairs.
Preventive Potential x
The problem is highly
preventable. The saIety oI the
Iamily will be improved since
the incidence oI accidents like
Ialling is minimized.
Salience of the
Problem
0 x 0
The Iamily does not perceive this
as a problem or condition
needing change since they
already got used to getting up to
their house without the help oI
stairs.
TOTA SCOR 3.67

Famil size beond what famil resources can adequatel 5rovide
Criteria Com5utation
ctual
Score
1ustification
Nature of the
Problem
x
It is a health threat because not all
the needs oI the members can be
provided and it can hinder them
Irom achieving their health
potential
Modifiabilit of
the Problem
x
This problem is partially
modiIiable since the Iamily size
can`t easily be changed and to
provide the important needs oI the
Iamily, the mother can look Ior an
additional job so that there will be
added income.
Preventive
Potential
x
The possibility oI increasing
Iamily size is reduced; the
available Iamily resources can be
utilized to meet the basic needs oI
each Iamily member.
Salience of the
Problem
x 0
The problem is Ielt by the Iamily
but they do not think that it needs
an immediate attention since they
are contented with what they
have.
TOTA SCOR 3.17

Lack of food storage facilities
Criteria Com5utation
ctual
Score
1ustification
Nature of the
Problem
x
It is a Ioreseeable crisis because
it may cause diseases to the
Iamily, iI eaten, due to its high
potential to be accessed by pests
and also to be spoiled easily.
Modifiabilit of the
Problem
x
The problem is partially
modiIiable because oI limited
Iinancial resources. On the other
hand, the Iamily can improvise
ways in having Iood storage
Iacilities.
Preventive Potential x Having proper Iood storage
Iacilities will prevent the Iamily
Irom acquiring communicable
diseases transIerred by insects
and rodents. It will also prevent
Iood poisoning.
Salience of the
Problem
x 0
The Iamily recognizes it as a
problem not needing an urgent
attention.
TOTA SCOR 3.17

4 Presence of insects and rodents inside the house
Criteria Com5utation
ctual
Score
1ustification
Nature of the
Problem
x
It is a health threat because
insects and rodents are
mechanical vectors Ior certain
diseases.
Modifiabilit of the
Problem
x
This problem is partially
modiIiable. The insects and
rodents enter the house through
the openings on the house`s
Iloor. The Iamily has Iinancial
constraints and thereIore,
cannot make improvements in
their house.
Preventive Potential x
Communicable diseases brought
by insects and rodents can be
prevented.
Salience of the
Problem
x
The Iamily knows that this is a
problem but they think that it
does not need immediate
attention since they believe that
by using a mosquito net at night
will provide protection Ior the
members oI the Iamily.
TOTA SCOR 3.17


Debts are in excess
Criteria Com5utation
ctual
Score
1ustification
Nature of the
Problem
1 / 3 1
The nature oI the problem is a Ioreseeable
crisis. Having a large debt that they cannot
pay can pose a great problem in the Iuture.
Modifiabilit
of the Problem
1 / 2 2
It is partially modiIiable since it takes time
to pay the accumulated debts specially that
there`s a limited income Ior the entire
Iamily budget.
Preventive
Potential
2 / 3 1 0
When the Iamily has paid their debts, then
their worries will be lessened. Also, they
will be able to learn how to budget their
income more appropriately.
Salience of the
Problem
2 / 2 1
The Iamily thinks that it is a problem that
needs immediate action since they are
worried that their debt will continue to
increase.
TOTA SCOR



ealLh roblem lamlly nurslng roblems Coal Cf Care Cb[ecLlve of
Care
lnLervenLlon lan
nurslng
lnLervenLlon
MeLhod nurse
lamlly ConLacL
8esources
8equlred

1noL enough
adequaLe llvlng
space

lnablllLy Lo
recognlze Lhe
presence of Lhe
condlLlon or
problem due Lo

uenlal abouL lLs
exlsLence
speclflcally
economlcal cosL
lmpllcaLlon
AfLer nurslng
lnLervenLlon Lhe famlly
wlll be able Lo make
changes ln Lhelr llvlng
area and be aware of
Lhere problem
AfLer nurslng
lnLervenLlon
Lhe famlly wlll
1 ulscuss
Lhe
conseq
uences
abouL
Lhelr
exlsLlng
proble
m
2 Able Lo
recognl
ze Lhelr
proble
m
3 Apply
approp
rlaLe
acLlon
for
Lhelr
proble
m

O ulscuss
wlLh Lhe
famlly
Lhe
naLure
of Lhe
problem
and lLs
consequ
ences
O Apply
healLh
Leachlng
Lo Lhe
famlly
how
lmporLa
nL ls Lhe
llvlng
space
for
Lhem
O Lxplore
wlLh Lhe
famlly
posslble
ways of
lmplem
O ome
vlslL
1lme and efforL
of Lhe nurse
and Lhe famlly

Lxpenses for
Lhe
LransporLaLlon
of Lhe nurse
enLlng
measur
es Lo
enhance
Lhelr
llvlng
space
O uevelop
Lhe skllls
of
famlly
member
on
enhancl
ng Lhe
llvlng
space of
Lhelr
house
O Lmphasl
ze Lhe
lmporLa
nce of
llvlng
space ln
Lhelr
house














CuLS Anu
uA1A

LAL1
8C8LLM

lAMlL?
nu8SlnC
8C8LLMS

CCAL Cl
CA8L

C8!LC1lvLS Cl
CA8L

nu8SlnC
ln1L8vLn1lCnS

ML1Cu
Cl nu8SL
lAMlL?
CCn1AC1

8LSCu8CLS
8LCul8Lu
LvALuA1lCn

Chlld has mlld
cough and
colds and
moLher refuse
Lo conLlnue
medlcaLlon
due Lo fear of
flnanclal
consLralnL

1he sLudenL
nurses
assessed Lhe
chlld and Lhey
gaLhered Lhe
followlng
daLa presence
of runny nose
LransparenL
mucous
secreLlons and
consecuLlve
coughlng


1) resence
of Cough and
Colds
unLreaLed

lnablllLy of Lhe
famlly Lo
provlde
adequaLe care
Lo lLs member
due Lo
a) lack of
knowledge on
Lhe naLure
and exLenL of
care needed


AfLer nurslng
lnLervenLlon
Lhe famlly
would be able
Lo be
educaLed
abouL Lhe
beneflLs of
conLlnued
medlcaLlon
and be
knowledge
able abouL
alLernaLlve
ways ln
helplng
address Lhe
problem such
as Lhe use of
herbal
medlclnes

AfLer nurslng
lnLervenLlon
1he famlly wlll be
able Lo
a) be educaLed
abouL Lhe exLenL of
care needed for
Lhe chlld
b) reallze Lhe need
for a conLlnued
medlcaLlon and
make approprlaLe
acLlons
c) flnd alLernaLlve
ways ln LreaLlng
Lhe slckness such
as uslng herbal
medlclnes


a) provlded
educaLlon abouL
Lhe need for an
exLenslve
medlcaLlon
b) provlded
Leachlng LhaL
prescrlbed
medlclnes are
carefully made and
lL ls safe
c) LaughL abouL
Lhe alLernaLlve
medlclnes


ome vlslL

1lme and efforL
of Lhe nurse


1ransporLaLlon
expenses

CCAL ML1
a) 1he famlly
was able Lo be
educaLed
Lhrough Lhe
healLh Leachlngs
provlded
b) 1he famlly
reallzed Lhe need
for a conLlnued
medlcaLlon so
she declded Lo
have her chlld
checked up
agaln





CuLS Anu
uA1A

LAL1
8C8LLM

lAMlL?
nu8SlnC
8C8LLMS

CCAL Cl
CA8L

C8!LC1lvLS Cl
CA8L

nu8SlnC
ln1L8vLn1lCnS

ML1Cu
Cl nu8SL
lAMlL?
CCn1AC1

8LSCu8CLS
8LCul8Lu
LvALuA1lCn


O oor
sanlLa
Llon ln
Lhelr
envlro
nmenL
O LxlsLe
nce of
flles
oLher
lnsecL
s LhaL
can
cause
lllness
O 1he
house
has
many
unnec
essary
Lhlngs
LhaL
make

oor
sanlLaLlon

lnablllLy Lo
recognlze how
hazardous Lhe
envlronmenL
ls due Lo

O Lack
of
Llme
O Lack
of
lncom
e Lo
buL
resour
ces
(Cleanlng
maLerlals)
O Lack
of
securl
Ly
O Lack
of
space

Cur goal ls
LhaL
AfLer 4 days
of nurslng
lnLervenLlon
Lhey wlll able
Lo have a
clean and
harmonlous
envlronmenL
1o llve ln



AfLer nurslng
lnLervenLlon Lhe
famlly should be
able Lo
a) glve lmporLance
of havlng clean
surroundlngs Lo
llve ln
b) knows Lhe
dangerous effecLs
of havlng a bed
envlronmenL



A) ulscuss some
meLhods or how Lo
malnLaln Lhelr
surroundlngs clean

b) LnumeraLe Lo
Lhem Lhe lllness
and dlseases Lhey
can acqulre of
havlng a bad
envlronmenL

c) Check Lhe
slLuaLlon of Lhe
famlly of Lhey are
able Lo malnLaln
Lhelr surroundlngs
clean decrease
Lhe exlsLence of
Lhelr
mosqulLoes


ome vlslL

1lme and efforL
of Lhe nurse


1ransporLaLlon
expenses

CCAL ML1
1he famlly was
able Lo perform
meLhods ln
malnLalnlng Lhelr
surroundlngs
clean
1hey were able
Lo enumeraLe Lhe
lllness and
dlseases Lhey can
acqulre of
havlng a bad
envlronmenL
1hey were able
Lo decrease Lhe
posslblllLy of
havlng breedlng
slLes of
mosqulLoes ln
Lhelr
surroundlngs










lL look
crowd
ed
O rese
nce of
wasLe
ln
fronL
of
Lhelr
house

O erso
nal
probl
ems



CuLS Anu
uA1A

LAL1
8C8LLM

lAMlL?
nu8SlnC
8C8LLMS

CCAL Cl
CA8L

C8!LC1lvLS Cl
CA8L

nu8SlnC
ln1L8vLn1lCnS

ML1Cu
Cl nu8SL
lAMlL?
CCn1AC1

8LSCu8CLS
8LCul8Lu
LvALuA1lCn

LlevaLed
house

no sLalrs golng
lnslde of Lhe
house

resence of
sharp ob[ecLs
ouLslde Lhe
house

lall hazards
caused by Lhe
lack of sLalrs
golng Lo
lnslde Lhe
house and
ouLslde Lhe
house


1 lnablllLy Lo
provlde a
home
envlronme
nL
conduclve
Lo healLh
malnLenan
ce and
personal
developme
nL due Lo

a fallure Lo
see
beneflLs
(speclflcally
longLerm
ones) of
lnvesLmenL
ln home
envlronme
nL
lmproveme
nL


AfLer nurslng
lnLervenLlon
Lhe famlly wlll
be able Lo do
some
modlflcaLlons
regardlng Lhe
sLalrs ln order
Lo prevenL fall
hazards


AfLer nurslng
lnLervenLlon Lhe
famlly wlll
a be able Lo clLe
Lhe harmful effecLs
of noL havlng safe
sLalrs
b be able Lo puL up
sLalrs ouLslde Lhe
house golng lnslde
Lhe house


1ulscuss wlLh Lhe
famlly especlally Lo
Lhe couple Lhe
lmporLance and
Lhe poLenLlal
ouLcomes of
lmplemenLlng Lhe
sald home
lmprovemenL So
LhaL Lhey won'L
regard puLLlng up
sLalrs as a useless
lnvesLmenL
2 Lxplore ways on
how Lhey can make
such change wlLh
mlnlmal cosL
ln order for Lhem
noL Lo feel
burdened by
consLrucLlng such
home
lmprovemenL



ome vlslL

knowledge
of Lhe
nurse
1lme and
efforL of
Lhe nurse
and Lhe
famlly


CCAL ML1
1he famlly
was able Lo clLe
some harmful
effecLs of noL
havlng safe sLalrs

1he famlly was
able Lo puL up
sLalrs








b lack of
knowledge
of
prevenLlve
measures



.

Drug Study

Generic Name: agundi (Vitex negundo)
t also known as:

Five-leaded chaste tree (Engl.)
Dabtan, Dangla, Eagundi(Ak.)
Kalipapa-madam (Mag.)
Kamala (Tag.)
imo-limo (lk.
ingie (bon.)
ingo-lingo (lk.)
Sugarai (Bag.)
Tugas (S. . bis.)

Classification: Herbal medicine
Suggested Dose:
agundi has been clinically tested to be effective in the treatment of colds, flu, bronchial
asthma, chronic bronchitis and pharyngitis. The leaves, flowers, seeds and root of
agundi can all be used as herbal medicine. A decoction is made by boiling the parts of
the plant and taken orally. Today, agundi is available in capsule form and syrup for
cough.

Preparations for agundi in relation to its parts:
Boil half cup of chopped fresh or dried leaves in 2 cups of water for 10 to 15 minutes.
Drink half cup three times a day.
The lagundi flowers are also good for diarrhea and fever. Boil as with the leaves.
The root is especially good for treating dyspepsia, worms, boils, colic and rheumatism.



Mode of Action:
Scientific analyses have shown that agundi has anti-histamine and anti-inflammatory
effects. These effects help the asthmatic because histamine can constrict the bronchial
tubes, and inflammation of mucus membranes can cause wheezing. n addition,
agundi was found to inhibit leukotriene release. uekotrienes, like histamine,
contribute to constricted breathing and inflammation of the lungs.

ndications:
agundi is beneficial for the relief of asthma and pharyngitis. t is also suggested
for the relief of rheumatism, dyspepsia, boils, and diarrhea. agundi, according to the
Philippine's Department of Health, helps relieve asthma, colds and fever and so with
other bronchopulmonary disorders. agundi can also lighten the symptoms of Chicken
pox. t also helps in the removal of worms.

Contraindications:
According to the Philippine nstitute of Traditional and Alternative Health Care or
PTAHC, there are no known contraindications for this drug, although it is
contraindicated for people with allergic reactions to agundi.

Drug nteractions:
f taking any other medications, consult physician first before using other herbal
medicines such as agundi.

Side and Adverse Effects:
There are no known side and adverse effects for this drug.

Nursing Responsibilities:
The use of traditional and alternative medicines in our country has been gaining
popularity a few years ago. One of the most commonly used herbal medicines is
agundi (Vitex Negundo). agundi as what have found out have both anti-histamine
and anti-inflammatory effects. A nurse or student nurse should monitor the blood
pressure of the patient/client using any drugs with anti-histamine effects because it
causes dilation of blood vessels and there is a risk for the decrease of blood pressure of
the client.
Usage of this drug should be first consulted with a physician especially for
patients or clients with cardiac problems because of the drug's ability to increase the
heart rate. We should take note that not all anti-histamine drugs have sympathomimetic
effects, which is helpful for relief of acute asthma attack.
Also, the clients that are or will be using agundi or any other medicines should
be informed by the student nurse/ nurse that before using any medications, they should
consult with a physician first. This is important especially in cases of misinformed
clients/patients to prevent self-medication.

Dru Study of Sambon
Generi. name: Sambong (Blumea Balsamifera)

CIassifi.ation: herbal medicine.

Suested Dose and Pre5aration
You can boil Sambong leaves and drink it as tea. To use as a diuretic, boil 2 Tbsp. of
chopped leaves and steep in 2 cups of boiled water for 15 minutes. Half this amount as
you take it with meals through the day (use 3 1/2 Tbsp. per day).
There are also Sambong pills produced in the Philippines and sold through various
alternative medicine distributors.
For Headache
To use Sambong for headache, simply heat enough fresh leaves over a fire until slightly
wilted. Then pound the leaves a little and place on the forehead and temples. A cloth
bandage may also be used to keep the leaves in place. Change the dressing every four
hours when needed.

ode of .tion:
Sambong works as a diuretic, which means that it removes excess fluid and sodium
from the body through urine. Because excess sodium in the system is known to
contribute to high blood pressure, diuretics are used alleviate the condition.

Indi.ations:
Sambong leaves are known for its ngai or Blumea camphor that is used as herbal
medicine to treat kidney stones, wounds and cuts, rheumatism, anti-diarrhea, anti
spasms, colds and coughs and hypertension. The Philippine Council for Health
Research and Development (PCHRD) has developed the technology for a sambong
herbal medicine tablet.


Contraindi.ations:
Avoid using with other diuretics. When taking diuretics, eat at least one banana a day.
Side and dverse Effe.ts:
There are no known side and adverse effects for this medicine.
ursin Res5onsibiIities:
The use of traditional and alternative medicines in our country has been gaining
popularity a few years ago. One of the most commonly used herbal medicines is
Sambong. As nurses, we should monitor the blood pressure of the client to know if the
sambong has done its role in lowering the blood pressure.
Also, the clients that are or will be using Sambong or any other medicines should be
informed by the student nurse/ nurse that before using any medications, they should
consult with a physician first. This is important especially in cases of misinformed
clients/patients to prevent self-medication.
http://www.ehow.com/about_5608375_uses-sambong-hypertension.html
http://www.medicalhealthguide.com/articles/sambong.htm
http://www.stuartxchange.org/Sambong.html
Conclusion:
A community is comprised of group of families with a certain commonality. A
healthy community consists of healthy families living together in harmony. deal as it
may seem to be, this kind of community can be achieved if true solidarity is present
among the members of the community and particularly within the family and if the
families in this community would work together to bring about a clean and green
environment for them to live. This type of community could also be attained if families
would be well-educated and would promote the well-being of each member. The family,
which is the basic unit of the society, is the community health nursing's target in the
promotion of health care, prevention of disease, simple treatment and rehabilitation. t is
through them that we deliver our services, promulgate our teachings and most
importantly, it is through them that we deliver our tender, loving care.
Reminiscing the things that we have done during the course of our four-week
community duty, we can certainly acclaim that we have done the best of our abilities in
relation to what we have learned in our two-year study in the College of Nursing.
ndeed, it was hard but the experience could have been harder if not for the little
background about good health by the families we were designated in. t was quite a
surprise at first for we have thought that the community that we're going to go was the
type that lacks, if not none, knowledge on health. Despite the hardships, we were able
to instil in them health values that we knew.


Recommendation:
To promote the level of health for the whole citizenry is the goal of Community
Health Nursing. With this in mind, we as student nurses have the responsibility to
promote health by educating the families in the community with all necessary health
theories and make them aware of certain factors in the environment that could affect
their well-being.
To the Ateneo de Davao University College of Nursing:
recommend that to continue to guide the student nurses and help them in
improving their performances related to health care in the community.
To the Community:
recommend that they have to prioritize their health problem and seek immediate
health care if there is health deficit to the family. To use the herbal medicines effectively.