Professional Documents
Culture Documents
Classification of Community
Components of a Community
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o Recreation – recreational activities/ facilities including types of
consumers, appropriateness of recreational activities and consumers.
o Political
o Socio – cultural
o Economics
o Environment
o Health Care Delivery
o Heredity
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CHAPTER 2
VITAL STATISTICS
Vital Statistics
The application of statistical method and techniques to the study of the vital
facts such as these concerning births, deaths and illnesses.
Statistical data which relate to the total numbers of various kinds of biologic
or vital events (like births, illnesses, marriages, divorces/ separations,
illnesses and deaths) to the size and characteristics of the affected
population.
Birth and deaths are registered in the Office of the Local Civil Registrar
of the municipality or city. The Local Civil Registrar of municipality is usually
the Municipal Treasurer or the Municipal Health Officer. In cities, births and
deaths are registered at the City Health Department.
Health Indicators
A list of information which would determine the health of a particular
community like population, crude birth rate, crude death rate, infant and
maternal death rates and to tuberculosis death rate.
Rates – a relation indicating the number of times a certain event occurs when a
certain number of exposures to the risks of occurrence in present in a given
period of time.
Crude Death Rates – is only a rough measure of the force of mortality or the
probability of dying in a population because death rates are largely influenced by
age and sex composition of the population.
Rates – In the Vital Statistics, a rate shows the relationship between a vital event
and those persons exposed to the occurrence of said event, within a given a area
and during a specified unit of time. It is evident that the persons experiencing the
events (the numerator) must come from the total population exposed to the risk of
same event (the denominator).
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These quantities need not necessarily represent the same entities, although the unit
of measure must be the same for both numerator and denominator of the ratio.
Crude or General Rates – These rates are referred to the total living population.
It must be presumed that the total population was exposed to the risk of the
occurrence of the event.
Specific Rates – The relationship is for a specific population class or group. It
limits the occurrence of the event to the portion of the population definitely exposed
to it.
Crude Death Rate – A measure of one mortality from all causes which may result
in a decrease of population.
Infant Mortality Rate – Measures the risk of dying during the 1st year of life. It is a
good index of the general health condition of a community since it reflects the
changes in the environmental and medical conditions of a community.
IMR = x 1000
Total No. of registered live births of same
calendar year
Maternal Mortality Rate – It measures the risk of dying from causes related to
pregnancy, childbirth, and puerperium. It is an index of the obstetrical care needed
and received by the women in a community.
MMR = x 1000
Total No. of live births registered of same year
FDR= x 1000
Total No. of live births registered of same year
Neonatal Death Rate – Measures the risk of dying the 1st month of life. May serve
as index of the effects of prenatal care and obstetrical management on the newborn.
NDR= x 1000
Total No. of live births registered of same year
Specific Death Rate – Describes more accurately the risk of exposure of certain
classes or groups to particular diseases. To understand the forces of mortality, the
rates should be made specific provided the data are available for both the
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population and the event in their specifications. Specific rates render more
comparable and thus, reveal the problems of public health.
Examples:
No. of deaths from a specific cause
registered in a given calendar year .
Cause specific Death Rate = x100000
Estimated population as July 1 in same
specified class or group of said year
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Two methods:
a. By applying observed specific rates to some standard population.
b. By applying specific rates of standard population to corresponding classes or
groups of the local population.
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CHAPTER 3
1. Welfare Approach
The immediate and or spontaneous response to ameliorate the
manifestation of poverty, especially on the personal level.
Assumes that poverty is God – given, destined. Hence the poor should
accept their condition since they will receive their just reward in.
Believes that bad luck, natural disasters and certain circumstances
that are beyond the control of people cause poverty.
2. Modernization Approach
Also referred to as the project development approach.
Introduces whatever resources that are lacking in a given community.
Focuses as technological approach.
Also consider a national strategy which adopts the western mode of
technological development.
Assumes that development consists of abandoning the traditional
methods of doing things and must adopt the technology of industrial
countries.
Believes that poverty is due to lack of education, lack of resources
such as capital and technology.
The Philippine Center for Population and Development in its effort to support the
Department of Health in the implementation of Primary Health Care (PHC) designed
the Health Resource Development Program (HRDP) to enable the health training
institutions e.g. schools of medicine, nursing and midwifery to effectively implement
their community – based health programs. HRDP sees Community Organizing (CO)
as a tool for people’s empowerment to health. It is used to generate community
participation and involvement in health activities and to prepare communities to set
up their own health programs.
DEFINITION OF COPAR
A social development approach that aims to transform the Apathetic,
Individual, Voiceless poor into dynamic, participatory and politically
responsive community.
This is also a collective, participatory, transformative and systematic process
of building people organizations by mobilizing and enhancing the capabilities
and resources of the people for the resolution of their issues and concerns
towards effecting change their existing oppressive and exploitative
conditions. (1994 National Rural CO Conference)
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A process by which a community identifies its needs and subjective,
develops confidence to take action in respect to them and in doing so extends
and develops cooperative and collaborative attitudes and practices in the
community. (ROSE 1967)
A continuous and sustained process of educating with people to understand
and develop their critical awareness of their existing conditions working with
the people collectively and efficiently on their immediate and long – term
problems, and mobilizing the people to develop their capability and readiness
to respond and take action on their immediate needs towards solving their
long – term problems, but not making them as subjects of research but rather
participants or co – researchers. (CO: A Manual of Experiencing PCPD)
Transformation of force, that enables the individuals, families, communities
to be responsible for their own health.
A phenomenon of interest goals and objectives at the health care worker and
the people in their way to health citizenry.
IMPORTANCE OF COPAR
1. COPAR is an important tool for community development and people
empowerment as this helps the community workers to generate community
participation in development activities.
2. COPAR prepares people / client eventually take over the management of a
development program in the future.
3. COPAR maximizes community participation and involvement.
4. COPAR mobilized community resources for community services.
PRINCIPLES OF COPAR
1. People, especially the oppressed and exploited sectors are most open to
change and are able to bring about change. Along this line, community
organizations should be based on the following:
a. Power must reside in the people – participation indicate power to
cooperate in order to have a good result.
b. Development is from the people to the people – progress is in the
hands of the people.
c. People’s participation should always be present – participation is
essential elements in COPAR.
2. COPAR should be for the interest of the poorest sectors of the society. The
solutions of problems commonly shared by these sectors must be focused on
collective organizations, planning and actions.
3. COPAR should lead to self – reliant community and society.
2. Consciousness – Raising
Through experimental learning is central to the COPAR process because it
places emphasis on learning that emerges from concrete action and which
enriches succeeding action.
1. Integration
A Community Organizer becoming one with the people in order to:
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a. immerse himself in the poor community.
b. understanding deeply the culture, economy, leaders, history and
lifestyle in the community.
METHODS OF INTEGRATION
a. Participation in direct production activities of the people like
planting, harvesting, fishing, and broom making.
b. Conduct of house to house visits.
c. Participation in social activities such as birthday parties, weddings,
fiestas, wakes, seasonal rituals and others. Community workers
nowhere should refrain from drinking. While drinking is an effective
strategies in integrating with male residents, excessive drinking has a
negative effect on the community worker’s reputation.
d. Conversing with the people where they usually gather such as stores,
water walls, washing streams and in churchyard.
e. Helping out in household chores like cooking, dishwashing,
cleaning the house etc.
2. Social Investigation
A systematic process of collecting, collating and analyzing data to draw a
clear picture of the community.
Also known as Community Study.
POINTERS FOR THE CONDUCT OF SOCIAL INVESTIGATION
a. Use of survey questionnaire is discouraged.
b. Community leaders can be trained to initially assist the community
worker/organizer in doing social investigation.
c. Data can be more effectively and efficiently collected through
informal methods (house to house visits, participating in
conversing in jeepneys and others)
d. Secondary data should be thoroughly examined because much of the
information might be available.
e. Social Investigation is facilitated is the Community Organizer is
properly integrated and has acquired the trust of the people.
f. Confirmation and validation of community data should be alone.
4. Ground working
Going ground and motivating the people on a one on one basis to do
something on the issue that has been chosen.
5. Group Meeting
People collectively ratifying what they have already decided individually.
The meeting gives the people the collective power and confidence.
Problems and issues are discussed.
7. Mobilization or Action
Actual experience of the people in confronting the powerful and the actual
exercise of people power.
8. Evaluation
The people reviewing the steps 1-7 so as to determine whether they were
successful or not in their objectives.
9. Reflection
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Dealing with deeper on going concerns to look at the positive values
Community Organizer is trying to build in the organization.
It gives the people time to reflect on the stock reality of life compared to the
ideal.
10. Organization
The People’s Organization is the result of many successive and similar
actions of the people.
The final organizational structure is set – up with elected officers and
supporting members.
The steps in building organizations are done in all or any of the phase
of the COPAR process.
Their application and the specific strategies and purpose may vary
slightly depending on the phase of the process it is applied.
PHASES OF COPAR
2. Entry Phase
Sometimes called the Social Preparation Phase as it is the activities done.
This phase includes the sensitization of the people on the critical events in
their life, motivating their to share their dreams and ideas on how to manage
their concern and eventually mobilizing them to collective actions on those
concerns this signals the entry of the community organizing.
This phase signals the actual entry of the community worker / organizer into
the community.
ACTIVITIES:
1. The sensitization of the people on the critical events in their life.
2. Motivating them to share their dreams and ideas on how to manage
their concerns.
3. And eventually mobilizing them to take collective action on these.
GUIDELINES FOR ENTRY INTO THE COMMUNITY
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a. Recognize the role of the local authorities by paying, them visits to
inform them of your presence and to orient them on the project
objectives.
b. One’s appearance, speech, behavior and lifestyle should be in keeping
with those of the community residents without disregard of there
being role models.
c. Avoid raising the expectations/consciousness of the community
residents by adopting a low key profile and approach. (Not to higher
the levels of expectations.)
METHODS OF ENTRY PHASE
a. House to house visits.
b. Participation in social activities.
c. Converse people in their usual gatherings.
d. Participate in livelihood activities.
e. Participate in household chores.
STRATEGIES:
1. Education and training.
2. Networking and linkaging.
3. Conduct of mobilization on health and development concerns.
4. Implementation of livelihood projects.
5. Developing secondary leaders in the community.
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Problem Identification is
jointly undertaken by the
people who are actors in
the situation and by the
researcher who is
initiating the research
process.
CHAPTER 4
1. RECODER / DOCUMENTATION
Responsibilities:
a. Keeps a written account of services rendered observations of the
conditions of the client, the needs and problem the attitude of the
client with the community.
b. Records our development changes – accomplishments of the
health care providers and the client accomplishments.
2. REPORTER
Responsibilities:
a. Disseminate any information which are necessary for the client in the
community.
b. Disseminate any information to the appropriate authority or any
agencies.
b. Reports
Refers to periodic summarizes of the services and activities
rendered to the community.
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Schedule of Health Center.
Schedule for laboratory.
d. Train people in making reports.
Encourage with people to report in the Health Center.
e. Assist people in research and community development activity.
Is one who provides basic community health care services for promotion of
health, prevention of illness, simple treatment and rehabilitation, the services
rendered utilize the a goal or objectives, content, method and skills used in
Primary Health Care and has a qualities of a good Health Worker.
a. OPEN
Accepts needs of joint planning and decisions relative to health care in
particular situation not resistant to changes; open to suggestions and
criticism.
b. TACTFUL
One who presides over an assembly meeting or discussion in a subtle
manner; does not embarrass but gives constructive criticisms; has good
diction, proper choice of words.
c. OBJECTIVE
Gives fair judgment, no biases.
Unbiased and fair in decision making; no favoritism.
d. GOOD LISTENER
Attentive always available for the participant to voice out their sentiments
and needs, listening is the key to good assessment; open to ideas; has
empathy.
e. EFFICIENT
Knowledgeable about everything relevant to his/her practice; has the
necessary skills expected from him/her.
f. FLEXIBLE
Able to cope with different situation.
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Carries out health services contributing to the promotion of health,
prevention of illness, early treatment of illnesses and rehabilitation.
Appraises health needs and hazards.
2. EMPOWERING AGENT
Emphasis on the active role of the client in all aspect of care include client in
all aspects of care.
3. COORDINATOR
Brings into consonance or harmony the community’s health care activity; one
goal / common goal.
4. FACILITATOR
5. HEALTH COUNSELOR
6. CO – RESEARCHER
Provides health with stimulation necessary for a wider or ore complex study
or problem.
Enforces community to do prompt and intelligent reporting of epidemiologic
investigation of diseases.
Suggest areas that need research.
Participates in planning for the study and in formulation procedures.
Assist in the collection of data.
Helps interpret findings.
Acts on the result of the research / study.
7. MEMBERS OF A TEAM
In operating within the team, one must be willing to listen as well as to
contribute to teach as well as to learn, lead as well as to follow to share
authority as well as to work under.
Helps make multiple services which the family receives in the course of
health care. Coordinated, continuous and comprehensive as possible.
Consults with and refers to appropriate personnel for any other community
services.
8. ADVOCATOR
Representative of the client.
Act as referral agent and assist client in obtaining the care deserve in the
patient.
9. HEALTH EDUCATOR
Primary responsibility of Community Health Nurse.
Is one who improves the health of the people by employing various methods
or scientific procedures to stimulate arouse and guide people to healthful
ways of living.
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3. Communication – exchange of information.
TRAITS AND QUALITIES OF A HEALTH EDUCATOR
1. Efficient
Plans with a people according to the needs of the client or community.
Knowledgeable about everything relevant to his practice; has the necessary
skills expected of him.
3. Good listener
Hears what’s being said and what’s behind the words.
Always available for the participant to voice out their sentiments and needs.
4. Keen observer
Maintain eye to eye contact.
Keep an eye on the proceedings, process and participants’ behavior.
5. Systematic
Put into sequence, how to arranged the activity.
Knows how to put in sequence or logical order the parts of the session.
6. Creative and Resourceful
Use any available resources and evolve participants in the discussion.
7. Tactful
Brings about issues in smooth subtle manner.
Does not embarrass but gives constructive criticisms.
8. Good Sense of Humor
Knows how to place a touch of humor to keep audience alive.
9. Knowledgeable
Have to knowledge relevant.
10. Open
Inviting the client to give their reaction, and share, ideas and criticism.
Involves people in decision making.
Accepts need for joint planning and decision relative to health care in a
particular situation; not resistant to change.
In making decisions about methodologies, the health educator has to choose specific
methods that will bring about the desired output and the technique should:
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BASIC SKILLS IN FACILITATING
METHODS SHOWED
a. Generate active participation of the learner.
b. Provide guide feedback.
c. Facilitate transfer of learning to on – the – job situation.
B. Preparation of IEC materials
Blackboard, chalk, pad paper, hand – outs.
C. Uses of a Teaching Plan
List of steps and activities and equipments needed in health education
session.
A lesson should be planned by having an outline of what is to be
taught and the methods to be used.
Time allocation for various activities should also be included.
SESSION DESIGN
Document which contains the rationale, objectives, subject matter / topic,
methodology and resources to be used during the health teaching.
Topic: _____________________________
Goal: _______________________________________________________________________________
Venue: _____________________________________________________________________________
Participants: _______________________________________________________________________
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After __
hrs. of
lecture
Manpower,
discussion
Internet,
the client
Books, Parameters
will be
Magazine,
Lecture of Question
able to: Tapes / film
Discussion / ___ and Answer
1.) -------------- showing,
min. Mr. _______ /
-------------- Role Play/ / Open
Multi Ms. ________
--------------
Forum
2.) -------------- media,
--------------
Money,
--------------
-------------- Facilities.
--------------
--------------
--------------
Conflict
To come into opposition neither weapons as in battle physically as in children’s
round and tumble or verbally as quarrel between two persons. Ii is due to
different ideas, viewpoint and opinion.
Conflict Management
Employing various strategies appropriate for the situation in order to solve with
conflict.
a. Know clear definition of your responsibilities.
b. Know the different needs of the individual.
THREE WAYS OF HAND LI NG C ONFLI CT
MY PROPOS AL
Open
Surrender Fighting Back confrontation
Distract Escalation of Communication
Suppressing feelings of anger Sort out ideas,
Differences Distortion of feelings
Denial perception Brainstorming 4d
Sickness sol’n
Fragmentation Resolution of
conflict
Through
resolution
17 through growth
Increase options.
Total suppression of differences will lead to physical and psychological
sickness.
1. Competition
2. Rivalry
3. Communication Barriers
4. Cultural differences
5. Different values and need
6. Lack of respect
1. Isolation (ignored)
2. No feedback recognition
3. Negative feedback (criticism)
4. Favoritism
5. Mix messages
6. Lecturing or talking by
7. Unrealistic dead limit / giving irrational order
8. passive aggression (pretending)
9. Personal put down (harsh negative criticism)
10. Breaking Promises
11.Threatening
12.Attacking
TYPES OF CONFLICT
1. Intrasender
Originates in the sender who gives conflicting instructions.
2. Intersender
Arises when an individual receives conflicting message from two or more
sources.
3. Interrole
Occurs when an individual belongs to ore than one group simultaneously,
have multiple role within the some organization.
4. Person role
The result of disparity between internal and external role.
May occur when one’s values, needs or capabilities were incompatible
with the role requirement.
5. Interperson
Common among people whose positions require interaction with other
person who has various roles in the same organization or other
organizations.
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6. Intragroup conflict
Occurs when the group faces a new problem.
7. Intergroup
Common where two groups have different goals and can achieve their
goals only at the others expensive.
8. Role Ambiguity
Condition in which individual don’t know what is expected of them.
Reason:
a. Inadequate job description.
b. Incomplete explanation of assigned tasks.
c. Rapid technological change.
1. Avoiding
A strategies that allows conflicting parties to calm down.
Can be used when issue is not critical.
Also appropriate when the other party is more powerful the issue is
important.
When one has no chance of meeting the goods or the cost of dealing with
the conflict is higher than the benefit of the resolution.
Also appropriate when one wishes to reduce tension and gain composure.
Create a lose –lose situation thru unassertive and uncooperative means.
2. Accommodating or Cooperating
Cooperative but unassertive.
Creates a win – lose situation.
Self – sacrificing - one neglects one’s own needs to meet the goals of the
other party.
Appropriate if the opponent is right more powerful, the issue is more
important to someone else.
3. Competing
Power oriented mode that is assertive but cooperative.
Appropriate when the person is very knowledgeable about.
Opposite of Accommodating = one is aggressive and pursue ones.
4. Comprising
Moderates both assertiveness and cooperation.
Result to lose – lose situation.
5. Collaborating
Assertive and cooperation.
It contributes to effective problem solving.
Requires mutual respect open and honest communication and should
decision making process.
Problem are identified, alternatives explored ramification considered
until difficulties are resolved.
Most effective method in dealing conflict.
Resolution, creates a win – win situation.
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Since the anger and resentment of the loser does not disappear but
simply goes underground to emerge later as “Backlash”
CHAPTER 6
STEPS:
1. COMMUNITY ASSESSMENT
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EXAMPLE OF DATA TO BE GATHERED
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Are within the competence of the implementor / community / care
provider; are accepted and understood by them; are within the
available potential time and resources.
Home visits
Conferences / Demonstrations
Health Service Delivery
Group discussion / Education
Information Dissemination
Self – evaluation
Peer evaluation
Evaluation by superior
Analysis of statistical reports
Use of standards
Records of tests
Case discussion
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Action – Reflection – Action Session (ARAS? ARFA)
3. PROGRAM IMPLEMENTATION
CHAPTER 7
Fertility
Refers to the ability of the body to reproduce, to create and sustain new life.
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It involves a cognitive decisions and behavioral practices that enable a
woman to have a wanted pregnancy and avoid an unwanted pregnancy
Family Planning
Should provide:
1. Contraceptive Education
2. Genetic Counseling
3. Infertility Counseling
4. Methods of Fertility Enhancement
5. Information regarding Alternatives (assisted) Birth Technologies
and Adoption Assistance
1. Identifying, Counseling and when appropriate making referral for clients who
are in need of information. About Family Planning and its services.
2. Provide and interpreting Family Planning instructions, information and
resources.
3. Contributing to the development of new methods, services and programs as
well as evaluating existing ones.
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1. Abstinence – refraining
2. Coitus interuptus – withdrawal
3. Periodic Abstinence
1. Calendar Method
2. Basal Body Temperature (BBT)
3. Cervical Mucus Method
4. Symptothermal Method
WITHDRAWAL
Is also called Coitus Interuptus.
The man with draws his penis from a woman’s vagina before he ejaculates so
that the sperm released from his penis does not enter her vagina.
There are problems with using withdrawal as a contraceptives method. First,
a man may release sperm before he has an orgasm.
LOCAL BARRIERS
Barriers methods of contraception are methods that prevent sperm entering
the reproductive system spermicides that immobilize and kill sperm, used in
conjunction with barrier methods, provide enhanced protection against
STD’s and increase protection against pregnancy.
1. Male Condom
Most widely used birth control device in the UN and in the world.
Shaped like a finger the condom is inserted over the erect penis before
intercourse.
This can be done by with man by woman.
A half – inch space or the pocket should be left at the end to collect the
ejaculate and to prevent the condom from tearing during ejaculation.
To prevent spilling sperm into the vagina after intercourse the man
should hold onto the condom as the penis is carefully with drawn.
Do not use petroleum gel.
ADVANTAGES:
DISADVANTAGES:
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MOST PROTECTIVE CONDOM – are those inside of latex.
2. Female Condom
A combination of a diaphragm.
It is soft relubricated.
ADVANTAGES:
DISADVANTAGES:
3. Diaphragm
An ordinary spring
A flat or Wide – Seal spring
Coil spring
4. Cervical Caps
ADVANTAGES:
Easy to use
Inexpensive
Do not dull sexual sensation and help prevent STD
Diaphragm and Caps however, must be fitted by a physician or
technician are available only by prescription.
DISADVANTAGES:
SAFETY:
Not all women can be fitted satisfactorily; they may need to be
refitted after pregnancy because of changes is cervical size.
To health Care Provider should check the woman’s ability to insert
and remove these devices correctly.
Prescriptions should be limited to woman without pap smear.
5. Vaginal Spermicides
ADVANTAGES:
DISADVANTAGES:
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Also associated with an increased incidence of candidiasis.
Couples feel uneasy.
DOUNCHES
Vaginal irrigations are not a reliable means of contraception, even when
spermicides are used in the douching solution.
Sperm may enter the cervix as soon as 15 seconds after ejaculation.
As a Nurse what Genetic Counseling will you advise to couples who have
unwanted pregnancy is abnormal.
RESPONSIBLE PARENTHOOD
Promote the basic needs of his / her family morally, spiritually, financially,
and emotionally.
Involves adequate performance of parents.
Adjust and adapt where they are living.
GENETIC COUNSELING
Consists of one or more encounters with the problems and their families with
the objective or providing information about their genetic disease.
a. Counselor must work with grief and anticipatory grief issues with the
knowledge of a potentially negative outcome a amount of hope and denial
usually prevails until the birth of the affected child brings family back to
reality.
b. Prevents knowledge that they are biologically responsible for their child
condition is a burden often too.
Genetic Counseling will start when the physician have the diagnoses
about the condition of the baby.
o A Physician
o Geneticist Consist of one or more encounter
with the family with objectives of
o Nurse providing information about them
o Psychologist genetic disease.
o Medical Specialist
PROBAND
a. The risk of figure, options, provide and framework for a course of action
taken by the individual, family and psychosocial family dynamics.
b. The information includes risk figure, options, and provides a framework
disease in question.
c. Typically Genetic Counseling process begins when a clinician refer a family
with a genetic disease has been identified its heavy to carry without
emotional damage.
INFERTILITY
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Two Types:
40% = Woman
40% = Men
10% = Both
10% = Undetermined
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