CHAPTER V

Problem Identification

This chapter includes the list of problems together with the corresponding score and rank
identified by the student nurses together with the family.

A. List of Problems Identified

RANK PROBLEM SCORE

Presence of Coughs and

1 3.5
Colds

2 Family Size beyond What 2.5

Family Can Adequately
Provide

3 Improper Drainage System 2.34

4 Presence of Dental Caries 2

5 Poor Home Condition: Poor 2
Lighting

6 Poor Home Condition: 2

Inadequate Ventilation

7 Poor Environment Condition: 1.67

Improper Garbage Disposal
Problem #1: Presence of Coughs and Colds

CRITERIA COMPUTATION SCORE JUSTIFICATION

1. Nature of the Problem 3/3 x 1 1 It is considered as a health deficit

because it signifies failure to maintain the
optimum level of health of the family. This
health problem requires an immediate
attention to avoid the transfer of the
disease to the family members and to
prevent further complications such as
Pneumonia.

2. Modifiability of the 2/2 x 2 1 The problem is easily modifiable.

Problem
Current Knowledge Mother Hershey is
knowledgeable enough on how to
 current
alleviate the problem,
knowledge
 family Family Resources Mother Hershey treats
resources the problem by increasing the children’s
fluid intake.
 nurse
resources Nursing Responsibilities Adequate

 community knowledge and skills to carry out proper

interventions are needed to help the
resources
family specifically Ruth and Baby Choco.
The student nurses provided health
teachings such as increasing fluid intake
and to constantly give Vitamin C rich
foods to increase resistance. Right
information was also supplemented to the
mother with regards to proper care during
this situation.

Family Resources The health center has

services such as free consultation.

3. Preventive Potential 3/3 x 1 1 It has moderate preventive potential.

Severity The problem can be eradicated

 severity/
if proper management is done and
 gravity attention is given. It is not yet severe
 duration since no other complications arise such
 current as Pneumonia.
management
 exposure of Duration Illness lasted only for a short
high risk time.
groups
Current Management Mother Hershey
provides medication to treat the problem.

Exposure of High Risk Group Only Ruth

and Baby Choco are affected by the
problem. However, all may be afflicted at
any time if no interventions will be
initiated. There is an easy transmission of
pathogen since all family members sleep
and eat together and it is also aggravated
by the poor ventilation in the house.

4. Salience 1/2x 1 0.5 The family considered it as a problem yet

they did not do immediate actions to
intervene it.

TOTAL 3.5
 Problem #2: Family Size beyond What Family Can Adequately Provide

CRITERIA COMPUTATION SCORE JUSTIFICATION

1. Nature of the It is considered a health threat because the
problem 2/3 x 1 0.67 family is unable to meet the body
requirements and cannot provide the health
needs of each member because of
inadequate financial resources, further
complications may arise.
2. Modifiability of the The problem is partially modifiable.
Problem 1/2 x 2 1
Current Knowledge The family is aware

 current that their family resources are not enough

knowledge to meet the basic needs of the family, like

 family Mother Hershey who has difficulty
resources budgeting their daily allowance because of
 nurse inadequate income being received by
resources Father Cadbury. In this case not all needs
 community of each family member are met.
resources
Family Resources - The family is not able
to provide the adequate nutrition that they
need due to financial constraints. The
budget of the family for food is not enough
to accommodate all the nutritional needs of
each family member.

Nurses’ Resources- The student nurses

can provide health teachings such as
budgeting, saving electricity and water
consumption and buying food which are
cheaper but nutritious to our body.

Community Resources - The community

does not have programs that can help the
family with the problem.

3. Preventive The problem is considered to be low

Potential 1/3 x 1 0.33 preventive.
  severity/ Severity The problem is severe because
the amount of money being allocated for
gravity
 duration each individual is insufficient to sustain the
current physical and health needs of each family
managem member.
ent
 exposure Duration The family had this problem for a

of high long period of time.

risk
Current Management Although the father
groups
is working, his income is not enough to
provide the adequate needs of the whole
family.

Exposure to High Risk Group The

children are at high risk because they
cannot meet their needs, such as nutritious
food for their growth.
4. Salience The family recognized the problem but they
1/2 x 1 0.5 do not feel the need of immediate attention
because they cannot find any other means
in order to find solution to the problem.
TOTAL 2.5
Problem # 3: Improper Drainage System

CRITERIA COMPUTATION SCORE JUSTIFICATION

1. Nature of the Problem 2/3 x 1 0.67 The problem is a health threat. It

can contribute to the breeding sites
for microorganisms and mosquitoes
which could bring about diseases
or illnesses such as dengue. Their
drainage system is open and dirty
which can really foster the
presence of these vectors.

2. Modifiability of the 1/2 x 2 1 The problem is partially modifiable

Problem because:

 current Current knowledge, technology

knowledge and intervention The family lacks

 family knowledge and interventions in this
resources problem. They do not do anything
 nurse about it and just let it as it is.
resources
Resources of the family Family
 community resources are available like
resources broomstick and manpower. It
depends on how the family will
utilize the specified resources.

Resources of the nurse The

student nurses gave health
teachings regarding the possible
effects and problems that may arise
from having an open drainage
system. They also explained that it
can contribute to the breeding sites
for microorganisms and
mosquitoes.

Resources of the community The

health center does not provide any
program regarding with this
 problem.

3. Preventive potential 2/3 x 1 0.67 The problem has a moderate

preventive potential because:
severity/
gravity Gravity or severity of the
 duration problem It is not severe since
 current there is no disease that happens to
management the family related to this problem.
 exposure of
high risk Duration of the problem The
groups family has an open drainage
system since the student nurses
met the family. Also, according to
Mother Hershey, their drainage has
been like that ever since they live
there.

Current management There is no

current management being done by
the family because they do not
perceive it as a problem.

Exposure of any high risk group

All family members are at risk to
acquire the disease coming from
open stagnant drainage since they
are all exposed to the problem,
especially the children who belong
to a high risk group. This, in turn
increases the problem’s preventive
potential.

Salience 0/2 x 1 0 The family does not recognize it as

a problem. The family is used to
having an open drainage because
they do not see it as a threat to
their health or safety so they do not
perform any actions about it.
Total 2.34
 Problem #4: Presence of Dental Caries

CRITERIA COMPUTATION SCORE JUSTIFICATION

1. Nature of the Presence of dental caries is considered a
problem 3/3 x 1 1 health deficit since the occurrence of such
is considered failure to maintain a healthy
life. Dental caries, also known as tooth
decay, where bacterial processes damage
hard tooth structure (enamel, dentin and
cementum). These tissues progressively
break down, producing dental cavities
(holes in the teeth). If left untreated, the
disease can lead to pain, tooth loss and
infection.
2. Modifiability of The problem is considered as moderately
the Problem 1/2 x 2 1 modifiable.

Current Knowledge- Though technology,

made to manage such disease is present;
the family has some general knowledge
about the disease and management.

Family Resources- The family does not

have allotted money for this problem.

Nurse Resources- The student nurses’

time, skill, knowledge – health teachings
are also great factors for modifying the
problem. The group’s provision of health
teachings such proper oral hygiene is
necessary to prevent the occurrence of
the disease.

Community Resources- The community

does not provide a free dental check-up.
3. Preventive The problem has a low preventive
Potential 0/3 x 1 0 potential.

Severity- The problem has a low

  severity/ preventive potential when it comes to
gravity/severity because it already caused
gravity
 duration damaged to the teeth.
 current
management Duration- The duration has a low
 exposure of preventive potential since it has been
high risk present for a long period of time.
groups
Current Management- No current
management is being done with the
disease because of financial problem.

Exposure Of High Risk Groups- There

is a high exposure of high risk group,
though, it is not communicable, only Ruth
were noted to have dental caries.
4. Salience The problem for the family is not a
0/2 x 1 0 felt/need problem due to the fact that the
family lacks the knowledge of the problem
and its possible effects.
TOTAL 2
 Problem #5: Poor Home Condition: Poor Lighting

CRITERIA COMPUTATION SCORE JUSTIFICATION

1. Nature of the The problem is considered a health threat
problem 2/3 x 1 0.67 because the family members are prone to
injuries due to difficulty to see objects
along their way, especially at night. They
can also develop eye problems in the
future brought about by poor lighting.

2. Modifiability of The problem is considered as partially

the Problem 1/2 x 2 1 modifiable.

Current Knowledge The family is not

 current aware of the existence of the problem and

knowledge the complications that can be brought

 family about by the inadequacy of lighting. There
resources are no interventions made by the family to
 nurse reduce the problem.
resources
 community Family Resources The Chocolate family
resources lack financial resources to purchase
additional lighting source but they can
make use of candles and improve their
window to allow passage of light

Nurse Resources The student nurses

can help the family in improving their
lighting by suggesting alternatives and
teaching them ways to prevent accidents
or eye problems that may result from poor
lighting.

Community resources- There are

electrical supply in the community and the
house has an electric line. The family can
make use of light bulbs as source of light
 especially at night.

3. Preventive The problem has a moderate preventive

Potential 2/3 x 1 .67 potential.

 severity/
Severity The severity is not that high
gravity
 duration since there have not been accidents that
current resulted from poor lighting. The family
managem also still manages to do their activities of
ent daily living.
 exposure
of high Duration The problem existed since they

risk transferred to the house.

groups
Current management The family did not
have any interventions to manage the
presence of inadequate lighting.

Exposure to High Risk Group The

whole family, especially the children is
prone to injuries since objects in the
house may not be very visible at night.
4. Salience The family does not consider it as a
0/2 x 1 0 problem, since they are not doing any
management to reduce the presence of
the problem.
TOTAL 2
 Problem #6: Poor Home Condition: Inadequate Ventilation

CRITERIA COMPUTATION SCORE JUSTIFICATION

1. Nature of the It is categorized as health threat because
problem 2/3 x 1 0.67 inadequate ventilation will impede the
proper circulation of air so as to freshen
and purify, the circulation of air will be
inadequate that may lead to inadequate
exchange of gases in the respiratory
system for normal breathing pattern. Thus
the organism that can cause Upper
Respiratory Tract Infection is easily
transferred to another member of the
family.
2. Modifiability of The problem is considered as non
the Problem 1/2 x 2 1 modifiable.

Current Knowledge This could also fall

 current with their problem in financial constraints

knowledge their income is only sufficient for their

 family basic needs that’s why they could not
resources allocate for the maintenance of their
 nurse house.
resources
community
Family Resources- The family lack
resources
material resources to improve the
ventilation of their house due to lack of
financial resources.

Nurses’ Resources- The Student Nurse

can inform the family about the
importance of adequate ventilation. The
Student Nurses can provide alternative
ways or suggestions in improving the
problem.

Community Resources- The community

can monitor the housing conditions
through survey and inspection; However,
 the barangay is lacking with programs to
be implemented due to lacking of funds.

3. Preventive The problem has a low preventive

Potential 1/3 x 1 0.33 potential.

 severity/
Severity The problem is considered
gravity
 duration severe because some of the family
current members already acquired airborne
managem diseases such as cough and colds.
ent
 exposure Duration The problem has been present

of high in the family ever since they live there.

risk
Current Management The family does
groups
not have enough financial and material
resources to improve the ventilation in
their house.

Exposure to high risk group All of the

family is at high risk of acquiring the
disease such as cough and colds. These
diseases are easily transmitted because
the family is having inadequate ventilation.

4. Salience The problem was not felt by the family due

0/2 x 1 0 to lack of knowledge and financial
constraints.
TOTAL 2
 Problem # 7: Poor Environment Condition: Improper Garbage Disposal

CRITERIA COMPUTATION SCORE JUSTIFICATION

1. Nature of the Improper garbage disposal is a health
problem 2/3 x 1 0.67 threat for it poses a high risk for an
occurrence of disease through harmful
microorganisms it may also contribute to
air pollution, thus, preventing the family
from maintaining wellness.
2. Modifiability of The problem is considered as non
the Problem 1/2 x 2 1 modifiable.

Current Knowledge The family is not

 current aware of the existence of the problem and

knowledge the complications that can be brought

 family about by the improper garbage disposal.
resources There are no interventions made by the
 nurse family to reduce the problem.
resources
community
resources Family Resources Insufficient knowledge
on proper disposal of garbage and
availability of material in disposing
garbage.

Nurse Resources The student nurses

were able to impart the possible
consequences if the problem continues to
exist like it can contribute to air pollution
and were also able to give information and
assist on proper garbage disposal like
proper segregation of garbage, covering
of garbage and recycling if usable things.

Community resources The community

does not have any program on the proper
collection of garbage in the community.
 3. Preventive The problem has a low preventive
Potential 0/3 x 1 0 potential.

 severity/
Severity The severity is high since there
gravity
duration have not been no interventions done to
current
solve the problem.
managem
ent Duration The duration is already a long
 exposure one, making the preventive potential low.
of high
Current management The family did not
risk
have any interventions to manage the
groups
proper elimination of garbage.

Exposure to High Risk Group All

members of the family are affected.
4. Salience This is not perceived by the family as a
0/2 x 1 0 problem due to the lack of knowledge and
because they are used to dump their
garbage of stream dump site.
TOTAL 1.67

CHAPTER VII
Family Coping Index
The Family Coping Index (FCI) was developed as a tool for practice, as an approach to

identifying the family need for nursing care and assessing the potential for behavioral changes,

and as a method of determining in a more systematic way in which the nurse can help the family

to manage. This index continues to be used today as a relevant method of evaluating a family’s

ability to cope with life’s daily challenges.

INITIAL FINAL JUSTIFICATION

1 3 5 1 3 5
1. Physical
Independence Mother does not pay attention
on the grooming of her
children, during the initial visit
the student nurses noticed
that the children are not well
groomed.

All the family members are

now receiving proper care
from their mother. Mother is
assisting her children to take
a bath as well as to combing
their hair and now wearing
clean clothes.
3. Therapeutic Mother does not give any
Competence medication nor render any
interventions in order to
alleviate the disease of her
children since she is not
knowledgeable enough to
what medication to be given.
Family carries out some
measures in treatment of
members that are sick, but
not all of them. Mother is able
to let the sick family member
to rest and increase water
intake, but can’t provide
necessary medications.
5. Knowledge of Mother has few general
Health knowledge of her children’s
Condition disease but does not know
the cause of the disease and
what medication to be given.
Mother is knowledgeable
about her children having
fever but does not know how
 it came about.

7. Application of The family diet is inadequate

Principles of to their nutritional needs and
Personal and their house is infested w/
General rodents and other vectors of
Hygiene diseases.
The family learns to clean
their house properly
especially the sites where
rodents and roaches lives, but
still, the nutrients that they
receive are inadequate.
9. Health Care The Family believes that
Attitudes health care is essential but
they lack financial means to
avail these services
The family understands the
need for medical care and are
confident with the health care
members but they do not
prioritize their health since
they lack financial means.
11. Emotional The family chooses to go to
Competence the health center though there
are not enough medications
to be given because they
can’t afford the cause of
medical care.
Family members are doing
well but they are not able to
plan for foreseeable
emergencies such as
members getting sick.

13. Family Living The family is dominated by

Patterns only one person – the father
 since he is the bread winner
of the family.
The father and mother share
the responsibility of decision-
making.
15. Physical Their house needs a lot of
Environment repairing and has poor
ventilation, lighting and
sanitation.
Their house needs a lot of
repairing and has poor
ventilation, and lighting.
Sanitation is no longer a
problem because the family
understands the importance
of a clean home environment
and thus, they frequently
clean the house.
17. Use of The family seldom participate
Community if there are available free
Facilities clinics because the health
center is far from their home,
and also because no one will
be left at home to look after
the house and the children,
also they lack of education/
knowledge about the
privileges that they can get
from these facilities; the brgy.
health center only offers free
vaccines for limited groups of
people e.g. pregnant, babies
The family is still an active
participant if there are
available free clinics and are
now more knowledgeable
about the privileges that they
can get from these facilities;
the Brgy. Health Center only
offers free vaccines for limited
groups of people e.g.
pregnant, babies.