The Family Health Nursing Process

Nursing Process in Family Health

 Reflect sequential progress, interdependent and overlapping

in their execution
 Sequence of Activities in FHN
 Establishes a working relationship with the client
 Conducts an initial assessment
 Categorizes Health Problems
 Determine the nature and extent of the family’s performance of
the health tasks on each of the health problems
 Determine priorities among the list of health problems
 Ranks health problems according to priorities.
 Decides on what problems to tackle in the order of
immediacy/urgency
 Defines nursing objectives in realistic measurable terms
 Plans approaches, strategies of action
 Implements the nursing care plan
 Evaluates the effectiveness of the interventions
 Re-defines nursing problems and re-formulates
Initial Data Base for Family Nursing Practice
Family Structures, Characteristics & Dynamics
 Members of the household and relationship to the head of the

family

 Demographic Data or Rank in the family

 Place of residence of each member

 Type of family structure and government

 Dominant family members in terms of decision making in

matters of health care

 General family relationship/ dynamics

Socio-Economic & Cultural Factors
 Income and Expenses

 Educational attainment of each

member
 Ethnic Background and
Religious Affiliation
 Significant Others

 Relationship of the family to

larger community
Home and Environment
 Housing

 Kind of neighborhood

 Social & Health facilities available

 Communication & Transportation Facilities Available

Health Status of Each Family Members
 Medical & Nursing history

 Nutritional Assessment

 Developmental Assessment

 Risk Factor Assessment

 Physical Assessment

 Results of Diagnostic or Laboratory Tests

 Values, Habits, Practices on Health Promotion,
Maintenance and Disease Prevention

 Immunization

 Healthy lifestyle practices

 Adequacy of rest and sleep,

exercise and use of protective

measures

 Use of promotive-preventive

health services
Typology of Nursing Problems
FIRST LEVEL ASSESSMENT
1.Wellness Condition

 Wellness Potential
 A nursing judgment on wellness state or condition based on client’s
performance, current competencies or clinical data BUT NO explicit
expression of client desire.
 Readiness for Enhanced Wellness
 A nursing judgment on wellness state or condition based on client’s
performance, clinical data and explicit expression of desire to achieve a
higher level of state or function in a specific area on health promotion
and maintenance.
 FIRST LEVEL ASSESSMENT
2. Health Threats
 Family history
 Threat of infection
 Family size beyond what family can adequately provide
 Accident Hazards
 Faulty/unhealthy eating habits
 Stress provoking factors
 Poor home/environment condition
 Unsanitary food handling and preparation
 Unhealthy lifestyle and personal habits/practices
 FIRST LEVEL ASSESSMENT
Health Threats
 Unhealthful lifestyles
 Physical inactivity
 Inadequate relaxation techniques
 Non-use of self protection methods
 Inherent personal characteristics
 Health history which induce the occurrence of a health deficit
 Inappropriate role assumption
 Lack of immunization
FIRST LEVEL ASSESSMENT
3. Health Deficits
 Illness states

 Failure to thrive/develop

according to normal rate

 Disability
 FIRST LEVEL ASSESSMENT
4. Foreseeable Crisis Situations
 Marriage

 Pregnancy

 Parenthood

 Abortion

 Adolescence

 Loss of Job

 Death of a member

 Divorce
 SECOND LEVEL ASSESMENT
 Inability to recognize the presence of a problem

 Inability to make decisions with respect to taking appropriate health

action

 Inability to provide adequate nursing care to the sick disabled,

dependent or vulnerable/ at risk member of the family

 Inability to provide a home environment which is conducive to health

maintenance and personal development

 Failure to utilize community resources for health care

Criteria in Different Priorities
Nature of the Problem
Presented
 Categorized whether a Health
Threat, Health Deficit or
Foreseeable Crisis

Modifiability of the Problem

 Refers to the probability of success
in minimizing alleviating or totally
eradicating the problem through
health intervention
Criteria in Different Priorities
Preventive Potential
 Refers to the nature and magnitude
of the future problem that can be
minimized or totally prevented if
intervention is done in the
problem.

Salience
 Refers to the family perception &
evaluation of the problem in terms
seriousness & urgency of attention
needed.
SCALE FOR RANKING FAMILY HEALTH PROBLEMS
ACCORDING TO PRIORITIES

Criteria Weight
1.Nature of the problem
presented
Scale: 1
 Wellness state  3
 Health Threat  3
 Health Deficit  2
 Foreseeable Crisis  1
SCALE FOR RANKING FAMILY HEALTH PROBLEMS
ACCORDING TO PRIORITIES

Criteria Weight
2.Modifiability of the
Problem
Scale: 2
 Easily modifiable  2
 Partially modifiable  1
 Not modifiable  0
SCALE FOR RANKING FAMILY HEALTH PROBLEMS
ACCORDING TO PRIORITIES

Criteria Weight
3. PreventivePotential
Scale: 1
 High  3
 Moderate  2
 Low  1
SCALE FOR RANKING FAMILY HEALTH PROBLEMS
ACCORDING TO PRIORITIES

Criteria Weight
4. Salience
Scale: 1
 A serious problem,  2
immediate attention
 A problem but not
needing immediate  1
attention
 Not a felt need /  0
problem
SCORING
1. Decide on a score for each of the criteria.
2. Divide the score by the highest possible score and multiply by the
weight.
Score
----------------- X Weight
Highest Score
3. Sum up the scores for all the criteria. The highest score is 5,
equivalent to the total weight.
 The higher the score (near 5 and above) of a given problem, the
more likely it is taken as a PRIORITY.
 With the available scores, the nurse then RANKS health problems
accordingly.
Example
Cues/Data
 37 year old mother of seven at 21
weeks AOG, with BP of 140/90
and slight pedal edema
 Mother verbalized, “…I did not
have problems during my previous
pregnancies, and even with my
present pregnancy… it just
happened that I passed by the
health center on my way to my in-
laws… so I thought of dropping by
the clinic… but actually I feel
alright, I don’t think I have to
worry.
Family Nursing Problem
 Possible Complicated
Pregnancy
 Inability to recognize presence
of a possible complication of
pregnancy due to lack of
knowledge
 Inability to provide adequate
nursing care to a pregnant
member due to lack of
knowledge on the nature and
management of health condition
 Failure to utilize community
resources for health care
Possible Pre-eclampsia
Actual
Criteria Computation Justification
Score
Nature of the The problem is a health deficit and
3/3 x 1 1
Problem requires more immediate intervention
Modifiability
The resources and interventions needed
of the 2/2 x 2 2
to solve the problem are available
Problem
Possibility of complications during labor
and delivery and occurrence
Preventive
3/3 x 1 1 odabnormalities in the infant are
Potential
prevented if pre-eclampsia is eliminated
as early as possible
Salience of The family doesn’t recognize the
0/2 x 1 0
the Problem existence of the problem
Total Score 4