A lecture presentation on identifying family health problem based on a given assessment strategy.

1. FAMILY HEALTH
ASSESSMENT

2. Family Health Assessment
◦ This involves a set of actions by which the status of a
family as client, its ability to maintain itself as a system
and functioning unit, and its ability to maintain wellness,
prevent, control, or resolve problems in order to achieve
health and well-being among its members are
measured.

3. Family Health Assessment (cont.)
Data
Collection
Data
Analysis
Diagnosis

4. Data Collection
◦ There are two important things to ensure effective and
efficient data collection in family health assessment:
◦ Types and kinds of data needed
◦ Family structure, characteristics, and dynamics
◦ Socio-economic and cultural characteristics
◦ Home and environment
◦ Health Status of each member
◦ Values and practices on health promotion and maintenance and
illness prevention
◦ Method of data gathering

5. Types of Data Needed (1)
◦ Family Structure, Characteristics, and Dynamics
◦ Members of the household and relationship to the head of the
family
◦ Demographic data
◦ Place of residence of each member
◦ Type of family structure – matriarchal or patriarchal, nuclear or
extended
◦ Dominant family members in terms of decision making
◦ General family relationships or dynamics

6. Types of Data Needed (2)
◦Socio-Economic and Cultural Characteristics
◦ Income and expenses
◦ Occupation and place of work of each member
◦ Adequacy to meet basic needs
◦ Who makes decision about family expenditure
◦ Educational attainment of each member
◦ Ethnic background and religious affiliation
◦ Significant others and role(s) they play in the family
◦ Relationship of the family to a larger community

7. Types of Data Needed (3)
◦ Home and Environment
◦ Housing
◦ Adequacy of living space
◦ Sleeping arrangement
◦ Presence of breeding or resting sites of vectors of diseases
◦ Presence of accident hazards
◦ Food storage and cooking facilities
◦ Water supply
◦ Toilet facility
◦ Garbage disposal
◦ Drainage system
◦ Kind of neighborhood
◦ Social and health facilities available
◦ Communication and transportation facilities available

8. Types of Data Needed (4)
◦ Health Status of each Family Member
◦ Medical history indicating current or past significant illnesses or
beliefs and practices conducive to health and illness
◦ Nutritional assessment (anthropometric data, dietary history,
eating/feeding habits/practices)
◦ Risk factor assessment indicating presence of major and
contributing modifiable risk factors for specific lifestyle diseases
◦ Physical assessment indicating presence of illness state/s
◦ Results of laboratory/diagnostic and other screening
procedures supportive of assessment findings

9. Types of Data Needed (4)
◦ Values, Habits, Practices on Health Promotion,
Maintenance and Disease Prevention
◦ Immunization status
◦ Healthy lifestyle practices
◦ Adequacy of:
◦ Rest and sleep
◦ Exercise/activities
◦ Use of protective measures
◦ Use of promotive-preventive health services

10. Data Gathering Methods and Tools
◦Observation
◦Physical Examination
◦Interview
◦Record Review
◦Laboratory/Diagnostic Tests

11. First Level Assessment (1)
◦The process whereby existing and potential
health conditions or problems of the family are
determined.
◦It relates what health problems exist and will exist.
◦Categories:
◦ Wellness State
◦ Health Threats
◦ Health Deficits
◦ Foreseeable Crisis

12. First Level Assessment (2)
◦Presence of Wellness Condition
◦ A clinical judgement about a client in transition from a
specific level of wellness or capability to a higher level.
◦ Based on client’s performance, current performance,
current competencies, or clinical data but no explicit
expression of client desire.
◦ May either be potential or readiness

13. First Level Assessment (3)
◦ Presence of Health Threats
◦ Conditions that are conducive to disease and
accident, or may result to failure to maintain wellness
or realize health potential
◦ Presence of Health Deficits
◦ Instances of failure in health maintenance
◦ Presence of Foreseeable Crisis
◦ Anticipated periods of unusual demand on the individual
or family in terms of adjustment/family resources

14. Second Level Assessment (1)
◦ Defines the nature or type of nursing problems that the
family encounters in performing the health tasks with
respect to a given health condition or problem, and the
etiology or barriers to the families’ assumption of these
tasks.
◦ It explains the family’s problems related to maintaining
health and wellness.
◦ It specified the measures that the family did not do due
to INABILITY.

15. Second Level Assessment (2)
◦ Determine if the family recognizes the existence of the condition or
problem. If the family does not recognize the presence of the condition
or problem, explore the reasons why.
◦ If the family recognizes the presence of the condition or problem,
determine if something has been done to maintain the wellness state or
resolve the problem. If the family has not done anything about it,
determine the reasons why. If the family has done something about the
problem or condition, determine if the solution is effective.
◦ Determine if the family encounters other problems in implementing the
interventions for wellness state/potential, health threat, health deficit, or
crisis. Identify these problems.
◦ Determine how all the other members are affected by the wellness
state/potential, health threat, health deficit, or stress point.

16. Typology of Problems in Family Health (First Level)
Wellness Condition Health Threats Health Deficits Foreseeable Crisis
1. Potential for
Enhanced
Capability for
2. Readiness for
Enhanced
Capability for:
a. Healthy Lifestyle
b. Health Maintenance
c. Parenting
d. Breastfeeding
e. Spiritual Well-being
1. Presence of risk factors of
specific diseases
2. Threat of cross infection from a
communicable disease
3. Family size beyond what
resources can adequately
provide
4. Accident hazards
5. Faulty/unhealthful
nutritional/eating habits for
feeding techniques/practices
6. Stress provoking factors
7. Poor environmental condition
8. Unsanitary food handling and
preparation
9. Unhealthful lifestyle and
personal habits
10. Inherent personal
characteristics
11. Inappropriate role assumption
12. Lack of immunization
13. Family disunity
1. Illness states
(wellness diagnosed
or undiagnosed)
2. Failure to
thrive/develop
according to normal
rate
3. Disability
1. Marriage
2. Pregnancy
3. Parenthood
4. Additional family
member
5. Abortion
6. Entrance to school
7. Adolescence
8. Divorce
9. Menopause
10.Loss of Job
11.Hospitalization
12.Death of a member
13.Resettlement in a
new community

17. Typology of Problems in Family Health (Second Level)
Inability to recognize the presence of the condition or
the problem due to:
1.Lack of inadequate knowledge
2.Denial about its existence or severity as result of fear of
consequences of diagnosis of problem
3.Attitude/philosophy in life which hinders
recognition/acceptance of a problem

18. Typology of Problems in Family Health (Second Level)
Inability to make decisions with respect to taking appropriate health
action due to:
1. Failure to comprehend the nature/magnitude of the problem/condition
2. Low salience of the problem
3. Feeling of confusion, helplessness, and/or resignation brought about by perceived
magnitude/severity of the situation or problem
4. Lack of knowledge as to alternative courses of action open to them
5. Inability to decide which action to take from among a list of alternatives
6. Conflicting opinions among family members
7. Lack of knowledge of community resources for care
8. Fear of consequences of action
9. Negative attitude towards the health condition or problem
10.Inaccessibility of appropriate resources for care
11.Lack of trust/confidence in the health personnel/agency
12.Misconceptions or erroneous information about proposed courses of action

19. Typology of Problems in Family Health (Second Level)
Inability to provide adequate care to the sick, disabled, dependent, or
vulnerable/at-risk member of the family due to:
1. Lack of knowledge about the disease/health condition
2. Lack of knowledge about child development and care
3. Lack of knowledge of the nature and extent of care needed
4. Lack of the necessary facilities, equipment, and supplies of care
5. Lack of inadequate knowledge and skill in carrying out the necessary interventions
6. Inadequate family resources for care
7. Significant person’s unexpressed feelings
8. Philosophy in life which negates or hinders caring for the sick, disabled, dependent, and at
risk member
9. Member’s preoccupation with own concerns or interests
10.Prolonged disease or disability progression which exhausts supportive capacity of family
members
11.Altered role performance

20. Typology of Problems in Family Health (Second Level)
Inability to provide home environment conducive to health
maintenance and personal development due to:
1. Inadequate family resources
2. Failure to see benefits of investment in home and environment improvement
3. Lack of knowledge of preventive measures
4. Lack of skill in carrying out measures to improve home environment
5. Ineffective communication patterns with the family
6. Lack of supportive relationship among family members
7. Negative attitude in life which is not conducive to health maintenance and
personal development
8. Lack of competencies in relating to each other for mutual growth and maturation

21. Typology of Problems in Family Health (Second Level)
Failure to utilize community resources for health due to:
1. Lack of knowledge of community resources for health
2. Failure to perceive the benefits of health services
3. Lack of trust or confidence in the agency or personnel
4. Previous unpleasant experience with health worker
5. Fear of consequences in action
6. Unavailability of required care
7. Inaccessibility of required care
8. Inadequate family resources
9. Feeling of alienation to the community
10.Negative attitude in life which hinders effective utilization of
community resources for health care

22. Prioritizing Health Problems

23. Prioritizing Health Problems
Criteria Weight
Nature or condition of the problem
Scale: wellness state (3)
health deficit (3)
health threat (2)
foreseeable crisis (1)
1
Modifiability of the problem
Scale: easily modifiable (2)
partially modifiable (1)
not modifiable (1)
2
Preventive potential
Scale: high (3)
moderate (2)
low (1)
1
Salience
Scale: Needs immediate attention (2)
Does not need immediate attention (1)
1