St.

Mary’s College

Bachelor of Science in Nursing

A case study of Perez Family

In partial fulfilment of the requirements in

Related Learning Experience

Presented to:

Mrs. Lesley C. Cadua, RN, MN, LPT

By:

Kimberly A. Milaran

BSN-2

July 2019
 Criteria

1. Introduction 5 points
2. Genogram 5 points
3. Demographic data 5 points
a) First Level Assessment 15 points
b) Second Level Assessment 15 points
c) Third Level Assessment 5 points
4. Family Coping Index 10 points
5. Family Care Plan 30 points
6. Spot Map 5 points
7. Reading 5 points
Total: 100 points
 Introduction

Family is a group of persons united by ties of marriage, blood or adoption,

constituting a single household, interacting and communicating with each other in their

respective social roles.

'Family' is a single word, with many different meanings. People have many ways

of defining a family and what being a part of a family means to them. Families differ in

terms of economic, cultural, social, and many other facets, but what every family has in

common is that the people who call it a family are making clear that those people are

important in some way to the person calling them his family.

(https://family.lovetoknow.com/about-family-values/meaning-family Retrieved July 17,

2019)

Globally, family aspects of humans have evolved specialized mechanisms for

processing information and motivating behaviour that deal with the distinct demands of

being a mate, father, mother, sibling, child, or grandparent. Such an evolutionary

perspective on family dynamics can provide insight into our behaviour in a way that no

other perspective provides. Family is thus dependent on every feature of an individual's

life, including beliefs, culture, ethnicity, and even situational experiences.

(https://global.oup.com/academic/product/family-relationships 9780195320510?

cc=us&lang=en& Retrieved July 17, 2019)

In the Philippines, Filipino family is based on a culture of respect. It is important

that we use polite language especially with our elders. Grandmothers and grandfathers

must be treated with the utmost respect. With Christian values being reinforced on the
natives, they learned to accept teachings that concerned the family like how important it

is to follow you parents and to respect elders.  We see this respect system even with

non-family members. When we are outside, if we see elders, we always must treat them

with respect. https://everything-filipino.com/the-filipino-familys-strong-bonds/ Retrieved

July 17, 2019)

In the same conviction, we the people of Davao Del Norte believe that families

have the greatest potential for raising healthy individuals. It can provide high levels of

love and support. when families break down and fail to provide healthy nurturing to their

members need, the effect throws impact not only to the lives of its members but, to the

communities those families belong as well. (www.itagumenos.com.ph) Retrieved July

17, 2019

This study shows how family differs in many functions, structures and

characteristics. This identifies the different needs of every family and shows the different

coping capabilities. Moreover, the family’s socio-economic data, housing and

environmental conditions have been cited with its corresponding nursing goals,

objectives of care and interventions.

 GENOGRAM

PEREZ FAMILY

Father Mother
A farmer A housewife

Eldest Son Daughter Daughter

A Technician Student Student
A. Family Structure and Characteristics of Dynamics

FAMILY POSITIO SEX AGE CIVIL EDUCATIONA PLACE OF

MEMBE N IN THE STATU L RESIDENC
R FAMILY S ATTAINMENT E

Noel Father Male 61yrs.ol Married High School Purok 2,

Perez d Graduate Sitio Pawas,
Dujali

Merlyn Mother Femal 56yrs.ol Married High School Purok 2,

Perez e d Graduate Sitio Pawas,
Dujali

Narsiso Son Male 31yrs. Married College Purok 2,

Perez Old Graduate Sitio Pawas,
Dujali

Noelen Daughter Femal 17yrs.ol Single Twelve Grade Purok 2,

Perez e d (current) Sitio Pawas,
Dujali

Reche Daughter Femal 15yrs.ol Single Tenth Grade Purok 2,

Perez e d (current) Sitio Pawas,
Dujali

Dave Grandchil Son 2yrs.old Single N/A Purok 2,

Ezekel d Sitio Pawas,
Perez Dujali

 Type of Family Structure

 This family is considered as a nuclear family because it is

composed of a father, mother and children in one household. The mother

and father are married as well as their son but they live in different house.

This kind of family structure has its own advantage because they can able

to sustain their daily needs and they can also budget well their monthly

income. They can also decide their own decision without relaying to other

people except of their children.

 General Family Relationship

As I have observed, they are open up to each other because of

what I have observed they are willing to accept any suggestions of each

other especially in decision making. They also show love and concerns

with each other because of their actions. And as verbalized by Mrs. Perez

they trust each other and they are open to each other.

B. Socio-Economic and Social Characteristics

Family Occupation Estimated Educational Tribe Religion

Member Income Attainment

Farmer 5,000.00 High Illonggo Southern

Noel School Baptist
Perez Graduate
 Housewife ------------- High Illonggo Southern
Merlyn School Baptist
Perez Graduate

Narsiso Technician 3,000.00 College Illonggo Southern

Perez Graduate Baptist
Student ------------ Twelve Illonggo Southern
Noelen Grade Baptist
Perez
Student ------------ Tenth Illonggo Southern
Reche Grade Baptist
Perez
Dave N/A ------------ N/A Illonggo Southern
Ezekel Baptist
Perez

C. HOME AND ENVIRONMENT

 Adequacy of living space

The space of the house is adequate to the members of the family. The

area is good for 5 or more since they are 5 members of the family are living

there. They have also a lot of space outside so that they can do some activities

there. They have also 2 bedrooms, a kitchen and dining area.

  Presence of Breeding Sites of Insects and rodents

Due to improper segregation of garbage there is a high risk of breeding

sites like cockroaches. Mosquitoes due to stagnant water and flies. Rats are

possible also because as verbalized of Mrs. Perez there is a lot of chance that

the rats can live in their surroundings because of the environment and it is a farm

area.

 Presence of Accident Hazard

Due to improper segregation of garbage there is a lot of sharp objects that

is present in the backyard and it can cause any accident to the family because

most of the time they are barefooted and this can lead to them to serious injuries

 Food and Water Storage

For the storage of their food they put it back to the cooking path because

they don’t have any food storage. For the water storage they use the water jag or

the water container itself to serve as their container.

 Cooking Facilities

The family are using chopped woods when they are cooking or sometimes

charcoal to cook. They get the woods in their surroundings since their house is

surrounded by trees. As verbalized by Mrs. Perez it is easy for them to use

chopped woods rather than have gas stove.

  Water Supply

The source of their drinking water from the water refilling station that they

bought weekly. And they used water from well to washed their clothes, washed

their dishes and other activities that needed water.

 Toilet Facility

The family able to provide their own toilet room. However, they don’t have

enough budget to make it more presentable because they only used leaves of

coconut tree and a piece of blanket that will serve as their door. The worst thing

is they don’t have a toilet if the water will over flow from the farm because their

comfort room is too low that can easily reach by water.

 Garbage/Refuse Disposal

The family can able to segregate the garbage but sometimes the choose

to burn it because they said they don’t have any garbage collector to their

community that’s why they burn it or throw it anywhere.

 Drainage System

The drainage system of the family is open. It is quite dirty because they

don’t have enough time to clean because they are busy to work and some

activities that needed to be prioritize.

 Lighting Facilities
 The family has its own electric connection. Sometimes, they use candle or

gas if they don’t have any electric connection.

2. KIND OF NEIGHBORHOOD

As verbalized by Mrs. Perez their neighborhood is good and they are kind

because sometimes they are sharing of what they have to each other and it is

good because they maintain that kind of attitude even before until now.

3. SOCIAL AND HEALTH FACILITIES AVAILABLE

The Health Center and basketball court are too far from their home that’s

why they visit it often. They visit only in the health center if they have sick family

member or sometimes to have an immunization. And in the basketball court they

are often to visit also because its far and they don’t have enough time.

4. COMMUNICATON AND TRANSPORTATION FACULTY AVAILABILITY

The access of their communication is through cellphones but they often

use it. They said they use it for emergency purposes and contacting his son

abroad. They use motor cycle for their transportation especially to her children

going to school.
 D. HEALTH STATUS OF EACH FAMILY MEMBER

The whole family is healthy they don’t have feel any serious illnesses. But

sometimes they suffer from cough and headache minor illnesses that can be treated

easily by medicines that prescribed by the doctors.

E. VALUES, HABITS, PRACTICES ON HEALTH PROMOTION, MAINTENNCE

AND DISEASE PREVENTION

1. IMMUNIZATION STATUS OF FAMILY MEMBERS

All of the children of Mrs. Perez are immunize including her grandchild and

she said that all of them are fully immunize because it is important to prevent any

diseases as verbalized by Mrs. Perez.

2. HEALTHY LIFETYLE PRACTICES

 Rest and Sleep

The family can manage rest and sleep every day because even though they

are busy they spent time to relax especially in the afternoon after taking their

lunch they have “siesta” time.

 Exercise/Activities

The family consider the daily activities like cleaning the house, washing

clothes, farming and others are considered as exercise

 Use of Protective Measures

The family doesn’t use any protective skin care because they are not much

conscious about their skin instead, they are using clothes, cap or jacket when

they are in the farm. But they don’t use any protective slippers during their

farming because it is hassle for them to move.

FIRST LEVEL OF ASSESSMENT

HEALTH THREATS

A. Poor environmental condition/sanitation

1. Improper garbage/ refuse disposal

 Most of the garbage of the family is improperly segregated and they just

put anywhere their trash. This could lead to serious problem because this could

be the breeding site of any diseases. This practice should be

minimized or stop because it will cause any harm to them especially to the

young members of the family.

2. Presence of breeding or resting sites of vectors or diseases

Due to improper garbage disposal there is possible presence of flies,

cockroaches that can be breed in the area. The stagnant water also can be

cause of any harmful illness like dengue.

B. Unhealthful lifestyle and personal habits/practices

1. Walking barefooted or inadequate footwear

As I have observed, some of the member of the family walking bare footed

as they do their daily chores and work. It can be cause of serious injury because

they have also sharp objects in the area and they don’t have any proper

segregation of trash.

C. Accident hazards

1. Fall Hazards
 The house of the family was surrounded by many trees and it is a health

threat to the family because it can be fall inside to their home anytime and they

don’t have any strong roof to support their home.

SECOND LEVEL OF ASSESSMENT

I. PRESENCE OF HEALTH THREAT

A. Poor environmental condition/sanitation

1. Improper garbage/ refuse disposal

Inability to make decisions with respect to taking appropriate health

action due to:

 Low salience of the problem/ condition

Mrs. Perez are not aware about the importance of having a

clean environment especially the proper segregation of the

garbage.

Client verbalized: “Gina tapok lang jud namo among basura diraa kay usahay

man gud wala name oras mang hinlo kay tungod naga trabaho mi sa uma”

2. Presence of breeding or resting sites of vectors or diseases

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

or vulnerable/ at risk member of the family due to:

 Lack of/ Inadequate knowledge about the disease/ health

condition (nature, severity, complications prognosis and

management)

They don’t have any idea about the stagnant water in their

backyard that can cause the breeding site of mosquitos and the

improper segregations of garbage that can be the breeding sites

also for the flies and cockroaches.

Client verbalized: “Dili man jud malikayan direa sa amoa na nay mga lamok, ok-ok,

ilaga og uban pa kay naa man mi sa may umahan unya isa pa kung amoa tapokon ang

basura kalaton man gihapon sa among binuhi na mga manok”

B. Unhealthful lifestyle and personal habits/ practices

1. Walking barefooted or inadequate footwear

Inability to make decisions with respect to taking appropriate health

action due to:

 Low salience of the problem/ condition

 Mr. & Mrs. Perez are not aware that without wearing any footwear can

cause a serious injury to them especially to their grandchild.

Client verbalized: “Na anad nalang man pud mi ma’am, unya dali man gud maka lihok

sa uma basta walay suot na butas or tsinelas maong na anad najud mi.”

C. Accident hazards

1. Fall hazards

 Inability to make decisions with respect to taking appropriate

health action due to:

 Failure to comprehend the nature/magnitude of the problem/

condition

Mr. & Mrs. Doesn’t recognizes the existing problem that can

be a health threat to their family because they cannot predict

if that moment that trees will directly fall to their house.

Client verbalized: “Wala man pud mi problema aning mga kahoy sa among palibot

ma’am pero naa lang juy panahon na nay matagak pero pasagdan raman pud namo”

SCALE FOR RANKING HEALTH CONDITIONS AND

PROBLEMS ACCORDING TO PRIORITIES

1. Improper garbage/refuse disposal

 CRITERIA COMPUTATIONS ACTUAL JUSTIFICATION
SCORING
It is a health threat as it is

1) Nature of the 2/3x1 0.66 conductive to disease

Problem and can promote

infections to any of the

family member if they will

not give an immediate

action
The problem is easily

2) Modifiability 2/2x2 2 modifiable by providing

of the health teachings and

Problem discussing its importance

and harmful effects to the

family and even to the

community.
The existing problem can

3) Preventive 3/3x1 gv 1 be prevented because of

Potential they have now the

knowledge because of the

health teachings that I gave

to them
The existing problem

4) Salience of 2/2x1 2 needed some immediate

the Problem action because it can

 affect their daily living
TOTAL SCORE = 5.66

2. Walking barefooted or inadequate footwear

CRITERIA COMPUTATIONS ACTUAL JUSTIFICATION

SCORING
It is a health threat to the
1) Nature of the 2/3x1 0.66
Problem family member because

walking without any foot

wear can lead to serious

injury to the family

member
The problem is easily
2) Modifiability 1/2x1 0.5
of the modifiable because it can
Problem
be seen every day and

they said also that they

are walking around

without foot wear

because they work in

farm
The problem can be
3) Preventive 3/3x1 3
Potential easily to prevented but

for them they for granted

it because they said

 “sanay na”
The family knew that is
4) Salience of 2/2x1 2
the Problem really a problem but for

them when they work

they are comfortable and

they can move freely

without any foot wear

TOTAL SCORE = 6.16

3. Fall Hazards

CRITERIA COMPUTATIONS ACTUAL JUSTIFICATION

SCORING
It is consider a health
1) Nature of 3/3x1 1
the threat to the family
Problem
because they can predict

if that fruit will fall and the

bamboo trees is a health

threat to them because

some part of the bamboo

are sharp and they

 walked barefooted

sometimes and that can

lead to a serious problem

to the family member

1) Modifiability 2/2x1 2 It can be easily modify
of the
Problem because of the house is

surrounded by many

trees
The problem can be
2) Preventive 3/3x1 3
Potential prevented because they

are aware that is possible

problem to their family

The family recognizes
3) Salience of 1/2x1 0.5
the Problem that it is a problem but

they don’t see that this

existing problem needed

an immediate action.
TOTAL SCORE = 6.5

4. Presence of breeding or resting sites of vectors of diseases

CRITERIA COMPUTATIONS ACTUAL JUSTIFICATION

SCORING
It is a health threat as it
1) Nature of 2/3x1 0.66
the can cause problems to
Problem
any of the family
 members.
The problem is easily
2) Modifiabilit 2/2x2 2
y of the modifiable as it was
Problem
discussed during health

teachings about the

harmful effects and

possible diseases we can

get from it.

Presence of breeding
3) Preventive 3/3x1 1
Potential sights of vectors or

diseases can be

prevented by maintaining

a proper and clean home

environment.

They recognize the

4) Salience of 2/2x1 2
the problem but they don’t
Problem
have any actions towards

to the existing problem.

TOTAL SCORE = 5.66
 PRIORITIZING HEALTH PROBLEMS

RANK HEALTH PROBLEM SCORE

1 Unhealthy lifestyle and 6.16

personal habits/practices:
Walking barefooted or
inadequate footwear

2 Accident hazards: Fall 6.5

Hazards

3 Poor home/ environmental 5.66

condition/ sanitation:
Improper garbage/refuse
disposal

3 Poor home/ environmental 5.66

condition/ sanitation:
Presence of breeding or
resting sites of vectors of
diseases as health threat
 FAMILY COPING INDEX

1 – No competence 3- moderated competence 5- complete competence

Coping Areas Score Justification

The family is able to do their respective tasks.
1) Physical Independence 3 However, they forget to perform their personal
hygiene like bathing and others.
The family sometimes relies in herbal
2) Therapeutic 3 medications from the herbal plants to use for
Competence treatment for the sick family member. They
also consult on the physician or in the health
center especially when in serious
illness/situations.
The family can identify some common
3) Knowledge of Health 5 diseases and minor illnesses and they can also
condition identify the factors affecting the health
condition of the patient.
The family is very concern of each members of
4) Application of 5 the family; they make sure that each member
principles of general of the family is immunized as part of preventive
hygiene measures. For the hygiene of the family they
take a bath regularly and they sleep and wake
up in the right time.
5 The family can identify and understands the
5) Health Attitudes need of medical treatment of the sick family
member. They also recognize the limits it
imposes while doing all possible effect for the
faster recovery of the sick family member.
The family is very open to each other and they
6) Emotional 5 open up if there is any misunderstanding or
 Competence any problem that can affect their relationship.
The family has their roles especially in
7) Family Living 5 disciplining their children and they respect
each other’s decision.
The family is able is able to sweep the floor but
8) Physical Environment 1 not all the time because they much focused in
their worked and that’s why they often leave
their house messy and poorly segregation of
garbage as result to improper disposal.
The family is able to visits the health center if
9) Use of community 5 they needed or they need some consultations
facilities and they also participate in any activities in the
community.

WHAT IS A COMMUNITY PROBLEM?

This covers a lot of ground. There's a long list of nominees. And you probably know
some of the main contenders. Can you name the leading problems in your own
community? Chances are you can at least start the list.

Below are examples of community problems:

Example Community Problems: Adolescent pregnancy, access to clean

drinking water, child abuse and neglect, crime, domestic violence, drug
use, environmental contamination, ethnic conflict, health disparities, HIV/
 AIDS, hunger, inadequate emergency services, inequality, jobs, lack of
affordable housing, poverty, racism, transportation, violence.

WHAT OTHERS WOULD YOU ADD?

Rather than aim for a complete problem list, here are some criteria you may consider
when identifying community problems:

 The problem occurs too frequently (frequency)

 The problem has lasted for a while (duration)
 The problem affects many people (scope, or range)
 The problem is disrupting to personal or community life, and possibly
intense (severity)
 The problem deprives people of legal or moral rights (equity)
 The issue is perceived as a problem (perception)

This last criterion -- perception -- is an important one, and can also help indicate
readiness for addressing the issue within the community.

Keep in mind that what is seen as a problem can vary from place to place, and from
group to group in the same place. Although there's no official definition of a community
problem, the above examples and criteria above should help you begin to name and
analyze community problems.

WHAT IS ANALYZING COMMUNITY PROBLEMS ALL ABOUT?

Analyzing community problems is a way of thinking carefully about a problem or

issue before acting on a solution. It first involves identifying reasons a problem exists,
and then (and only then) identifying possible solutions and a plan for improvement. The
techniques for analyzing community problems require simple logic, and sometimes the
collection of evidence.

WHY SHOULD I ANALYZE A COMMUNITY PROBLEM?

To better identify what the problem or issue is.

Kids gather on a street. Sometimes they drink; sometimes they get rowdy. What is the
problem here? The drinking? The rowdiness? The gathering itself? Or, the possible fact
that kids have nowhere else to go and few positive alternatives for engagement? Before
looking for solutions, you would want to clarify just what is the problem (or problems)
here. Unless you are clear, it's hard to move forward.

To understand what is at the heart of a problem.

A problem is usually caused by something; what is that something? We should find out.
And often the problem we see is a symptom of something else.
To determine the barriers and resources associated with addressing the problem.

It's good practice and planning to anticipate barriers and obstacles before they might
rise up. By doing so, you can get around them. Analyzing community problems can also
help you understand the resources you need. And the better equipped you are with the
right resources, the greater your chances of success.

To develop the best action steps for addressing the problem.

Having a plan of action is always better than taking a few random shots at the problem.
If you know where you are going, you are more likely to get there.

In general, when you tackle a problem, it's almost always smarter to analyze it before
you begin. That way, you've got a deeper understanding of the problem; and you've
covered your bases. There's nothing worse for member involvement and morale than
starting to work on a problem, and running up against lots of obstacles -- especially
when they are avoidable.

When you take a little time to examine a problem first, you can anticipate some of these
obstacles before they come up, and give yourself and your members better odds of
coming up with a successful solution.

WHEN SHOULD I ANALYZE A COMMUNITY PROBLEM?

Every community problem should benefit from analysis. The only possible exception is
when the problem is an immediate crisis that requires action this very moment. And
even then, analysis should help later.

However, there are conditions when analysis is especially important. And these
are:

 When the community problem is not defined very clearly

 When little is known about the community problem, or its possible consequences
 When you want to find causes that may improve the chance of successfully
addressing the problem
 When people are jumping to solutions much too soon
 When you need to identify actions to address the problem, and find collaborative
partners for taking action.

HOW SHOULD I ANALYZE A COMMUNITY PROBLEM?

The ultimate goal is - to understand the problem better and to deal with it more
effectively, so the method you choose should accomplish that goal. We'll offer some
step-by-step guidelines here and go over a couple of specific ways to determine the
causes of the problem.
1. Justify the choice of the problem.

Apply the criteria we’ve listed above – frequency, duration, range, severity, equity,
perception – as well as asking yourself whether your organization or another can
address it effectively, in order to decide whether the problem is one that you should
focus on.

Let’s take the problem we used as an example earlier: The percentage of

overweight and obese children in the community has been steadily
increasing, and now approaches 25%. Since we know that childhood
obesity tends to lead to adult obesity, and that obesity and being
overweight are linked to chronic conditions – diabetes, heart disease,
stroke – this is a problem that needs to be addressed now. Our
organization has the will and the ability to do it.

2. Frame the problem.

State the problem without implying a solution or blaming anyone, so that you can
analyze it without any assumptions and build consensus around whatever solution you
arrive at.  One way is to state it in terms of a lack of a positive behavior, condition, or
other factor, or  the presence or size of a negative behavior, condition, or other factor.

There are too many children in the community who are overweight or
obese. The problem is particularly serious among low-income families.

3. Identify whose behavior and/or what and how environmental factors need to
change for the problem to begin to be solved.

This can be as straightforward as individuals changing their behavior from smoking to

not smoking, or as complex as persuading legislators to change laws and policies (e.g.,
non-smoking ordinances) in order to change others’ behavior (smokers don’t smoke in
buildings or enclosed spaces used by the public) in order to benefit yet another group
by changing the environment (children are protected from secondhand smoke in public.)

All, and particularly low-income, children should have the opportunity and
the motivation to eat more healthily and exercise more. Parents may need
to change their children’s – and perhaps their own – diets, and schools
may need to adjust their lunch programs and exercise schedules. In low-
income neighborhoods, there needs to be greater access to healthy food
and more safe places for children to play or participate in sports, both
outdoors and indoors.

4. Analyze the root causes of the problem.

The real cause of a problem may not be immediately apparent.  It may be a function of
a social or political system, or may be rooted in a behavior or situation that may at first
glance seem unrelated to it. In order to find the underlying cause, you may have to use
one or more analytical methods, including critical thinkingand the “But Why?” technique.

Very briefly, the latter consists of stating the problem as you perceive it and asking “But
why?” The next step is to answer that question as well as you can and then asking
again, “But why?” By continuing this process until you get an answer that can’t be
reduced further, you can often get to the underlying cause of the problem, which will tell
you where to direct your efforts to solve it.

The difference between recognizing a problem and finding its root cause is similar to the
difference between a doctor’s treating the symptoms of a disease and actually curing
the disease. Once a disease is understood well enough to cure, it is often also
understood well enough to prevent or eliminate. Similarly, once you understand the root
causes of a community problem, you may be able not only to solve it, but to establish
systems or policies that prevent its return.

There are too many children in the community who are overweight or
obese. The problem is particularly serious among low-income families.
(But why?)

Because many low-income children don’t eat a healthy diet and don’t
exercise enough. (But why?)

Because their parents, in many cases, don’t have the knowledge of what a
healthy diet consists of, and because, even if they did, they lack access in
their neighborhoods to healthy foods – no supermarkets, produce
markets, farmers’ markets, or restaurants serving healthy food – and
therefore shop at convenience stores and eat out at fast food places. Kids
don’t play outside because it’s too dangerous – gang activity and drug
dealing make the street no place for children. (But why?)

Parents may never have been exposed to information about healthy food
– they simply don’t have the knowledge. Market owners view low-income
neighborhoods as unprofitable and dangerous places to do business. The
streets are dangerous because there are few job opportunities in the
community, and young men turn to making money in any way possible.

By this point, you should have a fair understanding of why kids don’t eat
healthily or get enough exercise. As you continue to question, you may
begin to think about advocacy with local officials for incentives to bring
supermarkets to low-income neighborhoods, or for after-school programs
that involve physical exercise, or for parent nutrition education or for anti-
gang programs…or for all of these and other efforts besides. Or continued
questioning may reveal deeper causes that you feel your organization can
tackle.
5. Identify the restraining and driving forces that affect the problem.

This is called a force field analysis. It means looking at the restraining forces that act to
keep the problem from changing (social structures, cultural traditions, ideology, politics,
lack of knowledge, lack of access to healthy conditions, etc.) and the driving forces that
push it toward change (dissatisfaction with the way things are, public opinion, policy
change, ongoing public education efforts, existing alternatives to unhealthy or
unacceptable activity or conditions, etc.) Consider how you can use your understanding
of these forces in devising solutions to the problem.

Forces restraining change here include:

 The desirability and availability of junk food – kids like it because it

tastes good (we’re programmed as a species to like fat, salt, and
sugar), and you can get it on every corner in practically any
neighborhood.
 The reluctance of supermarket chains to open stores in low-income
neighborhoods.
 The domination of the streets by gangs and drug dealers.

Some forces driving change might be:

 Parents’ concern about their children’s weight.

 Children’s desire to participate in sports or simply to be outdoors.
 Media stories about the problem of childhood obesity and its
consequences for children, both now and in their later lives.

A full force field analysis probably would include many more forces in each
category.

6. Find any relationships that exist among the problem you’re concerned with and
others in the community.

In analyzing root causes, you may have already completed this step. It may be that
other problems stem from the same root cause, and that there are other organizations
with whom you could partner. Understanding the relationships among community issues
can be an important step toward resolving them.

We’ve already seen connections to lack of education, unemployment, lack

of after-school programs, and gang violence and crime, among other
issues. Other organizations may be working on one or more of these, and
a collaboration might help both of you to reach your goals.

7. Identify personal factors that may contribute to the problem.

Whether the problem involves individual behavior or community conditions, each
individual affected by it brings a whole collection of knowledge (some perhaps accurate,
some perhaps not), beliefs, skills, education, background, experience, culture, and
assumptions about the world and others, as well as biological and genetic traits. Any or
all of these might contribute to the problem or to its solution…or both.

A few examples:

 Genetic predisposition for diabetes and other conditions.

 Lack of knowledge about healthy nutrition.
 Lack of knowledge/ skills for preparing healthy foods.

8. Identify environmental factors that may contribute to the problem.

Just as there are factors relating to individuals that may contribute to or help to solve the
problem you’re concerned with, there are also factors within the community environment
that may do the same. These might include the availability or lack of services,
information, and other support; the degree of accessibility and barriers to, and
opportunities for services, information, and other support; the social, financial, and other
costs and benefits of change; and such overarching factors as poverty, living conditions,
official policy, and economic conditions.

Sample environmental factors:

 Poverty
 Lack of employment and hope for young men in low-income
neighborhoods
 Lack of availability of healthy food in low-income neighborhoods
 General availability – at school as well as elsewhere – of snack
foods high in salt, sugar, and fat
 Constant media bombardment of advertising of unhealthy snacks,
drinks, and fast food

9. Identify targets and agents of change for addressing the problem.

Whom should you focus your efforts on, and who has the power to improve the
situation?  Often, these may be the same people. The best solution to a particular
problem may be policy change of some sort, for instance, and the best route to that may
be to mount an advocacy effort aimed at officials who can make it happen. People who
are suffering from lack of skills or services may be the ones who can do the most to
change their situation. In other cases, your targets may be people whose behavior or
circumstances need to change, and you may want to recruit agents of change to work
with you in your effort. The point of this step is to understand where and how to direct
your work most effectively.

Targets of change might include:

 Parents of children in low-income neighborhoods (or all parents in the
community) for education purposes
The children themselves
Elementary and middle school teachers
School officials responsible for school food programs
Executives and Public Relations officers of supermarket chains
Gang members and youth at risk of becoming gang members

A short list of potential agents of change:

Parents of children in low-income neighborhoods (or all parents in the

community) as controllers of their children’s diets
The Superintendent of Schools, School Committee, and school
administrators, as well as those directly responsible for school food
programs
Local public officials who could create incentives for markets to move into
underserved neighborhoods
Community Recreation Commissions, school officials, YMCAs, and other
entities that might create safe outdoor and indoor physical activity
programs for children
Community hospitals, clinics, and private medical practices
Public relations offices of national or regional fast food restaurant chains

With your analysis complete, you can develop a strategic plan that speaks to the real
causes of the problem and focuses on those targets and/or agents of change that are
most likely to contribute to improving the situation.

GOING BEYOND THE BASICS -- DOES ANALYSIS REALLY WORK?

Try this analysis out with a current problem in your own community setting.

What do you conclude? We hope you'll find some value in analysis. We do know that
when we have tried this method with real problems in our own communities, we have
drawn some additional conclusions of our own, going beyond the basics:

 Analyzing community problems can be hard work. It takes real mental effort.
We're not used to sitting down and thinking deeply about a problem. (We're too
busy!)
 Real community problems are likely to be complex. Economic development may
depend on the global economy; a force you can't have much effect on. You may
have opposition, either from within the community itself, or from powerful forces
trying to protect their own interests.
 When you go looking for reasons and underlying causes for significant problems,
you are likely to find more than one. Several different reasons may be influencing
the problem, in different amounts, all at the same time. It may not be an easy
 task to untangle all the reasons and their relative strengths, but it may be
necessary in order to reach a solution.
 The problem may not only have more than one reason; it may have more than
one solution too. Problems often call for multi-pronged solutions. That is, difficult
problems often must be approached from more than one direction. So in
revitalizing the downtown, you might want to (a) beautify the streets; (b) expand
the staff of the chamber of commerce; (c) run sidewalk sales; (d) look for outside
loans; and (e) recruit new businesses. These are all parts of the solution. Many
different types of actions might be necessary for revitalization.

When analyzing real community problems, the analysis may show multiple reasons
behind the problem. The analysis may not always be easy. The solution may be more
difficult still.

But that's why problems are problems. Community problems exist precisely because
they often resist clear analysis and solution. They persist despite our efforts. They can
be real challenges.

Yet this doesn't mean we are helpless. Analysis, including the analytic methods we
have described, can take you a long way. With good analysis, some resources, and
enough determination, we believe even the most troublesome problems can be
addressed, and ultimately, solved.

SUMMARY

There is a lot of existing problem in the community like adolescent pregnancy,

access to clean drinking water, child abuse and neglect, crime, domestic violence, drug

use, environmental contamination, jobs, poverty and more. It is important to analyze the

existing problem in the community because this is the way of thinking about some way

to fix the problem. The things the we must do is to identify the reasons of the problem,

identify the possible solutions and plan for improvement. In addition, it is important to

analyze the community problem because we can identify what the problem or issue is,

to understand what is at the heart of the problem, to determine the barriers and

resources associated with addressing the problem and to develop the best action steps

for addressing the problem.

 How can we analyze a community problem by justifying the choice of the

problem, frame the problem, identify whose behavior or what and how environmental

factors need to change for the problem to begin to be solved, analyze the root causes of

the problem, identify the restraining and driving forces that affect the problem, find any

relationships that exist among the problem you’re concerned with and others in the

community, identify personal factors that may contribute to the problem, identify

environmental factors that may contribute to the problem and identify targets and agents

of change for addressing the problem.

REFLECTION

There is no perfect family as well as a community. There is lot of instances that

our community facing a lot of problems. Through to this article, I learned that it is

important to know the different community problems because it is part of our daily living.

Sometimes, I didn’t notice that existing problem can really affect our community

because sometimes I take for granted all the problem of the community. But through to

this article I learned a lot of things that I must value.

As a student it is important to me that I know how to identify and analyze any

problems in the community because it can cause any chaos. Like Dr. Jose Rizal said

that “ang kabataan ang pag-asa ng Bayan” in a small action I can help to some people
to prevent any chaos and danger to their life. I can have used my knowledge by guiding

and teaching them the preventive problems in the community.

ST. MARY’S COLLEGE OF TAGUM, INC.

Tagum City, Davao del Norte

NURSING PROGRAM

FAMILY ASSESSMENT TOOL

I- PAMILYA

A.
Pangulo sa Pamilya: Noel Perez Apelyido sa Pamilya: Perez Family

Puluy-anan: Prk. 2, Sitio Pawas, Braulio J. Pangalan sa Gipangutana: Merlyn Perez

Dujali, Davao del Norte

Petsa: June 26, 2019

Klase sa Pamilya: Nuclear

Income (Binulan): 3,000 – 5, 000 a month

KINSA ANG NAGA DESISYON:

Bahin sa Kwarta: Bahin sa panglawas na Butang:

“Kami duha ang mag desisyon bahin sa “Kung bahin sa pang lawas ma’am kami

among kwarta ma’am” as verbalized by gihapon duha ang naga desisyon ma’am”

Mrs. Perez as verbalized by Mrs. Perez

B. Miyembro sa Pamilya

Amahan: Noel Perez Adlaw nga Natawhan: May 22, 1958

Trabaho: Rice Farmer Edad: 61 yrs.’ old

Estado: Married Relihiyon: Southern Baptist

Inahan: Merlyn Perez Adlaw nga Natawhan: June 10, 1963

Trabaho: House wife

Estado: Married Edad: 56 yrs. old

Relihiyon: Southern Baptist

Anak Adlaw Edad Trabaho Estado Relihiyon Tribo

nga
Natawha
n

Narsiso October 31 years OFW Married Southern Ilonggo

Perez 10, 1988 old Baptist

Noelen March 15, 17 years Student Single Southern Ilonggo

Perez 2002 old Baptist

Reche June 1, 15 years Student Single Southern Ilonggo

Perez 2004 old Baptist

APO UG UBAN PANG MIYEMBRO SA PAMILYA NGA KAUBAN NAG PUYO

Apo Adlaw Edad Trabaho Estado Relihiyon Tribo

nga
Natawha
n
 Dave April 10, 2 years N/A Single Southern Ilonggo
Ezekel 20017 old Baptist
Perez

II. ESTADO SA PANGLAWAS

A. Panglawas sa Amahan

Nasinating Balatian: NONE

Kasagarang Balatian: NONE

Maintenance na Tambal: NONE

Check-up: Last checkup= 90’s

b. Panglawas sa Inahan
Nasinating Balatian: NONE

Kasagarang Balatian: Cough and fever

Maintenance na Tambal: NONE

Check-up: Last checkup= 2018

C. Panglawas sa mga anak

Pangalan Asa Gianak Kinsay Balatian

Nagpaanak

Narsiso Perez Sa Balay Kumadrona N/A

Noelen Perez Sa Balay Kumadrona N/A

Reche Perez Sa Balay Kumadrona N/A

D. Nutrisyon sa mga Bata (edad 5 anyos paubos)

Pangalan Edad Vitamin Pamaagi Pamaagi Bakuna

sa sa
 Pagkaon Paglutas

Dave 2 years old Ferous “Naga “Wala siya Complete

Ezekel sulfate practice nag agi og Immunizations

Perez syrup lang siyag breast feed

siya siya saiyahang

lang” as mama” as

verbalized verbalized

by Mrs. by Mrs.

Perez Perez

E. Panglawas sa Pamilya

Pangalan Temp. Pulso RR BP Timbang Katas-on

 (degree (bpm) (cpm)

Celsius)

Amahan: 35. 9°C 62bpm 17 cpm 90/60mmH 60kls 5ft

Inahan: 35.5°c 74bpm 19 cpm 110/ 80 68kls. 5ft

mmHg

Anak:

III- NUTRISYON SA PAMILYA

A. KAPILA GAKAON SA ISA KA ADLAW? 3 times a day

B. KASAGARANG PAGKAON SA:

Pamahaw: Gulay og Kan- on

Paniudto Gulay og Kan- on

Panihapon: Gulay og Kan- on

Pamainit: “usahay wala name nagapamainit kay walay kwarta”

verbalized by Mrs. Perez

IV. PAMAAGI SA PAG PLANO SA PAMILYA

NAG GAMIT WALA NAG GAMIT

Calendar/ Rhythm method Condom

LAM Vasectomy

UBAN PA Ligation

ARTIPISYAL NGA PAMAAGI

Pills

IUD

Depo

V. RASON SA KASAKITON UG KAMATAYON

 a.) Asa dad-on kung magkasakit ang is aka miyembro sa pamilya

Health Center

Albularyo

Ospital

Uban pa

b.) Unsay buhaton kung magasakit?

Herbal: “usahay ra pero og dili makaya kay mag adto nami og doctor” as verbalized
by Mrs. Perez

Pagtambal sa Kaugalingon: NONE

Gireseta sa Doktor: N/A

c.) Unsay kasagarang sakit?

Cough and Fever

d.) Hinungdan sa Kamatayon?

N/A
VI. PANIMALAY

A.) Klase

A. 1. ATOP

Nipa Sin

UBAN PA: ______________________

A. 2. BUNGBONG

Semento

Kahoy

Amakan

Kawayan

UBAN PA: _______________________

A. 3. SALOG

Semento

Kahoy

Kawayan
Yuta

UBAN PA: _____________________

B.) PILA KABUOK KWARTO:

C.) Suga

Kuryente

Battery

Petromax

Lampara

Kandila

UBAN PA: _____________________

D.) Klase sa mga insekto o peste nga naa sa balay

Lamok

Langaw

Ok-ok

Butiki

ILAGA
UBAN PA: _________________

E.) Klase sa lutuan:

Uling

Kahoy

Kuryente

Gas Stove

LPG

UBAN PA: ____________________

F.) Pamaagi sa paglabay sa basura:

Bisan asa

Ginasunog

Ginabulag ang “malata: sa “di malata”

Ginalubong
 UBAN PA: _____________________

G.) Asa ginatago ang pagkaon

Refrigerator

Cabinet

Basket

Ginatakluban

UBAN PA: ___________________

H.) Drainage

KANAL:

OPEN CLOSE

VII

A.) Tubig
Gamitan Klase sa Tubig

sa

Tubig

Balon Bomba Nawasa Electric Ulan Tubod UBAN

Pump PA

Inom √

Hugas √

Laba √

Ligo √

UBAN

PA

B.) Punduhanan sa Tubig

Banga

Balde

Galon

Drum
 Tangke

Water Jug

UBAN PA: _________________

C.) Estado

Adunay Taklob

Sementado

Tangke

Walay Taklob

UBAN PA: _________________

D.) Distansya gikan sa balay:

VIII. KASILYAS

Klase Estado Distansya gikan sa

balay

Walay Naay Pribad Komo Kusina Gigikanan

Taklo Taklo
 b b o n sa Tubig

Water Sealed

Antipolo

Bisag Unsa

UBAN PA

IX. MGA DELIKADONG LUGAR SA:

Gawas sa Balay Sulod sa Balay

Kanal Gasul (walay safety regulator)

Balon/ Walay Taklob Posporo

Balay duol sa kahoy Gas

Buak nga Botelya Spray

Lansang sa gabok nga koral Gabok nga salog

Lapokon nga agianan Guba nga salog

Bitin/ Irong buang Mga hinagiban

UBAN PA: UBAN PA:

_______________________________ _______________________________

_______________________________ _______________________________

_______________________________ _______________________________

MGA BINUHING HAYOP

Klase sa Binuhian Hiniktan Naay Nabakunahan

Hayop Kulungan

Iro √ “wala tanan

nabakunahan
Manok √ ma’am” as
 Baboy √ √ verbalized by
Mrs. Perez
Bibe √

XI. KUMONIDAD

A. Klase sa B. Komunikasyon C. Serbisyo

Transportasyon

Pagbaktas Telebisyon Kapilya

Skylab Radio Eskwelahan

Bisekleta Pamantalaan Tindahan

Tricycle Cellphone Dula-anan

Pedicab Telepono Health center

Jeep UBAN PA: UBAN PA:

Bus
 UBAN PA:

Lain pang obserbasyon:

Based on my observation everytime that the water will over flow from the farm

the water water will directly goes in the backyard and I consider it as health threat to the

family especially they don’t have any proper segregation and they walked barefooted.

Kimberly A. Milaran

Pangalan sa Tigpangutana

DOCUMENTATION

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