PHINMA ARAULLO UNIVERSITY

COLLEGE OF NURSING

COMMUNITY HEALTH NURSING

RLE WORKBOOK
AREA:

BRGY BANITAN, GUIMBA, NUEVA ECIJA

DATE OF EXPOSURE:

09-22-2020

C.I.: Ms. Ruth P. Moralde

Submitted by: FABROS, JENNY A

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Family Assessment Tools

Family Coping Index

General Considerations

1. It is the coping capacity and not the underlying problem that is being rated.

2. It is the family and not the individual that is being rated.

3. Rating should be done after 2-3 home visits when the nurse is more acquainted with the family.

4. The scale is as follows:

* 0-2 or no competence

* 3-5 coping in some fashion but poorly

* 6-8 moderately competent

* 9 fairly competent

5. Justification- a brief statement that explains why you have rated the family as you have.

These statements should be expressed in terms of behavior of observable facts. Example:

“Family nutrition includes basic 4 rather than good diet.

6. Terminal rating is done at the end of the given period of time. This enables the nurse to see
progress the family has made in their competence; whether the prognosis was reasonable; and
whether the family needs further nursing service and where emphasis should be placed.

Areas to Be Assessed

1. Physical independence: This category is concerned with the ability to move about to get out of
bed, to take care of daily grooming, walking and other things which involves the daily activities.

2. Therapeutic Competence: This category includes all the procedures or treatment prescribed for
the care of ill, such as giving medication, dressings, exercise and relaxation, special diets.

3. Knowledge of Health Condition: This system is concerned with the particular health condition
that is the occasion of care

4. Application of the Principles of General Hygiene: This is concerned with the family action in
relation to maintaining family nutrition, securing adequate rest and relaxation for family
members, carrying out accepted preventive measures, such as immunization.

5. Health Attitudes: This category is concerned with the way the family feels about health care in

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general, including preventive services, care of illness and public health measures.

6. Emotional Competence: This category has to do with the maturity and integrity with which the
members of the family are able to meet the usual stresses and problems of life, and to plan for
happy and fruitful living.

7. Family Living: This category is concerned largely with the interpersonal with the interpersonal
or group aspects of family life – how well the members of the family get along with one another,
the ways in which they take decisions affecting the family as a whole.

8. Physical Environment: This is concerned with the home, the community and the work
environment as it affects family health.

9. Use of Community Facilities: generally keeps appointments. Follows through referrals. Tells
others about Health Departments services

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Family APGAR

AUTHOR/S: Gabriel Smilkstein, M.D.

FILIPINO VERSION: Philippine Academy of Family Physicians (PAFP)

PURPOSE: To assess general family function.

DESCRIPTION: Family function measures the extent to which a family works as a unit; it
denotes the family’s ability to cope and adjust to different situations based on 5 components:
adaptation, partnership, growth, affection and resolve. The Family APGAR (Adaptation,
Partnership, Growth, Affection, and Resolve) was originally designed by Smilkstein to assess
family function and is a rapid screening instrument for the family function-dysfunction. This
tool permits qualitative measurement of the family member’s satisfaction about family
relationships, and with the basic components of family function – Adaptation, Partnership,
Growth, Affection and Resolve. It would therefore reflect the caregiver’s view of the

functional state of his family. The Family APGAR questionnaire has been used in numerous
studies (mostly clinical studies) investigating family functioning. In the Philippines, it is one
of the most common tools used by family physicians for assessing families in the clinical
setting.

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SCORING: The Family APGAR consists of statements on five (5) parameters of family
functioning: Adaptability, Partnership, Growth, Affection and Resolve. The family member’s
response is based on the frequency of feeling satisfied with each of the five parameters using
a 3-point scale ranging from 0 (hardly ever) to 2 (almost always). The higher the score, the
higher the level of family function. More specifically, a higher score can be interpreted as a
greater degree of satisfaction with family functioning. Based on Smilkstein’s original
recommendations, the scale is scored by summing the values for the five items for a total
score that can range from 0-10. A score of 0-3 denotes a severely dysfunctional family, 4-7
moderately dysfunctional family and 8-10 highly functional family

TYPOLOGY OF NURSING PROBLEMS IN FAMILY NURSING PRACTICE

I. Presence of Wellness Condition-stated as potential or Readiness-a clinical or nursing judgment

about a client in transition from a specific level of wellness or capability to a higher level.
Wellness potential is a nursing judgment on wellness state or condition based on client’s
performance, current competencies, or performance, clinical data or explicit expression of desire
to achieve a higher level of state or function in a specific area on health promotion and
maintenance. Examples of this are the following

A. Potential for Enhanced Capability for:

1. Healthy lifestyle-e.g. nutrition/diet, exercise/activity

2. Healthy maintenance/health management
3. Parenting
4. Breastfeeding
5. Spiritual well-being-process of client’s developing/unfolding of mystery through harmonious
interconnectedness that comes from inner strength/sacred source/God (NANDA 2001)
6. Others. Specify.
B. Readiness for Enhanced Capability for:

1. Healthy lifestyle
2. Health maintenance/health management
3. Parenting
4. Breastfeeding
5. Spiritual well-being
6. Others. Specify.
II. Presence of Health Threats-conditions that are conducive to disease and accident, or may result
to failure to maintain wellness or realize health potential. Examples of this are the following: A.
Presence of risk factors of specific diseases (e.g. lifestyle diseases, metabolic syndrome)

B. Threat of cross infection from communicable disease case

C. Family size beyond what family resources can adequately provide

D. Accident hazards specify.

1. Broken chairs
2. Pointed /sharp objects, poisons and medicines improperly kept

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 3. Fire hazards
4. Fall hazards
5. Others specify.
E. Faulty/unhealthful nutritional/eating habits or feeding techniques/practices. Specify.

1. Inadequate food intake both in quality and quantity

2. Excessive intake of certain nutrients
3. Faulty eating habits
4. Ineffective breastfeeding
5. Faulty feeding techniques
F. Stress Provoking Factors. Specify.

1. Strained marital relationship

2. Strained parent-sibling relationship
3. Interpersonal conflicts between family members
4. Care-giving burden
G. Poor Home/Environmental Condition/Sanitation. Specify.

1. Inadequate living space

2. Lack of food storage facilities
3. Polluted water supply
4. Presence of breeding or resting sights of vectors of diseases
5. Improper garbage/refuse disposal
6. Unsanitary waste disposal
7. Improper drainage system
8. Poor lightning and ventilation
9. Noise pollution
10. Air pollution
H. Unsanitary Food Handling and Preparation

I. Unhealthy Lifestyle and Personal Habits/Practices. Specify.

1. Alcohol drinking
2. Cigarette/tobacco smoking
3. Walking barefooted or inadequate footwear
4. Eating raw meat or fish
5. Poor personal hygiene
6. Self medication/substance abuse
7. Sexual promiscuity
8. Engaging in dangerous sports
9. Inadequate rest or sleep
10. Lack of /inadequate exercise/physical activity
11. Lack of/relaxation activities
12. Non use of self-protection measures (e.g. non use of bed nets in malaria and filariasis
endemic areas).
J. Inherent Personal Characteristics-e.g. poor impulse control

K. Health History, which may Participate/Induce the Occurrence of Health Deficit, e.g. previous
history of difficult labor.

L. Inappropriate Role Assumption- e.g. child assuming mother’s role, father not assuming his

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role.

M. Lack of Immunization/Inadequate Immunization Status Specially of

Children N. Family Disunity-e.g.

1. Self-oriented behavior of member(s)

2. Unresolved conflicts of member(s)
3. Intolerable disagreement
O. Others. Specify._________

III. Presence of health deficits-instances of failure in health maintenance.

Examples include:

A. Illness states, regardless of whether it is diagnosed or undiagnosed by medical

practitioner. B. Failure to thrive/develop according to normal rate

C. Disability-whether congenital or arising from illness; transient/temporary (e.g. aphasia or

temporary paralysis after a CVA) or permanent (e.g. leg amputation secondary to diabetes,
blindness from measles, lameness from polio)

IV. Presence of stress points/foreseeable crisis situations-anticipated periods of unusual demand

on the individual or family in terms of adjustment/family resources. Examples of this include:
A. Marriage

B. Pregnancy, labor, puerperium

C. Parenthood

D. Additional member-e.g. newborn, lodger

E. Abortion

F. Entrance at school

G. Adolescence

H. Divorce or separation

I. Menopause

J. Loss of job

K. Hospitalization of a family member

L. Death of a member

M. Resettlement in a new community

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N. Illegitimacy

O. Others, specify.___________

Second-Level Assessment
I. Inability to recognize the presence of the condition or problem due to:

A. Lack of or inadequate knowledge

B. Denial about its existence or severity as a result of fear of consequences of diagnosis of
problem, specifically:

1. Social-stigma, loss of respect of peer/significant others

2. Economic/cost implications
3. Physical consequences
4. Emotional/psychological issues/concerns
C. Attitude/Philosophy in life, which hinders recognition/acceptance of a

problem D. Others. Specify _________

II. Inability to make decisions with respect to taking appropriate health action due
to: A. Failure to comprehend the nature/magnitude of the problem/condition

B. Low salience of the problem/condition

C. Feeling of confusion, helplessness and/or resignation brought about by perceive

magnitude/severity of the situation or problem, i.e. failure to breakdown problems into
manageable units of attack.

D. Lack of/inadequate knowledge/insight as to alternative courses of action open to them

E. Inability to decide which action to take from among a list of alternatives F. Conflicting

opinions among family members/significant others regarding action to take. G. Lack

of/inadequate knowledge of community resources for care

H. Fear of consequences of action, specifically:

1. Social consequences
2. Economic consequences
3. Physical consequences

4. Emotional/psychological consequences
I. Negative attitude towards the health condition or problem-by negative attitude is meant one that
interferes with rational decision-making.

J. In accessibility of appropriate resources for care, specifically:

1. Physical Inaccessibility

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 2. Costs constraints or economic/financial inaccessibility
K. Lack of trust/confidence in the health personnel/agency

L. Misconceptions or erroneous information about proposed course(s) of

action M. Others specify._________

III. Inability to provide adequate nursing care to the sick, disabled, dependent or
vulnerable/at risk member of the family due to:
A. Lack of/inadequate knowledge about the disease/health condition (nature, severity,
complications, prognosis and management)

B. Lack of/inadequate knowledge about child development and care

C. Lack of/inadequate knowledge of the nature or extent of nursing care

needed D. Lack of the necessary facilities, equipment and supplies of care

E. Lack of/inadequate knowledge or skill in carrying out the necessary intervention or

treatment/procedure of care (i.e. complex therapeutic regimen or healthy lifestyle program).

F. Inadequate family resources of care specifically:

1. Absence of responsible member

2. Financial constraints
3. Limitation of luck/lack of physical resources
G. Significant persons unexpressed feelings (e.g. hostility/anger, guilt, fear/anxiety, despair,
rejection) which his/her capacities to provide care.

H. Philosophy in life which negates/hinder caring for the sick, disabled, dependent, vulnerable/at
risk member

I. Member’s preoccupation with on concerns/interests

J. Prolonged disease or disabilities, which exhaust supportive capacity of family

members. K. Altered role performance, specify.

1. Role denials or ambivalence

2. Role strain
3. Role dissatisfaction

4. Role conflict
5. Role confusion
6. Role overload
L. Others. Specify._________

IV. Inability to provide a home environment conducive to health maintenance and

personal development due to:
A. Inadequate family resources specifically:

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 1. Financial constraints/limited financial resources
2. Limited physical resources-e.i. lack of space to construct facility
B. Failure to see benefits (specifically long term ones) of investments in home environment
improvement

C. Lack of/inadequate knowledge of importance of hygiene and

sanitation D. Lack of/inadequate knowledge of preventive measures

E. Lack of skill in carrying out measures to improve home environment

F. Ineffective communication pattern within the family

G. Lack of supportive relationship among family members

H. Negative attitudes/philosophy in life which is not conducive to health maintenance and

personal development

I. Lack of/inadequate competencies in relating to each other for mutual growth and maturation
(e.g. reduced ability to meet the physical and psychological needs of other members as a result of
family’s preoccupation with current problem or condition.

J. Others specify._________

V. Failure to utilize community resources for health care due to:

A. Lack of/inadequate knowledge of community resources for health care

B. Failure to perceive the benefits of health care/services

C. Lack of trust/confidence in the agency/personnel

D. Previous unpleasant experience with health worker

E. Fear of consequences of action (preventive, diagnostic, therapeutic, rehabilitative) specifically:

1. Physical/psychological consequences
2. Financial consequences
3. Social consequences
F. Unavailability of required care/services

G. Inaccessibility of required services due to:

1. Cost constrains
2. Physical inaccessibility
H. Lack of or inadequate family resources, specifically

1. Manpower resources, e.g. baby sitter

2. Financial resources, cost of medicines prescribe
I. Feeling of alienation to/lack of support from the community, e.g. stigma due to mental illness,

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AIDS, etc.

J. Negative attitude/ philosophy in life which hinders effective/maximum utilization of

community resources for health care

K. Others, specify __________

GENERAL OBJECTIVE:

At the end of the rotation as Student Public Health Nurse at Brgy Banitan, Guimba
Nueva Ecija , I will be able to:

SKILLS:

Able to apply all those nursing skills such as interview assessment

Able to do some physical assessment to the client.

Able to recognized or determined the diagnostic problem of the family

Able to solve the minor health problem of the Family

Promote and educate the family for able for them to be aware on their health status.

KNOWLEDGE:

Educate and promote wellness to the family is one of the role of being a nurse, so, as a
student nurse/future nurse I am capable or able to educate or promote some awareness to
the family I interviewed and observed for me to help them to be aware in their health status
or condition.

ATTITUDE:

Patient is the virtue to achieved the goal of the nurses. You must be humble enough to know
or while interviewing them for able for me to build a trust and connection with them.

Be a good listener, not just because you need to listen but it is one of the attitudes of a nurse.
Good lister in a way that they will feel that you are already interested knowing them in this
way they will say what is real fact about them, in this way this will makes your work easily
done.

DAILY PLAN OF ACTIVITIES

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DATE: 09-22-2000

TIME :4:45 pm

ACTIVITIES: Interview with the father

REMARKS: Why he used cigarettes and asking if he did know what is the
consequences of all his unhealthy lifestyle.
Teaching how it affects to human body.

DAILY PLAN OF ACTIVITIES

DATE: 09-24-2020
TIME : 8:55am

ACTIVITIES: Interview with the mother

REMARKS: Health teaching how is it important to maintain the blood pressure and the
psychological behavior to the member of family.

DAILY PLAN OF ACTIVITIES

DATE: 09-24-2020
TIME: 1:14pm

ACTIVITIES: Determining the psychological problem in the family with the member of the
family.

REMARKS: Moral support are not present in the family. No psychological support which can
lead to not open communication
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DAILY PLAN OF ACTIVITIES
DATE: 09-28-2020
TIME:7:05pm

ACTIVITIES : Interview with the oldest member of the family

REMARKS: How to maintain healthy body without any diseases, sickness ect. The oldest
member has no any present and history of illness due to eating of healthy vegetables and being
engaged to sports which is volleyball.
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DAILY PLAN OF ACTIVITIES

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DATE: 10-03-2020
TIME:9:15am
ACTIVITIES: Health education to the family
REMARKS: Regards the pros of having a healthy life style the positive changes of
behavior.

Family Coping Index

Family Coping Index is measured with the following scores:

1- No competence 3- moderately competence 5-complete competence

Coping Area Score Justification

1. Physical independence - 5

The family able to move freely without any health problems. They don’t feel any pain in
their joints or no physical disabilities so they are fully aware on their health problems. Every
member of the family has no health problems they are all healthy as of now.

2. Therapeutic Competence – 5

The Family didn’t believe any superstitious medical belief such as hilot, faith healer,
herbal medicines (Albolaryo) but they do buy some medicines without any prescription of any
Doctor such as paracetamol, mefenamic, amoxicillin, diatabs ect. They are truly believe in
what the Doctor’s say when they feel something the is not normal in their health they will go
the hospital for check-up without any second thought.

3. Knowledge of Health - 5

The family is not that knowledgeable enough about their health condition but they mean
that they sometimes goes in folk medicines.
They are all aware of bad habit can lead them into danger health condition but their father
still uses cigarette.

4. Application of the -5
Principles of General Hygiene
They all do the general hygiene they are all aware that doing proper hygiene is for them to
avoid any diseases or sickness in their health. They can eat three (3) times a meal in a day they
do have a snacks and sleep well and do sleep more than 8hrs and drink as well they are all
aware that drinking 8more glasses a day can helps them become hydrated.

4. Health Attitudes – 5
The family know about the health status condition and they do not put it into action
because they are afraid of knowing that their symptoms are in more serious health problem so
sometimes they just taking medicines for them to be well and do some folk medicines too.

5. Emotional Competence- 1
The family doesn’t feel any support to each other when someone is in stress they always a
argue about the random things. There is no open communication between all the family

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 members. Some are not like to open their problems to their parents because their parents will
just think it as a negative. The emotional connection in their family is poor.

6. Family Living - 1
Some are they understand each other but not that open communication because of temperance
of the parents so when someone commit mistakes they will probably didn’t tell it to their
parents to avoid fight. When someone open up about their problem one of the family will
argue so open communication and closeness are not really present in the family.

8. Physical Environment-5

Their house is free from any danger such as falling debris, flood, but the stairs are not
good for children. They do have garbage bag which there is a garbage collector who will
collect it every Saturday so they didn’t burned it because it is also one of the brgy rules in
their brgy.

9. Use of Community -3
Facilities
One of the family member is one of the counselor/konsehal of the brgy so they all
know where and when to call help in their community is there is something happened. The
father in their family attended meeting about the good plan for the brgy including the garbage
whom all the citizen of the brgy should do the proper garbage disposal.

Total Score: 35/9 = 3.888

Interpretation: Coping in some fashion but poorly the family should aware on their family
status they should be aware on how to build a strong family and one of that is the to build an
openly communication between each other this can lead them into good family.

They are all aware in terms of health but not in emotional state which is the problem on
their family

Scale is as follows:
* 0-2 or no competence
* 3-5 coping in some fashion but poorly
* 6-8 moderately competent
* 9 fairly competent

Family APGAR

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Score: 6/15
Interpretation: The family is not opened with each other, lack of open communication
between all the family members. This interview is based on their youngest child whom she
experienced some stress and mistakes before but family didn’t care at all they just blame her
for what she did so instead of supporting and advising her they didn’t do that but instead
whenever there is a problem the parents always shouted at them and didn’t talked in a nice
way.

Family APGAR

Score: 6/15
Interpretation: The family is not opened with each other, lack of open communication
between all the family members. This interview is based on their youngest child whom she
experienced some stress and mistakes before but family didn’t care at all they just blame her
for what she did so instead of supporting and advising her they didn’t do that but instead
whenever there is a problem the parents always shouted at them and didn’t talked in a nice
way.

SCALE FOR RANKING HEALTH CONDITIONS AND PROBLEMS ACCORDING TO

PRIORITIES

CRITERIA WEIGHT

1. Nature of the condition or problem presented

3

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 1
Scale** wellness state
3
Health deficit
2
Health threat
1
Forseeable crisis

2. Modifiability of the condition or problem

2
Scale ** easily modifiable
2
Partially modifiable
1
Not modifiable
0
3. Preventive potential
1
3
Scale** high
2
Moderate
1
Low

4. Salience
1
2
Scale** a condition or problem,needing
immediate attention
A condition or problem not needing immediate
attention
1
Not perceived as a problem or condition needing
change.
0

PROBLEM LIST (PRIORITIZATION

# FAMILY NURSING CARE DIAGNOSIS DATE IDENTIFIED

1. Lack of open communication

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 2. Lack of spiritual and emotional support

3. Mostly afraid of having a checkup to the hospital.

4. Mostly believed in folk medication due to financial support.

5. Even try “tandok” than injecting for the anti-rabies.

6. Aware of the consequences of unhealthy lifestyle but hard to stop.

7. Maintenance to high blood pressure are not maintained due to financial issue

8. Lack of physical activities or unhealthy life style.

9. Unhealthy foods being served.

10. Lack of moral support to each other.

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 FAMILY NURSING CARE PLAN 1
PRIORITIZED PROBLEM: Unhealthy life style.
FAMILY PROBLEM: Father use cigarettes 1 pack per day
DATA NURSING DIAGNOSIS : Risk for Kidney failure due to addictive smoking of the patient.
Risk for lung cancer due to addictive smoking habit of the patient.
GOALS : Make the patient realized the negative effects of unhealthy lifestyle to the human health
including the diseases such as lung cancer, kidney failure ect.
Motivate the patient to be aware of the consequences of smoking.
OBJECTIVES :
The patient is aware of the negative impact of smoking for his health.
The father will stop using cigarettes.
The patient will so healthy lifestyle for the restoration of the human body functions.
To restore the normal function of the lung and kidney of the patient.
..IMPLEMENTATION:
Discuss with the client about the negative effects of smoking in the human body.
How to stop or control yourself not to smoke again.
Suggest an action regards of how to change the unhealthy lifestyle into healthy life style.
INTERVENTION RATIONALE:
For the client able to focus on the healthy lifestyle and stop smoking and aware of the negative effects of
it to human body.
EVALUATION:
The client tried to change the unhealthy lifestyle into healthy lifestyle.
Being aware now about the negative
Breathing of the client is became normal due to lessen use of cigarettes day by day.
Able to control his self in using cigarettes.
Changes in the use of cigarettes from 1 pack each day into 5pcs of cigarettes only per day.
FAMILY NURSING CARE PLAN 2
PROBLEM: EMOTIONAL HEALTH PROBLEM

FAMILY PROBLEM: Lack of open communication

DATA
NURSING DIAGNOSIS : Risk for depression/anxiety due to lack of open communication to each other.

GOALS : Build a strong relationship between them by knowing their family main conflict and to
realized their mistakes and the real value of the family.
OBJECTIVES :
Able to family to know their family conflict which is the lack of open communication between
each other
Able to build strong family relationship.
Able to have a good communication to each other
Able to give morally and emotional support to each member of the family.
..IMPLEMENTATION:

Discuss with them the observed main conflict in their family that can lead them into more serious health
problem
INTERVENTION RATIONALE:
Risk for depression/anxiety due to lack of open communication. Family need to determined the main
conflict on their family and what should do to provide the risk on their family.
EVALUATION:

Family members knows the problem of the family which is lack of open communication. Where
the family closeness of each members are become stronger than before.

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 FAMILY NURSING CARE PLAN 3
PROBLEM: EMOTIONAL HEALTH PROBLEM

FAMILY PROBLEM: Lack of open communication

DATA
NURSING DIAGNOSIS : Risk for depression/anxiety due to lack of open communication to each other.

GOALS : Build a strong relationship between them by knowing their family main conflict and to
realized their mistakes and the real value of the family.
OBJECTIVES :
Able to family to know their family conflict which is the lack of open communication between
each other
Able to build strong family relationship.
Able to have a good communication to each other
Able to give morally and emotional support to each member of the family.
..IMPLEMENTATION:

Discuss with them the observed main conflict in their family that can lead them into more serious health
problem
INTERVENTION RATIONALE:
Risk for depression/anxiety due to lack of open communication. Family need to determined the main
conflict on their family and what should do to provide the risk on their family.
EVALUATION:

Family members knows the problem of the family which is lack of open communication. Where
the family closeness of each members are become stronger than before.

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 FAMILY NURSING CARE PLAN 3
PRIORITIZED PROBLEM: HEALTH AWARENESS.

FAMILY PROBLEM : Lack of health knowledge and awareness and ineffective medical belief.
DATA NURSING DIAGNOSIS : Ineffective information due to medical belief
GOALS : Able for the family to trust the scientific medical information rather than the folk
medicines or superstitious medical believe.
Able for them not to be afraid in terms of checking in the hospital.
Able to be aware and knowledgeable enough for their health situation or condition.
OBJECTIVES:
To help every member of the family to focus on scientific fact which is they need to trust medical hospital
than herbal superstitious belief.
Promote medical facts at the same time respecting their religious belief.

IMPLEMENTATION :
Some activities that will make them realized the importance of having an effective way of using medicine
and able to trust the scientific facts than superstitious belief because believing herbal or albularyo can
cause ineffective recovery and unreliable information.
EVALUATION:
Able to trust the scientific facts or medical field than believing unreliable ways of recovery or medicines.

LEARNING FEEDBACK DIARY (LFD)

Therefor I conclude that this workbook or this activity really helps me a lot on how to

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 determine the problem and how to cope and resolve every problem which can really helps to my

future profession which is I already helped them how to resolve those information I was

experienced to become a health educator which I applied during the interview this really helps me

to know them more and their health status. This activity really helps me when I will visit for

community check up where communication is being enhanced and improve the way you use

those different techniques of interview which you will determine the main problem on the family

how to apply the nursing diagnosis.

WEEKLY EVALUATION

Observation is what I used this weekly evaluation which is I observed if there is a change when I

discussed with them about the problem and how it affects the relationship of the other. As of now there is

a change regards the health awareness, social interaction, moral support and unhealthy life style behavior

of every member of the family.

CHN RELATED JOURNAL

(The purpose of this article is to present an in-depth analysis of the concept of community health nursing

(CHN) advocacy. Walker and Avant’s (2010) 8-step concept analysis methodology was used. A broad

inquiry into the literature between 1994 and 2014 resulted in the identification of the uses, defining

attributes, empirical referents, antecedents, and consequences, as well as the articulation of an operational

definition of CHN advocacy. Model and contrary cases were identified to demonstrate the concept’s

application and to clarify its meaning. This analysis contributes to the advancement of knowledge of

CHN advocacy and provides nurse clinicians, educators, and researchers with some conceptual clarity to

help improve community health outcomes.

JOURNAL REFLECTION
This journal enhanced and improved my skills in interviewing and interacting with the client, determining
the problem and how to resolve it. This really helps for my future profession in terms of giving care and
educating people what to do and what should not do.

Reference
Maglaya, A. Concept of community health nursing practice in the Philippines Public

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 health nursing in the Philippines by the Department of Health

Udan, J. (2009). Health Assessment and physical examination 1st edition.

Udan, J. (2009). Theoretical Foundation of Nursing

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