B.

Family Nursing Diagnosis

Nursing Diagnosis may be formulated at several levels :

- Individual
- Family Members
- Family as a unit
- Family in relation to it’s environment/community

Aside from the most common tool used for Nursing Diagnosis ,which is NANDA, Family
Coping Index is used as well. This tool is based on the premise that nursing action may help
a family in providing for a health need or resolving a health problem by promoting the
family’s coping capacity. It also provides a system of identifying areas that may require
nursing intervention and areas of family strengths that may be used to help the family deal
with health needs and problems. The Index focuses on identifying coping patterns of the
family in nine areas of assessment.

Remember : Family is treated as unit therefore, if a family member is unable to cope in a

particular category, but the other family members are able to compensate, the family is still
rated a adequately coping.

Usually , a likert scale is suggested to be used. It is then followed by the observations of the
nurses to justify the score given on a certain area.

Nine Areas of Assessment of the Family Coping Index :

(Freeman and Heinrich,1981)

1. Physical Independence
o Refers to the family member’s mobility and ability to perform activities of daily
living
Examples: Feeding themselves, Performing activities that promotes hygiene
2. Therapeutic Competence
o Refers to family’s ability to comply with prescribed or recommended procedures
and treatment to be done at home
Examples: Medications, dietary recommendations , use of wheelchairs
3. Knowledge of Health Conditions
 o Refers to the understanding of the health condition or essentials of care
according to the developmental stages of family members.
Examples : Knowledge of the family members regarding a certain
condition/disease (How it’s transmitted?, is it hereditary?)
4. Application of Principles of Personal and General Hygiene
o Includes Practice of general health promotion and recommended preventive
measures
5. Health Care Attitudes
o Refers to the family’s perception of health care in general.
o This is observed in the Family’s Degree of responsiveness to promotive,
preventive and curative efforts of health workers
6. Emotional Competence
o Degree of emotional maturity of family members according to their
developmental stage
o This is observed in behaviors such as how the family deals with daily challenges,
their ability to sacrifice and think of others and acceptance of responsibility
7. Family Living Patterns
o Refers to interpersonal relationships among the family members, management
of family expenses and the type of discipline at home
8. Physical Environment
o Includes home, school, workplace and community (environment) whichmay
contribute to the health of the family
9. Use of Community Facilities
o Refers to the ability of the family to seek and utilize, as needed, both
government-run and private health, education and other community services.

Things to Remember in Using the Family Coping Index:

General Considerations

 It is the coping capacity and not the underlying problem that is being rated.
 It is the family and not the individual that is being rated.
  Rating should be done after 2-3 home visits when the nurse is more acquainted with the
family.
 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
 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.
 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.

Scaling Cues

The following descriptive statements are “cues” to help you as you rate family coping. They are
limited to three points – 1 or no competence, 3 for moderate competence and 5 for complete
competence.

Always remember: IT IS THE COPING CAPACITY THAT IS RATED, NOT THE PROBLEM.

References :

 Famorca, Z. U. Et Al (2013) Nursing Care of the Community , Singapore , Elsevier

Singapore
 Family Coping Index (n.d.) Retrieved from : https://www.rnpedia.com/nursing-
notes/community-health-nursing-notes/family-coping-index