FAMILY PROFILE
Barangay: San Rafael East Santa Maria, Isabela
Zone: 04
Household number: 0073
CIVIL EDUCATIONAL
FAMILY MEMBER GENDER AGE BIRTHDAY BIRTHPLACE OCCUPATION
STATUS ATTAINMENT
HUSBAND
Mcgyver V. Laggui Male Married 31 October 29,1989 Santa Maria, Isabela College Graduate Office Staff
WIFE
Katrina C. Laggui Female Married 28 October 19,1992 Santa Maria, Isabela College Graduate Baker
SON
Klein Myver C.
Male Single 10mos. old May 04,2020 Santa Maria, Isabela N/A N/A
Laggui
OTHER MEMBERS OF THE FAMILY
Farmer/ Barangay
Ignacio R. Laggui Male Married 61 July 31,1959 Santa Maria, Isabela College Graduate
Captain
November
Flora V. Laggui Female Married 57 Santa Maria, Isabela Elementary Graduate Farmer
24,1963
Marco Ignacio V.
Male Single 18 July 19, 2002 Santa Maria, Isabela High School Level N/A
Laggui
Matthew V. Laggui Male Single 16 April 28, 2004 Santa Maria, Isabela High School Level N/A
December
Leiza Kim L. Bingil Female Single 10 Santa Maria, Isabela Elementary Level N/A
06,2010
INITIAL DATA BASE FOR FAMILY NURSING CARE PRACTICE
I. FAMILY STRUCTURE AND CHARACTERISTICS
A. HEAD OF THE FAMILY
Name: Ignacio R. Laggui
Age: 61
Sex: Male
Birthday: July 31,1959
Civil Status: Married
Address: San Rafael East Santa Maria, Isabela
Religion: Roman Catholic
Position in the Family: Father
Educational Attainment: College Graduate
Occupation: Farmer/ Barangay Captain
B. DEMOGRAPHIC DATA
NAME
POSITION
OF BIRTHDA CIVIL EDUCATIONAL OCCUPATI
IN THE AGE RELIGION
FAMILY Y STATUS ATTAINMENT ON
FAMILY
MEMBER
Mcgyver Husband 31 October Married College Roman Office Staff
V. 29,1989 Graduate Catholic
Laggui
Katrina Wife 28 October Married College Roman Baker
C. 19,1992 Graduate Catholic
Laggui
Klein Son 10mos May Single N/A Roman N/A
Myver C. . old 04,2020 Catholic
Laggui
Ignacio Father 61 July Married College Roman Farmer/
R. 31,1959 Graduate Catholic Barangay
Laggui Captain
Flora V. Mother 57 November Married Elementary Roman Farmer
Laggui 24,1963 Graduate Catholic
Marco Brother (1) 18 July Single High School Roman N/A
Ignacio 19,2002 Level Catholic
V.
Laggui
Matthew Brother(2) 16 April Single High School Roman N/A
V. 28,2004 Level Catholic
Laggui
Leiza Niece 10 December Single Elementary Roman N/A
Kim L. 06,2010 Level Catholic
Bingil
C. COMMUNITY ORGANIZATION
D. TYPE OF FAMILY
[ ] Nuclear [ ] Blended
[√] Extended [ ] Gay/Lesbian
[ ] Cohabitation [ ] Foster
E. WHO MAKES THE DECISION IN THE FAMILY?
[ ] Father [ ] Mother [√] Both
F. WHO WORKS FOR THE FAMILY?
[ ] Father [ ] Mother [√] Both [√] Other, specify: All except 18y/o
below
II. SOCIO – ECONOMIC
A. NUMBER OF FAMILY MEMBER/S WHO ARE WORKING: ____________________
B. FAMILY MONTHLY NET INCOME
[ ] 1, 000 – 2, 000 [ ] 7, 000 – 8, 000
[ ] 2, 000 – 3, 000 [ ] 8, 000 – 9,000
[ ] 3, 000 – 4, 000 [ ] 9, 000 – 10, 000
[ ] 4, 000 – 5, 000 [ ] 10, 000 – 11, 000
[ ] 5, 000 – 6, 000 [√] 11, 000 – above
[ ] 6, 000 – 7, 000
C. HOW DO YOU PRIORITIZE THE FOLLOWING? (Rate from 1 – 3)
[1] Food
[3] Education
[2] Health care (check – up, consultation, hospitalization)
III. HOME AND ENVIRONMENT
A. HOME
1. Ownership: [√] Owned [ ] Rented
2. House structure: [√] Concrete [ ] Semi – concrete [ ] Nipa
3. Type: [ ] Bungalow [√] 2 storey [ ] Others, specify: ____
4. Number of rooms: ______4____________
5. Light facility: [√] Electricity [ ] Methane gas lamp [ ] Candle
[ ] Kerosene: ( ) Hasag ( ) Lamp
6. Floor area (square meters): _______80____________
B. WATER SUPPLY
1. Source [√] Open dig well [ ] Pump well [√] NAWASA
[ ] River [ ] Rain [ ] Others, specify:____
2. Ownership: [√] Owned [ ] Shared/Communal
3. Distance from the house (meters): ______12_________
4. Storage of drinking water: [√] Jar with faucet [ ] Jar without faucet [ ] Plastic
bottle [ ] None
5. Source of drinking water: [√] Faucet [ ] Commercialized
C. WASTE DISPOSAL
1. Garbage
Ownership: [√] Owned [ ] Communal [ ] None
Container: [√] Covered [ ] Open
Method of disposal: [ ] Open dumping [√] Compost pit [ ] Burning
2. Drainage [√] With [ ] Without
D. TOILET
Ownership [√] Owned [ ] Communal [ ] None
Type [ ] Pit – privy [√] Water sealed [ ] Flush type
Distance of toilet from source of drinking water (meters): _____5__________
IV. HEALTH PRACTICE AND MEDICAL HISTORY
A. PAST ILLNESS OF THE FAMILY DURING CHILDHOOD [specify]
Husband Common Cold
Wife Rashes
Son Cough and Cold
Father Common Cold
Mother Flu
Brother(1) Cough and Cold
Brother(2) Chicken Pox, Cough and Cold
Niece Flu
B. PRESENT ILLNESS OF THE FAMILY [specify]
Husband None
Wife UTI, Skin Asthma
Son None
Father Hypertension
Mother Hypertension
Brother(1) Asthma
Brother(2) Asthma
Niece None
C. IMMUNIZATION
NAME OF TETANUS
BCG OPV DPT MEASLES HEPA B
FAMILY TOXOID
MEMBER
Mcgyver Yes Yes Yes Yes Yes Yes
V. Laggui
Katrina C. Yes Yes Yes Yes Yes Yes
Laggui
Klein Yes Yes Yes Yes Yes Yes
Myver C.
Laggui
Ignacio R.
Laggui
Flora V.
Laggui
Marco Yes Yes Yes Yes Yes Yes
Ignacio V.
Laggui
Matthew Yes Yes Yes Yes Yes Yes
V. Laggui
Leiza Kim Yes Yes Yes Yes Yes Yes
L. Bingil
D. HOME REMEDIES BEFORE CONSULTING HEALTH PRACTITIONER
[+] Use of herbal medicines
[+] Use of over the counter drugs
[ ] Neglects the disease
[ ] Others, specify____________________
E. HEALTH PRACTICES OBSERVED
[ ] Offering (atang) [+] Consulting a doctor [+] Consulting a quack
doctor
F. FAMILY RECREATIONAL ACTIVITIES [check all applicable]
[+] Listening to radio [+] Watching TV [ ] Others,
specify_______
[+] Reading books, magazines, comics [ ] Sports
G. RECREATIONAL MATERIALS AVAILABLE IN THE HOME [check all applicable]
[+] Radio [+] Reading materials (books, magazines, comics)
[+] TV [+] Cellphones [ ] Others, specify_______
V. VALUE – BELIEF SYSTEM
A. SOURCE OF STRENGTH [rate from 1 – 4]
[1] God
[2] Husband/Wife
[3] Children
[4] Parents
B. RELIGIOUS PRACTICES USUALLY OBSERVED
[√] Going to mass
[ ] Attending prayer meetings
[ ] Others, specify ______________
C. DOES IT HELP YOU IN YOUR DIFFICULTIES? [√] Yes [ ] No
VI. LIVESTOCK/PET
WITHOUT
LIVESTOCK/PET WITH LEASH WITH OWN HOUSE
LEASH/ASTRAY
Dogs Yes
Chickens Yes
Pigs Yes
Ducks Yes
RISK FACTOR ASSESSMENT (questions should be treated as structure and it will depend on how
many question you will ask. Answers must also be indicated as basis for prioritization and FNCP.
Provide three risk factors)
ASTHMA
HYPERTESION
SMOKING
DRINKING ALCOHOLIC BEVERAGES
Structured Questions:
1. What do you do to improve your health?
I drink my medicine on time and eat right amount of food.
2. Do you have regular check-ups with your doctor?
I usually go to heart center on the date that the doctor asked me to come
3. Do you take in alternative medicines or other herbal medicines you think that will improve you current
health?
I intake herbal drink and herbal supplements from recommendations from friends and relatives.
I also drink multivitamins and vitamin C tablets.
