COMPREHENSIVE FAMILY CASE

REPORT
of

Rol’s Family

Family Medicine Community Health I

Section A
Group 17
Cada, Kristian
Caeg, Anne Clarisse
Calupig, Tiffany Grace
Capacio, Diane Chloe

October 7, 2010
 INTRODUCTION

“Family is the most pervasive and enduring context of human relatedness. There
is no way to intervene in an individual’s life and not affect his or her family. The family
is not a potential source of problem but also a major source of resource in health care,
especially because society expects families to have a sense of responsibility towards their
member”.

-Anonymous

Filipino Families typically consists of a father, mother and their children,

categorized as a nuclear type of family. Often times or most probably seen in the context
of relatedness, the close and knit ties of each family members that extends to its other
generation, from primary family up to the relatives, and shares the same household and
will then be categorized as an extended family type. In this manner, our group case is of
very significant as to how will categorizing a family would place them, from nuclear to
extended, and from extended to single parenting type of family.

Our group handles the Rol Family, Mrs. Anastacia Rol our primary contact person
is married to Mr. Augusto Rol, they had three children, Arnold being the eldest, followed
by Anthony and the youngest is Ana Marie. Due to many circumstances their family
structure was changed, from marital separation to the launching family years as her two
sons have already had their own families.

The family of Mrs. Anastacia Rol (56 years old) is now composed of her as the
mother, her daughter Ana Marie Rol (19 years old) and her grandchild Anjenica (3 years
old). We can classify their family structure basically not a typical nuclear family, as Mrs.
Rol is already separated from her husband and lives now as a single parent rearing for her
youngest daughter, Ana Marie and grandchild Anjenica. Their Family structure and
function will be further discussed in the latter topics.
 THE FAMILY GENOGRAM

Mrs. Anastacia Rol, 56 is married to Mr. Augusto Rol, 55, in the year
1973 but separated in 1999. They had three children, the eldest is Arnold Rol 36 years
old married to Janet in the year and had 3 children, Arriane Jaze, 16, Alrriane Jake, 12
and Alanize 15. Anthony Rol - 34 years old, second of the siblings was married to
Rowena, 31, and had 3 children, namely, Anthoinette 6, Anthony Jr., 5 and Alleah, 2.
Prior to Anthony’s wife Rowena, he had a previous partner, Imelda, 35, but not married
to her. They had 2 children, Mark Antony, 16 and Mark Aldrin, 14. The youngest of the
children of Mrs. Anastacia is Ana Marie Rol- 19 years old. Ana Marie had a child a
swell, named Anjenica, 3 years of age, but Ana Marie is not married to her daughter’s
father which is Erza James 27.

Only Mrs. Anastacia, Ana Marie and grandchild Anjenica live together in the
same household. After her separation from Mr. Augusto Rol 10 years ago because Mr.
Augusto Rol had a another partner, Indang, and lived in together then, leaving Mrs.
Anastacia to rear for her 3 children, after her 1st son leaving the household for building
his own family,year 1994, the second son followed,year 1995, leaving Mrs. Anastacia
and the youngest daughter in the house hold. When Ana Marie, youngest child, entered
college, age 16, she conceived a baby girl and had to stop schooling for her pregnancy.
Ana Marie is not married to the father of her daughter since she was still a minor then.
During this time, it was a very disappointing and depressing years for Mrs. Anastacia
Rol.

Such circumstances in the family may have contributed to the deteriorating health
of Mrs. Anastacia Rol. She is the index patient in the family for having cervical cancer.
She was diagnosed having stage 2 cervical cancer in 2008, was prompted for immediate
treatment and cure. She had undergone treatment for almost 2 years and had survived it.
Up until now, she is recovering from her sickness with the help of her children and
relatives, supporting her financially and emotionally even if sustenance is difficult for
them. One can say Mrs. Rol’s family had undergone many trials, emotionally, physically
and psychologically but she was able to surpass these life’s tremors.
 FAMILY APGAR QUESTIONNAIRE
Part 1

Almost Some of the Hardly

Always Time Ever
A I am satisfied that I can turn to my
family for help when something is √
troubling me
P I am satisfied with the way my family
talks on things with me and shares √
problems with me
G I am satisfied that my family accepts
and supports my wishes to take on new √
activities or directions
A I am satisfied with the way my family
expresses affection and responds to my √
emotion such as anger, sorrow and love
R I am satisfied with the way my family
and I share time together √

Scoring: Evaluation:
Almost Always – 2 Highly functional – 8 -10
Some of the Time – 1 Moderately dysfunctional – 4 -7
Hardly Ever – 0 Severely dysfunctional – 0 -3

** With the total of 6 in APGAR part 1 scoring, we evaluated Mrs. Anastacia’s

satisfaction with her family as Moderately Dysfunctional. Some of the factors that it is
moderately dysfunctional is that because of the fact that her 2 sons have their own family
already, when she have problems, she is having doubts about if she could tell it to her
sons or she would keep it to herself.
FAMILY APGAR QUESTIONNAIRE
Part 2
Who lives in your home? List the persons Check the column that best describes
according to their relationship to you. how you now get along with each member
of the family listed. (for example, spouse,
significant other, child or friend)

Relationship Age Sex Well Fairly Poorly

Daughter 19 F √
Grand daughter 3 F √

** We evaluate this there is no presence of conflict between them and the communication
is still open even if they fairly get along with each other

SCREEM

Economic SCREEM - Resources SCREEM Pathology

Economic stability is sufficient to provide Economic
both reasonable satisfaction with financial • Economic deficiency
status and an ability to meet economic • Inappropriate economic plan
demands of normative life events

• Economic SCREEM – Resources

- A small business, which is Bingo

• Pathology
- Mrs. Anastacia owns a small business, which is bingo, in their community. The
collected income is one of the ways wherein she gets her money for the daily
expenses of the family. And with this kind of socioeconomical way of living, she
is prone to different kind of diseases because of close contact to the people around
 her. And due to this fact, she became dependent on the small income that they get
in their business, and she never think of going back to her work again.

FAMILY PSYCHODYNAMICS, STRUCTURE& FUNCTION

The Mrs. Anastacia Rol family structure is based on Single Parent Family
composed of Mrs. Anastacia, the mother, her daughter, Ana Marie and her grand
daughter, Anjenica. This is due to the fact that Mr. Augusto and Mrs. Anastacia got
separated 10 years ago. Their functional unit of family is based on Family of Procreation
wherein family is established by means of marriage. And based on authority, Mrs.
Anastacia may be classified as Matricentric due to absence of Mr. Augusto which makes
Mrs. Anastacia in a dominant position.

One problem that we focus on Mrs. Anastacia is the time when she was diagnosed
to have Cervical Cancer in November 5, 2009, which the family started to experienced
crisis when they learned about it. The good thing about Rol’s family is that they still
manage to be optimistic individuals towards the situation. Her relatives and her 2 sons
helped her in the all the expenses regarding with her treatment, especially Anthony, who
is working in Qatar. While her daughter supports and tends to all her needs and the one
who’s with her in check up. On this year, 2010 of August 24, the doctor said that Mrs.
Anastacia is cured for Cervical CA but still need to undergo monthly check up. After that
crisis, you will see that the family stays intact and we can say that the family is back to its
equilibrium state.
 ROL’S FAMILY CIRCLE
STAGES IN THE FAMILY LIFE CYCLE
 The family life cycle represents composite of individual development changes of
family members. It shows the evolution of the marital relationship and thus represents
cyclic development of the evolving family unit.
It is important to study the family life cycle of the index patient or the family
itself because the events in their family life cycle can be related to clinical events and to
their health maintenance. The two levels of orders of magnitude of changes are first
order changes which involve increments of mastery and adaptation. It is a “need to DO”
something new which involve tasks that must be accomplished by the family and family
members. The second level of order id the second order changes which involve
transformation of an individual’s status and meaning. It is a “need to BE” something new
to which there are specific goals to be attained in a particular stage of family life cycle.

STAGE I: UNATTACHED YOUNG ADULT

Second Order Changes:
 Young Anastacia wents to be a Secretary. She usually volunteered to write
on the blackboard in her class.

 She’s the eldest sister in the family. She had many responsibilities like
taking good care of her brothers and sisters as well as being a good
daughter to her parents. On the latter years, she feels like tied-on-the-neck
with her parents thus to escape that life, she married Mr. Augusto.

First Order Changes:

 Mrs. Anastacia went on schooling up to third year high in Arellano High School.

 When she was still young, her neighbor asks her to buy palabok in the market, he
gave extra money to her so that she can ride on the Calesa for fast transportation.
But instead of spending that extra money she got, she went on the market by
running and walking fast. The extra money she got will then be her allowance for
schooling on the next day ahead.

 She served as a second mother to her brothers and sisters. Mrs. Anastacia also
reminisce her Simbang Gabi together with her young brothers and sister. They
 regularly attended masses, so one night she woke up all his brothers and sisters to
prepare for the mass. When they came to the church, they were confused about
the time to start the mass because the church was still close. One individual told
them that it was only 12 o’clock in the midnight. The reason behind this was that
they don’t have a clock in their house. Young Anastacia decided to sleep her
brothers and sisters in the lobby of the church and wait for the mass in the dawn.

Problems Encountered:
 The life at that time is hard and many things are not achievable in a limited time
frame like no electrical supply, no water supply, financial support for schooling,
etc.

 Young Anastacia stopped schooling because his elder brother Eliseo who was
supporting her schooling was fired in the Casino he was working with.

 When they transferred in Valenzuela, it was hard for her to walk to ride a Jeepney
just to go for schooling. She did not know that there is a local school near their
place.

STAGE II: THE NEWLY MARRIED COUPLE

Second Order Changes:
 She eloped with Mr. Augusto.

 Mrs. Anastacia married Mr. Augusto on November 16, 1973 in Civil. She was 19
at that time while Mr. Augusto was one year younger to her.

 Mrs. Anastacia lived with her husband’s family.

 Mrs. Anastacia has no problem with her in-laws.

First Order Changes:

  Mrs. Anastacia worked in the canning worker in a local sardine factory.

 Mr. Augusto worked as a painter and still does painting at the present. But before
she married Mr. Augusto, Mr Augusto was waiter in a local restaurant.

 Mrs. Anastacia is already pregnant before she married Mr. Augusto.

STAGE III: THE FAMILY WITH YOUNG CHILDREN

Second Order Changes:
 Mrs. Anastacia gave birth to her eldest son, Arnold Rol, July 21, 1974 eight
months after her wedding.

 She gave birth to her second son, Anthony Rol, April 6, 1976, two years younger
form the eldest son.

 She gave birth to her youngest sibling, Ana Marie at the age of 37. It was fourteen
years before from the last time she gave birth.

 She delivered all of her siblings normal.

First Order Changes:

 The couple worked hard so that they can provide the daily needs of their family.

 She took contraceptives for ten years after her birth to her second son.

STAGE IV: FAMILY WITH ADOLESCENTS

Second Order Changes:
 When Arnold was still courting Janet, they usually brought Ana Marie in their
dates. Ana Marie and Arnold has wide year gap, thus people thinks that Ana
Marie was Arnold and Janet’s daughter.

 Anthony, second son, had his first intimate relationship with Imelda.
First Order Changes:
 The couple worked hard for the schooling of their two sons and for providing
necessary needs to their youngest sibling Ana Marie.

STAGE V: LAUNCHING FAMILY

Second Order Changes:
 Arnold, the eldest son, eloped with his girlfriend Janet and in latter decided to
marry her because she was already pregnant. Arnold was 19 when he married
Janet.

 Several months after Arnold marriage, Anthony also wants to marry his girlfriend
Imelda because his girlfriend was also pregnant.

 Imelda, the pregnant girlfriend of Anthony at that time, did not marry Anthony
but they had two sons named Mark Anthony, 16 and Mark Aldrin, 14.

 Anthony is now married to Rowena on 2003. They have three siblings at the
present. They were Anthoinette, Anthony Jr. and Alleah with ages are 6, 5, and 2
respectively.

 When Ana Marie was 16 and a freshman in Fatima University, she had her
boyfriend Erza James, more than 10 years older than her and got pregnant.

 Ana Marie and her daughter Anjenica are living with Mrs. Anastacia until now.

First Order Changes:

  Mrs. Anastacia took the responsibilities for the nuptial of her eldest son. During
the nuptial of her eldest son Arnold, she cried out because her son was still young
and had not finished college degree.

 Arnold and his wife lived for a while with his wife’s family.

 Mrs. Anastacia wants her second son to continue his study in replace to the eldest
son who already got married. But unfortunately, Anthony had pregnant his
girlfriend and eventually stopped studying to support his own family.

 Mr. Augusto had his new relationship with his common law wife, Indang, They
do not have siblings.

Problems Encountered:
 Arnold has no job and cannot sustain the needs of his new family.

 Anthony needs to support his girlfriend because she is pregnant. He has also no
job at that time because he was supposed to still be studying.

 Anthony wants to marry Imelda but Mrs. Anastacia cannot financially support
them because she already spent her money in Arnold’s nuptial.

 Ana Marie is still young to have a baby. She eventually stopped schooling
because she needs to take good care of her growing child.

 Mr. Augusto developed a new relationship.

STAGE VI: FAMILY IN LATER YEARS

Second Order Changes:
 Mrs. Anastacia and Mr. Augusto has a good relationship eventhough her partner
has a new partner in life.

First Order Changes:

  Mrs. Anastacia regularly attends symposium, seminars, etc. in their Barangay.

 When she has available time and money to spend with, she visits her grandson
and granddaughters.

 Arnold and his family family regularly visit Mrs. Anastacia. They are now
permanently living in Marilao, Bulacan.

 Anthony is now in Qatar. He is a painter there.

 Mr. Augusto gave regular financial support to Mrs. Anastacia.

 Mrs. Anastacia owns a small BINGO game outside of her house for extra income.

Problems Encountered:
 Mrs. Anastacia found out that she has a cervical cancer last 2009. Luckily she is
already cured and was released in the Jose Reyes Medical Center last August
2010.

 Now, she is attending regular monthly check-up.

SOCIOCULTURAL FACTORS IN THE FAMILY

1. Lower Socioeconomic Group- the Rol family could be classified in this type of
group. They depend primarily on the day to day survival and enjoyment. Their
house is not made of concrete materials; instead it is only made of wooden
materials.

2. Lower Social Class- like the above statement, they are more concerned with
pragmatic or practical issues of day to day survival and enjoyment.
 3. Cultural Factors- Mrs. Anastacia has a good value about life. She is already
contented in whatever she has at the moment. She is not a smoke use. Her
younger brother Dominador is a cigarette smoker. She always wake up early
because that was the training of her parents when was still young. They should
woke up early and start cleaning the house, fetching water for their water supply,
etc. The reason of her father is that whenever they wake up late in the morning
that is a sign of being lazy. At early morning when she woke up, she regularly
clean their backyard and their house.

a. Food- Mrs. Anastacia’s favorite fruit is banana, and she even eats it solely
during lunch of dinner whenever she did not like the food serve in their house.
She is now regularly eating vegetables in served. She did not cook for their
food. Her sisters Aida or Jocelyn regularly shares food to them. Mrs.
Anastacia usually buys food for her family’s meal.

b. Exercise- Mrs. Anastacia’s exercise is the daily cleaning of their house and
fetching water in the water pump outside their house.

c. Faith- before Mrs. Anastacia was regularly attending masses. Now she only
requires Ana Marie and her young daughter to attend mass every Sunday in
Fatima Church. Mrs. Anastacia only attends mass during Christmas or in
special occasions in her life.

d. Lifestyles- Mrs. Anastacia is now so fun with traveling and leisures in life.
She treats her house as a refuge for safety and comfortability because she is
living near her brothers and sisters houses.

APPLICATION OF PREVENTIVE MEDICINE IN THE FAMILY

Preventive Medicine is a science and art of preventing disease, prolonging life

and promoting physical and mental health and efficiency for groups and communities,
individuals and families by organized mass action and private patient care.
 The family exercises different ways to prevent certain diseases such as, practicing
a healthy diet, having a clean environment and a water supply that is safe enough to drink
for the family.

Mrs. Anastacia is very compliant when it comes to her medications and her
monthly check-ups with her physician. She is cooperative in taking vitamins and
supplements like Caltrate, Ferrous Sulfate, and Ascorbic Acid for her body. In their
barangay, she constantly attends in the daily seminars prepared by the health workers in
the barangay health canter.

ROLE OF THE FAMILY IN PRIMARY HEALTH CARE

The goal of primary health care is to improve the state of health and quality of life
for all people thru self-reliance and self-determination.
 When Mrs. Anastacia was diagnosed to have a stage 2 Cervical Cancer, Arnold,
her son, together with his wife accompanied her. All throughout the diagnosis,
medication and recovery her children was always there to support her and never failed to
uplift her every time she was losing hope. Anthony who is in Qatar and Mr. Augusto
helped her financially for the hospital expenses and medications.

Meanwhile, Ana Marie took over the household responsibilities while Mrs.
Anastacia is having her chemotherapy and recovering in her Cervical Cancer treatment.
She sometimes took over her eldest brother Arnold in seeing her mother in the hospital.
 Rol’s Family

Family Medicine Community Health I

Section A
Group 17
Cada, Kristian
Caeg, Anne Clarisse
Calupig, Tiffany Grace
Capacio, Diane Chloe
October 7, 2010

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