Group 4: Karl, Bia, Cliff, Chin, Harm, Joanna, Berto,

Geno, Paula, Mica

Ahaa, ito pala si Jayme ang

batang payatot!

12 kg

92 cm

BMI = 14.2

Severely Stunted

Severely Underweight

Normal BMI

Pale Conjunctivae

Impacted Cerumen

Cervicolymphadenopathy

Dental Caries

Medical

Family

Social/Environme

nt

Behavioural

Economic

Interventions

Poor Eating Habits

Dental Caries

Exposure to TB

Poor Hygiene

“Ako si Jayme. Payatot at malungkot!

Behavioural

“PICKY EATER”

GENOGRAM

47

43

20

18

16

13

11

10

8 8m

29

26

4 3

malnutrition

TB

Hemorrhagic stroke

FAMILY MAP

breadwinner

Caregiver (controlling)

Index patient

Parenting Style and Family Meals: Cross-Sectional and 5-year Longitudinal Associations

Parenting style has the potential to impact eating behaviors

Authoritative parenting style predicted higher frequency of family meals

Child BMI was also positively associated with parental stimulation of healthy intake

High parental control over child eating interferes with children's self-control over their intake thus leading to a deviant eating style

FAMILY APGAR FM 1 FM 2

ADAPTATION I am satisfied that I can turn to my family for help when something is troubling me

1 2

PATNERSHIP I am satisfied with the way may family talks over things with me and shares problems with me

2 2

GROWTH I am satisfied that my family accepts and supports my wishes to take on new activities or directions

2 2

AFFECTION I am satisfied with the way my family expresses affection and responds to my emotions, such as anger, sorrow or love

2 2

RESOLVE I am satisfied with the way my family and I share time together

2 2

OVERALL ASSESSMENT 9 10

Highly Functional

APGAR

Parameter resource pathology

SOCIAL The family has a good relationship with each other and also among the members of the community because the parents have a lot of relatives in the community

Although they have good relationships with each other. The father is always out for work which would impair their relationship with each other in the future. Also, the extended family does not share with the family’s success. They even envy and try to bring each other down.

CULTURAL The family has good kinship practices, they can rely on each other. They believe in traditional practices which make them bonded with the community

Some practices, like hilot, are not helpful in treating severe conditions and a lot of times, it will make the illness worse.

Religious The family members are all Roman Catholics

The family is not active with their practice and does not go to church regularly

Economic In the economical aspect, the family can pay and provide for their basic needs

The family’s resources are only enough to provide their everyday necessities but when emergencies or crises happen, their finances may not be able to cover for them.

Educational The family is able to finish basic education and has access to health education in the health center.

Even though they have this basic education, they have health misconceptions which prevent them from seeing the gravity of their health situation. Their knowledge of basic health is inadequate the protect them in their environment.

Medical The family lives near the health center which makes it easily accessible for them. Also, the Ilugin local government and NGO’s have good programs that they can access. The mother is enrolled to Philhealth.

For now, there are medical programs which are advantageous to the people and good, but when the time comes that there serious illnesses which cannot be handled by the health center, the family does not have enough resources to seek help from other institutions.

Interventions

Transtheoretical Model of Change

by Prochaska & DiClemente, 1983.

Pre-Contemplation

Increasing awareness Does the family recognize the need for a change?

Educate the family on the importance of a healthy lifestyle and diet

Do they understand the consequences of unhealthy eating habits and opposing parenting styles? Teach them about the short term and long term

effects of being unhealthy Do they see the benefits of living a healthy lifestyle?

‘Quiz’ them on their learnings

Contemplation

Re-affirm the family’s decision to make changes Praise the family’s decision to commit to

change State, once again, the benefits that they will

gain from it Assure that you support their decision

Preparation

Target and build specific knowledge and specific skills Make a list of objectives

Set achievable goals for the family Start with small, realistic goals that are easy to

attain

Action

ChildStart slowly but surely

Introduce vegetable and fruits one at a time

Encourage but not coerceUse of coercive control tactics to counter

children’s resistance during mealtimes resulted to problematic eaters (Sanders, et. al., 1993)

Action

ChildSet simple cognitive rules

Vague instruction giving was particularly likely to be associated with increased food refusal and decreased chewing (Sanders et. al, 1993)

“When, then” rule

Action

Parents

Establish a unified parenting styleAuthoritative parenting styleCommunicate with one another

Set an example to children

Maintenance

Are they aware of the change they have achieved?

Are they aware of the things that they may tempt them to revert in their old behavior?

Maintenance

Operant conditioning: creating an environment that will support healthy eating habits and reduce exposure to bad eating healthy habits

Maintenance

Availability of high fat, high sugar foods are considered antecedent of poor eating habits (Bowmann and Pratt, 2008)o Discourage buying junkfoods,

chocolates and candieso Discourage buying noodles and

other unhealthy alternatives

Maintenance

Reinforce positive behavior by commending good behavior

Associate healthy eating with happiness. Make eating time a pleasurable activity

Be involved in community programs that motivate them to continue the change.

Maintenance

Addressing other issues that will contribute to the problems (e.g. finances)