PFC MATRIX
COMMUNITY-
COMPONENTS PATIENT-CENTERED FAMILY-FOCUSED
ORIENTED
Relevant Hx and PE Family Genogram (on a Six building blocks of
separate sheet) health
DATA Psychosocial issues APGAR 1 Score Social determinants of
health
SCREEM
Clinical features
ANALYSIS Psychosocial issues
Bioethical issues
DIAGNOSIS
MANAGEMENT Non-medical treatment
/
Medical Management
INTERVENTION
* 6 Building Blocks of Health (WHO): i) service delivery, ii) health workforce, iii) health
information systems, iv) access to essential medicines, v) financing, vi) leadership /
governance
COMPONENTS PATIENT CENTERED FAMILY FOCUSED COMMUNITY ORIENTED
DATA Relevant History and PE; Family History Social determinants of health;
Psychosocial issues Family Assessment Six building blocks of health;
Tools, Family Systems Work history; Endemicity
Assessment
ANALYSIS Salient clinical features, Salient features of the Salient features of the
psychosocial, bioethical family dynamics and/or assessments on the SDH and
issues family systems Health system
assessment
DIAGNOSIS/ Medical diagnosis (ICD-10) May mention barriers to May mention barriers to care /
CONCLUSION / Psychosocial diagnosis care/ those things those enabling to care
ASSUMPTION enabling to care
MANAGEMENT/ Treatment: Non-medical and Family intervention to COPC-based
INTERVENTIONS Medical Management address both medical and Addressing the issues identified
Medical and Individual psychosocial issues (existing and proposed)
psychosocial intervention identified
Family GENOGRAM / Family MAP
FAMILY ___________________
DATE _____________________
ADDRESS _________________
II
III
Legend:
Family APGAR 1 QUESTIONNAIRE
ALMOST SOME OF HARDLY
ALWAYS THE TIME EVER
I am satisfied that I can turn to my family for help when
something is troubling me
I am satisfied with the way my family talks over things
with me and shares problems with me
I am satisfied that my family accepts and supports my
wishes to take a new activities and directions
I am satisfied with the way my family expresses affection
and responds to my emotions
I am satisfied with the way my family and I share time
together
TOTAL
LEGEND:
Highly Functional. 8-10
Moderately Dysfunctional 4-7
Severely Dysfunctional 0-3
FAMILY APGAR PART 2 QUESTIONNAIRE
Who lives in your home? How do you get along?
Name Relationship Age Gender Well Fairly Poor
SCREEM
PARAMETER STRENGTH WEAKNESS
SOCIAL
CULTURAL
RELIGIOUS
EDUCATIONAL
ECONOMIC
MEDICAL
FAMILY ECOMAP
SCHOOL CHURCH
WORK HEALTH CARE
FRIENDS RELATIVES
Legend:
________ Positive
_ _ _ _ _ _ Tenuous
~~~~~~~~ Stressful