CHAPTER ONE

INTRODUCTION

1.0 BACKGROUND OF THE STUDY:

Family case study: is aimed at approaching a family for identification (diagnosis) of

a health problem affecting them and finding solutions to the problems by a health worker.

This may include purpose of research or health promoting in other word, the family

case study is the process of setting closer to family for a specific reason which are for

observation and care giving through family case study a health worker can be able to

understand the problem of the family and finding solution to the problems.

1.1 DEFINITION OF TERMS:

Family case study is defined as the depth description or act of finding out details

occurred of giving information about case of a particular person suffering from a specific

disease as well as several conditions on health of the family.

A: family is a basic social unit of the society consisting of father, mother, and their

children.

B: case a case of patient who is suffering from diseases or illness that can be managed or

transferred from one place from medical care to another.

C: study is an act of acquiring knowledge and skills for improving particular on achieving

the stated objectives.

1. To identify the development change that occurs during of the disease.

2. To reduce morbidity and mortality rate among under five children due to

pneumonia.

3. To promote good relationship between health and the family members.

4. To promote health of the family

5. To identify some environmental factor and how it affect their family

6. The possible factor that contribute to the increase incidence rate of pneumonia

case

1.3 CASE IDENTIFICATION AND TREATMENT:

This case was brought to the primary health care in Shira local government area of

Bauchi state. The patient was brought with the case of pneumonia usually present at Shira

with certain sing and symptoms which include cough, high or persistent fever, chest in

drowning, fast and difficulty in breathing hypoxia, (low oxygen) stride (wheezing) the

most microorganism that cause pneumonia are virus, bacteria and fungi. But the most

common cause of pneumonia is bacteria if taking immediately, the patient may be come

unconscious. This case study is been carried out with the use of survey, design,

observation, home visit and also with material for data collection such as pen rular, and

exercise book.
2
1.4 DISCRIPTION OF THE AREA OF THE STUDY:

The study was conducted in Shira local government area Bauchi state. The area is

along Bauchi road, the disease between the area of the study and the health facility is

about 2km.

The area consists of various ethnic groups and most of them are Housa/fulani, the

major occupation of the population is farming, business and civil servants. The area has

some features such as primary health centers, dispensaries, clinic, and primary school,

secondary school and good road network and electricity.

i. Ethnic background: The background of the people are Hausa/fulani

ii. Educational background: The family usually study and acquire both Arabic and

western education

iii. Environmental factors: Their environmental is very conducive likewise the do not

have adequate water supply in their house, they have good road network adequate supply

of electricity, topography of soil.

iv. Health seeking behavior people in community usually visit the health facility when

seeking for medical assistance even the village around shira community are coming to the

facility for delivery and other medical assistance.

v. Immunization status in terms of immunization they usually cooperate by taking their

children for routine immunization whenever announcement is passed. Apart from this

3
majority of them use to visit the health care facility for their health need, monthly,

weekly immunization schedule. Base on my acknowledgement and reading this location,

the children have all received their immunization schedule as stated.

vi. Family feeding Patten this family their three square meals every day, in which in the

morning they usually take Akara and pap, sometime left over, food ("dumame") in the

afternoon they take "Tuwo," with vegetables and akra soup among others.

1.5 DESCRIPTION OF THE COMPOUND:

The head of the house hold is civil servant he is working under ministry of

education, he is a teacher in government secondary school shira the house was built with

block cement, plastered and painted with light green paint, the house is located in

unguwar gabas shira local government area Bauchi state.

The house comprise of kitchen, but there is not well or tap as their source of water in

the house. They go back yard to fetch water for their consumption.

The family it is a nuclear family which comprise of five members, the family

members includes, husband, wife and their children the couple usually practice family

planning to give to their children.

- Family pattern family of Mal. Abubakar Muhammad include his brother whom some of

the children are students and some are civil servant and his wife Zainab Abubakar

4
- Composition this is composed of five peoples in the house i.e. the father (Head of the

house hold), the mother and three (3) children.

CHAPTER TWO

2.1 INTRODUCTION

This chapter deal with the literature review on the subject of the study (pneumonia),

pneumonia is general terms that refers to the infection of the lungs which can be caused

by a variety of microorganisms includes virus bacteria and parasite, most types of

5
pneumonia are caused by virus (F I V) respiratory sentential virus (R C V), and para

influenza virus. Pneumonia begin and affect lower and upper respiratory tract infection of

the nose and throat presenting with a symptom of pneumonia beginning after 2 or 3 days

of a cold sore throat and can also occur at any change.

2.2 DEFINITION:

Pneumonia can be defined as the inflammation of the structure of the lungs, it is one

of the commonest manifestation of pneumococcal disease. It may occur in subject of any

age but it is uncounted most frequently in the young and old age.

2.3 CAUSES/ETIOLOGY:

The causative agent of pneumonia is bacteria streptococcus pneumonia, a gram-

positive bacteria with variety of organism include bacteria viruses, my coplasma,

protozoa and fungi can cause pneumonia under appropriate condition the commonest of

pathogens especially in labour pneumonia, is the bacteria streptococcus pneumonia.

Other includes streptococcus aureanus are hemophilic influenza.

Legianela pneumonia spread through water distribution system e.g. air condition

system, and is transmitted via droplet inhalation klepsella pneumonia and system, and

psendomania aureanus are common cause of hospital acquired pneumonia.

2.4 MODE OF TRANSMISSION:

6
 Pneumonia is spread from one person to another through dropped infection if local

condition are favorable involved pneumonia inflammation becomes established

thromboplastic which may cause atitis media clinical observation and studies in

experimental animal suggest that most inhalation of nasopharyngial secretion containing

pneumonia may spread to adjacent to lower with or pericardium about one third of pleura

with pneumococcal pneumonia have a positive blood culture and bacteria may spread

through the positive circulation to reach the meningitis arthritis etc.

2.5 SIGNS AND SYMPTOMS:

1. Fever

2. Cough

3. Chest drawing

4. Fast or difficult breathing

5. Hypoxia (low oxygen)

6. Strider

7. Unconsciousness

8. Convulsion

9. Coryza

10. Anorexia
7
 11. Dyspnoea

12. Hemoptysis (coughing with blood)

2.6 INCUBATION PERIOD:

The incubation period depend on the immunogical status of the pleura and cavity of

the inhaled infectious agent. The incubation period depend on age, it manifestation

quickly in young children and old age. The young children who has under five years has

a range of two 2 to 3 weeks.

2.7 DIAGNOSIS:

Pneumonia can be diagnosis on prompt life, good history and physical examination.

2.8 LUNGS ABCESS:

1. This term is described localized separation of the lung access with cavity formation

on the most X-ray often with the presence of a fluid level and not due to tuberculosis.

2. Emphysema: emphysema means the presence of pus within the pleural cavity, this

usually arise from Bacteria infection spreading from a severe pneumonia or after the

rapture of lungs abscess in the pleural spaces.

2.9 CONTROL MEASURES OF PNEUMONIA:

These include care of the mouth and skin, fluid should be given to avoid

dehydration. The patient is normally nursed by sitting upright; move in the most

8
comfortable to clear chest cough suppressant such as codeine linctus can be treated

symptomatically.

MANAGEMENT TREATMENT OF PNEUMONIA:

1. Bed rest and adequate intake of fluid

2. Cough expectorants e.g cough syrup 5mls t.D.s x 5/7

3. Antibiotic should be given e.g IV amoxicillin 250mg 8 hrly x 24 hrs.

4. Giving normal saline 5% glucose

5. Analgesic should be given e.g p.c.m syrup 5mls t.D.s x 5 days

7. Mother should be avoid exposing their children to cold environment

8. If the condition does not level for over management.

PREVENTIVE MEASURES OF PNEUMONIA:

1. Health education on personal and environmental sanitation

2. Avoid overcrowding especially in bedroom

3. Early detection and promote treatment of effected person without delay

9
 4. Protection of children from cold weather

5. Nutritionals food for the body

2.10 SURVEILLANCE:

Is a common illness which affecting approximately 550 million people globally a

year, and occurring in all part of the world from May 2010 through December 2015, 5600

children age 25 month who met a pneumonia case definition adapted by giving

pneumococcal vaccine accurate development and introduction plan sponsored

surveillance the case facility rate for pneumonia in hospital was % (15 death) and

children who died. After a medium of days of hospitalization (range 0-24 days)

furthermore, in Nigeria February 1992.

In Nigeria pediatrician and community health workers intervention parent living in

1268 house hold in rural tropical rain forest community children between 1 and 5 years

old comprised the largest group of pediatric death (556.4%) followed by those older than

5 years (43%) 1 to 2 month old infant (19.1%) and new born (6.193%).

CHAPTER THREE

METHODOLOGY:

This chapter deals with the method employed by the researcher in gathering the

information for the study. It involves method used in selecting simple from total

population and the instrument for data collection.

- Interview

- Home visit

3.1 OBSERVATION: is the process through which a researcher watch a produce as it is

been conducted. It is also a process where by a health worker observe the environmental

of family for advice.

Based on my observation of Mr. Aminu isah house during this research, the following

are some of the fact that are observed within the family compound in which they live. My

first observation is the structure of the family which is deserved as external and internal

environment of the house in the family. Also their source of water supply is well and is

away from latrine, the usually store food in the house they, have grinding machine, they

grind their food stuff with observation they are carried out is motivate them on their

positive health habit and advice was given on how to improve their positive health habit.

Examples of positive and negative habit are as follows.

1. Early marriage

2. Depriving of child from mother for the purpose of weaning

3. Cutting of umbilical cord with contaminated knife or razor blade

POSITIVE HEALTH HABITS

1. Immunization
11
 2. Exclusive breast feeding

3. Family planning

3.2 INTERVIEW: this is a way which an interviewer will get information from the

interview by giving him a question and receiving feedback from the interview. During

this many information question are asked both the positive and negative information were

received from the family members. These questions include their source of water supply

and how they are managing their solid and liquid waste.

Furthermore, mode of their food preparation, number of bedroom that is in the house,

kitchen, toilets, e.t.c. Mr.Aminu isah is asked how he is maintaining the health of his

family. After the interview, I understand that the life of Mr. Aminu isah is going in the

normal way.

However, they appreciate and regard all the advice to them after the decision.

- Did you take any drugs before?

- When did you start feeling the symptoms of the sickness?

- Did you experience any types of condition before?

- Did you condition involves all the family members or affecting only one person?

- How are you feeling now?

12
 CHAPTER FOUR

SCHEDULE OF THE VISIT

4.1 INTRODUCTION:

Home visit: is one of the method used to achieve the objectives of the case study, it

is to observe the family health need and how they keep health worker to interact with

family in order to guide them on promoting and maintaining their health.

4.2 OBJECTIVES:

1. To observe the immediate environment

13
 2. To interact socially with the family

3. To know the economic status of the family

4. To assist in promoting health of the family and its member

5. For management and quick recovery of patient

4.3 NUMBER OF VISIT:

FIRST VISIT ON 10 MAY, 2021

During this visit, interview was carried out head of the family and the family members.

OBJECTIVE OF THE VISIT

1. To gain cooperation of the household head

2. To know the health status of the children

3. To monitor the immediate environment

EVALUATION:

The family members were evaluated and the individual responses show that the massage

was well received and put it practice.

SECOND VISIT ON 10 JUNE 2021

14
During this visit the general environment sanitation was conducted and found that there is

lean environment and also the general improvement of the child

OBJECTIVES OF THE VISIT:

1. To identify family health

2. To find out whether Mr. Aminu know the case prevention and control of the

pneumonia infection

EVALUATION:

After the discussion, questions were asked enough to make sure there is health behavior

and personal hygiene which will improve their healthy condition.

FOURTH VISIT ON 10 JULY 2021

My patient was brought to me during this visit they finished all drugs given to him by

health worker at the P.H.C Shira local government area, Bauchi state

The condition is stable no any other complain, ire educated the parent about health of

their children on pneumonia infection, the signs and symptoms, the clinic manifestation

of the pneumonia.

OBJECTIVES OF THE VISIT:

1. To set the general improvement of the child

2. To access the health condition of the family compound

4. To re- check the health status of the child who suffered from pneumonia

EVALUATION:

I also received some responses from family about their toilet, waste disposal, drinking

water and food e.t.c because there are some disease predisposing factors that are related

to the observation of the family members.

4.4 OUT COME:

At the end was very grateful to God almighty Allah because my patient has fully

recovered from pneumonia infection based on the treatment which is given to him and the

health education. The family appreciated my care concern, child and the entire family

members.

16
 CHAPTER FIVE

5.0 SUMMARY, CONCLUSION, RECOMENDATIONS, AND LIMITATIONS

5.1 SUMMARY:

The family case study was written on the child of under five years old suffering from

pneumonia in shira local government area of Bauchi state. The child with pneumonia

suffered a lot of complication of care is not taken may even lead how the visit was

scheduled and carried out and goal were articulation the visit.

5.2 CONCLUSION:

17
 The aims and objectives of the research have been achieved as the researcher was

able to educate the family to understand that the cause of pneumonia is not a spirit but

microorganism.

The main objective is to educate the family/public on the various causes, sing and

symptoms of pneumonia and how to prevent it before the condition become worse.

5.3 LIMITATION:

The family case study was carried out at shira community on the cause of

pneumonia there were so many childhood diseases such as whooping cough, diphtheria,

tetanus e.t.c which required depth investigation to the progress of the family case work.

Other includes traditional and cultural factors which affect the quality of the family

case study work.

5.4 RECOMMENDATION:

1. The community should be enlightened on the case and effects of pneumonia and

how to prevent it.

2. The community leaders should encourage their environment clean and maintain

proper ventilation.

3. The mother should be educate on the important of exclusive breast feeding and

how wearing.

18
 4. The health worker should educate community on how to prepare balance diet

using locally available resources.

5. The government should be faithful in giving the immunization and maintain the

cold chain at optional standard and educate the mother and care givers on the

importance of taking the entire antigen that should be giving to a child.

REFERENCES:

1. BB Jefrey (1998) child health Tropical Africa

2. Critical nursing care 3 edition JB LIPPIN Cotton Company (2000)

3. Peter Okon (2014) communicable diseases (2 edition)

4. Roberts circles lore, (1992) epidermiology and community health. Landon edition

5. Ross and Wilson, anatomy and physiology 12 edition (2012)

6. Dennis guide to community Health Vol . 1,2 and Vol . 3 (2 edition)

19