+

FAMILY MEDICINE MODULENavigating disease and wellness with families thru integration/collaboration using biopsychosocial team-based approach

Helen S. Sigua, MD, MHA, BFEF, FPAFP

+Criteria for selecting family

Willing to give written ethical consent for longitudinal nurturing

Convenient and safe for visitation, near LEC project site Residing on a permanent status by way of ownership or

evidence of long –term lease With member with chronic ilness trajectory No member who is alcoholic or physical abuse/violence

problem

+Family practice interprofessional collaborative practice model

+Drivers for integration

+Shades of continuity to achieve

+Players in the envisioned system of care

+LEARNING COMPETENCY 1

Given a family in the community,

At end of the year, the student must demonstrate an understanding of the micro and macro psychosocial, behavioral, contextual (home & community) factors which influence the family’s manner of navigating disease and wellness.

The student is expected to use that understanding to collect and incorporate relevant data into an appropriate care/intervention project addressing the following specific issues:

+Specific issues to address:

Forces that affect health-seeking behavior Effect of family relationships & dynamics on health and

illness and vice versa Complex behavioral change towards health

improvement Age(developmental & normative)-related behaviors Role of education, economics, school/ workplace

environ, social institutions, & leisure on their health Community resources and public health programs &

resources

+Learning Competency 2

Given a family with a sick member in the hospital setting,

the student is expected to demonstrate an understanding of the micro and macro biomedical and psychosocial, behavioral, and contextual (hospital/health systems) factors influencing the family’s manner of navigating disease.

The student is expected to gather and incorporate data into an appropriate care/intervention plan that addresses the same specific issues as enumerated earlier.

+Strategies for family health & wellness intervention System diagnosis Community action Self-efficacy Patient education Supportive environments and healthy public

policy Decision-making support

+ LEARNING TARGETS

Disease in its undifferentiated presentations, and 2 kinds of trajectory acute, chronic

Wellness: promotive

+3 E’s

EngagingEvaluatingEquipping

+family engagement process

To apply patient-centered communication skills/techniques and models in establishing rapport and partnership with the families

To get relevant information about both biomedical and psychosocial state of health and all influencing factors using both micro (person & family) and macro (beyond family) lens

To get a glimpse of the family’s structure & function in terms of dynamics, roles, resources, using family systems theory

To integrate professionalism and ethical during encounters To set and align health & wellness goals with the family

+Process & outcome outputs for family engagement process (July 2013) Documentations of this journey in terms of KII, family

conferencing, home visits, oculars, direct observation Identification of the skills/techniques/models applied on

patient-centered communication, facilitation skills, family skills

Accomplished home visit form, pre-FC worksheet, FC process checklist, FC outcome form, family satisfaction survey

Self-reflection

+Family evaluation process (September, 2013) Biomedical---longitudinal care plan with trajectory Psychosocial

Family assessment tools applied and their outcomes Meanings derived from the tools Coming up with a cohesive interpretation of the family

in terms of structure & functionality Sharing and validating with family

+Family equipping process (Dec, 2013) Carrying out your family nurture plan Outcomes and significant progress of the

intervention/care/nurturing process Measures: qualitative, but not necessarily purely

narrative Conclusions, lessons learned, insights, inspirations

+accessibility

+Structure : logical model worksheet

+For more in-depth consumption

Insel & Roth. 2012. Wellness Worksheets Coleman & Newton. 2005. Supporting Self-management in

Patients with Chronic Illness Dilorio, et al. 2002. Motivational Interviewing as Health

Promotion. Arnold, R. 2010 . (Hospital) Critical Care Communication

Fundamental Skills. Kissane et al. 2007. Conducting a Family Meeting. A BDI Logic Model for working with young Families: a

resource kit. http://www.healthyteennetwork.org/index.

+Adviser assignments & their contact numbers/emails Group 1 Sigua 09086429944 , 861-37-

11hsigua@gmail.com Group 2 Dionisio Group 3 Lazaro Group 4 Pascual Group 5 Abrogena Group 6 Madrigal Group 7 Josef

+ toolkit

Sigua’s electronic tool inventory (2012-13), family consent from, logic model worksheet

Sigua’s powerpoint, demo video, family conferencing skills card (2013)

All lectures from yl5 to yl7 www.fmdrl other benchmarks & standards we can google along

the way

that can help us reach our goals & targets

+Community Pediatrics rotation

In-vivo processing thru demo return demo of family conference and home visit using 2 families referred to Family Medicine

Pre-FC worksheet after toolwork Informal but structured and prepared for Documentations Tuesdays 1-5 PM

+ Patient-centered care plan (March, 2014) Select a case from any hospital , handled by

consultants with family-leveraging skills training (list will be provided at that time)

Apply the 3’s as much and as far it can allow you in the short time

Usual case presentation with a patient-centered tweak

+Grade Computation

Individual Final exam - 20% 50 mcq 60 passing

Individual Attendance/Punctuality- 10%

Group Clinical Performance-70&

(360 degree) Adviser’s grade (40) Peer grade (20) Family satisfaction (10)