# Situation: The public health nurse visits a family registered at the Barangay Health Station (BHS). The father, 55, is an office clerk and the mother, 52, is a teacher. Their children are a 23-year-old daughter who leaves next month to work overseas, a 19-year-old son in college, and a 16-year-old daughter in high school. All three children live at home. No member has a current illness. The nurse rates the family from 1 (no competence) to 5 (complete competence) in nine areas, such as physical independence and therapeutic competence, to judge how much nursing service the family needs. Which tool is she using?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=627131  
> language: ko  
> subject: Nursing Practice I — Community Health Nursing

## 문제

Situation: The public health nurse visits a family registered at the Barangay Health Station (BHS). The father, 55, is an office clerk and the mother, 52, is a teacher. Their children are a 23-year-old daughter who leaves next month to work overseas, a 19-year-old son in college, and a 16-year-old daughter in high school. All three children live at home. No member has a current illness.

The nurse rates the family from 1 (no competence) to 5 (complete competence) in nine areas, such as physical independence and therapeutic competence, to judge how much nursing service the family needs. Which tool is she using?

## 보기

1. Family Coping Index **✔ 정답**
2. Caregiver burden scale
3. Family ecomap
4. Family health tree (genogram)

**정답: 1**

## 해설

The Family Coping Index rates a family's coping capacity in nine areas, including physical independence, therapeutic competence, knowledge of the health condition, hygiene, health attitudes, emotional competence, family living patterns, physical environment, and use of community resources. Each area is rated from 1 (no competence) to 5 (complete competence), and low ratings show where nursing service is needed.

## 심화 해설

The Family Coping Index is the tool being described in this scenario. It is a structured assessment instrument used in community and public health nursing to quantify how well a family can manage health-related demands. The index evaluates coping capacity across nine specific domains, and each domain is scored on a 1 to 5 scale, where 1 indicates no competence and 5 indicates complete competence.

The nine areas assessed by the Family Coping Index are:

- Physical independence

- Therapeutic competence

- Knowledge of the health condition

- Hygiene

- Health attitudes

- Emotional competence

- Family living patterns

- Physical environment

- Use of community resources

Low scores in any of these nine areas signal a deficit in the family's ability to cope, which directly guides the nurse in determining the type and intensity of nursing service needed. For example, a family with a low rating in therapeutic competence may require more teaching about medication administration or wound care, while a low score in use of community resources may indicate the need for referral to available health programs at the Barangay Health Station.

The psychometric foundation of this tool is supported by research. A study by Choi and colleagues examined a revised version of the Richmond/Hopkins Family Coping Index and found that the revised operational guidelines improved the variance explained by the index from 59% to 83% [1]. Interrater reliability was high, with values at or above 0.97, and the correlation with another coping index was 0.94 [1]. These findings indicate that when nurses use clear, standardized instructions, the Family Coping Index produces consistent and meaningful ratings of family coping.

In the scenario, the nurse is assessing a family with no current illness. This is important because the Family Coping Index is not limited to families with an active disease. It evaluates the family's overall capacity to handle potential or future health challenges, including preventive care, health maintenance, and response to stressors such as a family member leaving for overseas work. The tool helps the nurse identify vulnerabilities before a crisis occurs.

Key point! The Family Coping Index is distinct from a genogram or ecomap. A genogram maps family structure and health history across generations, while an ecomap diagrams the family's connections to external systems. The Family Coping Index, in contrast, produces a numerical rating of functional coping in specific areas, which is what the nurse in this situation is doing.

Watch out! Do not confuse the Family Coping Index with a caregiver burden scale. A caregiver burden scale focuses specifically on the strain experienced by an individual providing care to a dependent person, whereas the Family Coping Index assesses the entire family unit's competence across multiple health-related domains, regardless of whether a specific caregiving role exists.References (research sources)

- [1]Health-specific family coping index for noninstitutional care.Research articleChoi T, Josten L, Christensen ML (1983) · DOI: 10.2105/ajph.73.11.1275

## 임상 시나리오

Family Coping Index in Home VisitsScoring nine domains to target nursing interventions
The Family Coping Index rates nine domains—including physical independence, therapeutic competence, and use of community resources—on a scale from 1 (no competence) to 5 (complete competence).

Low scores in any domain indicate where the family needs nursing service. For example, poor therapeutic competence suggests a need for medication or wound care teaching, while low community resource use may prompt referral to programs at the Barangay Health Station.

CautionDo not confuse this numerical rating tool with visual tools like the ecomap or genogram; those map relationships and health history, not coping competence.

## 핵심 개념

- **Family Coping Index** — A structured community health nursing tool that rates a family's coping capacity in nine areas on a 1 (no competence) to 5 (complete competence) scale to determine needed nursing services.
- **Therapeutic competence** — One of the nine Family Coping Index domains; the family's ability to carry out prescribed treatments, medications, or care procedures.
- **Physical independence** — A Family Coping Index domain assessing the family's ability to manage activities of daily living and physical care needs without external assistance.
- **Use of community resources** — A Family Coping Index domain evaluating the family's ability to identify and access available health and social services such as the Barangay Health Station.
- **Family ecomap** — A visual assessment tool depicting a family's relationships and connections with external systems, organizations, and support networks.

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