A CLIENT / FAMILY CARE CENTERED CARE STUDY

ON

SCHOOL DROPOUT

WRITTEN BY

MENSAH EBENEZER

(1319180079)

A FINAL YEAR STUDENT OF COMMUNITY HEALTH NURSES’

TRAINING SCHOOL AKIM ODA

JUNE, 2021
 A CLIENT / FAMILY CARE CENTERED CARE STUDY

ON

SCHOOL DROPOUT

WRITTEN BY

MENSAH EBENEZER

(1319180079)

A FINAL YEAR STUDENT OF COMMUNITY HEALTH NURSES’

TRAINING SCHOOL AKIM ODA

SUBMITTED TO THE NURSING AND MIDWIFERY COUNCIL OF GHANA

IN PARTIAL FULFILLMENT OF THE REQUIREMENT FOR THE AWARD

OF DIPLOMA CERTIFICATE IN COMMUNITY HEALTH NURSING

JUNE, 2021
 PREFACE

The family care study is a report writing on the total nursing care, given to a client

and his/her family during a specific period of time by the student nurse. It is also a

scientific way of nursing a patient based on her actual and potential health need.

A client and family centered care study is based on rendering quality health care to

client and his family using nursing process. The nursing process functions as a

systematic guide to client or family centered care with five sequential steps. They are;

assessment, diagnosis, planning, implementation, and evaluation. The care is based on

thorough understanding that, the client is a unique individual with his own problems

that needs to be solved to avoid complications. In order to achieve this, attention

should be given to the physical, spiritual, social and psychological needs of the client

in relation to the family and the community in which client lives.

A community health nurse student is supposed to write a client family

centered care study in partial fulfillment for the award of a diploma certificate in

community health nursing by the Nursing and Midwifery Council of Ghana. The

study helps the student to have knowledge and understand the problem or disease

condition, the signs and symptoms ,causes ,side effects ,complications ,preventions,

diagnosis , treatment and education.

The study also reviews the importance of the relationship that exist’s between

the patient’s family and the community as a major factor in health care and health

recovery.

i
 ACKNOWLEDGEMENT

This care study would not have been successfully completed without the help

of many people.

My first thanks goes to the client Master L. A and his family for their co-operation

and time in making this study a success.

Special thanks go to the authors whose work serve as a guide for the study and also to

principal of the school Mr. Jones Abeka- Baah, and the tutorial staff of the Nurses’

Training College, Akim Oda. I also express my sincere thanks to Mrs. Mercy Odoom

for her efforts and time spent to shape this script and making correction in this script.

Lastly I would never forget the strong support of my family and friends who

supported me throughout this project. I say God bless you all.

TABLE OF CONTENT

ii
PREFACE i
ACKNOWLEDGEMENT ii
TABLE OF CONTENT iii
LIST OF TABLES iv
CHAPTER ONE 1
INTRODUCTION 1
ASSESSMENT OF CLIENT AND FAMILY 3
Client’s Particulars 4-5
Client/Family Medical and Socio-Economic History 6
Client’s Past Medical /Surgical History 7
Client’s Present Medical/Surgical History 8
Obstetric History 9
Client’s Developmental History 10
PROBLEMS IDENTIFIED 11
SWOT ANALYSIS 12
OBJECTIVE OF THE STUDY 13
Specific Objectives 13
CHAPTER TWO 14-24
LITERATURE REVIEW 14
CHAPTER THREE 25
HOME VISITING 25
HOME SITUATION 28
HOME VISITING AND CARE PLAN 29
TENTH HOME VISIT ON 16th MAY, 2021 47
HANDING OVER AND CONTINUITY OF CARE 49
SUMMARY 51
CONCLUSION 53
RECOMMENDATION 54
REFERENCE 55
SIGNATORIES 56
APPENDIX 57

iii
 LIST OF TABLES

Table 1: NURSING CARE PLAN FOR SECOND HOME VISIT.............................29

Table 2: NURSING CARE PLAN FOR THIRD HOME VISIT ................................32

Table 3: NURSING CARE PLAN FOR FOURTH HOME VISIT.............................35

Table 4: NURSING CARE PLAN FOR FIFTH HOME VISIT .................................38

Table 5: NURSING CARE PLAN FOR SIXTH HOME VISIT.................................41

Table 6: NURSING CARE PLAN FOR NINTH HOME VISIT................................45

TABLE 7: PHARMOCOLOGY OF DRUG USED…………………………...……….54

iv
 CHAPTER ONE

INTRODUCTION

The importance of education cannot be over emphasized in this ever-changing

world. It is an established fact that many developed countries achieved their

development due to their high-quality educational system, because quality education

ensures quality individuals, (Acquilano, 2014). Basic education has gained central

importance in the lives of students for achieving further higher education. This is

initial gateway for enhancing the literacy rate in societies providing basic education

for social, political and economic development, (Bilquees&Saqib, 2004). Therefore, a

society is said to be unhealthy if a considerable percentage of its inhabitants are

school dropouts. Various researchers defined the phenomenon of “school dropout”

differently. According to Al-Malik (2015), school dropout is a term used for children

who for any reason other than death, discontinued schooling and leave their education

uncompleted.

I met my client during one of my routine home visit in Jamaica a suburb of

Akim Oda, on 28th February, 2021 in their home during school hours. I met my client

and mother who offered me a seat after I have greeted. I introduced myself as Mensah

Ebenezer a final year student of Akim Oda Community Nurses’ Training College. I

asked client why he is in the house during school hours and we also had a brief

discussion concerning their health. In the course of the discussion, it became obvious

that client has dropped out of school for almost eight months, as a result of lack of

financial support and peer influence. I became more interested and wanted to assist

him to go back to school and therefore asked permission from the mother to use client

and the family for my client and family centered study and she agreed.

1
 I told them I will nurse them for a period of ten weeks after which I will hand

them over to a social welfare officer and a community health nurse for continuity of

care. I assured them of confidentiality in the course of the study and afterwards.

For the purpose of confidentiality my client will be represented as Master L. A

and the mother as Madam B. A and his guardian as Mr. S. A. I thanked them and

scheduled the next visit with them on 14th March, 2021.

2
 ASSESSMENT OF CLIENT AND FAMILY

Assessment is the systematic, comprehensive process of collecting, organizing

and documenting specific data gathered from client and family (Offei and Abeka,

2010).

3
 Client’s Particulars

NAME : Master L. A.

DATE OF BIRTH : 10th August, 2001

AGE : 19 years

SEX : Male

MARITAL STATUS : Single

NEXT OF KIN : Mr. S. A

RELATIONSHIP : Guardian

RELIGION : Christian

EDUCATIONAL LEVEL : Junior High School

OCCUPATION : Unemployed

LANGUAGE SPOKEN : Twi and English

HOMETOWN : Akim Oda (Eastern Region)

NATIONALITY : Ghanaian

CURRENT PLACE OF RESIDENCE : Old Town

ADDRESS : B37/1 (Jamaica)

HEIGHT :157cm

WEIGHT ON FIRST VISIT : 60kg

4
 Mother’s Particulars
NAME OF MOTHER : Madam B. A

AGE : 40 years

RELIGION : Christian (Assemblies of God)

PARITY : G3P3

EDUCATIONAL BACKGROUND : Senior High School

ETHNICITY : Ashanti

OCCUPATION : Trader

ADDRESS : B37/1 (Jamaica)

MARITAL STATUS : Single parent

5
 Client/Family Medical and Socio-Economic History

According to Master L. A (my client) and mother, (Madam B. A) there is no

known hereditary diseases such as diabetes, sickle cell and epilepsy in the family.

There is also no history of mental illness such as clinical depression and

schizophrenia. She said though sometimes they suffer periodically from minor illness

such as headache, fever and cold they usually visit the hospital or clinic whenever

they have any health problem and at times, they seek assistance from licensed

chemical seller for drugs. L. A’s mother confirmed that she works at a poultry farm as

a laborer which serves as their source of income, since the husband left her and they

sometimes seek help from the extended family when there is the need as well as from

Mr. S. A the guardian of Master L. A. Client mother added that there is a cordial

relationship between them and the members of the family and the members within the

community.

6
 Client’s Past Medical /Surgical History

Master L. A’s mother confirmed that client has been admitted to the hospital

before, during childhood which she cannot recall or provide information on it. Client

has passed through all the immunization period, whenever he is sick with headache,

abdominal pains and feels feverish, he seeks health care at the hospital or sometimes

seeks assistance from licensed chemical seller for drugs. My client has not

undergone any surgical procedure. He has no known allergies.

7
 Client’s Present Medical/Surgical History

Client is not having any present medical condition. He has dropout of school for

about eight month and these sometimes make him feel shy and stigmatized when seen

by friends who are in school. He has not undergone any surgery.

8
 Obstetric History

Client is a male and has no obstetrical history.

9
 Client’s Developmental History

Client started his education at the age of five (5) and passed through his

kindergarten to primary. He started growing hair around the pubic and genitals at the

age of 10, client is thirteen years old and was in JHS 2. According to Erickson’s

psychosocial theory my client at age 13 falls within identity verses role-confusion

(12-20 years, Adolescence). At this time individual are faced with finding out who

they are, where they are coming from and where they are going in life.

This is a testing stage as people try to determine what is unique about

themselves and what roles are. People of this age are concerned with their career,

marriage and so forth. Confusion results when the individual fails to reach any clarity

about their roles that they are to play in life. In this case they do not value themselves

as contributors in any way to the society not knowing where to belong and what

values are important and how to go about earning a living.

A healthy resolution at this stage results in the virtue of fidelity, which is the

ability to live by society’s standards despite its inconsistencies and imperfections. The

person who has achieved the quality knows who he or she is and has found a place to

belong and make a contribution. With all these analyses, I can say that my client falls

under the confusion stage because he doesn’t know his role in the society at his age

due to his drop out.

10
 PROBLEMS IDENTIFIED

1. Client has inadequate knowledge about importance of education

2. Poor reading habit

3. Client lacks financial support from mother

4. Stigmatization

5. Client’s brother was having high body temperature.

6. Client is anxious to go back to school.

7. Client mother fetched water from a container without a well-fitting lid.

8. Client’s mother has a cut on the hand.

11
 SWOT ANALYSIS

Client’s Strength

1. Client can read and write.

2. Client has valid National Health Insurance Scheme.

3. Client communicates in English and Twi.

4. Client and family are cooperative.

5. Client is willing to learn more

Weakness

1. Client lacks financial support from parents.

2. Client has inadequate knowledge about importance of education.

Opportunities

1. Client is still young and can go back to school.

2. Clients’ extended family is ready to support him to go back to school.

3. Client has the opportunities to access health care with the NHIS

4. Client has several schools around his area.

Threats

1. Clients lack parental control

2. Clients lives in an area where dropout is prevalence

3. Clients is still among his peers who are likely to influence him

12
 OBJECTIVE OF THE STUDY

Objectives are something that you plan to achieve, especially in business or

work. This may be a long term or short-term objectives.

Objectives are in two categories namely;

1) General objectives

2) Specific objectives.

General Objectives

1. To help my client to be enrolled back to school.

Specific Objectives

1. To familiarize myself with client and family to assess home situation

2. Educate both client and parents on the importance of education and the effect

of school dropout.

3. Educate client on personal hygiene.

4. Encourage client mother and family and authorities to support client

financially.

5. Liaise with school authority to enrolled client back to school.

6. Encourage school authorities to ensure that client is not stigmatized and

create a friendly atmosphere

7. Council client’s mother to get involved in monitoring the academic progress

of client in school.

8. Advice client to stop moving with bad friends who have already dropped out

of school

9. Educate client and family on the effect of broken home

10. Prepare client and family for handing over and continuity of care.

13
 CHAPTER TWO

LITERATURE REVIEW

This chapter reveals the definitions of concept, cause effects and prevention of

school dropout.

DEFINITIONS

School dropout is described as an act where student leave school before the

completion of the program for which they are enrolled for unforeseen reasons Umoh

(1986). School dropout is one of the most disturbing acts which affect student

academically, parents, school and the nation as a whole. High drop out of students at

primary level education has attracted the attention of researchers and academics in

developing countries. The findings of studies vary depending on societies situations.

These researchers also differentiated between rural and urban policy, gender biases,

and even school distance. This section shed light on literature published by researcher.

Chaurd and Mingat (1996) studied dropout of students in two provinces (Punjab

and NWFP). They argued that the drop out of students is low in private school than

public schools. Their study also indicated that students drop out is lower in schools

offering classes in evening (double shifts). Those schools offering double shift

provide flexibility to parents to send their children to school because children are

helping their poor parents in earning some money. Thus, students are able to attend

schools as well as help parents earn their money. Moreover, the drop out is higher in

single gender female schools than single gender male schools. Kemal and Maqsood

(2002), studied the drop out of students in rural and urban areas. They argued that the

harsh treatment of the students helped in increasing the retention of students in rural

areas whereas such harsh treatment was not accepted in the urban areas.

14
 The importance of education cannot be ignored in this ever-changing world. It is

an established fact that many developed countries achieved their development due to

their high-quality education system, because quality education ensures quality

individuals. This education is fundamental for every individual which are the basic

units of society, playing a vital role needed for healthy societies. Therefore, society is

said to be unhealthy if a considerable percentage of its inhabitants are school dropout.

Most researchers defined the phenomenon of “dropout” differently, according to

Jamil et al (2010), school dropout is a term used for the children who for any reason

other than death, discontinued schooling and leave their education uncompleted. Basic

education has gained central importance in the lives of students for achieving further

higher education. This is the initial gateway for enhancing the literacy rate, it is

societies providing basic for Social, Political and Economic development.

CAUSES OF SCHOOL DROPOT

Children may dropout from school due to many reasons and studies listed and

these reasons are in country specific in context based on their social, political,

cultural, economic and environmental circumstances. Malik, M. Zahid, (2000) putted

forward that literacy, poverty, low level of motivation, lack of understanding, child

labour, corporal punishment, teacher behavior and the school environment are such

factors that contribute to the dropout. All of this contributes to school dropout.

Therefore, causes of school dropout can be group into the following; Environmental,

Social and Economic factors, which are outlined below.

Environmental causes

15
 1. Some teachers do not care about the student or help them; teachers

need to use interactive teaching strategies to develop positive

relationship unto their student.

2. Poor infrastructure of the school, such as students being congested in a

classroom, made most uncomfortable and as a result will make some

student dropout if not rectified as soon as possible.

3. Inadequate security of student, where by students are being hurt here

and there without a help from school authorities, it will deter most to

stop school.

4. Lack of proximity of the school to the students, in some instances the

site or location of the school is a little far from the community and

when this happened it will make some students feel reluctant to go to

school, if there is no means of transport.

Social Factors

1. Poor Academic Performance: Access to basic education is the heart of

development and also sustaining access to meaningful learning that has benefit which

is vital to improvement in outcome (Sather, Z.A and C.B Lloyd, 1994). This depicts

that, children who quit schooling as a result of their inability to meet the standard of

learning in school are low productive. With respect to the fact that poor academic

performance is in existence; poor attendance on the part of the children is much

experienced or felt. Most children absent themselves from school because of low

capabilities and abilities to learn perfectly (World Bank, 2009).

16
2. Peer pressure, some friends do influence their friends in school which mostly

bring about negative effect and will make that individual stop school if his friends act

as such.

3. Teenage pregnancy, school dropout can happen if a student becomes pregnant

in the course of training, she has no option than to opt out from school due to the rules

n regulations in that school and sometimes due to the mockery of friends.

4. Some lack interest in school they attend, when this happened the child can

leave the house for parent to see he is going to school, but not so.

Economic Factors

1. Nidhi et al (2007) has also found out that parent economic state and their

educational background play a vital role in educating their children, which may

expose them to school dropout and there is greater chance of gender discrimination.

Client causes for dropping out of school

The following are the causes of my client dropping out of school;

1. Social factor: Peer influence .

2. Economic factors: Client mother does not have any secured job which will

fetch her enough money to support L. A’s education.

Client lives with his mother only and his needs are not always met

EFFECTS OF SCHOOL DROPOUT

17
These can be group into individuals, family and community;

Individual Effects

1. Social vices such as prostitution, robbery, drug abuse, since the individuals has

dropout from school will engage him/herself in these activities because the person is

always with friends in this act.

2. Inability to fit into the job market, if one is unable to acquire the requisite

knowledge and skill he deserves as a result of dropping from school it will make the

individual face challenging’s at the job market.

3. The individual finds it difficult to be with friends who has been able to make it

in school, respect and confident are reduced.

Family Effects

1. Loss of respect from neighborhood, especially those who have been able to

attain a high level of education

2. Increase in dependency ratio on the family, where those few who are able to

make it in life needs to cater for the majority which make burden comes to the family.

Community Effects

1. Poor contribution to community progress.

Effect of school drop out on my client

18
1. Peer influence.

2. Poor interpersonal relationship between teachers and students.

3. Decreased opportunities for career advancement.

4. Vulnerable to early sexual behavior.

5. Poor academic performance.

PREVENTION OF SCHOOL DROPOUT

19
There are many issues that are impediment to the diminution of the effects of school

dropout. The following discussion reveals some factors that can help curb school

dropout and their challenges.

1. Preschool: Preschool centers can be of help to eliminate dropouts, as

elder girls with childcare obligations are normally taken out from school to

take care of their little brothers or sisters (Sherman, R.Z.& Sherman,

J.D.,1990). Also, for children from socio-economically disadvantaged

families, the compensatory role of preschool seeks to minimize later school

failure. Thus, preschools must foster a foundation of learning skills that are

built upon in elementary school and beyond. In contrast, for children from

more advantaged families, the role of preschool is viewed as enrichment.

2. Monetary Assistance: Loan accessibility: Children who are from

families that gain access to loans from banks or any other form of financial

assistance are to a large extent unlikely to be taken out of school. This affects

those in the rural communities as loans become very difficult to access. Some

families do have access to credit yet they give support to their wards on

condition. This explains that conditional child support (provisional assistance)

is an important intervention on school dropout. Provisional assistance: There

are some forms of assistance such as monetary, food and many others which

facilitate or help parents to send their wards to school.

3. Excellent (Quality) Intervention: Intensive care: It is important to improve

monitoring, accountability measures or systems and motivations. Parents’

involvement and frequent accurate information from the school authorities are of very

imperative in intensive care. Monitoring is not the only factor that can be used to

resolve the problem of school dropout under quality intervention rather community

20
involvement can be used to review. Also, community participation in the school

activities or collaboration between school authorities and the community can help

increase enrolment into education and moderate dropouts as well as improving

teachers’ attendance.

Ameri, (2014). Also suggest some preventive measures of school dropout

1. Educate both parents and student on the need for attending school, effects of

school dropout and encourage them not to engage themselves to stay at home.

2. There should be some measures to ensure good interpersonal relationship

among teachers and students to make them have interest in school and obtain the

desire being in school.

3. Provision of basic needs to the students by parents which will make their outfit

normal and have the wish to be in school.

4. Government should collaborate with school to organize scholarship for

brilliant but needy students to motivate them.

21
 CLIENT AND FAMILY TEACHINGS

1. Educated the family to ensure that it is good to educate your child

2. Encouraged the mother to try and provide any assistant client need in other to be
reenrolled

3. Encouraged the mother to provide comfort and affection for the child.

4. Educate client and family on personal cleanliness.

5. Educate client and family on reproductive and adolescent health.

6. Encouraged client and the mother to comply with all the necessary guidelines
that would be given in the course of the supervision.

PUBLIC HEALTH IMPORTANCE

The chapter two reveals that school dropout has a great effect on the individual due to

the trend of in-security and some easy way to make amends. It is quite difficult to

22
prevent the growing youth from not involving in absenteeism which automatically

leads to school dropout but from the study findings, it is inferred that most

teenagers/youth involve in dropout from school due to the information they get either

from friends through socialization or financial problems which my client falls a victim

of such problem. It was also noted that broken homes/single parenting and poor

academic performance on some part of these individuals are some of the factors that

lead to school dropout.

1. School dropout can result to social vices such as prostitution, robbery, drug

abuse, since the individuals has dropout from school will engage him/herself in these

activities because the person is always with friends.

2. Inability to fit into the job market, if one is unable to acquire the requisite

knowledge and skill in school as a result of dropping from school will make

individual face challenging’s at the job market.

3. Low self-esteem from neighborhood, especially those who have been able to

attain a high level of education will always intimidates those who did not.

4. It also increases dependency ratio on the family, where those few, who are

able to make it in life needs to cater for the majority which make burden

comes to the family.

5. Poor contribution to community progress.

6. The individual finds it difficult to be with friends who have been able to make

it in school, respect and confident are reduced. So, this has become a public health

concern that school dropout needs to be reduced.

23
CHAPTER THREE

HOME VISIT

24
 HOME VISITING

Home visit is the art of making a healthy visit in the homes of client and the

family to reach and teaches them healthy living and promoting their confidence in

caring for client at home. It is the core of preventive nursing (Community Health

Nursing). It is carried out by the public health nurse as well as other health

professionals with varying objectives. Home visit remain an excellent way for the

nurse to observe home situation and family, family interaction, and various negative

and positive forces that operate on the client.

There are two types of home visit. These are Routine home visit and Special home visit.

1. Routine home visit: This is the visit carry out by a Community Health Nurse who

goes from house to house to render health services with no client in mind.

2. Special home visit: This type of home visit has a particular client in mind. During

special home visit, the nurse obtains the particulars from the source of referral. The nurse

with the help of these particulars goes straight to the client house or setting to render

specific health service. The kind of visit rendered to Miss. E.A is the special type of visit

PURPOSE OF HOME VISIT

1. To recognize and identify family needs and advice on appropriate solutions

when necessary.

2. To provide care to the individuals and families, including support in times of

stress, give advice and guidance in cases of illness as well as care of healthy

families.

3. To prevent and control communicable disease.

4. Home visit helps trace defaults of health services.

ADVANTAGES OF HOME VISITING

25
1. It helps to establish a good working relationship between client and health

workers

2. It helps to ensure continuity of care and follow up of discharged patients.

3. It helps the nurse to work with families in their own setting where they are

more at ease and ready to open up.

DISADVANTAGES OF HOME VISITING

1. The client and family privacy may be invaded by the nurse

2. Unfavorable weather conditions can prevent from embarking on regular

home visit

3. Transportation to and from the client and family’s home may be

expensive.

26
 FIRST HOME VISIT ON 14TH MARCH, 2021

Objectives

1. Familiarize myself with clients and family and to assess home situation

On the 14th March, 2021, at 12:00 pm, I made my first home visit a week after I

met client during a routine home visit. I arrived at his place at 12:00pm and met his

mother who was cooking outside with client, I exchange greetings with them and they

offered me a seat and some water to drink. She called other siblings of L. A to join us.

I introduced myself to the family again. They once again welcomed me and

showed their gratitude and promise to cooperate in all issues concerning L.A, and

would not hesitate to bring out anything bothering them in terms of health. I also

assured them in terms of confidentiality and total nursing care. I told them that my

visitation will be a period of time after which I would hand them over to community

nurse for continuity of care.

I observe that the surroundings were tided up and the dustbin was well covered.

And I commended them for keeping their environment clean.

We agreed on 21 st March, 2021 as my next visit. I thanked them for their support

and cooperation; they also showed their appreciation by saying thank you.

Problem identified

1. No problem identified.

27
 HOME SITUATION

Master L.A and his family are staying in a compound house which they rent, and

it is made of cement and roofed with aluminum sheet at Jamaica in Akim Oda. The

floor is cemented. The area is of dispersed settlement. There is a kitchen and a bath

house inside it as well; it has six rooms in all and they are well ventilated. They fetch

water from a pipe as their source of water and electricity as their source of energy.

The waste made in the house is kept outside in a dustbin and is emptied when it

is full at the refuse damp van, there is a drainage system in the house.

28
 HOME VISITING AND CARE PLAN

SECOND HOME VISIT ON 21TH MARCH, 2021

Objectives

1. Educate both client and parents on the importance of education.

The second visit to client and his family was made on 21 st March, 2021 at

4:00pm. As I entered, I met one of the siblings of L. A, who took me to their porch

where the family were seated, I greeted them and they responded, I observe the

environment and it was clean. I asked about how they are faring and they responded

they are fine and they offered me a seat, I then made known to them my objective for

the day, after exchanging greetings with them. I introduced my objective for the visit

which was on the importance of education, I asked them how they understand

education itself and how is it important to send your child to school? I realized they

were finding it difficult to answer so I took that opportunity to elaborate to them that

education is the acquisition of skills, values, beliefs and habits. I went on to talk about

its importance and the chances one gets when educated in terms of the job market

that it enables one to fit well into the society as well as into the family and to

contribute his or her quota. I added that some of the effects of lack of education are

unemployment armed robbery and prostitution among others. I asked them for

feedback concerning what we have discussed and they did that correctly. I asked

whether they have any questions to ask. I them allowed them to ask and appropriate

answers were given. I thanked them for their time, coorporation and participation. We

scheduled 28th March 2021 as my next visit.

Problem identified

29
1. Client and family lack adequate knowledge on education.

30
DATE/ NURSIN OBJECTIV NURSING NURSING EVALUATIO
G ES/ ORDERS INTERVENTION
TIME
DIAGNO OUTCOM
SIS E
CRITERIA

21/03/20 Deficient Client and 1.Reassure client 1. client and family were 21/03/2021
21 knowledg family will and family that they reassured that that they will 4:45 pm
e related gain will gain gain adequate knowledge
At Goal fully met
to adequate knowledge into on importance of education
4:00 pm ignorance knowledge important of as client and
2.. They were educated on
on on the education family asked
the effects of not going to
importanc importance more questions
2.Educate client school
e of of education and contributed
and family on
education within 45 3. Client and family were to the discussio
effects of not going
minutes as educated on the importance
to school
evidenced of education.

by client and 3. Educate them on 4. Client and family asked

family the importance of
more questions on what was
asking more education
discussed and appropriate
questions 4. Encourage client
answers were given.
and and family to ask
questions. 5. Client and family were
contributing
5. Ask client and asked for feedback on what
to the
family for feedback was discussed and they did
discussion
that correctly.

TABLE 1: NURSING CARE PLAN FOR SECOND HOME VISITON 21ST MARCH,2021

29
 THIRD HOME VISIT ON 28TH MARCH, 2021

Objectives

1. Educate client on personal hygiene and its importance.

My third home visit to client and family was on 28 th March, 2021 around

3:30pm. On my arrival, I was told L. A is in the bathroom, so I was giving a chair to

sit on to wait for him. Meanwhile it was only the brother I met in the house. I asked of

the other members and was told that they have travelled to Swedru for a church

program and will be coming back the following day. I asked, how he is faring and he

responded he is fine. We were later joined by L. A who welcomed me once again, I

asked how he is feeling which he said he is alright, just that for the past four days he

fine it difficult to go out of his house because, his friends who are still in school have

been mocking him whenever he sees them and this has affected his social interaction

outside.

I first reassured him that everything will be alright and he will go back to

school, I told him that he shouldn’t feel intimidated by his friends but should rather

concentrate on his preparation of helping his mother in other to be re-enrolled back to

school, I also advised him that he should not be playing with friends who always

mock at him instead be with those who will encourage him. I asked if there is any

question for me and they said no. I then told them my objective for the day is personal

hygiene, I discussed with them on the need to maintain personal cleanness at all times,

such as bath at least twice a day, brush teeth twice a day, regular washing and

changing of cloth

when dirty, cutting finger and toe nails to keep them short and neat to avoid infections

when they are overgrown. I added that the importance of personal hygiene is to

prevent certain infections, bad odour, bad breath, as well as to improve the general

30
wellbeing of an individual. I asked if they have any questions on what we have

discussed and they said no.

I thanked them for their time and cooperation and bid them good bye. We then

scheduled our next visit on 4th April, 2021

Problem identified:

1. Client is being stigmatized.

31
 Table 1: NURSING CARE PLAN FOR THIRD HOME VISIT ON 28TH MARCH
2021.

DATE/ NURSIN OBJECTI NURSING NURSING EVALUATIO

VES/ ORDERS INTERVENTION N
TIME G
OUTCO
DIAGN
ME
OSIS
CRITERI
A

28/03/20 Impaired Client will 1. Reassure 1. Client was reassured that 28/03/2021
21 social be free client that stigmatization will stop.
4:30 pm
interactio from stigmatization
At 2.. Client was advised not to
n related stigmatizat will stop. Goal fully met
play with friends who will
3:30 pm to ion within
2. Advise client mock at him
stigmatiz 48hours as as client was
not to play with
ation evidenced 3. Client was advised to
friends who able to interact
by client always play with friends who
mock at him. with friends
happily will encourage him.

interacting 3. Advise client who mocked at

4. Client’s family were
with to always play
encouraged to support him to him
friends with friends who
be enrolled back to school.
will encourage
him.
4. Encourage
client’s family to
support him to
be enrolled back
to school.

32
 FOURTH HOME VISIT ON 4TH APRIL, 2021

Objective

1. Encourage family members to support client financially.

On 4th April 2021 around 8:30 am I paid my fourth home visits to L.A and

family with the aim of encouraging them to support client financially and any

help that may contribute to his enrollment back to school. I got there around

9:00 am but unfortunately his mother had gone out to visit her friends in the

vicinity. They called her on phone and offered me a seat, within 20minutes she

was with us. The objective was introduced. The mother made me aware that

they are trying all that they could to make preparation concerning L. A been

enrolled back to school. The mother made me aware that they have been able

to sow school uniform for him, I congratulated and encouraged them to do

more.

I asked them if there is any problem, they responded that they are alright with the

exception of one of the siblings of L. A, an 18-year-old boy who was having fever this

afternoon. I took my thermometer from my home visit bag and check his temperature,

it recorded 38.3c. I served him a prescribed antipyretic (Tab Paracetamol 1g) and

assisted him to tepid sponge to reduce the temperature.

I then educated L.A’s brother after the bath to take enough rest and visit the

hospital if the symptoms persist. I advised him to sleep under insecticide treated net,

since fever could also be a sign of malaria but he responded that he sleeps in the bed

net and spray the room with insecticide spray whenever he decide not to sleep in the

bed net. I reassured them that he will get well soon and encouraged them to sleep

33
under the treated mosquito net. They expressed their gratitude to me for my time and I

also thanked them and asked them permission to live. We then scheduled the next

visit on the 11th April, 2021.

Problem identified.

1. Client’s brother was having high body temperature

34
 Table 2: NURSING CARE PLAN FOR FOURTH HOME VISIT ON 4TH APRIL, 2021
DATE/ NURSING OBJECTIVE NURSING ORDERS NURSING EVALUAT
S/ INTERVENTION ION
TIME DIAGNOS
IS OUTCOME
CRITERIA

04/4/20 Altered Client’s 1. Reassure client’s 1. Client’s brother and the 04/4/2021
21 body brother’s brother and the family family were reassured that 2:30pm
comfort temperature that temperature will his temperature will
At Goals fully
related to will be reduced subside. subside.
met client’s
8:30am (fever within the
2. Assist client’s brother 2. Client’s brother was brother’s
(38.3) range of 36.2
to tepid sponge. assisted to tepid sponge to temperature
to 37.2 c in 6
reduce the temperature. read
hours as 3. Recheck temperature
36.6℃ and
evidenced by after 10 minutes 3. His temperature was
he
thermometer rechecked after 10 minutes
4. Give tablet verbalized
reading 36.6c paracetamol 1g for 7 4. Tab paracetamol 1g was the absence
and him days. given of fever.
verbalizing the
5. Serve cold drinks 5. Cold drinks was served
absence of
fever 6. Encourage client 6. Client’s brother and
brother and family to family were encouraged to
always sleep under the always sleep under the
treated mosquito net. treated mosquito net.
7. Advise him to go to
7. Advised to go to the
the hospital if symptoms
hospital if symptoms
persist.
persist.

35
 FIFTH HOME VISIT ON 11TH APRIL, 2021

Objectives

1. Liaise with school authorities to enroll client back to school.

On the 11 th April, 2021 at 8:30 am, I made my fifth home visit to find out how my

client and family are doing and inform them that, I will be going to the school where

L. A has decided to go, being his formal school to seek permission from school

authorities for L. A to be enrolled back to school. They welcomed me and offered me

a seat, I thanked them. Later I asked them for my leave to the school, which the

mother agreed to go with me.

I walked together with the mother to the school around 9:45 am, we were

directed to the headmaster’s office, and he welcomed us and offered us a seat. We

then told him our mission to the school at that time, all in the name of L. A to be

enrolled back to school, he asked us the reason why he dropout from school

previously, I made him aware that it was purposely financial difficulties, but now I am

here with the mother we have come to plea on his behalf that we will make sure that

the necessary measures are put in place to help him stay in school.

The headmaster agreed to our request and asked us to register him, he gave us

the registration form to fill, afterwards he assured us that L. A can start school the

following week. He called the teachers and informed them and they were all happy

that L. A will be enrolled back to school. I pleaded with the teachers to ensure a

friendly atmosphere for him when he comes and they must also ensure that his friends

and mates will not laugh at him. They promised to help him to learn. We thanked him

and the teachers assured us that they will do their best for L. A and we left there

around 11:30 am. I went home with the mother and when we got to the house the

36
facial expression of L.A was not encouraging, I asked him and he said he is anxious

of going back to school, but he is afraid that the teachers will beat him and some of

the student will be laughing at him. I encouraged him and reassured him to allay his

fear and anxiety that nothing will happen to him and they are going to receive him

with open arms and he will be happy being in school again.

I thanked them and asked permission to leave, and we scheduled our next visit

on 18th April, 2021.

Problem identified:

1. Client is anxious of going back to school

37
 Table 3: NURSING CARE PLAN FOR FIFTH HOME VISIT ON 11TH APRIL, 2021

DATE/ NURSING OBJECTI NURSING ORDERS NURSING EVALUATION

VES/ INTERVENTION
TIME
DIAGNO
SIS OUTCOM
E
CRITERI
A

11/04/2021 Anxiety client will 1. Reassured client to 1. Client was reassured 11/04/2021
be relieved
At related to allay his anxiety and to allay his fears and 2:30pm
of anxiety
11:30 am client fear anxiety.
within 2 Goals fully met
enrolling hours as
2. Encourage client to 2. Client was encouraged as client look
evidenced
back to
by client feel free and relaxed to feel free and relaxed cheerful
school
looking for school and do his for school and do his best
cheerful
best.
3. Client’s family were

3. Educate the family educated to motivate and

to motivate and encourage him

encourage him

38
 SIXTH HOME VISIT ON 18TH APRIL, 2021

Objectives

1. Follow up on how client is coping in school.

On the 18th April, 2021, at 3:45 pm, I made my sixth home visits to my client and

family. On my arrival I saw L. A’s mother sitting on a chair cooking, I greeted her

and I was giving a seat beside her. I asked of her health and that of the rest of the

family members and she replied ‘everyone is fine’. I told the mother the aim of my

visit, that is to know how L. A is coping with his studies in school. I proceeded by

asking questions pertaining to L.A, like is he coping with the school positively or

negatively, how is his behavior, is he happy to be in school again? The mother said he

is cooperating very well, as she was told by one of the teachers of L. A. We were later

joined by L. A who welcomed me and I asked about his health, which he said he is

doing very well.

I took the opportunity to ask him to share with me on what is happening in

school, how the environment feels like for him, how he is coping with studies and

friends? He made me aware that everything is going on well. I congratulated him to

continue with that attitude and everything will be fine.

During our interaction I realized that L. A’s mother was fetching water to cook

from a container that was not having a well-fitting lid I therefore took the opportunity

to ask her on the need to have a well-fitting lid to cover the container to prevent

infection as dirt and files can enter the water before she uses it to cook or they drink

thereby getting disease like cholera, typhoid and others She thanked me and

immediately looked for a well-fitting lid to cover the container. I asked for
39
clarification if they don’t understand anything and they said they are okay. I thanked

them for their cooperation and time. They also showed their appreciation by thanking

me for everything I am doing for them. I asked permission to leave and we scheduled

our next visit on 25th April 2021.

Problem identified:

1. Client mother fetched water from a container without a well-fitting lid.

40
 Table 4: NURSING CARE PLAN FOR SIXTH HOME VISIT ON 18TH APRIL, 2021

DATE/ NURSIN NURSING NURSING NURSING EVALUATI

G OBJECTI ORDERS INTERVENTION ON
TIME
VES/
DIAGN
OSIS OUTCOM
E
CRITERI
A

18/04/2 Risk of Client and 1. Educate client and 1. Client and family were 18/04/2021
021 infection family will family on the educated on the 4:15 PM
related to be free importance of importance of covering
At Goals fully
uncovere from covering the the container with a well-
met as client
3:45 d water infection container with a well- fitting lid to prevent
mother
PM within 30 fitting lid to avoid infections.
covered the
minutes as infection.
2. Client and family were container
evidenced
2. Educate client on educated on the risk with a well
by client’s
the risk involved in involved in not covering fitting lid.
mother
not covering the the container with a well-
covering
water with a well- fitting lid to avoid
the
fitting lid. infections.
container
with a 3. Educate client and 3. Client and family were

well-fitting family on the dangers educated on the dangers

lid. of not covering the of not covering the

container with a well- container with a well-
fitting lid. fitting lid such as getting
infections like cholera
typhoid and others

41
 SEVENTH HOME VISIT ON 25TH APRIL, 2021.

Objectives:

1. Counsel client’s mother to get involved in monitoring the academic progress

of client in school.

On 25th April, 2021. I embark on my 7 th home visit. I exchange greetings with my

client’s mother and I introduced my objective for the day to her. I counsel client’s
mother to constantly get involved with how client L. A academic is progressing in
school. I told her to visit the school and ask about his performances in the class from
his class teacher and the school authorities and also monitor when he’s in the house to
make sure he is always learning to make sure he is progressing well academically.

I also told her that she should also encourage him to do his homework and try
if she can get a teacher to assist him with his homework’s at home or if she can
manage to let him join vacation classes during vacation so as to encourage him to
learn and progress academically. I thanked them and ask for my leave and we
scheduled the next visit on 2nd April,2021.

Problem Identified

1. No problem identified.

42
 EIGHTH HOME VISIT ON 2nd MAY 2021

Objectives:

1. Advice client to stop moving with bad friends who have already drop out of school.

On 2nd may 2021, I went for my eight home visit. I met client and family in the house and

they offered me a seat in the living room. We exchanged greetings and I introduced my

objective for the day which was on advising client to stop moving with bad friends who

have already dropout of school. I advise client to stop moving with bad friends who have

already dropout of school since they have the tendency to influence him once again to stop

school again and join their company to engage in bad activities they engage in. I advise client

to make good friends who are serious with their studies and academics since those friends

will make him better in his academics and ensure his progress at a faster pace and give him

good advice as well and he agreed. I added that some of the effects of moving with bad

friends brings about social vices like armed robbery, school dropout, truancy, poor academic

performance, streetism and others and I asked if he would like to associate himself with these

social vices mentioned and he said no, He is now focused and want to finish school, get a job

and help his mother who is suffering to get him to the level he want to. He assured me and

the mother that he’s going to keep away from those bad friends and be focused. I was happy

and the mother was also happy to hear this from her son. I ask client to give me a feedback of

all that I have said and he repeated all that I have said to me. After client L.A has repeated all

that I have told him, I thanked client and mother and they also thanked me for the advice. We

scheduled our next visit on 9th April,2021.

No problem identified.

43
 NINTH HOME VISIT ON 9TH MAY, 2021

Objective;

1. Educate client and family on the effects of broken home

I made my ninth home visit on 9 th May, 2021.I met my client and family at 3:00pm. I greeted

client mother and he offered me a seat and told me client L.A has just return from school and

he is in the room changing himself and he will join as soon. Client came with a cheerful face

and I asked why he is so excited and he told me his class teacher conducted a test in the

morning during a math’s class and he emerged as the top student and the teacher asked the

class to clap for him and he is so happy. I also congratulated him and his mother did the same

and we asked him to keep it up. I therefore went ahead to introduce my objective for the day

which is to educate client and family on the effects of broken home.

I educated client and family on the effects of broken home which are lack of parental

control, teenage pregnancy, drug abuse, lack of comfort and affection, armed robbery,

prostitution, and streetism and they promised to adhere to the education given and make sure

client L.A is not affected. The mother also told me she sent a text message to L.A father and

he replied back that since he is in school, he would contribute his quota now that he is in

school to avoid L. A been dropout from school again. L. A became happy and I became

happy that the father has now taken the responsibility to support client’s education.

During the conversation, I realized client mother’s facial expression has changed and

when I asked her, she said when she was peeling cassava the knife cut her hand. I dressed her

wound and taught her how to dress it subsequently. I went on to ask client and family if there

are any questions and they said no. so they thanked me for my endless support and I also

thanked them for their cooperation at all times and they escorted me out side and scheduled

our next visit on 16th May, 2021.

44
Problem Identified

1. Client’s mother has a cut on her hand

45
 Table 5: NURSING CARE PLAN FOR NINTH HOME VISIT ON 16TH MAY 2021.

DATE/ NURSING NURSING NURSING NURSING EVALUATION

OBJECTIVES/
TIME DIAGNOSIS ORDERS INTERVENTION
OUTCOME

CRITERIA

16/05/2021 Impaired skin Client’s 1. Dress 1. Client mother’s 18/05/2021

integrity mother’s skin client cut was dressed

At At
related to a integrity will be mother’s and she was taught
3:00pm 2:00pm
cut on the restored within cut. how to do it on her

hand five days as own. Goal fully met

2. Educate
evidenced by as client
family on 2. Client mother
the cut being mother’s cut
infection and family
healed. was healed.
prevention educated on

by keeping infection

the cut prevention by

clean. keeping cut clean.

3. Advise
3. Client mother
her on
advised on intake
foods rich
of reach in protein
in protein
and vitamin C for
and
effective healing.
vitamin C.

46
 TENTH HOME VISIT ON 16th MAY, 2021

Objective:

1. Preparing of client and family for handing over

On the 16 May 2021. 1 embarked on my tenth home visit on my tenth home visit!

went to my to client house at 4:00pm in the evening I met client and family in the

living room watching television. I greeted them and they responded, they are all doing

very well. They offered me a seat and gave me a glass of water to drink and

introduced my objective for the day which was to prepare client and family for

handing over. I then informed client and family that my care has come to an end as

informed them the first time we met that I will render care to them for a period of ten

weeks after which I will hand them over to a social welfare officer and a community

health nurse for continuity of care. I told them that my care has come to an end since

I have a practical exam which I needed to concentrate on and that I have already

informed the new caregivers concerning the condition of the client and family, the

care rendered and education given so far.

I added that the new caregivers are also competent and therefore shouldn't

hesitate to tell them their problems. I assured them of confidentiality and thanked

them for their cooperation and time throughout the care. They also thanked me for the

care rendered and the education given to them I told them on 30th May 2021 during

my last visit I will come with the social welfare officer and the community health

47
nurse to hand them over for continuity of care. Finally, I asked if they have any

problem and they said no and client and mother were very happy that I was able to

help client LA get back to school and they said they have no problem. They escorted me and

bid me farewell and we said good bye to each other and we scheduled 30th May 2021 as our

next visit.

PROBLEM IDENTIFIED

No problem identified

48
 HANDING OVER AND CONTINUITY OF CARE

I met my client and family at Jamaica on 28 th February, 2021 during a routine home visit.

Client and family were informed that they will be nursed for a period for ten weeks after

which I will hand them over to a new care giver for continuity of care.

On 16th May 2021 during my home visit client and family were informed that my care

has come to an end and that I will hand them over during my next visit as I have already

informed them the first time we met. I made them understand that the new care givers are

equally competent and skillful enough and that they shouldn’t hesitate to tell them their

problem. I added that I have already informed the new caregiver about the client and family

condition, the care rendered and education given so far and that I will come with them during

my handing over.

On 13th May, 2021 I went to the social welfare officer and the community health nurse

at Akim Oda. I told them about my client and family condition, care rendered and education

given. They welcomed me and they introduced themselves to me after which they asked me

of my mission I introduced myself as a final year student of Community Health Nurses’

Training College at Akim Oda. I informed them that I am providing care to a school dropout

client who I chose for my client family care centered care study whom I meet on the 28 th

February 2021 during one of my routine home visit and therefore to ensure continuity of care,

and I would appreciate if they would continue with the care given to my client since my care

has come to an end. They agreed to take over and we scheduled the date for the next visit on

30th May, 2021.

On 30th May 2021, I paid my last visit to my client and family with the social welfare

officer and the community nurse. My main aim was to hand client and family to both the

social welfare officer and the community health nurse. We got to the house at 4:00pm. We

49
met client and family and exchange greetings and I introduced the social welfare officer and

the community health nurse to my client and family. I informed them that the social welfare

officer and the community health nurse will continue with the care as I have already informed

them. They promised to take good care of my client and family.

Finally, they assured my client and family of Confidentiality and to assist them with

any challenges they are facing. Client and family were happy and promise to co –operate with

the social welfare officer and the community health nurse. I thanked my client and family for

their cooperation and information given to them to practice whatever we have discussed.

Client and family also thanked me for the care rendered to them and support given. The

social welfare officer and the community health nurse planned the next visit with them. I

thanked my client and family and promised to check up on them anytime I pass by. The

social welfare officer and the community health nurse also thank them and the community

nurse scheduled the next visit and the social welfare officer promised to do a follow up and

finally we bid them farewell and left

50
 SUMMARY

I met my client during one of my routine home visit on 28 th February, 2021, At Jamaica on

condition of school dropout. School dropout is described as an act where student left school

before the completion of the program for which they are enrolled for unforeseen reasons.

Causes of school dropout include; Peer pressure, Teenage pregnancy, Poor Academic

Performance etc. however my client dropping out of school was as a result of peer pressure

and financial difficulties. My main objective was to enroll client back to school. Specific

objectives were set and some of these were; to liaise with school authorities to put client back

to school, advise client to stop moving with bad friends who have already dropped out of

school and counsel client’s mother to get involved in monitoring the academic progress of

client in school.

I planned to embark on home visit in other to carry out my specific objective. In all, ten home

visits were embarked on during which problems were identified. Some of the problems

identified were; stigmatization, client mother fetching water from a container without a well-

fitting lid and client brother having a high body temperature. Nursing orders were given using

the nursing process and with effective intervention and client and family’s cooperation, all

objectives set were fully met.

Client and family were prepared for handing over on 16th May, 2021 for continuity of care. I

told them that my care has come to an end and therefore there is the need to hand them over

to new care givers as I informed them the first time we met that I will render care for a period

of 10 weeks after which I will hand them over for continuity of care. I told them the new care

givers are equally competent and they shouldn’t hesitate to tell them their problems and I

assured them of confidentiality.

On 13th May 2021, I informed both the social welfare officer and the community

health nurse and we scheduled 30th May, 2021 as our handing over. On 30 th May, 2021 I went

51
together with the social welfare officer and the community health nurse to my client’s house

where I handed them over for continuity of care.

At the time I handed them over client and family’s condition has been improved,

client was able to return back to school and he is successfully going to school and is

performing well academically and the mother is seriously engaged in trading to raise enough

money to support her son.

52
 CONCLUSION

This study has offered me great opportunities and a challenging one as a student of

CHN. Which has helped me to provide total nursing care to a family by putting into practice

the knowledge and skills I acquired during my training. It has boosted my confidence level

and made me more competent since I had the opportunity to practice independently, by

leading the family to identify and prioritize needs, set objectives, plan, implement the

appropriate nursing interventions.

The study has also offered me a real learning experience, working with a family as a unit

and yet providing individual nursing care. There was a good job satisfaction as client and

family came to accept me as being part of them whilst meeting my objectives for the care

study.

53
 RECOMMENDATION

Judging from the increased benefit derived from this exercise, I recommend to the Nursing

and Midwifery Council to maintain this family centered care study as part of the requirement

for the award of a diploma certificate for student nurses to have the basic experience in the

care of client and family within the community.

I also recommended to all health workers especially Akim Oda Registered Community
Health Nurses to conduct effective home visit in order to identify hidden people with various
conditions and give needed care, health educations and management.
I recommend that there should be measures to ensure good interpersonal relationship among
teachers and students to make them have interest in school and the desire being in school.
I recommend that there should be provision of basic needs to students by parents which will
make their outfit normal and have their wish to be in school.
I recommend that government should collaborate with schools to organize scholarship for
brilliant but needy students to motivate them.
I further recommend to the Public Health Nurse whom I handed my client over to ensure
continuity of care.

Lastly, I suggest that the family centered care study should be started in the second semester

of the second year so that, students can have enough time to supervise their client. Thank

You.

54
 REFERENCE

Chaurd and Mingat (2012). General knowledge on school dropout. Research report for the

international workshop on education Policies and prospects. A global perspective

Jamil Asif, Atta Amer, Malik, BalachTalil-ur-Rehman, Danish Ehsanullah, Muhammed and

SiddiqSaiqa, (2010). Parents and teacher’s comprehension on Determinants of early

school dropout, World applied science journal11.12:148-1493.

Kemal and Maqsood (2015). A journal on dropout and truancy in Africa. ZDnet San

Francisco. Retrieved Fromhttp://www.zdnet.com/devices-have/68028

Malik, K, M. Zahid, (2013). Causes of school dropout in primary school dropout in primary

school. Pakistan Journal of Applied Science 2.6:646-648.

Nidhi Kotwal, Neelima and Sheetal Rani, (2017). Causes of school dropout among rural

girls in Kathua District: J. Hum. Ecol 22.1:57-59.

Sather, Z.A and C.B Lloyd (1994), Who Gets Primary Schooling in America: Inequalities

Among and Within Families “American Development Review, vol.33 No.2. pp. 103-

134.

Sherman, R.Z.&Sherman. (1990) “Dropout Prevention Strategies for the 1990s (Draft Copy)”

Washington, D.C: Pelavin Association, Inc.

Umoh (1986). Comparative study of perception of selected school in Kwara state ‘the Nig. J.

Gurdancecounceling 2:15-25.

Valverde Shaw (2015), students and behavior in the class: Controversy in the classroom.

Retrieved from http://www.associated.content.com

World Bank (2009). World Development Report: Spatial Disparities and Development

Policy.

55
 SIGNATORIES

NAME OF CANDIDATE: MENSAH EBENEZER

SIGNATURE: ………………………………………………………………………….

DATE: ……………………………………………………………………………....

NAME OF SUPERVISOR: MRS. MERCY ODOOM

SIGNATURE: …………………………………………………………………….

DATE: …………………………………………………………………………

NAME OF DISTRICT PUBLIC NURSE: MS. GRACE DANQUAH

SIGNATURE: …………………………………………………………………...

DATE: …………………………………………………………………….

NAME OF PRINCIPAL: MR. JONES ABEKAH BAAH

SIGNATURE: ………………………………………………………………………...

DATE: ……………………………………………………………………...

56
 APPENDIX

TABLE 7: PHARMACOLOGY OF DRUG USED

Classification Dosage/route Action Side effect Remarks
of
administration
Analgesics / Orally 5mls/1g Reduce fever Headache, No side effect
anti- pyretic and pain dyspnea

57
45
45
42