Family Health Assessment Part

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Running head: GUIDED IMAGERY AND PROGRESSIVE MUSCLE RELAXATION

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Family Health Assessment

NRS-429VN Family Centered Health

Promotion

Family Health Assessment

Family health assessments are very important. In order to map out an effective teaching plan, an assessment is needed to gather the family’s style, preference, needs, beliefs, and values. The information collected will help to identify the role they will play in managing the health and support for the patient. Understanding, that the family can have both positive and negative influences on the patient (GCU, 2018). In this interview, a family was selected for a focused functional assessment questionnaire consisting of three open-ended questions on eleven different health patterns. This paper will describe the family structure, current health, and overall health behaviors. Two health pattern strengths identify three barriers to health and how the family systems theory can be applied. The family structure consists of the mother sixty-one, two daughters thirty-three and thirty, and the granddaughter is three. The mother is retired and was married twice but divorced after thirty years. They live in Philadelphia, Pa. The mother babysits her granddaughter while her oldest daughter works two jobs and is currently looking for a house. The other daughter also works two jobs and is moving out of the country to teach English. This is a Hispanic working class family.

Values/Health Perception

The family’s church is non-denominational, and they live a Christian lifestyle. All family members regularly attend service. The mother reports that she is very active in the church as a Minister and worship leader. The thirty-year old is a Sunday school teacher. Both daughters are relatively healthy but the thirty-year old is overweight. The mother is also overweight and has several health conditions such as: diabetes, heart disease, HIV, neuropathy, sleep apnea, high blood pressure and narcolepsy. The family reports no to smoking, drinking and drug use. Both daughters have gym memberships and discuss how they are going regularly to maintain health and to lose weight. The mother states that due to her pain status her activities are limited.

Nutrition

The youngest daughter is a vegetarian and does all the food shopping for the house. The mother and oldest daughter and grandchild have separate lists of foods to buy. They try to prepare healthy meals for the mother, but she admits that she down fall is snacking. She loves eating sweets like cookies, chips, and ice cream. They all seem to drink plenty of water. The mother says that they have a water purifier connected to the faucet. The grand child has a healthy well- balanced diet and on occasion the oldest daughter says that she enjoys loaded nachos.

Sleep/Rest

When asked about sleep and rest they are not getting enough. Both daughters are working two jobs and the mother has sleep apnea and reports after waking up feeling sometimes tired throughout the day. The maximum number of sleeping hours is six a day for the family members. According to the sleep health article adults 18 -64 is required to sleep 7-9 hours a day (JNSF, 2020).

Elimination

The mother states that all the other family members have regular clear urine and bowel patterns. However, she suffers from stress incontinence and that she also takes a water pill that constantly keeps her going to the bathroom...

Activity/Exercise

This family is not getting enough exercise or activity. The mother reports that due to the current pandemic that her family’s activity is down. She uses to walk her grandchild to the playground every day to run and play. The daughters report that they are active during work but are too tired to fit in a work out in between jobs or even at the end of the day. They all say that they have gained weight since the pandemic started.

Cognitive

The mother reports that they are all mentally capable and have knowledge to function properly. However, she can get forgetful at times. But she makes all of her appointments and can fill her medication planner weekly.

Sensory/Perception

Everyone in the household wear glasses except for the three-year-old. No hearing devices or aids. All hearing and visions exams are up to date. The mom reports of a new diagnosis of cataracts that she is planning to remove next month.

Self-Perception

They all seem happy with life. The mother talked about living with HIV and how she never thought she would be living with the disease thirty years later, seeing her children grow up and having a grandchild. She gives God all the credit and glory. The youngest states that she changed her bad eating habits and is on a mission to lose the weight.

Role Relationship

This is a close-knit family, and they have a strong bond. They spend a lot of time together and have long conversations and plans for the future. The youngest daughter is the head of the family. She is the smartest and coordinator that keeps everyone one on schedule.

Sexuality

Everyone in the household is heterosexual. No one is dating now or in a relationship. The mother talked about not dating or being sexually active since leaving her husband. The daughters didn’t choose to comment.

Coping

When asked this question the family all said thankful for life, that they have a strong prayer life, and prayer helps them get through the tough times. They rely on God to work it out. That everyone have times of difficulty, but they rely on their faith. The mother was very vocal when this question was asked. She cried describing how God continues to bless her in spite of her illnesses and that she is still alive to tell others about his grace and mercy.

Describe Two Health Pattern Strengths

Two functional health pattern strengths noted in the findings were values and coping. The family ‘spirituality gave a sense of peace. The way the mother expressed her purpose gave importance to a deeper meaning to her life. How she has a strong belief in God and how the other members are connected and share the same feelings.

Three Barriers Identified

The three barriers of health that were identified were nutrition, sleep/rest, and activity/exercise. They have nutrition problems with eating junk foods and foods high in saturated fats, calories and sodium. The mother already has a diagnosis of diabetes, hypertension and heart disease to name a few. The other daughter will get the same diagnosis if she fails to make changes to her poor eating habits. Six hours of sleep or less is not enough. Rest is needed for cardiac health and can reduce stress. Physical activity can lower blood sugar levels and reduce the risk of developing it among other things. Using the pandemic as an excuse for not exercising is unacceptable.

Describe How the Family Systems Theory can be applied

By using The Calgary Family Assessment Models (CFAM), structural, developmental or functional categories a nurse can use therapeutic communication and questioning with an applied assessment to use interventions and create change and improve family functioning (Flexa Souza, Lavareda Costa, & Nunes Carvalho, 2017).

Conclusion

In the end of the interview, the family realized how much they learned from each other and also needed each other, the importance of family health assessments, behaviors, preferences and beliefs that create health promotion. This is just one of many examples used through interventions that can help to resolve health disparities.

References

Duncan, M. J., Oftedal, S., Rebar, A. L., Murawski, B., Short, C. E., Rayward, A. T., & Vandelanotte, C. (2020). Patterns of physical activity, sitting time, and sleep in Australian adults: A latent class analysis. Sleep Health: Journal of the National Sleep Foundation6(6), 828–834. https://doi-org.lopes.idm.oclc.org/10.1016/j.sleh.2020.04.006

Flexa Souza, T. C., Lavareda Costa, C. M., & Nunes Carvalho, J. (2017). Calgary family assessment model applied in riverside context. Journal of Nursing UFPE/Revista de Enfermagem UFPE11, 4798-4804. doi:10.5205/1981-8963-v11i12a24132p4798-4804-2017

Grand Canyon University (Ed). (2018). Health promotion: Health & wellness across the continuum. Retrieved from https://lc.gcumedia.com/nrs429vn/health-promotion-health-and-wellness-across-the-continuum/v1.1/

Appendix A

Family Health Assessment Questionnaire

This family agreed to participate in a family functional assessment. Three open- ended questions were asked on eleven different topics to assess the family’s functional health patterns. The names are not included due to confidentiality.

Values/Health:

1. What is your religious background in your family? We are Christians, and regularly attend service together.

1. How would you describe the health of your family? Both daughters answered “good” and the mother said, “I suffer with diabetes, heart disease, HIV, neuropathy, sleep apnea, high blood pressure, and narcolepsy.

1. What are some of your health goals for this year? Everyone said “more exercise”. Then the mother said to not get sick and try to eat better.

Nutrition:

1. What types of food do you shop for? Vegetables, Meat, fish, bread, cheese, eggs, milk and snacks such as ice cream, pizza and chips

1. How many times a day do you eat? The mother said, I snack all day, the oldest daughter said three times and the youngest said six mini meals.

1. How many nutritious meals do you consume in a day? The youngest daughter said all of her meals are nutritious. The mother said two and the oldest daughter said two but the three-year-old is getting three to four including snacks.

Sleep/Rest:

1. How many hours of sleep are you getting at night? They all said about six, and said the three-year-old takes a nap during the day and gets about eight to nine hours.

1. What time do you go to bed? All the adults said after the news maybe between ten or eleven o’clock. The three-year-old is in the bed at eight pm.

1. How long does it take to fall asleep? The mother replied first and said “as soon as I put my mask on, the oldest said “not long” and the youngest said “within a few minutes”. And the three-year-old takes some time.

Elimination:

1. How often do you urinate during the day? The mother said “I take a water pill it keeps me going all day, the oldest daughter said maybe “four to five times a day”, and the youngest said that’s a good question “I really don’t keep count”. The three year old is going “every two to three hours”.

1. Describe a typical bowel pattern? The mother says one a day, the youngest at least three, and the oldest said one a day. The three year old goes sometimes one or two times a day.

1. Discuss any bowel issues or health conditions? No issues or problems

Activity/Exercise:

1. How often do you exercise, and what kind? The mother replied “none”, the oldest said “I used to work out a lot but now it’s hard to get it in”, the youngest said “me too”.

1. Describe any challenges that may prevent or limit activity? The mother said “I suffer from chronic pain, and neuropathy and I also have a herniated disc”, the daughters said the time gets away from us.

1. What other activities do you take part in? The oldest daughter said “sometimes I walk in between my work breaks”, the youngest “when my schedule permits, “I work out with my girlfriend”.

Cognitive:

1. Have you had any difficulty with your memory? The mother stated “sometimes I may forget little things but overall I remember important things, like taking my medicine”. Both daughters answered “my cognitive abilities are normal”

1. How do you communicate with others? The mother states “I communicate with my doctor’s well”, both daughters replied “we communicate pretty well’.

1. How do you keep your memory sharp? The mother replied “crossword puzzles”, the oldest “reading” and the youngest says “Listening to music”.

Sensory/Perception:

1. I see that everyone in the family wears glasses. How long have you been wearing glasses? The mother replied “for fort-two years, the oldest daughter says “fifteen years”, and the youngest replied “twelve years”.

1. What would a day be like if you didn’t have on your glasses? The mother replied “I wouldn’t be able to see or drive”, both daughters laughed and replied the “same here”.

1. What if any hearing problems do you have? All family members said they had no issues with any senses or perception.

Self-Perception:

1. How do you feel about life in general? The mother replies “I’m thankful for life, God has kept me here, considering my illnesses I’m content, the oldest daughter replied “I’m also happy with my life”, the youngest replied “I can’t complain”.

1. How would you describe yourself? The mother replied, “Loving, gentile, and giving”, the oldest replied “humble and caring”, and the youngest replied “smart, caring and reliable”.

1. How do you feel about accomplishing your goals? The mother replied “my goals was living to see my children grow up and becoming successful”, the oldest replied “I wanted to finish school and travel, marriage didn’t happen but I have a wonderful daughter now”, the youngest said “my goals were accomplished and now I’m looking forward to the next chapter”.

Role Relationship:

1. Who takes care of the family? The youngest replied “I take care of the family. I’m the planner and organizer”, the mother replied “I give the advice” and the oldest “I lay down the law”.

1. How are the relationships between one another? The mother replied “I will speak for us all. We have disagreements, but it all works out in the end”

1. How are the finances handled? The mother Replied “I’m on a fixed income. My daughters split the bills and I contribute to the groceries”.

Sexuality:

1. How is your love life? The mother replied “I have been celibate for thirty years”, both daughters replied “I’m single”.

1. What are you doing to find a mate? The mother replied “nothing”, the oldest daughter replied “I’m not actively looking or dating but if I meet someone special I would show interest”, and the youngest replied “I’m too busy right now”.

1. What is your sexual orientation? All members said “heterosexual”.

Coping:

1. How does your family cope with stress? The mother replied “we have a strong prayer life, we come together and pray”. “We don’t just pray during a crisis but daily”.

1. How do you cope with a loss? The mother replied “I have a large extended family, and when and if we suffer a loss we grieve together, pray and then talk about the good times”.

1. What motivates you to keep going? The mother replied family, staying positive, and life. The daughters agreed.