Conducting a thorough assessment of a families health, and health beliefs is important in understanding the family as a whole unit. “A comprehensive family assessment provides the foundation to promote family health” (Edelman & Mandle, 2006, p. 154). Once a health assessment is completed, the nurse can initiate health promotion and disease prevention activities to assist in promoting a healthy lifestyle. In this paper, the findings of a complete family health assessment, including nursing diagnoses and resources will be summarized. Eleven Functional Health Patterns
A middle class, Caucasian family was interviewed, and a complete health assessment was conducted. The family present in the home consisted of a father, age 55, his daughter, age 29, and the daughter’s son, age 12. The eleven functional health patterns of this family were assessed and are summarized as follows. Great value is placed on family as a whole. This family has a strong bond between each other that has helped them through tough times. Another value of importance is honesty and trust. It is important that they be truthful to each other in order to maintain trust within the family. This family voiced their view of health perception as “not being ill”. Although they would ideally like to be healthy, they engage in non-healthy behaviors such as smoking cigarettes daily and small amounts of alcohol intake. Concerns were voiced regarding smoking cessation, but it was stated “smoking is something we enjoy”. All members of the household recognize that greater focus should be placed on nutrition.
The family reports that due to busy lifestyles including work and school, they have difficulty preparing healthy, nutritious meals. Fast food and processed foods are relied upon often, due to lack of time and energy. All three members of the household report being overweight due to lack of adequate nutrition. The father works the graveyard shift at a local grocery store and sleeps approximately six to seven hours per night, and has done this for over 25 years. Daughter and son report getting 8-10 hours of sleep on a regular basis. With a busy lifestyle of work, school, and extracurricular activities, they report “they do not always feel rested”. This family reports no problems with bowel movements. All three members report having regular bowel movements on a daily basis. The family reports attempting to exercise regularly, but with busy schedules of work and school it is not consistent. Another setback stated is weather. In Arizona, heat plays a role in this family’s activity level in the summer. In winter months, the family engages in outdoor activities such as hiking and walking. The father and daughter have a high school level education.
The son currently is in elementary school in the sixth grade. The family reports learning in a multimodal style including aural and visual. All members of the family have normal hearing and visual screening tests without the use of assistive devices. This family once viewed themselves as a strong family unit. After the death of the wife, mother, and grandmother in 2007 due to cancer, they report the family has since weakened. They now state they have to work twice as hard to maintain a similar home life. They have learned to work together to get basic tasks completed, such as laundry, grocery shopping, and cleaning. The father is the main moneymaker. He works at a grocery store as a night stocker to provide for his daughter and grandson. The daughter works also works at a grocery store as a cashier, and strives to be a positive role model for her twelve-year-old son.
In this family, the father and daughter reside in the same household. Neither father nor daughter report being in a sexual relationship at this time. Coping has been an issue in this household. After the 2007 death of the wife, mother, and grandmother, the daughter became severely depressed. For approximately nine months, she reports major depressive symptoms, and being unable to care for her son. Grief stricken himself, the father was of minimal help to his daughter. Through the help of psychiatric physicians, the daughter has since attained help and continues to work on her battle with depression. Nursing Diagnosis and Health Promotion Strategies
A nursing diagnosis that can be made from the assessment of this family is nutrition, more than body requirements. “Overweight and obesity are common health conditions in the United States” (Camden, 2009). This family must “adopt changes to promote a healthier lifestyle” (Newman, 2009, para 27). Through the use of dietary changes and exercise, small health changes can be made (Newman, 2009). Working with a dietician to create healthy meal choices that are both affordable and easy to prepare, will assist the family in making this lifestyle change. Also, encouraging small steps towards creating an exercise plan, such as an evening walk, then building from there, by adding more strenuous activity such as jogging, will promote health a healthier lifestyle.
Resources available to assist the family with proper nutrition include the American Heart Association. This company offers excellent nutritional resources for families including healthy meal choices, and can be contacted by phone or mail. Another resource is the United States Department of Agriculture, food and nutrition information center. This website offers excellent information regarding diet and disease, as well as nutrition assistance programs.
Another nursing diagnosis suited for this family is ineffective coping. It was stated by the daughter that after the death of her mother in 2007, she fell into a severe depression that affected the entire family. “Five to 11 percent of the total population of the United States will experience major depression at some time in their life. Over half of those will have recurrent episodes periodically throughout their lives” as stated by Preskom (Horsley, 2004, p. 1). With the assistance of a psychologist, education can be provided to the daughter and family regarding antidepressant medications and the importance of continued use. Also, education regarding the importance of psychotherapy for both daughter and family are necessary in promoting family health.
National Alliance on Mental Illness, is a community resource that offers a helpline for information on mental illnesses, and referrals to local groups and self help groups for support, education, and services for families and individuals. Mental health America, NMHA.org, provides information available on the website regarding medication, disorders, treatment, groups, and insurance. Systems Theory
The systems theory guided this writer through the family assessment by providing recognition that families’ behaviors and responses have influence on the family’s patterns and lifestyles. This theory also provided this writer insight regarding families’ interactions with each other including communication and decision-making. Conclusion
The promotion of family health relies greatly on the comprehensive family assessment conducted by the nurse (Edelman & Mandle, 2006). By assessing the family as a whole and incorporating the 11 functional health patterns, nursing diagnosis are determined, proper interventions and resources are provided, allowing for the promotion of family health.
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Newman, A. (2009). Obesity in older adults. The Online Journal of Issues in Nursing. 14.
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