Family health as a whole is an integral part of the development of healthy individuals. In order for the family to produce healthy individuals they need to function well holistically in all aspects of family life including health and wellness. If even one individual in the family is experiencing health issues which are not being addressed it can have a detrimental effect on the whole family. Therefore, it’s imperative that when performing an assessment on a family the nurse has as complete and thorough assessment as possible in order to identify any areas in which there is a problem.
“Families provide the structure for many health-promotion practices; therefore, family assessment informs health-promotion and disease-prevention appraisal. Within families, children and adults are nurtured, provided for, and taught about health values by word and by example. Within families, members first learn to make choices to promote health.” (Edelman, 2014) Once the nurse identifies the problem or problems they can develop an appropriate family nursing care plan. This paper will be based on one family’s interview with two nursing diagnosis and care plans developed to promote a brighter healthier future for the family. The Family
The family is a white Hispanic first and second generation American low middle class that consists of a 43 year old single mother, a 13 and 7 year old daughters that were conceived out of wedlock from a long term extramarital affair. The father is only sporadically in the picture accounting for visits of 3 to 5 hours once a month. Values and Health Perceptions
Health is viewed in this family as being asymptomatic of any illness. The mother promotes healthy eating, exercise/activities, teaching right from wrong, encourages open communication and for the family to express themselves freely. The family practices preventative care including well check ups, vaccinations, dental, and vision care. The mother feels that preventative care is very important in the overall scope of well-being. Nutritional Perceptions
The mother feeds herself and the children small healthy portions, restricting sodas, fried foods and junk food to promote good nutrition. The Hispanic culture includes many fried foods and she modifies recipes to exclude frying to cut back on the fat content. She serves breakfast and lunch on a schedule and two snacks, one at 5 pm and one at bedtime while the family is at home. When at school the children eat lunch at the cafeteria. She limits eating out to special occasions and as a reward. Sleep and Rest Perceptions
The mother has a set bedtime for the children of 9 pm which they rarely deviate from even on weekends and holidays. She tries to go to bed by 11pm and spends those 2 hours in between the children’s and her bedtimes as “mommy time” in which she unwinds and relaxes. The mother routinely wakes up at 5:15 am to prepare for the day and the children awaken 30 minutes later to eat breakfast and get ready for their day. Elimination Patterns
The mother states that both children were potty trained by the age of 2 and she did not encounter any difficulties in the training. There are no skin or urinary problems in the family but the youngest child suffers from constipation when he eats cold cuts and hotdogs. She states that her food “gets stuck in her digestive tract” which is called “empachada” in Spanish which is an old wives tale. Because of this she is hyper vigilant of asking and even observing the stools that her children have. She practices folk medicine when this occurs by administering castor oil, hot teas, and massaging of the stomach, back and calves to alleviate the “empachada”. Activity and Exercise Perceptions
The Family incorporates exercise by walking to and from school, going swimming, riding bikes to the park, and going to Jump Land and playing on the trampolines at least 3 times per week. She states that they don’t formally exercise but have activities that are fun and active. Cognitive Perceptions
The mother states that her oldest daughter has ADHD and dyslexia. Because of this she maintains the routine schedule for afterschool homework where she can be available to help and to encourage that they stay on task. She encourages learning by taking the girls to outings to the library and bookstore and has instilled a love for reading since an early age in both girls. She leads this by example being an avid reader herself. The mother feels that education is a team effort between the teachers and parents and is in close contact with her children’s teachers in order to accomplish this. Sensory Perceptions
The mother said that they are non-practicing Catholics. The family does not attend church regularly. She teaches her children about God and the saints, right from wrong, celebrates religious holidays such as Easter and Christmas, and attends church on the occasional holiday. They do not follow any special diet restrictions that are preached by the church. Self Perception
The mother feels that others see her as a strong independent woman. Even though she is independent she perceives herself as not being as strong as people think. She faces daily challenges and conquers most of her fears but she definitely doesn’t feel as strong as people believe she is. Role and Relationship Perception
This family is not a very traditional Hispanic family in that she is a single mother with two daughters born out of wedlock. The mother is the main provider and works outside the home. The children have daily chores and help prepare meals. Her relationship with her family is very close and she is the go to person or factotum for her family. She feels that this adds additional stress because she feels that everyone needs her and she needs to be there for everyone but she has no one to lean on herself. Sexuality Perception
The mother is not currently in any kind of relationship and is abstinent. She finds it difficult to maintain an active sexual lifestyle being a single working mother. She states that she is done having children but is not currently on any birth control due to no sexual partner at this time but if the occasion should call for it she would definitely use condoms to prevent pregnancy and disease. She is open about sexuality with her children and encourages them to talk to her about reproduction. She also provides them with age appropriate reading material regarding sexuality and reproduction. The mother would like for her children to have the whole fantasy of love, getting married, and having a family in the traditional sense but she would rather see them happy as single mothers than miserable in a marriage. Coping Perception
The mother deals with stress by avoidance, pulling away from the situation, letting everything calm down and then finding a solution. Her biggest stress factor right now is financial, making sure that the bills get paid and she has enough money left over to provide rewards for them. The father of the children only provides occasional monetary assistance. She is aware that her coping is ineffective and states that she needs to develop better communication skills. This family though loving has a some risk factors that endanger the family’s health. These are Altered bowel elimination evidenced by youngest daughters intolerance to cold cuts and “empachada” bouts and Ineffective individual coping as evidenced by the mothers avoidance in stressful situations. Conclusion
In order to adequately assist families in achieving health, it is important for the nurse to assess the family as a whole as well as its individual members (Grand Canyon University, 2011).
By conducting a thorough and effective family health assessment we are able to help families by providing nursing diagnosis and care plans to improve the family’s well-being and health.
References
Edelman, C. (2014).
Health Promotion Throughout the Life Span [VitalSouce bookshelf version]. Retrieved September 23, 2014 from
http://pageburstls.elsevier.com/books/978-0-323-09141-1/id/B9780323091411000061_t0015
Grand Canyon University. (2011).
The form and function of the family, Grand Canyon University, NRS 429V Lecture 4, retrieved from: https://lc-ugrad1.gcu.edu/learningPlatform