Family Health Assessment - Assignment Example

Running Head: Family health assessment Family health assessment Insert Name Institution Date Family health assessment Introduction A family is as a system with biological, psychological, and social aspects. This understanding is of significance. The family plays an important role in supporting and upholding health of the family members. The family also provides both physical and emotional support to members. Since its inception, the nursing profession has consistently acknowledged the importance of the family in relation to health. Family focus form an essential part of the nursing practice since the health and illness is learnt in the context of the family behavior. When one or more member of the family experience health related issues it affects the whole family. Society survival is pivoted in the health and wellbeing of the members of the family where the maintenance and restoration is vital (Harmon Hanson & Thalman Boyd, 1996). The family theory is value-laden and reportedly varying over time in response to changes in major concepts, values and social developments. Family seems to be described according to what they look like of what they do. A family may also be defined as any combinations of two or more persons who are related by virtue of ties that bind them together by mutual consent, birth, adoption, and placement and together they assume duties for various combinations for physical being and care of the group members. The family developmental theory is an example of multi-dimension advancement in the study of family and its related issues which is important in clarifying the causes of the pattern changes experienced by the family members as they live. The theory also explores the dynamics of the family and how adjustments happen in the family life cycle. The family group is governed by the social norms that organize and control them. There are a quite another of tools that can be used family health assessment. The Calgary Family Assessment Model (CFAM) is made up of three main areas of assessment: family unit structures and we here we explore the internal, the external and contextual; the family development stage captures the stages of development, the tasks assigned to members and finally the functional status, this encompasses instrumentals such as activities of daily living and expressive that is made up of the problem solving , communication, roles, the power, norms and beliefs, coalitions and alliances. Areas of great importance are explored deeper during the assessment and also that depends with the circumstances of a particular family. The genogram and ecomap are the two common tools used in family evaluation. The tools highlight the picture of the family generational and intergenerational associations and also identify the connections within families. The tools also indicate the relationship within families and the outside world. In the case of the family health assessment, a lot has been considered to be taken for granted by the professionals when dealing with the clients, as helping professionals in the health sector it is essential to make it clear to the patients so that there is understanding of what is happening. The possible outcome of any assumption is to dehumanize patients not because of one being unsympathetic, but because wrong assumptions are made about the patients' knowledge of the way we work. (McConnell, Campbell, & Nelso, 2001) To address such kind of occurrences, in every move during the family assessment interview, we honestly share our consideration of what has transpired with the family; we ensure that the family understands our reported observations and concurs with them, and we get their blessing to go on before proceeding. This step will ensure the collaboration is courteous, involves the family, and there is clarity of what their role is in the process. This leads to the orientation stage where it is clearly stated to the family members what their role is in the assessment process. This will make it clear to the family members what to expect during the session and also make them understand what they are there for and also enables the clarity and input from the participants on how they think sessions have to be arranged and what the possible expected outcomes. This helps in minimizing the possible resistance that the process is likely to face. The idea was clearly outlined to the family, what is being planned to be done and how the objectives will be achieved. The rationale of foreseeing them as a family was also explained. Theory phases There are three main phases in the family developmental theory. The initial phase centers on the family life cycle which encompasses the expected steps and developmental path that family partake over time; this allows for further studying of the family from the beginning to the end; from birth to date and growth and maintenance processes. The contemporary theory focuses on the responsibilities and relationships within the family. The family roles act as the guiding principle which include the status, position and tasks that add to the sustainability of the family. Though some negative roles limit the family potential in what they can do, roles make it easier for the family to set goals on what is expected of them and this may present another dimension in seeing the family in terms of the functions they can comfortably serve (Harmon, 1996). Lastly the theory explores the strengths and weaknesses of the family growth and development. The family strengths help the members of the family to believe in their potential in acquiring resources and ability to face the challenges in life. The more people work together the more strong they are and this is the basis of the family strength that each family explores in effectively journey through life. (McConnell, Campbell, & Nelso, 2001) Family strength has been handy in handling individual challenges such as distress. The theory recommends that family strength to be nurtured while decreasing the family limitation or weakness if any. Description of the family The family came from Saudi Arabia to studying in Australia and the family is made up of the father named Khalid 34, mother Moneerah 30 and two children Nasser 5 and Torky 3. Apparently the father is diabetic person and he will undertake his studies in Master of education in Australian university. Though diabetes is considered to be a family disease, no other member of Khalid family was found to be suffering from the ailment. It is an established fact that if a family member is diagnosed with diabetes, the functions of a member of the family will be affected and in this case, Moneerah`s life has been affected by the illness of the husband and her life has never been the same. The children are affected too to some extend though apparently the wife`s life is more directly affected. Diabetes seems to be like any other chronic disease though it’s a bit unique in such a way that it has a continuous huge illness management responsibility that affects the family and the patient (The International Diabetic Federation, 2006). Major health issues experienced by the family In their paper, Ahmed, Kheir, & Hamed (2001) stated that family managing a diabetic patient is affected by a couple of factors that all contribute in shaping the family responsibilities and this may vary from challenges in relation to the severity of illness, the duration of illness, factors development, personal self-concept, social support, stressors, gender, personal self-concept, the social support and family coping strategies. The coping events include the way people respond or deal with stressful events at individual levels (McConnell, Campbell, & Nelso, 2001). In this family we see the sense of high self esteem among the members of the family, intellectual mastery and psychological hardiness which is seen to have helped the family in coping with life strains associated with the being in a family headed by a diabetic patient. The family is found located in Sidney City, in Australia. The family of focus here is made up of four members, two males and two females. The ages are 34, 30, 5, and three for the father, mother, son and daughter respectively. The family can be described to be composed of two adults and two children. The family is migrated from Saudi Arabia and the family speaks both Arabic though the adults are good English speakers and the children are also catching up with the English language which is foreign to them. Looking at the affective involvement, there exists several styles that are identified and they include the absence of involvement, involvement devoid of feelings, narcissistic participation, emphatic involvement, over-involvement and symbiotic involvements. Emphatic involvement is considered the most effective and the symbiotic and absence of involvement is least effective. Moneerah is considered to be involved emphatically and this can be attributed to the fact that she is the other elderly person in the family apart from the ailing Khalid and the presence of the two young children. Khalid may be seen as over-involved since he is the sole bread winner for the family, he has to attend to his studies and work related responsibilities at the same time he sees himself to be more of the burden to Moneerah since she has to attend to all the family chores. When it comes to behavioral control, there exists three situations taken into account and they entail during dangerous situations, during meeting and when expressing psychobiological desires and obligations such as drinking, eating, sleeping, sex or aggression and during the interpersonal social behavior inside and outside the family. The typical and scope of the acceptable of behavior is determined by various styles such as being chaotic, rigid, flexible or laissez-faire and to maintain any given style certain techniques are put in place to maintain them. The Khalid family is seen to be flexible and there was no trace of any chaos. The composure displayed by kids was unprecedented. Family relationship and communication patterns The communication focuses on the interaction between two or more persons in the family and from this emerges patterns as they interact over time. In a communicative relationship the partakers affect and are affected concurrently by others. The communication is transactional in such that interpersonal communication is mutually impacting each participant. Whenever two people interact they both create a context within which each other relate and thus the impact of how much each talks does not matter and the mutual impact remains the same. Here the relationship seems take precedence over individuals. In the family set up, we see that individual communication within an interpersonal perspective and the communication reflect on the nature of the relationship that exists among the members. Understanding the family genogram may highlight the concerns pertaining the multigenerational communication patterns and associations. Looking at the transactional nature of communication may require our exploration of the how the communication has been developed across the generations and each actor`s perception and the reaction to each other shapes the communication patterns. This is exhibited when family members act in certain way towards other members without necessary understanding why they do so or even to think why they are acting in that way. And when such patterns become ingrained, they may become part of the generational inherent attributes which are passed down to family members consciously or unconsciously. Though there are various broad instrumental and effected areas in communication, they include the case of direct and clear communication, clear and indirect communication, masked and direct communication or masked and indirect communication, the clear and direct communication is considered effective compared to masked and indirect communication considered least effective. From the discussion, the members of the family gave their own views of their health status. The family highlighted a couple of things that affect their family`s health and there were a couple of worries that were raised. The family reported to be doing housing exercise and spent leisure time together. The father usually spends the weekends with the whole family. During school vacation, the family usually plans for a holiday vacation outside their home city. Khalid is the main source of the finances that is running the family. Mrs. Moneerah is a housewife and she does all the family shopping and she plans the food for the whole family and she is the one who directly handles all the household duties. The family relationship is tight as shown in the delight in the children faces when the interview was being contacted. No member of the family is reported to be smoking though Khalid is the main patient who is having diabetic. In the context of family support; Mr. Khalid is the main source of financial support. The members of family were proud of each other, despite the fact that the young ones may not be able to conceptualize the depth of their dad`s illness, the family can be concluded to be emotionally healthy. The family enjoys family gathering that is usually organized by the members of local neighborhood where the kids weekend extravaganza is organized twice a month. The community is organized in such a way that there are mechanisms in place to address any needs arising within the neighborhood. The environment is very conducive as the social amenities are well developed and the social structure favors the tastes and preferences of the Khalid`s family. The school is within vicinity from the family house, the hospitals and even the shopping mall is within the family reach. The crime rate is generally very low, the traffic is minimal and the only experienced noise is from the noise during school holidays when all the teenagers are around and they play loud music. The health services are very supportive as there exists a reliable emergence address system. The chemists operate the whole day. Family coping strategies It is evident that the coping strategies have an indirect approach in aiding the family members’ relationship by reducing the psychological interferences such as depression in the diabetic father. The family has exhibited family collective coping approach has been successful in reducing the depressive symptoms. This indicates that family support shows an indirect the presence of the mother has helped the children in coping with their dad`s situation. The psychological strength exhibited by the family indicates the power of family unity in coping with stressors in life. The understanding among the family members has also immensely contributed in the management of the challenges associated with Khalid`s diabetic situation. It was also evident that Khalid`s depression at any given instant in his diabetic situation had an impact on the people around and the same could be seen in the faces of the children and wife. Corbin & Strauss, (1988), reported that depression in any member of the family can be very harmful in that it does not only affect just the depressed but everyone around them and other family members will find it difficult and draining to deal with the depressed person, the depression is infectious. The major observed challenge associated with this is that the relationship with depressed person is usually damaged as the other members of the family will try to avoid any associations to do with them. This usually results in worsened self-image (Miller, 2000) and makes the family member feel even more far part from the other members this increasing the depression of the family member. May coping strategies that impact positively in family adjustment are reported. Hill, 1954 suggested that successful adjustment to a chronic ailment is controlled by many factors incorporating various psychological factors. In a study that targeted to examine the level in which the social support , personal resources, psychological adjustments and coping styles can provide or balance the normal life of different types of the household structures and the impact on each family members of the family, it was found that different individuals in different ways. The use of supportive, optimistic and self-reliant coping approach resulted in enhanced psychological adjustments of the family members (Milton, Holland, & Whitehead, 2006). The use of inappropriate and emotional coping mechanisms has been shown to be resulting in a major shift in the family adjustments problems. The study by Corbin and Strauss (1988) illustrated that people with diabetes differed styles styles of households differed in the satisfaction witrh their resources and the way they cope with the illness.Social support, effective coping strategies and more satisfactoru personal resources are associated with better family change (Corbin & Strauss, 1988). The family and health care specialists have to decide on the effective coping strategies that guarantee most favorable treatment for the diabetic patients that supports their mental health and individual ability. There is need to show the impact of the coping strategies on the family adjustment.The coping strategies are diverse among individuals who experience life strains and these strategies include problem solving, prayer, social support, physical and mental exercise, denial, ignoring the problem and withdrawal (Jacobsen, 1986). Usually when an illness affects the family members, they work together in addressing the problem to resume the normal life. According to (Freund & McGuire, 1991), the trouble caused by diabetes results in reduced self-esteem, self-confidence, the productive contribution to the community, or it may dominate their interaction with other members of the society. Observation When looking at the problem solving, there are two types of problems which is either instrumental or affective and the stages to address the problem involve several stages and they include identification of the problem, communicating the problem to the to the affected persons and individuals, coming up with alternative action plans, settling for the better options, take the appropriate action, observing the action being taken and evaluation of the success and failures of the process (Jacobsen1986). This can only be effective when the whole process is followed to the last stage but a problem cannot be solved when even it cannot be identified. Conclusion To be able to carry out the family health assessment, all the laid down procedures have to be followed and completion of all the steps in the assessment produces valuable information about family problems, and family strengths (Jacobsen1986). The information should be collected in close association with the family and this lays the foundation for fosters cooperation in later collaborations and the understanding gained allows for clear decision making process. References Ahmed, A., Hussein, A., Kheir, M., & Ahmed, N. (2001, March 4). Impact of . diabetes mellitus on Sudanese women. Practical Diabetes International, pp.. 115-118. Corbin, J., & Strauss, A. (1988). Unending Work and Care: Managing Chronic Illness in the Home. San Francisco: Jossey-Bass. Freund, P. S., & McGuire, M. D. (1991). Health, Illness, and the Social Body: A Critical Sociology. Englewood Cliffs: Prentice Hall. Harmon Hanson, S. M. (1996). Family assessment and intervention. In S.M. Harmon Hanson & S. Thalman Boyd (Eds.) Family health care nursing, 147-172. Hill, R. (1954). Social Stresses on the Family. Social Casework, pp. 139-156. International Diabetic Federation, (2006). Today’s children to bear brunt of diabetes epidemic. Cape Town: Release Press. Jacobsen, D. (1986). Types and Timing of Social Support. Journal of Health and Social Behavior, pp. 250-264. McConnell, E., Harper, R., Campbell, M., & Nelso, J. (2001). Achieving optimal diabetic control in adolescence: the continuing enigm, Diabetes . /Metabolism Research and Reviews, pp. 67-74. Milton, B., Holland, P., & Whitehead, M. (2006). The social and economic consequences of childhood-onset Type 1 diabetes mellitus across the lifecourse: a systematic review. Journal of Diabetic Medicine, pp. 821-829. Thalman Boyd, S. (1996). Theoretical and research foundations of family nursing. In S. M. Harmon Hanson & S. Thalman Boyd (Eds.), Family health care nursing. (pp. 41-56). Philadelphia: F.A. Davis. Read More