Child and Family and their Social, Cultural and Relationship Problems - Essay Example

Nursling analysis, assessment and Care plan Abstract The goal of this paper is to analyze, asses and identify social, cultural and or relationship problems in the given family, which resulted in the child's current condition, and formulate a necessary interventions and care plan in order to provide nursing care in the child's health and development, as well as aim to find a appropriate solution to the child's current psychological and physical issues. Nursing analysis, assessment and care plan A family assessment, also known as a home study, is a tool used to gather important and necessary background information on the patient and his immediate relatives. The information that is gathered is essential in determining what has affected the patient, and therefore is very important in determining what steps to take in order to provide a care plan and intervention. This makes a family assessment a good approach to take in determining how to provide assistance and care to our patient and finding out what steps to take in order to provide long term wellness. A family assessment should contain discussions regarding the type of family, family finance, safety, health, emotional support within the family and outside the family and family roles. (Pillittery, 2007). This will be the guide that this paper will use in order to gain the necessary information it needs in order to create an appropriate conclusion. This will also help in the paper's goal, which is to provide recommendations on nursing recommendations for a six(6) week period. This paper's main discussion points are; The case and it's background Genogram of the family Family assessment Suicide assessment Family issue and identification Analysis and assessment of identified family issue Analysis of the issue in relation to current literature Strength identification and analysis Nursing intervention plan and rationale Nursing care plan The case and it's background The case we are presented with provides us with a multitude of variables, facts, ideas and sources. Most, if not all of these things are things that will have some sort of effect on the child, either for short term, or in the long run. We were provided with a short family background, relationship descriptions, summaries of actions and histories, and these are the points of the case that our paper will focus on and use in order to get the needed results. We will also be relating these facts to current literature in order to get a bearing on the correct path to take for the assessment and nursing care plan. Aside from the family influence, cultural, religious and environmental influences also play an important role in this case, as, according to a paper by oregonstate.edu, these social influences will have a resounding effect a persons attitude or outlook. Aside from the factors stated above, the case had also described some issues such as the child's difficulty in adjusting to life in a foreign place, being diagnosed with Post traumatic stress disorder, suffering from a form of Dyslexia, being diagnosed with Epstein-barr virus, having been teased at school due to his racial background, and being unable to be with the people he is comfortable with for one reason or another. On their own, these issues may be minor, but combined, they create a massive impact on the child and his wee-being. We will take all of these factors into consideration for the entire duration of the case. Genogram Here is the genogram of the Farrokh family, based on the description provided in the case study. Family assessment Jalil is a member of the Farrokh family. They are of Iranian descent. He has 3 brothers and one sister. Both of his parents are still living and both are employed. They migrated to Australia around 8 ½ years ago. They follow the Muslim faith. Their family finances handled by his parents but due to financial constraints, Jalil has to work part time in order to support his studies. The family has had experiences dealing with emotional or mental difficulty, one example being Jalil, who was diagnosed with Post-traumatic stress disorder, but were able to cope with it effectively. The family has not had a lot of time to spend with each other as they are all busy either working or studying. The men of the family often attend prayer at their mosque and are involved in the local Iranian club. The children are also involved in extracurricular activities such as sports. The father has worked as a pharmacist in Iran, and now works in a cafe, while the mother, previously a school teacher, is now mostly a stay-at-home parent with a part-time position as a tutor. Suicide assessment According to Jalil's family, he has shown symptoms that lead to depression such as loss of interest in school, prayer or other activities, sudden weight loss, and aggression. According to multiple sources, adolescents who are depressed are at a high risk of suicide. He has also shown evidence of alcohol usage, disconnection from his family, and an interest in literature related to taking ones own life. This makes the possibility of suicide very real. Family scenario issue identification and analysis Based on the case information that is available, we can gather that there are multiple factors that we can consider to be issues affecting the child's current mental state and health status. This portion of the paper will concentrate on identifying the factors or issues that are family-driven and focusing on at least one issue that can be considered a major influence. These factors or issues are as follows: The family's lack of time to spend with each other The constant and sudden relocation of the family The family's different religious or cultural profile from the environment Jalil's experience with racism, discrimination, and teasing Jalil's separation with the people he feels comfortable with Jalil's acceptance of his illness (Epstein-Barr) Jalils apparent suicidal tendencies Analysis and assessment of identified family issue In order to narrow the paper's focus in terms of issues, the paper will focus mainly on the issue of Jalil's apparent suicidal tendencies. This will be the issue of focus as, if not kept in check, may result in more serious health problems. A few other things to consider may be the effects of depression on our subject. According to Adele Pillitteri in her book “Maternal & child health nursing, Care of the childbearing and child rearing family, Fifth edition, Volume 2.” Signs of childhood depression may include but are not limited to loss of interest or pleasure, siginificant weghtloss or gain, depressed mood, suicidal ideation, and or feelings of worthlessness. Also, according to scienceinpublic.com in their article, “Suicide in Australia” death in children resulting from suicide have risen in Australia in the recent past. Although, according to the article, recent steps in order to prevent or lessen this figure have been effective, the rate of increase in recent times is still quite alarming. This is also a necessary point of focus because the issues stated in the article are described as main factors that prompt a suicide attempt. Issues such as separation anxiety, post-traumatic stress disorder, and depression are, according to Sheila L. Videbeck, some of the factors that increase the risk of suicide attempts. Other factors that also come into play, which are also evident in the scenario, are isolation, recent loss, lack of social support and critical life events. And, things to also keep in mind are the things like unexplained changes from the person's usual behaviour, erratic behaviour, and unstable lifestyles. This study will further discus literature related to the main issue in order to highlight some of the risks associated with the child's current status, emotional responses and reactions, and his apparent suicidal tendencies. Analysis of the issue in relation to current literature With the help of current related literature, this study will shed light on the dangers, factors, influences and effects of suicidal tendencies. We will use related literature in order to highlight this issue's importance and urgency. All of the literature that will be used will be both on similar topics, and will be current, no older that 5 years. In an article by Physorg.com called “Are young children prone to suicide? Signs to watch for”, it mainly focuses on depression and sadness as a factor for suicide and suicidal tendencies. Although it focuses on young children, it does state “(suicide) ranks third for 10- to 14-year-olds and second for those 15 to 24” as top causes for death. This highlights the danger of suicide in people within our subject's age group. The case also describes a scenario where in the child seems to be in a sad frame of mind. Another article called “Teen Depression, A GUIDE FOR PARENTS AND TEACHERS” by Melinda Smith, M.A., Suzanne Barston and Jeanne Segal, Ph.D, focuses on teen depression, its signs, symptoms and possible results or outcomes if untreated. The article highlights some tell tale signs of teen depression. Some of the signs mentioned in this paper were also exhibited by our subject, such as Withdrawal from friends and family, Loss of interest in activities, Irritability, anger, or hostility, Lack of enthusiasm and motivation and a change in eating or sleeping habits. This does not automatically mean that our subject is suffering from depression, however, we should take note of these symptoms carefully in order to avoid any unwanted scenarios. The paper also states that depression in teens is very different from depression in adults, and as such, must be looked at differently and approached differently. Many effects of depression have been stated in the paper, one of them being suicide, however, the other effects are nothing to ignore either, and as such, depression should be treated or avoided as much as possible, whenever possible. The same article above also discusses suicide signs to watch out for in teens, and at least one of them raises and alarm, which is when they seek out ways of taking their own lives. This gives us a small peek in to what our subject is possibly thinking, as well as ways in order to communicate and assist the teen that may have suicidal tendencies. In yet another article, this time a news article by ERIK ECKHOLM and KATIE ZEZIMA from the New York times newspaper titled “6 Teenagers Are Charged After Classmate’s Suicide”, bullying was the main force that drove a teenager to commit suicide. Although other factors such as abuse and harassment played a role in this suicide case, it all started from bullying, which was also experienced by our subject. Granted that the intensity or extent of bullying may not have been as extreme, we must recognize that bullying in its self, no matter how intense or how often, has some sort of negative effect on the target of the bullies. This is supported by another article called “Teenage Bullying”, from bullyingstatistics.org. This article identifies the kinds of bullying and their effects. Although the case only describes one kind of bullying which is verbal, we cannot discount it as something minimal. The last article I will be including as related literature takes a look at the role of the family in depression. The article called “Depression: A Family Matter” by Hara Estroff Marano, discusses on the effects of a depressed or seemingly depressed person on a family unit, and also states that assistance or care from the person’s family can be a good staring point for both support and solution creation. This gives us a good point to focus on. This means that we can use the subject’s family as a focal point in assisting him and providing effective support. Strength identification for the family Looking at the provided information as well as the family’s description, we can gather that although there are issues that need to be addressed, there are also plenty of strengths that are evident in the family’s habits, culture and outlook. These strengths will be key factors that we can leverage for the advantage of the child. We can use these strengths as a sort of foundation or backbone to build on. As seen in the case description, one of the innate strengths that the family has is that it knows when to seek help. This is seen when they sought counseling for Jallil’s Post-traumatic stress disorder. This is also evident when they worried about Jallil’s suicidal tendencies and recent change in behavior and consulted their religious leader or Imam. Although the case does describe them as being a very self sufficient family with the ability to make an effort for themselves, as seen in them taking jobs other than what they were accustomed to or being working students, it also shows that they know when an issue needs an outside opinion. Another strength that is described in the case file , and a strength we can certainly leverage is the family's ability to move on from a traumatic experience. This was seen when the family resumed a normal lifestyle after the war, and made a life for themselves after their experience in the boarder camp. Yet another strength that this family possess is their trust or faith in their religious belief. This is seen when they drop other activities that are supposed to be done on a Friday night in order to be able to pray and attend their religious meetings. This is also evident when they asked their religious leader for advise regarding their son's changing condition. This shows the level of trust they have for their Imam. Another strength that they possess is their close bond with the group of people of the same culture as them, within their community. This provides them with a sort of support group in which people who have similar opinions, culture, and idea would be able to provide them with advise on situations that they may have already encountered. The last strength that this study will discuss is the family's urgency and effort in order to provide for themselves financially. This is seen when they are described to have taken jobs different from what they are accustomed to. This shows that the urgency for financial stability is more important that being comfortable with the job they have. This is also seen in the children's effort to study and work at the same time in order to stay self-sufficient to a certain extent. Nursing intervention plan and rationale. Identify degree of risk/potential for suicide and seriousness of threat. Rationale: In order for you to plan an appropriate and effective counter measure and to prevent further undesired issues arise. Providing safe environment. Rationale: Physical safety of the client is a priority. Assuring that the child is comfortable in his environment and making sure to avoid physical injury in conjunction with mental fatigue. Develop therapeutic nurse-patient relationship. Rationale: It will help to promote a sense of trust and it is also a great opportunity for the client to verbalise feelings openly. Use silence and active listening when interacting with the client. Rationale: Letting the client know that you are willing to listen to his feeling and perceptions. It also consider the client as a worthwhile person. Negotiate No-Suicide Contract. Rationale: This contract will give the client the sense of responsibility. It should also contain that the client must notify care givers to the first impulse to harm himself. Teach the client effective social skills such as allotting time for family communication and voicing out of opinions and concerns. Rationale: This will ensure that the child and the others of the family have an outlet in order for them to share their needs and get support. Continuously give positive feedback when necessary. Rationale: It will give hope to the client in facing certain problems such as illness and anxieties. Discuss losses client has experienced and meaning of those losses. Rationale: Allowing the client to voice out feelings in order to provide closure and acceptance. Engage in physical activity programs. Rationale: Promotes feeling of self-worth and improves sense of well-being. Teach the client about the problem-solving process. Rationale: Successful use of the problem-solving increases the client's confidence in the use of coping skills. Reference Adoption (2011), michigan.gov, September 13, 2011, http://www.michigan.gov/dhs/0,1607,7-124-8566-24032--F,00.html Definition of Suicide (November 12, 2010) medterms.com, September 13, 2011, http://www.medterms.com/script/main/art.asp?articlekey=24337 Depression (2009) thefreedictionary.com, September 13, 2011, http://medical-dictionary.thefreedictionary.com/depression Doenges, M. E, Moorhouse, M. F, Murr, A. C, (2006) Nurse's pocket guide. Diagnoses, prioritized interventions and rationales, Edition 10. September 13, 2011 Eckholm, E. Zezima K. (April 8, 2010) "6 Teenagers Are Charged After Classmate’s Suicide" www.nytimes.com, September 13, 2011 http://www.nytimes.com/2010/03/30/us/30bully.html Genogram (2011) wikipedia.org, September 13, 2011, http://en.wikipedia.org/wiki/Genogram Grief after Suicide (2011), cmha.ca September 13, 2011 http://www.cmha.ca/bins/content_page.asp?cid=3-101-103 Influence Theories, Social Influence, (2010) oregonstate.edu, September 13, 2011, http://oregonstate.edu/instruct/comm321/gwalker/influence.htm Marano, H E. (January 05, 2011,) Depression: A Family Matter, psychologytoday.com, September 13, 2011 http://www.psychologytoday.com/articles/200303/depression-family-matter Pillitteri, A. (2007) Maternal & child health nursing: care of the childbearing and childrearing family. Fifth edition, volume 2. September 13, 2011 Smith, M., M.A., Barston S. and Segal, J. Ph.D (June 2011), Teen Depression, A GUIDE FOR PARENTS AND TEACHERS, helpguide.org, September 13, 2011 http://www.helpguide.org/mental/depression_teen.htm Suicide in australia., (2010) scienceinpublic.com, September 13, 2011, http://www.scienceinpublic.com/2006/mentalhealth/suicide.htm Teenage Bullying, (2011), bullyingstatistics.org September 13, 2011, http://www.bullyingstatistics.org/content/teenage-bullying.html Videbeck, S. L, (2006) Psychiatrich mental health nursing, Third edition. September 13, 2011 Young, M. E. (February 11, 2010 ) Are young children prone to suicide? Signs to watch for, http://www.physorg.com, September 13, 2011, http://www.physorg.com/news185130296.html Read More