Lack of Socialization in Tinas Family with Other Society Members - Case Study Example

Child Issue Name Institution Date Introduction The case study involves a 15 year old girl, known as Tina Kaufman. Tina is an active student at school and participates in school sports and her academic grades are above average. She lives with her biological mother and her stepfather. In addition, Tina has a brother who does not live with the family and is a gay and her parents do not talk with him. Tina’s family is an upper middle class and the family rarely socializes with other society members. Her parents have a strained relationship mostly because her mother visits her parents, something Tina’s father does not like. Most of the Tina’s family interest revolves around Tina’s athletic activities. The main social issue facing Tina is isolation since her family rarely interacts with others as well as negative emotional status due to the misunderstanding between her mother and her stepfather. The health issue that Tina is facing is bad health due to inappropriate diet as well as improper eating habits (Folkman, 2010). Tina is so much concerned about her weight and she normally skips lunch and does not eat unless when she is hungry. She also often takes snacks and her mother is so busy that she does not have time to take meals with the family. Tina’s friends have been making negative remarks about how Tina has added weight and this has aggravated Tina’s concerns regarding her weight. This paper will identify goals of care that would be considered when working with Tina’s family as well as the appropriate nursing interventions in this case. Health issues Tina’s disturbed emotional status Weight concerns Tina’s unhealthy eating patterns Social issues Lack of socialization in Tina’s family with other society members Disintegrated family, for example, Tina’s parents do not talk to her brother and her mother being too busy for the family Tina’s parents having a strained relationship Goals Promotion of a Healthier Body Weight for Tina Kaufman This goal will involve advising Tina on the appropriate diet to take in order to have a healthier body weight. Stabilizing of weight for Tina is a suitable goal since she is a young adolescent and still growing and this will enable a reduction in the proportion of body fat to lean tissue as height growth take place (Cheung, 2007). For Tina, her weight progress will be observed through a decline in BMI percentile. In addition, stabilizing Tina’s body weight will decrease insulin resistance and also enhance glucose tolerance, which is important in her health. Tina needs to rectify her eating habits and adapt more healthy eating patterns, for example she should ensure that she takes all her meals and balance food as well. Reducing carbohydrate intake and also taking small portions of proteins and more vitamins in all her meals will be important in promoting a healthier body weight for Tina (Gong, et al, 2008). Promotion of Tina’s Psychosocial Well-Being From the case study, the psychological state of Tina is not satisfactory mostly due to circumstances surrounding her. First, the state of her family maybe destabilizing her emotional status, for example, the unhealthy relationship between her mother and her father. Constant argument between her stepfather and her mother because of the mother visiting her parents might be affecting Tina negatively. Additionally, Tina is also not comfortable with her weight, the reason she skips lunch. Basically, most adolescents who are overweight have a negative body image, low self esteem and depression (Sen, et al, 2007). In order to improve Tina’s psychological health, the treatment goals will focus on; Understanding Tina’s genetically determined body size Setting up practical expectations for Tina’s weight change Setting up healthy coping strategies Managing stress level of Tina Assertive communication Improved social skills (Cheung, 2007) Ensuring Tina’s Family Support Tina needs family support to encourage her and thus one of the goals will include that she gets family support. Generally, physical activities as well as food habits are some of the behaviour patterns determined through cultural, familial, environmental, and peer influences (Lazarus, 2006). When an adolescent is going through what Tina is experiencing, this is a family matter. Therefore, Tina requires the positive support along with role modeling from all the members of her family and also their dedication to making required changes in Tina’s activity and food patterns. Studies have shown that children who are overweight and have non-supportive families have a likelihood of a poorer prognosis (Nevonen, et al, 2006). In reference to this case, Tina’s family members should be encouraged to find time each other as this will improve the relationship between the family members and also promote healthier eating patterns, which is important for Tina and the family at large. Communication between the family members should also be improved and become more open as this will reduce constant tension and stress among family members (Huebner, et al, 2007). Nursing Interventions One of the nursing interventions for Tina will entail establishing a positive atmosphere for her, which will include regular family activities involving social, non-competitive activities; for example enrolling Tina is a health club membership and encouraging her to take part in school, church and community activities. Developing a positive food atmosphere for Tina will include ensuring that she takes healthy food bought and prepared and ensuring that she eats all her meals with pleasant conversations (Puskar, 2009). Nursing intervention in this case will also involve establishing a positive emotional atmosphere through ensuring that Tina’s family members do not tease or make negative remarks regarding her weight. Therefore, it should be ensured that all Tina’s family makes the required changes in their food patterns. For instance, her family will be advised to give Tina non-food incentive and rewards in case of any positive behavioural change, allowing Tina to make her own choices concerning the types and quantity of food to eat and taking part in family therapy (Puskar, 2009). As a first line of treatment to Tina’s depression state, individual therapy would be an appropriate nursing intervention. Psychotherapy will also be important in ongoing stressors will aggravate Tina’s depression symptoms. Normally, a depressed child might be carrying a sense of failure and thus individual psychotherapy will assist in reducing symptoms of depression and will help Tina in becoming aware of and addressing her feelings of failure and self blame (Fertman, 2006). Cognitive Behaviour Therapy (CBT) is also a suitable nursing intervention in this case. In this intervention, Tina will be taught new skills of reducing some of depression symptoms, in particular the emotions accompanying her depression. As a result, through CBT Tina will be helped to recognize and describe her negative emotions. Accordingly Tina will be guided to think of new and more positive options where she will be given an opportunity to practice new ways of thinking and feeling and her feeling will be discussed with the nurse. In general, these methods have been studied widely and have assisted a number of depressed children (Hassanain, et al, 2008). Parental guidance sessions will also be included during nursing intervention. This is because these sessions will assist in Tina’s parents in managing her condition, identifying efficient parenting skills. Learning how to function as a family in spite of Tina’s condition as well as dealing with Tina’s complex feelings that can arise when raising her due to her depressed state. In addition, family therapy will also be helpful because Tina’s depressed state is as a result of matters impacting the family as a whole (Fertman, 2006). Group psychotherapy is another beneficial intervention in Tina’s case. This is because it will provide a safe place for Tina to talk with other child going through similar situation and will also allow Tina to practice social skills within a carefully structured environment. Finally, school-based counseling will be helpful to Tina because it will help her navigate the social, behavioral as well as educational demands of the school setting (Daniels, 2008). Conclusion Tina has both social issues as well as health issues. The social issues are as a result of her family rarely interacting with others, affecting her socialization and her family being not entirely intact. Tina’s mother is busy such that she does not have much time with her family while her brother George does not live with the family. Health issues can be attributed to Tina’s unhealthy eating habits as well as a probable depression resulting from the constrained relationships in her family and her concerns regarding weight. The key goals when caring for this family include; Tina’s psychosocial well-being, ensuring family support/unity in addition to promoting a healthier body weight for Tina. The nursing interventions in this case include, engaging Tina in Cognitive Behaviour Therapy (CBT), employing group psychotherapy and parent guidance sessions, individual therapy, school-based counseling in addition to establishing a positive atmosphere for Tina. These nursing interventions will help Tina in maintaining a healthy feeding, improving her emotional status and tackling her weight concerns. References Cheung, P. (2007). A study on body weight perception and weight control behaviours among adolescents in Hong Kong. Hong Kong Medical Journal. Vol. 13/16–21. Daniels, J. (2008). Weight and weight concerns: Are they associated with reported depressive symptoms in adolescents? Journal of Pediatric Health Care. Vol. 19/33–41. Fertman, C. (2006). School based mental health promotion: Nursing interventions for depressive symptoms in rural adolescents. California Journal of Health Promotion. Vol.4/4. Folkman, S. (2010). Stress, appraisal, and coping. New York: Springer. Gong J, et al. (2008). Weight perception and psychological factors in Chinese adolescents. Journal of Adolescent Health. Vol. 33/202–210. Hassanain, R. et al. (2008). Instrument development for the determination of adolescent health needs. Journal of Adolescent Health. Vol. 12/2. Huebner, ES. et al. (2007). Sociodemographic differences in depressed mood: Results from a nationally representative sample of high school adolescents. Journal of School Health. Vol. 77/4. Lazarus, R. (2006). Emotion and adaptation. New York: Oxford University Press. Nevonen, L. et al. (2006). Weight concerns, body image, depression and anxiety in Swedish adolescents. Eating Behaviors. Vol. 7/161–175. Puskar, K. (2009). The Relationship between Weight Perception, Gender, and Depressive Symptoms among Rural Adolescents. Rural Nurse Health Care. Vol. 9/1. Sen, N. et al. (2007). The association of self-esteem, depression and body satisfaction with obesity among Turkish adolescents. (BioMed Central) BMC Public Health. Vol. 2/4. Read More