Nursing Assessment of a Family - Term Paper Example

Family Assessment Name Institution Affiliation Family Assessment Principles of family assessment Family assessment is a process of gathering and organizing information that would enable the nurse to get a deeper understanding of the family involved. Understanding the patient’s family and the role they play in healthcare management will lay the foundation for care provision to the patients. Nurses spend valuable time assessing the families to learn about the strengths and barriers that are present all along. Patients and family bears need to tell their health history and its impacts on their lives. Nurses build trustworthy relationships that are the basis of patient and family relationship Good family assessment requires Institute observation skills and active listening. Gathering data about family structure, family and needs does not have to be restricted to structured interviews. Informal conversations with patients and family while passing medications or interactions will give an outline of the family picture. A good family assessment is about relationship building. Nurses engage in identifying the strengths, values and goals to build a mutual trust and respect between them (Ball, Bindler, Cowen, & Ball, 2012). Open communication is important because it helps the nurses to identify formal and informal support that can eliminate the factors causing risk. Family assessment should focus on building on the strengths. Acknowledging and building on the strengths enables the family to develop a plan that uses subsisting powers as the basis of the change process (Ball, Bindler, Cowen, & Ball, 2012). A good assessment takes into account all the factors affecting the family and the community. The good assessment takes into account both formal and informal ones. A partnership with families helps to build the family sense of control and ability to succeed while assuring the identification of appropriate support and services. A good assessment should be specific to serve as the basis of support and service plan geared to a particular family. Assessment sets clear, specific and achievable goals. Family care principles emphasize on the strengths perspectives. Every individual, family and community have strengths. Family assessment is focusing on the strengths identifies, mobilizes and respects the resources and knowledge that every person including a child family and community and the potential of transforming their experiences and lives. Trauma, abuse, illnesses and abuse may be a source of challenges and opportunities. The strengths perspective acknowledges that people who frequently face adversity are resilient, and we can learn from them on the strategies to overcome adversity. Holding high expectations of clients and keeping an alliance with their hopes and visions recognize their promise and possibility. In children and young people, family assessment evolves the capacity and recognizes their ability to grow and change as they go through various stages of development. Calgary Family Assessment Model Family Assessment Calgary Family Assessment Model is an internationally accepted template for nurses to collect, conceptualize and organize family data from families. CFAM is useful in helping the families and the nurses to address the challenges facing the families. The main categories of CFAM are structural, developmental and functional levels (Barry & Barry, 1996). Structural assessment The structural assessment is broken down into an internal structure that describes the relationship between the family members and the external structure that describes the relationship between the family and the environment to which the family lives (Carpenito, 2009). Internal assessment The extended family consists of the Matt and his partners Tina, who are expectant to get twins, have been married for five years. Tina. 26 years of age operate a sole proprietor business of selling coffee while Matt is an automotive mechanic and successfully negotiated with employees to work locally in this time of expectancy. The couple has had two miscarriages in the first trimester due to Tina’s health concerns. The family has monogamous marriage, and both Matt and Tina are the decision, makers. Suzie, 24 years of age, sister to Tina will support the family after the successful delivery for six months. His partner lives independently with two kids. External assessment Externally, the assessment falls into two main subcategories. First, the generations within the nuclear family are assessed and CFAM recognizes larger systems such a work relations, family issues and agencies such as the courts welfare and service providers that directly affect the welfare of the family. Tina’s Mother, Marion Aged 52 years had two kids, Suzie and Tina were diagnosed with postnatal stress after the birth of Suzie, which had gone unnoticed for some time. Marion was divorced by his husband when Tina was 14 years. Tina’s father, Bruce 56 years old, works in Indonesia, remarried Ade, 39 years old and makes regular visits to Australia. Matt’s parent, Henry aged 64 and Marcia aged 59 are divorced, both living in Perth and have remarried in the last five years. Matt’s older brother, aged 31 years of age is single working overseas as engineers. Matt’s families members live have long distance relationship in different countries due to the nature of their works. This has lead to minimal interactions between them although Henry travels to Australia for their holiday’s days. Contextual assessment The context of the family is described as the background relevant to the family events and personalities. These are the elements of ethnicity, social classes, spirituality and environmental factors (Denham, Eggenberger, Krumwiede, & Young, 2012). Matt and Tina have ardent Australian history origin. Both partners are in their first marriage staying together although Matt’s work involves lots of traveling outside the country. The family has persevered a lot of pain associated with miscarriages. Matt is trained as a mechanic while Tina is a business, lady. Matt’s employment and Tina’s coffee shop are the primary sources of income for the family, and there is some instability in income from the variations of coffee sales. Matt’s salary cannot sustain the family during the postnatal period when the Tina will not be working. Matt and Tina are finding it hard to integrate themselves in their new social class f parents. Matt is struggling to join the fellow surfers and plans to join the surfing club. Tina plans to join the walking mom group to meet other new moms. The strengths of this family are based on the readiness to learn and accept the support. Matt is ready to join local surfing club and take the family for lunch and meet the like-minded people. Tina is ready to join new walking parents group to share the experiences. Suzie will help the family to raise the twins for six months after weaning. Marion is very supportive to Tina and ready to help in raising the grandchildren. Identification and discussion of family issues; Adjusting the marriage to accommodate the children Emotional health is a state of well-being for both the Matt and Tina and the expected twins. Wellbeing will help the couple to cope and manage the stress and maintain relationships with the newborns and enjoy life. During pregnancy, the many experiences everything that the mother’s experiences, from food, air ad food. When the mother is happy and calm, this allows the baby to develop in a calm, happy environment (Robb, 1998). Anxiety can increase the particular hormones in the mother’s body that can affect the wellbeing of the child. After birth, the baby receives the information from the environment. All the interaction with baby from the moment is born helps to shape the way it will think (Platt, 1985). Feel and behave later in life. Good emotional health helps to maintain a positive relationship with the family members and helps the couple through the challenges of adjusting to a new baby together.Having twins is exciting for the entire extended family and a welcomed event. The transition from nonparents is a normal stressful experience for parents. Parents assume new responsibilities overnight and never change the way they had been before the child came. The twins will greatly influence this young family in many ways, and they need a lot of support from size, Marion, support groups and share experiences from the experienced parents. Using social networks can offer broad and alternative sources of social support. These interactions will help Matt, and Tina identifies child rearing problems and takes care of it as early as possible. Infants provide certain levels of stress on the family although at many times they are guards against loneliness. These effects may occur throughout the lives of the parents and children. Both the parents will be exhausted from insufficient sleep. The new parents are inexperienced in rearing the children and baby care and the new roles always cause friction in the family. The nurse should be able to pinpoint the problems fast and act accordingly. Anxiety is affecting the young family. Women who experience miscarriages feel very anxious when pregnant again. Most women may not want to buy or anything for the baby just in case the loss happens again. The parents avoid bonding with the child during the pregnancy as a protection against the pain of loss. Tina is expecting twins after two successive losses, and this contributes to the anxiety. Her medical complications and multiple births had exerted a lot of physical and emotional demands both in prenatal and postnatal stages. Tina worked until the last days of her pregnancy because of the past experiences of losing the pregnancy and was not ready to fully commit to the pregnancy in order to avoid the pain of the loss that may occur (Pillitteri, 2007). The aim of nursing is to reduce the postnatal anxiety and prevent the graduation of the anxiety to depression. Psychotherapy will aim to help address the challenges the young family is encountering in accommodating the new members of their nuclear family. The nurse will pursue couples therapy to help the couples understand each other and develop a god relationship. The demands on both pre and postnatal periods create tension in the relationships. Nurses should offer positive ways to adjust to the new changes, relating to each other and improve the relationships between the twins, Matt, and Tina as well as the extended family. Social support and low postpartum loss of libido Prior to this pregnancy, Matt and Tina had not integrated themselves with the experience parents who could have offered them support at this transition moment. Suzie and Marion have offered themselves to help the family raise the kids. Tina has opted to breastfeed the twins for the first six months meaning she will be away from work. Matt is concerned about his financial ability to cater for the new demands that come for the period he will be the sole family, breadwinner. The goal of the nurse will be to advise Suzie and Marion on the support needed to help them, build a genuine understanding of themselves, and appreciation of the duties that come along with the parenthood. The couples should choose a serene time to talk about the issues affecting them and thing they have noticed that were absent before the new parental status (Moriyama, 2008). Women who have partners who help with household chores and who feel valued and noticed by their partners are more likely to feel affection towards them and be interested in sex. Following the birth of a child, physical and hormonal changes occur which haves an effect on the bodies. These are dyspareunia due to healing or infection, low mood, and depression and physiological changes associated birth breastfeeding associated with breastfeeding and contraception (Fort et al., 1969). These affect the woman’s sexual needs and impacts on her relationship with the partner. There is unmet need for discussing these issues and offering sensitive help and advice to the young women Tina seems to have postnatal low libido and claims will take some time before resuming the normal sexual relationship with Matt. Matt and Tina should not expect too much from each other and should understand each other about postnatal libido. The nurse will aim to listen carefully to the couple, and if there are medical concerns, the couple should be referred to a general practitioner. Tina has made it categorically that she will breastfeed for six months. The hormonal changes associated with breastfeeding leads to painful sex due to low levels of estrogen. Studies have shown improved mood and increased sexual activity and frequency of sex within four weeks of stopping breastfeeding. The nurse should offer advice such as the lubrication to reduce painful intercourse (Dickason, Silverman, & Kaplan, 2007). Tina is confident that the sexual desire will return shortly after delivery. Before embarking on the clinical explanations, nurses need to allow the professionals should give the couples a chance to raise issues significant to them. This will help the nurses to have a wholesome picture of the situation and offer helpful solutions to the couples. References Ball, J., Bindler, R. M., Cowen, K. J., & Ball, J. (2012). Principles of pediatric nursing: Caring for children. Boston: Pearson. Barry, P. D., & Barry, P. D. (1996). Psychosocial nursing: Care of physically ill patients and their families. Philadelphia: Lippincott. Carpenito, L. J. (2009). Nursing care plans & documentation: Nursing diagnoses and collaborative problems. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. Denham, S., Eggenberger, S., Krumwiede, N., & Young, P. (2012). Family focused nursing care. Dickason, E. J., Silverman, B. L., & Kaplan, J. (2007). Maternal-infant nursing care. St. Louis: Mosby. Fort, A., Field, K., Carey, S. J., Harwell, P., Emory University, & National Medical Audiovisual Center. (1969). Exploration of the problem oriented system. Atlanta, Ga.: Audiovisual Center. Moriyama, M. (2008). Family Nursing Practice and EducationWhat Is Happening in Japan? Journal of Family Nursing, 2(3), 21-45. Pillitteri, A. (2007). Maternal & child health nursing: Care of the childbearing & childrearing family. Philadelphia, PA: Lippincott Williams & Wilkins. Platt, S. (1985). Measuring the burden of psychiatric illness on the family: an evaluation of some rating scales. Psychological Medicine, 2(4), 45-59. Robb, Y. A. (1998). Family nursing in intensive care part one: is family nursing appropriate in intensive care? Intensive and Critical Care Nursing, 3(2), 32-56. Read More