Family Health Assessment Narrative Essay

FLORIDA NATIONAL UNIVERSITY NURSING DEPARTMENT RN TO BSN PROGRAM COMMUNITY HEALTH NURSING FAMILY HEALTH ASSESSMENT After you have read chapter 20 of the class textbook and review the PowerPoint presentation, choose a family in your community and conduct a family health assessment addressing the questions below. 1. Family composition. Type of family, age, gender and racial/ethnic composition of the family. 2. Roles of each family member. Who is the leader in the family? Who is the primary provider? Is there any other provider? 3. Do family members have any existing physical or psychological conditions that are affecting family function? 4. Home (physical condition) and external environment; living situation (this must include financial information). How the family support itself. For example, working parents, children or any other member 5. How adequately have individual family members accomplished age-appropriate developmental tasks? 6. Do individual family member’s developmental states create stress in the family? 7. What developmental stage is the family in? How well has the family achieve the task of this and previous developmental stages? 8. Any family history of genetic predisposition to disease? 9. Immunization status of the family? 10. Any child or adolescent experiencing problems 11. Hospital admission of any family member and how it is handled by the other members? 12. What are the typical modes of family communication? It is affective? Why? 13. How are decisions make in the family? 14. Is there evidence of violence within the family? What forms of discipline are use? 15. How well the family deals with crisis? 16. What cultural and religious factors influence the family health and social status? 17. What are the family goals? 18. Identify any external or internal sources of support that are available? 19. Is there evidence of role conflict? Role overload? 20. Family Health Assessment Narrative Essay

Does the family have an emergency plan to deal with family crisis, disasters? Identify 3 nursing diagnosis and develop a short plan of care using the nursing process. Please present your assessment in an APA format on a 12 Arial font, word document attached to the forum in the discussion tab of the blackboard and in the SafeAssign exercise (mandatitle “family assessment” 4 evidence-based practice references besides the class textbook are require and must be quoted in the assignment. A minimum of 1000 words are required, excluding the first and reference page (Websites can be used but will not count toward grading). 2 replies to any of your peer’s assessment/posting are required sustained with the proper reference. You must identify two family problems and present a nursing care plan using the nursing process addressing the problems. The assignment must be posted in the discussion tab of the blackboard for your peers to review and reply and in the SafeAssign Exercise in the assignment tab of the blackboard to verify originality. Assignments must be posted in both forums if not the assignment will grade it as 0. Due date: Sunday March 20, 2020 at 11:59 PM to be posted in both forum and for replies on Wednesday March 23, 2020 at 11:59 for replies only. I will not accept assignments posted in the replies forum. If you have any questions, please contact me via e-mail as soon as possible. Chapter 20 Family Health Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. Working with Families    Working with families has never been more complex or rewarding than now. Nurses understand the actual and potential impact that families have in changing the health status of individual family members, communities, and society as a whole. Families have challenging health care needs that are not usually addressed by the health care system. . Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 2 How Do You Define a Family? Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 3 Definitions of a Family Historical definitions:  The environment affecting individual clients  Small to large groups of interacting people  A single unit of care with definable boundaries  A unit of care within a specific environment of a community or society Current theorists:  Two or more individuals who depend on one another for emotional, physical, and economic support. Members of family are self-defined. – Hanson & Kaakimen (2005)  The family is who they say they are. – Family Health Assessment Narrative Essay

Wright & Leahey (2000) Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 4 Inclusive Definitions of Family “Family” means any person(s) playing a significant role in an individual’s life. This may include person(s) not legally related to the individual. Members of “family” include spouses, domestic partners, and both differentsex and same-sex significant others. “Family” includes a minor patient’s parents, regardless of gender of either parent … without limitation as encompassing legal parents, foster parents, same-sex parent, step-parents, those serving in loco parentis, and others operating in caretaker roles. – Human Rights Campaign ( 2009) Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 5 The Changing Family  Purposes of the family ➢ ➢  To meet the needs of society To meet the needs of individual family members Examples of different family types ➢ Traditional, nuclear family ➢ Multigenerational family household ➢ Cohabitating families ➢ Single-parent families ➢ Grandparent-headed families ➢ Gay or lesbian families ➢ Unmarried teen mothers Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 6 The “Sandwich” Generation Figure 20-1 From Pew Research Center: Social and Demographic Trends: The Sandwich Generation. http://www.pewsocialtrends.org/2013/01/30/the-sandwich-generation/. Accessed March 15, 2013. Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 7 Why Is It Important for the CHN to Work with Families?     The family is a critical resource. Any dysfunction in a family unit will affect the members and the unit as a whole. Case finding can identify a health problem that leads to risks for the entire family. Nursing care can be improved by providing holistic care to the family and its members. – Friedman, Bowden, & Jones (2003) Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 8 Approaches to Meeting the Health Needs of Families Moving from the Individual to the Family Moving from the Family to the Community Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 9 Moving from the Individual to the Family  Family interviewing ➢ Manners ➢ Therapeutic conversations ➢ Genogram and Ecomap ➢ Therapeutic questions ➢ Commending family or individual strengths ➢ Issues in family interviewing • Many locations, family informant, family health portrait, involvement of children  Intervention in cases of chronic illness Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 10 Moving from the Family to the Community       The health of communities is measured by the well-being of its people and families. Families are components of communities. Cross-comparison of communities must include health needs as well as resources. Cross-compare the needs of the families within the community and set priorities. Delegation of scarce resources is essential. A double standard in public health is tolerated. Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 11 Family Theory Approach 1. Any “dysfunction” that affects one member will probably affect others and the family as a whole. 2. The family’s wellness is highly dependent on the role of the family in every aspect of health care. 3. The level of wellness of the whole family can be raised by reducing lifestyle and environmental risks by emphasizing health promotion, self-care, health education, and family counseling. Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 12 Family Theory Approach (Cont.) 4. Commonalities in risk factors and diseases shared by family members can lead to case finding within family. 5. Individual is assessed within larger context of family. 6. Family is vital support system to individual member. – Friedman (1994) Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 13 Systems Theory Approach The family as a unit interacts with larger units outside the family (suprasystem) and with smaller units inside the family (subsystem). – Friedman (1998) Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 14 Healthy Families     Members interact with each other; listen and communicate repeatedly in many contexts. Healthy families establish priorities. Members understand that family needs are the priority. Healthy families affirm, support, and respect each other. Members engage in flexible role relationships, share power, respond to change, support the growth/autonomy of others, and engage in decision making that affects them. – DeFrain (1999) and Montalvo (2004) Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 15 Healthy Families (Cont.)     The family teaches family and societal values and beliefs and shares a religious core. Healthy families foster responsibility and value service to others. Healthy families have a sense of play and humor and share leisure time. Healthy families have the ability to cope with stress and crisis and grow from problems. They know when to seek help from professionals. – Family Health Assessment Narrative Essay

DeFrain (1999) and Montalvo (2004) Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 16 Structural-Functional Conceptual Framework  Internal structure ➢  External structure ➢ ➢   Family composition, gender, rank order, functional subsystem, and boundaries Extended family and larger systems (work, health, welfare) Context: ethnicity, race, social class, religion, environment Instrumental functioning (routine ADLs) Expressive functioning ➢ Emotional, verbal, nonverbal, circular communication; problem solving; roles; influence; beliefs; alliances and coalitions Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 17 Developmental Theory  Family life cycle (Duvall & Miller, 1985) ➢ ➢ ➢ ➢ ➢ ➢ ➢ Leaving home Beginning family through marriage or commitment as a couple relationship Parenting the first child Living with adolescent Launching family (youngest child leaves home) Middle-age family (remaining marital dyad to retirement) Aging family (from retirement to death of both spouses) Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 18 Family Health Assessment Tools  Genogram ➢  Family health tree ➢  A tool that helps the nurse outline the family’s structure Family’s medical and health histories Ecomap ➢ Depicts a family’s linkages to their suprasystems Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 19 Family Health Assessment Tools  Family Health Assessment ➢ Addresses family characteristics, including structure and process and family environment ➢ Information obtained through interviews with one or more family members, subsystems within the family, or group interviews of more than two members of the family ➢ Additional information obtained through observation of family and their environment Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 20 Genogram Figure 20-2 Redrawn from Genopro Software: Symbols used in genograms, 2009: www.genopro.com. Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 21 Ecomap Figure 20-4 Redrawn from Hartman A: Family Health Assessment Narrative Essay

Diagrammatic assessment of family relationships, Soc Casework 59:496, 1978. Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 22 Social and Structural Constraints   Identify what prevents families from receiving needed health care or achieving a state of health Usually based on social and economic causes ➢ ➢ ➢ Literacy, education, employment If disadvantaged, often unable to buy health care from private sector Hours of service, distance and transportation, availability of interpreters, and criteria for receiving services (age, sex, income barriers) Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 23 Family Health Interventions  Institutional context of family therapists ➢ ➢ ➢ Ecological framework: A blend of systems and developmental theory that focus on the interaction and interdependence of families within the context of their environment Social Network Framework: Involves all connections and ties within a group; social support Transactional model: A system that focuses on process as opposed to a linear approach Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 24 Applying the Nursing Process    Knowledge of self, previous life experiences, and values is crucial in planning home visits Gather referral information, review assessment forms, and gather intervention tools (e.g., screening materials, supplies) before going to the home Flexibility is important in working with families Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 25 …