Family_Health_Assessment

Running head: FAMILY HEALTH ASSESSMENT Family Health Assessment Leslie Davison Grand Canyon University Family-Centered Health Promotion NRS 429v Renita Holmes March 10, 2012 Family Health Assessment "A family is a set of interacting individuals related by blood, marriage, cohabitation, or adoption who interdependtly perform relevant functions by fulfilling expected roles" (Edelman & Mandle, 2010, p. 172). Merriam-Webster defines family as a group of individuals living under one roof and usually under one head (“Family“, 2012, p. 1). In the past, a "typical" family consisted of a father, a mother and children. These days, it can be a single mother or father and the children or husband and wife without children or it can mean same-sex couples (Edelman & Mandle). "How each member relates to one another can influence the understanding of behavior, which is demonstrated in the family's structural, functional, communicational and developmental patterns" (Edelman & Mandle, p. 172). For this reason, the nurse should do a family health assessment for health promotion and disease prevention (Edelman & Mandle). One assessment tool is Gordon's 11 Functional Health Patterns. Using Gordon's functional assessment (Gordon, 2002, p. 1), a family assessment was completed and this paper will discuss the outcomes of that interview. Holism and the totality of the person's interactions with the environment form the philosophical foundations of Gordon's functional health patterns. This foundation provides a context for collecting data that provide information about the entire person and most life processes. By examining functional patterns and interactions among patterns, nurses accurately determine and diagnose actual or potential problems, intervene more effectively, and facilitate movement toward outcomes to promote health and well-being (Gordon, 2007). In addition to providing a framework to assess individuals, families, and communities holistically, functional health patterns provide a strong focus for more effective nursing interventions and outcomes (Edelman & Mandle, 2010, p. 150). Health perception and health management is how the family views their health and how their health is managed. The family interviewed is an elderly couple (T. Jaramillo & E. Jaramillo, personal communication, March 06, 2012, 2012), Mrs. J. is 67 and the Mr. J. is 78 and has been married for fifty years. The Mrs. J. has been diabetic for twenty years and is controlled with diet and exercise, the Mr. J. has cataracts and is hard of hearing. When asked how their health is, they exclaimed, "Good!" Neither of them smoke or use tobacco or drink alcohol. They both participate in walking for at least thirty minutes a day (T. Jaramillo & E. Jaramillo, 2012). Nutritional-metabolic pattern describes the family's nutritional and metabolic status. Mrs. J. normally eats in times of stress where Mr. J. tries to find yard work for stress relief . They usually sit down at the dinner table together for meals and rarely go out to eat (T. Jaramillo & E. Jaramillo, 2012). Dietary habits, learned within the family context, involve behavioral patterns central to daily life (Edelman & Mandle, 2010, p. 178). Elimination patterns are used, especially when interviewing elderly patients, to find out if there have been any changes in bowel habits (Edelman & Mandle, 2010). Mrs. J. stated that they do not have any problems with constipation or diarrhea but that her husband has to wear a diaper for urine incontinence. Mr. J. denies any pain or burning with urination and states he is on medication to help with incontinence (T. Jaramillo & E. Jaramillo, 2012). Activity-exercise pattern represents how the family expends energy. The Jaramillo family is very active, they enjoy gardening and small home projects. They both deny any diseases that affect the cardio-respiratory system or the musculoskeletal system (T. Jaramillo & E. Jaramillo, 2012). "Cognitive-perceptual pattern identifies characteristics of language, cognitive skills, and perception that influence desired or required family activities" (Edelman & Mandle, 2010, p. 179). Mr. J. wears a hearing aid due to damage to his ear drum from working around loud equipment as a young man. Mrs. J. denies any problems with her hearing and has to wear reading glasses. They both prefer to read and write in English (T. Jaramillo & E. Jaramillo, 2012). Sleep/rest pattern is important because "without the restorative function of sleep, individuals exhibit decreased performance, bad temper, and decreased stress tolerance and may rely on substances such as alcohol or other chemicals to induce sleep" (Edelman & Mandle, 2010, p. 179). When asked to describe their sleep/wake cycle, Mrs. J. said that they now sleep in different rooms and that they normally go to bed at nine o'clock and wake up at five o'clock and rarely get up throughout the night. Methods used to promote sleep include warm baths, hot tea or relaxing in bed watching television (T. Jaramillo & E. Jaramillo, 2012). Self-perception/self-concept pattern "concerns how families access information to make decisions, how concrete or abstract the thought processes are, and whether decisions focus on present or future issues" (Edelman & Mandle, 2010, p. 180). When asked how they handle family problems Mrs. J. stated that they will have family meetings to discuss any important issues, but for smaller problems, they normally discuss it amongst themselves (T. Jaramillo & E. Jaramillo, 2012). Role/relationship pattern "identifies characteristics of family roles and relationships" (Edelman & Mandle, 2010, p. 180). Mrs. J. perceives herself as the "head" of household and Mr. J. agrees with her and stated that he prefers it this way. Mrs. J. is a mother, sister, aunt, grandmother, great-grandmother, friend and wife. She is the one the family looks to in times of crisis. Mr. J. is a father, brother, uncle, grandfather, great-grandfather, friend and husband. (T. Jaramillo & E. Jaramillo, 2012). Sexuality/reproductive pattern "describes sexuality fulfillment, including behavioral patterns of reproduction" (Edelman & Mandle, 2010, p. 182). Both partners denied any disease or dysfunction of the reproductive system. Mrs. J. had a hysterectomy when she was 44 due to fibroid tumors and she had been pregnant five times and had four live births (T. Jaramillo & E. Jaramillo, 2012). Coping/stress tolerance pattern "helps to depict the family's adaptation to both internal and external pressures" (Edelman & Mandle, 2010, p. 186). Neither family member has ever been treated for emotional distress. When asked how do they deal with stress, Mrs. J. said, "We pray" (T. Jaramillo & E. Jaramillo, 2012). Value-belief pattern characterizes the family's perspective and attitudes about life meanings, values, beliefs, spirituality and how these issues affect behavior. One of the questions asked was what principals did they learn as a child that they consider important yet today and Mrs. J. answered, "Do unto others as you would have done to you." She said that they strongly believe in that saying and she raised her children to believe that as well. She said that they belong to a non-denominational church and that they attend regularly (T. Jaramillo & E. Jaramillo, 2012). Nursing diagnoses for this assessment are: 1) Health-Seeking Behaviors, 2) Readiness for Enhanced Nutritional Metabolic Pattern, and 3)Risk for Impaired Urinary Elimination due to functional urinary incontinence (“Nursing Diagnoses“, 2005, expression 1-3). Knowing that every family is different, assists the nurse to properly care for her patients. Using a family assessment tool, the nurse is able to identify any underlying factors that may be contributing to the patient's illness and allows for a more systematic approach (Edelman & Mandle, 2010). The family health assessment questionnaire follows this paper. References Edelman, C. L., & Mandle, C. L. (2010). Health promotion throughout the life span (7th ed.). St. Louis, MO: Mosby. Family. (2012). In Merriam-Webster. Retrieved March 9, 2012, from http://www.merriam-webster.com Gordon’s 11 functional health patterns. (2002). Nursing Forms. Retrieved March 08, 2012. Retrieved from http://www.scribd.com/doc/6418349/Gordons-11-Functional-Health-Patterns Heritage. (2012). In Merriam-Webster. Retrieved March 3,2012, from http://www.merriam-webster.com/dictionary/heritage Nurses’ handbook of health assessment. (2005). In J. R. Weber (Ed.), Nursing diagnoses (wellness, risk, and actual) grouped according to functional health patterns. Retrieved March 08, 2012, from http://jxzy.smu.edu.cn/jkpg/UploadFiles/file/TF_06928152357_nursing%20diagnoses%20grouped%20by%20functional%20health%20patterns.pdf FAMILY HEALTH ASSESSMENT QUESTIONARE 1) Health Perception: a) What types of aerobic exercises do you participate in for at 30 minutes' b) Does anyone in your home smoke, drink alcohol, or use any illegal/recreational drugs' c) Describe your current health. 2) Nutritional-Metabolic a) What do you do to relieve stress' b) How many times a week do you and your family sit down to share a meal' 3) Elimination a) When was your last bowel movement and is it normal' b) Do you experience pain or burning with urination' 4) Activity-Exercise a) What are your hobbies' b) Do you or anyone in your family have any diseases that affect cardio-respiratory system or musculoskeletal system which might limit you participating in any exercise' 5) Cognitive/Perceptual a) Do you have any difficulties hearing or with your vision' Explain. b) Which language would you prefer any reading material' 6) Sleep/Rest a) Describe your sleep-wake cycle. b) Do you have to take any medications to induce sleep' c) What methods do you use to promote sleep' 7) Self-Perception a) How do you solve family issues' b) How are you feeling today' 8) Role-Relationship a) What is your role in your family' b) Describe what your role is at work. 9) Sexuality-Reproductive a) Do you or your spouse have any disease/dysfunction of the reproductive system' Explain. b) How many pregnancies and live births have you had' 10) Coping/Stress Tolerance a) How do you usually cope with stress' b) Have you or your spouse ever been treated for emotional distress' 11) Value-Belief a) What principals did you learn as a child that are still important to you today' b) What religious affiliation do you belong to and do you attend regularly'