Nursing Family Health Assessment

Running Head: FAMILY ASSESSMENT 1 Family Nursing Assessment Bowie State University Instructor: Professor Bobbie Ruth Masters. FAMILY ASSESSMENT 2 Family Nursing Assessment To effectively serve a community, it is important to understand the community. This understanding can be achieved through a community assessment. The findings from an assessment will define the extent of the needs that exist in a community and the depth of the assets available within the community to address those needs. This understanding of needs and assets can be used to strategically plan and deliver relevant, successful, and timely services. When home visits are scheduled, it gives a chance to the professional to educate the family, give needed support. Home visits give a chance to professionals to support a family at their home, making it more comfortable and safe for the family. The most inspections involve check equipment like smoke detectors, safe storage of firearms and chemicals, lead paint, water quality, the number of rooms in the house based on the number of children etc. The family I assessed E.F., an African from Cameroon who lives in Silver Spring MD. The paper will review an assessment of E.F.’s family, interviewing them to find how that E.F. needs and designing an effective intervention . Nursing Family Health Assessment

The paper will be concluded by an evaluation of the intervention used to help solve the problems this family was facing. This important finding will be drawn partly from home safety and environmental assessment. Home Safety/Environmental Assessment This is a nuclear family which is composed of two parents and three children (two boys and one girl). The father is a dialysis technician and the mother is a stay home mom raising their three kids. The father is responsible for paying all the bills. The decision for mum not to work was to the benefit of the family. Babysitting is very expensive and makes more sense for the mother to stay home and provide quality care to the children. The family lives in a two-bed room apartment on Hewitt avenue with a kitchen, a living room, two bathrooms and a balcony. The apartment faces FAMILY ASSESSMENT 3 the parking lot so the children get enough light during the day. Some detector in the house is in good working condition because it was alarming when the mother of the house was cooking and some smoke from frying French fries initiated the alarm. Every unit in the apartment complex has a fire extinguisher in case of fire. It is securely protected to prevent children for attempting to play with it. There is a bathroom in the master’s bedroom and the other in the hallway. Safety is very important in this apartment as well as knowledge about emergency preparedness. Emergency Preparedness Many people are concerned about the possibility of a public health emergency such as a natural disaster, act of terrorism, or disease outbreak. People need to be informed about disaster. Check with your local emergency management agency to find out what kinds of emergencies could happen in your area. Find out how to get local emergency alerts. Check with your local health department or emergency management agency to see how they share emergency information. Some places use emergency texts, phone calling systems, digital road sign, social media, sirens and speakers. The family lives in an apartment complex where residents are all in their apartments and have little association with neighbors. Nursing Family Health Assessment

The husband listens to news at work and at home after work. His wife is the one who is always listening and making sure that all information about things happening in the county is known. It is very challenging because she is very busy taking care of three children. My assessment concludes that they need more information about disaster management. The family relies on the cell phones and television for weather alert. The family always goes to the stores to buy food, water, flashlight, and other supplies, needed in the house during any snow storm. The family has one car and the wife begs friends and family members for rides when going for appointments. FAMILY ASSESSMENT 4 This family thought that they were ready for any emergency since they always go out and shop when there is announcement about inclement weather. An Emergency preparedness kit for your home is an essential part of keeping you and your family safe in times of emergency. Being prepared ahead of time not only provides you with piece-of-mind but is the best insurance should disaster strike. They had no knowledge about an emergency preparedness first-aid kit that can be stored at home. They did very well stocking emergency food supplies and other small house hold essentials like flash light, candle, water etc. Assessment of this family will give information about areas that need to addresses to maintain a stable home. Assessment of the E.F.’s Family The well-being of any family depends on the interrelationship between all members of the family. They depend on one another for emotional support, financial, physical support. They express love to each other and always supportive when there is a crisis in the family. This family is the nuclear type with father, mother and three biological children. The E.F. family lives in Silver Spring in Montgomery County in the state of Maryland. Nursing Family Health Assessment

They are Africans from Cameroon. Mr. E.F. is 48 years old, his wife is 30 years old. They have been married for six years. They moved to United states in May, 2011 with their son who is now eight years old. They now have two more children which were delivered here in Maryland. They are both healthy as well as their children. Mrs. E.F. has gained a lot of weigh compared to when she arrived here in May, 2011. The family must function with each family member having their own functions. FAMILY ASSESSMENT 5 Family Functions Family function is the process by which the family operates including communication and manipulation of the environment for problem solving. A functional family is one in which family members fulfill their agreed upon roles and responsibilities; treat each other with respect and affection; and meet each other’s needs. There are different functions I the family and each one contributes to the success or failure of the progress of the family. The health, illness and wellbeing of the family is extremely important to a perfect role of the family. Mr. E.F.’s is responsible for providing income to the family while his wife is responsible for taking care of the children and running the welfare of the family. Mr. E.F. leaves the house in the morning at 5.30 am every day to work as a dialysis technician and returns home at 8pm or nine pm in the evening. He is very tired and can only share quality family time for a short while before going to be because he needs to wake up early in the morning the next day to go to work. Mrs. E.F. on the other hand is totally responsible for the welfare of the children. She takes care of the children, cooks and buys food for the house when her husband is not at home. She showed serious commitment to the relationship’ She will strap her children in the stroller (the three-year-old and 1.5 years old) and walk with the eight-year-old to the grocery store to buy food. This family is very generous and open their door to friends and family. The E.F. family always invite friends to their apartment for meals. They eat a lot at home and go out occasionally just to introduce the children to public eating. They are always together on Sunday and go to church when they can. They are Presbyterian Christians and go to church every other Sunday because her husband needs time to rest and wash his clothes. Both parents are very serious about educating their children. The eight-year-old has a private teacher who visits their home to assist him with his assignment. Mr. and Mrs. E.F. are both overwhelmed with their respective function but still set FAMILY ASSESSMENT 6 aside a special day that they take their children to a baby sitter to spend time with each other. Despite the busy schedule of both husband and wife, this family tries to balance life to function well. Nurses play several roles family theories that describes relationships. Family theories There is no single theory or conceptual framework that fully describes the relationships and dynamics and can be used to understand and interview with families (Stanhope & Lancaster (2012). Community health nurses must also blend family nursing theories with public health theories and framework to work with individuals and families and populations of families. There are three theories: family systems theory, family development and life cycle theory a biological systems Theory. (Stanhope & Lancaster (2012). Family Systems Theory. A family is a system in which each member has a role to play and rules to respect. Members of the system are expected to respond to each other in a certain way according to their role, which is determined by relationship agreements. Within the boundaries of the system, patterns develop as certain family member’s behavior is caused by and causes other family member’s behaviors in predictable ways. Maintaining the same pattern of behaviors within a system may lead to balance in the family system, but also to dysfunction. For example, if Mrs. E.F. decided to be disrespectful to her husband, it might lead to a dysfunction of the family. According to Stanhope and Lancaster, the family systems theory helps the nurse “to understand how a family is an organized as whole as well as composed of individuals.” Nursing Family Health Assessment
. The purpose of the family system is to maintain stability through adaptation to internal and external stresses that are created by change. This family consist of father, mother, and three young children who need their parents fully for survival. Any FAMILY ASSESSMENT 7 dysfunction will destabilize the lives of these young children. Nursing assessment of family systems includes assessment of individual members, subsystems, boundaries, openness, inputs and outputs, family interactions, family processing and adapting or changing abilities. Stanhope and Lancaster (2012). Family Development and Life Cycle Theory. This theory according to Stanhope and Lancaster (2012), provides a framework for understanding normal predicted stresses that family experience as they change and transition over time. One developmental concept of this theory is that families as a system move to a different level of functioning, thus implying progress in a single direction. Family disequilibrium and conflicts occur during these expected transition periods from one stage of family development to another, (Stanhope, & Lancaster, 2012). This family is still young and has long years ahead of them to raise their three kids. The family has no time for vacation because of the demands of modern life. They must work hard in their different roles to take care of their family. There is a lot of adjustment that needs to be made as the years pass by as they watch their children grow. Thus, family development and life cycle theory emphasizes how families change over time and focuses on interactions and relationships among family members. Bioecological Systems Theory. This theory is very useful for community/public health nurses since it helps identify the stresses and potential resources that can affect family adaptation (Stanhope, & Lancaster, 2012). The author identifies four systems which are the microsystem, mesosystems, ecosystems and microsystem. The microsystem includes the apartment complex and its neighborhood, the FAMILY ASSESSMENT 8 extended system. The mesosystem of Mr. E. F’s family can be his extended family. He has a large family in MD and always has celebrations in his apartment like thanksgiving, Christmas new year etc. The author states that these are people that the family interacts with but not daily. The microsystem are broad overarching social ideology and cultural values, attitudes, and beliefs that indirectly influence the family. This family is not dysfunctional because they all have different roles in their home. They are very happy and being admired by neighbors around but there are some health risks involved that needs to addressed for better functioning. Health Risk Assessment This family has no biological risk involved because the kids are all healthy with their parents. The mother is very serious with their wellness appointments and doing screening test for prevention of diseases. The family states that they live in an environment where the crime rate is low. It is difficult to hear of any crime in the community. This family is stable because the father works very hard and despite the challenges in finances, they still manage to run their family without stress. The family makes sure they eat healthy food such as green leafy vegetables, most African foods and Mr. E.F. attempt to eat out occasionally just for a change. Mr. E.F. drinks alcohol and smokes sometime while Mrs. E.F. Has an issue of being overweight. Nursing Family Health Assessment

This is where there is crisis at home because the wife gets upset with him from drinking and smoking to help the family. This serves as a behavioral risk because there are many diseases associated with smoking and alcohol intake. Family Resources The husband and wife do have insurances coverage from his job while the children are covered by Medicare. The Medicare policy for the children is great because they do not have to FAMILY ASSESSMENT 9 suffer from copay for appointments or drugs. Both husband and wife are very healthy and mostly use their insurance to do screening for preventive health. Family Strengths Communication is essential so that family members respect each other’s needs and wants. Without it, they will not know what each other thinks or feels, which can make family life more difficult. This family has a strong communication system. They discuss family dynamics all the time. Even though, Mrs. E.F. is not working, they have a joint account where she gets money to run the affairs of the house and pays other bills. The father expresses to the wife when things are tough financially so she can budget very well to prevent any crisis. Most couples today do not communicate well. There is selfishness and lack of trust between couples. Effective communication is not just talking but also listening. By listening well to other people in your family, you encourage them to talk about what’s most important in their lives. It’s easy to get careless about listening, especially in families. We take it for granted that we know what the other person means or pretend to listen while doing something else. This attitude does not build the family. Unity brings progress to the family. Unity solves a lot of problem and builds a stronger family. This family is very united because I never the wife complained about money even though she was not working. The single income coming in from the father’s job was used to run all financial affairs of the family. The family is very united because whenever there is a problem it is solved and unity be established. They both contribute differently to the welfare of the house. They are always together during holidays. This family is very supportive of each other. The support of family and friends during a crisis has long been seen to have a positive emotional effect on people. However, this support also has a FAMILY ASSESSMENT 10 physical benefit as well. However, the presence of friends or family members has been shown to reduce these rates among people during difficult periods. The mother always has dinner ready for the family as soon as dad is home from work. They appreciated each other all the time and showed affection. This family is affectionate and appreciates everything that people do for them. When I visited the family, the mother went immediately to the kitchen to get some food. The husband was very excited and sat down to chat with me. I noticed that there was strong affection between the husband and his wife. They called themselves “PPP” and “MIB”. They communicated on many issues and when I asked questions, most of the time the couple will respond in the same way. The children were always together. The eight-year-old boy was very responsible and took care of his siblings. This family showed great affection to each other, very caring and respectful to all. Respect is an important cultural practice for them. This family has strong respect for each other. The mother of the house looks at the father as the head of their household. The husband in turn had so much respect for his wife. These values have been passed unto the children. When I entered the house, the children greeted me as well as their parents. They all went back to their rooms because of the training that had. They saw that it was important for them to let their parents chat with me. The eight-year-old was always leading the younger ones to do it right. The parents are teaching the eight-year-old to be respectful so that the younger ones can learn from him. They are still faced with weaknesses which must be identified. Family Needs FAMILY ASSESSMENT 11 Identification of five needs based on priority are babysitter, income, transportation, emergency preparedness and lifestyle changes. This family has three children and it is very demanding for the mother to take care of them. She would have preferred a baby sitter but the income is not sufficient for them. The family has only one source of income and it is very challenging to manage what they have. Three children under the age of eight years old is very tough. Nursing Family Health Assessment

The cost of buying diapers alone is very challenging. The wife is planning to work during the weekend to supplement the income of the father. There is the need for transportation. There is presently only one care which the husband uses to work. His wife must take the boss, call a cab or walk to buy food or run other errands. A second car will be of great relief to the family. Emergency preparedness is another area of need. The family does not have any emergency plan in place. They do need to be educated about what to do during any emergency. They should always keep water, canned food, and first aid kit, flash etc., Lifestyle changes is need for Mr. E.F. who smokes and drinks. Second hand smoking is more dangerous that first hand smoke. The young children will be at risk respiratory disease. His wife is constantly talking to him about quitting and reducing or stopping alcohol. Family Problems Nurses will be challenged to help families identify the primary problem confronting them and to step aside and accept the family priority as they work in partnership with the family to keep their interventions simple, specific, timely and realistic (Stanhope, & Lancaster, 2012). Nursing Family Health Assessment

This family FAMILY ASSESSMENT 12 needs a babysitter to assist the mother in taking care of these children. They have discovered a lady leaving in the next block of the apartment complex but the financial capability is not there. Their identified role is a care giver strain related to no babysitter. One of this family’s diagnosis will be care giver strain related to lack of no babysitter. It is important to have intervention to address this problem. All the five areas of need will be addressed and intervention taken to address this family’s problems. Intervention Plan The author states the nurse works with the family to help them design realistic steps or a plan of action based on their ability successfully adapt to the health issue given to the strengths of the family. To solve the problem of getting a baby sitter, Mrs. E.F can be given information about the social welfare offices for assistance. She can also use friends and family members for help. Mr. E.F. should be educated about the risk of smoking and drinking alcohol. He needs to understand the effect of his action on his kids. H …Nursing Family Health Assessment