Family Evaluation
The Jiron’s are the typical two-parent family residing in the Miami-Dade community in Miami, Florida. They belong to the Hispanic ethnicity. The family consists of the father of 45 years old, the mother of 40 years, and two daughters aged 20 and 17.
The father is the leader in the family and the primary provider. The mother mainly engages in the household work, but from time to time, she works as a part-time accountant in an outsourced team of freelancers. The older daughter also has a part-time job as an accountant that she does in the hours free from her main activity, which is the studies in college. The younger daughter is a school student and she sometimes engages in the working activity during the holidays or weekends.
No one in the family is affected by serious health issues both physical and mental. Everyone in the family is self-contained and can support one’s physical needs without any significant health limitations.
The family dwells in a two-bedroom house with a backyard and small garden where the mother grows some fruit trees and flowers with the help of the younger daughter. The family’s financial status is moderate. They have enough funds to cover their basic needs. The father has full insurance coverage at work. However, the mother has no insurance at all since she works as a freelancer. The older daughter has only partial insurance coverage provided by the company where she is an accountant employed part-time. The younger daughter has access to medical care only through the Medicare Act provisions.
Individual family members accomplished age-appropriate developmental tasks demonstrating their high intelligence rate, high level of emotional intelligence, and general developmental excellence. Evaluation of the family micro-climate has suggested that everyone is striving to develop cognitively because such preparedness affects their life quality and income level.
Family member’s developmental state does not create stress in the family since all have achieved considerable results in this area. They do not stop on the good results they have continuing to engage in developmental training. They also visit voluntary health promotion educational sessions conducted by advanced practice nurses in the local church from time to time.
Currently, the family is in a teenage developmental stage according to Duvall’s family evaluation taxonomy; however, very soon the status will change for launching because the older daughter is about to end up the preparations to leave the parents’ house (Goldenberg & Goldenberg, 2012). The family had excellent results in achieving the goals set during this and previous developmental stages.
The family has a quite broad history of genetic predisposition to the disease. The family head’s father died of a stroke at the age of 59 and the mother is alive and is on treatment due to such chronic disorders as controlled diabetes, emphysema, and hyperlipidemia. His siblings currently suffer from obesity, hyperlipidemia, emphysema, and chronic pancreatitis. The wife’s father is alive and generally well but the only problem is the major depression due to his mate’s death. The mother passed away from breast cancer three years ago at the age of 62. The wife’s siblings are all alive and well. The oldest sibling began to suffer from chronic pancreatitis and controlled diabetes two years ago at the age of 43.
The family immunization status is excellent. Every member has all the necessary vaccinations according to age.
Addressing the family wellness, the father has developed the weight problems and hyperlipidemia identified during the annual screening he has as a part of his working license confirmation. His interrogation has identified that he has an unhealthy diet with multiple national meals of Nicaragua cuisine containing high rates of sugar, fats, salts, and fried components. In addition, due to the busy schedule, he complaints that he is not able to find time to exercise as he did earlier. He used to be a smoker in his twenties. He managed to quit smoking until his forties. Currently, he is a smoker again. He smokes one pack of cigarettes a day for four years. Other family members are well.
Last winter, the younger daughter was admitted to the hospital with left lung pneumonia. All family members were supportive, with the mother being the most active visitor. Father and the older daughter expressed their wish to visit more often because they were concerned that their busy schedule prevented them from more active participation. The family members recall that they tried to rehabilitate by spending more time with the youngest girl when she was discharged from the clinic and extending help to restore her health.
The typical modes of family communication can be identified as quite effective but there are some issues. The stronger point is the communication between the mother and daughters. The identified problem is the emerging problems in the communication between the mother and father that began when the man had accepted an offer to have more responsibility at work and began to spend more time there. Communication between the siblings is quite effective. There exists a good level of mutual support among them.
The decision-making process in the family is headed by the father. He makes the major decisions as for the family plans, major purchases, vacation destinations, traveling, and similar issues. The mother is responsible for household-related decision-making. The daughters help the mother and actively participate in family discussions. The most important decisions are made at the family council.
There is evidence of violence in the family originating from the father who demonstrates quite a heated temper and is generally a jealous person. He tends to express his power by applying physical and oral violence to the wife. However, the problem does not have a routine character. The forms of discipline used are heart-to-heart talk and at times, the couple visits the family consultant.
The family’s ability to deal with a crisis can be qualified as moderate. The family has passed through a couple of crises due to the husband’s outburst of jealousy. The wife is not sure if she would continue to strive to keep the marriage.
The family is of Hispanic origin. The husband came from Nicaragua back in the 1980s when he was a teenager. The wife was born in Miami in a family of immigrants from Spain. The daughters were born in the United States. The parents support Catholic traditions and celebrate Hispanic culture. They generally stick to Hispanic eating and lifestyle habits. The daughters are more assimilated into American culture. They state they would like to consider themselves atheists.
The primary family goal currently is to help the daughters acquire quality education and find a deserving place in life. After resolving these issues, the parents feel they would want to spend some time thinking if they would decide to maintain their marriage after sending the daughters from home. Each individual in the family is concerned about health and wants to engage in health promotion activities. They set the goals helping them find time for maintaining their health status despite the busy schedule.
As for the internal sources of support, the family enjoys emotional and physical support from the grandparents and parents’ siblings with their families. The big family gathers during the main holiday in a year. There are no external sources of support in the family.
There is no evidence of the role of conflict. Everyone in the family performs one’s role.
The family has an emergency plan to deal with disasters. The main highlights from the plan can be seen on the fridge in the kitchen. They have also collected emergency bags for each member of the family. They are aware that they need a good plan to overcome the current conflict between the husband and wife due to his jealousy but they are not confident whether they will want to maintain family after their daughters leave home.
Family Diagnosis
The major problems identified during the family assessment were related to the lack of physical activity and unhealthy eating habits. At that, the daughters seem more concerned about their health, looks, and wellness. They strive harder to find time for physical activity and try to avoid unhealthy food containing high-fat rates and sugar rates. However, they confess it is not always easy because the mother is a good cook and it is difficult to reject the temptation.
The father can be identified as the person subjected to the highest risk of morbidity because he is a smoker, he spends much time at work, he is subjected to high stress at work, he has self-control issues and this makes his life even more stressful, and he has no free time to engage in physical activity. Instead, he prefers to relax spending time next to the computer or watching TV. Besides he has a strong family history of morbidity. His father died of a stroke. Moreover, the man was diagnosed with hyperlipidemia and he has weight issues. Judging from the above mention, the father is at the risk of cardiovascular disease and diabetes (CDC, 2016; DeBoer, 2013).
The mother can be characterized as a person with quite good healthy habits. The mother finds time for physical activity, which is a good factor. However, being a member of Hispanic culture, she enjoys unhealthy foods and often cooks them to feed the family. Another risk factor for her is the family history of breast cancer.
The daughters are the most exemplary persons in the family striving to maintain good health. They can be praised for their quite healthy eating habits and spending sufficient time physical activity. They do not have harmful habits. The major risk factors they are subjected are the family history of breast cancer and cardiovascular and pulmonary diseases. However, since they strive to modify their habits, this risk factor may have less impact on their health condition until they are at an older age (Barker & Chang, 2013).
Overall, the three nursing diagnoses for the family are (1) the unhealthy eating habits the father has, (2) the father’s tobacco use increasing his risk for cardiovascular morbidity, and (3) the father’s hyperlipidemia.
Plan of Care
First, the father and other family members need to be educated about the importance of healthy eating habits (Fayers & Machin, 2013). The family members need to support the father’s lifestyle modification. The father should be educated about the urgency of smoking cessation for him and referred to the national smoking cessation help desk. It is important to monitor his smoking status until he quits. Finally, he needs to be placed on Lipitor medication to improve cholesterol rates.
References
Barker, P., & Chang, J. (2013). Basic family therapy. New York: John Wiley & Sons.
Centers for Disease Control and Prevention (CDC) (2016). The surprising truth about prediabetes. Web.
DeBoer, M. D. (2013). Obesity, systemic inflammation, and increased risk for cardiovascular disease and diabetes among adolescents: A need for screening tools to target interventions. Nutrition, 29(2), 379-86.
Fayers, P., & Machin, D. (2013). Quality of life: the assessment, analysis and interpretation of patient-reported outcomes. Burlington, MA: John Wiley & Sons.
Goldenberg, H., & Goldenberg, I. (2012). Family therapy: An overview. New York: Cengage Learning.