Nursing Diagnosis: Family Health Assessment

Introduction

Family health assessment is a tool deployed for estimating the atmosphere in a family. The primary aim of this technique is to collect as much information about each family member as possible to obtain a better understanding of the health status of each of them and apply it to choosing the right way of treatment (Willemse & Kortenbout, 2012). This family assessment focuses on the White family, who live in New York. Father, aged 43, is a teacher at a nearby school. Mother, aged 38, is a librarian. They have two daughters aged 17 and 15. They attend the same school where their father is employed. Father works full-time while the mother is employed part-time.

Gathering the required information implies conducting interviews with family members. It should be noted that all questions are open-ended and family-centered. They are organized in accordance with Gordon’s functional health patterns, i.e. cover such patterns as health perception, nutrition, sleep/rest, elimination, activity/exercises, cognitive, sensory-perception, self-perception, role relationship, sexuality, and coping (Jones, Duffy, Flanagan, & Foster, 2012).

List of Questions

Health Perception

  • How would you estimate the current state of your family’s health?
  • How would you describe a common pattern for treating diseases in your family?
  • What are your ways of improving health?

Nutrition

  • How would you describe your family’s traditions regarding mealtime?
  • What are the typical products and beverages consumed?
  • What is the common number of meals a day?

Sleep/Rest

  • When do you normally wake up and go to sleep?
  • How do you relax before going to sleep?
  • Which sleep concerns can you mention?

Elimination

  • Which health concerns with skin, bladder or bowel can you mention?
  • How often do you have to satisfy your elimination needs?
  • How do you treat health concerns related to bladder, bowel, and skin?

Activity/Exercises

  • How would you describe your daily exercises?
  • How do you promote physical activities in your family?
  • What would you prefer for a weekend: being at home or hiking?

Cognitive

  • How would you describe the state of your family’s cognitive perception health?
  • How often do you have your eyes and ears checked?
  • What is the easiest way for your family to learn something new, e.g. rules?

Sensory-perception

  • How would you describe the motto of your family?
  • What are the primary goals of your family?
  • How important is a religion to your family?

Self-perception

  • How would you describe your family?
  • Which problems can you mention?
  • How often do you feel anger or annoyance when with your family?

Role Relationship

  • What is the role of division in your family?
  • Are you comfortable with the roles you play?
  • What do you do to improve role responsibility in your family, neighborhood, and work/school?

Sexuality

  • How open are you when you speak about sexuality with your children?
  • How satisfied are you with your sexual relationships?
  • How satisfying sexual needs influence the atmosphere in your family?

Coping

  • What is your strategy for coping with significant problems and crises?
  • How hard do unforeseen crises affect the atmosphere in your family?
  • What significant changes, which happened during the last year, can you mention?

Summarizing the Findings

General physical and psychological condition in the family under assessment seems to be healthy. They do not mention any significant health concerns except for seasonal diseases such as flu. Every time they notice equivocal symptoms, they visit a doctor. Mother decided that health is the most valuable resource. That is why she established the rule of taking medical examinations annually, which is strictly followed. They do not report any health concerns with bladder, bowel, skin, and cognitive perception. However, the father and one of the daughters wear eyeglasses.

Another way for improving health is seen in a healthy and nutritious diet. Because their mother works part-time, she has enough time to take care of her family’s needs. The most common products in the Whites’ diet are vegetables, fruit, fowl, porridge, dairy products, and some homemade sweets. Their most common beverages are juices, tea, coffee, and milk. In general, they try to avoid junk food and control the amount of sugar in their food. They have a strong culture of meals having breakfasts and dinners together. Except for these two meals, they have 2 to 3 more food intakes a day.

Healthy sleep is another rule established by the mother. On average, sleeping time is seven to eight hours. Before going to bed, they usually spend some time together watching TV, reading books, or sharing the news. It is their way of relaxation before sleep. The White family acknowledges the importance of physical exercises. However, they do not have enough time for exercise during the working week. That is why they take a walk to their job/school and back home and go hiking every time they have such an opportunity. This family prefers active weekends to sit in front of the TV.

The White family does not have a motto. However, it lives under several rules promoting physical and psychological health and mental wellbeing. They believe that family is a fortress, and trust and openness is a key to happiness and harmony. That is why parents feel free to demonstrate their tender feelings towards each other in front of their kids and are open to discuss sexual relationships with the girls. Their primary life goals are to provide family members with enough space for self-development and children with higher education as well as take care of their health.

Nevertheless, they are obliged to play their roles. Father is a breadwinner and the leader of this family. Mother is a part-time housewife seeing herself responsible for the health of her loved ones. Daughters are obliged to listen to their parents and follow their decisions. Even though this family is not religious and considers itself to be modern, this role division is strict and cannot be negotiated or protested. However, there are no signs of violence and everyone seems happy with such a role relationship. This friendliness and openness is also the Whites’ strategy to handling any crises or problems, although they cannot mention any big changes during the last year.

Wellness Nursing Diagnoses

Based on this family health assessment, it is possible to identify wellness nursing diagnoses, i.e. determine the areas of health either physical or psychological, in which family members want to see improvements (Carpenito-Moyet, 2012). First of all, we see some kind of collision in-role performance. Even though the father is a breadwinner and leader of this family, the mother determines primary rules promoting medical examinations, healthy food, and physical examination. Moreover, the White family draws a strict line between parents and children. It means that the first diagnosis is ineffective role performance (Weber, 2013; Ladwig, Ackley, & Makic, 2014).

In addition to it, even though openness and trust are promoted in the family, children feel that they do not have a real influence on decision-making, although they are already 15 and 17 years old. It means that they might feel strain, fear, or unwillingness to share their thoughts. Wellness nursing diagnosis is readiness for enhanced communication (Weber, 2013; Ladwig, Ackley, & Makic, 2014), i.e. finding the ways to make it more productive and open.

References

Carpenito-Moyet, L. J. (2012). Nursing diagnosis: Application to clinical practice (14th ed.). Philadelphia, PA: LWW.

Jones, D., Duffy, M. E., Flanagan, J., & Foster, F. (2012). Psychometric Evaluation of the Functional Health Pattern Assessment Screening Tool (FHPAST). International Journal of Nursing Knowledge, 23(3), 140-145.

Ladwig, G. B., Ackley, B. J., & Makic, M. B. F. (2014). Mosby’s guide to nursing diagnosis (5th ed.). Saint Louis, MO: Elsevier.

Weber, J. R. (2013). Nurses’ handbook of health assessment (8th ed.). Philadelphia, PA: LWW.

Willemse, J. J., & Kortenbout, E. W. (2012). Undergraduate nurses’ experience of the family health assessment as a learning opportunity. Health S A, 17(1), 1E-9E.