The Harris Family Assessment
Health practices are activities performed by individuals or families as a whole to promote health and prevent disease. Health practices vary from family to family and nurses play a pivotal role in promoting health for the family. Families identify and perform health-maintenance activities based on their perceptions about their health because their choices are influenced by the family’s values, beliefs, priorities, cultures and practices. Being a nurse requires an assessment of the family as a whole. A family health assessment is to evaluate and describes the health status of a given family (Edelman & Mandle, 2010). The Gordon’s 11 functional health patterns help to organize basic family assessment information. These patterns consist of values/health perception, nutrition, sleep/rest, elimination, activity/exercise, cognitive, self perception, role relationship, sexuality, and coping (“Gordon’s 11 functional,” 2008). The purpose of this assignment was to interview the Harris family, summarizing the results and to develop appropriate diagnosis. The Family Assessment
Positive Attributes
During a personal interview with John and Christine there were some positive family assessments revealed in regards to health maintenance/perception, nutritional pattern, exercise pattern, stress patterns and belief patterns. John is an overall health individual who drinks protein shakes and works out daily by jogging early in the morning. Dean, the oldest son, plays sports in middle school. Brent, who is a toddle, goes to mommy and me classes for his activity and Christine takes Brent out on bike rides daily before he has his nap. Since Christine has had a blood clot after giving birth to Brent, she has some restrictions to food, but she does the cooking for the family and they adjusted just fine to the restrictions. Their daily intake is primarily fish, vegetables, whole grains and salad. John and Dean have green leafy salads and Brent and Christine have fruit salads. The family as a whole does drink water daily and eats between thee-six times daily. Since the family does have a daily intake of whole grains and water in the diet, there are no deficits when it comes to elimination needs except that Brent hasn’t mastered being potty trained at night. The family as a whole has individual ways of getting exercise. John and Christine have a close relationship; they lean on each other for advice and to help handle their stress level. This family values one another, God and their morals to help guide them in the right direction when needed (C. Harris, personal communication, November 04, 2013). Areas of Improvement
The family assessment also revealed some area of improvements such as sleep and sexual patterns. Sleep patterns are just as important as nutritional patterns because without restful nights an individual may have a decreased in their performance, bad temperament, and a decreased stress tolerance, which can only burden the family dynamics (Edelman & Mandle, 2010). With son Brent sleeping in the bed, John and Christine have little time alone which affects their sexual encounters and there sleeping habits. Brent goes to bed with his mom and dad, if Brent had his own bed, his bedtime could change so that Christine could have some alone time with herself and her husband, which could spark things in the bedroom. Christine stated that she is in the habit of waking up during the night to check on the children; perhaps, if Brent was in his own bed Christine may sleep a full night without his tossing and turning (C. Harris, personal communication, November 04, 2013). Therefore, an implementation would be to wean Brent out of his parent’s bedroom and into his own room; this could also give Brent a sense of identity and responsibility. There could be a Risk for Impaired Child Attachment r/t changing sleeping habits; however, with the families love and nurturing, a nurse could think Brent will adjust quickly. According to Edelman and Mandle, any change in one family member will affect the entire family unit. In order to implement this change, the nurse needs to assess and educate the family about the pro’s and cons of Brent sleeping in his own bed; Is the family ready for change? Need for Change
One of the biggest concerns for the nurse performing the assessment is any negative expressions which are seen with role-relationship patterns and self perceptions patterns. This is an educated family that has additional support through grandparents. Some of Christine statements can lead the nurse to believe that these areas are personal, but requires improvement. Christine feels responsible for the home and if she wasn’t around things would fall apart; however, she also said that if she could change anything she would want a part-time job just to get out of the house. Christine life revolves around her family, while family is important, so is having your own identity and a group of friends to lean on if needed (C. Harris, personal communication, November 04, 2013). Therefore, one diagnosis would be Readiness for Enhanced social interaction r/t mom stating she doesn’t have time to hang out with friends AEB no alone time from toddler. A desired outcome would be to increase social interaction by leaving the house alone for at least 2 hours weekly and to have date night with her husband. This could help rekindle the sexual intimacy that could lead to a romantic night; thereby, increasing Christine’s confidence in herself. Another diagnosis would be Risk for Situational Low Self-Esteem r/t sexual tension AEB statements that mom doesn’t feel like her feelings matter. A desired outcome would be to communicate openly with her husband about her feelings. Last diagnosis for Christine would be Feelings of helplessness r/t need to feel like she makes a difference AEB statements made by mom about the need for a part-time job. A desired outcome would be that mom would get actively involved in community functions which can reduce feelings of helplessness (Weber, 2005). With these diagnoses, the major implementation would be for Christine to gain a part-time job or volunteer to get her out in the community even if it is just on weekends. This would increase her social health, ensure that she felt like she makes a difference and boost her self-esteem, which would only benefit the overall health of the family. Conclusion
According to the American Academy of Pediatrics Report of the Task Force on the Family, they have stated that “Families are the most central and enduring influence in children’s lives. The health and well being of children are inextricably linked to their parents’ physical and emotional and social health, social circumstances and childrearing practices” (Edelman & Mandle, 2010). A family assessment should be considered imperative when appraising one’s health promotion and disease prevention because within the family; children and adults are nurtured, provided for, and taught about healthy values by word, by expressed or implied example, and this is where individuals first learn to make choices to promote their health. Comprehensive family assessment provides the foundation to promote family health. During the family assessments it is useful to listening to families, engaging in dialogue, recognizing patterns, and assessing family potential for active positive change (Edelman & Mandle, 2010).
References
Edelman & Mandle, C. (2010). Health Promotion Throughout the Life Span (7th ed). Mosby. Retrieved from http://pageburstls.elsevier.com/books/9780323056625/ Gordon’s 11 functional health patterns. (2008, Oct 07). Retrieved from http://www.scribd.com/doc/6418349/Gordons-11-Functional-Health-Patterns Weber, J. (2005). Nurses’ handbook of health assessment. (5 ed.). Philadelphia: Lippincott Williams & Wilkins. Retrieved from http://jxzy.smu.edu.cn/jkpg/UploadFiles/file/TF_06928152357_nursing diagnoses
