The Friedman Family Assessment Model draws heavy on the structure-function framework and on developmental as system theory. The model takes a broad approach to family assessment, which views families as a subsystem of society. The family is viewed as an open social system ((Stanhope & Lancaster, 2008). In this paper the subject to identify is a family assessment using the Friedman Family Assessment Model, including three nursing diagnosis. Friedman Family Assessment Model Identifying Data The Lazar family resides in Whittier California.
This is a two parent family in which 42-year-old Steve (S) is the husband and biological father who works as a truck driver for a distribution company and his wife Maria (M) also the biological mother is a stay-at-home mother. S is Romanian and M is from Mexico both residing in California for 26 years. S and M have two daughters Jennifer (J) 16 and six months pregnant, and Liz (L) 19. The Lazar family is middle-class and follows Catholic practices. M does not speak English; S speaks English, Spanish, and Romanian fluently. Dietary habits are traditional as well as home decor.
S and M have High school diplomas although do not have a college education. J is currently in adult school and L attends Rio Hondo College. Developmental Stage and History of Family S and M have living parents; S is close with his family and frequently interacts with them. M was raised by her grandmother so she does not have a close relationship with her mother however, M grandmother has since deceased. M does not have siblings and S is close with is siblings still. Developmental task of the family are somewhat accomplished according to age, although M feels in competition with society and the pressure that it rings. J has not developed a balance between freedom and responsibility as evidence by her pregnancy. L is on track developmentally as evidence by responsibility to her education and balance with her peers. The family is generally in good health with the exception of S alcohol abuse and tobacco use. S is a functioning alcoholic that holds a paying job however drinks substantially during his leisure time. Environmental Data Family lives in a two-bedroom home, two bathrooms, family room, and dining room, all with well lighting, working water supply, and electricity.
The house is clean with good hygiene, there are no safety hazards, and waste and garbage disposal is adequate. The family feels a moderate sense of privacy although would like to have more independent space. The family has lived in this neighborhood for 20 years it is a well kept residential area with mostly a Hispanic population. M and J are not familiar with community services and S is typically to proud to use the services provided. L makes use of her college services but otherwise is not familiar with other services in the community.
Family Structure Communication patterns within the family need substantial work, often the communication between family members is not clear nor firm, children do not respond favorably to feedback, there is not much listening and frequent feelings of judgment occur. M is very emotional and cries often when speaking with her daughters, M and S do not communicate often other than to discuss bills or their daughters. S makes most of the decisions in the house, and it is evident J and L have a higher respect for S. M continues to attend church, and would like the family to attend however that has since faded with time. S and M believe school is important although realize they were not as active in their daughters education and social habits as they should have been.
Family Function S believes his function in this family is to provide financial survival and provide protection and that M should maintain the home as a full-time homemaker. Since J is expecting a new baby in a couple months she realizes she will need to take on a whole new role both at home and in society. She ealizes her responsibilities will change and become much more difficult. M is trying to fit in the community better to assist her daughter with what she needs however it is more difficult since she does not speak English. The family has different individual health status need although they are generally healthy. One concern for the whole family observed was bad eating habits that can lead to obesity and diabetes. With S drinking and smoking he is opening himself up to higher risk of heart disease, liver disease, cancer, and high blood pressure. Family Stress and Coping
Currently the largest family stressor is S substance abuse. M is fearful S may lose his job one-day or become ill due to his addiction. J pregnancy has also put a strain on the family because they will need to support one more family member in a couple months because J does not have a job. M attends church to cope with her stressors and receive strategies to help cope from her pastor. S continues to seek alcohol consumption to mask his stress, and L verbalizes she tries to stay away as much as possible and study. The strength within the family has been maintained with prayer.
Priority Family Nursing Diagnosis The first nursing diagnosis chosen is Ineffective Health Maintenance related to lack of familiarity with neighborhood resources as evidence by lack of knowledge of community resources and services. A nursing intervention for this diagnosis is to provide the family with community resources appropriate for their needs including the phone number, address and giving them a description of the resource. A second intervention is to assess client’s feelings, values, and reasons for not inquiring on such important issues.
The second nursing diagnosis chosen is Risk for Spiritual Distress related to experiencing disturbance in belief and value system manifested by verbalization of lack of faith and hope. The first nursing intervention that would benefit the family is to establish an environment that promotes free expression of feelings and concerns. The second nursing intervention is to encourage family to attend the church which they were once a part off, and encourage clergy from local churches and ministries to make house visit if desirable to family.
The third community nursing diagnosis chosen is ineffective coping related to personal vulnerability manifested by verbalization of alcohol abuse. The first nursing intervention is to provide the family with the knowledge and first steps necessary in obtaining access to substance abuse agencies. Second intervention is to connect a social worker or case manager with the family to point them is the right direction with their desired outcomes. Conclusion
The Friedman Family Assessment Model draws heavy on the structure-function framework and on developmental as system theory. The model takes a broad approach to family assessment, which views families as a subsystem of society. The family is viewed as an open social system ((Stanhope & Lancaster, 2008).
References
Carpenito-Moyet, L. J. (2010). Handbook of Nursing Diagnosis (13th ed. ). Chester, PA: Wolters Kluwer Health Stanhope, M. , & Lancaster, J. (2008). Public Health Nursing (7th ed. ). St. Louis, MO: Mosby Elsevier.
