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Nursing System Theories for Family Health Assessment

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    My family health assessment was conducted using the 11 Gordon functional health pattern. Marjorie Gordon’s functional health pattern is a guide for establishing a comprehensive nursing date base, using the 11 categories enable nurses determines the following aspects of health and human function (Gordon 1987). The Gordon 11 functional health patterns are health perception/health management, nutrition, elimination, activity/exercise, cognitive, sleep/rest, self perception/self concept, roles and relationships, sexuality and reproduction, coping and stress tolerance, values and belief.

    This paper will summarize the findings of each health pattern as well as the family based nursing diagnoses of each assessment, including the developmental and system based theory guide in the family assessment, combined with web-based resources of health promotion and illness prevention in the family. The assessment started with health perception and health management pattern which focuses on a person’s well-being, habits, and behaviors for maintaining health. The writer selected her family which consists of a father (50years old), a mother (33 years old) and five (5) children age 12, 10, 8, 7, and 4 months old.

    Based on the health perception and health management, this family has a history of diabetes and hypertension health problem and has lost two uncles (maternal mother’s side) from complications of diabetes. No member of the family indulges in any health risk behavior such as smoking tobacco, drugs, and alcohol; except prescription medications for hypertension and over-the-counter medications for common cold and flu symptoms, and sleeping/relaxation medications. Based on the nutritional metabolic pattern, the family stated that they abstain from food with high sodium due to the family history of high blood pressure.

    This family eats together mostly during the weekends because the children prefer to eat breakfast and lunch at school during week days. Dinner is prepared by the mother and everybody eats at their own time at least two hours before bed time. Each member of the family takes multivitamin pill everyday as an additional supplement to diet. With the elimination pattern, the family has a normal bowel and bladder pattern and does not have diarrhea or constipation or need any form of laxatives to move the bowels.

    The children are encouraged to drink water and eat fresh fruit and vegetables which are part of the everyday dinner menu. However with sleep and rest, the mother and children do not have any problem with resting and falling asleep and they can sleep for between six and eight hours, but father has problem falling and remaining asleep and sometimes can only sleep for 3 hours or at the most 5-6 with a sleeping medication. Because the children are all school age, parent makes sure the children go to bed at 9:00pm, so they can have enough sleep and wake up in the morning well rested and get ready for school.

    For activity and exercise, the family stated that they don’t exercise every day, but they are physically active. The children go for swimming lesson twice weekly, and the whole family goes on skating every Sunday evening. Based on the cognitive-perception pattern, decisions are made by parents and the children ideas and input are welcome when they are congruent and meaningful to the subject matter. Medical attention is sought seven days after over-the-counter medications and home remedies fail to eliminate symptoms completely.

    For example, if one of the children has cold or flu symptom, mother being a nurse, administers over-the-counter medications known to treat common cold and flu symptoms, but if medication is not effective, the child is taking to the hospital to see a pediatrician for better health evaluation. However, based on self-perception-self concept pattern, the family stated that they felt good with their self accomplishments. Father is an accountant and mother is a registered nurse; they are blessed with five children (four girls and a boy). The children are doing very well academically and are on honors row.

    They behave appropriately at school and their teachers like them and always acknowledge them for good behavior, conduct, participation and performance in class. The family also has good relationship with other families in the neighborhood. When it comes to roles and relationship, both parents are employed and they both manage the finance of the family. Every member of the family has his / her own task. The house chores are divided amongst the children based on seniority, while the parents go to work and take care of the financial obligations of the family.

    They also help the children with cleaning, cooking, laundry, and school assignments. Both couples are sexually active when it comes to sexuality-reproduction, and they both express satisfaction to some extent in their sex relationship. On work schedules, father works from 9am to 7-8pm, and mother works 11pm-7:30am. Even with the rough schedules, they still communicate and find time for each other and also for the children. After being blessed with five children, intra-uterine device (IUD) is used by mother as a form of birth control method. The coping-stress pattern assesses the family’s ability to handle and manage stress effectively.

    The main stressful issue for this family was the opposite work schedule, and father taking care of the four month old baby why mother is working midnight shift. Extended family members are not living close enough to help. The church members are very helpful when it comes to taking the children to church programs when mother and father are not available, but it is difficult to find somebody to help keep the children sometimes when the couples have occasion to attend or just want to spend time together alone. Stress is more of family related, but both parent speak with one voice, and take mutual decisions in stressful times.

    Father sometimes takes medications to sleep/relax, but mother do not take any medication and can easily fall asleep once children are in school and four month old baby is asleep. The assessment of value and belief is reflected on the family cultural practices, values and beliefs, and spiritual life. The family maintains their cultural practices when it comes to behavior acceptable to the society, home medication remedies, cultural attires, food preferences etc. Regarding home remedies for health promotion and illness prevention, this family seeks medical treatment from doctors and specialists and visits the clinic/hospitals for treatment.

    This family is Christian that believes in the power of fasting and praying. They seek God’s face in every situation, have good support system from fellow church members, respect and spend time with one another, and are very flexible when it comes to adopting and accepting western lifestyle. Based upon the assessment, two wellness nursing diagnoses was determined. Disturbed sleep pattern due to night shift rotation, and readiness for enhanced family coping due to lack of child care support. Father is unable to get enough sleep while taking care of the four month old baby at night when mother is at work.

    Both couples agreed that mother will work three days a week instead of five. Mother also went back to school to get her baccalaureate degree in nursing. By reducing work days, mother can help take care of the baby at night while father gets some sleep and mother can also have more time to study. Both couple has decided to manage their finances until mother gets through with school and baby grows older and could sleep throughout the night. Having somebody to help out with five children is not easy, so both couples have to work together and encourage each other knowing that present situation is for the time being.

    The health promotion strategies based on readiness for enhanced family coping are increased coping ability, functioning, and enriching lifestyle. The assessment should be done by identifying each family member’s perception of issue. The nurse encourages the family to express their concerns and fears by communicating and reaching agreement on how identified issues can be resolved or managed. Goals should be realistic and obtainable. Both couples should reach an agreement on how to manage their resources/finances as mother cut down on work days to help father take care of baby, and also continue with her education.

    The nurse should also suggest the following rituals such as relaxation activities, hot shower, listening to music, and can also provide web information that addresses sleep/rest disorders and stress management. From developmental perspective, the nurse knowing the family composition, interrelationships, and its particular life cycle can predict the overall family pattern (Edelman 2010). The developmental perspective was built on Erikson’s theory of psychosocial development that addressed different developmental stages.

    As families enter into a new developmental stage, transition occurs, these events such as marriage, childbirth, releasing members as adolescents and young adults, and aging years move families through new stages (Edelman 2010). Each stage builds upon the previous stage if successful, gives the family the opportunity to realize their potential towards health promotion and intervention, and also goal attainment. For instance, family adjusting their work schedule to help care for the children and relieve stress from lack of sleep will benefit both parent and positively affect the development of the children.

    With the system perspective, the nurse views the family as a whole, and provides health care that addresses the families need. In conclusion, an accurate family health assessment is important in planning, and implementation of appropriate health promotions. The nurse using the 11 Gordon functional health pattern is able to gather data and provide health promotion and intervention that addresses the families need. The developmental and system theories are powerful tools to help the nurse with the family assessment. References. Edelman, C.

    L. , Health Promotion throughout the Life Span (7th Ed) 2010, St. Louis, Missiouri: Mosby Elsevier. http://www. helpguide. org/mental/stress_management_relief_coping. htm. www. pbs. org/livelihood/nightshift/wenresources. html. Koshar J, “N340 Woman’s Health & Illness in the Expanding Family & N345 Clinical Practicum” http://www. sonoma. edu/users/k/kosher/N340/N345_Gordon_FHP. html. ,[Fact sheet]. August 17, 2012 Weber, J, R. (2005). Nurses handbook of health assessment, 5th edition. Philadelphia: Lippincott Williams Wilkins

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