Introduction
The evaluation of patients and their families is one of the most important issues of effective treatment and disease prevention. A method of genogram allows for assessing family dynamics, focusing on physiological and psychological concerns, which can be considered in terms of genetic predisposition (McGoldrick, 2016). This paper aims at examining a case study based on the genogram and family table to understand the existing risks and suggest preventative strategies.
Genogram Assessment
The chosen family consists of three generations, each of which has certain genetic diseases, including diabetes, cardiovascular problems, hypertension, psychological issues, and so on. Mrs. M., the target patient, has one daughter, who was diagnosed with diabetes in her infancy. In addition, M.’s also has type 2 diabetes, while other family members are not affected. The patient’s mother, Mrs. N., and paternal uncle, Mr., suffered from a brain attack in the period between 40-49 years. Psychological disorder is another common condition that is diagnosed in the patient (panic disorder), maternal grandfather (eating disorder), and maternal uncle (depression).
Hypertension is one of the most pronounced chronic diseases in a given family. Namely, maternal grandfather, mother, paternal grandmother, and paternal uncle have the identified illness, which was diagnosed between 30-60 years. Considering that hypertension presents an elevated risk to those whose parents were affected, it is critical to pay more attention to this disease. For example, lifestyle changes can be considered, including nutrition and adequate physical activity.
The presence of heart disease in the family history is an aggravating factor that increases the likelihood of developing hypertension (Patel, Masi, & Taddei, 2017). The ability to control the patient’s and her family’s blood pressure should be targeted by a nurse.
Osteoporosis is diagnosed in paternal grandfather, who died from a heart attack, and paternal uncle. It is associated with the potential fractures of the bones of the thigh, forearm, and vertebrae in the back (Li et al., 2017). Often, a person does not even consider the existence of such a disease. The family members should be aware of osteoporosis symptoms to receive timely treatment. For example, one can suspect it with pain in the lumbar and thoracic areas of the back, and stoop, as well as pain in the spine and its deformities (Li et al., 2017). Also, osteoporosis, the symptoms of which cannot be disregarded, can be expressed by increased fatigue and a decrease in calcium and bone strength, resulting in bones becoming more fragile and easily damaged.
Among other genetic diseases, there is one case per such conditions as irritable bowel syndrome, dementia, high cholesterol, lung cancer, diabetic kidney disease, and unknown disease. Since two persons died from a heart attack, it seems to be rational to increase attention towards protecting vessels and monitoring blood circulation. Based on this genogram and table assessment, it is useful to suggest several interventions that would help the family in reducing health risks.
Risk Assessment
Since the family is at high risk of developing hypertension, heart disease, and osteoporosis, timely prevention is needed. Healthy lifestyle promotion is the first counseling intervention that includes consuming nutritious food with a sufficient content of calcium and other minerals. In addition, sunbathing is useful for saturating the body with vitamin D. Moderate physical activity implies that the patient selects the preferred exercises and sports to train his or her body. Hypertension is a risk factor for such illnesses as cerebrovascular accidents along with coronary heart disease (Patel et al., 2017).
Hypertensive heart disease with the onset of acute myocardial infarction, chronic heart failure, acute cerebrovascular accident, and progressive renal failure can be noted among the causes of death in patients with hypertension. Therefore, it is necessary to reduce the factors predisposing to the disease.
Patient education is the second counseling intervention, the application of which is associated with greater awareness of the family members. The risk factors for hypertension are age, exogenous factors (acute and chronic stress), and social status (a significant increase in the prevalence of hypertension is observed among people in low-income groups). While some factors cannot be changed (age, heredity), others are quite amenable to impact. An unhealthy diet, high cholesterol and other fats in the blood, low physical activity, smoking, excessive alcohol consumption, poor quality of drinking water, and air pollution should be avoided.
By eliminating the above factors at least partially, one can improve his or her well-being and prolong life. Being overweight is also a predisposing factor in hypertension since it leads to impaired lipid metabolism and coronary heart disease. Information on the mentioned risk factors and prevention strategies should be communicated to the family in an understandable form, such as brochures, links to official websites, and tracking applications.
Conclusion
To conclude, the genogram is a useful tool to evaluate the family health history and note the concerns that require more attention. The knowledge that is gained from risk assessment allows for formulating relevant counseling interventions to reduce the likelihood of diseases. It is found that the chosen family is prone to developing hypertension, osteoporosis, and heart disease. Patient education and healthy lifestyle promotion were identified as the preventative measures to assist this family in improving and supporting their health.
References
Li, C., Zeng, Y., Tao, L., Liu, S., Ni, Z., Huang, Q., & Wang, Q. (2017). Meta-analysis of hypertension and osteoporotic fracture risk in women and men. Osteoporosis International, 28(8), 2309-2318.
McGoldrick, M. (2016). The genogram casebook: A clinical companion to genograms: Assessment and intervention. WW Norton & Company.
Patel, R. S., Masi, S., & Taddei, S. (2017). Understanding the role of genetics in hypertension. European Heart Journal, 38(29), 2309-2312.