For performing the family health assessment, the Yosleidy family residing in Miami, Florida, was selected. The assessment was conducted on the basis of the provided set of questions. The researcher has conducted interviews with each member of the family in order to gather the data needed for performing the assessment.
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- The Yosleidys are a nuclear family consisting of Mr. Yosleidy, aged 45, Mrs. Yosleidy, aged 47, and their children: Alicia, aged 17, Lima, aged 20, and Juan, aged 22. Thus, there are two males and two females in the family. The Yosleidys originate from Latin America and identify themselves as Hispanic.
- The parents are certainly the leaders of the family. Mr. And Mrs. Yosleidy consider themselves equal in the leadership position and believe that they do not follow gender stereotypes when indicating the leader of the family. Mrs. Yosleidy is the primary provider since her income is stable, unlike the income of Mr. Yosleidy. The other providers are Mr. Yosleidy, Juan, and Lima.
- Mrs. Yosleidy has been diagnosed with Stage I bipolar disorder a few years ago. Her mental state occasionally makes her withdraw from communication with the children and husbands, which definitely affects the family function, influencing her ability to fulfill her roles of a mother and wife.
- The home is in a perfect physical condition. It is comfortable and has all the necessary facilities. All the children have separate rooms. The family mostly subsists on Mrs. Yosleidy’s salary of an accountant. Mr. Yosleidy is a fiction writer; his earnings are considerable but irregular. Lima and Juan work to satisfy their needs, but their housing expenses are paid by the parents.
- In general, the family members are accomplishing their developmental tasks appropriately.
- Alicia’s current developmental state causes stress in the family, even though it is a normal condition for an adolescent. She is trying to behave like an adult and wants to get a job, but her parents consider her not mature enough and advise her to focus on her studies and, most importantly, the preparation for applying to college.
- The family has successfully completed the previous developmental stages: Mr. and Mrs. Yosleidy have met and created a family, gone through the complicated period of the newly married adults, given birth to the children, gone through the steps of school and preschool children (if Alicia’s one remaining year of school is not counted). The parents have successfully prepared their children for their future life and given them the necessary resources to become autonomous persons. The family is now approaching the stage of middle-aged adults. Lima and Juan are planning to live on their own, and Alicia will most likely be leaving for college in a year.
- No predispositions to disease in the family were reported by the clients.
- The Yosleidys have taken all the required vaccinations, as well as all the vaccinations recommended by the state government of Florida due to the serious concern of Mr. and Mrs. Yosleidy about the health and well-being of their family.
- As it was already mentioned, Alicia is experiencing problems in communication with her parents because of her coming of age and their complications with accepting their child in her new position of an adult.
- No family member is currently admitted to hospital.
- The mode of family communication is consensual. The parents treasure open conversation; the mode of communication is affective due to the general emotionality of the family members (Koerner & Fitzpatrick, 2005, p. 56-57). According to Mrs. Yosleidy, it is normal for the people of Hispanic heritage to be affectionate towards their children and receive the same in return.
- In the family, crucial decisions that would have an impact on the entire family are made at the family council, where all family members are allowed to express their opinions freely without any regard to their age, but the councils are held under the leadership of Mr. and Mrs. Yosleidy. In case if a serious decision impacts only a particular member (for instance, Lima decides to buy a car with her own money), they are expected to consult with the other family members but make a decision themselves. Alicia is expected to rely heavily on her parents’ opinion while making decisions for two reasons: she does not have her own money, and she is younger than others. This mode applies to her selection of colleges.
- No evidence of family violence was received. Mr. and Mrs. Yosleidy believe that a child is a person capable of agency, reflection, and understanding of the consequences of their actions. In addition, they think that their children are too mature for punishments. For these reasons, they prefer conversation as a form of discipline.
- The family generally deals with crisis well due to the openness of the family members to each other and their ability to communicate effectively. For instance, when Lima was in a relationship with an abuser, her family members supported her and helped her stop this relationship.
- The Yosleidy are not deeply religious. They are fond of traditions when it comes to kitchen or holidays, but their views on health and lifestyle are contemporary. For instance, they do not consider that having sexual life in teen ages or applying for mental help is shameful. Such views of the parents have influenced the thinking and, hence, the behavior of their children, which has an impact on their health.
- The main family goal is to make all family members content with their lifestyle. The current goal is to educate the children, particularly help Alicia to get to a college and help Juan and Lima finish their higher education.
- The sources of external support are the family’s counselor, Alicia’s educators, and the mental health specialist at Lima and Juan’s colleges. Internal support may be received from Mr. and Mrs. Yosleidy’s parents, who are both on good terms and in frequent communication with the family.
- Mrs. Yosleidy is experiencing a role conflict: she is spending more time at work than with the children. Conversely, Mr. Yosleidy is at home almost all the time, and he speaks to children or engage in activities with them rather often. Mrs. Yosleidy considers this situation somewhat inconsistent with her necessity to fulfill the role of a mother.
- The family has emergency plans for a crisis. These plans involve their sources of support and bank savings. They also have a shelter under their yard.
In the course of the assessment, three nursing diagnoses were identified.
First, Mrs. Yosleidy is concerned about the fact that her disease (Stage I bipolar disorder) has a negative impact on her communication with family and her fulfillment of motherly duties. Among the people of her cultural heritage, it is considered that a mother should be devoted and attentive to her children, but the disease forces her to limit the communication with them at the times of crisis. This contradiction may make the outcomes of her disease even more complicated for her.
Second, the fact that Mrs. Yosleidy has a stable income while the income of her husband can vary, which is why she is the primary provider, has an impact on her motherly role and, hence, her mental condition as well. Mrs. Yosleidy is worried about the insufficient amount of time that she spends with her children, as well as she feels that their father is closer to them than herself. She believes that such a distribution of time is inappropriate for a mother, but her work leaves her no choice. A conflict between the roles of a mother and a provider can be clearly seen in Mrs. Yosleidy (Duxbury & Higgins, 1994, p. 56).
Third, Alicia’s coming of age creates problems in the communication between her and her parents. Alicia has reached a new stage of development, which is consistent with the norms of healthcare (Bornstein, Hahn, &Haynes, 2010, p. 719-729) and the traditions of the American society. However, her parents cannot accept the fact that their daughter is becoming an adult and will soon lead an independent life. Such a situation leads to tension in the family. In fact, this reaction is widespread among the parents of adolescents (Hatherley, 2014, p. 65).
Nursing Care Plan
Using the knowledge of the nursing process, the collected data, and the established diagnoses, the researcher has developed a specific nursing care plan.
The goals of the nursing care are: reduce the impact of bipolar disorder on the fulfillment of motherly duties by Mrs. Yosleidy; eliminate the conflict between the roles of a mother and a provider in Mrs. Yosleidy; make Mr. and Mrs. Yosleidy accept that their daughter is becoming an adult.
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The outcomes of the nursing care are: increase the participation of the family members in the treatment of Mrs. Yosleidy’s disease; modify the way, in which Mrs. Yosleidy fulfills her motherly duties; improve the communication between Alicia and her parents.
The mentioned goals and outcomes should be achieved through the fulfillment of the following nursing orders:
- Enlightening the other family members on the nature of Mrs. Yosleidy’s disease and the ways, in which the family can help her to cope with the disease (Reinares, Colom, Rosa, Bonnin, Franco, Sole, Kapczinski, & Vieta, 2009, p. 84-86). Her relatives can consult special literature regarding the issue.
- Deciding on the ways, in which Mrs. Yosleidy can fulfill her motherly role without leaving her job. For instance, she can spend more time with the children on her days off while Mr. Yosleidy is doing all the housework on these days.
- Assigning more “adult” tasks to Alicia, which would, firstly, help her parents to become sure that she is mature enough and, secondly, let her try an “adult” role. For example, she can organize a family holiday or make a presentation to the family about her college choice, explaining the advantages and disadvantages of her choice.
For the present work, the researcher has selected the Yosleidy family and conducted an assessment relying on client interviews. Based on the assessment, three nursing diagnoses were established. A specific nursing care plan was developed for the family.
Bornstein, M.H., Hahn, C., & Haynes, M.O. (2010). Social competence, externalizing, and internalizing behavioral adjustment from early childhood through early adolescence: Developmental cascades. Development and Psychopathology, 22(4), 717-735.
Duxbury, L., & Higgins, C. (1994). Interference between work and family. Employee Assistance Quarterly, 9(3-4), 55-80.
Hatherley, P. (2014). Developmental tasks for children, adolescents & adults. Bloomington, Indiana: Balboa Press.
Koerner, A., & Fitzpatrick, M.A. (2005). Family communication patterns theory: A social cognitive approach. In D.O. Braithwaite & L.A. Baxter (Eds.), Engaging theories in family communication: Multiple perspectives (pp. 50-65). Thousand Oaks, California: SAGE Publications.
Reinares, M., Colom, F., Rosa, A.R., Bonnin, C.M., Franco, C., Sole, B., Kapczinski, F., & Vieta, E. (2009). The impact of staging bipolar disorder on treatment outcome of family psychoeducation. Journal of Affective Disorders, 123(1-3), 81-86.