In the professional nursing practice, it is important to be aware of the comprehensive information regarding the family assessment instruments. A high level of validity and reliability of assessment instruments for use with family members of different age assist the accumulation of the accurate data needed for the design of the appropriate interventions and treatment of diagnoses (Lee, Leung, & Mak, 2012). The purpose of this paper is the investigation of the family assessment instruments and their application for the generation of the effective intervention. The study will help to understand the different aspects of nursing assessment and, thus, will make a significant contribution to the improvement of professional clinical practice.
Evaluation of Family Background
The selected family consists of four members: a woman of 38 years (Olivia), a female adolescent of 15 years (Anna), a boy of 8 years (Peter), and an elderly male of 67 (Alroy). All the family members, besides Alroy, were born in the USA. The ethnic/cultural origins of the eldest person in the family come from Scotland where he lived until the age of 23.
Olivia is the leader of the family. She is a single mother and is a primary provider of a family. She has a decent job as an accountant in an international organization, and, therefore, the family’s financial condition is in a prosperous state. Anna is a high school student, and she is preparing herself for the admission to a local community college next year. Peter is a student as well; currently, he attends the upper elementary class. Alroy is retired; he is regarded as a valuable member of a family who provides a large portion of the moral support to others.
The primary financial resource is Olivia’s work. Her financial revenues allow maintaining the good living conditions for all family members. Moreover, being an elderly person, Alroy receives his monthly pension payments. The financial and other decisions in the family are primarily made by Olivia. But when the issue is somehow interrelated with other family members, they usually discuss the potential advantages and disadvantages of the decision that is to be made together.
Physiological Assessment
Alroy was previously diagnosed with the impaired walking, and he thus experiences the loss of physical mobility. The difficulties with walking appeared as a consequence of a long-term chronic hypertension. Sometimes there are the periods when Alroy can perform independently. However, during the aggravation of symptoms he needs the assistance of his family members because his movement ability becomes extremely limited.
Anna experiences the problems with her weight. Currently, she is considered an overweight person. Her physical condition yet didn’t significantly affect her health in a negative way, but time after time she has the severe headaches and dizziness that may be regarded as the symptoms of hypertension. Previously, Anna never addressed the medical settings for help with her weight problems, and she didn’t pass through the intervention practice so far.
Olivia doesn’t have any physical or psychological conditions, but due to the nature of her professional occupation, she is frequently exposed to the high level of stress. Moreover, as an accountant, she has a sedentary lifestyle.
Alroy’s wife died of the breast cancer. Thus, the female members of the family are predisposed to the disease. It is also known that a few of the relatives previously had cardiovascular diseases (arrhythmia) and some neurologic diseases.
The family members are not prone to the seasonal and other ailments. Nevertheless, when Olivia is exposed to a high level of stress at work, she may catch a cold easily. Alroy and the children’s immunity are in a good condition at most of the times.
Assessment of Communication and Coping Mechanisms
All the family members can adequately accomplish the age-appropriate developmental tasks. Their cognitive, emotional, and academic performance may be considered as well-developed; therefore, the family doesn’t feel any kind of stress related to the need for coping with the severe developmental delays.
The families with the school children have the specific tasks to fulfil that are primarily aimed at the provision of support and care of the young students. At this stage, it is important for the caregivers to be involved in the children’s development, and it is particularly necessary to be able to establish sound relationships with them because it assists the development of children’s psychological coping mechanisms and facilitates the adoption of the skills of the social interactions in them. Olivia and Alroy do their best in the attempts to care about Anna and Peter. However, due to Alroy’s physical condition and Olivia’s professional commitment, the children often spend time independently. Nevertheless, the children do not experience any significant difficulties in the multiple aspects of their lives, and they are usually encouraged to act irrespectively of the adults’ opinions and assistance. Overall, it is possible to say that the family development goes smoothly. Overall, the communication within the family may be estimated as effective and positive. The family members rarely have conflicts and show respect to each other. Therefore, it is possible to say that the family has a strong bonding and is at a good emotional state.
When speaking of cultural and religious traditions, the family members do not perceive themselves as being largely influenced by them. The family belongs to the tradition of Catholicism. Olivia and Anna perceive religion as a conventional thing and do not deeply engage in it. On the contrary, Alroy sometimes goes to church and regards himself as a faithful person. From his perspective, religion helped him to cope with various life crises, and especially his wife’s death.
Overall, the family doesn’t have the plan for dealing with the emergency and crisis situations, but they find the main source of support in each other. The family doesn’t have financial or relational difficulties; they have good social interrelations (friends and colleagues) that also help them to overcome various life challenges.
Diagnosis and Intervention
Alroy
The eldest family member is diagnosed with the walking impairment that requires him to use supportive equipment or the help of others. The impairment is characterized by the inability to walk downhill and uphill, misbalance, poor muscle strength, etc. (Marques-Vieira, Mota de Sousa, Carias, & Caldeira, 2015). The walking impairment has both psychological and physical implications for a patient. First of all, the physical dysfunction is often followed by pain. Moreover, the limited movement ability and independence provoke the psychological and emotional distress; it also may lead to the social isolation and depression (Marques-Vieira, Mota de Sousa, Carias, & Caldeira, 2015).
The patient’s assessment revealed the moderate level of mobility and pain. The suggested intervention for Alroy thus includes the application of the assistive devices such as belts that would help him to move more efficiently (Marques-Vieira, Mota de Sousa, Carias, & Caldeira, 2015). It is also suggested to attend the exercise treatment assisted by the physical therapist. The regular daily walks are suggested. In case the aggravation of physical condition appears, it is possible to take the anaesthetic that would relieve the pain.
The good family relations put Alroy in the advantageous position regarding the provision of the psychological support. The communication with relatives and the involvement into the family activities provide the emotional and psychological aid for Alroy and help him to avoid the negative psychological states.
Olivia
The assessment made it clear that the patient needs the intervention for the problems related to the sedentary life and the excess level of stress. The sedentary lifestyle is regarded as a cause of multiple diseases such as obesity, cardiovascular conditions, problems with muscles and joints, diabetes, and others (Broderick, Hussey, & O’donnell, 2014). It increases the aging process and provokes stress and insomnia. Since there were the cases of cardiovascular problems in the family, the intervention is of significant importance for Olivia as it will help to prevent the undesirable health outcomes.
First of all, the patient needs to be involved in the physical activities and fitness on a regular basis. It is observed, that fitness also helps to reduce the stress level significantly (Broderick, Hussey, & O’donnell, 2014). By including more healthy food into the diet, Olivia may also improve her immunity status. Through the maintenance of fine physical shape, the patient will be able to increase the muscle strength and psychological endurance (Broderick, Hussey, & O’donnell, 2014). Olivia will avoid multiple illnesses, and it thus will help to reduce the financial expenses.
Anna
Overweight catalyzes multiple health conditions and provokes the excess body load. The unhealthy diet, bad eating habits, and lack of physical activity are the major factors of the obesity development (Vieira et al., 2015). The genetic factors also play a significant role in the weight gain, because a set of particular genes is responsible for the metabolism, energy consumption process, etc. (Vieira et al., 2015). Nevertheless, in the family, the cases of obesity were not observed previously. Thus, the intervention for Anna should be focused on the physical activity increase and the elaboration of a healthy diet.
It is suggested to visit the professional nutritionist who will provide the necessary information related to the dietary issues (Vieira et al., 2015). The causes for the weight gain should be established and eliminated. The physical activity should be regular. But Anna needs to approach it carefully due to hear headaches and dizziness. The consultation with a professional trainer is recommended.
The overweight children and adolescents are often exposed to the psychological pressure that interferes with the establishment of social interactions with peers and adults. Thus, the caregivers need to pay attention to the teenager’s emotional conditions and provide the psychological support if needed.
Conclusion
The family health assessment is an integral part of the professional nursing practice. Along with the estimation of the physical conditions in individuals, the family assessment skills include the efficient evaluation of the patients’ demographic, cultural, and spiritual backgrounds (Lee, Leung, & Mak, 2012). Since these domains largely affect the individuals’ psychological and physical states, they may be successfully used in the treatment process and provide the nurse with the understanding of patients’ strengths and weaknesses that should be paid more attention. The consideration of multiple aspects allows a nurse to develop the innovative and effective intervention plans that would help their patients to improve health.
References
Broderick, J., Hussey, J., & O’donnell, D. (2014). Comment on ‘interventions to improve exercise behaviour in sedentary people living with and beyond cancer: A systematic review’. The British Journal of Cancer, 111(12), 2377-2378.
Lee, A. C., Leung, S. S., & Mak, Y. (2012). The application of family-nursing assessment skills: From classroom to hospital ward among final-year nursing undergraduates in Hong Kong. Nurse Education Today, 32(1), 78-84.
Marques-Vieira, C., Mota de Sousa, L., Carias, J., & Caldeira, S. (2015). Nursing diagnosis “impaired walking” in elderly patients: Integrative literature review. Revista Gaúcha de Enfermagem, 36(1), 104-111.
Vieira, C., Enders, B., Coura, A., Lira, A., Medeiros, C., & Mariz, L. (2015). Nursing diagnosis of overweight and related factors in adolescents. Investigación y Educación En Enfermería, 33(3), 509-518.