Family Health Assessment
Family health assessments are an interactive way to gather information regarding family history and dynamics, level of knowledge and interaction. “Families provide the structure for many health-promotion practices; therefore, family assessment informs health-promotion and disease-prevention appraisal”. (Edelman, Kudzma, & Mandle, 2014, p. 150) This paper will review a completed family health assessment that addresses eleven separate topics. After reviewing and analyzing the information, appropriate wellness diagnoses will be identified. Including the whole family is important since “Family health practices, whether effective or ineffective, encompass activities performed by individuals or families as a whole to promote health and prevent disease” (Edelman, Kudzma, & Mandle, 2014, p. 150).
The family that completed this assessment is comprised of four members, two parents and two children. The adult female is the biological mother of the two boys. She is 47 and works in a managerial role. The adult male is also the biological father of the two boys and this is his second marriage, the first resulting in no children. He is 43 and works as a maintenance worker for the state. The children are two boys, ages 15 and 13. The adults have been married for 18 years.
The first topic discussed was values and health perception. This family has what they describe as good health insurance and have regular checkups. The adult male did have recent surgery to correct his acid reflux. Overall as a family, they feel their health is above average. The adult female takes medication for high cholesterol while the adult male takes medication for hypertension, high cholesterol and reflux. The 15 year old(USDA Food and Nutrition Service, n.d., p. 1) son is currently taking oral medication for his acne while the 13 year old does not take any daily medications. Both the adult male and female stated their biggest health concern is the need to lose weight. The adult male even stated that his doctor had told him if he did lose weight, his acid reflux could improve and he might be able to eventually stop taking his blood pressure medication.
Nutrition and activity/exercise were the next topics reviewed. As a family, they all agreed they could eat healthier. On average, they eat out or carry in meals 3-4 times a week. They are aware of websites with healthy eating guides, how many calories should be consumed in a day and what appropriate serving sizes are. The difficulty for them tends to be planning meals ahead and not having enough time to focus on fixing healthy meals. They have started trying to incorporate exercise in their lives. The adults walk 1-2 miles at a time around 3 times a week. The boys both participate in sports activities, so are fairly physically active. The 15 year old works out daily with home weights as well.
Sleep/rest and elimination were also discussed. All members of the family stated there were times they did not get enough sleep and usually woke up feeling tired. For the boys, homework, playing video games and using electronics were reasons given for staying up late. Early school start times were also attributed to the lack of sleep. The adult female said household responsibilities and her husband’s snoring were among reasons she had difficulty getting enough rest. The adult male believed worrying about work and responsibilities can keep him from being able to go to sleep sometimes. No one in the household had any issues or changes with their elimination habits. In the past, the 13 year old had difficulties with bowel movements but after a couple of years taking fiber supplements and stool softeners, the issues resolved.
The next topics addressed were cognitive and sensory perception. The adult female has a BS degree in management while the adult male is a high school graduate. The younger son does have adhd and has taken medication in the past but isn’t currently taking it. The youngest is also a kinesthetic learner, so he can struggle in a regular classroom setting. All four family members wear glasses and they are necessary in a learning environment. While none of the family members have any memory deficits, there is a strong family history of Alzheimer’s on the females said that does concern her. All of the senses seem to be intact, though the adult male states he has a decreased sense of smell related to his past smoking history.
Self-perception and role relationships were discussed with the individuals separately and then together. The family dynamics are very traditional. While both parents work outside the home, all four members of the family agreed separately that the adult male was the disciplinarian. The adult female was frustrated at times with the lack of support from all members with household chores, describing the men in the household as “lazy”. The oldest child stated that the parents were easier on and had less expectations for the youngest. All members seemed to have respect and love for the others and the boys were respectful of their parents.
Sexuality was the most uncomfortable topic for the boys to discuss. They left the room when their parents answered questions. The adults both felt their sex life was satisfying but not as frequent as they would like due to other household obligations and the need for sleep. The boys were both aware of ways to prevent pregnancy and STD’s and were able to discuss abstinence and condoms. The 15 year old was also aware that due to the medication he is currently taking for acne, if he did have sex two forms of birth control would be needed.
Each member had different ways to coping with stress. Previous to quitting, smoking was the adult male’s way of coping with stress. He said that now he tries to keep busy by working in the yard or in his garage. The adult female likes to discuss with her mother or friends things that are bothering her. The oldest boy likes to lift weights and exercise when feeling stressed or upset, while the youngest boy plays video games or on the computer. Recently a close family member was hospitalized with a serious illness and all members said they were able to count on the others to lend emotional support and also assist each other in day to day activities.
After completing the assessment the first wellness diagnosis would be health seeking behaviors. They are aware of the importance of exercise and are incorporating it into their weekly activities while encouraging the boys to continue their healthy activities. Encouragement needs to be provided with a focus on the positive benefits of these changes. Another wellness diagnosis would be readiness for enhanced family coping. While they all have their own ways of coping with stress, in times of need, they can depend on each other and come together as a family. Since both adult members stated they needed to lose at least 30 pounds to be at a healthy weight and that they eat too much, an actual diagnose would be “imbalanced nutrition-more than body requirement” (Weber, 2005, p. 1). With this diagnosis the first step would be assessing if any education deficits were present and determining their desire to make dietary changes. If they were ready, the next step should be setting realistic, attainable goals for controlling dietary intake by focusing on a diet with limited empty calories that is full of fresh fruit, vegetables, and lean proteins with portion awareness.
With the family health assessments a nurse is able to analyze information and form family and individually appropriate nursing diagnoses. This paper reviews one family’s assessment and a few diagnoses that are appropriate for this family. By completing this assessment a nurse is able to “collaborate with the family to assess, improve, enhance, and evaluate family health practices” (Edelman et al., 2014, p. 151).