Category: Family

The need to have quality health care for all Americans irrespective of their financial capabilities has forced the government to develop programs that would help achieve this. According to Nemeth (2012), most of the American hospitals have been faced with scenarios where some of their patients fail to pay their medical bills because of their limited financial resources. This has affected their operations, especially those that are funded by the government. The American Hospital Association has therefore come up with a framework that would help improve the health care of American families. This association made a number of recommendations that are focused on improving health care within this country.

This research paper analyzes the framework given by this association and how advanced practice nurses may contribute in achieving the goals. According to Healy (2011), in the framework given by the American Hospital Association, the first article states that no child should be without health care. This means that the association appreciates the fact that health care is one of the basic needs, especially to children below the age of five years. At this stage, children are always vulnerable, and if they are not given proper medical attention, then they can easily succumb even to very simple illness. The second item in this framework emphasizes the need to ensure that all Americans do not suffer from major illnesses or injuries simply because of lack of financial capacity to pay for the medical expenses. As mentioned above, health care is a basic need that every human being needs. It is necessary to ensure that no one is denied health care because he or she cannot afford. This association also appreciates the need to make emergency medical attention to all Americans.

This is very important because it is on record that some patients have perished simply because they could not pay for the emergency medical attention in time. The aging population is another group that deserves to be given quality health care according to this framework. As Shi (2012) notes, the aged are prone to various illnesses, and unless they are given quality health care, they can easily succumb to these illnesses. Like children, some of these aging people lack the capacity to pay for their medications unless they are supported by other able family members. This puts them at risk because unless they get this support, they may not get the needed medication. This framework defines a new approach that can be used to ensure that this group does not entirely depend on their family members.

This framework defines a new approach of health care provision in this country that engages health care users. By involving these stakeholders, it is possible to come up with a more refined approach in the provision of health care in the country. Jansson (2013) says that Advanced Practice Nurses have an active role to play in achieving the goals set in this framework. Their professional service in offering quality health care to anyone who visits their facilities is of paramount importance. They need to work without focusing on ones financial capacity or any other demographic factors. They can also help in mobilizing stakeholders, especially the health care users to get engaged in defining policies in this sector. This way, it will be possible to come up with policies that would meet their interests adequately.

References

Healy, J. (2011). Improving health care safety and quality: Reluctant regulators. Surrey: Ashgate.

Jansson, B. S. (2013). Improving healthcare through advocacy: A guide for the health and helping professions. Hoboken: Wiley.

Nemeth, C. P. (2012). Improving healthcare team communication: Building on lessons from aviation and aerospace. Aldershotd: Ashgate.

Shi, J. (2012). Delivering health care in America: A systems approach. Sudbury: Jones & Bartlett Learning.

A family health assessment is an important step in the development of medical worker-patient relationships, which promotes the possibility to obtain enough information about health promotion and disease prevention. Communication is a good method to discover more about family values, personal feelings, and overall reflection (Persson & Benzein, 2014). In this essay, a family consisting of five members will be selected and interviewed about their styles of life, health, dietary habits, regular activities, and attitudes towards entertainment, climate, and the environment (see Appendix).

The analysis of the answers of participants and the application of the family systems theory should help to understand better the peculiarities of the patient and family care. The family health assessment is a unique chance for a nurse to learn patients needs, health conditions, and expectations from care under a particular situation within the chosen context.

Family Structure

In this project, an extended family of five people who live together will be evaluated in terms of their health and disease prevention. There are a father (40), a mother (38), a grandfather (fathers father) (75), a daughter(10), and a son (7). All the family members are White American Christians who live in a stand-alone house in Southeast Gables, Miami, Florida. The family is representative of a middle-income class with stable wages and several opportunities.

After the death of the grandmother because of diabetes and because of old age, the grandfather moved to his son. The family accepted the man positively with the only concern that was based on his smoking habit. The parents did not want their children to experience smoking outcomes and related diseases, and the grandfather tries to keep the promise and smokes outside when children are at school.

Traditions and respect for adults are highly appreciated in this family. The father is an office clerk, and the mother works in the local hospital as a nurse. Despite their occupations and routine obligations, the family has a tradition to have common dinners every evening and spend one of the days off (usually Sunday) together, playing games or barbecuing. All the members support each other, discuss various themes, and never lie.

Health Behaviors

Regarding the profession of the mother, this family is generally aware of the basics of a healthy style of life. They develop strong hygiene habits, take certain disease preventive steps, and avoid extensive use of tobacco and alcohol (except the grandfather). However, both the father and the mother are overweight due to the lack of physical exercise and the preference for a sedentary way of living. Children have normal BMI, but they are exposed to obesity-related problems because of fast food they like at school. The health behavior of the grandfather is provocative and dangerous, but he likes to use his experience, knowledge, and personal issues to prove the chosen position. His word still has some power in this family, and all the members try to find a compromise.

Health Strengths and Problems

As a nurse, the mother evaluates the wellbeing of her children regularly. One of the functional strengths is education and enhanced awareness about various diseases and their signs, which provides an opportunity to discover problems at the early stages and take the necessary diagnostic steps. Another strong aspect is based on the negative experience of the family with their grandmother and her diabetes.

This disease requires regular care and monitoring. Despite the attempts of the family to monitor glucose levels and take the necessary medications, the woman died at the age of 65. Still, this family learned how to support each other in sickness (Baig, Benitez, Quinn, & Burnet, 2015). The major barriers cover such areas as smoking dependence, family history of diabetes, and obesity. These risks increase the chances of the family having some chronic diseases and decrease the quality of life in the future.

Family Systems Theory

To promote some positive changes in family members and improve overall family functioning, a theory is recommended. Kaplan, Arnold, Irby, Boles, and Skelton (2014) discussed the benefits of the Family Systems Theory (FST) in treating people with obesity or overweight. According to this theory, there are eight concepts in terms of which each member should comprehend his or her role in family relationships. A family is defined as an emotional unit with specific interconnected and interdependent systems that reject isolation (Kaplan et al., 2014). An understanding of triangles and multigenerational transmission processes defines the quality of the relationships and explains the worth of behavioral changes in each member.

Conclusion

In general, families vary in their structures and attributes, and nursing interventions depend considerably on how a person accepts social and moral norms, understands duties, and deals with barriers. In this case, the family with a history of diabetes, obesity predisposition, and smoking habits of one member is recommended to apply the Family Systems Theory to underline the connection with this group of people and determine the roles each member should complete. The establishment of health behaviors is an integral part of human life, and the chosen family has good changes to achieve positive changes in case emotions, personal needs, and sibling positions are taken into consideration.

References

Baig, A. A., Benitez, A., Quinn, M. T., & Burnet, D. L. (2015). Family interventions to improve diabetes outcomes for adults. Annals of the New York Academy of Sciences, 1353(1), 89-112.

Kaplan, S. G., Arnold, E. M., Irby, M. B., Boles, K. A., & Skelton, J. A. (2014). Family systems theory and obesity treatment: Applications for clinicians. ICAN: Infant, Child, & Adolescent Nutrition, 6(1), 24-29.

Persson, C., & Benzein, E. (2014). Family health conversations: How do they support health? Nursing Research and Practice, 2014, 547160. Web.

Appendix

Interview Questionnaire

1. What is the meaning of a solid way of life for you? What propensities do you think about undesirable? Would you be able to call your familys way of life solid?
2. What items are dependably on your family table? What dishes do your relatives not acknowledge? Is it accurate to say that you are happy with your eating regimen?
3. Do all your relatives rest enough amid the week? Provided that this is true, what routine have they created to accomplish this? If not, how regularly do you encounter feeling unwell from absence of rest?
4. Do any of you have any unfortunate propensities? Are there any preclusions on them in your family? What different bans and disposals exist in your family?
5. What is your opinion about games? Does your family have any most loved diversions? Do you do a day by day least of activity to look after vitality?
6. What do you think about appropriate human services? Are there any controls that your relatives can manage without the assistance of a restorative expert? How regularly do you visit your specialist?
7. Are your relatives touchy to climate changes? What is your opinion about exceptionally harsh, sweet or fiery nourishment? Did you ever get circulatory strain issue or swoons?
8. How would you by and by evaluate your wellbeing right now? Okay prefer to change your way of life towards a more advantageous one? What precisely might you want to change?
9. Is there an outright pioneer in your family? What are the jobs of whatever remains of the relatives? Does every part concur with the current family way of life game plans?
10. Concerning grown-ups: would you say you are happy with your sexual coexistence? Have you experienced any medical issues around there? How does your family take care of this sort of issues, if vital?
11. How frequently do your relatives encounter worry at work/school? What encourages you unwind? Do you have any family exercises to help ease strain following a monotonous day?

Introduction

Family-centered care is a medical practice aimed at helping all the members of the same family, which is often the case when several problems manifest themselves. The spectrum of intervention may involve different procedures and imply engaging both adults and children in collaborative activities. In the family in question where all members without exception have certain health problems, this type of assistance is obligatory because the current situation is alarming and dangerous.

Identifying the social determinants of health (SDOH) may help find out the key factors that affect the well-being of adults and both children one of whom is in the womb. This work is aimed at developing a special action plan that could help promote healthy habits in the family under consideration and allow developing an appropriate intervention strategy for qualified professionals.

Social Determinants of Health

The background of the analyzed family is rather difficult, and the determination of corresponding SDOHs is a significant task since the specific causes of the problems may be detected. According to Adler, Glymour, and Fielding (2016), these criteria include such indicators as economic stability, social environment, health habits, community context, and education. In relation to the family in question, its social environment, health habits, and economic stability are the most significant factors.

Firstly, the almost complete lack of contact with other people affects the participants of the assessment negatively because natural communication is not maintained, and psychological issues occur. Secondly, those health habits that were formed in adulthood do not allow parents to interact normally, which may be due to hereditary predisposition and an example from their personal families. Finally, the level of income is another component of SDOHs since the lack of money hampers the normal development of all members. As a result, rather extensive work should be carried out with the participants.

Age-Appropriate Screenings

Since each member of the family in question has certain health problems, screening procedures are needed to determine the nature of optimal interventions. For instance, Peter has a pronounced tendency to deviant behavior under the influence of alcohol, and in order to prevent the development of associated diseases, for example, the cirrhosis of the liver, it is essential to test the functions of his body. In addition, working with a psychologist is necessary in order to find out the main motives for such a lifestyle.

For Anne, Peters wife, more complex screening procedures are needed. Since the woman experiences the symptoms of post-traumatic stress disorder, psychiatric consultation is mandatory. The situation is complicated by the fact that Anne is pregnant with her second child, and as Muzik et al. (2016) argue, maternal stress hormones during pregnancy modulate fetal stress hormone reactivity (p. 585). In addition, a hereditary tendency to corpulence and high blood pressure carries an additional threat to the womans health. Since she has type 2 diabetes, her blood sugar level should be checked constantly, and consultation with a nutritionist is desirable.

Finally, for Alan, Peter, and Ann three-year-old child, work with specialists from a correctional center is necessary. Since the boy has signs of developmental delay, the degree of his social adaptation is to be checked through conversations and involvement in gaming activities. The help of a child psychologist can also be useful because the child rarely communicates with parents, which affects his cognitive development negatively.

Health Model

As a method of helping the family members, a social cognitive model will be chosen. According to Smith, Felix, Benight, and Jones (2017), this framework helps people cope with the effects of stress and violence. The choice of such a model is due to the fact that the adult family members suffer from depressive disorders, and their child has difficulties in socialization. Work aimed at eliminating the effects of mental deviations is an effective mechanism that may allow parents to establish contact with their son and contribute to the birth of a healthy second child. As Smith et al. (2017), this model implies self-regulation as one of the significant components of interpersonal interaction. Therefore, such a framework is a valuable tool to help the family in question.

Steps for Family-Centered Health Promotion

In order to provide real assistance, the following steps for family-centered health promotion are offered as a plan of action:

1. To organize contact with psychologists, including both family sessions and individual therapies.
2. To involve the husband in the treatment program for alcohol addiction and to stimulate his desire to apply for a job.
3. To provide care for the wife and engage specialists of different profiles, including a psychologist, an endocrinologist, and a nutritionist.
4. To create an appropriate educational environment for the child so that he could receive the necessary information for development and could contact peers.
5. To monitor the family after the birth of the second child and control his or her development.

Conclusion

The considered action plan aimed at promoting healthy habits and social adaptation of the family has clearly expressed emphasis on individual work since each of the participants in the assistance program has personal problems. Relevant screenings are needed to identify the spectrum of work to be done. As a health model, a social cognitive framework will be applied. The action plan includes individual interventions and helps to restore the normal lifestyle of the family members.

References

Adler, N. E., Glymour, M. M., & Fielding, J. (2016). Addressing social determinants of health and health inequalities. Jama, 316(16), 1641-1642. Web.

Muzik, M., McGinnis, E. W., Bocknek, E., Morelen, D., Rosenblum, K. L., Liberzon, I.,& Abelson, J. L. (2016). PTSD symptoms across pregnancy and early postpartum among women with lifetime PTSD diagnosis. Depression and Anxiety, 33(7), 584-591. Web.

Smith, A. J., Felix, E. D., Benight, C. C., & Jones, R. T. (2017). Protective factors, coping appraisals, and social barriers predict mental health following community violence: A prospective test of social cognitive theory. Journal of Traumatic Stress, 30(3), 245-253. Web.

Achieving course competencies is necessary for further progress in the nursing profession. The role and scope of practice of modern nursing have proved to be significant in this course. Advanced practices can be seen as the exercises of an occupation or profession that are ahead of contemporary thought at the highest level of problems. This paper reports on possible practices that family nurse practitioners can perform to achieve the family nursing course competencies.

The role of a nurse practitioner is to carry out comprehensive assessments and promote health and the prevention of illness and injury. As a family nurse practitioner, it has been my mandate to educate family members and public in general on the significance of quality healthcare and the various ways of avoiding injuries and illnesses. I have had the ability to assess my childrens health status and defined the appropriate nursing actions. I assessed the childrens health and found that one of them required special attention, in this respect, I recommended the appropriate medicine. As a family nurse practitioner, I educate families on the significance of primary care. Carrying research on possible illnesses on a family member has been my greatest achievement after which I will recommend the best cure or nurse practice (Mirr & Zwygart-Stauffacher, 2010, pp. 16-19).

There are various health care systems available in different forms. There are those that the government finances. This system Obama care dictates that every person has a right to decent healthcare financed by the government. This mean that nurse practitioners will have more to do in the field of research and education of the people. The implication is that people who are not seriously ill might misuse the opportunity. Some would take unnecessary tests that might deny their rightful need. This would not meet the physical or social needs of patients. The other health care system is the private system. Patients must pay for the services rendered to them. This could be costly, but here, services can be individualized thus meeting the patients needs (Mirr & Zwygart-Stauffacher, 2010, p. 31).

Some changes though need to be made within the healthcare organization so as to improve the delivery of healthcare and its outcomes to consumers. Some of these changes include individualized and well-coordinated services. The goal of these changes is to promote maximum possible functional independence. Moreover, health services are essential throughout life and not just once in a while. Therefore, patients physical, mental, social and spiritual needs must be met. This means that a patients quality of life must be maximized (Schimpff, 2012, pp15-18).

Some issues have emerged in the areas of scholarships. It is essential that practitioner nurses participate in documenting nurse practitioner outcomes in the area of healthcare reforms. In this way, they will collaborate well and lead to amicable reforms that are necessary in the environment. This also will increase the knowledgebase, which will further their development in the area of work. As a nurse practitioner, I have learnt to collaborate well with my respective colleagues and patients in planning care and making decisions about the most acceptable treatments. I communicate regularly with my patients or family members to make sure that they adhere to the dosage administered to them (Wizemann, et. al, 2011, p57)

Health reforms, Patient Protection, and Affordable Care Act are the current issues that have powered some ethical debates over specific contentious matters. However, the American College of Emergency Physicians has produced a guiding document and a Code of Ethics and healthcare reforms that are likely to manipulate cost control in the public health, early death crowding, and end of life matters.

In conclusion, I have learnt to use the principle of communications and collaboration that have helped me improve my skills as a family nurse practitioner. I have embraced education to patients and their family to certain illnesses and the primary care that needs to be taken.

References

Mirr, J. M. P., & Zwygart-Stauffacher, M. (2010). Advanced practice nursing: Core concepts for professional role development. New York, NY: Springer.

Schimpff, S. C. (2012). The future of health-care delivery: Why it must change and how it affects People. Washington, D.C: Potomac Books.

Wizemann, T. M., Institute of Medicine (U.S.), & Institute of Medicine (U.S.). (2011). Health literacy implications for health care reform: Workshop summary. Washington, D.C: National Academies Press.

The role of a Family Nurse Practitioner (FNP) is of particular importance in primary health care. According to Nurse Journal Staff (2021), a significant rise in nurse practitioner jobs can be observed over the recent years. This trend means that FNPs are becoming an increasingly essential part of the health care team and are expected to fulfill a wide range of functions. Furthermore, advanced-practice registered nurses contribute to the development of the nursing practice by merging medicine and nursing due to their expanded skills and knowledge, as well as broad experience. In the context of the ongoing COVID-19 pandemic crisis, the shortage of healthcare staff highlights the importance of transitioning the FNPs role (Nurse Journal Staff, 2021). Hence, the current trends in health care and the growing demand for professionals in this field indicate that there is a need for change in the primary care system due to the expanding role of Family Nurse Practitioners.

One of the current trends related to the role of a Family Nurse Practitioner is a shortage of primary care professionals in the United States. As reported by Torrens et al. (2020), primary care is facing a crisis in healthcare provision & that must be addressed with creative solutions, including new models of care (p. 1). In this regard, advanced-practice registered nurses already have additional responsibilities and provide medical care for adults and children facilitated by policies that support the autonomy and authority of FNPs (Nurse Journal Staff, 2021). Nurses become valued more as key members of the health care team delivering patient-centered care. At the same time, there is a need for a comprehensive approach to implementing supportive practices nationwide in order to meet the growing demand.

The health care system is facing new challenges, and the demand for primary care staff is predicted to increase. Nurses are expected to be flexible and competent in various areas to promote patient safety and well-being in rapidly changing conditions. In addition to demonstrating expertise in clinical practice, FNPs must enhance management and leadership skills and contribute to research to enable improvements in the primary care system. According to the study findings by Torrens et al. (2020), there is a number of facilitators and barriers to advance the Advanced Nurse Practitioner role in the primary care settings for better patient outcomes. As per Torrens et al. (2020), an FNP can enable positive change by working autonomously, using professional judgement, working collaboratively across professions and agencies in addition to monitoring risk and evaluating outcomes (p. 2). Team consensus is another essential part of the implementation of the advanced practice registered nurse. It is worth noting that organizational processes, such as developing protocols and policy guidelines, can have both positive and negative implications for the enhancement of the FNP practice.

To summarize, the current trends with regard to the Family Nurse Practitioner role suggest that there is a need for further transformation of the FNP key functions and contribution to primary care. Growing demand for health care services, personnel shortage, and the aging population are the major factors that can shape the role of advanced practice registered nurses and bring them to the forefront of medical care. As a result, it is essential for Family Nurse Practitioners to develop leadership skills and promote the change and the transformation of their role for better health care quality and patient outcomes.

References

Nurse Journal Staff. (2021). 7 future job trends for nurse practitioners. Nurse Journal.

Torrens, C., Campbell, P., Hoskins, G., Strachan, H., Wells, M., Cunningham, M., Bottone, H., Polson, R., & Maxwell, M. (2020). Barriers and facilitators to the implementation of the advanced nurse practitioner role in primary care settings: A scoping review. International Journal of Nursing Studies, 104, 1-21.

Importance of Family Nursing

The importance of family nursing practices was not recognized until late twentieth century when the need for family nursing became a burning issue for the system of health care. In this respect, the family became an integral part of the health care system because the family in whole was considered a client of the nursing practices as well as each separate member of the family under discussion. As such, it became apparent that the system of nursing needs reforms and reorganization that would meet the needs of families in health care.

For instance, as suggested by Friedman, Bowden, and Jones (2003), the first family nursing is conceptualized as a field where the family is viewed as context to the client or family member (p. 32). In other words, recognizing a family as an influential context to the clients health and diseases, a nurse can take appropriate measures on the way to effective treatment. Moreover, health care professionals should approach the needs of family members with regard to the needs of the family.

Family as a System

Nursing and family

Family works as a system in promoting the health of its members because every member is vulnerable to some infections while this condition can be influential t other members of the family. Besides, different demographic and socioeconomic factors can impact the health of the family with regard to the health of each member separately. The interdependence of family members on each other and their mutual dependence on different factors makes the family a separate client with its specific needs and expectations. In this respect, family can be viewed and treated as a sum of its members, as a client, or as a component of a society (Friedman, Bowden, and Jones, 2003, pp. 33-34).

The family nursing is based on recognition of the familys needs when the peculiar features of each family member are clear and nursing staff can address the needs of each member effectively. As health care providers may be unaware of the peculiarities related to the health condition of other family members and different factors influencing each member, it is necessary to develop family nursing practices applying various family nursing theories aimed at explaining the relation between health conditions of different family members.

Family and family members

Family members are basic components in the assessment, analysis, and treatment of family and each member as a part of the family. As such, it is necessary to remember about the factors that can influence family members in such nursing practice environment as an Acute Care Hospital (Veterans Affairs) that provides veterans with adequate treatment with regard to their specific needs, especially if this concerns entire families.

As Friedman, Bowden, and Jones (2003) claim, in episodic settings  especially in intensive care units and emergency departments, where immediate lifesaving measures are needed  a predominant patient focus is undesirable (p. 36). This means that Acute Care Hospital is, in some way, is removed from the family nursing practices and issues, especially compared to other specialty areas which means that family nursing can be ineffective to the extent it is effective in other specialty areas or fail to accomplish the mission f family practice at all.

Concept of Family

The concept used in the Acute Care Hospital (Veterans Affairs)

Though there are many concepts of family that can be applied to family nursing practices, the Acute Care Hospital as a part of the Veterans Affairs system cannot include all family concepts. However, most concepts can be considered applicable to the Acute Care Hospital for Veterans Affairs system aimed at rehabilitation and treatment of veterans who defend the honor of their country. In this respect, children and husbands/wives can find themselves near the patients to support them.

However, it happens that acute care hospital is deprived of opportunity to provide family nursing help aimed at treating the patient with regard to the situation with other family members. Nevertheless, it happens that family members influence greatly the health condition of a veteran. As reported by Orem et al. (2003), patients should be treated in accordance with their needs for daily self-care, necessity of meeting with family members and friends with regard to certain economic or spiritual difficulties (p. 9).

The most helpful concept in family nursing practice

Congregate housing and home sharing are opportunities for elderly people in hospitals mentioned by Meiner (2005, p. 184). However, the acute care hospitals have difficulties with analyzing the family situations when veterans need acute help. For instance, it is problematic to assess the economic and spiritual conditions in the family if the patient was brought to the hospital by an ambulance and no other family members were with him at that moment. In this respect, the main problem is that acute care hospital for veterans provides a limited number of health care services and has no access to the information about the patient.

The period of treatment can bring some changes into this situation when family members and friends visit the patient. So, the nursing staff can analyze and evaluate the family relations of the patient and certain factors that can be influential for his/her health. For example, if the economic conditions of the family are worse than expected and the home environment is inappropriate for the extensive course of rehabilitation, the nursing staff should consider this component of the family nursing practice.

Theories in Nursing Practice

Analysis of theories

There are different theories in the field of family nursing. For instance, Neumans model recognizes the definitions of the following four concepts that are commonly used in nursing practice: client, environment, health, and nursing (Sitzman and Eichelberger, 2010, p. 79). This model enables the nursing staff of the hospital to address the needs and illnesses of the patient with regard to other factors mentioned in this model. Nightingales environmental model suggests that Examining environmental aspects, such as light, noise, or warmth can provide new insights into human responses to health and illness (Basavanthappa, 2007, p. 48).

At the same time, it is necessary to think about self-care and ability of the patient to take care of himself/herself at hospital and after being discharged from hospital. Thus, it is also possible to introduce the Orems self-care model into nursing practice (Butts and Rich, 2010, p. 614). As soon as the nursing staff can find the most reasonable balance and apply the most appropriate practices to patient care, the health care system may benefit from introduction of family nursing into all specialties of nursing.

Conductive theory

The theory applicable to the acute care hospital for Veterans Affairs can adapt such strategies as those presented in the Neumans system model, Orems self-care model, and Nightingales environmental model that presupposes the analysis of environment to create the most appropriate conditions for the patient. However, the model suggested by Orem can be ineffective right at the beginning because the patients are brought to the acute care hospital because they are not able to take medicines and other means of medication prescribed by the physician.

In other words, the situation in the acute care hospital differs from other departments in terms of the character of trauma and illness and the way patients should be treated. Nevertheless, the environmental theory applied by Florence Nightingale can be considered conductive to the acute care hospital setting because it is important to take into account the conditions in which the patient finds himself/herself after being brought into the hospital and in the rehabilitation period.

Conclusion

The concept of family is a broad issue that needs consideration in order to be applied to the family nursing practices. Though the area of family nursing is a rather new specialty, different theories and models have been developed for more effective provision of health care services to patients. When regarding the acute care hospital for Veterans Affairs, the nursing staff has to assess the environment most appropriate for patients and create the best conditions because other models of family nursing activities such as Orems self-care model do not seem to be applicable for the acute care hospital because patients are not able to provide self-care activities to them. In other words, the importance of family nursing is not always applicable for all specialties in nursing.

Reference List

Basavanthappa, B. T. (2007). Nursing theories. New Delhi: Jaypee Brothers Publishers.

Butts, J. B., and Rich, K. L. (2010). Philosophies and theories for advanced nursing practice. Sudbury, MA: Jones & Bartlett Learning.

Friedman, M. M., Bowden, V. R., and Jones, E. G. (2003). Family nursing: Research, theory, and practice (5^th ed.). Upper Saddle River, NJ: Prentice Hall.

Meiner, S. E. (2005). Gerontologic nursing. St. Louis, Missouri: Elsevier Health Sciences.

Orem, D. E., McLaughlin Renpenning, K., and Taylor, S. G. (2003). Self-care theory in nursing: Selected papers of Dorothea Orem. New York: Springer Publishing Company.

Sitzman, K., and Eichelberger, L. W. (2010). Understanding the work of nurse theorists: A creative beginning (2^nd ed.). Sudbury, MA: Jones & Bartlett Learning.

Values, Health Perception

The interviewed family consists of a husband, wife (both in their 30s) and a boy of 12 years old. All members of the extended family live outside the state. Family members consider themselves to be healthy. They do not drink alcohol and do not smoke. When asked about medical checkups they said that they had not visited a doctor since the end of 2017. However, they plan to do a full checkup this month.

Nutrition

The family has a fairly healthy diet with a mix of vegetables, fruits, and meat. However, the husband eats snacks on a regular basis. This habit has spread to the child and may lead to the diet becoming unhealthy. The fluid intake of the family is average, with an appropriate amount of water and other liquids consumed by each member of the family. Water is the preferred choice of fluid in the family. The husband of the family noticed that in the recent months he has gotten heavier and is concerned with becoming overweight.

Sleep/Rest

Members of the family sleep 8-9 hours on average during weekdays and 9-10 hours during weekends. No abnormalities or issues with sleep were recorded. Nobody has evident problems with snoring, night terrors, or other reasons for waking up at night aside from going to the bathroom. All family members stated that they feel rested after a full nights sleep, aside from nights after difficult days at work. Nobody in the family has a habit of taking naps.

Elimination

The wife and child do not have issues with bowel elimination patterns as they did not report any discomfort. However, the husband noted that he has recently experienced constipation which lasted two days. Nobody had any complaints about urinary elimination patterns as no discomfort or abnormality was noted by the family. The frequency of both elimination patterns is appropriate for all members of the family, with the exclusion of constipation issues.

Activity/Exercise

Each member of the family has their own activity pattern. The husband almost never exercises and limits his physical activity to work-related ones. He states that his work is too stressful to combine it with the additional strain from physical activity. The wife exercises every morning by doing aerobics and goes on walks in the afternoon. She also plays badminton on the weekends in the local park. The child often goes on walks, plays soccer at school and loves to ride a bicycle. All activities are performed with relative consistency and are done within the healthy limits of exercise.

Cognitive

Both the husband and wife learn best when they have audio aids available. However, the child is a predominately visual learner and does not have a significant response to audio aids. Nobody appears to have issues with learning through standard approaches. The family uses trivia and logic-based tabletop games to keep their cognitive processes operating whenever it appears important. Cognitive activity pattern of the family overall appears to be healthy.

Sensory-Perception

The wife cannot see clearly in the distance due to her nearsightedness. To resolve this issue, she wears glasses or contacts depending on the social context of the activity she is involved in. The husband and child do not have issues with sight. No member of the family reported having difficulties in hearing. When asked about numbness or any other discomfort when touching objects, nobody had any instances that they could recall. However, during one of the previous questions, the husband complained about a finger that lost some of its sense of touch after being burned on the stove.

Self-Perception

All members of the family were asked about their self-esteem. Both the husband and wife considered themselves to be confident, likable, and generally good people. However, this was stated without any sense of self-obsession. The child is currently too young to be fully self-aware but is on the verge of gaining a deeper understanding of himself. His self-esteem is slightly lower than average, but no clear issues are present. Nobody in the family reported feelings of hopelessness or depression. The parents aspire to support their child as well as advance in their carrier to buy a house because they currently live in an apartment. The child wants to finish school and become a doctor.

Role Relationship

The husband grew up in a large family with parents, as well as two brothers and two sisters living in the same house. The wife was an only child raised by her father. Her mother passed away when she was four, and extended family members rarely visited them. Currently, the family lives as a unit and does not have frequent visits from the extended family which consists of three uncles and two aunts. The husband belongs to the local bowling club and attends their weekly tournaments on weekends. The wife does not have an official membership in any social group but often socializes with neighbors. The child has a circle of friends but does not socialize outside of it. Nobody feels like they need additional ways of socializing.

Sexuality

The parents are sexually active whenever possible, but due to parenting responsibilities, these opportunities are limited. The wife did not report any issues with her reproductive organs. The husband is more concerned about his sexual health but also does not have any issues to report.

Coping

No one in the family had any difficult situations happen in the last year. The husband feels stressed, but wife and child do not. Nobody uses any medications designed to help with coping.

Wellness Problems

The majority of the health patterns of the family are healthy. However, the husband experiences excessive stress related to work. This seems to prevent him from having a healthy level of physical activity. Without physical activity, his eating habits are starting to affect his weight (Wang et al., 2015; Grimes, Bolhuis, He, & Nowson, 2016). Currently, he is not overweight, but if he continues to maintain his focus on snacks, he may gain excessive weight which will become a health issue. In addition, his level of stress may lead to burnout at work and other issues if it is not handled properly (Boren, 2014).

Questions

1. Are you healthy?
2. Do you drink alcohol or smoke?
3. When was your last checkup?
4. What is your diet?
5. What do you drink?
6. Are you concerned about weight?
7. How much do you sleep?
8. Do you wake up at night?
9. Do you feel refreshed after sleep?
10. Do you feel discomfort during bowel elimination?
11. Do you feel discomfort during urinary elimination?
12. How many times do you go to the bathroom in a day?
13. Do you exercise?
14. Do you play sports?
15. How often do you exercise?
16. What teaching aids help you best?
17. Do you have any issues with the standard learning process?
18. How do you maintain cognitive awareness?
19. Do you see well?
20. Do you hear well?
21. Do you have any issues with numbness?
22. Are you confident?
23. Do you ever feel hopeless or depressed?
24. What are your goals in life?
25. How big was your family?
26. How do you live now?
27. How do you socialize?
28. Are you sexually active?
29. Do you have issues with female health?
30. Do you have issues with male health?
31. Did anything difficult happen last year?
32. Do you feel stressed?
33. Do you take medications for coping?

References

Boren, J. P. (2014). The relationships between co-rumination, social support, stress, and burnout among working adults. Management Communication Quarterly, 28(1), 3-25.

Grimes, C. A., Bolhuis, D. P., He, F. J., & Nowson, C. A. (2016). Dietary sodium intake and overweight and obesity in children and adults: a protocol for a systematic review and meta-analysis. Systematic Reviews, 5, 7.

Wang, J. B., Cadmus-Bertram, L. A., Natarajan, L., White, M. M., Madanat, H., Nichols, J. F., & Pierce, J. P. (2015). Wearable sensor/device (Fitbit One) and SMS text-messaging prompts to increase physical activity in overweight and obese adults: A randomized controlled trial. Telemedicine and E-Health, 21(10), 782-792.

Family assessment is crucial as it helps address the issues affecting family members. According to Mansfield et al. (2019, p. 825), this type of assessment provides the nurse a multidimensional view into the familys life. Similarly, nursing interventions for health promotion ensures the family members develops a clear understanding of their emotional and physical well-being. Nevertheless, this paper attempts to describe the structure of the family in which the respondents were interviewed, to summarize the general health behavior, to provide an in-depth description of two functional health patterns and the application of the family system theory. Therefore, when conducting a family interview, it is imperative to focus on key attributes such as nutrition, exercise, role relationship, cognitive and health perception which affect the familys overall health.

Family Structure

The family interviewed, the Jason family, comprises of four members: father, mother, and a 12 and 5- year old boys. The family has been living in a three-bedroom house for the past 10 years. They are of Asian-Indian origin  they migrated to the U.S 20 years ago. They follow and worship Sikhism, a type of religion whose origin is in the Punjab region. The father owns a sanitary ware shop with the wife working as a registered nurse in one of the healthcare facilities in the region. They are a middle class family who works extra hard to ensure their children receive high quality education. Their children go to school by bus while the wifes workplace is 20-minutes drive away. Overall, Jason family was very generous and welcoming and was more than willing to share their life story.

Family Health and Health Behaviors

The Jason family is more cautious about their health, especially since the mother is a registered nurse. She places huge amount of emphasis on nutrition, elimination, activity, cognitive, sensory perception, self-perception, role relationship, sexuality, and coping. The parents constantly educate their children the importance of making healthy choices to eschew lifestyle diseases. As evidenced in the interview, the family always strives to maintain a balanced diet comprising of fruits, vegetables, protein and carbs. According to the husband, having a diet rich in nutrients helps ensure they remain physically and mentally active. On the issue of sleep, the family usually sleeps for about 10 hours every day. However, the children are allowed to take naps during the day, especially during weekends and holidays. As for elimination, the members tend to visit the bathroom up to six times a day. The family takes seriously any incontinence, especially for their children. The family takes physical activities very seriously-they occasionally participate in exercises such as cardio at least thrice a week.

All the family members, including the children can read and write well. Similarly, there are no issues of forgetfulness in the family. Additionally, the Jason family has no issues with their senses  they perceive illness when a member feels weak or lacks appetite. Also, each family member has a role to play in the house, especially during weekends where everyone participates in the cleaning. The husband and wife view sexuality as a feeling that has helped their family stay together. Currently, the family is healthy and relies on the wife and mother for any advice regarding the health issues.

Findings

The two functional health pattern strengths of the Jason family, based on the questionnaire, are Sleep/Rest and Activity/Exercise. On sleep, the family gets enough sleep as per their physicians recommendation. However, Twenge et al. (2019) notes that children aged 2-5 years should sleep for a maximum of 13 hours. This explains why the five-year boy takes naps during the day-for about 30 minutes. In essence, the family sleep functional health pattern is strong which ensure they remain mentally active and healthier. On the issue of exercise, the father is tasked with the responsibility of ensuring the members go out on walks or gym for about one hour. Although the mother does not like exercising a lot, she made it a routine to walk to work on Thursdays.

The three areas in which barriers were noticeable are cognition, coping and nutrition. Firstly, on cognition, English is their second language which sometimes affects their ability to communicate with their care provider. Secondly, on coping, the family requires more education on the different types of coping skills such as meditation (Janah, & Hargiana, 2021). Lastly, their nutrition consists of more carbohydrates since they rely more on fast-food.

Application of Family Systems Theory

Family system theory can be applied to solicit changes in family members and, return, achieve significant impact to the whole family functions. Bowens family systems theory can be used to help analyze problems affecting this family. For instance, the theory holds that by modifying one subsystem of family, the other parts of the system will be affected (Jakimowicz et al., 2021). By observing the emotions of the family system, one is able to understand the behaviors of individual members. A good example here is when one member, such as the father, decides to take part in physical exercises; his action will have an impact on the whole family.

Conclusion

Family assessment plays a crucial role in helping address issues affecting family members and, in this case, the Jason family. As evidenced above, family is more cautious about their health, especially since the mother is a registered nurse. She places huge amount of emphasis on nutrition, elimination, activity, cognitive, sensory perception, self-perception, role relationship, sexuality, and coping. These attributes are critical when it comes to ensuring the members lead a healthy life-style.

References

Jakimowicz, S., Perry, L., & Lewis, J. (2021). Bowen Family Systems Theory: Mapping a framework to support critical care nurses wellbeing and care quality. Nursing Philosophy, 22(2), 12-20. Web.

Janah, M., & Hargiana, G. (2021). Levels of stress and coping strategies in family caregivers who treat schizophrenic patients with risk of violent behavior. Journal of Public Health Research, 10(1), 24-44. Web.

Mansfield, A. K., Keitner, G. I., & Sheeran, T. (2019). The brief assessment of family functioning scale (BAFFS): A three-item version of the general functioning scale of the family assessment device. Psychotherapy Research, 29(6), 824-831. Web.

Twenge, J. M., Hisler, G. C., & Krizan, Z. (2019). Associations between screen time and sleep duration are primarily driven by portable electronic devices: Evidence from a population-based study of US children ages 017. Sleep Medicine, 56, 211-218. Web.

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