Category: Family

Genogram Report

Introduction

The above pictorial illustrates the genogram of the Barack Obama family. It clearly depicts three generations from grandparents to off springs. This report gives a detailed account of each of Obamas relation.

Third Generation

At the top left of the genogram are President Obamas maternal grandparents, Stanley Armour Dunham and Madelyn Lee Payne. They were both born in Kansas and got married on May 5, 1940. Stanley was born on March 23, 1918 and died on February 8, 1992 in Honolulu, Hawaii (Collins, Jordan and Coleman 180).

His remains are buried in Punchbowl national Cemetry located in Honolulu, Hawaii. Payne, on the other hand, was born in the year 1922 in Wichita, Kansas and she died 86 years later on November 3, 2008 in Honolulu, Hawaii (Powell 24). The family was blessed with a daughter, Stanley Ann Dunham who became President Obamas mother.

Second Generation

On the right side at the top of the genogram are Baracks paternal grandparents, Onyango Obama and Akuma both of whom were of Kenyan origin (Collins et al. 181). Onyango was polygamous and had two other wives, Habba and Sarah who was his third. Onyango is estimated to have been born in 1895 and died in 1979. From his early life, he was a traveler and had been to most parts of the country.

He later settled in Nairobi to work as cook for the missionaries who had made inroads into the country. Onyango was then recruited to fight on behalf of England, Kenyas colonial master during the infamous World War I. He visited countries in Europe as well as India (Collins et al. 179).

Upon returning from the war, he lived in Zanzibar for sometime. Family members believe that it was during his stay there that he converted to Islam from his former Christian faith impacted by the missionaries.

Onyango Obama and his second wife Akuma had children one of whom was Barack Hussein Obama, Sr. However, Akuma left the family while the children was still too young. It was at this time that Sarah took over the responsibility of taking care of the children. She is referred most often by Barack Obama as his grandmother. Sarah was born in 1922 and lives in Kogelo, Kenya.

First Generation

The next generational level includes President Obamas parents. Barrack Hussein Obama, Sr. was born in 1938 in a village called Nyangoma-Kogelo which is found in Kenyas Siaya District (Powell 27). In 1982, he was killed in a car crash in the city of Nairobi.

Obama was survived by several wives, Kuzia, Ann Dunham, Ruh, and Jael. With the other three wives, Obama Sr. had seven children. One of the half siblings died in 1981 and is buried in Nyangoma-Kogelo village, Siaya District (Collins et al. 181). The rest of the children live in Kenya, the United Kingdom or the United States.

Barrack Obama Jr.s parents first met while at the University of Hawaii as students (Collins et al. 181). Ann Dunhams parents had moved there from Kansas City. Ann was born on November 27, 1942 in Wichita, Kansas. On the other hand, Barack Sr. was in Hawaii as student under the international exchange program. Later, Ann became an anthropologist in Hawaii and also worked in Indonesia.

Barrack Sr. became an Economist with the Kenyan Government. The two were joined together in marriage in 1960 in Hawaii and bore Barack Hussein Obama, Jr. The marriage did not last long and ended after two years. Ann was married for the second time to Lolo Soetoro who was of Indonesian origin in 1964 (Powell 31). In 1966, Lolo went back to Indonesia after his student visa was revoked due to political instability in his country.

Ann and Barack left for Jakarta in Indonesia a year later after she had graduated. The marriage produced a half sister for Barrack Jr. She is known as Maya and married to Komal. However, the second marriage collapsed after 14 years. Barrack Jr.s mother died on November 7, 1995 after suffering from ovarian cancer (Collins et al. 181).

The first generation of the genogram depicts the immediate family of President Barack Hussein Obama. He was born on August 4, 1961 in Honolulu, Hawaii at the Kapiolani maternity & Gynecological Hospital. His parents are Barack Hussein Obama, Sr. and Stanley Dunham.

The parents divorced when Barack Jr. was just two years of age after which the Barack Obama Sr. relocated to Massachusetts for further studies. He later went back to Kenya to take up a job in the government (Collins et al. 181). Barrack Jr. stayed briefly in Indonesia before he sent sent back to the US to stay with Madelyn Payne, his maternal grandmother in Hawaii.

He went on with his studies and later graduated from Columbia University and Harvard Law School (Powell 36). It was while in law school that President Obama met Michelle Robinson, his wife.

They have two daughters, Malia (13) and Sasha (10). In 2008, Barrack Hussein Obama ascended to the presidency of the United States to become the first ever African American President. He will be seeking a second term in office during the next presidential elections.

Works Cited

Collins, Donald, Jordan, Catheleen and Coleman, Heather. An introduction to family social work. Cengage Learning, Inc., 2009, 178-181

Powell, Kimberly. Tracing the ancestry of Barack Hussein Obama. John Wiley and Sons, 2010, 24-37

Background

In Australia, there has been rapidly growing cases of obesity, cancer, heart diseases and diabetes among young families (Wallace, 2010).

An effective health promotion initiative that targets young families can significantly lower the rate of obesity and chronic diseases by promoting healthy lifestyles (Bluford, Sherry & Scanlon, 2007). While individual programs can reduce cases of chronic diseases and obesity, they have short-term outcomes. Therefore, it is imperative to develop health promotion initiatives that have long-lasting impacts on promoting health and wellbeing of the public. The initiative should be coordinated, sustainable, responsive and support existing practices (Victoria Department of Health, 2013). The health promotion initiative will adopt evidence-based practices and reliable partnership to promote public health and reduce obesity in Christmas Bay, Sydney.

Aim

The main objective of this health promotion initiative is to promote healthy lifestyle with the aim of reducing high cases obesity, overweight and other chronic diseases among children and young adults through healthy diets and physical activities.

Target Group

The health promotion initiative targets young families living at Christmas Bay, Sydney. The target group consists of children and young adults. A study of young children aged 2 to 4 years in Sydney established that nearly one in six were overweight or obese (Zuo, Norberg, Wen and Rissel, 2006).

Main Method

The health promotion initiative shall rely on various modes of communication to reach the target group.

There would be public education, social marketing and engagement (de Silva-Sanigorski et al, 2010). These methods shall ensure that people receives accurate information on obesity, overweight and chronic diseases. Public education shall strive to change peoples attitudes about healthy diets and physical activities. The campaign shall meet healthy living needs of children and young families.

Media strategies shall involve the use of local magazines, newspapers and radio for mass coverage.

Another critical approach of the health promotion initiative will focus on the use of local level efforts to enhance the campaign. The initiative will work alongside local organisations and offer any support, including financial aid and form strong partnership with the aim of accounting for local programmes, infrastructures, and planning procedures.

The strategy to take local level promotion will ensure a coordinated and consistent process across various locations in Christmas Bay, schools, families and other settings with both low and high number of residents.

Local partnership with councils will ensure that the initiative promotes and provides:

• A critical workforce to facilitate outreach programmes.
• Focused interventions for specific children and young adults in a given locality.
• Funding for facilitating and implementing healthy living alternatives.
• Facilitate policies implementation in schools and workplaces.
• Promotion materials that match local languages.

Potential Barriers

Several potential barriers may hinder effective implementation of the health promotion initiative in Christmas Bay, Sydney. One major challenge would be a lack of interest among the target group (Gatewood et al, 2008). This would require the program to focus on changing the attitude of the target group about healthy living. Some individuals may dismiss healthy foods as tasteless and expensive. These are personal barriers, which hinder behaviour changes to healthy diets.

Lack of interests, experiences, poor perception about physical exercise and time to prepare healthy diets may negatively affect health promotion outcomes.

Environmental factors could also have negative impacts on the health promotion initiative. These may include social factors related to family, workers, schools and friends, which may encourage or discourage health promotion activities. They may affect eating and physical activities of an individual (Doak, Visscher, Renders & Seidell, 2006).

Inaccessible locations and rising costs could also affect the program negatively.

Self-efficacy highlights whether the predicted behaviour will take place. It would indicate how the health promotion initiative might be effective and last among the targeted group. Health-specific self-efficacy is the optimistic belief that one is capable of adopting a healthy lifestyle or making health behaviour change (Gatewood et al, 2008). Hence, self-efficacy relies on ones ability to adjust and make healthy lifestyle choices.

Evaluation

A key feature of the health promotion initiative in Christmas Bay, Sydney would include monitoring and evaluation tools to assess progresses and outcomes of the initiative. The initiative shall support data collection from the target group to provide evidence for its effectiveness and outcomes on the target group.

The health promotion initiative shall develop an evaluation and database centre to support its local partners in managing promotion activities. This strategy would provide data for comparative purposes and evaluating feedback. Feedback shall be used in enhancing programme activities. Therefore, the initiative will ensure inclusion of emerging issues and evidence into the health promotion initiative.

Conclusion

Given the rising cases of obesity, overweight and chronic diseases among young families in Australia, it is imperative to develop an effective health promotion initiative that can have long-term effect on the target population.

The programme shall depend on local partnership and collaborative strategies alongside strong media campaigns and other modes of communication to overcome barriers among the target group. Hence, the deployed resource shall have the desired outcomes.

The evaluation process shall involve data collection from the target population. Results will be used to enhance health promotion activities.

References

Bluford, D. A., Sherry, B., & Scanlon, K. S. (2007). Interventions to prevent or treat obesity in preschool children: a review of evaluated programs. Obesity (Silver Spring), 15(6), 13561372. Web.

de Silva-Sanigorski, A., Bolton, K., Haby, M., Kremer, P., Gibbs L, Waters, E., & Swinburn B. (2010). Scaling up community-based obesity prevention in Australia: Background and evaluation design of the Health Promoting Communities: Being Active Eating Well initiative. BMC Public Health, 10(1), 65. Web.

Doak, C. M., Visscher, T. L., Renders, C. M., & Seidell, J. C. (2006). The prevention of overweight and obesity in children and adolescents: a review of interventions and programmes. Obesity Review, 7(1), 111136. Web.

Gatewood, J. G., Litchfield, R. E., Ryan, S. J., Geadelmann, J. D. M., Pendergast, J. F., & Ullom, K. K. (2008). Perceived barriers to community-based health promotion program participation. American Journal of Health Behavior, 32(3), 260-71. Web.

Victoria Department of Health. (2013). Promoting childrens health. Web.

Wallace, N. (2010). Obesity diaries: Welcome to fat Australia. GlobalPost. Web.

Zuo, Y., Norberg, M., Wen, L. M., and Rissel, C. (2006). Estimates of overweight and obesity among pre-school aged children in Melbourne And Sydney. Journal of Nutrition Dietetics, 63, 179-182. Web.

Introduction

The provision of quality health care services is not a guarantee that patients will recover within a short time. Disease and patient management is a complex process that requires the efforts and support of all stakeholders concerned with ensuring a patient recovers successfully and within a short time. Some health conditions are long-term and this means that there are no prospects of patients recovering from them. However, proper health care services and family support ensures the patient lives a normal and happy life while putting the condition at its weakest level.

Family support in managing terminal illness is important since it supplements the medical services offered by health care providers. The support that family members provide to their sick loved ones helps the patients to understand that the family still loves, appreciates, and values them. Patients suffering from any illness require emotional and psychological support to ensure they understand their conditions and feel they are still part of their families and society. This paper examines a case study of failed family support to a sick patient and the remedies that could have been used to alleviate the situation.

Analysis

The case study is of a 15-year-old boy suffering from reversible yet life-threatening kidney failure. The treatment being offered was expected to alleviate the pain that comes with kidney complications. There was no possibility of performing a kidney transplant and this means that the doctors had to use other interventions to manage the condition. These approaches included a healthy diet, exercising, and medication that were supposed to alleviate the condition. The nurses preferred that the patient be taken back home and these services are provided to him while at his parents place. This was the best alternative since it reduced the costs of hospital bills and ensured the patient was close to his family members.

Parents and other family members were supposed to offer emotional and psychological support to help the patient to recover faster. However, the boy experienced several recurring and new infections and this means that doctors realized his parents and other family members were not taking good care of him. Sick people cannot take good care of themselves because they are weak and the pain they experience might also not allow them to do anything that requires a lot of movement or energy. Therefore, they need the assistance of family members and friends to ensure they eat healthy foods, take baths, and visit the washrooms when they need to do so.

The determination of the medical treatments and processes to be used to manage kidney failure includes the commitment of the family to provide aftercare services. These services include following-up on the clinical appointments, ensuring that the patient has taken the medication as prescribed by the doctor, and eating a healthy diet. The patient is supposed to live in a hygienic place and this means that the boys room should be cleaned thoroughly and regularly. Maintaining healthy hygiene was necessary to ensure that new infections did not develop and the existing ones responded positively to treatment.

The hospital was the best place where the boy would have received treatment and avoided all the unnecessary complications and infections associated with the home environment. In addition, the boy would have recovered faster with proper care and assistance from the doctors and the nurses who would have ensured a strict dietary schedule and the right medication.

The patient in this case study is not in a stable mental state to determine what medical processes are suitable for him. The mental illness affecting the patient could not allow him to make any decision that would improve the disease management program and ensure a positive recovery process is maintained. The Patient Self Determination Act of 1990 passed by the U.S. Congress states that competent people are allowed to make their desires known and what they wished for during end-of-life experiences. Also, extended in this Act was the Durable Power of Attorney which gives a competent person the right to assist in making end-of-life decisions when the individual is no longer competent.

Conclusion

The appropriate surrogate to make the decision should be the one that meets the ethical, moral, and financial obligations required by a patient. In the case of the 15-year-old boy, the mother fits as the surrogate. Other options include asking the court to place the child either in foster care or in a medical facility; however, these options may affect the boy psychologically by taking him away from his home and family environment. The child is unable to cooperate with health care providers since he does not understand how delicate his condition is and the risks he faces. These and other aspects of his mental condition made it difficult for the patient to receive quality medical and family help to live like a normal person.

Available nursing literature demonstrates the need for an individual who is not part of the resuscitation team to be present to provide support to family members during resuscitation efforts (Cottle & James, 2008). This individual is known by many common names, such as family support person, family facilitator, and chaperone, among others. This essay discusses the importance of the family facilitator in resuscitation efforts.

First, it is important to have a family facilitator assigned to family members during resuscitation to provide supportive care to family members witnessing the resuscitation of a close relative (Cottle & James, 2008). Such supportive care may include spiritual nourishment, emotional and social support, as well as confidence-building. It is important to note that supportive care to the family members should be granted by the family facilitator before the members are allowed into the resuscitation room and extended throughout the resuscitation period into post-resuscitation (Fell 2009).

Second, it is important to have a family facilitator assigned to family members to adequately prepare them before entering the resuscitation unit through providing information on the events that they are likely to witness, &and an explanation about invasive interventions and the physical effects that these can have on their relative (Cottle & James, 2008, p. 44). According to these authors, not only is it important that clear ground rules are set to guarantee that the presence of family members does not interfere with the resuscitation efforts but it is also important that family members have prior information about the person being resuscitated. Such information reduces stress and helplessness that may face family members when left in the dark (Agard, 2008).

Third, the family facilitator has a critical role in assisting family members who may be overwhelmed by the events in the resuscitation room to ensure that resuscitation efforts are not interrupted (Fell, 2009). Some family members may begin to cry uncontrollably or even faint upon seeing their loved one, while others experience emotional outbursts. It is therefore important for the family facilitator to remain with the family members throughout the resuscitation process to escort them from the room and offer support to those who may be unable to cope (Cottle & James, 2008).

Fourth, it is important to have a family facilitator assigned to family members during resuscitation not only to explain procedures and medications (Fell, 2009) but also to communicate sensitive decisions that may be made, such as the decision to terminate a resuscitation attempt (Cottle & James, 2008). Although such decisions need to be addressed sensitively, preferably by involving the family members and the resuscitation team, it is well known that some family members may experience difficulties coming to terms with some decisions which may involve terminating the resuscitation efforts. Consequently, it is the family facilitator who communicates the decision to terminate the resuscitation effort as well as guides what is likely to follow (Cottle & James, 2008).

Lastly, according to Agard (2008), it is important to have a family facilitator in a resuscitation effort &to identify family members with appropriate coping mechanisms who may desire to be present during resuscitation (p. 158). This is a critical role in ensuring that the resuscitation process goes on uninterrupted as only those with adequate coping mechanisms may be allowed to witness the exercise. As clearly stated in the literature, the family facilitator should have the capacity to evaluate family members and exclude those who may exhibit unstable coping mechanisms and emotional instability, or those exhibiting combative behavior, altered mental status, and drug or alcohol dependency (Agard, 2008; Fell, 2009).

Reference List

Agard, M. (2008). Creating advocates for family presence during resuscitation. MEDSURG Nursing, 17(3), 155-160.

Cottle, E.M., & James, J.E. (2008). Role of family support person during resuscitation. Nursing Standard, 23(9), 43-47.

Fell, O.P. (2009). Family presence during resuscitation efforts. Nursing Forum, 44(2), 144-150.

Home Visits

The purpose of home visits is to give a more detailed assessment of the family structure, the natural or home environment, and behavior in the home environment (Stanhope & Lancaster, 2017, p. 323). It is possible for the nurse to work closely with the client to modify interventions accordingly. Compared to a hospital or other inpatient care, home visits have positive long-term effects and can be cost-effective for society. An invaluable aspect of a home visit is the fact that it extends beyond simply providing care in a different environment. Rather, it is an effective method of intervention.

There are many advantages to using this service, including convenience for clients, especially those who have mobility issues or are unable or unwilling to travel; control over the setting and comfort of the clients; the ability to customize services; and the ability to discuss concerns and needs in a natural, relaxed environment. In contrast, costs are a significant disadvantage. Preparation for the pre-visit, travel time and expenses to and from the clients home, and post-visit follow-up contribute to the high cost.

Phases of Visit

The visit is a five-phase process. The first phase, initiation, involves the initial interaction of the family and the nurse. The initiation phase provides the foundation for an effective therapeutic relationship (Stanhope & Lancaster, 2017, p. 323). The second stage, previsit, requires the nurse to assess the referral or the family record for any risks associated with the visit. The third stage, in-home, is spent chiefly developing the relationship and carrying out the nursing procedure. Assessment, intervention, and evaluation are all continuing processes. What happens during the home visit is determined by the cause of the visit. The fourth stage, termination, occurs when the goal of the visit has been achieved and planning for future visits is possible. The final step, postvisit, involves careful documentation of the visit, services provided, diagnoses, etc.

Contracting with Families

The literature defines contracting as a strategy aimed at formally involving the family in the nursing process and jointly defining the roles of both the family members and the health professional (Stanhope & Lancaster, 2017, p. 327). The nursing contract is a renegotiable working agreement that is not necessarily recorded. In fact, the contract must and will be renegotiated in the in the nursing process in most cases. It might be a contingent or noncontingent contract. A contingency contract states a specific reward for the client after completion of the clients portion of the contract (Stanhope & Lancaster, 2017, p. 327). A noncontingency contract, on the other hand, does not stipulate any direct rewards but rather benefits the contractor with positive outcomes of the nursing process. The agreement must be made with the familys most responsible and fitting member.

Contracting (phases and challenges)

The nursing contract is a three-stage process, which includes the beginning, working, and termination phases (Stanhope & Lancaster, 2017). In the first stage, data collection occurs. The parties establish needs and goals and develop a treatment plan. In the second stage, the family and the nurse divide responsibilities and determine the time frame in which the contract will stay in power. Then, they implement the plan, evaluate its effects, and renegotiate if necessary. In the final stage, the contract is terminated as the goals are either achieved or not.

Contracting entails multiple advantages and disadvantages. On the one hand, it promotes the clients agency in care and stimulates learning through implementation. On the other hand, this approach requires a lot of effort from both parties to be successful. According to Stanhope & Lancaster (2017), some nurses may have difficulty relinquishing the role of the controlling expert professional; contracts are not always successful, and contracting is neither appropriate nor possible in every case (p. 328).

Empowering Families

According to literature, the goal of an empowering approach is to create a partnership between the nurse and the family characterized by cooperation and shared responsibility (Stanhope & Lancaster, 2017, p. 328). Empowering is aimed at enabling families to be active and responsible for their health care. As help-giving sometimes entails harmful consequences for the family and the practitioner, empowerment might be an effective strategy for preventing health risks. For instance, help-giving might lead to resentment and depreciation if the quality of service is subpar or if treatment goals are not fulfilled. Researchers note that for families to become active participants, they need to feel a sense of personal competence and a desire for and willingness to take action (Stanhope & Lancaster, 2017, p. 328). Families must be recognized as competent units capable of providing care for themselves to prevent frustration and devaluation.

Empowering Families (LGBTQ+)

Empowering approach is especially important for vulnerable groups such as LGBTQ+. As noted by Stanhope and Lancaster (2017), nurses ought to provide culturally competent care for such communities (p. 329). Historically, the medical system has challenged LGBTQ+ couples with unique obstacles. For instance, same-sex couples may struggle with visiting partners at hospitals or adopting children (Stanhope & Lancaster, 2017). In addition to that, same-sex couple still struggle with legal medical recognition in numerous states. Those barriers seriously impair trust and appreciation for medical professionals, thus directly and indirectly increasing health risks in LGBTQ+ families. Although it might be discomforting for a nurse to discuss such private issues as the intimate life of LGBTQ+ couples, those conversations offer a great deal of empowerment for marginalized people. As Stanhope and Lancaster (2017) state, nurses can facilitate the recognition of such families in the medical system.

Reference

Stanhope, M., & Lancaster, J. (2017). Family health risks. In Foundations for Population Health in Community/Public Health Nursing-E-Book (pp. 310-332). Elsevier.

Complementary and alternative medical therapies see more and more use when addressing the needs of pediatric and adult populations. CAM stands for a set of holistic medical practices that care for the patient as a whole, treating his or hers body, mind, emotion, and spirit (Complementary, alternative, or integrative health, n.d.). CAM is becoming more popular among the higher-class and educated patients, with 20 to 30 percent of general pediatric patients having undergone at least 1 such therapy (Kemper, 2001). As primary healthcare providers for school-age and adolescent-age groups, pediatric nurses make good use of CAM therapy, as it allows for holistic and non-invasive ways of addressing the problems health and psychiatric problems that children might have. Examples of CAM include biochemical (medications, herbs, supplements), lifestyle (diet and exercise), biomechanical (massage, surgery), and bioenergetic (acupuncture, homeopathy) options (Kemper, 2001).

Child obesity represents a problem among school-aged children, particularly in the USA. Aside from obvious physical disadvantages, obesity leads to an array of psychological disorders that often need to be addressed by pediatric nurses through the use of CAM therapy. In particular, child obesity may lead to psychological disorders like anxiety, depression, and low self-esteem (Nieman & LeBlanc). These factors are often amplified by the fact that obese children are treated cruelly by their own classmates, as obesity is often viewed as a stigma, and afflicted children are subjected to ridicule. The primary method of CAM therapy against child obesity and associated psychological problems is diet and exercise (Nieman & LeBlanc).

As indicated by numerous studies and child development theories, children aged between 9-13 years put a great emphasis on several socio-physiological factors that are key to their personal growth and development (Child development theorists, n.d.). They value the ability to learn and achieve perfection in performing manual tasks, developing skills, and expanding their knowledge. Hospitalized school-aged children often feel a degree of disconnection from their classmates and schools, especially when the hospitalization period lasts for a long period of time. As a result, their personal skill development may become stilted (Ratnapalan, Rayar, & Crawley, 2009). They may experience trouble readjusting and returning back to the regular schedule and find themselves lagging behind their classmates in performance, which, in turn, may cause alienation and the development of deeper psychological issues. Hospitalized school-aged children and adolescents have a special need for continuing their education and facilitating personal growth even when hospitalized. It is of paramount importance to provide them with means of continuing their studies, should their condition allow them to do so. Having parents and teachers visit young patients during the hospitalization period, and providing them with books, manuals, and timely homework assignments would ensure that they would not lag behind in education and development and will not have any trouble reintegrating back into the school setting (Ratnapalan et al., 2009).

The role of the pediatric nurse is very important here, as it is her duty to facilitate cooperation with school authorities, and invite teachers to participate in this extracurricular activity, should they have the time and desire to do so. In the absence of teachers, the nurse is ought to become a teacher as part of the CAM therapy and provide guidance to the hospitalized child, to the best of his or her ability. As the majority of school programs are forming the basic understanding of many sciences and subject, a well-educated nurse could easily double as a substitute teacher for any child placed in her care.

References

Child development theorists. (n.d.). Web.

Complementary, alternative, or integrative health: Whats in a name? (n.d.). Web.

Kemper, K.J. (2001). Complementary and alternative medicine for children: Does it work? Western Journal of Medicine, 174(4), 272-276.

Nieman, P., & LeBlanc, C.M.A. (2011). Psychological aspects of child and adolescent obesity. Paediatr Child Health, 17(3), 205-206.

Ratnapalan, S., Rayar, M.S., & Crawley, M. (2009). Educational services for hospitalized children. Paediatrics & Child Health, 14(7), 433-436.

Pediatric nurses play a paramount role in promoting health within the pediatric population and recognizing the family unit as consideration for planning care. In pediatrics, just like in any other field of medicine, nurses make up for the majority of the workforce. This means that pediatric nurses serve as the main mediators between families, children, and various healthcare plans and programs available to them (Guises, 2014). Pediatric nurses can promote health in various ways, but mostly through the direct, hands-on approach, and through education. Even though pediatric nurses are always available, in the majority of scenarios, it is parents who will take primary care of the child. A nurse can assist them by providing all the necessary advice and information required to take proper care of the child at various stages of their development (Guises, 2014).

When developing a plan of care for the child, it is very important to consider its stage of development. Depending on this stage, the child may have different physical and psychological needs, as well as be exposed to different kinds of high-risk behaviors. Children at the early stages of infancy tend to be vulnerable to anything that might cause them to harm due to a lack of understanding or care for personal safety (Child development theorists, n.d.). At the same time, an older and more developed child could have deeper psychological needs than mere physical care provided by a parent or a nurse.

For a child below one year of age, the feeling of safety and trust is considered one of the most important psychological aspects of their being. It is very important for the childs parents to realize that at this stage of development there is nobody else in the world that the child cares about or trusts more. In developmental care for toddlers, parental presence is mandatory, as, without the physical presence of the mother or father, the child would feel lost, frightened, and insecure. At the same time, the pediatric nurse would not carry the same level of trust for the child and will be unable to provide comfort. Newborn children tend to have very specific physical needs such as the need for breast milk, which cannot be fully replaced by artificial supplements, as breast milk contains a unique mixture of vitamins necessary for child growth. The concept of breastfeeding is important and must always be included in a young childs care plan (Kornides & Kitsantas, 2013).

Complementary and alternative medical therapy plays an important role in pediatric care. According to Barnes, Bloom, and Nahin (2007), the use of CAM therapy tactics varies between 13 and 68%. The percentage and the level of success of CAM therapy depend on the nature of the medical emergency and the age of the child. Naturally, no doctor will use homeopathy to treat a condition that could only be solved via surgery. Still, CAM therapy is viewed as favorable for toddlers and newborn babies for several reasons. First, it promotes herbal medications, as the side effects of standard medications may be too much for the newborn organisms. Second, dietary advice and physical exercise are important for proper baby development, as the digestive tract flora is formed from very early ages, and proper dietary choices early on would prove to be a long-term investment into a childs healthiness and growth. Massages for babies, on the other hand, are an excellent way of helping the child that has stilted initial growth to catch up, as muscle and nerve stimulation during massages can help overcome whatever conditions are blocking its physical growth (Field, 2014).

When it comes to safety and health considerations, many parents do not know what kinds of dangers their children are exposed to at different ages. For newborn babies and toddlers, who are already capable of moving around the house while crawling, the most important health consideration resides in the relative dangers of the environment. Hazards are numerous, ranging from sharp corners of the furniture to small items that can be ingested to house animals and electric sockets (Holmes, Keane, & Rode, 2012). It is important to inform the parents about all of these dangers and design a care plan that will account for these dangers. It is important never to leave a toddler without supervision, as it is impossible to isolate the entire house from harm. This stresses out the importance of having at least one parent dedicated to taking care of the baby at all times. Sharp corners of the furniture ought to be covered in soft protective cloth, all items that pose a danger should be removed or put above the babys reach. Electric sockets should be plugged with special plugs that could be bought at a store. In addition to safety measures, the parents must be instructed about dietary choices and baby hygiene (Holmes et al., 2012). Many parents do not know how often to change the diaper or even how to do so, due to a lack of experience, especially if it is their first child. It is up to the nurse to provide all the required knowledge and demonstrate the techniques in practice.

References

Barnes, P.M., Bloom, B., & Nahin, R.L. (2007). Complementary and alternative medicine use among adults and children. National Health Statistics Report, 10, 1-23.

Child development theorists. (n.d.). Web.

Field, T. (2014). Massage therapy research review. Complementary therapies in clinical practice, 20(4), 224-229.

Guises, E. (2014). The role of pediatric nurses in health education. Soins. Pediatrie, Puericulture, 277, 39-42.

Holmes, W.J.M., Keane, B., & Rode, H. (2012). The severity of kettle burns and the dangers of the dangling cord. Burns, 38(3), 453-458.

Kornides, M., & Kitsantas, P. (2013). Evaluation of breastfeeding promotion, support, and knowledge of benefits on breastfeeding outcomes. Journal of Child Healthcare, 17(3), 274-263.

Medicine in its historical development acts as such a social institution in which many bioethical ideas were born and mastered. To solve the problems that it has been facing for many centuries, medicine is forced to turn to philosophy, its ideas, and its provisions, thereby confirming that modern society needs ethics and philosophy. The activity that future doctors choose is moral in itself, presupposing love for ones neighbor, presupposing compassion, a desire to help. Any moral problems that a doctor faces become the subject of philosophical discussion.

There was a misunderstanding in the situation with the patient Lucinda Ramirez since the nurse did not specify from her exactly how she should have acted. In this situation, a basic knowledge of psychology would help: often, a person thinks about his own during a conversation and loses the essence of the conversation without realizing it. Most likely, Ramirez was embarrassed to admit that, in fact, she does not remember half of the stages of treatment of her wound (Decety, 2020). The nurse should have asked the patient to repeat the stages of treatment to make sure that everyone understood each other. Of course, there is no universal recipe for interaction with the patient, but implementing simple recommendations will be an important step towards cooperation with him in the fight against the disease. On the one hand, these recommendations cover universal rules of productive communication that satisfy the interlocutors. On the other hand, rules focused specifically on preventing refusal of treatment, not serious attitude to it.

In conclusion, for a doctor as a professional, such key points as correct diagnosis, the appointment of adequate treatment and obtaining a certain result, and the presence of clinical thinking (allows the doctor to build a collaborative relationship with the patient) are important. In addition, communicative competence is important, which implies the presence of certain psychological knowledge. For example, it is good when a doctor knows about personality types, about the ways of experiencing and responding to stress in different people depending on the type of temperament.

Reference

Decety, J. (2020). Empathy in medicine: what it is, and how much we really need it.The American journal of medicine, 133(5), 561-566. Web.

The Social Determinants of Health That Affect the Family Health Status

Some common social determinants of health that affect the health status of the Lara-Watts family include health services, healthy children and development, personal health practices, and coping skills, and education and literacy (Palmer et al., 2019). These factors impact the family in different capacities, and thus they collectively influence the health status of the entire Lara-Watts family. Health services are crucial to the family because they enable the different members of the family to understand their health conditions and thus be able to promote their quality of life. For instance, health services are significantly prevalent in this family since some family members require regular medical appointments. Mike has undergone open heart surgery, survived two instances of prostate cancer, and is a recovering addict. As such, through the scheduled medical screening services, the doctors can monitor Mike while assessing his progress toward full medical recovery.

Personal health practice is another social factor that influences the health status of this family. Different members of the Lara-Watts family are involved in activities that contribute to improving their health. These services are vital since they help to maintain better mental health and promote health (Palmer et al., 2019). For instance, Mike has to attend AA meetings even though he has been clean for six years. These meetings allow him to relieve the pressures of succumbing to the urges while also acting as a way of recognizing and commending his efforts, thus encouraging him to keep fighting. Similarly, Marty engages in counseling veterans, allowing him to interact with others who understand his experiences. Therefore, through sharing experiences, he can maintain his mental health by venting off excess pressures. Mike and Marty have organized date nights; these dates are essential since they allow for better communication about issues affecting the family and marriage. This is important because it allows them to identify their problems, strengthening the family.

Age-Appropriate Screenings for Each Family Member

The Lara-Watts family comprises six members with vast age differences; age-appropriate screening for each family member is in order. Mike is 51 years old and thus is open to the risk of suffering significant diseases unchecked. Some of the most appropriate screenings for Mike include a prostate exam and eye screening. These are the most appropriate tests for Mike because he has a history of prostate cancer which has reappeared after treatment; as such, it will be safer to conduct regular screenings to ensure that cancer does not crouch back unnoticed (Querns, 2020). He wears glasses that indicate a problem with his eyes; therefore, the screening will help to know the causes of the problem and whether it can be cured. Marty is 48 years old; the most appropriate screening comprises testing for depression (Querns, 2020). Marty is a veteran, and thus his experience on the battlefield still rattles him and causes night terrors. Additionally, he has to attend counseling meetings to achieve normalcy. The test for depression will help ensure he is not a danger to himself or the people around him.

Stephanie is the mother of Chase and Clayton, and she is twenty-nine years old. The most age-appropriate screenings for her include a cervical exam and a breast exam (Live Healthy, n.d.). At her age, she is at risk of developing breast and cervical cancer; regular screening will be essential in ensuring that these cancers do not develop to life-threatening stages undetected. Andre is 14 years old; therefore, some age-appropriate screenings include STD/STI screenings. Being a teenager and at the peak of adolescence, he is bound to begin indulging in either protected or unprotected sexual intercourse. As such, the test will ensure they are not infected. Chase and Clayton are 9 and 7 years old, respectively. The most appropriate screening for both is dental screening and counseling testing for Clayton (Fosse & Edelstein, 2022). Children are bound to eat sugary things and fail to maintain proper dental hygiene as such, and the screening will help ensure thy teeth are kept well and free from decay and infections. On the other hand, Clayton can be given counseling testing, which will help manage the effects of ADHD and, thus, his bowel movements.

A Health Model to Assist in Creating a Plan of Action

Gordons health model is the most suitable model that will assist in making an action plan. The model was developed in 1982 by a professor and nursing philosopher, Marjory Gordon. The model is also known as the functional health pattern model because it comprises eleven categories. It was developed to help nurses collect data from their patients for assessment of functioning and the capacity of their physical and mental activities (Barnes et al., 2020). The eleven patterns are essential in facilitating comprehensive data collection. They include the health management outline, metabolic, elimination, exercise, perceptual, rest, self-concept, relationship, reproductive, stress tolerance, and belief outlines (Hooper, 2018). This model encompasses all aspects of a patients life, hence its efficiency in data collection and assessment.

This model is the most appropriate model for this family. Some of the advantages of this model include the diverse patterns that allow nurses to collect comprehensive data on the functioning and physical and mental capacities of the respective patients. The model will enable the physicians and nurses attending to the family to have a clear idea and medical history of the patients in case of a first encounter hence accuracy in the diagnosis. Based on the interview, this design model covers a wide range of issues that this family is dealing with, for instance, the issue of exercise; Mike is barely able to exercise as much as he would like; therefore, the physicians will provide alternative ways of exercising. Additionally, Mike and Marty have joined AA and veteran counseling, respectively.

The Steps for a Family-Centered Health Promotion

Based on the Gordon model, there are five steps involved in family health promotion. These steps include organizing contact with specialists; the family members seek help from a trained and certified professional. The second step involves committing ones spouse to professional help. In this case, Mike would get an appointment with therapists or a supervised AA group. Through this group, the people share their problems and thus encourage each other. The third step involves supporting a spouse or a partner to seek professional help in dealing with their problems. As such, Marty would go to the veterans meeting, where they share and talk about their current issues. The fourth step involved establishing a comfortable environment for the children and thus motivating them to learn more information. The final step involves an assessment of the family to evaluate the impact of the model on the family. The communication strategies used during family-centered health promotion include using a research-based approach, understanding the concepts and language, health literacy, and internet access.

References

Barnes, M. D., Hanson, C. L., Novilla, L. B., Magnusson, B. M., Crandall, A. C., & Bradford, G. (2020). Family-centered health promotion: Perspectives for engaging families and achieving better health outcomes. INQUIRY: The Journal of Health Care Organization, Provision, and Financing, p. 57.

Fosse, C., & Edelstein, B. L. (2022). State Medicaid Authorities Policy Communications With Providers on Individualized Pediatric Dental Care. Public Health Reports, 137(3), 506-515.

Hooper, J. I. (2018). The family receiving home care: Functional health pattern assessment pane. Home Care Provider, 1(5), 238243.

Live Healthy at Any Age. (n.d.). Web.

Palmer, R. C., Ismond, D., Rodriquez, E. J., & Kaufman, J. S. (2019). Social determinants of health: future directions for health disparities research. American Journal of Public Health, 109(S1), S70-S71.

Querns, D. (2020). 10 Essential Health Screenings for Men. Brigham Health Hub. Web.

Introduction

Generally, most pregnant women expect to have a natural birth during delivery. However, uncertainties such as the failure of the cervix to dilate or medical emergencies may prompt obstetricians to opt for a caesarean section (C-section) to save the lives of both the mother and unborn baby. Even though some individuals choose C-section over normal delivery, a significant number of expectant mothers prefer undergoing natural birth. Traditionally, C-sections involve privacy that prohibits patients from observing and engaging in birth. This practice denies women the opportunity to experience the aspect of delivery. To reduce the limitations, some healthcare facilities have adopted a family-centred Cesarean birth to guarantee pregnant women a chance to have a delivery close to the natural birth. The exercise deviates from the traditional C-section in several ways. First, it allows a woman to observe the birth process. Second, it provides room for close relatives to accompany the mother in the delivery room. A family-centred caesarean delivery is vital in facilitating immediate bonding between the mother and baby, leading to proper connection.

Discussion

A family-centred C-section is the process of delivering a baby in a way closer to the natural birth. The practice enhances family connection and safe surgical exercise during the whole process. The procedure entails lowering the crucial part of the surgical drape, thus enabling the mother to fully watch the birthing of her baby through an installed transparent window. Immediately after securing the infants from the womb, they are placed on their mothers chest as a standby nurse performs evaluation and cleaning of the baby while standing at the head of the patient bed. The obstetricians always ensure the whole activity simulates the normal birth procedure to allow mothers to experience the nature of childbirth.

Patients undergoing a family-centred C-section are exposed to an array of experiences than those who receive the traditional approach. First, the mother feels respected during the procedure and practice because they have the opportunity to fully observe all the activities and steps the birthing and the baby is going through (Kram et al., 2021). This aspect enables the patient to have control of what is happening to the newborn, thus facilitating the connection between her and the infant. Moreover, nurses guarantee women their wishes, making them remain happy and engaged throughout the delivery period. For instance, before subjecting the young one to weight or bathing, practitioners enquires from the mother to issue consent.

Furthermore, unlike traditional C-sections, a family-centered C-section does not have strict restrictions to family members joining the patient during the process. Allowing close relatives such as spouses and mothers-in-law enhances family love, thus making the mother feel and enjoy the connection and affection from the loved ones. The presence of a husband makes the mother be courageous and self-assured of the care from the family (Huang et al., 2019). When couples share such crucial moments together, the bond between them grows stronger, which is beneficial for the growth and wellbeing of the infant.

The act of placing the baby on the mothers chest immediately after the surgery is an amazing experience for women undergoing gentle caesarean encounters. The practice permits obstetricians to allow mothers to hold their babies as other procedures continue. The approach enables patients to have and develop feelings towards the newborn. The activity simulates natural birth, thus making mothers have adequate time to connect with infants. The conduct is different from a typical C-section where the baby is taken to paediatric care. When skin-to-skin contact between the patient and baby occurs, the bond development rapidly takes place (Machold ET AL., 2021). Similarly, the procedure facilitates the ability of patients to breastfeed the infants with ease. The engagement allows patients to feel part of the birthing. Therefore, they remain proud of their contribution towards delivery.

The nurses place babies on the bare chest of the mother for a duration of one hour. The body contact enables the infant to smell their mothers and be close to their breast. This enhances the connection between the young one and the patient, thus making it easier for the baby to breastfeed successfully. Furthermore, skin-to-skin contact enables the mothers body to effectively regulate the babys body temperature. The attachment developed during the practice serves a major purpose in the future development of the infant.

Similarly, the delivery room is arranged in a more comfortable manner to enable the patient to feel comfortable throughout the exercise. For example, the LED lights are kept deem to reduce interferences. Nurses only adjust the lighting when surgery is being performed on the patient. Moreover, mothers have the ability to choose their favourite music to be played in a low tone to soothe the whole process. This allows pregnant women to remain active and focused while undergoing through birthing. In addition, the husband can also capture the birth moments in pictures or videos for the mother to observe after she is through with the medical attention. This would boost her experience, encouraging her to embrace family-centered C-section in future if birth conditions demand.

Moreover, the practice allows nurses to leave a womans hand free, thus enabling her to carry the baby. The feeling of holding a newborn is a crucial experience, and most expectant women are eager to have the opportunity to hold their infants (Deys et al., 2019). This experience is missing in the traditional C-section, where the overall focus is surgical activities to remove the baby from the womb. It makes most mothers feel disengaged from their young ones because they lack that first-hand touch.

Lastly, a gentle C-section plays a vital role in enhancing maternal mood. Generally, when a mother has better experience with the birth process, her postpartum state improves accordingly, which is fundamental for the wellbeing of a woman after delivery. Therefore, undergoing a family-centered C-section childbirth enables the reduction of depression that can occur due to bad outcomes that mothers encounter during the birthing process. The technique is effective in boosting the emotional status of women after delivering a baby in the hospital setting.

Conclusion

In summary, a family-centered C-section childbirth plays a significant role in making mothers have a gentle delivery that is close to natural birth. The practice enhance pregnant womens experience during delivery in various ways. Unlike traditional C-sections, the approach enables mothers to watch the birthing process, making them feel part of the procedure. It also allows patients to hold their babies in the chest, creating close and immediate skin-to-skin contact that is important for the wellbeing of the baby and the mother. In addition, it has less restriction, thus allowing close relatives such as spouses to accompany the wife during the surgery. The practices facilitate the development of a strong bond between the infant and parents, which is significant for the health of the baby.

References

Deys, L., Wilson, V., & Meedya, S. (2021). What are womens experiences of immediate skin-to-skin contact at caesarean section birth? An integrative literature review. Midwifery, 101, 103063.

Huang, X., Chen, L., & Zhang, L. (2019). Effects of paternal skin-to-skin contact in newborns and fathers after cesarean delivery. The Journal of Perinatal & Neonatal Nursing, 33(1), 68-73.

Kram, J. J., Montgomery, M. O., Moreno, A. C. P., Romdenne, T. A., & Forgie, M. M. (2021). Family-centered cesarean delivery: A randomized controlled trial. American journal of obstetrics & gynecology MFM, 3(6), 100472.

Machold, C. A., ORinn, S. E., McKellin, W. H., Ballantyne, G., & Barrett, J. F. (2021). Womens experiences of skin-to-skin cesarean birth compared to standard cesarean birth: A qualitative study. Canadian Medical Association Open Access Journal, 9(3), E834-E840.