NRS-429N Family Assessment Part II Solved
NRS-429N Family Assessment Part II Solved
Describe the SDOH that affect the family health status. What is the impact of these SDOH on the family? Discuss why these factors are prevalent for this family.
2. Based on the information gathered through the family health assessment, recommend
age-appropriate screenings for each family member. Provide support and rationale for your suggestions.
3. Choose a health model to assist in creating a plan of action. Describe the model selected. Discuss the reasons why this health model is the best choice for this family. Provide rationale for your reasoning.
4. Using the model, outline the steps for a family-centered health promotion. Include strategies for communication.
Family Assessment Part II
Family health assessment is the process utilized by healthcare providers in collecting information from a given family concerning health promotion and disease prevention activities. The assessment involves the examination of several health patterns and life choices that affects the health outcome of the family. Several environmental factors, termed as social determinants of health (SDOH), are normally taken into consideration when conducting family health assessments (Runyan, 2018). This paper elaborates on the SDOH affecting a family and routine age-appropriate screening recommended for the family, in addition to the assessment and application of appropriate health models.
SDOH Affecting Family and Family Health Status
SDOH refers to the factors within an individual’s environment with the capacity of affecting the health status of the individual (Runyan, 2018). Such factors tend to determine the conditions in which a person was born, grew up, works, and grows old. Based on the family health assessment results, Mrs. K’s family is of Hispanic-American descent from an upper-middle-class economic standard. The family has access to education, a healthy diet, and healthcare services hence promoting their general health. However, some of the SDOH that seems to affect the family are stress upon the family when Mrs. K’s mother’s arthritis worsens and inadequate physical exercise as a result of reduced energy given that most family members are aged. Stress can lead to several mental disorders such as anxiety and depression, which compromise the quality of life of the individual. Consequently, reduced physical exercise can worsen most of the conditions that the family is already suffering from such as hypertension, hyperlipidemia, and arthritis. Evaluating such SDOH will help the nurse formulate the most effective plan for promoting the health of the family.
Age-Appropriate Screening Recommendations
Routine health screening is essential in health promotion among all individuals, but the screening tests might differ depending on the parson’s age. Mrs. K’s family is made up of 3 elderly between the age of 60 to 95 years and young adults age 21 and 24 years old. For the young adults, I would recommend routine screening such as cholesterol check, given the family history of hyperlipidemia, full-body skin check for examination of suspicious skin lesions or moles, diabetes screening, pelvic and
NRS 429N Family Assessment Part II Solved
breast lumps examination for the daughter, and testicular examination for the son (Roy et al., 2020). The daughter should also be screened for vaccinations such as HPV in addition to cervical cancer screening. Blood works such as Complete Blood Count, Liver Enzyme Markers, Plasma Glucose, Complete Metabolic Panel, Sexually Transmitted Disease Tests are also recommended annually for both the two children. Psychological screening such as depression screening is also necessary given that the family is stressed when Mrs. K’s mother’s arthritis worsens.
For the three elderly, most of the earlier age annual routine screening is normally continued with additional tests, given that advanced age predisposes individuals to several health complications. The annual routine screening as discussed earlier includes BMI check, blood pressure, cholesterol check, skin screening, diabetes screening, immunization, depression screening, blood works, breast examination, cervical cancer screening for the women, and testicular screening for the husband (Roy et al., 2020). Additional screenings will be prostate screening, osteoporosis, flu vaccine, and colorectal cancer screening.
Assessment of Health Model
Looking at Mr. K’s health status, the most appropriate health promotion model to use is the Calgary family assessment model (CFAM) together with the Calgary family intervention model (CFIM). The model employs the utilization of short-form interviews giving a clear picture of the conditions affecting the family. The information gathered is analyzed in such a way that the nurse will categorize the things that are relevant to the family’s health status in a multidimensional aspect to reflect on the dynamics of the family (Kläusler-Troxler, Petry, Lanter, & Naef, 2019). The structure of the models also promotes the evaluation of both internal and external components of the family, in addition to contextual components. These two models help the nurse develop personalized interventions to help meet the family’s health needs.
Application of Health Model
Utilization of the CFAM/CFIM health models requires the nurse to assess the family structure to determine the type of internal relationship among family members. This assessment will help the nurse understand existing family needs and problems such as stress and how they feel about each other’s health conditions. In application of this model, it is also necessary to evaluate both the external and contextual family structure to familiarize with problems associated with these structures (Kläusler-Troxler, Petry, Lanter, & Naef, 2019). Lastly, the CFIM tool will be utilized in coming up with personalized interventions for the promotion of the family health status.
Conclusion
Generally, the health outcomes of most families are affected by several internal and external factors in a given environment. Such factors, termed as social determiners of health are utilized when conducting family health assessments for health promotion purposes (Roy et al., 2020). Models such as CFAM and CFIM are also utilized to ensure that personalized interventions are employed in improving the general health status of the family.
References
Runyan, C. N. (2018). Assessing social determinants of health in primary care: Liability or opportunity. Families, Systems, & Health, 36(4), 550. https://doi.org/10.1037/fsh0000377
Roy, S., Moss, J. L., Rodriguez-Colon, S. M., Shen, C., Cooper, J. D., Lennon, R. P., … & Ruffin IV, M. T. (2020). Examining Older Adults’ Attitudes and Perceptions of Cancer Screening and Overscreening: A Qualitative Study. Journal of Primary Care & Community Health, 11, 2150132720959234. https://doi.org/10.1177/2150132720959234
Kläusler-Troxler, M., Petry, H., Lanter, R., & Naef, R. (2019). Implementing Family Systems Nursing through a participatory, circular knowledge-to-action research approach in women’s health. International Practice Development Journal, 9(2), 5. https://doi.org/10.19043/ipdj.92.005
Social determinants of health are factors within one’s family and community that affect their access to healthcare services. Arthur’s family was interviewed in the previous project. The assessment showed the existence of significant health-related needs for the family. Nurses and other healthcare providers should collaborate with the family in developing healthcare plans to transform their lifestyles and behaviors. Therefore, this paper examines the social determinants of health affecting Arthur’s family, age-appropriate screenings for the family members, and appropriate health model that can be used to develop a plan of care for the family.
Social Determinants of Health Affecting the Family
As noted above, social determinants of health are factors within one’s environment that influence their access to healthcare services. The factors include those in places where one was born, work, grew, aged, and died. The interview with Arthur’s family showed the existence of several social determinants of health affecting them. One of them is the lack of awareness about their health needs. Education is an important aspect in health that increase population’s awareness about health risks and how to avoid them. However, Arthur’s family is not aware of the health risks associated with sedentary lifestyles. The family members rarely engage in active physical activity despite being obese and Arthur suffering from hypertension (CDC, 2022). Arthur and his son consume high amount of high calorie foods, which increases their risk of health complications such as cancer, hypertension, diabetes, and stroke. Therefore, their lack of awareness about the health risks of their lifestyles and behaviors is a crucial determinant of the family’s health.
The other social determinant of health seen in Arthur’s family is the affordability of healthcare services. Despite Arthur and his son suffering from hypertension and obesity respectively, they rarely visit the hospital for assessment and treatment. The family noted experiencing financial hardships, which makes it difficult for them to access and utilize the healthcare services that they need. The American healthcare system is among the most expensive in the world (Palmer et al., 2019). As a result, families from low socioeconomic backgrounds often experience challenges in affording the healthcare services they need for their health and wellbeing.
The other social determinant of health evidence from the family assessment is social and community contexts. Arthur’s family demonstrated the lack of adequate family support system during the assessment. This could be seen from the family members failing to provide their daughter her desired social support when she experienced a relationship failure. The family also does not discuss about issues related to sexuality and relationship due to the influence of their religious beliefs (Palmer et al., 2019). The wider social and community system also does not support healthy habits for its members. This can be seen from the easy access to fast foods for the family members and the lack of community systems to increase the population’s awareness about the importance of healthy lifestyles and behaviors (CDC, 2022). Therefore, Arthur’s family social and community contexts act as their social determinants of health.
Age-Appropriate Screenings
Arthur’s family members should utilize different age-appropriate screenings for their health promotion. The age-appropriate screenings for John Arthur include eye examinations, hearing tests, blood pressure screening, skin, dental, and testicular examinations. Age-appropriate screenings for Cate Arthur includes skin, dental, blood pressure, hearing, and eye examinations. The age-appropriate screenings for Chris Arthur includes eye, blood pressure, hearing, dental, and skin examinations. Mr. Arthur’s age-appropriate screenings include blood pressure, testicular, blood glucose, cholesterol, colonoscopy, and prostate screening tests. The age-appropriate screenings for Mrs. Arthur include ovarian cancer screening, mammography, bone density, cholesterol, blood glucose, blood pressure, pelvic, and cervical cancer screenings (Fragala et al., 2019). These screenings are important for early detection and prevention of potential health problems that may affect the family members.
Health Model for the Family
A health model that can be adopted to assist in creating a plan of action for the Arthur’s family is the transtheoretical model. Transtheoretical model is a theory of change used to facilitate behavioral change among the target populations. It promotes long-term behavioral change through multiple adaptions and actions over time. The model postulates that people are in different stages of readiness to embrace healthy lifestyles and behaviors (Castrucci & Auerbach, 2019). As a result, the nurse should create awareness about the change and provide enabling factors for the process. The transtheoretical model asserts that change occurs in steps that include precontemplation, contemplation, preparation, action, and maintenance. This model is appropriate for the family since it will promote sustained lifestyle and behavioral change among the family members (Pennington, 2021). Since change occurs in steps, it would be possible to implement strategies that will prevent family members from relapsing to their unhealthy habits.
Steps for a Family-Centered Health Promotion
The transtheoretical model provides several steps that must occur for the delivery of family-centered health promotion. The nurse should create awareness among the family members for the change in the precontemplation stage (Pennington, 2021). The family members should be made to understand the health risks associated with their behaviors and the need for a change. The nurse should facilitate them to develop interest in changing their behaviors in the contemplation stage. She should also help them to explore strategies that they need for their optimum health and wellbeing in the preparation stage (Liu et al., 2018). The nurse should then guide them in implementing new, healthy lifestyles and behaviors in the action phase. The focus is on ensuring incremental adoption of healthy lifestyles and behaviors and assisting the family members not to relapse to their unhealthy behaviors. The last stage in creating sustainable change is maintenance where family members have stabilized the desired healthy behaviors (Prochaska, 2020). Therefore, the transtheoretical model of change provides an effective approach to assisting the family achieve their desired health promotion goals.
Conclusion
Overall, Arthur’s family experiences significant social determinants of health that affect their healthcare access and health-related outcomes. The nurse should work with the family in identifying the effective ways to promote the optimum health of the family members. The transtheoretical model of change can be applied in assisting the family to achieve its health promotion goals. The model provides steps for achieve sustained behavioral change in the family.
References
Castrucci, B., & Auerbach, J. (2019). Meeting individual social needs falls short of addressing social determinants of health. Health Affairs Blog, 10(10.1377).
CDC. (2022, May 9). Social Determinants of Health | NCHHSTP | CDC. https://www.cdc.gov/nchhstp/socialdeterminants/index.html
Fragala, M. S., Shiffman, D., & Birse, C. E. (2019). Population health screenings for the prevention of chronic disease progression. Am. J. Manag. Care, 25, 548–553.
Liu, K. T., Kueh, Y. C., Arifin, W. N., Kim, Y., & Kuan, G. (2018). Application of transtheoretical model on behavioral changes, and amount of physical activity among university’s students. Frontiers in Psychology, 9, 2402.
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. https://doi.org/10.2105/AJPH.2019.304964
Pennington, C. G. (2021). Applying the transtheoretical model of behavioral change to establish physical activity habits. Journal of Education and Recreation Patterns, 2(1).
Prochaska, J. O. (2020). Transtheoretical model of behavior change. Encyclopedia of Behavioral Medicine, 2266–2270.