Family Focused Functional Assessment

Family Focused Functional Assessment

Grand Canyon University: NRS-429

Family Focused Functional Assessment

A family health assessment is used to design safe, effective and manageable goals towards health and wellness. Margory Gordon established the Gordon’s functional health patterns theory; these patterns are separated into 11 categories that help to better assess the well-being of the family (Current Nursing, 2017). In these categories an array of systematic questions are asked to determine the health patterns that are reflected. This in turn gives the foundation to build the education components of treatment for the family. Using Gordon’s functional health patterns theory, this exercise was completed based on a family of four in Washington state, their answers to the questions in the 11 categories lead to the writers application of using the family system theory to solicit changes in the family that will provide positive change to the family’s function over time.

Values/Health Perception

The family interviewed is a mixed cultural family husband is Mexican and wife Caucasian, the wife was raised Mormon and goes to church regularly with their two children and the husband explain to be he does not go based on a different belief system but it didn’t seem to stand in the way of their families relationship. The kids are 4 and 8 years old, the youngest is a spunky little girl and the 8-year old is an athletic boy with an abundance of energy. When we spoke about their life prior to interviewing them they proclaimed happiness, they have been married for 10 years and everything in life has seemed to come together they are now in the process of moving into a new house and are excited for the next adventure it will hold with new schools and programs for the kids.

When asked about their perception on their health they all agreed to being a fairly healthy and active family, they exercise about 3-5 times a week and eat a mostly whole food diet. The daughter was born with an autoimmune disease where she cannot process fructose, this factor has shaped the way they all eat to make their daughter feel comfortable and the husband added it’s not a bad way to eat, and we always find something good to make. The energy of the family seems fresh and full there were no signs of over exhaustion besides the father who had just gotten home from his 48-hour shift at the fire station.

Nutrition

With their daughter diet modifications in mind I asked about their “go-to” meals, chicken and rice with any green vegetable. This is the only thing their daughter likes to eat right now and the whole family enjoys it. The kids have a regular 3 meals a day and in between snack and the parents said they usually skip breakfast and just have coffee then have their 2 big meals at lunch and dinner. For snacking they usually eat cheese sticks and lunch meat between lunch and dinner and did confess to all of them typically over eating at meals.

Sleep/Rest

The whole family thinks to have a pretty normal sleep schedule and no one has issues with sleep apnea or insomnia. Their nighttime routine involves spending time together talking about their days, 20-30 minutes of reading, brushing teeth and going to bed. The kids normally get about 9 hours of sleep and the parents average about 6 hours. No one uses any sleep aids yet the dad joked of counting alcohol as an aid on some nights.

Elimination

The topic made the family slightly embarrassed to talk to me out their toileting schedule but did provide that they do not have any difficulties unless their daughter is to eat something with fructose than she has stomach upset/diarrhea. At the kid’s ages now they have had very rare spells of accidents in bed while the kids were giggling at the thought. The dad said he wakes up to empty his bladder at least once in the middle of the night but had no concern with it and blamed it on drinking too much water or alcohol before bed.

Activity/Exercise

As a fireman and sales associate at an exercise equipment store, the parents engage in cardio and weight lifting at least 4 days a week. Their daughter is in cheer and dance and their son plays football and baseball year round. I asked if they did anything to compensate for the days with no exercise, and they admitted to just taking the day off and starting over the next day granted that they still eat a pretty healthy diet due to their daughter diet restrictions.

Cognitive

Each family member believed that their mental capacity was normal they told me they only feel foggy if they were sleep deprived. Both kids are at the average reading/writing level for their ages and are very coordinated and balanced. No concerns were identified in this topic.

Sensory-Perception

Both parent have prescription glasses, the kids have great vision in reference to their last check up. They have no problems with taste or smell. I asked about any interpretation issue noticed with their children, and they were quick to respond that both love to talk and can get distracted pretty quickly because they are so busy minded but still doing well in school.

Self-Perception

The families self esteems were described as through the roof and very confident. They contribute to the community by volunteering locally and donating clothes to shelters in need.

Role Relationship

The household is mainly run by the wife but also counters to the husband when he is off shift and she is at work. They seem to balance out their tasks by the whomever gets home later picks up what is left, so they all contribute including the kids in simple chores. Discipline towards the kids is mainly handled by the dad who describes himself as strict. Depending on the context he will either have a discussion or give “tough love” and send the child to their room. The dad continued on that it does not interfere with the relationship and that the kids learn from their mistakes and respect him.

Sexuality

This was a tough topic to discuss with them as they were not open about many feelings, they were able to tell me that they do not believe in public affection and if there were any concerns sexually that they have a strong, open and honest relationship where it would be discussed if needed.

Coping

With coping, they tend to become guarded and very little communication is reciprocated in times of stress. The husband uses the gym to let out frustrations and the wife has the support of her church, mother and mother-in-law to console her. They both agreed while talking that this is their biggest difficulty and finding a way to console each other rather than separating to their coping mechanisms would be a good change.

Conclusion

The use of Gordon’s assessment provides a holistic approach to care that a basic nursing assessment would not identify. “Observations of spontaneous interactions provide an indication of how family members engage in demonstrations of affection, concern, and mutual understanding” (Wright & Leahey, 2013. ch.5). I found through this assessment I could see when answers were more guarded or confident than others and it helped me get a more clear response. Family systems theory adapts one of the members to then motivate the rest of the family to follow along (GCU, 2018). Two strengths in this family are certainly activity/exercise and sleep/rest they have a very healthy lifestyle and there is little that needs to be changed. Yet the weaknesses I found were in coping, sexuality, and self-perception. These are where I felt them guarding answers and I believe by adapting the husband to be more open with communication between family, whether in good or bad situations, would lead to improvements in these categories and set the family up for positive adaptation to an open communication household.

References

Current Nursing. (2017). Nursing theories: A guide to nursing theories and models. Retrieved from http://currentnursing.com/theory/functional_health_patterns.html

Grand Canyon University (Ed). (2018). Health promotion: Health & wellness across the continuum. Retrieved from https://lc.gcumedia.com/nrs429vn/health-promotion-health-and-wellness-across-the-continuum/v1.1/

Wright, L.M., & Leahey, M. (2013). Nurses and families: A guide to family assessment and intervention. Philadelphia, PA: F. A. Davis Company.

Appendix A

Family Assessment Interview

Family description:

4 members

Fireman (3 days a week)

mom – sales – (5 days a week) and also full time in school

Damion 8 year old boy, sporty, active, happy

Devon 4 year old girl, spunky, energized

10 years of marriage

Values/Health Perception

How would you describe your family’s current health?

Healthy/in shape – energized

Devon – autoimmune disease – cannot digest fructose

What type of things do you do to maintain health?

Diet – whole foods

Exercise – 3-5 days for parents – extra curricular activities for kids

Describe the value of health for your family.

Yes its importance for us, we all like to feel good and junk out in moderation.

Nutrition

What are your go-to meals for the family?

Rice and chicken with some type of green veggie any and all types – pretty much all Devon can eat anyways

What type of snacks do you have available?

Cheese sticks and lunch meat

How do you track portion sizes?

Don’t do very well – typically over eat

Alcohol?

2-3x a week, enjoy after long days to unwind

Sleep/Rest

How many hours of sleep does each family member get a night?

Kids – easily 8-10

Parents – average 6

What is a typical night-time routine?

Family time – 20-30 min of reading, brush teeth and go to bed.

Does any one in the family use any type of sleep aids?

No, unless you count alcohol (2-3 days a week)

Elimination

Does any one in the family have difficulties eliminating

No, Alba & Becca

Kids have never expressed that they have trouble

Does the family all have normal bowel movements? How many?

Normal 1-3 a day

Only constraint is if devon eats something with fructose/diarrhea/stomach upset

Do you ever wake up middle of the night to urinate?

Alba – yes

Becca no

Kids very rarely will have an accident (once in 3 months)

Activity/Exercise

Does your family exercise? How many times a week and what type?

Yes 3-5 days a week – cardio and weight lifting combined

Is anyone in the family taking part in sports?

Devon – cheer practice and dance

Damion – football and baseball year round

If activity is not done due to time constraints how to you compensate?

We don’t we will just take the day off and start over the next. Still eating healthy due to diet restriction

Cognitive

Does anyone in the family ever get confused/cant comprehend?

No not unless were sleep deprived from are busy kids

For their educational level how is everyone reading/writing?

Average

How is the family’s coordination?

Very coordinated

Sensory-Perception

Are there any interpretation issues with the children at school? Explain.

Talks a lot – gets distracted other than that do very well in school

Devon is very busy and distracted easily but haven’t noticed any concerns compared to friends

Does anyone have difficulty tasting/smell?

No

How is each family member’s eyesight? Does anyone wear glasses?

Parents both have prescription glasses

Kids – great vision at last check up

Self-Perception

How is each of your self-esteem?

Through the roof – quick to answer to elaboration

How does your family contribute to the community?

Made baskets for the homeless in the winter time Becca and son

Clothes donation

Becca and daughter volunteer locally

Where do you see your family in 10 years?

Damion 18 – school – independent at that age going to college, moving out

Devon 14 – school – home but independent, and smart

Settling into a new house, traveling

Role Relationship

Who is the primary caregiver of the family?

Becca – takes on most house hold duties and when Alba is home he picks up what ever is left to do and visa versa if alba is home and Becca is working all day

How does your family break up household tasks? What are each persons role in the family? (Chores/cooking)

Day-to-day split it up and have the kids help us with things like laundry, sweeping, wiping down counters

How do you discipline?

Strict – dictated by situation – discussion vs tough love and sent to their rooms

Alba says it does not interfere with the relationship they learn from their mistakes and respect us.

Sexuality

Are your open about your sexuality? How to you show affection publicly?

No not at all – no public affection that’s just weird – Alba

How do you and your partner view your relationship as lovers and parents?

Married for 10 years – strong, comfortable, organized

Do you discuss openly any sex issues with your partner?

If we had any it would be known and discussed openly between them

Coping

How are stressful situations handled in the family?

Not very good together – guarded not a lot of communication

Alba states he has a temper at times so he tends to decompress by going to the gym

How is your support system and whom do you each go to for advice?

Alba – no support doesn’t use any, probably has people just doesn’t reach out

Becca – mom and mother in-law, girlfriends

Is there any use of religion or medical professional when coping?

Church – Mormon religion – Becca and kids

Alba – not religious, does not go to church with them

No counseling is used in the family