Family Assessment Part II
Grand Canyon University: NRS 429VN
Family Assessment Part II
Social Determinants of Health
Social determinants of health (SDOH) can be defined as the settings that people are born into, grow and live in, work or attend school in that can have an effect on their overall health (Schroeder, Malone, McCabe, & Lipman, 2018). SDOH are important for the nurse to assess as these can have a great impact on a person’s health especially their ability to even access healthcare (Faulkner, 2018b). For this family specifically, there are several SDOH that impact their overall health status, most all of them positively but there are a couple that could be having a negative effect. As far as economic SDOH, both Christine and Josh have good jobs that offer health benefits, and they can afford to live in a nice, family friendly neighborhood that is safe for Reese to grow up in. Unfortunately, Reese only is with his dad and Christine on the weekends, most of the time Reese lives in a not so great neighborhood where there is a lot of crime and violence, this has caused some anxiety with Reese and limits his ability to go outside and be active. Education SDOH is where they may see negative effects, Reese primarily lives with his mother specifically during the school week, she lives in an area where the quality of schools is not that great and there are a greater population of people living unhealthy lifestyles. Health literacy is also a component under education, Christine although very smart has very limited health literacy when it comes to diabetes, although she has taken steps to improve this. Overall, the family is not negatively affected by SDOH, which has a positive effect on their health.
Health screenings on adults and children are a way to address a person’s health prior to them actually being afflicted with an illness. Some screenings that would be important for this family would include annual well checks with primary care and specialist, eye exams, vaccinations as required and well woman check for Christine. Josh sees his primary care doctor once to two times yearly already, he also sees his endocrinologist at least two to three times per year. Encouraging both adults to continue their yearly preventative visits will ensure that any health concerns are caught early. The focus for Reese would continue to be the normal yearly health, vision and dental screenings, he could also benefit from mental health screenings due to disrupted home environment and living situations.
Adaptive Model of Health
The adaptive model of health is described as a nursing model for when a person is afflicted with a negative health concern, and they are able to “acclimate to a disruption in his or her health” and not face a great deal of change in their life (Falkner, 2018a). This model describes a person who is able to utilize strong coping skills to deal with the negative effects their health condition imposes on them. The adaptive model of health fits this family the best as it plays to their strengths as they both work in the mental health field, and they expressed that they have great communication within their relationships. This model allows for them to acknowledge their illness/health concerns and adapt the changes required into their current lifestyle. Utilizing this model, it is important to assess the four elements; physical, self-concept, interdependence and role function, that can affect a person adapts ability to cope with their medical concerns (Faulkner, 2018a). Developing a customized care plan for this family includes looking at the goals and structuring interventions to address possible concerns and changes needed.
Application of Adaptive Model of Health
With the goals of being to improve Josh’s diabetes and Christine’s desire to lose weight, the nurse would customize a care plan for them including them being more physically active four to five times per week, eating a healthy diabetic diet consistently within the household and decreasing alcohol consumption to two nights per week. The plan would include assessing any stimuli that may decrease their chances of success. Physically they may be sore from becoming more active, their bowels may change with their improved diet, and they may not feel well for the first few days of not drinking consistently. Self-concept and interdependence are areas where they would need to communicate effectively with each other and Reese to allow for any concerns and for support while implementing the changes. Lastly addressing role function, ensuring that roles within their family specifically Josh trying to be the encouragement for being more active and Christine for taking on the nutrition within the home. It is very important that their roles within their family are acknowledged and understood which will then ensure positive health promotion.
Falkner, A. (2018a). Understanding families and health promotion. In Grand Canyon University (Ed.), Health promotion: Health & wellness across the continuum (Chapter 2). Retrieved from https://lc.gcumedia.com/nrs429vn/health-promotion-health-and-wellness-across-the-continuum/v1.1/#/chapter/2
Falkner, A. (2018b). Understanding families and health promotion. In Grand Canyon University (Ed.), Health promotion: Health & wellness across the continuum (Chapter 5). Retrieved from https://lc.gcumedia.com/nrs429vn/health-promotion-health-and-wellness-across-the-continuum/v1.1/#/chapter/5
Schroeder, K., Malone, S. K., McCabe, E., & Lipman, T. (2018). Addressing the Social Determinants of Health: A Call to Action for School Nurses. Journal of School Nursing, 34(3), 182–191. Retrieved from: https://doi-org.lopes.idm.oclc.org/10.1177/1059840517750733