Family Assessment

Posted: September 3rd, 2013

Family Assessment

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Family Assessment

Family assessment using the Friedman Family assessment model

The assessment model developed by Friedman is mainly an adaptation on the structure-function scaffold and developmental as system theory. The Friedman family assessment model approaches family assessment by perceiving the family as a subsystem of society. The model perceives the family as an open social system (Stanhope & Lancaster, 2008). This paper involves the assessment of the family of Mr. F. V using the Friedman family assessment model using at least three nursing diagnosis.
Identifying Data

Mr. F. V’s family resides in Mayfield Heights, Ohio. This is a two parent family where the forty eight year old Mr. F. V., is the husband and biological father, currently unemployed with Mrs. D. V., being his wife. She is also the biological mother to their son, Mr. J. V., who is currently away attending college. The wife is the only person who is working since the husband is unemployed. The couple also lives with Mrs. R.L., who is the biological mother to Mr. FV. Mr. FV., owns a vehicle but he is unable to drive it because he ails from shortness of breath. The wife is the one who drives albeit suffering from multiple sclerosis and is functional on most of the days of the week.

Developmental Stage and History of Family

Mr. F. V and his wife Mrs. D. V, are living parents to a single son Mr. J. V. Mr. F is close to his family and frequently interacts with them. He lives in the same building with his mother, Mrs. R.L, who is ailing from Rheumatoid arthritis. The developmental roles are mostly handled by the mother, R.L although she at times falls ill and lies in bed all day long. The current financial crisis that Mr. F is in due to his unemployment status renders him to feels as if he is in competition with the family and the society. He fails to provide to the family being the head of the family and the provision roles are left upon the wife.

Economic:

Mr. F is currently unemployed as his physical condition renders him unable to perform rigorous task. His attempts to acquire disability from social security are currently fruitless as he has been pursuing them for the last one year to no avail. The wife is disabled suffers from multiple sclerosis. His mother is also on Medicare but has access to pension from her deceased husband. She therefore uses these funds to pay the bills. She is also the owner of the home where the entire family resides.

priority family nursing diagnosis for this family.

Activity exercise pattern

Wellness diagnoses:      Ineffective breathing pattern. The nursing assessment identifies factors that may cause harm the husbands’ respiratory function. The client experiences a definite failure of sufficient ventilation caused by an altered breathing pattern. The client recounts of how he fell short of breath with the situation not changing even after sitting down. The client later attests of having a pressure pain in the middle of his chest. The defining characteristics for this diagnostic include shortness of breath and alteration in respiratory rate from baseline (Sateia, Doghramji, Hauri, & Morin, 2000).

The client runs the risk of activity intolerance. This is whereby the individual is at risk of having an occurrence of deprived psychological or physiological energy to tackle or endure the required daily activities.

Coping–Stress tolerance

Wellness diagnosis:       Readiness for enhanced family coping. The diagnosis of ineffective coping is based on the reversal of roles from provider to dependant as the client is currently jobless and depends on the wife for all the financial requirements. Further frustrations are added by the fact that he cannot access disability from social security and has been waiting for close to a year. Ineffective coping is indicated by disturbance in the pattern of tension release. The client suffers from uncertainty due to lack of sufficient recourses. There is the evidence of drugs and alcohol abuse involving smoking cannabis sativa. Client reports that the entire family fails to understand him. The risk factor involved with the diagnosis includes the risk of post trauma syndrome, risk of suicide, risk of self-directed violence and the risk of ineffective family coping (Sateia, Doghramji, Hauri, & Morin, 2000).

Nursing interventions to influence this issue in a positive way that involves the nursing role in working with families

The nursing interventions for respiratory wellness for Mr. F. V, involve inform the client on the need of implementing measures aimed at alleviating activity intolerance. These activities involve the engaging in activities that primarily promote the conservation of energy. The client is to uphold rigorous activity restrictions as advised, decrease the amount of environmental activity and noise, manage nursing care in relation to taking time intervals of uninterrupted rest and provide the client with the necessary assistance concerning self-care activities.

Additional opportunities for intervention that promote rest and conserve energy avoid situations of anxiety and avoid or minimize fear. The personal effects and supplies are to be kept within easy reach to minimize movement as possible. Sleep is encouraged through engaging in diversional activities during after hours. Normal sleeping hours are to be observed and a regular schedule put into place and adhered to. The individual is to be encouraged to take part in activities or actions that maintain an adequate cardiac output. The individual is to take part in an oxygen therapy. The daily activities are to be increased gradually in tolerable levels to coincide with the interventions aimed at promoting coping.

The client is instructed to report any case of decreased tolerance for activity. If the any of the prescribed activities causes any pain, the individual is instructed to cease immediately or if he suffers shortness of breath, dizziness or instances of intense fatigue and weakness.  The client is to make an appointment with a professional if he notices the persistence of some of the signs and symptoms of activity intolerance. The focus of teaching should be on protection from secondhand smoke and prevention of possible respiratory infections. Since the client smokes cannabis sativa, he ought to be taught on the relevance of smoking cessation. This is the most crucial intervention for respiratory wellness. These activities involve the engaging in activities that primarily promote the conservation of energy. The client is to uphold rigorous activity restrictions as advised, decrease the amount of environmental activity and noise, manage nursing care in relation to taking time intervals of uninterrupted rest and provide the client with the necessary assistance concerning self-care activities.

The necessary intervention is to provide a source of encouragement to the client and support, in evaluating lifestyle. Analyze effects on the future of both the client and the family (Sateia, Doghramji, Hauri, & Morin, 2000). This is mainly because transplant clients fail to conclusively analyze on the realistic extents of their conditions and do not realize the risks and benefits that come with transplantation. Research indicates that most individuals entering a transplant program find it difficult to adopt. The client may also be undergoing denial concerning the effects of the use of immunosuppressant drugs, biopsies and regular clinical visits (Deakin, McShane, Cade, & Williams, 2005).

The clinician is to monitor the probable risk of the client causing injury to self or others. This is because drugs and substance abuse highly results into suicide and homicide. The use of verbal and non-verbal therapeutic communication techniques that involve active listening, using empathy and understanding in encouraging the client to exercise freedom in expression in relaying negative feelings, concerns and fears. The exhibitions of possibilities of psychological coping can only be exhibited when the client indicates a framework of appraisal (Sateia, Doghramji, Hauri, & Morin, 2000).

The nurse is to collaborate with the client in finding his personal strengths. The identification of these strengths will enable the individual to gain value and beliefs in addition to enabling coordination of interventions to conform to the individual’s perception of threat (Ackley, & Ladwig, 2003). Another opportunity for intervention involves the addition and mobilization of support through the encouragement of the individual to undergo Oak and Acorn facility and enrolment in any of the available senior companion programs. The moral and peer support provided in these programs are pivotal in the support of coping in adults (Ackley, & Ladwig, 2003).

As an opportunity for intervention, the nurse is to offer the client instruction pertaining to the relevant coping strategies that may include engagement into physical activity to form as a distraction, deep breathing exercise and reminiscence. Available alternative coping strategies ought to be introduced to the individual as a choice of a new coping strategy. The nurse is to engage the individual in reminiscence. Reminisce is pivotal as an intervention to coping as it reduces the chances of depression and enables the individual to have positive memories and induce well-being.

References

Stanhope, M., & Lancaster, J. (2008). Population-centered health care in the community (7th ed.). St. Louis, MO: Mosby Elsevier.

Ackley, B. J., & Ladwig, G. B. (2003). Nursing Diagnosis Handbook: An Evidence-Based Guide to Planning Care (4^th ed.). St. Louis, MO: Mosby Elsevier.

Deakin, T. A., McShane, C. E., Cade, J. E., & Williams, R. (2005). Group based training for self-management strategies in people with type 2 diabetes mellitus. The Cochrane Collaboration. Hoboken, NJ: John Wiley and Sons, Ltd.

Sateia, M. J., Doghramji, K., Hauri, P. J., & Morin, C. M. (2000). Evaluation of chronic insomnia. An American Academy of Sleep Medicine review. Sleep , 23 (2), 243.