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Discussion #1 Anthony Pena
Assessment of Health Promotion: Case 1
- Do you think it is appropriate that J.R. is adapting his practice by incorporating traditional Indian healing practices along with Western medicine? Support your answer with evidence-based practice recommendations.
J.R. is a nurse practitioner in a clinic on a large, isolated Indian reservation. His patients and community have a disproportionately high rate of alcoholism and suicide. He believes the most important component of his job is to promote wellness among his clients. He does this by incorporating traditional Indian healing practices along with Western medicine. Dr. Madeleine Leininger, a well-known nursing theorist, developed the transcultural nursing theory that helps explain cultural competence (Červený et al., 2022). The decision that J.R. has taken to compare Indian cultural health practices with Western medicine is defined in nursing as cultural competence and sensitivity. Cultural competence requires healthcare providers, including nurse practitioners, to be aware of and appreciative of the values, beliefs, and practices of different cultural groups. The American Nurses Association reports that every nurse provider must practice cultural humility and inclusiveness. In addition, the nurse’s code of ethics recommends that a nurse be aware of their cultural identifications to avoid providing biased care to patients. I therefore believe that it is appropriate that J.R. is providing this type of care to his patients. because it helps decrease racial, economic, and social disparities in care. In addition, this strategy will help improve treatment adherence, patient satisfaction, and health outcomes for this population.
- An effective health assessment incorporates not only physiological parameters; please suggest other parameters that should be considered and included in health assessments to reach maximal health potential in individuals.
A health assessment is a structured collection of health information and analysis to develop an accurate diagnosis and treatment plan for the patient (Danielson et al., 2019). It helps health providers detect health conditions and abnormalities that can affect a person’s health. Apart from physiological parameters, other parameters should be considered and included in health assessments to reach maximal health potential in individuals. One parameter is a patient’s family medical history, as this helps to identify whether a patient is at increased risk of a disease. A person’s lifestyle, such as diet, exercise, and substance use, is an important parameter in a health assessment as it helps identify how a patient’s lifestyle choices are contributing to their health (Pessanha et al., 2022). Mental health is another important parameter in health assessment, as it helps determine the patient’s mental status and whether any mental conditions or factors are contributing to their health. Another parameter is a patient’s past medical history and chronic conditions. Apart from helping healthcare providers develop differential diagnoses, this parameter helps to assess any chronic or major illness-causing illness.
- Name the different family developmental stages and give examples of each one.
According to Duvall’s Family Development Theory, families tend to transition through life in a structured order across the lifespan (Pessanha et al., 2022). In theory, families move to the next stage after they have successfully mastered tasks at each stage. The first stage is the beginning of a family, where two individuals come together through marriage to begin a family but are not yet ready to have children. The tasks during this stage include establishing a satisfying home, their marriage, and preparing for childbirth. The next stage is childbearing, which involves the birth of a child and calls for adjustment to the increased family size. Additional tasks include caring for an infant and providing the infant with a supportive developmental environment. The family with preschoolers is the next stage, where the oldest child is between two and a half years and six. The tasks during this stage are catering to the needs of the preschooler, coping with the added demand and attention, and decreasing privacy at home.
The next stage is family with schoolchildren, with the oldest child being between six and 13 years old. The tasks include promoting and supporting academic achievements and striving to fit in with the rest of the community, including schoolchildren. Family with adolescents is the next stage, with the oldest child being between ages 13 and 20. The tasks of this stage include allowing and supporting these adolescents to become independent, coping with their independence, and developing new interests as a couple beyond childcare. The launch stage is the next step, which involves the oldest child leaving home to live an independent life and the youngest child doing the same. Tasks involving letting go of young adults into an independent life and maintaining a supportive home environment. The empty nest stage involves the time from the time the youngest child leaves home to the time the couple retires. Tasks include renewing and redefining their marriage relationship, adjusting to retirement, and maintaining ties with their children. The final stage, which is the aging family, includes the time from retirement to the death of the surviving couple. The task includes adjusting to the death of one partner and life alone.
- Describe family structure and function and the relationship with health care.
Family structure is defined as the configuration of people living together that make up a family (Michaelson et al., 2021). Most families consist of the traditional family structure of a father, mother, and children. However, over the years, the diversity of the family structure has increased to include a single-parent structure where children are raised by one parent, a sexual minority family structure where children are raised by people of the same sex, and adoption, whereby a couple decides to adopt a child. Family function, on the other hand, is the social and structural concept of the family environment. This means the interactions and relationships within the family. These two concepts are connected to healthcare in that a family serves as a support system for its members, which can be beneficial as they can provide support to members to seek medical help, adhere to treatment plans, and live healthy lives. In addition, the family plays an important role in decision-making. This means they are involved in many of the decisions, including health care. As such, family function and structure can influence the type of treatment sought, end-of-life decisions, and other healthcare decisions.
Discussion #2 Leslie Perez
Case Study 2
P.Q. is a nurse practitioner in a rural, agricultural community. The community is populated mostly by the Hispanic families that work in the fields. Many of the families are migrant workers. They stay in his community during the planting and harvesting seasons and then migrate back to Mexico or to other communities where they can find work.
Many of the families that he helps are struggling to stay together. Many parents must leave their young children behind in Mexico. Husbands and wives are separated frequently, putting additional stress on the family system. As a child of migrant farm workers, P.Q. understands their predicament first-hand and is able to assist the families he serves with viable health-promotion plans.
P.Q. uses the following five measures of family functioning to determine the effectiveness of interventions:
- changes in interaction patterns
- effective communication
- ability to express emotions
- responsiveness to needs of members as individuals
- problem-solving ability
Define each one and give clinical examples.
The observation of changes in interaction patterns involves analyzing how those migrants interact with their distant family members and then discovering specific patterns in those interactions (Puffer et al., 2020). For instance, if a migrant father is interested in sports and primarily uses that during his interactions with his isolated son, P.Q. can use that aspect while handling him.
With concern to effective communication, this measure focuses on assessing how effective is the communication of migrant workers with their remote family members. When they are able to openly communicate their physical and mental state to their dependents, the healthcare interventions of P.Q. can be successful.
Measuring the ability to express emotions evaluates how those migrant workers can express their emotions to family members and how effectively all of them handle each other’s emotions. If P.Q. correctly measures this aspect, he can constructively handle workers experiencing emotional breakdowns with the support of their family members.
When evaluating the responsiveness to the needs of members as individuals, one should consider the fact that when providing healthcare to a sizable community, it is necessary to adopt a personalized approach to fulfill the needs of members. Similarly, P.Q. has to understand the condition of each member and accordingly customize the interventions.
Finally, measuring the family’s problem-solving ability includes evaluating how migrant workers and their family members find solutions to their health problems. When they collaboratively, efficiently, and empathetically manage the problems, the interventions can be successful.
An effective health assessment incorporates not only physiological parameters; please suggest other parameters that should be considered and included on health assessments to reach maximal health potential on individuals.
In addition to physiological parameters, social status and educational qualifications should also be considered. When individuals’ social status, particularly their lifestyle, profession, and social interactions, are focused and included during health assessment, customized interventions can be provided and their fullest health potential can be achieved. Similarly, including their educational levels can enable healthcare personnel, especially P.Q., to personalize the healthcare interventions. For instance, they should provide more awareness to individuals with basic or no education.
Name the different family developmental stages and give examples of each one.
To begin, during the couple stage, two individuals agree to live together, perhaps by becoming a married couple. As they consistently discover ways to understand each other’s expectations, they also comprehend their health statuses and requirements. Transitioning into the childbearing stage, the couple would expand their family by giving birth to children. During this stage, they not only identify their parental responsibilities, but also the healthcare needs of their new additions. As the children grow and begin to go to school, the parent’s responsibilities will become more diverse in this stage. The children’s new environments can lead to different healthcare necessities, and the parents have to be prepared to handle them.
As a family with adolescents, communication becomes more open as the teenagers face more mature topics, such as sexuality, substance use, diet, and exercise in this stage. It is important to adequately seek counsel to support adolescents through this transition from childhood into adulthood. Becoming a family with young or middle-aged adults also means the parents are moving on into more mature care themselves, such as having to manage chronic conditions and transitioning into menopause, for example. The focus begins to shift back to the parents from the children in this stage. In the final stage, a family with older adults can benefit from counseling regarding nursing home care, social activities, and nutrition. This is also when bereavement counseling takes place.
Describe family structure and function and the relationship with health care.
Family structure is the different ways in which each family is composed of a variation of members. For instance, a family unit consisting of only biological parents and children are a nuclear family. Additionally, a family unit comprising of just one parent and their children is referred to as a single-parent family. Additionally there are blended families, in which the couple incorporates children from another relationship (Grüning Parache et al., 2023). According to various studies, the family structure determines the outcomes of health status and healthcare interventions. For instance, children from single-parent families struggle with more behavioral disorders and have difficulty following healthcare interventions compared with children from traditional families (Grüning Parache et al., 2023). Hence, family structure is associated with healthcare outcomes.