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Introduction
Family health assessment is a useful tool applied by healthcare practitioners. Diverse health issues including acute or chronic diseases influence both the patient and his or her family. A healthcare practitioner needs professional skills and knowledge to provide health assessment evaluating health condition of family members and detecting possible changes (Dains, Baumann, & Scheibel, 2015). One of the productive ways to complete family health assessment is a therapeutic conversation (Persson & Benzeln, 2014).
Wright and Leahey (2013) introduce the Calgary Family Assessment Model (CFAM) which is defined as an integrated, multidimensional framework based on the foundations of systems, cybernetics, communication, and change theory and influenced by postmodernism and biology of cognition (p. 47). The model consists of categories such as structural, developmental, and functional; and subcategories which determine the course of assessment. Practitioner decides on the choice of subcategories that are most beneficial for the assessment purposes ( How to apply the CFAM to clinical practice, n.d.). Consequently, this assessment was conducted on the basis of CFAM guidelines and subcategories were selected to reflect the peculiarities of the assessed family.
Family Structure
Extended Family
The interviewed family which is traditional. There are five members of the family living together. The husband is 52 years old. He is a top-manager in a retail company and spends most of his time at work. His father, who is 74, lives with them. He is retired but still active and three times a week volunteers in the community center.
The wife is 50. She is a veterinary but she does not work in a clinic. She runs a pet shop and has a veterinary office there. There are two children in the family. The elder daughter is 26. She is a student at a medical university and will become a surgeon when she graduates. She works part time in the hospital. The younger son is 18. He is a college student. At weekends, he works in the delivery service of the local restaurant. Both children frequently help their mother in the shop.
Medical History of Family Members
Health assessment comprises current complaints and present illnesses of patients as well as the past history and family history (Bickey, 2013). The father has been recently diagnosed with hypertension. He has been having severe headaches and the examination showed an increase in blood pressure. He was prescribed a therapy to control BP and was advised to change work load. After taking medicine and reducing extra hours at work he feels better and his BP is within normal limits. The wife does not demonstrate any serious health problems.
The two pregnancies she had resulted in Caesarean delivery. She is allergic to seafood. The grandfather feels good for his age. The age changes are normal and does not influence his activity. He has had diabetes for 20 years, but he manages it well and the chronic disease does not influence his life quality. He regularly checks blood glucose, takes supportive therapy, and follows the prescribed diet. The daughter is generally healthy. She has shortsightedness that developed at the age of 7, so she has to wear glasses. She plans to have a laser eye surgery this year. The son had scoliosis in primary school, but regular exercises eliminated the problem and he does not have any complaints at present. As children, they both had chicken pox.
Sexual Orientation
The family members are not and were not previously involved in homosexual relations. Thee all report to be heterosexual.
Ethnicity and Race
The family is American. They all were born in the United States except for grandfather who came back to America at the age of six from Cuba where his parents worked. They all are white.
Social Class
The interviewed family belongs to upper-middle class. The father works in top management of a big company, and the mothers pet shop brings sustainable profit because it is the only shop with a veterinary service in the area. Three years ago, the family moved to a bigger house in a more fashionable district which is more convenient for all family members. Father, mother, and a daughter have their own cars while son prefers riding a bicycle. They prefer travelling around the country, but once a year they fly to an exotic country.
Religion and Spirituality
All family members except for the son are religious but not fanatic. They are Baptists and visit the local church on Sundays almost every week. The older generation believes that their faith is a great support in complicated life situations and they can come to a priest with any worry to find an answer.
Environment
This family lives in a favorable peaceful environment. Their new house is located in a nice silent street. On the whole, the community they live in is cleverly planned with good access to the necessary facilities. Public transportation is not very developed, but the family owns three cars and it is not a problem. The only negative feature of this area is that it is detached from the city center.
Family Developmental Stage
Stage of the Family Life Cycle
The interviewed family is on the stage 5 of the family life cycle. This stage is launching children and moving on, and the children in this family will soon live separately (Wright & Leahey, 2013). Although both children still live with the parents, the daughter is going to live separately after she graduates and finds a job. The son is likely to live with parents at least till the end of his college.
Appropriateness of Developmental Tasks
One of the developmental tasks suitable for this family at their developmental stage is Development of adultadult relationships between grown children and their parents (Wright & Leahey, 2013, p. 101). Adult-adult relationships in this family are developing successfully. Both children demonstrate certain maturity in making decisions about their life. Moreover, they combine work and studies to achieve some financial independence. Still, the task is in progress and will be completed after both children start their independent life separately from parents.
Genogram
Genogram is a scheme that allows to review family relations in more detail and analyze the births, deaths, marriages and other significant family events. It has a definite structure and is, in fact, a graphic picture of family life including all its members (Deena, 2013). The genogram of the interviewed family is presented in figure 1. It depicts family connections starting from grandparents. Also, it reflects the attachment bonds in the family under analysis. As it can be seen, there are strong attachment bonds between the parents and their children.
Family Functional Status
Functional status of the family comprises some communication and interaction peculiarities. It is also influenced by the approaches to problem solving that are accepted in the family. Finally, functional status includes family considerations about life, health and illness.
Family Communication
Wright and Leahey (2013) single out such aspects of the family communication as emotional, verbal, and nonverbal. The assessment in the process of the interview revealed that fact that this family is emotional. All family members are free to express their feelings and emotions. It is a good sign because such openness allows to share not only positive but also negative emotions and stimulates family interaction in finding solutions. One of the bright impressions is the sense of humor that is a family feature. Verbal communication is widely used by all family members. It is mainly oral. The family members communicate at home or on the phone if they are away during the day.
Also, they have a board with chalk on their refrigerator for written messages. It is used both for memos and for sentimental messages. The assessment allows to make a conclusion that the family has a variety of topics to discuss. They are equally interested in grandfathers community affairs, mothers pet shop, or studies of the younger generation. The children admitted that they can come to any of adults in case they need an advice or have a problem. Non-verbal communication is another feature of this family. They have a certain system of secret signs they can use to understand each other. It is another proof of close relations and mutual understanding within a family.
Solving Problems in the Family
Every family faces certain problems at different stages of its development and problem-solving skills are important to find the best solution. The assessed family demonstrates that a problem of one member becomes a concern of the others. It is evident from their attitude to the members who have chronic diseases. For example, the whole family follows a healthy diet with less sugar and fats to support father and grandfather. Also, when the father was diagnosed with hypertension, the children started a tradition to spend at least one evening a week with him to prevent him from working extra hours. On the whole, the family demonstrates pro-active problem-solving model. As the oldest family member, grandfather usually has the main authority. Still, the decisions are made after the discussion with all members and they all have the roles of advisors in this process. In case of necessity, a third party is involved. For example, when health issues are touched, the family would consult a healthcare professional.
Beliefs about Life and Illnesses
Family beliefs are frequently decisive for the behavior of the family members in diverse conditions. The assessment shows that the family beliefs are sound and based on logics. The religion does not have a significant impact on their beliefs about treatment. The family is partially influenced by the elder daughter who is studying to become a doctor, so all health-related problems are solved with specialists after thorough examination and necessary tests. The family believes that their health and overall quality of life depend on the lifestyles and try to make it as healthy as possible.
References
Bickey, L.S. (2013). Bates guide to physical examination and history taking (11th ed.). Philadelphia, PA: Lippincott Williams and Wilkins.
Dains, J.E., Baumann, L.C., & Scheibel, P. (2015). Advanced health assessment and clinical diagnosis in primary care (5th ed.). St. Louis, MO: Elsevier Mosby.
Deena, S. (2013). Genogram instructions marriage and family [Video file]. Web.
How to apply the CFAM to clinical practice. (n.d.). Web.
Persson, C., & Benzeln, E. (2014). Family health conversations: How do they support health? Nursing Health Research and Practice, 1-11. Web.
Wright, L.M., & Leahey, M. (2013). Nurses and families. A guide to family assessment and intervention. Philadelphia, PA: F.A. Davis and Company.
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