Case situation #1
1) It is important for nurses to integrate conceptual theoretical framework when working with families because it enhances and expand the nurse’s knowledge, it helps understand family structure, function and processes. It prepares the nurses to think critically about how to intervene and provide the best possible support to the family. In this case scenario, John’s diagnosis has an impact on all family members, therefore helping the nurse to construct possible interventions in how to help the family deals with this new diagnosis so that they don’t become dysfunctional. According to Hanson, “by integrating several theories nurses acquire different ways to conceptualize problems thus enhancing the possibilities of successful intervention” resulting in promoting health and wellness.
1b) the three concepts fro systems/ communication theory that may help guide my understanding of this family are:
a) Concept 1: a family system is a part of a larger suprasystem and is composed of many subsystems.
b) Concept 2: the family as a whole is greater than the sum of its parts.
c) Concept 3: a change in one family member affects all family members. (In this case scenario, it is John’s diagnosis).
Using the CFAM, the areas of the functional assessment that I would plan to explore are: a) instrumental: how does John get through his activities of daily living such as eating? Since he is a diabetic his nutritional needs need to be discussed, his adherence to this 2300 cal ADA diet. Blood glucose monitoring; assess level of compliance, regular exercise program, self insulin administration. His physical status, does he looks his stated age?
b) Expressive functioning: aa) emotional communication: since John‘s diagnosis affect him emotionally and result in him withdrawing from his usual activities, it is important to assess emotional communication, assess John‘s feeling about his diagnosis is very important. Also considering his age group it is important to assess how he feels compare to other children of his age. The mother’s emotions should be addressed based on her concerns about her son’s behavior change. Also the fact that the grandparents rely on both Nancy and Brian for emotional and physical support is a lot of stressors for this family. bb) non-verbal communication: paying special attention to Nancy’s body posture, eye contact facial expression, gestures. cc) Problem solving is another area that needs to be assessed. Since the mother has identified John’s problems, what are her solutions to these problems? How would the family help John cope with his diagnosis? How about Patty‘s feeling about mom and dad all focused on John. Would the mother change her job status to part time or the father? What percent of time would be devoted to care for the children?
3) The stage of development that I expect for this family as well as the chief tasks the family would be expected to accomplish:
d) Stage III: families with young children. aa) Task: joiningin child rearing, financial and household tasks.
In this case scenario both parents work full time, who prepares meals and when. Who supervise John’s eating habits to help him maintain his 2300 calorie ADA diet. Who take care and supervise Patty? Who helps Patty with her homework? If John’s insurance does not pay full price for his insulin how much money does the family have to contribute on insulin and blood glucose monitoring.
This diagnosis has an impact on the developmental needs of the family: It impacts their financial needs, emotional and physical needs. It might require that one of them stop working full time and spend more time with John, give him the emotional support needed, help him cope with the diagnosis, teach him healthy eating habits. Their budget will be increased, based on the fact that John may or may not have full insurance coverage for his medicines. Remember the parents are middle- income, therefore money is an issue here and need to be addressed.
Case