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High-Risk Family Assessment and Health Promotion
Nursing 542
Anitra Wilson
Professor Brown
June 4, 2015

Introduction
In the nursing practice, the family assessment provides an important element to the health care team with an overview of the patient and the family's health. This assessment is a very critical part of the nursing process, due to the fact that diseases and certain conditions can impact the family as a solid unit, it is imperative that the nurse be able to identify the effects that substance abuse can have on both the patient and their family members. Families that suffer from drug addiction are labeled high-risk and require unique nursing interventions. The purpose of this paper is to address substance abuse and how it affects the family as a solid unit, along with the nursing measures used to assist the both patient and family with coping with this condition. Surprisingly, over the years the number of adolescents that abuse substances has increased drastically. Substance abuse is a condition that continues to affect millions of families worldwide. This condition affects all people regardless of race, sex or religion. Substance abuse is the abuse of legal or illegal substances. The most used substances used by adolescents are amphetamines, opiates, alcohol, marijuana, prescription medications, cocaine, and hallucinogens. Substance abuse can cause adolescents to stop attending school, participate in unsafe situations, legal issues, and health problems and affects relationships with friends and family members. A few examples of behaviors displayed due to substance abuse are as follows: lying, avoiding family members, lack of participation or interest in activities they used to enjoy, getting in trouble at school are with the law, missing school, depression or suicidal ideation. Research has been conducted to determine if the family and the home environment has an effect on adolescents and substance abuse.

Assessment of the family A thorough family assessment should be conducted to help identify the possible causes for substance abuse. Changes in family structure can affect the family’s ability to carry out family functions. How families are organized can determine what interventions can be used to achieve desired outcomes. The adolescent years can be very confusing for some. Any changes within the family unit may cause stress and delays in certain developmental areas. As a result of the family unit being responsible for majority of the adolescent’s socialization and teaching them how to become productive adults, health care treatment is directed towards the family to help prevent this condition. Some adolescents believe that abusing substances help them cope or deal with their stress or problems, increase their self –esteem and makes them fit in with their peers. Nursing staff need to remain nonjudgmental and empathetic when caring for this family. During the family assessment, the nurse may inquire as to how the family is dealing with their loved one's drug use, how they are coping, and how their family has been affected. It is important for nursing to assess what the illness means to the family and how it has affected the family structure and function. Most importantly, the nurse should strive to gain the patient's perception of the situation and how they feel about their family member's participation in their care. “While the nurse is working with families, he or she must also have the ability to “stand back” and observe the conditions and situations existing tin the home and in the “dance” between family members (i.e., their interactive patterns)” (Friedman et al., 2003). Readiness for change should also be determined. During the family assessment, the nurse should assess the family support system and how they are coping with the situation, family history of substance abuse, recent family changes, abuse and other factors that may influence the adolescent’s behavior.
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