Family Health Assessment: Example of Case Study

Introduction

Community health nurse is a very important component I the community which the nurse shares the knowledge and the awareness to the community. According to NCBI (2013) “Community nurse is aimed to transgression in practice of education and care, the respect for human dignity, the bonds among values and practices of the community and the physical health of individuals”. This family health assessment example is reflected on the community as it purpose is to determine the clients and family needs, and to clarify and determine the needed interventions to improve the health stats of the family.

General Client Profile

A.H.I is 61 years old, Bahraini male, Muslim, married since 35 years, he is a retired and was working in Asry, known case of diabetes type 2 and sickle cell trait, lives in Bani Jamrah with his wife and 1 son, the family members included 3 daughters which all of them are married, the oldest one is 28, and the other 2 daughters are twins which are 26 years old and finally comes the son and he is 21 years old, the son is studying in university of Bahrain while the daughters are house wife’s. Mr. A.H.I had diabetes more than 20 years, he checks his sugar level every 3 months in the budaiya health center regularly and takes his medicines regularly.

Community Details

Mr. A.H.I home is in Bani Jamrah which takes about 5 minutes to reach budaiya health center by car with a distance approximately 650m. This health center provides health services for all people in that specific area. However, this health center considers a type “B” health center because it has all the facilities except physiotherapy which only found in type “A” health center. Moreover, this health center has different clinics which are non-communicable disease clinic (NCD), diabetic clinic, dental clinic and child and mother`s care clinic. The only environmental hazard in that area is that the roads are narrow and high chance for accidents to happen.

Community Facilities

Mr. A.H.I home is in a residential area where most of the facilities are available. There are many supermarkets which Mr. A.H.I and his family can buy their needs from it. Also, about 4-6 mosques available in that area. Moreover, health center, schools, a place to walk in, gardens, and all kind of shops are available near Mr. A.H.I home. Mr. A.H.I is very aware of the resources that the community provides in it and he has access to all of them and use most of them.

Family Assessment

Type of family:

Mr. A.H.I family is considered as nuclear family which consists of Mr. A.H.I wife and his son. Mr. A.H.I daughters live with their husbands in Bahrain, the oldest is 28 years old while the other two are twins which are 26 years old, the son is 21 years old the daughters are house wife’s while the son is studying in university of Bahrain.

Socioeconomic status:

Mr. is retired he gains around 800 BD per month and his wife is not working. Mr. A.H.I explained that this income is enough and adequate for him and his family.

Roles of family members and communication with them:

There is no specific role for each one in Mr. A.H.I family, they share all the responsibilities whenever anyone can, but mainly Mr. A.H.I buys the food and all the needs for the house and the family while his wife does the house job which is cleaning and cooking, while the son is helping them in all these things. The daughters do not have any roles in the house, but they have good communication with Mr. A.H.I and his family. Finally, all the family members have strong relationship and communication with each other

Genogram:

According to the genogram, Mr. A.H.I wife is known case of HTN, cholesterol and diabetes, while Mr. A.H.I father died because of normal death while his mother died because of diabetes, he is the only son for them and does not have any sisters or brothers. In which Mr. A.H.I is known case of diabetes type 2 and has sickle cell trait. Mr. A.H.I family has some disease which may pass to other family members like sickle cell trait.

Individual health needs:

Mr. A.H.I is known case of diabetes type 2 and sickle cell trait, which he is on metformin 2 tabs daily, empagliflozin 25mg 1 tab daily, ASA 81mg 1 tab daily, and gliclazide 60mg 2 tabs daily, as for his wife she is taking concor 1 tab daily, lipitor 1 tab daily before sleep and metformin 2 tabs daily. Prior to Mr. A.H.I problem I chose to do physical examination for the neurologic system and cardiovascular system.

• General appearance: conscious, oriented to time, place, and person, looks fresh and normal, facial expression normal and comfortable, no signs for dehydration or fatigue.
• V/S: temperature: 36.9C, pulse: 91 beet/min, respiration: 16/ min and blood pressure: 118/79 mmhg.
• Weight and height: Mr. A.H.I weight is 59KG and his height is 171
• Neurologic system examination:
• Inspection: Mr. A.H.I can walk straight and stay balanced in the third walk, straight on his toes, on the heels. Planter flexion and dorsiflexion are strong to permit this.
• The Romberg test: Client can maintain posture and balance.
• Rapid Alternating Movements: Pat the knee with both hands: Done with equal turning and quick rhythmic pace,
• Thumb to each finger: Done quickly and accurately.
• Finger to finger test: Client movement was smooth and accurate.
• Finger to nose test: Accurate with smooth movement.

Family Needs

Family values, norms, culture:

Sometimes Mr. A.H.I family does not use medicines to cure the disease or remove the pain, they use traditional ways to treat it, for examples drinking Marqadoosh to removes stomach pain. Also, the family would use over the counter medications.

Coping of individual members:

Mr. A.H.I is retired and he was used to work daily from 6 AM until 4 PM and when he retired he was bored had nothing to do, but gradually he was trying some new hobbies to get used in this new lifestyle.

Relationship with others and caring (siblings, spouse, parents):

Mr. A.H.I said that he has a strong relationship with his family so almost every day his daughters come to his house and gather up, but since of the current circumstances they does not come.

Psychological, emotional, and spiritual needs:

Mr. A.H.I stated that he gets his psychological and emotional needs from his wife, and from his friends, while the spiritual needs get it from praying. Since the family is Muslims, Mr. A.H.I daily goes to the mosque and attends any prayers activities in the neighborhood and helps in any spiritual community activities.

Family's social support in relation to client health condition (such as friends, relatives, religions organizations, neighbors):

Mr. A.H.I always reminds him to take his medicines regularly and to check his V/S daily, also his wife checks her sugar level with him daily since she has diabetes too and also to support him.

Family Health Practices

Nutrition:

Mr. A.H.I and his family eat 3 meals daily, but for Me. A.H.I is following low sugar and carbohydrates diet while his wife eats normal diet as well as his son and he only eats something with sugar or high in carbohydrates when there is a family gathering and he eats minimum amount of it.

Hygiene:

As for the hygiene Mr. A.H.I stated that he and his family members showers 2 times daily and whenever he goes outside and comeback, he takes a shower.

Physical activity of family members:

Mr. A.H.I stated that every day he and his wife go to the beach and walk their for about an hour and then come back while his used to go the gym but because of the corona virus he is not able to go so he enjoys running in the neighborhood.

Sleep pattern:

Mr. A.H.I sleeps from 10-11 pm and wakes up at 8 am, sometimes he sleeps at 12 or 1 if there was any business he needs to attend to or do.

Preventive health care practices including health screening:

Mr. A.H.I checks his blood sugar regularly and go to the appointments regularly and when he feels pain or any serious problem he goes to the hospital, also he takes his medication regularly with missing a dose. Unhealthy practices among family members: Mr. A.H.I and his family are not smokers. on the other hand, when his wife is going to prepare food sometimes, she uses a lot of oil and fat in that food.

Family Care Plan

In short term Mr. A.H.I and his family will verbalize the importance of eating healthy food. In long term: Mr. A.H.I and his family will design a dietary modification to meet individual long-term goal of weight control, using principles of variety, balance, and moderation. Moreover, there is a need to: 

• Set appropriate short-term and long-term goals for the family.
• Negotiate with the family regarding the aspects of their diet that will need to be modified.
• Encourage water intake.
• Advise the family to measure food regularly.
• Educate the family about adequate nutritional intake. A total plan permits occasional treats.
• Allow and encourage the family to adopt an exercise routine that involves 45 minutes of exercise five times per week.

Recommendation For the Remaining Health Problems

My recommendation for Mr. A.H.I is to rather than eliminating all the carbs, just following a low carb diet which should include nutrient dense and high fiber carb sources like vegetables, also intake of 20-90 grams of carbohydrates per day is effective in improving the blood sugar and not losing weight. My recommendation to Mr. A.H.I and his family to do checkups, because as the human growth the risk increases for having a disease, and its free, no payment requires to do checkups, and if these checkups can help Mr. A.H.I and his family to discover if there is any disease so it can be treated well.

Conclusion

In conclusion, Mr. A.H.I is 61 years old diagnosed with diabetes type 2 and have sickle cell trait, lives with his wife and son in Bani Jamrah, Budaiya Health Center is almost 5-10 min away from him, have all the resources for him and his family, has 3 daughter and all of them are married. moreover, I talked and explained everything about Mr. A.H.I and his family life and what are the problems for him and his family and mentioned my recommendation to him.

References

• Ana Muntean, R., 2020. The Role of The Community Nurse in Promoting Health and Human Dignity-Narrative Review Article. [online] PubMed Central (PMC). Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4436534/