Introduction
With the various changes witnessed in the society’s demographic structure and delivery of the healthcare services, the nursing profession is largely recognizing the importance of the family in regard to the wellbeing as well as the health of individuals and families. Essentially, nursing practice involves caring for individuals as well as families whereby this requires nurses to have the relevant skills and knowledge to enable them work with families and foster healthy choices among individuals and families (Carlson & Carlson, 2014).
As such, in order to establish healthy and collaborative relationships and foster the involvement of families in their care, nurses are embracing the need to acquire the required and necessary additional skills, knowledge and support to enable them assist families with addressing their health problems as well as improve their wellbeing. Currently, most of the families have better knowledge and understanding in regard to illness and health and desire to participate in their health matters though interactions with the healthcare professionals. Thus, it is essential for nurses to acquire the required competencies and knowledge to enable them provide the appropriate care individuals and families and assists them to adopt healthy choices (Duhamel et al., 2015).
The Calgary Family Assessment model (CFAM) is one of the most essential tools in nursing that provides nurses with the appropriate framework to carry out family assessments (Wright & Leahey, 2012). In regard to this, CFAM assists nurses with collecting the relevant information through family assessment whereby this information guides and helps nurses with developing interventions that can be used in effectively addressing specific health issues within the family (Bickley & Szilagyi, 2012). Basically, CFAM comprises of three main categories (i.e. structural, functional and development) whereby these categories comprises of other subcategories. As such, this paper will focus on demonstrating the assessment of the family of a woman suffering from COPD using the CFAM (Calgary Family Assessment model).
Family composition
The JM family is a nuclear family that comprises of JM the mother aged 37 years, her husband PK aged 39 years and their three children. Their children include; TD a 15 year old daughter, BS a 12 year old boy and CK their last daughter aged 3 years. The couple has been married for about 17 years and they are in a heterosexual, monogamous relationship. In addition, the family is Hispanic and considers themselves as “upper-middle class”. All of their children are in school and they reside at home, thus they depend on their parents for their basic needs. TD the oldest child is in high school while both BS and CK are in primary school. Moreover, it is quite apparent that JM’s family has an excellent life and both parents can adequately meet their basic and financial needs as well as the children’s needs. In regard to employment, JM is a lawyer while her husband works as a university lecturer, thus they have a decent pay that can adequately meet their needs. On the other hand, the family has comprehensive health insurance cover meant for the whole family. The family lives in a large house and have a dog that they are strongly attached to since they consider the dog to be part of their household. In relation to what comprises her family, JM stated that her family comprises of her husband, three children and herself.
In addition, she stated that they have a very close relationship with their extended family and later got married. JM grew up in New York while her husband grew up in New Jersey though they met at the university. Currently, the live and work in the same area in New Jersey. JM parents and siblings live in New York while her husband’s parents and most of his siblings live in New Jersey. Both JM and her husband visit their parents as well as their siblings several times every month and thus they maintain a close relationship with their parents as well as siblings.
In regard to their extended families, JM and her husband’s extended families comprises of four generations. JM’s parents are alive and live in New York, her parents have raised five children with JM as one of them and all her siblings have their own families. JM’s parents received university education where her father worked as a banker while her mother worked as a pharmacist though currently they are retired and spend most of their time at home or with friends. All of her siblings have university education and have decent careers and they visit each other as well as their parents quite often especially during holidays. In relation to her grandparents, most of her grandparents are alive while some are deceased. On the other hand, her husband’s parents are alive and live in New Jersey though they are fairly healthy and thus her husband visits them regularly to check on their progress. Her husband is the third among six siblings. Her husband’s parents had college education where both of them previously worked as teachers. In regard to his husband’s grandparents, his maternal grandmother is the only surviving grandparent while the others are deceased. All of her husband’s siblings have their own families and live in different parts of the United States though they visit each other when possible and maintain a close relationship.
In relation to medical history, JM suffers from COPD that developed from her smoking habit since she was sixteen years old. She stated that she manages her condition through the use of medications, exercises and is currently trying to quit smoking though she admits that it is quite challenging to her to quit the habit and states that she has managed to reduce her level of smoking from two packets a day to one packet and hopes to eventually quit the habit. Apart from COPD, JM has no medical history of any other illness unless the occasional common illnesses such as common cold. Her parents are in fairly good health. JM’s mother is in good health has no medical history apart from the occasional common illnesses. However, JM’s father was diagnosed with hypertension about years ago but he effectively manages his condition through regular exercises and maintaining a healthy diet. In addition, JM’s paternal grandmother was also diagnosed with the hypertension about seven years ago and manages the condition through medications and healthy eating. Her paternal grandfather died of lung cancer five years ago while her maternal grandmother succumbed to heart attack. On the other hand, her husband is in good health and has no medical history apart from the occasional common illnesses such as tonsillitis, common colds and acute bronchitis. Her husband’s parents are fairly healthy and suffer from various illnesses and have a family physician who is involved in managing most of their health issues. PK’s father was diagnosed with diabetes five years ago and manages the condition through healthy eating, physical exercises and medications while his mother suffers from hypertension that she manages through healthy eating. Her husband’s surviving grandparents are fairly healthy, his paternal grandmother suffers from diabetes and last year she underwent surgery due to colon cancer and uses various medications whereby this has affected her health and engagement in daily activities. His maternal grandfather died three years ago as a result of cardiopulmonary attack while his paternal grandmother father died of liver cirrhosis five years ago. Although, most of their extended families members do not smoke, a significant number of the family members consume alcohol. In relation to sexual orientation, JM is in a heterosexual monogamous relationship with her husband and describes her siblings and as heterosexual. Nonetheless, she stated that they generally accept individuals from all the sexual orientations.
The generation of JM’s family are basically natives in the United States and thus they are identified as Hispanics. Moreover, JM was brought up and exposed to various ethnicities and interacted with individuals from different ethnic and racial affiliations, thus she embraces people from different backgrounds. Religion is one of the most essential aspects in JM’s family and the family identifies themselves as Catholic. Furthermore, religion influences most aspects concerning their daily life such as praying and saying grace during meal times and helps in shaping various family dynamics. The family attends masses weekly and abides by all the Roman Catholic doctrines.
In regard to environment, JM grew up in a comfortable home within a very secure neighborhood. The family currently lives in a large house in a safe neighborhood that has all the necessary amenities such as adequate water supply. Her children have many friends with the neighborhood they go to the same schools and her family considers their neighbors to be nice people and interact well with them.
Developmental stage
Basically, JM’s family is in the third as well as fourth developmental stages simultaneously. On the light of this, JM’s family is in the third stage of development (i.e. family with adolescents) since they have a fifteen year old daughter as well as a twelve year old son whom are adolescents and live with the family at home. During this stage, teenagers usually desire to be more independent, thus their teenage children want to be more independent especially her older daughter who is usually involved with her friends. Due to this fact, their older daughter is usually in conflicts with her parents especially her mother. Nonetheless, JM emphasizes that honesty as well as open communication among the family members has enabled them to have a healthy and trusting relationship. Additionally, the family is in the third stage of development (family with young children) since their last daughter is still a child aged three years. The key task in the fourth stage of development has been development of a healthy relationship between the parents and the teenagers fostered trough honest, open communication as well as trust.
Functional status
Functioning is among the key essential aspects in a family and refers to the routine activities involving their daily lives and basically comprises of two components (i.e. instrumental and expressive functioning). In regard to instrumental functioning, JM is involved in most of the household chores and ensures that hey children are prepared early for school by ensuring that they have breakfast on time. In addition, JM prepares all the meals though she is helped by her older daughter especially during the weekends. JM also engages in regular exercise and takes a forty minutes’ walk within the neighborhood every day whereby this has enable her to maintain a healthy weight. Moreover, her husband also engages in regular exercise and participates in various sporting activities. Her older children usually assist in running various errands in the house such as cleaning the house. However, most of their evenings are spent doing homework but JM ensures that they go to bed early in order for them to get adequate sleep. In relation to expressive functioning, the family embraces open communication especially in expressing their emotions and opinions. JM discourages verbal attacks from the children and encourages them to directly communicate with each other when expressing their emotions as well as feelings.
In regard to problem solving, JM and her husband usually discuss pertinent issues affecting the family whereby this enables them to come up suitable solutions and avoid conflicts. JM husband is the authoritative figure in the family and is involved in all the crucial decision making processes. In addition, JM’s husband usually sets rules to be followed by the family and both JM and her husband work closely to ensure that their children abide by the set rules and administer punishments when necessary. Apparently, most of the family roles are well established whereby both JM and her husband are they key sources of income within the family. As such, most of the financial decisions involving the family are usually discussed among the two parents. However, JM is involved in most of the household chores such as cooking and ensures that their children’s needs are adequate met. In relation to influence and power, JM’s husband is the key decision maker in the family through he usually consults his wife on various issues such as financial decisions. Both JM and her husband work together to ensure that the household rules are strictly followed by the children and openly communicate with their children about their expectations. Moreover, JM’s older daughter is the siblings’ role model and usually behaves in an exemplary manner so as to foster good behavior among the other children. Furthermore, JM’s older daughter is authoritative over her other children though on a lesser scale as compared to her parents and she ensures that they complete various tasks assigned to them.
JM’s family believes that health is not limited to the absence of diseases as well as illnesses but rather includes various aspects such as the mind and the soul. In regard to this, the family utilizes various approaches in dealing with emotions as well as feelings. Additionally, the family participates in regular physical activities and adopts healthy eating habits whereby this enables them to maintain a healthy lifestyle. However, most of the family beliefs are greatly influenced by religion and the family upholds high moral values grounded on the Catholic faith. In the light of this, the family abides by the catholic doctrines and most of their acts are tied to the catholic faith. For instance, the family does not consume meat on specific days such as Good Friday. More importantly, education also has a great influence in regard to their beliefs on health as well as illness and since the parents are well educated they understand the key determinants of health and take proactive action to ensure that they maintain healthy lifestyle choices as well as their children (Barker & Chang, 2013).
Conclusion
The Calgary family assessment model is an essential tool in nursing that enables nurses to effectively carry out family assessment aimed at acquiring valuable information on the various factors that influence the health of individual family members and the whole family system (Barkley & Robin, 2014). Thus, nurses should understand the family influence on a patient’s health so as to provide suitable interventions. Moreover, the model enables nurse to identify the strengths as well as weaknesses of the family in regard to addressing health issues whereby this helps nurses to customize their intervention to adequately meet the individual as well as family health needs (Kaakinen et al., 2014).
References
Barker, P., & Chang, J. (2013). Basic family therapy. John Wiley & Sons.
Barkley, R. A., & Robin, A. L. (2014). Defiant teens: A clinician's manual for assessment and family intervention. Guilford Publications.
Bickley, L., & Szilagyi, P. G. (2012). Bates' guide to physical examination and history-taking. Lippincott Williams & Wilkins.
Carlson, K., & Carlson, K. (2014). Nurses and Families: A Guide to Family Assessment and Intervention. Issues in mental health nursing, 35(7), 565-565.
Duhamel, F., Dupuis, F., Turcotte, A., Martinez, A. M., & Goudreau, J. (2015). Integrating the Illness Beliefs Model in Clinical Practice A Family Systems Nursing Knowledge Utilization Model. Journal of family nursing,21(2), 322-348.
Kaakinen, J. R., Coehlo, D. P., Steele, R., Tabacco, A., & Hanson, S. M. H. (2014). Family health care nursing: Theory, practice, and research. FA Davis.
Wright, L. M., & Leahey, M. (2012). Nurses and families: A guide to family assessment and intervention. FA Davis.
