According to Edelman & Mandle, 2010, the term “family” is defined as a set of interacting individuals who is related by blood, marriage, cohabitation or adoption who interdependently perform relevant functions by fulfilling expected roles. These relevant functions include values and practices the family has on health or family health practice. The term “structure” refers to the organizational characteristics of the family, the sub system and the basic rules that influences interpersonal choices and behaviors in the family (A,Vetne, September, 2001).
Family consists of both functional and structural components. Family structure refers to family composition including roles and relationships where as Family function consists of process within the system as information and energy exchange occurs between families and their environment (Edelman & Mandle, 2010). Structural family therapy refers to a body of theory and practice that approaches individuals in their social and relational context (A. Vetne, 2001). Health care professionals, especially nurses play an important role in promoting health care for the family.
Using family focused approach is a priority when providing efficient family care and support. Behavior patterns, beliefs, perceptions and values form the essential components of health assessment when maximum health potential of the individuals is considered by a nurse (Edelman & Mandle, 2010). Health practice varies from one family to another family and each family has a unique way of health perception, belief, value and cultural practice. Health perception and values are focus on the individual’s perception of their health, health beliefs and values (Edelman & Mandle 2010).
Gordon’s 11 health patterns play a vital role in elaborating various types of family health assessment. These patterns form the standardize format for effective family assessment using a systematic approach with emphasis on developmental stage and risk factors. I have completed the assessment questions according to Gordon’s health patterns for Mr. DJ’s family by asking questions from each functional health patterns and my findings are as follows. Mr. DJ is a 45 years old Ethiopian who has moved to USA for 8 years ago with his wife Rahel and their two girls aged 12 and 10. Both Mr.
DJ and his wife Rahel are well educate and leads a successful professional life. He is a senior economist and she is a elementary school teacher. He works late hours and some weekends as well while Rahel works 8-9 hours a day. They both enjoy good foods and Mr. DJ enjoys drinking 2 beers with dinner almost every day. Mr. DJ is overweight (240lb) and takes medication for high blood pressure and Mrs DJ is also slightly overweight (175lb) and takes medication for high cholesterol and chronic back pain secondary to MVA few years back. She takes Flexeril and Motrin as needed for the pain.
The health perception value of Mr. Dj’s family is somehow different than most Americans belief. Although they believe in modern health practice to prevent illness and maintain good health, they also believe in God’s power of miracle, healing diseases by drinking holly water and bathing in it. They also believe in the healing of herbal product. Mr. DJ stated that the family maintain their health by having annual checkups, keeping the children’s immunizations up to date and having preventive tests such as pap smear, mammogram. Based on the nutritional pattern questions, Mr.
DJ’s family stated that they eat mostly traditional Ethiopian food which is made of pancake like bread with different types of sauce (chicken, lamb, vegetable). The sauce is usually made of strong spices mixed with oil and butter. They are not conscious about their calorie intake and eat minimal fruits and vegetables. They eat out 2-3 times a week because of their busy and long hour working schedules. Mr. DJ’s and his family usually go to bed by ten pm and wake up by six am. They sleep about eight hours a night except for the days Mr. DJ has to work late nights.
Mr. DJ stated that the days he did not get enough sleep, he noticed that he has decreased performance and bad temper. Their children know the time to go to bed and they do that without being told every day. Based on the questions related on the Activity/Exercise pattern, Mr. DJ’s family stated that they do not participate in any types of exercise programs and they are not a member of a gymnastics center around their area. According to Mr. DJ, since both parents have a busy work schedule, they did not make the kids participate in any activities either. Although Mr.
DJ is overweight and has stressful work schedule, he admitted that he did not try hard to start exercise. He will be starting a new job next month which is going to give him less working hours and more family time and he and his wife are looking forward to join a gymnastic center soon. Cognitive patterns include the ability of individual to understand and follow directions, retain information, make decision, solve problems and use language appropriately (Edelman & Mandle, 2010). Both Mr. and Mrs. DJ are well educated and understand the positive side of healthy life style.
They also stated that they read a lot about health related news and magazines. According to the Ethiopian tradition, the husband is the decision maker in the house but since they live in the US, they both participate in decision making. Mr. DJ stated that they only speak their own language (Amharic) at home so that the children will not forget the language in the future. Valuable beliefs pattern describes values including the individual’s beliefs, values and goals (Edelman & Mandle, 2010). This pattern also includes perception of what is right, what is good and conflicts that beliefs and values impact (Edelman & Mandle, 2010).
Based on Mr. DJ’s family values and belief assessment, the family has a very strong faith in God’s power of miracle. Although they believe in modern medicine, they are strict Orthodox religion followers and believe that holy water can prevent and heal diseases and illness in general. They have a great family values, love for each other, respect, understanding and support. The self-perception pattern encompasses the sense of each individual personal identity, goals, emotional patterns and feelings about the self (Edelman & Mandle, 2010).
This pattern also includes how the individual attitude is towards self such as his body image and self esteem. Mr. DJ’s family states that they do not have a self esteem issues. Their strong religious faith, love, support and respect to each other help them deal with this pattern. The children are very proud of being who they are and their back ground as well. Mrs. DJ states that she teaches the kids the basic traditional values and beliefs of their country of origin. Based on the relationship pattern, Mr. DJ stated that he and his family has a strong family relationship.
Rahel (wife) said that they spend family time with their kids once a week by doing different types of activities such as movie, games and eat out in a restaurant. They also have a good relationship with their friends, extended families and church community. The sexual reproductive pattern describes the individual’s sexual self concept, sexual functioning, intimacy methods and reproductive areas (Edelman & Mandle, 2010). This topic is a very sensitive topic for Mr. DJ’s family. Mr. DJ stated that he is not comfortable talking about his sexual life with anyone other than his wife since it is kind of a ‘taboo’ according to his tradition.
In general, he stated they have a happy sex life. Stress patterns include the individual’s ability to process life crises and to resist disruptive factors that will influence self integrity, ego, conflict resolution, stress management and accessibility of necessary resource. Mr. DJ has a very busy and stressful job where he needs to work late hours and sometimes weekends. Mr. DJ’s family has a very open communication skill to deal with stressful issues. Their strong faith in God and prayers also helps them deal with stress. Gordon’s 11 health patterns helped me gathering the necessary data to determine what kind of health perception Mr.
DJ’s family has, their educational needs, identify health issues and health goals. Based on my health assessment, the wellness and family diagnosis I chose for Mr. DJ’s family are readiness for enhanced Activity-Exercise pattern related to a desire to improve physical activities and readiness for enhanced nutrition related to a desire to improve nutritional status. Mr. and Mrs. DJ admitted that the family needs to start exercising and change their diet regime. They also stated that they are ready to make the necessary changes needed to live healthy. Currently Mr.
DJ’s family is at risk of nutritional imbalance secondary to high carbohydrate and fat consumption. Although both parents are well educated, they would benefit from receiving more teaching about what a good, well balanced diet should be, how to read food labels on cans and packs and what is important to know and pay attention to, good carbohydrate choices and importance of high fiber, vitamins and protein intake. I also offered different websites and community resources for further education and improve their coping skill. I advised the family set a realistic goal to make the exercise and diet changes and live a healthy life.
Mr. DJ’s family understands that being physically inactive and poor diet choice of cardiac diseases, high blood pressure diabetic and many more diseases for them and the children. I encouraged the children to get 30-60minutes of physical activities most days of the week, encourage the children to be active in choosing family physical activities like walking, biking and swimming. By making life style changes as a family, the family whole family would realize the benefits of eating better, being physically active and better weight management.