Introduction
The essence of nursing care is to assess situations, collaborate with patients, address their health conditions, and meet their physical and emotional needs. Sometimes, it is required to make observations and follow the already prescribed plans. There are also cases when communication and support are expected.
In this paper, attention will be paid to an 86-year-old female patient who declines diagnostic testing of her rectal bleeding and cardiac murmurs and rejects her adult children’s involvement in care and decision-making processes. Despite a professional recommendation by a mid-level provider about the importance of testing for a patient with a family history of colon cancer, the patient is not interested in further assessment and testing. Nurses apply various theories and models in their practice to deliver care effectively, achieve positive health outcomes, and promote overall well-being. The best course of action for a nurse to help the patient is to use the Family Health System Model to assess individual and family functions, understand life aspects, and encourage collaboration.
Patient and Family Assessment
Rectal bleeding and a large friable mass in the rectum are warning signs of colorectal cancer. According to Purich et al. (2022), patients with a family history of colon cancer and presenting symptoms are at high risk for severe gastrointestinal complications and cancer. Regarding the patient’s age, experience, and awareness of health issues, it is possible to assume she understands her risks but does not want her family involved in this healthcare decision-making process. The nurse is primarily responsible for monitoring the patient’s vital signs and bleeding, performing tests, administering medications, and replacing fluids to predict dehydration or heavy and life-threatening bleeding.
However, assessing family relationships is also necessary because the woman may require additional support and care, especially if she rejects diagnostic testing and wishes to return home. Family plays a crucial role in promoting health and maintaining physical and emotional well-being (Ho et al., 2022). Therefore, attention should be paid to situational, behavioral, and structural factors in this family and to clarify what prevents cooperation and provokes such patient decisions.
Application of the Family Health System Model
Overview
The Family Health System Model belongs to a group of ecological models where nurses focus not only on clinical care but also on interpersonal relationships within particular contexts. Such models explain the worth of the environment within which patients develop their judgments and behaviors, addressing their experiences at macro, meso, and micro levels (Ho et al., 2022). The chosen model serves as a framework for nurses to integrate relationships, connections, personal needs, and the environment.
Problem
It is not enough to identify a health problem and solve it. It is more important to consider the patient’s development over time and in various contexts. A hospital is a temporary place where people obtain help and care. A home environment affects people’s readiness to obtain health and nursing care. Family is one of the major systems in which human health is directly produced and maintained through interactions and support (Hanson et al., 2019). Therefore, even if the patient does not find it necessary to involve her family, the nurse must carefully examine the three domains of the Family Health System Model and achieve the desired goal – to involve the patient’s children in the diagnostic decision-making process.
Solution
The best course of action based on the Family Health System Model includes three steps. First, the contextual application requires identifying all living family members and friends, their ages, and their abilities to influence the patient in the care process. Jim is a 59-year-old son whose judgments can be effective. Still, more information about his employment and overall relationships with the mother must be found. Lisa is a 58-year-old daughter whose gender roles can be similar to the patient’s. Second, functional application is based on the relationships the chosen family develops.
Individual communication will allow the nurse to clarify their roles, core processes, and patient health expectations. Following the preferred model, nurses must prioritize family health and genetic complications (Pusa et al., 2021). Therefore, informing children about the risks based on a family history of colon cancer is required. Finally, the structural domain assesses family routines, including income sources, external help, family visits, and counseling. The nurse educates all family members about possible health complications and outcomes to ensure they understand the progress of the disease and its diagnostic value.
Conclusion
In conclusion, patients with rectal bleeding and a family history of cancer need to understand the importance of accurate diagnosis for choosing the best course of treatment. In the case under analysis, the patient is aware of her health complications. Still, she does not want to continue her diagnostic testing or involve her children in care decision-making. The nurse is obliged to inform family members if they are official representatives and support systems of the patient.
The Family Health System Model can be applied to examine the contextual, functional, and structural factors that may affect individual and family health, and to take appropriate nursing practice actions. The judgments and attitudes of older patients may deteriorate for various reasons, and the goal is to ensure that the family is aware of the overall situation and supports the patient’s interests and needs.
References
Hanson, C. L., Crandall, A., Barnes, M. D., Magnusson, B., Novilla, M. L. B., & King, J. (2019). Family-focused public health: Supporting homes and families in policy and practice. Frontiers in Public Health, 7.
Ho, Y. C. L., Mahirah, D., Ho, C. Z. H., & Thumboo, J. (2022). The role of the family in health promotion: A scoping review of models and mechanisms. Health Promotion International, 37(6).
Purich, K., Zhou, Y., Dodd, S., Yuan, Y., & White, J. (2022). How can we better identify patients with rectal bleeding who are at high risk of colorectal cancer? An observational study. International Journal of Colorectal Disease, 37(3), 573-582.
Pusa, S., Isaksson, U., & Sundin, K. (2021). Evaluation of the implementation process of a family systems nursing approach in home health care: A mixed-methods study. Journal of Family Nursing, 27(3), 235-249.