Introduction
The family plays an important role in providing care and maintaining the health and well being of members. As a unit, the family plays a crucial role in the health promotion paradigm. As such, it is important for nurses to assess the family as an individual unit for appropriately diagnosing and selecting necessary interventions for achieving suitable health outcomes. A nursing diagnosis is defined as a clinical judgement about an individual or a family projecting actual and potential health problems (Nanda International, 2003).
Gordon’s (1994) set of eleven health patterns can be used to by nurses to assess and identify existing or potential health issues for effective interventions (Muller-Staub, et al., 2007). This paper reviews a family interview within the paradigm of health promotion and intervention in nursing. The review is based on the eleven categories proposed by Gordon (1994) which allow a holistic view of individuals and enable nurses to determine functional health patterns. The selected family includes three Indian Americans, living in the United States for the past several years. The nurse interview assesses the family with the aim of conducting a diagnosis which will provide the basis for the selection of nursing interventions to achieve appropriate outcomes for better health outcomes (McFarland & McFarlane, 1997).
The three members of the family are Mr. Shetty, father and family head (a software engineer), Mrs. Shetty, his wife, a homemaker, and their college going son, Alok.
Summary of Health Findings
Health Perception and Management
The family appears to be well informed about health issues and has a concise idea about the importance of health and wellbeing. They also clearly understand the importance of nutrition in maintaining a healthy life. However, Mr. Shetty has type 2 diabetes and is on medication for the disease. Mrs, Shetty does not have any disease. She does complain of occasional breathlessness. The family is disciplined, religious and highly spiritual. All the three members are closely knit and reflect similar life values.
Nutritional Metabolic Pattern
Mrs. Shetty is extremely particular about cooking and serving nutritious, home-cooked healthy food. The family eats three meals a day, breakfast, lunch and dinner, all prepared at home by Mrs Shetty. The members make it a point to eat a minimum of one meal together and usually get together for dinner. Average intake of water is between 1.5 to 2 liters a day per person. The family enjoys coffee and drink several cups a day. The family practices strict abstinence from alcohol and is aware of the health problems associated with aerated drinks. They prefer fruit juices over aerated drinks. Rice is a major component of their diet.
Pattern of Elimination
The urination pattern of the Shetty family appears to be normal. However, Mr. Shetty does complain of some constipation and feelings of uneasiness when his bowel movement is not smooth.
Activity and Exercise Pattern
Even though the family is aware of the importance of healthy eating behaviors, the level of physical activity is very low. Assessing the answers it was apparent that Mr. Shetty does not have any exercise regime. Mrs. Shetty too is busy with household work and showed no inclination towards exercise. Their son Alok, also does not have any exercise regime and is not involved in any sports activity. All the members of the family are overweight and mildly obese.
Cognitive Pattern highly
Mr. Shetty has glaucoma, which he believes has been genetically passed to him. The family does not have any history of depression or mental health issues. Mr. and Mrs. Shetty are both highly qualified and their son is currently pursuing post graduation in computer engineering from a deemed university.
Sleep and rest patterns
Mr. Shetty sometimes experiences insomnia due to high work pressure and long hours of work on the computer. Mrs. Shetty and her son have no problems with sleep and rest. All of them feel rested after 6 to 7 hours of a night’s sleep.
Self Perception Pattern
Mrs. Shetty is slightly overweight and wishes to lose some weight. Mr. Shetty also projects dissatisfaction with his weight and expresses the desire to lose some weight. Their son who is obese seems dissatisfied with his weight. He attributes this obesity to the high intake of rice in their diet.
Relationship Patter
Mrs. Shetty projects herself as the caretaker of the family and feels responsible for their health and well being. Mr. Shetty, being the sole earning member, identifies himself as the major decision maker of the family. Their son Alok seems to have issues about being overprotected by his parents. The family has a close circle of friends mostly from the same culture and community. They are closely knit and do not project any major problems.
Sexuality Pattern
There was a level of discomfort discussing this pattern with the Shetty family. This can be attributed to their culture which does not allow for easy discussions about sex. Alok is the only child in the family and seems to be over protected by his parents.
Stress and coping patterns
The family members do not consume alcohol since they are devoutly religious and their religion does not permit alcohol intake. There is no indication of drug use or smoking. Their son upholds their family values and does not consume alcohol. He does not smoke either.
Wellness and family diagnosis
The Gordon (1994) guide helps nurses assess the responses of individuals in the family with the aim of determining the possible behaviors which could pose a risk to the health of individuals. The diagnosis and assessment are aimed at helping nurses address some health related problems such as lack of exercise and dietary restrictions (NANDA, 2005). The interview allows the nurse to identify wellness nursing diagnosis for the family for enhanced health outcomes (Muller-Staub et al., 2007).
While the family seems to be aware of healthful eating, there is a complete lack of physical activity. This puts all the three members at risk for obesity and weight related health issues such as diabetes, cardiovascular illnesses and other obesity related disorders. Mr. Shetty is a diabetic and needs some form of physical activity to help keep his diabetes under check, which is now controlled with the help of medication. Mr. Shetty also needs to keep his eye pressure in control due to his glaucoma. Mrs. Shetty too has a family history of diabetes and is at risk for the disease due to her obesity.
Cooking and dietary habits need to be improved since rice intake is high. The family needs to be informed about the importance of exercise and a physical activity regime to maintain weight and good health. Alok and Mrs. Shetty seem to exhibit signs of self dissatisfaction and wish to have a better body image. Sleep patterns indicate mild stress which needs to improve considering Mr. Shetty’s diabetes and eye problem. The nursing intervention would be to collaborate with a dietician so that the family can balance their meals. Intervention is also needed to ensure an exercise regime for physical activity.
References
Gordon, M. (1994). Nursing diagnosis: Process and application (3rd ed.). St. Louis: Mosby.
McFarland, G., K. & McFarlane, E., A. (1997). Nursing diagnosis & interventions. 3 ed., St. Louis: Mosby.
Muller-Staub, M., Needham, I., Odenbreit, M., Lavin, M. A., & Achterberg, T. (2007). Improved quality of nursing documentation: Results of a nursing diagnoses, interventions, and outcomes study. International Journal of Nursing Terminologies and Classifications, 18(1), 5-17.
Nanda International (2005). Nursing diagnoses: Definitions and classification, 2005-2006. Philadelphia: Nanda International.