Introduction

Nurses have an obligation to provide safe, ethical and competent care to their clients and families, in particular. The bulk of nursing practice involves a family, which focuses on assessing the broader health determinants and applying community skills development with the aim of helping families to make healthy decisions (Kaakinen, Coehlo, Steele, Tabacco, & Hanson, 2014). When providing care to a patient, a nurse often places a patient in the context of his or her patient including potential health risks in the family. The family is considered to be the unit of care for nursing practice (Kaakinen et al., 2014). The current paper performs a family assessment with the aim of identifying present health issues, genetic and future health risks. The need for a community health nurse and health promotion plan are also discussed in this paper.

Health Issues Present in the Family

The Friedman Family Assessment helped in the identification of present health issues. This assessment focuses on various aspects that might affect family members’ health including the environmental data, family structure, family’s developmental stage, family functions, and stressors, coping, and adaptation of a family. The first health issue revealed in the assessment stems from a family’s perception of the healthcare system. Most of the family members expressed their distrust in the US healthcare system, especially with regard to the concern that doctors do not meet their expectations. For them, they expect the doctor-patient relationship to be welcoming, personal and exhibit concern for a patient. They perceive doctors as always being in a rush and do not have time to develop personal relationships with them. As a result, they perceive doctors as being untrustworthy. This distrust in the healthcare system results in the family refraining from seeming care in hospitals; instead, they rely on traditional alternatives or home remedies. The members of the family are hesitant to take medication and prefer natural medicines. Although they acknowledge that they are ineffective and somewhat risky, they are comfortable with this form of treatment. Essentially, the family trusts alternative medicine practitioners rather than medical doctors, which is a significant health issue. The cultural barriers for Hispanics in accessing care have been documented by several scholars (Perez-Escamilla, 2010; Ransford, Carrillo, & Rivera, 2010). Apart from lacking trust in the healthcare system, the family also cited other barriers that hinder them from accessing doctors’ assistance including lack of healthcare insurance coverage and the perceived immigration consequences. Language barrier was mentioned by one family member, who stated that health information is not published in Spanish. The overall outcome is that a disconnect exists between the family and healthcare system since these factors deter the family members from seeking care services. Another health issue discovered from the family health assessment is low levels of physical activity. Family members reported living sedentary lifestyles and were not informed of the health benefits associated with living an active lifestyle. Other health issues found from the assessment included infrequent preventive health tests and logistical challenges in receiving care, especially with respect to transportation. Moreover, the family genogram shown in Figure 1 below shows that three family members are currently suffering from a myriad of illnesses including diabetes, heart disease, and cancer. The second genetic risk for the family members is heart disease.

Genetic Risks Present

Genetic risks are an important consideration when performing family health assessments. A scrutiny of the health genogram of the family shows some significant genetic risks for the family. The first genetic risk for the family is cancer. A family history of cancer has been identified as a risk factor for the disease. Several studies show that cancer in relatives increases one’s risk of developing cancer (Boyle & Levin, 2008). In the context of the family, it is evident from the side of the mother that her sister currently has cancer and her brother died of cancer. Therefore, the children are at risk of cancer. A first-degree relative having a heart disease increases the risk of suffering from the illness, especially if the relative developed a heart disease when aged 45-55 years (Roger et al., 2011). Moreover, diabetes has been identified as a hereditary component of heart disease. From the family health genogram, in Figure 1 above, it is evident that father’s side has a family history of heart disease and diabetes. As a result, the children are at risk of developing heart disease. Currently, two children already have diabetes, which further increases their risk of developing heart disease.

Future Health Risks for the Family

In addition to the genetic risk factors mentioned in the preceding section, a number of future health risks for the family have been identified. A potential health risk relates to lifestyle diseases, which can be attributed to the inactive lifestyles of the family members. Currently, the mother is suffering from alcohol abuse whereas two children have already developed diabetes. This sedentary lifestyle increases the risk of the family members developing diseases such as dementia among the parents, stroke, depression, high blood pressure, osteoporosis, muscle degeneration, and excess weight (obesity).

Comparison of Findings with the Topics and Objectives and Preventive Measures Found for Healthy People 2020

The Healthy People 2020 has the overall goals of eliminating disparities in health and improving health of all people. Other goals include promoting the quality of life, facilitating healthy behaviors and enhancing the overall health outcomes in terms of disability, injury, disease, and reducing premature death (Healthy People 2020, n.d.). The preventive measures relevant to this family include healthcare access, cancer, diabetes, heart disease and stroke, and physical activity. In all these measures, the family scores low on attainment of the Healthy People 2020. With regard to access to quality healthcare, a number of barriers hinder the family from accessing care services such as cultural and language barriers, and preference to traditional medicine. Hospital care is not the first line of defense for the family, which means that the family only seeks hospital care after traditional medicine has failed. This implies that the family does not receive care in a timely manner as stipulated by the Healthy People 2020 goals. With regard to cancer, the Healthy People 2020 has the goal of lessening the number of cancer cases including the death, disability and illness attributed to cancer (Healthy People 2020, n.d.). Regarding diabetes, the Healthy People 2020 initiative seeks to reduce the burden posed by diabetes and enhance the quality of life for those having diabetes as well as those who are at risk. The risk factor for diabetes among the family members is high, which can be attributed to the sedentary lifestyle. This is not in line with the goals of the Healthy People 2020. Moreover, the family has a limited understanding of heart disease and physical activity. Overall, the findings show that the family is not on the right track as regards the achievement of the Healthy People 2020 goals.

The Need for a Community Health Nurse to Begin Health Promotion for the Family

The family evidently requires a community health nurse to commence health promotion. This need stems from the fact that the family is typified by numerous risk factors that can be modified to prevent future health risks. In particular, the risk factors for diabetes and heart disease can be modified through health promotion strategies.

The plan to reduce the health risks for the family should focus on two broad aspects, which include interventions aimed at modifying behavior and reducing the risks associated with cancer. The health promotion should seek to change the perceptions of the family members regarding the healthcare system. The ultimate objective is to ensure that the family members consider hospital care as the first line of defense by getting them to trust the healthcare system (Perez-Escamilla, 2010). The second focus of the promotion is to ensure that family members understand the importance of living active lifestyles, especially in reducing the risk of diabetes and heart disease already present in the family. Lastly, the health promotion should focus on cancer awareness aimed at ensuring that the family members get frequent cancer screening to facilitate early diagnosis and treatment of cancer (Boyle & Levin, 2008).

Conclusion

Various health issues facing the family have been identified, which include cultural and language barriers to accessing care, low levels of physical activity, infrequent preventive health tests and logistical challenges in receiving care. The genetic risks for the family are cancer and heart disease. Amidst these findings, health promotion for the family is needed that specifically focuses on modifying the family’s perceptions of the healthcare system, having active lifestyles, and cancer awareness to encourage frequent cancer screening.

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