University Family Assessment: Patient Selection and Health Promotion

This assignment explores a student's values and beliefs related to family nursing and health promotion, examining how these influence decision-making in patient selection and care. The student analyzes three patients they would choose and three they would not, detailing the rationale behind each decision, including assumptions made and proposed assessment and health promotion strategies. The assignment also incorporates family nursing theories, such as the Hill’s ABCX model and the Calgary Family Intervention model, to guide the assessment and intervention approaches. The self-reflection section highlights the importance of empathy, compassion, and clinical knowledge in family assessment and health promotion. The student emphasizes the significance of family involvement and communication in delivering effective patient care.

1Running head: FAMILY ASSESSMENT
Family assessment
Name of the student:
Name of the University:
Author’s note

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Introduction:
Nurses have a critical role in health promotion of client as they can support nurse to
achieve positive health outcome and increase patient’s knowledge in self-management. Nurse’s
decision making in relation of health promotion and behavioural change of patient is shaped by
their values and beliefs. These values help to understand the approach needed to respond to
patient’s health problem and negative health behaviour (Kemppainen, Tossavainen & Turunen,
2013). Through this reflective journal, personal values and beliefs related to family nursing and
health promotion will be explored and justification will be given regarding decision making for
three patients.
Selection of patients and the decision making process for each patient:
Based on my experience and knowledge regarding family nursing and health promotion,
the three patients that I would choose from the list of bios include Alex Abraham, Bernetta Bold
and Charlie Heron. The following is the details of the decision making process for each patient:
Patient 1: Alex Abraham
Factors influencing the decision making process:
The first patient that I have chosen is Alex Abraham who is a 42 year old man with type
II diabetes. He has a work shift of 12 hours and stays away from two weeks a time. He is having
difficulty in accepting his diagnosis. The factors that made me choose this patient included my
skills in therapeutic communication process and professional values of empathy towards the
client. This is because Alex mainly requires positive reinforcement to accept his diagnosis.

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Hence, through empathetic communication style, I will help him deal with his diagnosis and
learn self-management techniques to effectively manage his diabetes.
Key assumptions about the patient and the family:
Based on the description of the scenario, I have the assumption that currently Alex lacks
knowledge regarding the disease and the way to control and manage his diabetes. I assume that
he has no self-management knowledge related to diabetes.
Strategies to proceed with Family nursing assessment and family health promotion
To proceed with the family nursing assessment, my first strategy will be to assess
patient’s knowledge about the disease and his perception related to the impact of the new
diagnosis on him and his family members. This will to understand immediate needs of patient
and family in relation to health promotion and understand the type of health education to be
given to promote positive health (Moghaddasian, Dizaji & Mahmoudi, 2013).
After the above assessment, empathetic communication style will be used to educate
patient about the disease and develop his self-management skills. The significance of using
empathetic style is that it will support establishing working alliance with patient and addressing
ambivalence of patient regarding rigorous treatment or change in lifestyle following diagnosis.
Another significance of prioritizing effective communication style during patient education is
that interpersonal communication in decision making is more valued by patient rather than
passive delivery of education (Jones et al., 2016).
Patient 2: Bernetta Bold
Factors influencing the decision making process:

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I have chosen Bernetta Bold because she suffers from social isolation issues and based on
my skills in social support, I am confident that I can give her the right support needed to address
social isolation.
Key assumptions about the patient and the family:
I have the assumption that lack of family member presence is a major issue for her that
has affected her current health. How far, Bernetta’s children is involved in her care needs to be
analysed.
Strategies to proceed with Family nursing assessment and family health promotion:
I will start the family nursing assessment by involving Bernetta’s children in the family
assessment interview. The significance of family assessment is that it will help to collect data
about family structure and relationships and understand its impact on current symptoms of client.
This will guide in identifying how Bernetta’s family can provide social support and address her
withdrawal symptoms. In family nursing, family involvement is critical to make family member
active participant of the care process and get proper data related to health experience of patient
(Santos et al., 2017). In addition, as Bernetta has been referred for home care, I will use
humanitarian principles like respect and dignity to establish appropriate relationship with
Bernetta and provide her social support.
Patient 3: Charlie Heron
Factors influencing the decision making process:

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The third patient is Charlie Heron. The main factor behind choosing this patient is that he
is a five year old boy with acute respiratory distress and since I am experienced in paediatric
intensive care, I feel I am competent to address respiratory issues of the child.
Key assumptions about the patient and the family:
I have assumed that the child’s parents absence may further influence anxiety of the child
and managing the child without his parents would be a barrier in care.
Strategies to proceed with Family nursing assessment and family health promotion
To proceed with the family nursing assessment, I will inquire Charlie’s grandparents
about the history of asthma and previous evidence of acute respiratory distress. I will also inquire
regarding any history of allergy. The significance of this form of family assessment is that it will
to collect information related to illness prognosis, familiarization with care and assuring the best
possible care (Kaakinen et al., 2018). After the family assessment, I will proceed with respiratory
assessment and provide emergency supplemental oxygen to provide relief from respiratory
distress.
Rationale for not selecting patients:
I would not have chosen the following list of patient if choice was an option:
Factors influencing the decision making process:
I would not have chosen Fiona Friday because she is a patient referred for prenatal care
and I don’t have competency and knowledge regarding prenatal care according to stages of
pregnancy Hence, I am not confident in providing appropriate care to the patient.

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I would have not selected Dixie Cup, 13 year old patient too because she has been
admitted in a psychiatric unit and I have work experience mainly in paediatric nursing. Hence, I
feel that I would not be competent enough to identify mental health needs of the client. In
addition, the rationale for avoiding care of Hailey Berry is that she has been diagnosed with
cervical cancer. As cancer is a critical care area, handling this patient would be difficult.
Key assumptions about the patient and the family:
Based on the description of Fiona Friday, a 16 year old girl with second trimester of
pregnancy, the key assumption that I have is that responding to her prenatal care would be an
ethically challenging because of her teenage pregnancy.
The key assumptions that I have made based on review of Dixie Cup case study is that
abuse or poor experience in school might be the reason for her depression.
In case of Hailey, I have the assumption that as she had been instructed for review with a
nurse for preoperative checklist, she is currently at early stage of cervical cancer.
Family nursing assessment and family health promotion
To engage in appropriate family nursing assessment, I will use my values of compassion
and human dignity to provide appropriate care to her. As she has no family close by, I will start
with an initial screening interview with Fiona’s friend and her family as currently they are the
members with whom she is living. I will collect data related to her current social circumstances,
the situation leading to pregnancy and her current mental state. This will help to assess social and
economic circumstances and social support needs of Fiona. This approach is relevant with
family-centred care as it will help to explore the ideals of empowerment and disadvantages for

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client (Coyne, 2015). This will be followed by prenatal advice to Fiona by addressing her
ambivalence and giving her positive motivation regarding pregnancy using my personal values
of compassion (Hodgkinson et al., 2014).
To proceed with family assessment for Dixie, I will conduct interview with Dixie to
explore why she is more upset with her family. I will ask her question about her family and
relationship with them and link it with her currents symptom. It will be cost-effective approach
to identify risk for disease development and encouraging patient to make positive change in her
life (Dieperink et al., 2018). In case of Hailey Berry, I will complete the pre-operative checklist
and engage in interaction with patient and their family regarding the potential of surgery and
importance of positive mind in recovery.
Family nursing theories guiding family nursing assessment and health promotion:
The family nursing theory that has guided me in family nursing assessment for different
case scenario patients include the Hill’s ABCX model and theory of family stress which is based
on the assumptions that there is relation between multiple stressors and family crisis. This model
enables evaluation health promotion by assessment of stressors, family crisis, shared family
beliefs and protective factors in family. For all the patient, I have prioritized conducting family
assessment to establish link between family crisis and their current health condition. This helped
to develop appropriate health promotion plan and develop resilience of patient and families in
managing disease (Rosino, 2016). I have also used Calgary Family Intervention model to
develop strength and resilience based intervention for patient. This model has helped me to tailor
interventions according to the family dynamics and individual family needs of each patient
(Leahey & Wright, 2016).

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Self-reflection:
From the overall experience of selecting patients for family assessment, I learnt about the
importance of the values of empathy and compassion in building therapeutic relationship with
patients. These values can be useful in helping patients with chronic illness to accept their
diagnosis and promote positive coping to deal with illness. The clinical knowledge helped to
prioritize family assessment need and health promotion needs of each patient. Completing the
project helped to gain awareness about Hill’s ABCX model and theory of family stress in
accurately identifying protective and risk factors for a family. This experience cam help me to
engage in effective identification of family health needs and addressing key family conflict or
burden in management of illness of family members.
Conclusion:
To conclude, the experience of choosing patients based on my personal values and beliefs
revealed how my professional experience and personal values can help to engage in therapeutic
communication with family. The understanding regarding family assessment theory and my
expertise in paediatric nursing in the ICU helped to effective plan health promotion interventions
for each client.

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References:
Coyne, I. (2015). Families and health‐care professionals' perspectives and expectations of
family‐centred care: hidden expectations and unclear roles. Health expectations, 18(5),
796-808. doi: 10.1111/hex.12104
Dieperink, K. B., Coyne, E., Creedy, D. K., & Østergaard, B. (2018). Family functioning and
perceived support from nurses during cancer treatment among Danish and Australian
patients and their families. Journal of clinical nursing, 27(1-2), e154-e161.
https://doi.org/10.1111/jocn.13894
Hodgkinson, S., Beers, L., Southammakosane, C., & Lewin, A. (2014). Addressing the mental
health needs of pregnant and parenting adolescents. Pediatrics, 133(1), 114-122.
Jones, A., Vallis, M., Cooke, D., & Pouwer, F. (2016). Working together to promote diabetes
control: A practical guide for diabetes health care providers in establishing a working

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alliance to achieve self-management support. Journal of diabetes research, 2016.
doi: 10.1155/2016/2830910
Kaakinen, J. R., Coehlo, D. P., Steele, R., & Robinson, M. (2018). Family health care nursing:
Theory, practice, and research. FA Davis. Retrieved from:
https://books.google.co.in/books?
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and+health+promotion+&ots=28kVrj7uq6&sig=3lxvwlSRDca0jzYkBF-
3bgh81D8&redir_esc=y#v=onepage&q=family%20nursing%20assessment%20and
%20health%20promotion&f=false
Kemppainen, V., Tossavainen, K., & Turunen, H. (2013). Nurses' roles in health promotion
practice: an integrative review. Health Promotion International, 28(4), 490-501.
https://doi.org/10.1093/heapro/das034
Leahey, M., & Wright, L. M. (2016). Application of the Calgary Family Assessment and
Intervention Models: reflections on the reciprocity between the personal and the
professional. Journal of family nursing, 22(4), 450-
459.https://doi.org/10.1177/1074840716667972
Moghaddasian, S., Dizaji, S. L., & Mahmoudi, M. (2013). Nurses empathy and family needs in
the intensive care units. Journal of caring sciences, 2(3), 197. doi: 10.5681/jcs.2013.024
Rosino, M. (2016). ABC‐X Model of Family Stress and Coping. Encyclopedia of Family Studies,
1-6. DOI: 10.1002/9781119085621.wbefs313

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Santos, L. G. D., Cruz, A. C., Mekitarian, F. F. P., & Angelo, M. (2017). Family interview guide:
strategy to develop skills in novice nurses. Revista brasileira de enfermagem, 70(6),
1129-1136. http://dx.doi.org/10.1590/0034-7167-2016-0072