NRS 429 Topic 3 Assignment Family Assessment Part II
Family Assessment Part II
Families have unique health needs that nurses should prioritize in providing their needed care. Nurses utilize models of health promotion and evidence-based interventions to optimize family health outcomes. Practice interventions such as inter-professional collaboration and incorporation of technology into the care process contribute to outcomes, including efficiency, quality, and safety in addressing family needs. Social determinants of health also influence the interventions by nurses in their roles when working with families. Therefore, this essay examines the social determinants of health for the interviewed family, age-appropriate screenings for family members, health model, and its application in promoting family-centered health promotion.
Social determinants of health affect the interviewed family. Social determinants of health have been defined as factors within environments where individuals are born, live, grow, work, and age. They affect the overall health, quality of life, functioning, and risks predisposed to individuals in their societies. The social determinants of health that affect the interviewed family include economic stability, access to quality healthcare, neighborhood, and built environment, and community and social context. The family’s economic stability is a critical determinant of its health. It influences the family’s ability to afford its needed care and healthy foods (Palmer et al., 2019). The parents in the interviewed family are employed. However, they find it hard to access their needed care due to the cost and geographical location of specialized services.
Access to quality healthcare is another family’s social determinant of health. Quality healthcare services are important in promoting optimum health and recovery of the family members. However, the interviewed family experiences challenges in accessing its needed quality care. The family finds it difficult in accessing quality care for the grandfather due to challenges associated with cost and distant location of specialized services. The other social determinant of health is neighborhood and built environment. Environmental hygiene and well-planned built spaces contribute to the family’s health. They increase access to exercise spaces for the children and healthy diets for the family. The family lives in a moderately healthy environment, which minimizes its predisposition to environmental health hazards and risks. Community and social contexts also act as the family’s social determinants of health. Community resources such as social support systems contribute to the family’s health(Islam, 2019). The interviewed family has adequate support from the community members. As a result, it contributes to its coping with adversities and complex health needs.
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Screening is important for the early identification and management of health problems that include diabetes, hypertension, obesity, and changes in sensory functions among others. Each of the family members has age-appropriate screening that they should utilize for their health. The recommended screenings for the parents include blood pressure, breast, prostate, and colon cancer, eye tests, weight, cholesterol check, skin, and hearing tests. The screenings facilitate early detection of health problems such as hypertension, skin cancer, vision, hearing, and cancers. The age-appropriate screenings for the grandfather include mental status examination, bone density studies, height and weight, and shingles and pneumococcal vaccinations. The screenings facilitate early detection and management of health problems, including osteoporosis, mental health problems, and vulnerability to communicable diseases. The recommended screenings for the children include weight, height, eye, skin, breast, blood pressure(McKinnon, 2021).
The health belief model can be used in creating a plan of action for the interviewed family. The model can be used to facilitate nurses’ understanding of the factors contributing to the health and influencing behavioral change in the family. The model asserts that individuals change their behaviors based on the perceived threats associated with a health problem. Additional factors such as perceived susceptibility, severity, benefits, cue to action, and self-efficacy influence a family’s decision to change its behaviors. The health belief model is applicable for the family, as it provides it with accurate information about steps of implementing change(Saghafi-Asl et al., 2020). It also empowers the family members to adopt sustainable interventions for behavioral change.
Steps for a Family-Centered Health Promotion
The health belief model can be used to develop family-centered health promotion. One of the steps to achieve the outcome is performing a needs assessment to identify the health needs of the family. The second step is family health education. Health education empowers the family about effective strategies they can use to achieve their desired health outcomes. The third step entails guiding the family in implementing behavioral change interventions. The aim is to ensure consistency in the use of the interventions by the family members. The fourth step is data collection to determine the impact of behavioral change interventions(Grove & Gray, 2018). Evaluation is the last step where family assessment is done to determine its level of behavioral change.
Social determinants of health affect significantly the health of the family. Nurses have crucial roles in addressing them for the family’s optimum health. The health belief model appliesto promote behavioral change in the interviewed family. It can be used to promote sustainable behavioral change, which minimizes adverse health outcomes. Therefore, its use is anticipated to promote the health of the interviewed family.
Grove, S. K., & Gray, J. R. (2018).Understanding Nursing Research E-Book: Building an Evidence-Based Practice.Elsevier Health Sciences.
Islam, M. M. (2019). Social Determinants of Health and Related Inequalities: Confusion and Implications.Frontiers in Public Health, 7, 11. https://doi.org/10.3389/fpubh.2019.00011
McKinnon, M. (2021).Health Promotion: A Practical Guide to Effective Communication.Cambridge University Press.
Palmer, R. C., Ismond, D., Rodriquez, E. J., & Kaufman, J. S. (2019).Social Determinants of Health: Future Directions for Health Disparities Research.American Journal of Public Health, 109(S1), S70–S71. https://doi.org/10.2105/AJPH.2019.304964
Saghafi-Asl, M., Aliasgharzadeh, S., &Asghari-Jafarabadi, M. (2020).Factors influencing weight management behavior among college students: An application of the Health Belief Model.PLOS ONE, 15(2), e0228058. https://doi.org/10.1371/journal.pone.0228058
Refer back to the interview and evaluation you conducted in the Topic 2 Family Health Assessment assignment. Identify the social determinates of health (SDOH) contributing to the family’s health status. In a 750-1,000 word paper, create a plan of action to incorporate health promotion strategies for this family. Include the following:
Describe the SDOH that affect the family health status. What is the impact of these SDOH on the family? Discuss why these factors are prevalent for this family.
Family Assessment Part II
The promotion of optimum health outcomes and wellbeing of families and communities is an important role for nurses. Nurses utilize family-centered, evidence-based interventions that ensure efficiency, quality, and safety in practice. Issues such as social determinants of health may act as barriers to accessing and utilizing quality healthcare services by family members (Hill-Briggs et al., 2020). Therefore, this paper examines the social determinants of health that were identified from the selected family, age-appropriate screenings, health model, and steps for family-centered health promotion.
Social Determinants of Health
Social determinants of health refer to the conditions that affect the health, access to health care services and their utilization by different populations. They encompass the conditions where individuals were born, grew, reside, work in their daily lives, and age. The assessment of Mr. Shawn’s family revealed some social determinants of health that affect them. One of them is knowledge about health issues affecting them (Hill-Briggs et al., 2020). Mr. Shawn’s family suffers from health problems that include diabetes, hypertension, and obesity. The interview conducted with the family revealed that the family engaged in unhealthy dietary habits before Mr. Shawn’s diagnosis of hypertension and diabetes. Their daughter is also obese due to poor dietary habits and sedentary lifestyles. Mr. Shawn’s family health problems are largely attributable to lack of knowledge about the importance of healthy lifestyles and behaviors (Sokol et al., 2019).
The other social determinant of health evident in the family is the lack of social support system for Mr. Shawn’s daughter. The interview revealed that despite being obese, the daughter does not want to engage in active physical activity and transforming her lifestyles and behaviors due to low self-esteem. The implication of this is that the family and the society lack adequate social support systems to help people like Shawn’s daughter have a sense of identity and engage in activities that promote her health. Social support systems are important in helping the vulnerable and the affected feel accepted in their society as well as encouraging them engage in activities that promote their optimum health and wellbeing (Sokol et al., 2019).
The other social determinant of health identified from the family assessment is socioeconomic status. Mr. Shawn’s family is a middle-income family. Family’s socioeconomic status affects the affordability and utilization of high-quality healthcare services for its members. Issues such as medical insurance coverage for the family members also affect access to healthcare services (Hill-Briggs et al., 2020). However, being a middle-income family, Shawn’s family may experience minimal challenges in accessing the care that they need for different health problems affecting its members. Therefore, interventions that address the above social determinants of health should be adopted to ensure the optimum health and wellbeing of the family members.
- Based on the information gathered through the family health assessment, recommend age-appropriate screenings for each family member. Provide support and rationale for your suggestions.
- Choose a health model to assist in creating a plan of action. Describe the model selected. Discuss the reasons why this health model is the best choice for this family. Provide rationale for your reasoning.
Using the model, outline the steps for a family-centered health promotion. Include strategies for communication.
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Social determinants of health are factors within one’s family and community that affect their access to healthcare services. Arthur’s family was interviewed in the previous project. The assessment showed the existence of significant health-related needs for the family. Nurses and other healthcare providers should collaborate with the family in developing healthcare plans to transform their lifestyles and behaviors. Therefore, this paper examines the social determinants of health affecting Arthur’s family, age-appropriate screenings for the family members, and appropriate health model that can be used to develop a plan of care for the family.
Social Determinants of Health Affecting the Family
As noted above, social determinants of health are factors within one’s environment that influence their access to healthcare services. The factors include those in places where one was born, work, grew, aged, and died. The interview with Arthur’s family showed the existence of several social determinants of health affecting them. One of them is the lack of awareness about their health needs. Education is an important aspect in health that increase population’s awareness about health risks and how to avoid them. However, Arthur’s family is not aware of the health risks associated with sedentary lifestyles. The family members rarely engage in active physical activity despite being obese and Arthur suffering from hypertension (CDC, 2022). Arthur and his son consume high amount of high calorie foods, which increases their risk of health complications such as cancer, hypertension, diabetes, and stroke. Therefore, their lack of awareness about the health risks of their lifestyles and behaviors is a crucial determinant of the family’s health.
The other social determinant of health seen in Arthur’s family is the affordability of healthcare services. Despite Arthur and his son suffering from hypertension and obesity respectively, they rarely visit the hospital for assessment and treatment. The family noted experiencing financial hardships, which makes it difficult for them to access and utilize the healthcare services that they need. The American healthcare system is among the most expensive in the world (Palmer et al., 2019). As a result, families from low socioeconomic backgrounds often experience challenges in affording the healthcare services they need for their health and wellbeing.
The other social determinant of health evidence from the family assessment is social and community contexts. Arthur’s family demonstrated the lack of adequate family support system during the assessment. This could be seen from the family members failing to provide their daughter her desired social support when she experienced a relationship failure. The family also does not discuss about issues related to sexuality and relationship due to the influence of their religious beliefs (Palmer et al., 2019). The wider social and community system also does not support healthy habits for its members. This can be seen from the easy access to fast foods for the family members and the lack of community systems to increase the population’s awareness about the importance of healthy lifestyles and behaviors (CDC, 2022). Therefore, Arthur’s family social and community contexts act as their social determinants of health.
Arthur’s family members should utilize different age-appropriate screenings for their health promotion. The age-appropriate screenings for John Arthur include eye examinations, hearing tests, blood pressure screening, skin, dental, and testicular examinations. Age-appropriate screenings for Cate Arthur includes skin, dental, blood pressure, hearing, and eye examinations. The age-appropriate screenings for Chris Arthur includes eye, blood pressure, hearing, dental, and skin examinations. Mr. Arthur’s age-appropriate screenings include blood pressure, testicular, blood glucose, cholesterol, colonoscopy, and prostate screening tests. The age-appropriate screenings for Mrs. Arthur include ovarian cancer screening, mammography, bone density, cholesterol, blood glucose, blood pressure, pelvic, and cervical cancer screenings (Fragala et al., 2019). These screenings are important for early detection and prevention of potential health problems that may affect the family members.
Health Model for the Family
A health model that can be adopted to assist in creating a plan of action for the Arthur’s family is the transtheoretical model. Transtheoretical model is a theory of change used to facilitate behavioral change among the target populations. It promotes long-term behavioral change through multiple adaptions and actions over time. The model postulates that people are in different stages of readiness to embrace healthy lifestyles and behaviors (Castrucci & Auerbach, 2019). As a result, the nurse should create awareness about the change and provide enabling factors for the process. The transtheoretical model asserts that change occurs in steps that include precontemplation, contemplation, preparation, action, and maintenance. This model is appropriate for the family since it will promote sustained lifestyle and behavioral change among the family members (Pennington, 2021). Since change occurs in steps, it would be possible to implement strategies that will prevent family members from relapsing to their unhealthy habits.
Steps for a Family-Centered Health Promotion
The transtheoretical model provides several steps that must occur for the delivery of family-centered health promotion. The nurse should create awareness among the family members for the change in the precontemplation stage (Pennington, 2021). The family members should be made to understand the health risks associated with their behaviors and the need for a change. The nurse should facilitate them to develop interest in changing their behaviors in the contemplation stage. She should also help them to explore strategies that they need for their optimum health and wellbeing in the preparation stage (Liu et al., 2018). The nurse should then guide them in implementing new, healthy lifestyles and behaviors in the action phase. The focus is on ensuring incremental adoption of healthy lifestyles and behaviors and assisting the family members not to relapse to their unhealthy behaviors. The last stage in creating sustainable change is maintenance where family members have stabilized the desired healthy behaviors (Prochaska, 2020). Therefore, the transtheoretical model of change provides an effective approach to assisting the family achieve their desired health promotion goals.
Overall, Arthur’s family experiences significant social determinants of health that affect their healthcare access and health-related outcomes. The nurse should work with the family in identifying the effective ways to promote the optimum health of the family members. The transtheoretical model of change can be applied in assisting the family to achieve its health promotion goals. The model provides steps for achieve sustained behavioral change in the family.
Castrucci, B., & Auerbach, J. (2019). Meeting individual social needs falls short of addressing social determinants of health. Health Affairs Blog, 10(10.1377).
CDC. (2022, May 9). Social Determinants of Health | NCHHSTP | CDC. https://www.cdc.gov/nchhstp/socialdeterminants/index.html
Fragala, M. S., Shiffman, D., & Birse, C. E. (2019). Population health screenings for the prevention of chronic disease progression. Am. J. Manag. Care, 25, 548–553.
Liu, K. T., Kueh, Y. C., Arifin, W. N., Kim, Y., & Kuan, G. (2018). Application of transtheoretical model on behavioral changes, and amount of physical activity among university’s students. Frontiers in Psychology, 9, 2402.
Palmer, R. C., Ismond, D., Rodriquez, E. J., & Kaufman, J. S. (2019). Social Determinants of Health: Future Directions for Health Disparities Research. American Journal of Public Health, 109(S1), S70–S71. https://doi.org/10.2105/AJPH.2019.304964
Pennington, C. G. (2021). Applying the transtheoretical model of behavioral change to establish physical activity habits. Journal of Education and Recreation Patterns, 2(1).
Prochaska, J. O. (2020). Transtheoretical model of behavior change. Encyclopedia of Behavioral Medicine, 2266–2270.
Health is the state of being free from illness, mental stress, physical harm, or social
distress. Therefore, good health goes beyond being free from sickness and injury. Health
promotion seeks to enable people to take charge of their health and maintain and improve it,
according to Jennings and Bamkole (2019). Health promotion is witnessed through five major
areas: creating enabling environments, making public policies, boldening community action,
grooving personal skills, and reorienting the delivery of health services (Dadaczynski et al.,
2022). This discussion will explain how the concept of health has changed over time and why it
is essential for nurses to implement health promotion interventions based on evidence-based
Before the late 19th century, the concept of health only encompassed the idea of being free
from illnesses. There were sanitary challenges that people lived with, and it made diseases
widespread. Thus, being free from diseases was a luxury and termed as being in good health, as
Herzlich and Pierret (2020) explain. The late 19th century and early 20th century saw fewer
diseases as sanitary conditions improved. The invention of vaccines in the 20th century changed
the focus from curing diseases to preventing them. In this period, the concept of health was
revised to encompass a broader view to include wellness, illness, and overall well-being as a
health package (McCartney et al., 2019). A person’s social well-being, mental state, and spiritual
state are part and parcel of the current concept of health.
Since the first health promotion conference in 1986 in Ottawa, Canada, health promotion
has changed over time (Nutbeam et al., 2021). The charter developed during that conference has
been the foundation of health promotion evolution for over three decades. Health promotion has
led to the introduction of health education in higher institutions to equip healthcare professionals
with the necessary knowledge and skills to tackle current and emerging health crises. Advancing
technology has necessitated health information dissemination to a larger audience, thus
increasing the rate of health promotion. Different jurisdictions worldwide have held health
promotion conferences yearly to expand the scope and reach of patient education and general
wellness. Various educational grants sponsor health promotion research to further the strategies
for health promotion under the umbrella of improving individual lifespans in evidence-based
practices. Nurses must implement health promotion interventions based on evidence-based
practice because EBPs provide the most effective care in a structured way, ensuring better
patient outcomes and social well-being.
The concept of health has changed over time due to advancements in healthcare
education, the widespread use of modern technology, the development of government healthcare
frameworks, and research in health promotion. This change has prompted the inclusion of
people’s social, spiritual and mental needs to be evaluated as their health needs. The implication
is that many diseases previously grouped as fatal have become manageable under new
medications and healthcare. The utmost healthcare is achieved when nurses implement evidence-
based practice proposals that have proven to improve the health of society.
Dadaczynski, K., Carlsson, M., & Gu, Q. (2022). Guest editorial: Leadership in school health
promotion. The multiple perspectives of a neglected research area. Health Education,
122(3), 261-266. https://doi.org/10.1108/HE-04-2022-138
Herzlich, C., & Pierret, J. (2020). Illness: From causes to meaning. In Concepts of Health, Illness
and Disease (pp. 71-96). Routledge. https://doi.org/10.4324/9781003136378-5
Jennings, V., & Bamkole, O. (2019). The relationship between social cohesion and urban green
space: An avenue for health promotion. International Journal of Environmental Research
and Public Health, 16(3), 452. https://doi.org/10.3390/ijerph16030452
McCartney, G., Popham, F., McMaster, R., & Cumbers, A. (2019). Defining health and health
inequalities. Public Health, 172, 22-30. https://doi.org/10.1016/j.puhe.2019.03.023
Nutbeam, D., Corbin, J. H., & Lin, V. (2021). The continuing evolution of health promotion.
Health Promotion International, 36(S1), i1-i3. https://doi.org/10.1093/heapro/daab150
Family Assessment Part II – Rubric
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|Criterion||1. Unsatisfactory||2. Less than Satisfactory||3. Satisfactory||4. Good||5. Excellent|
|SDOH Affecting Family and Family Health StatusSDOH Affecting Family and Family Health Status||0 pointsSDOH affecting family health status, and the direct impact to the family, are not presented.||22.5 pointsSDOH affecting family health status are partially presented. SDOH listed are not relevant to the family. The direct impact to the family, and why the factors are prevalent to the family, are unclear. There are inaccuracies.||23.7 pointsKey SDOH affecting family health status are summarized. The SDOH identified are relevant to the family. The direct impact to the family, and why the factors are prevalent to the family, are generally discussed. More support or rationale is needed in some areas.||26.7 pointsThe overall SDOH affecting family health status are accurately identified and described. The SDOH identified are relevant to the family. The direct impact to the family, and why the factors are prevalent to the family, are discussed.||30 pointsThe SDOH directly affecting family health status are relevant, accurately identified and thoroughly described. The direct impact to the family, and why the factors are prevalent to the family, are discussed in detail. The discussion is well supported and illustrates insight into SDOH and their effect on family health status.|
|Age-Appropriate Screening RecommendationsAge-Appropriate Screening Recommendations||0 pointsAge-appropriate screenings are not presented.||22.5 pointsScreenings are presented for some family members. The screenings are not age appropriate. Screenings are not relevant to the information gathered through family health assessment.||23.7 pointsScreenings are presented for each family member. Screenings are generally age appropriate, but entirely not relevant based on the information gathered through family health assessment. More rationale and support is required.||26.7 pointsScreenings presented for each family member are age appropriate. Screenings are relevant and based on the information gathered through family health assessment. Some minor rationale or support is needed.||30 pointsScreenings presented for each family member are age appropriate and highly relevant. Screenings correlate to the information gathered through family health assessment. Strong rationale and support is presented.|
|Assessment of Health ModelAssessment of Health Model||0 pointsA health model to assist in the creation of a plan of action is not presented. The model chosen is not a health model.||22.5 pointsA health model is selected to assist in creating a plan of action. The description of the model is incomplete. It is unclear why the chosen model is best for this family.||23.7 pointsA health model is selected and described. A summary of how the model will assist in creating a plan of action is presented. A general overview for why it is best for this family is provided. More rationale and support is required.||26.7 pointsA health model is selected and described. A discussion of how the model will assist in creating a plan of action is presented. Reasons for why it is best for this family are provided. Some rationale or support is needed.||30 pointsA health model is selected and thoroughly described. A detailed discussion of how the model will assist in creating a plan of action is presented. Reasons for why it is best for this family are clearly outlined. Strong rationale and support are provided to support reasoning.|
|Application of Health ModelApplication of Health Model||0 pointsFamily-centered health promotion using selected health model is omitted.||22.5 pointsSteps for a family-centered health promotion are partially presented. The health promotion is not based on the health model. Significant aspects are missing. There are major inaccuracies.||23.7 pointsThe health model is used to create a general family-centered health promotion. The steps to achieve the desired outcome require more detail to illustrate a clear plan of action. A general plan for communication with the family is presented. More rationale and support is required.||26.7 pointsThe health model is used to create a relevant family-centered health promotion. The steps to achieve the desired outcome are illustrated. Strategies for communication with the family are presented.||30 pointsThe health model is used to create a relevant and viable family-centered health promotion. The steps to achieve the desired outcome are described in detail. Appropriate strategies for communication with the family are clearly presented. The health promotion is well-designed and demonstrates an ability to assimilate findings and appropriately apply theoretical knowledge to achieve desired outcomes.|
|Thesis Development and PurposeThesis Development and Purpose||0 pointsPaper lacks any discernible overall purpose or organizing claim.||5.63 pointsThesis is insufficiently developed or vague. Purpose is not clear.||5.93 pointsThesis is apparent and appropriate to purpose.||6.68 pointsThesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose.||7.5 pointsThesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.|
|Argument Logic and ConstructionArgument Logic and Construction||0 pointsStatement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources.||5.63 pointsSufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility.||5.93 pointsArgument is orderly, but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis.||6.68 pointsArgument shows logical progressions. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative.||7.5 pointsClear and convincing argument that presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.|
|Mechanics of Writing (includes spelling, punctuation, grammar, language use)Mechanics of Writing (includes spelling, punctuation, grammar, language use)||0 pointsSurface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used.||5.63 pointsFrequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register), sentence structure, or word choice are present.||5.93 pointsSome mechanical errors or typos are present, but they are not overly distracting to the reader. Correct sentence structure and audience-appropriate language are used.||6.68 pointsProse is largely free of mechanical errors, although a few may be present. A variety of sentence structures and effective figures of speech are used.||7.5 pointsWriter is clearly in command of standard, written, academic English.|
|Paper Format (use of appropriate style for the major and assignment)Paper Format (use of appropriate style for the major and assignment)||0 pointsTemplate is not used appropriately or documentation format is rarely followed correctly.||2.25 pointsTemplate is used, but some elements are missing or mistaken; lack of control with formatting is apparent.||2.37 pointsTemplate is used, and formatting is correct, although some minor errors may be present.||2.67 pointsTemplate is fully used; There are virtually no errors in formatting style.||3 pointsAll format elements are correct.|
|Documentation of SourcesDocumentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)||0 pointsSources are not documented.||3.38 pointsDocumentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors.||3.56 pointsSources are documented, as appropriate to assignment and style, although some formatting errors may be present.||4.01 pointsSources are documented, as appropriate to assignment and style, and format is mostly correct.||4.5 pointsSources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.|
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