After my sister-in-law had introduced me to the Johnson family, I called them and we agreed to meet in their apartment on Saturday morning when the whole family will be home. When I got to their apartment they welcome me with a smile. I introduced myself as a second year nursing student from George Brown College. I told them I was doing a family project and that the assignment will require me making about 7 visits to their home by the time it is completed. In my conversation with the family I employed different communication skills that enabled me to obtain as much information as possible from the family as they felt comfortable enough to willingly share it. I listened very carefully to the family when responding to my questions. I used paraphrasing, restatement, reflection, occasional touching and silence during our conversation. I also used open-ended questions like, “how does the socio-economic status of the family in Canada compare with their homeland’s? Question of this nature is open-ended. It is aimed at making the family feel at ease and increases their level of participation.
“Such questions are designed to permit the client to express the problem or health need in his/her own words (Arnold and Boggs, 1999, p.217). “resource for everyday living, the ability of family members and a family as a whole to achieve stage specific development tasks”. I began the assessment of the family’s health and concerns by asking them to describe for me how they perceive their current state of health. Mr. and Mrs. Johnson (Michael and Elizabeth) seem to have similar perception of what being healthy is. They stated that being healthy entails being free of any bed-ridden illness and being able to perform a reasonable level of physical activities like walking, gardening, dancing and spiritually at peace with one’s self. Tracy (eldest child) described good health as being about staying physically fit and slim built through regular exercise. She also said good health is reflected in good skin with no sign of diseases and a stress free mental state.
Clement and Cathy being younger than Tracy, understandably however, described good health as being able to participate in many sporting activities, partying occasionally, and not eating a lot of junk food. After they have all told me what their understanding of good health was, I asked them to grade the overall health of the family from poor, fair, fairly good, good to excellent. They scored their overall health as fairly good. They said their choice was based on the fact that with the exception of Tracy the family does not exercise at on regular basis. Also, Elizabeth suffers from hypertension. They admit they eat junk food during the week because the hardly find to cook. The family’s past experience with health issues principally borders on Elizabeth’s ( mother) stress level and weight problem. Elizabeth is slightly overweight and has hypertension. According to her she might have inherited it from her father since she was about 40 years of age.
Elizabeth had a crisis late last year, at friend’s Christmas party. She stated, “I think I had a little too much to drink that day and that must have caused blood pressure to rise”. She stated she came home from the party that evening and complained about a pounding headache and took Tylenol. About 2 hours later, the headache worsened and her temperature rose. Michael (father) stated, him and the eldest child Tracy had to rush her to emergency unit of the local hospital. The triage nurse checked her B.P. Elizabeth’s BP was 190/108 which was above her normal BP of 150/100. She was then sent for further tests to ensure there has not been any damage to her organs. “what did your family find helpful from the doctors and nurses at the hospital? As a CHN I believe the Johnson family health issues are mainly stress, hypertension and Elizabeth’s weight problem.
Getting the family’s current stress level and the mother’s in particular to a level such as will not develop into another health crisis is a major concern. Increased weight and stress could elevate the mother’s BP. Also increase in the family overall stress level could affect the family’s harmonious relationship due to lack of communication and attention from the parents and the eldest child, Tracy. Related to Elizabeth’s (mother), hypertension, the family is concerned about her not eating breakfast and lunch regularly at home because of the long hours she spends at her job. The family fears this might result in her consuming food with high salt and fat content, which will obviously not help her weight gain and hypertension. The family will be introduced to “Canadian Food Guide” for 6 weeks. This will show them appropriate servings of nutritious food even with their busy schedule and keep them healthy without weight gain problems especially for the mother.