Family and Community Health

Introduction

A family assessment is an important tool to assess a child’s overall health aspects. It also aims to understand the functions and dynamics of the family which will assist the nurse to determine the possible factors of risks that will be addressed to the child. The family assessment focuses on certain areas like physical, cognitive, moral, and psychosocial. This will enable nurses to understand and comprehend better and will lead to better addressing the potential problems based on the categories.

Family Composition

My family assessment was conducted on the 31st of October from 7-9 pm on a female client named Belle who is currently a petite 9 year and weighs 25.8kg and 130cm in height. She has been wearing spectacles due to her myopia and eczema since birth. She is presently Primary 3 and studying in Yishun Primary School.

The family resides at Block 124, Yishun Street 11 together with her father Arthur aged 39, mother Cecilia aged 34 who are married, younger brother aged 4, grandmother aged 65 and their domestic helper in her mid-30s.

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Arthur’s father in law is not residing with them as his preference is to stay alone in an individual unit. This is a middle-income family. Her father is a Christian and her mother is a Buddhist and both parents is working in the Telecommunications Industry respectively and works permanently on a regular office hours job from 9am-5pm.

According to Duvall’s (1957) 8 stages of family development. This family is categorized in Stage 4, families with school-aged children. The tasks involved in this stage are mainly (1) giving encouragements to the child based on his/her educational achievements, (2) encouraging the child to create relationships outside of the family and (3) allowing the parents to learn and adjust to the child overall development

Physical Domain

In the aspect of the physical domain which consists of 2 areas based on Fine and Gross Motor skills.

Fine motor skills are defined as the coordination of the small muscles which is usually our hands and fingers using our eyes. Gross motor skills are those that require the entire body dynamics that involve the whole-body movement using our larger muscles to perform daily tasks. Belle’s fine motor skills is developing at a normal pace where she is able to use chopsticks, peel oranges, fixing legos, and baking cakes and biscuits. These daily activities will be essential for her as it will help improve her skills and being confident in herself. Belle is very active in sports such as western boxing, rollerblading, swimming, ballet, and gymnastics and this will allow her to improve her overall physical wellness and gain personal satisfaction through the sports.

Cognitive Domain

According to Piaget Theory of Cognitive Development, (2013), Belle is categorized under the Concrete Operational Stage where they become capable of thinking logically and starting to think like an adult as well. For belle’s cognitive development process, she can portray logical thinking by organizing her daily and school timetable based on the important priorities and arranging them based in sequence. At home, she posed open ended questions and learning to form structured questions during communications with her parents at home. Lastly, she can appreciate and recognizing different individual viewpoints at both home and school thus giving her the opportunities to learn and gain understanding through interactions within the environment.

Moral Domain

Based on Lawrence Kohlberg Theory (1971), there are 3 levels of Moral development stages:

1. Pre-conventional Stage 1 &2
2.  Conventional Stage 3&4
3. Post- Conventional Stage 5&6

During the pre-conventional Stage, Belle is responsive to the rules set out by her parents and is either deemed to be either good or bad or right or wrong. If she does not listen to her mother, she will be punished. These will be indicated to her that there are certain rules in the house that needs to be met and must be followed.

In the conventional stage, Belle’s father will explain and provide the reasoning why punishing is needed if rules are not met. This will allow her to understand the rationale and will comply in the future.

At the post-conventional stage, she looks up at her father who is the main individual that will be speaking to her based on all the explanation and reasoning behind the punishment as she feels more adaptive and comfortable with her father.

Psychosocial Domain

According to Erikson's psychosocial theory (Industry), this age is considered where children are able themselves to being socially productive skills and tools. For Belle, she helps out with the household like sweeping and cooking. These activities provide her a positive approach towards being a responsible individual in the future based on self-development, self -esteem and self-evaluation. In general, Belle's overall assessment of the different domains suggested that there are no developmental delays in her growth.

To promote good health and family bonding. There are community resources and facilities located in the central part of Yishun that are available for Belle’s family. The community center provides family activities and programs like the Embracing Parenthood Movement where parents forged a stronger bond with young children through different means of fun interaction and communication through activities. The polyclinic is also located just beside the community center where Belle can seek general treatment if she is unwell and are able to have the different vaccination or dental services which is required for her current age. Her family can gain insightful information on areas such as health promotion strategies, nutritional information, and health strategies. Financial counseling is also provided for her family in the event they are unable to make payments for certain procedures. A community hospital is also within range if immediate interventions is needed. The library is located conveniently located within the shopping mall for Belle to access and expand her interest of reading.

The community resources provided for Belle and her family with the relevant resources and information connecting them with valuable resources. It is also an important tool for bringing children and families together. These resources focused on the development of child needs and requirements. Some resources mainly focused on promoting family bonding with their kids while most resources give general services like healthcare, programs on parent’s education, and library services that will benefit and contribute to the overall well-being and her family.

As a nurse, the interventions we can give to the family if there is an unavailability of community resources, the nurse can advise her family to visit the relevant community websites or links on important information and search the web for topics that could assist them Belle’s continuous growth and further development of her family.

Overall, the entire process of the assessment an experience allows me to gather the important details and identifying the key main points that could assist in the preparations of the family assessment tool. My impression of Belle and family is a functional family