Family Health Care Nursing Provide The Person And Family Centred

Question: Disccuss about the Demonstrate The Ability To Provide The Person And Family Centred. Answer: Introduction Family health care nursing is a science that has evolved 20 years ago. Family Health Nursing involves a philosophy and a way of interacting with the consumer that influences the collection of information by the nurses, patient intervention, advocacy, and the approach of spiritual care (Kaakinen et al. 2014). This philosophy and practice are based on the assumption that health and illness are family events and that health affects all family members. The practice assumes that family has the impact on the health care outcomes (Hockenberry and Wilson 2014). The paper deals with the case study of Emma who is having difficulty in coping up with the development of her 14-year-old son Josh and 4-year-old daughter Lucy. She is anxious about her pregnancy and new coming baby. As a registered nurse working at the early childhood clinic, I have been assigned to deal with this case. The aim of the paper is to demonstrate the ability to provide the person and family centred care in the given situa tion. The paper reports the support provided to the family from the perspective of the role of the registered nurse. The paper discusses the physical, cognitive, and psychosocial development of Lucy and Josh. The report describes the developmental milestones expected to be achieved by both the children. Further, the family assessment is presented in the paper including the factors influencing Emma and her family. The family centred nursing care required in this case is described including the communication, and interviewing strategies that will assist with relationship building with Emma and her family. Lucys physical, cognitive and psychosocial development As per initial health examination, Lucy has normal physical development with fine motor skills. According to Van der Fels et al. (2015), an average height for a four-year-old girl is 101.6 cm, and weight is 16 kg. Lucy was found to have the height of 105 cm and weight of 15.5 kg. In the present condition, she can be considered to have normal growth pattern with no abnormalities found. Genetics may be responsible for the fast growth of height. However, she is a fussy eater which is a risk for overweight or obesity if remain unaddressed. She is also at the risk of under nutrition (Berger et al. 2016). There are no physical activities mentioned by Emma in which Lucy seems to be engaged. However, she is energetic, hard to control and oppositional. It indicates of oppositional defiant disorder. She lacks engagement in the playful activity like other children of this age. Lucy is new to her locality and is away from father may not have friends and may lead to poor psychosocial development. Her mother being pregnant may spend less time with Lucy in fun activity. Lucys elder brother being student fail to spend enough time with her. Therefore, Lucy may not be receiving adequate psychological support, which may have led to defiant behaviour. However, once, starting with schools she would enjoy healthy psychosocial development as she may engage in play, receive peer support and strengthen cognitive development (Van der Fels et al. 2015). Johns physical, cognitive and psychosocial development At the age of 14, John is also having a normal physical and cognitive development. He has manageable behaviour. He is trying to accustom to his new residence and school. Since he is in middle of puberty, he would undergo frequent mood changes, which is normal at this age (Carr 2015). He will undergo the change in physical appearance and development of secondary sexual characteristics such as the growth of beards (Ivashchenko et al. 2016). Separation from old friends and father being distant he could be lacking a psychological support. It is increasing his anxiety to attend to new schools. Poor social connection in the new residence, lack of friends may add to negative emotional changes (Carr 2015). At this stage, he is eager about identity formation. However, it is less easy to see his cognitive changes at this age. After visiting his new school, he could enjoy healthy psychosocial development due to the gain of peer support and cognitive changes that will help him to learn complicat ed materials in school (Earl, Hargreaves, and Ryan 2013). Developmental milestones During the fourth year, a girl child is expected to gain weight at the rate of 6 grams per day.A girl at this age is expected to have 20/20 vision and have a sleep of 11-13 hours at night. They are expected to grow to the height that is double the birth height. Improved balance and coordination skills are expected at this age (Earl et al. 2013). They are expected to strengthen their fine moor skills and gross motor skills. A child at this age should be able to dress up themselves cut out shapes, run, jump, and play with balls. At this age, children are more curious, develop vocabulary, expected to be aggressive, and lack moral concepts, and tend to rebel if too much is expected of them (McCoy et al. 2016). At this age, a child is expected to play and engage in sporting activities, learn to share of things and to read together. At the age of 14, a child attains early adolescence. A boy at this age begins growth spurt and is highly likely to be aware of the sexual orientation. It is expected of a boy at this age to coordinate theory with evidence (Grossman et al. 2014). The capability of formal operational reasoning is expected to increase at this age. Boys tend to be more self-focused in early adolescence as they tend to become more idealistic and critical. A continuous improvement in meta-cognition and cognitive self-regulation is expected at this age. At this age, boys learn to evaluate vocational options regarding interests (Pinquart 2014). A 14-year-old boy is expected to be able to make the subtle adjustment to speech style, and continue to improve grammatical constructions. Vocabulary continues to increase at this age (Shaffer and Kipp 2013). At this age boys are expected to have the conflict with parents, gender stereotyping of behaviour, high dependence on peer support and show conformity to peer pr essure (Grossman et al. 2014). Family assessment Assessment of Emmas family is necessary to identify the potential problems and the nursing needs. It is necessary to ensure the familys understanding and acceptance of the existing family. The family assessment will help to plan and provide the required service with the active participation of the family members. The objective of the assessment is to help the family develop an ability to independently handle their health problem (Dingwall et al. 2014). During interview the procedural and questioning model was used to identify the key concerns of Emma (Milner, Myers and O'Byrne 2015). In the procedural model Emma will be assessed to see what criteria of service she fits. In the questioning model Emma will be asked series of question using active listening skills of communication to understand the nature of the concerns. A non defensive attitude was maintained. Acceptance and empathetic understanding was practiced to avoid being judgmental to the clients concerns. To start with family structure and characteristics Kaakinen et al. (2014), Emma is a 34 years old woman who is six months pregnant with her third child. She has the 4-year-old daughter Lucy and 14-year-old son John. Her husband Michael stays away from her due to contractual work. Her family lives interstate. However, Michael's parents live locally and are supportive. Emma has the good relationship, interaction and communication with them. She lacks psychological support from her husband who is in WA; thereby she is accountable for all the decisions. It has only been six weeks in her new residence. She is unable to manage her four-year-old daughter Lucy due to her oppositional behaviour. John has good bonding with his mother but is keen to have his fathers support. Assessment of the socio-economic and the cultural characteristics Bastable (2016) of Emmas family showed that she is a homemaker and is financially dependent on her husband. Michael is the sole income earner with his parents being retired. In her new residence, she lacks communication with her neighbours due to lack of awareness of the cultural considerations of the new place. Therefore, she has the poor relationship with the larger community. John is attending school and is presently in 9 standards. Lucy is yet to join the school. Since the client has visited the early childhood clinic, it was not possible to assess her home environment. The health assessment Esposito (2013) showed that the Emma is anxious about her pregnancy and lacks the ability to cope with her young daughter's challenging behaviour. She is anxious as she is alone and taking care of her newborn would be difficult if the present condition continues. Due to poor relational network, lack of husbands and parental support, she could be finding it unmanageable to handle both children and home. She is also anxious about her son joining the new school and fitting in the new environment. John seems to have good health except for lacking psychological support from his father and peer support. Lucy has developed a habit of fuzzy eating and is exhibiting defiant behaviour. She has turned oppositional and hard to control for her mother. Overeating behaviour of Lucy may lead to obesity (Lobstein et al. 2015). However, there is no prominent mental or physical health concern. In her family, only Lucy is in urgent need of immunisation. Emma would need to reduce st ress and anxiety as well assistance to manage her home as well as children. The further assessment shows that the client is aware of her problem and is ready to address her concerns. It is indicating that she believes in preventive service as she is seeking help to be able to cope with her childrens development and home management. It means that the client is contemplating her health issues, which means it would be easy to implement the interventions (Dingwall et al. 2014). She seems to lack the problem solving capability although she can cope with her activities of daily living. She also seems to lack the problem solving skills that are adding to her anxiety and panic (Taylor 2014). Potential problems of Emma and her family Based on the assessment it appears that Emma has potential to develop fatigue due to increasing anxiety. If undressed it may lead to depression, which may be harmful during pregnancy. These depressive symptoms may further add to disruptive behaviour of Lucy. She may consequently fail to fulfil the psychological needs of Lucy and John. The emotional insecurities may hamper her self-care. It increases the potential of miscarriage, preterm delivery and giving birth to the baby that is low birth weight (Goodman et al. 2014). Emma is at risk of poor physical and mental health due to financial constraints and lacks broad social network. Other than these stressors, the strengths of Emma include support from Michaels further. Family centred care It can be concluded that deep emotional concerns and mental health are the immediate sources of concern. To enjoy physical and mental well being the client needs the broader social network. The client needs to learn the self-care activities and ways to cope up with anxiety and handle the defiant behaviour of Lucy. For this case, family centred care is the appropriate approach (Macy 2013.). Family centred care is the nursing practice directed to a family as a unit care with the goal of health improvement (Paul 2016). In this approach, the nurse focuses on childrens safety and needs within the contest of the family. The goal of this approach is to build on familys strength to obtain optimal outcomes. It is a collaborative practice, which includes day-to-day interactions among the patient, nurses, physicians and the health care professionals for planning, and delivery of health care (Psaila et al. 2014). This approach considers the developmental, social and emotional aspects of health care delivery (Carpenito-Moyet 2014). It is based on the principle of respecting each child and member of the family, respecting the cultural, ethnic and socio-economic factors affecting the familys experience. It includes the principle of providing formal and informal care. Further, this approach involves empowering each child to discover her strength and build confidence (Coyne 2015). It i s also grounded in the principle of the allowing the client to have choice and control on the care delivery. This approach is also guided by the principle of sharing honest and unbiased information with the client (Shields et al. 2014). Intervention Emma will be provided with the relaxation techniques to relieve her of anxiety and depression. It may include music therapy, exercises, yoga and meditation (Glover 2014). This method will keep her body and mind calm and is cost effective service. It will ensure her sufficient rest. Further, she will be provided with diet chart that will meet her nutritional requirements adequately. Further, she will be educated about the pregnancy care and adverse consequences of anxiety, panic and depression such as miscarriage (Tragea et al. 2014). To avoid isolation, Michel's parents will be involved in care services to incorporeal their values, beliefs and family cultural considerations (Glover 2014). Since John is an adolescent, he will be involved in Emma's care to increase support and assistance. This may include teaching him to be self-dependent that will decrease the burden on Emma. Pharmacological therapy includes administration of drugs that reduce anxiety or antidepressants. Emma will be provided support during pregnancy, childbirth, infancy, childhood and even in adulthood (Smith et al. 2014). The nurse will assess the home environment of Emma to ensure the safety of the family members. It may include removal of sharp pointed objects that may harm Lucy. Emma will be provided with the diet chart to be followed for Lucy to prevent overeating and obesity. The nurse will further assess John and Lucys cognitive development and a presence of any behavioural concerns. The nurse may perform laboratory tests and other tests of integrity ad function for both John and Lucy. If the test results are positive, then it may relive Emma of her insecurities (Psaila et al. 2014). In the case of Lucy, there is a need for identifying the degree of opposition defiant disorder. Lucy will be immunised against polio, chicken pox, and vaccine for diphtheria, Pertussis and tetanus before starting her school (Shields et al. 2014). Emma will be educated about the strategies required to communicate efficiently with Lucy and deal with her defiant behaviour (Pears et al. 2015). She will be further informed about the various cost-effective interventions considering her financial constraints. Some of the strategies include avoiding being permissive with Lucy. Emma must be diligent to develop strong virtues in John and Lucy (Dittman et al. 2016). She will be advised on appropriate job opportunities for her husband in the local area to ensure happy marital life. Counselling is appropriate for John where he will be helped to explore new opportunities in new place and school. Counselling will give him the confidence to fit in the new environment and thrive academically, socially and personally (Murimi et al. 2015). Counselling will help him learn and accept the limitation of his parents and assist his mother in household management. He will be explained about taking responsibility such as caring for Lucy and addressing her needs of play and psychological support. Referral services In a case of complicated situation, multiple interventions are needed. Therefore, Emma will be referred to the social worker for addressing other crisis in the family. She will be referred to psychologists for intense counselling and anxiety therapy. She will be referred to the physician in community service centre who will offer treatment at lower cost. In a case of severe depression, a physician can treat her with pharmacological therapy. She will be referred to family advocate to allow Emma to speak in her voice. Lucy cab is referred to psychologists for treating her oppositional behaviour (Smith, Swallow and Coyne 2015). Conclusion In conclusion, the child and family health nursing is a generalised, well-balanced and integrated approach to enhance the optimal functioning of an individual and the family as a unit. The paper has discussed the family cantered care for Emmas family. The care strategies are based on evidence-based options and the intervention is based on collaborative practice. Therefore, it is expected that it will lead to optimal outcomes. Conclusively, family health nursing begins with nurse process. This process helps to practice with family perspectives which lead to effective intervention. References Bastable, S.B., 2016.Essentials of patient education. Jones Bartlett Publishers. Berger, P.K., Hohman, E.E., Marini, M.E., Savage, J.S. and Birch, L.L., 2016. 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