NRS-429 Family Assessment Part II 

Sample Answer for NRS-429 Family Assessment Part II  Included After Question

Description:

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:

  1. 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.
  2. 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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A Sample Answer For the Assignment: NRS-429 Family Assessment Part II 

Title: NRS-429 Family Assessment Part II   

Family Assessment II

The health and wellbeing of families depend largely on the social and environmental factors in their communities. Social and environmental factors influence the access to and utilization of healthcare services. They act as critical determinants that can either enhance or hinder the utilization of healthcare services and health outcomes of individuals with different health needs. Therefore, this paper explores the social determinants of health, age appropriate screenings and health model that can be utilized to ensure family-centered health promotion for the family interviewed in assessment one.

Social Determinants of Health

Social determinants of health are non-medical factors that play a role in influencing the health outcomes of individuals, families and communities. They mainly refer to the conditions where individuals are born, work, grow, live and age (Hill-Briggs et al., 2021). The assessment with the family showed a number of social determinants that influence its health. One of them is the level of income.

Income is a critical determinant of health, as it influences access and affordability of care. Income also influences the affordability of health insurance programs that in turn helps lower the costs of care (Palmer et al., 2019). Income appeared to affect the health status of the family. It affected the family’s affordability of healthy diets, utilization of screening services and treatment services for the different health problems affecting the family members.

The other social determinant of health identified in the family during the interview is education. Education influences the awareness of individuals to healthy lifestyles and behaviors. It influences the uptake of services such as screening and treatment services for health problems. Education also influences other predictors of health and wellbeing such as employment status and level of income (Donkin et al., 2018).

The interviewed family had well-educated members. The husband and wife were educated and working while children are in the university. The benefit of education could be seen from their increased utilization of preventive and health promotion services such as screening and treatment of diseases to prevent their progression and worsening of symptoms.

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The other social determinant identified in the family is unemployment. While the parents of the family were employed, they experienced a high dependency rate from the other family members (Hill-Briggs et al., 2021). The interview showed that the grandparents and children depend largely on the little income from the parents, which affect their overall health and wellbeing. The high rate of dependency affects affordability of healthcare services as well as healthy diets for the family, hence, its health and wellbeing.

The other social determinant identified from the interview is food insecurity. Adequate, healthy food is important for the promotion of the health and wellbeing of families and communities (Palmer et al., 2019). Healthy foods prevent health problems such as obesity and malnutrition in the community. The interviewed family reported that despite having access to healthy foods, affording them was a challenge. As a result, they were predisposed to making unhealthy food choices in some situations, which affects their health and wellbeing.

The last social determinant of health identified from the interview with the family is housing. Safe housing is important for the promotion of health of the families. The housing conditions such as hygiene, aeration and space should promote the health and wellbeing of the occupants. The environment should also be clean to minimize the exposure of the family members to disease causing organisms (Donkin et al., 2018). The interviewed family lives in a healthy environment and housing. As a result, they have minimal exposure to environmental hazards that could predispose them to health problems.

Age Appropriate Screenings

Screening is an important tool utilized for primary prevention. It facilitates early identification and management of potentially life threatening health problems such as obesity, diabetes, heart disease and cancer among others. Each of the family members in the interviewed family has age-appropriate screenings that they need. The appropriate screenings for all the family members irrespective of their ages include weight, blood pressure, blood glucose levels, eye and ear, cholesterol, and skin screenings for pathological lesions.

The children require additional screenings that include breast examination, Pap smear, and testicular examinations. The parents require screenings that include pelvic exam, Pap smear, testicular, breast examination, and cholesterol check. The grandparents require screenings that include prostate screening, mammography, full body scan, and colonoscopy.

Health Model

The selected model to guide the plan of action for the interviewed family is health belief model. Health belief model can be utilized to understand and predict the ability of individuals to change their health-related behaviors. The model focuses on transforming the beliefs that individuals have towards their health and health behaviors for them to embrace the needed lifestyle and behavioral modifications. By focusing on influencing factors such as perceived threat to sickness, severity, susceptibility, benefits, and cues to action, healthcare providers can inspire sustained behavioral change among individuals at risk of health problems (Liu et al., 2021). Consequently, it makes the health belief model an effective theory that can be used to achieve sustained positive behavioral change in the family.

Steps for Family-Centered Health Promotion

The health belief model provides insights into the steps that can be utilized to deliver family-centered health promotion. One of the steps is open communication. Open communication among family members and healthcare providers contribute to trust and honesty. It also empowers the vulnerable to embrace positive behaviors that will contribute to their health (Kıssal & Kartal, 2019). The second step is recognizing the importance of the family.

NRS-429 Family Assessment Part II 
NRS-429 Family Assessment Part II 

Families exist as unique entities with members having interrelated relationships. As a result, the model leverages the need for active involvement of the family members in the exploration of health issues facing them and interventions to prevent and manage them. The other strategy is health education. Health education creates awareness among the family members about the need for lifestyle and behavioral transformation.

Through it, family members are empowered to play a proactive role in addressing their health needs. The last strategy from the model is the use of family appropriate interventions to promote their health. The model asserts that the interventions for health promotion should be culturally appropriate and adaptive (Liu et al., 2021). They should be relevant to the actual and potential needs of the family members to enhance their use and promotion of health.

Conclusion

Overall, social determinants of health have critical effect on the health of families. Social determinants of health such as level of education, employment status, and income influence the access to and utilization of care services. The health belief model can be used to promote the desired behaviors in the family. The strategies of the model guide the implementation of sustainable strategies that would enhance the health, wellbeing, and understanding of the family on issues affecting them.

References

Donkin, A., Goldblatt, P., Allen, J., Nathanson, V., & Marmot, M. (2018). Global action on the social determinants of health. BMJ Global Health, 3(Suppl 1), e000603. https://doi.org/10.1136/bmjgh-2017-000603

Hill-Briggs, F., Adler, N. E., Berkowitz, S. A., Chin, M. H., Gary-Webb, T. L., Navas-Acien, A., Thornton, P. L., & Haire-Joshu, D. (2021). Social Determinants of Health and Diabetes: A Scientific Review. Diabetes Care, 44(1), 258–279. https://doi.org/10.2337/dci20-0053

Kıssal, A., & Kartal, B. (2019). Effects of Health Belief Model-Based Education on Health Beliefs and Breast Self-Examination in Nursing Students. Asia-Pacific Journal of Oncology Nursing, 6(4), 403–410. https://doi.org/10.4103/apjon.apjon_17_19

Liu, C., Chen, X., Huang, M., Xie, Q., Lin, Q., Chen, S., & Shi, D. (2021). Effect of Health Belief Model Education on Increasing Cognition and Self-Care Behaviour among Elderly Women with Malignant Gynaecological Tumours in Fujian, China. Journal of Healthcare Engineering, 2021, e1904752. https://doi.org/10.1155/2021/1904752

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

A Sample Answer For the Assignment: NRS-429 Family Assessment Part II 

Title: NRS-429 Family Assessment Part II 

In part I of the assessment, I interviewed Family N, a nuclear, African American family comprising six members. The age of the family members includes Mr. N, 58; Mrs. N, 55; firstborn (female), 30 years; second-born (male), 26 years; third-born (male), 23 years; and fourth-born (female), 15 years. During the interview, strengths were noted in the functional health patterns of Nutrition and Activity/Exercise, but problems were identified in Values/Health Perception, Sleep/Rest, and Role-Relationship. The purpose of this paper is to discuss the SDOH affecting family N and create a plan of action to incorporate health promotion measures for the family.

SDOH Affecting Family and Family Health Status

Social determinants of health (SDOH) are the non-medical factors that positively or negatively affect individuals’ health outcomes. All the family members have at least completed their high school education. Their literacy levels have enabled them to understand measures to maintain good health  (Hahn, 2021). For instance, Mrs. N observes healthy dietary habits since she understands the health risks of unhealthy diets like high-fat and salty foods. The family’s annual household incomeis adequate to provide them with decent housing, healthy foods, and access to healthcare, which have significantly led to better health outcomes.

Additionally, employment has positively affected the family and its health status. The family has access to private health insurance provided by Mr. N’s employer, which enables them to access health services that they would be limited from accessing without insurance. Furthermore, the family lives in a rural neighborhood, enabling them to grow vegetables and fruits and source food from the farm (Islam, 2019). This has contributed to positive health outcomes since they can access healthy foods. The security in the neighborhood also enables them to walk to work, which promotes their physical health.

Age-Appropriate Screening Recommendations

Mr. N will be recommended to undergo screenings for hypertension, lung and colorectal cancer. The USPSTF recommends hypertension screening for adults 18 years and above. It also recommends yearly screening for lung cancer using low-dose computed tomography (LDCT) in persons 50 to 80 years with a 20-pack-year smoking history and those currently smoking (USPSTF, n.d.). In addition, the USPSTF recommends colorectal cancer screening for adults 50 to 75 years. Screening recommendations for Mrs. N will include breast cancer, hypertension, colorectal cancer, and cervical cancer. The USPSTF recommends biennial mammography screening in females 50 to 74 years, and she is thus a candidate (USPSTF, n.d.). Furthermore, cervical cancer will be indicated because the USPSTF recommends cervical cancer screening every three years using cervical cytology alone or every five years with high-risk human papillomavirus (hrHPV) test alone.

The firstborn daughter will be recommended screenings for hypertension and cervical cancer using cervical cytology or hrHPV test. Recommended screening for the 26 and 23-year-old sons includes hypertension and HIV. The USPSTF recommends HIV infection screening in adolescents and adults 15 to 65 years (USPSTF, n.d.). Screening for major depression will be recommended for the 15-year-old.

Assessment of the Health Model

The Health Belief Model (HBM) can be used to create a plan of action in health promotion for family N.  HBM was developed to explain why individuals engage or fail to engage in preventive health measures. The model asserts that an individual’s belief in a diagnosed illness and their perception of a treatment’s effectiveness predicts their chances of behavior change (Zhao et al., 2022). HBM variables include perceived severity, susceptibility, barriers, benefits, self-efficacy, and cues to action. HBM can be used to identify if the family perceives a threat of developing a chronic illness to be serious. HBM will also identify if they feel they are susceptible to diseases, have the confidence to adopt the recommended preventive measures, and if they perceive that there are more benefits than barriers to adopting the preventive measures.

Application of Health Model

Applying the HBM will be guided by the variables: susceptibility, severity, benefits, barriers, and self-efficacy. In perceived susceptibility, the family members will be assessed on their perception of being at risk of developing chronic illnesses and measured using the five-point Likert scale (Shitu et al., 2022). Perceived severity will include assessing the family’s perception of the seriousness of chronic illnesses. The family will then be asked about their perception of the benefits of adopting healthy lifestyles to assess perceived benefits. Perceived barriers will be assessed by asking about the family’s perception of the factors limiting them from adopting disease-preventive measures (Shitu et al., 2022). Self-efficacy will be measured by assessing the family’s confidence in adopting the recommended preventive interventions. The interviewer will establish a rapport with the family at the beginning of the interview and use respectful language to maintain effective communication.

Conclusion

Various SDOHs have influenced family N’s health, including the education level, income, employment, and neighborhood. The SDOH have positively impacted the family’s health as they understand the impact of lifestyle practices and have access to insurance, healthy foods, and healthcare services. The recommended screenings for the members include hypertension, lung cancer, colorectal cancer, cervical cancer, HIV, and depression. HBM since it will help understand why the family members have adopted or failed to adopt certain preventive measures.

References

 Hahn, R. A. (2021). What is a social determinant of health? Back to basics. Journal of public health research10(4), 2324. https://doi.org/10.4081/jphr.2021.2324

Islam, M. M. (2019). Social Determinants of Health and Related Inequalities: Confusion and Implications. Frontiers in public healthpp. 7, 11. https://doi.org/10.3389/fpubh.2019.00011

Shitu, K., Adugna, A., Kassie, A., & Handebo, S. (2022). Application of Health Belief Model for the Assessment of COVID-19 preventive behavior and its Determinants among Students: A structural equation modeling analysis. PloS one17(3), e0263568. https://doi.org/10.1371/journal.pone.0263568

 United States Preventive Services Taskforce (USPSTF). (n.d.). A and B recommendations | United States preventive services Taskforce. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation-topics/uspstf-and-b-recommendations

Zhao, Y. C., Zhao, M., & Song, S. (2022). Online Health Information Seeking Among Patients With Chronic Conditions: Integrating the Health Belief Model and Social Support Theory. Journal of Medical Internet Research24(11), e42447. doi: 10.2196/42447