A. Identifying Data
My name is (insert please) and this paper is my family case study according to the criteria set by the Friedman Family Assessment model aimed at facilitating the task of the nurse to assess a family from community and health-based perspectives. The family under consideration consists of three members: a father, a mother, and their son, i.e. me. Although I am already a grown-up man, I have chosen my parents for the assessment due to the conviction that childhood and adolescence years lay the foundation of the person’s perception of the notion of family as well as other essential things like health and healthy lifestyle. If the family has been “multi-challenged”, i.e. “known as vulnerable, multi-problem, multi-stressed” and has displayed poor attitude to health and health care, there is a high probability that children brought up in such circumstance will cultivate similar patterns in their own families (de Melo & Alarcao, 2011, p. 400).
All family members are White Americans. Parents are of the Caucasian origin, though the great-grandmother in the maternal line claimed to have Latin American ancestors, yet these traits are not obvious in the descendents and there are no documented proofs of the fact. Father and mother met on the last year of college and married soon after their graduation. Father’s name is (insert, please) and mother is (insert, please). The entire family follows Catholicism, being fairly religious and adhering to major religious norms and rules. All important religious holidays like Christmas or Easter are used to be celebrated in the family circle, often with numerous relatives attending big family parties. All family members consider themselves to be Americans and are marked by their belonging to the Western culture. Concerning political views, parents support currently the ideological position of the Republicans, though none of them is especially keen on politics despite a firm belief in democracy and the power of people to influence the situation in the country. The family belongs to a typical middle class in terms of social stratification. Mother has worked as a teacher of history for more than 25 years while father has been a private entrepreneur and owned a small business enterprise. The income of both parents has been sufficient to lead a lifestyle when no one lacked anything essential. There is only one child in the family.
Family’s recreational and leisure time activities have evolved over time in terms of preferences and abilities to get involved into favorite occupations. In the youth, father was fond of soccer, but later golf became his favorite leisure time activity. Mother preferred a less active pastime and had a hobby of collecting and reading rare books, preferably on historical topics concerning the history of the USA. However, the family used to spend much time together in order to promote understanding and unity. Hiking became their favorite leisure time activity when their son could join them in the trips. Thanks to this hobby, the family spent much time in the fresh air and travelled to various destinations known for their natural beauty. Son has also shared his father’s fondness of soccer. In the high school, he was a member of an amateur soccer team, yet later he preferred watching matches rather than participating in them. Nowadays, recreational activities of the family have become less active due to the senior age of parents. Now, they like spending time in the comfort of their home either reading and watching TV or inviting their friends for tea and a card game. Besides, they like attending a theatre and try to do that at least once per month.
B. Developmental and Environmental Data
Family’s present developmental stage is stage 8 called ‘Families in retirement and old age’ (Stanhope & Lancaster, 2012). The elder people under consideration have been in their retirement age for about 10 years, yet they claim that their lives have not become miserable and senseless with the loss of job and with the advent of less active life. In fact, they are happy that they have more time to devote to their hobbies and relax a bit after many hard-working years. Father and mother are the representatives of the new generation of old people who are educated, healthy, and active. Besides, their health has not deteriorated to the state that would require radical medical intervention or constant supervision. Of course, they are not as healthy as they used to be and their age means the increase of risk of some diseases and the reduction of their physical capabilities, but active lifestyle and healthy diet as well as timely visit of health care specialists enables these people to stay strong and optimistic.
In terms of developmental tasks fulfillment, the family displays a high level of adapting to the changes caused by age. First, parents manage to maintain satisfying living arrangements as they have not moved out of the house they bought some decades ago. They have not greatly suffered from the economic crisis and loss of jobs as they have savings that enable them to conduct their lives in the way they are used to do. This way, they have also avoided the trauma usually evoked by the need to relocate. Second, adjusting to reduced income has undergone gradually and rather smoothly. Of course, they had to give up some costly habits, but it was not traumatic for them. Third, the husband and wife have supported each other in the period of transition to the current stage. Their marital relationships are said to be stable and strong. There has never arisen a risk of divorce despite some minor quarrels that happen in many families. Furthermore, parents are supported by their son who is ready to assist them in anything they may require. The larger family like cousins, nieces, and nephews are also an integral part of the assessed people’s life, thus facilitating their coping with problems and potential losses. Nonetheless, the most important task that the family tries to fulfill is to make sense of their existence, which is done through active participation in the community’s life, socialization with friends and peers, communication and maintenance of close ties with the child, and adoption of various hobbies like the recent one concerning food tourism. Moreover, all health concerns are being consulted with a doctor and are thus taken care of in an appropriate and timely manner.
Nuclear family’s history is rather prosaic as a man and a woman met in their senior year in college, fell in love, and decided to marry soon after their graduation. Both people come from ordinary White American families attending the Catholic Church. This way, there were no obstacles to their marriage coming from their history or origin. When the father was offered a job in another state, his then-pregnant wife supported his decision and they moved together, which has never been regretted by any of them. Three years after marriage, a son was born and he was the only child in the family. Mother stayed at home with a child for three years, after which he started attending a kindergarten as the mother decided to start teaching again. Luckily, the family’s life was devoid of any tragic or epic moments. The happy and content life of the family was led in a two-storied house in the suburbs. The house is rather spacious and has been decorated by the mother. There is a garden where a child once used to play and where now the family spends time in the evenings and organizes family picnic gatherings. The distinguishing mark of the house is a large library on the first floor, which has been mainly collected by the mother who simply adores books. The family’s connection with the larger family like parents’ cousins, nephews, and nieces is solid and constant, which leads to some holidays being spent all together in various corners of the US.
C. Family Structure and Family Functions
The family under consideration displays harmonious family interrelations presupposing “fairness, mutual trust and respect, effective communication, conflict management, and commitment” (van der Merwe et al., 2012, p. 18). Communication is essential for all family members who try to listen to each other and be efficient and productive in the process of interaction. Father and mother sometimes seem to have developed deep understanding of each other that does not even require elaborate utterances. External variables that affect communication in the family include parents’ occupation. For instance, the mother sometimes starts ‘teaching’ her family members while father brings home his commanding tone. On the whole, communication in the family is open and free, encouraging the exchange of ideas, thoughts, and stories. The decision-making process differs on the basis of which issue to is to resolved and which decision is to be hence taken. Although the father is claimed to be the head of the household, the mother is the informal leader as she is immaculate while implicitly manipulating her husband who sincerely believes that he is the one to take a wonderful decision. Right after marriage, father supposed that ideal wife should stay at home and look after children and the house. Nonetheless, our family was not androcentric and all vital decisions have been taken on the basis of mutual agreement and support. Gender stereotypes partially affected father’s perception of an ideal wife, yet the mother managed to dissuade any stereotypes, hence excluding gender social stereotypes and labeling from the variables affecting role structure that among others include community, beliefs, education, and position in life.
The most important family values are thus sincerity, truthfulness, support, friendliness, commitment, good humor. Family values are first and foremost influenced by family members, society in large, outer familial circle, and lifestyle. Parents have taught their son to be truthful and sincere no matter what as these two qualities are the prerequisite requirements of trust and commitment. The only value conflict that has occurred in the family concerns the mother’s decision to work when the son was about three years old as the father voiced an opinion that woman’s priority should have been the bringing up of their child rather than career. However, mother believed that job would bring her moral satisfaction and an opportunity for self-fulfillment, which in turn would make her a better mother. The value conflict was then successfully resolved in a way that left both partners satisfied. This value was also the main cause of stress, which necessitated the mother to turn to a specialist who prescribed her sedatives to reduce the level of stress. Other values have not had a significant effect on the health status of the family. Concerning affective responsiveness, it “refers to the ability of the family to respond to a full range of affective experiences with the appropriate quality and quantity of feelings” while “affective involvement denoted how often, and to what degree, family members show an interest and invest themselves in each other” (Aarons et al., 2007, p. 558). In our family, these two features are pronounced, though to a lesser extent in the relationships of a son and a father with the latter seeming sometimes excessively restrained and tensed. At the same time, closeness and nurturance are obvious in the mother-son relations.
On the whole, the child has been reared in accordance with a typical Western cultural pattern and Catholic religious beliefs. However, no ideas or opinions have ever been imposed on a boy as parents trusted in their child’s ability to choose for himself what suits him most. Belonging to middle social class implies that the child has got decent education and never suffered from deprivations of any kind. Family plays a pivotal role not only in the normal circumstance of child upbringing, but it becomes even more significant in stressful situations, especially when the health of a child depends on the family like in the case of coping with medically unexplained symptoms (Kozlovska et al., 2013). Nonetheless, the researches claim that “family stress is not universally understood and is often confused with individual stress, which is generally managed well by nurses” while “substantial evidence shows that few nurses have the requisite intervention skills for a more family centered approach to care” (Tomlinson et al., 2011, p. 712). In my case, family stress has not contributed to any health problems. Moreover, my parents were very supportive when I undergone physical rehabilitation after a leg trauma in the high school obtained during a soccer match. It was a surprise for me at that time that parents did not insist on my abandoning sport and were ready to accept any decision while assisting me in proper healthy behavior afterwards.
D. Health Care Function
The assessed family has a very serious attitude towards health. They have always supported an idea that health is a treasure that should be preserved through a healthy diet, active lifestyle, sport, and lack of harmful habits or avoidance of potentially dangerous situations. Therefore, parents encouraged their child to turn to health care specialists in case some concerns arise in order to treat a possible disease on an early stage rather than wait till it would become serious and would require much time, money, and efforts. Healthy lifestyle is one of the values that the parents have managed to instill in their son.
The family defines health as a state of well-being when nothings either in body or spirit worries a person and causes discomfort or pain. Thus, illness is a deviation from this normal state of harmonious physical and mental well-being. Taking into account that the family members are well-educated people who take care of themselves, their level of knowledge concerning health is high. Due to such a responsible attitude to health issues, both parents do not suffer from major chronic diseases and are regarded as relatively healthy for their age. There was a risk of heart disease in the family as mother’s father suffered from heart attack at a rather early age, yet the woman has always been aware of the risk and took preventing measures to minimize the risk. Otherwise, there are no alarming features in the family’s health history. Family’s feelings and perceptions of health care services have varied over the years. In the youth, they did not view the services as something of utmost importance, thus spending less on health care insurances. With the years passing and their health slightly deteriorating, they have altered their opinion and now suppose that investing in one’s health is a requirement of a safe and happy life. Besides, it is traditionally supposed that White Americans have the most serious and responsible attitude to their health and health care services in comparison with other ethnic groups like Hispanic Americans, for instance (Aarons et al., 2007).
Family assessment is an extremely useful tool that facilitates a medical worker in better comprehension of a patient, his/her vision of health and appropriate care services as well as his/her family’s role in the treatment and recovery process. Having assessed my family with the help of the Friedman Assessment Model, I have learnt some new facts about my parents and have deepened my understanding of how a typical White American family supposedly deals with arising health issues. Actually, the assessment has not influenced much my definition of family as it has only justified an already existing one. Nonetheless, it has slightly altered my vision of how health should be treated in order to enjoy a content life in the old age. Health should never be taken for granted and health care specialists are the only people who can help others develop a productive attitude towards health matters. Undoubtedly, all families differ in various respects and the assessment of one family cannot serve as a model for the rest. A professional nurse should be flexible and able to adapt to different circumstances, including the ones connected with family assessment.
It seems that nowadays most experts advocate for a systemic approach to family assessment, which would make this tool even more efficient and useful (Nichols & Tafuri, 2013). One of the most recent developments that appeals personally to me in this respect is the concentric sphere family environment model and companion tools for culturally congruent family assessment, which is an all-encompassing approach to this matter (Hohashi & Honda, 2011). Furthermore, it should be noted that “there is little research on nursing students’ application of family health assessment in clinical practice”, which justifies the need to incorporate more practical lessons into the curriculum rather than only theoretical knowledge concerning family assessment (Lee et al., 2011, p. 78). All things considered, conducting family assessment of one’s own family is the initial step towards understanding one’s own attitude towards health issues, which is a significant stage on the way towards being able to help people with their health concerns.