community family assignment
TRANSCRIPT
8/3/2019 Community Family Assignment
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DOMINICA STATE COLLEGE
Faculty of Health Sciences
ASSOCIATE SCIENCE GENERAL NURSING
COMMUNITY NURSING HSC 121
FAMILY NEEDS ASSESSMENT
Presented to
MS. LAURENT
By
MONETTE LAURENT
REBEKAH ROBERTS
0498
CAROL TELEMACQUE
0692
29. 11.11
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CONTENTS
ACKNOWLEDGEMENTS
INTRODUCTION 4
INTERVIEW 5
FINDINGS FROM INTERVIEW 17
PLANS FOR MEETING PRIORITY NEED 18
GROUP¶S ASSESSMENT OF THE PROCESS 19
CONCLUSION 21
BIBLIOGRAPHY 22
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ACKNOWLEDGEMENTS
The group wishes to thank all those who, by way of any direct or indirect
assistance helped make this process a smooth one and this project a reality. God, first
and foremost for all that we are and produce, as it is a manifestation of his numerous
blessings, his guidance and mercy.
Gratitude is extended to the family on whom this assignment was based, for their
patience, team work and cooperation with our group. Their willingness to learn and their
willingness to collaborate with us on this endeavour has undoubtedly assured that
education and improvement has taken place in their household and will bring forth
lasting and positive change in their hygiene habits.
We also wish to thank our esteemed lecturer for this unique opportunity that has
afforded us a very meaningful glimpse into community nursing. This aspect of nursing,
as we have first-handedly seen, is one than can bring great rewards in prevention and
management of disease and collaboration and connection with individuals in the
community.
We would also wish to thank our fellow classmates and others persons in the
community and elsewhere from whom we have gained insight, increased understanding
and assistance throughout this entire process.
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INTRODUCTION
This project allowed us as a group, to gain a very interesting, insightful and
helpful experience of community nursing. It allowed us the opportunity to collaborate
with other medical personnel, individuals from the community and family members. This
collaboration afforded us the opportunity to ensure proper assessment and holistic care
to the family, allowing us to meet the priority need adequately and effectively.
Community nursing is a branch of nursing that allows nurses the unique
opportunity to connect and collaborate with individuals, families, groups and
organisations to promote health and wellness in the community, and to prevent, early
diagnose and treat diseases that may occur. To ensure all of these, stated above occur,
the nurse must have a great knowledge of all the families under his or her care and
must maintain regular meetings and a great communication level with them and all
individual members.
This project allowed us the opportunity to gain a large amount of knowledge on a
family in the community, allowing us to pinpoint their health needs, risk behaviours and
their susceptibility to diseases. Using this information we were able to address the
priority need for the family, ensuring that in meeting the need, whatever our plan of
action was, it was sustainable by the family. This entire process allowed our
collaborative and creative skills to come through in the group and with other individuals.
It is our hope that by assisting this one family we will indirectly increase the health of the
surrounding families and community.
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FAMILY HEALTH ASSESSMENT
Family Surname: Gabriel and Victor
Household members (name, age, and relationship to head of household):
Ignis Victor ± 32 years (Head of Household) Merle Gabriel- 24 years (Girlfriend)
Jess Victor ± 6 Years (daughter) Naheim Victor- 5 years (son)
Nelton Victor- 2 years (Son)
Family composition:
3 Males 2 Females
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Genogram:
Family health tree (include health problems of individual members):
y The family was unable to identify any known health problems for the members.
Christina
Valmond
Emma
Durand
Pierre
Gabriel
Angela
Valmond
Zando Tina
Gabriel
Unavailable
Ignis
Valmond
Merle Gabriel
Damian
Victor
Nelton
Victor
Naheim
Victor
Jess
Victor
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Family characteristics Sour ce(s) of information Date
Common law family Family Interview 17/10/11
Extended family
Relatives living outside household:
Damian Victor (Oldest son)
Location of relatives:
Castle Bruce and Sineku
Frequency and duration of contact:
Weekly (Castle Bruce) Hour Visits and monthly (Sineku) Day visits
Means of communication:
Phone calls and Visitation
Family mobility
Length of time living in residence:
11/2 year
Location of previous residence:
Castle Bruce
Frequency of geographic moves:
3 times in 10 year period
Country /area of origin:
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Dominica, Castle Bruce and Kalinago Territory
Family structure
Educational experiences:
Primary school completion- both parents, high school (1st form drop out)- mother, 2nd
and 3rd children are in primary school at present.
Family characteristics Sour ce(s) of information Date
Common law family Family Interview 17/10/11
Employment history:
Father- Fishing and farming and mother- has never been employed
Financial resources:
Money obtained from father¶s fishing and farming as well as assistance from Christian
Children Fund for all the children in household.
Leisure time interest:
Family visits to the beach, river and play time at the park
Division of labour:
Mother- care of the household and children
Father- Financial income
Allocation of roles:
Father- is in charge of most decisions and Mother accepts what is decided by father
concerning household.
Distribution of authority and power:
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Father ±is head of household and makes most of the crucial decisions and Mother-
allowed decisions making relating to household if father is absent.
Family cohesion
Emotional bonding of family members:
Consistent interaction occurs within the family through continuous family oriented
activities and family cohesion.
Degree of individual autonomy:
Individuals are allowed to have clear options when decisions are made mainly by the
father but mother choose to allow whatever decisions that are made by father to be
established and children due to age abides as well.
Family adaptation
Flexibility in role change:
Regular exchange of authority between parents occurs in the event of absence of one in
the household
Flexibility in power structures:
Father is in charge of household and mother is allowed to take charge in the absence of
father.
Family Processes
How members communicate:
Regular cohesion between parents and limited discussion among 2 older children with
mother are carried out.
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How decisions are made:
The father is mainly the decision maker of the household.
How problems are solved:
The father and mother discuss and from whatever is discussed and both thinks are best
then that is the route followed.
How conflict is handled:
Discussions are held between parents
Family social integration
Language(s) and /or dialect (s) spoken, where:
English and Creole
Literacy, ability to read or write in English language(s):
Both parents are able to read and write, and first 2 children are able to read at age
appropriate level.
Degree of racial or cultural identity:
Father is blended (Negro and Kalinago), mother is Kalinago, and all 4 children are
blended.
Degree of social networks with neighbors, friends, and other family members:
The family is integrated into the community and interacts with neighbors and friends and
the entire family members. Neighbors, friends and family members all visit and are
visited by family members with exchange of produce and other items.
Network with religious organizations:
The family is Roman Catholic and attends church sometimes.
Network with social organizations:
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The children are provided with food and school supplies by Christian Children Fund.
Degrees of stress experienced by the family
Combinations of stressors:
1. The house lacks piped water and water has to be carried in buckets from the
public pipe.
2. The house lack electricity making it difficult to sometimes cope with care of the
children.
3. It is sometimes difficult to plan meals because children do not eat provisions.
Family characteristics Source(s) of information Date
Common law family Family Interview 17/10/11
Family health behavior
Activities of daily (how family spends typical day):
Father: Wakes up and goes off to fish at sea or goes off to the farm based on the
weather and season of both farming and fishing. He returns at the end of the day to the
household.
Mother: Wakes up and prepares breakfast, feeds children and organize them for school,
then drops them off at school. She returns home with the last child, cleans up and cooks
lunch. Later she picks up both children from school and returns home. She assists with
homework and at the end of the day put all the children to bed.
Health history:
Mother- 4 pregnancies, No surgical interventions.
Father- No know medical interventions
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Children: 2nd, 3rd and 4th children all suffered from infantile jaundice
Health status (i.e., problems and priorities):
Presently there are none.
Risk behaviors:
Poor hygiene practices in environment, food preparation and home.
Self care (health promotion and prevention):
Mother and children are presently all receive regular screening at the health center
Father is too busy to get screening.
Health care resources:
Presently no one in the household is on any medication, all the children are presently up
to date with vaccines and receive regular screening, and the mother also receives
regular screenings.
Professionals and lay healers:
The family believes in the use of both medical and herbal medications for healing.
Working with the family and agencies:
The family only has interactions with the Christian Children Fund.
Family strengths:
The parents are able to discuss the family problems despite the father being the head of
the household; the family is also able to adjust to the role changes when one parent is
absent. The family is also able to cope financially despite only one parent being the sole
provider to the household.
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Family priorities:
The children are first priorities in the household; the provision of food is second in line,
then the household maintenance and finally the parents.
Family ± nurse contract(s):
Nurse Peltier and Nurse Seraphine
Family cultural influences
Values, attitudes, and beliefs about;
Spirituality: The family believes in God as the almighty and attends church
Rituals (holidays and celebrations): The recognition of holidays such as Christmas,
birthdays, independence, lent and other catholic celebrations by all the members of the
family.
Customs: The usual customs that are followed by the family are based on religious
beliefs.
Dietary habits: Both parents do not eat chicken or drinks milk but the children are
allowed to eat both chicken and milk.
Child ±rearing practices: None of the children in the household eat provision and thus
other food sources have to be provided for them.
Health: Regular screenings are done for the children at the local health center.
Folk diseases and folk medicine: The use of herbal medicine for both parents and
children are practiced in the family.
Cultural healers: The parents believe in the practice of healers and herbal medicines.
Care of ill family member: The care of ill family members are handled by the use of
medical and herbal medication.
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Role of spiritual leader in care of ill family member: Provides advice on illness and use
of herbal medications
Family characteristics source(s of information) Date
Common law family Family Interview 17/10/11
Family residence
Adequacy of size:
The house has 1 porch and 3 rooms, they are divided as follows; 1 is the kitchen, 1 is
the living room and the other is the bed room with 2 beds.
Structurally safe:
The house is set on a concrete foundation at the base of a small hill with structurally
sound design.
Sanitation water, sewerage and garbage:
The water is collected from the public pipe on the street across from the household,
garbage is collected in container and put out for collection by the garbage truck, and the
use of pit latrine is used in the disposal of sewage.
Adequacy of sleeping arrangement:
The first 2 children sleep in one bed and the last child sleeps in another bed with the
parents.
Modes of transportation:
The use of public transportation is the main source for the family. Walking is also done
to get to the school and to the father¶s farm.
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Resources: The Incomes is from the father jobs and assistance from Christian Children
Fund.
Grocery shopping: The father does most of the household shopping
Pharmacy: The health center pharmacy is the main source of the family medicine
supply and if the medication cannot be given is runs out; it is purchased at the private
pharmacies.
Recreational (e.g parks): The family visits the local park, the beach, river and other
community activities such as children parties.
Educational: The both father and mother completed primary school, the mother dropped
out in 1st form, the 2nd and 3rd children are in primary school.
Religious: The family is Roman Catholic.
Emergency (i.e fire and hospital): The emergency numbers are all written down on a
chart on the living room and phone directories are present in the household.
Neighbourhood interaction: The family is in contact with all the neighbors, and close
interaction is maintained among all, with visits to each other and sharing of supplies
such as food.
Family environment Source(s of information Date
Common law family Family Interview 17/10/11
Family community
Industry and business:
The sale of ground provision and fish by the father provides income to the family.
Leadership:
The father is the head of the household.
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Government:
The parents in the family choose not to comment on the present day government.
Migration (i.e., in and out of community):
No one in the immediate family is presently out of state, the family visits the mothers
family in Sineku via public transportation every 2 months.
Community memberships/interaction:
The family is not involved in any groups in the community but participates in community
activities particularly on holidays such as beach days and children parties.
Social services:
The family uses the basic services provided by the government to the public for the
health maintenance of the family e.g. Vaccination programs, pharmacy services and
screening for adults
Health services:
Most of the family keeps abreast with the changes of the health services provides by the
community nurses in the health center.
Primary care: The use of relevant health care services within the health care setting is
utilized by the family for health maintenance and prevention of diseases.
Institutions (e.g., hospital or nursing home): There are no known family members in
nursing home or hospital care at present.
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FINDINGS FROM INTERVIEW
Based on the interview done, we as a group have ascertained that the needs of
the family are hygienic and nutritional. During our assessment we visualized that the
surroundings inside and around the home were in quite a disarray and in desperate
need of cleaning. We viewed several areas that could harbour microorganisms that
could potentially cause serious diseases especially in children, of which there are three
in the family. We were also told that the children do not like ground provisions and as
such mostly eat refined starchy foods such as macaroni and rice. It was also a cause for
concern to as well since, nutrition is important especially for children in the early stage
of development.
We then therefore concluded that the priority need was hygiene around the home
for the family. We also, based on our findings, decided to focus some of our efforts and
teachings on nutrition to ensure a healthier diet for the parents and children, one that
would be cost effective and sustainable.
We concluded from our interview that the parents have poor educational background,
which pointed out to us that we especially needed to make any teaching or learning
materials simple and easy to understand.
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PLANS FOR MEETING PRIORITY NEEDS
NEEDS TO BE MET
1. KNOWLEDGE ABOUT ENVIRONMENTAL HYGIENE AND FOOD
PREPARATION HYGIENE IN AND AROUND THE HOME.
2. KNOWLEDGE OF NUTRITIONAL MANAGEMENT
HOW TO MEET THOSE NEEDS
KNOWLEDGE ABOUT ENVIRONMENTAL HYGIENE AND FOOD PREPARATION
HYGIENE IN THE HOME
y Demonstrate cleaning methods and techniques for different areas of the home
y Teach to include children in household chores
y Teach to cover drums and other sources of water
y Teach parents to burn, bury and dispose of garbage properly
y Prepare posters on cleaning around the house
y Donate proper and necessary cleaning supplies to the family
KNOWLEDGE OF NUTRITIONAL MANAGEMENT
y develop charts and posters showing food pyramid and how to combine foods
from six foods groups and include recipes
y Demonstrate how to combine foods to prepare a health meal.
y Teach parents to include children in food preparation
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GROUP¶S ASSESSMENT OF THE PROCESS
The assignment process for us was very exciting as it gave us a chance to get
into the community and have one-on-one interaction with a family.
We therefore placed a great deal of emphasis on this assignment and spent a
considerable amount of time planning our intervention for the family. We ensured that
we developed a great rapport with the family members to ensure that we got full and
correct information from the members. We acquainted ourselves with the
neighbourhood and the resources available to the family. Garbage disposing areas,
water sources, drainage, toiletry facilities and road networks were assessed and taken
into consideration along with the family¶s relationship with their neighbours and friends.
We gathered as much information on the family as possible to ensure that whatever
care was given was priority for the family and was done in a way that would be most
beneficial.
On the day of the intervention we were slightly nervous but knowing that we had
laid enough ground work with the family and had planned carefully our intervention, we
pushed our anxiety aside. The day as it turned out was very fruitful and enjoyable for all
of us and the family, as we were able to accomplish all of our goals and left knowing
great satisfaction for a job well done.
There is always room for improvement, but because of the level of dedication
and seriousness we placed into doing this project the improvement to be made is small.
Overall, the opportunity to do this was one we relished and as such ran with it. We are
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very grateful for the opportunity to put what we have learnt, in the courses of community
nursing, health assessment, health promotion and others to make this a most fruitful
and rewarding enterprise.
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CONCLUSION
Personal experience is one of the greatest ways to gain knowledge and this
assignment has given us the opportunity to do so. Community nursing is a very
important and sometimes neglected aspect of the nursing practice. If taken seriously
and practiced with the importance and fervour for which it deserves, this area will serve
to limit the prevalence and occurrence of preventable, communicable and non
communicable diseases and will ensure early diagnosis of diseases.
Community nursing should be focused on the family as this group is the
cornerstone and the foundation of communities. This very integral group is why it is very
important that proper assessment of this group and communication and collaboration
with its members occur.
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BIBLIOGRAPHY
Aguilar, I. Gables, H. (2006). Disease Prevention in Encyclopaedia of health and
education for the family , (vol. 4, pp. 72-94). Toledo: Education and Health
Library
Howse K., Dunton H., Marshall D. (1998). Family Matters; a Guide to Family Life,
(pp. 163-170) Grantham: Stanborough Press Ltd.
Snyder, B. (2008). Kozier & Erb¶s fundamentals of nursing, concepts process &
practice. Julie Levin Alexander.