NRS 429 Family Assessment Part II

Sample Answer

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 income is 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 research, 10(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 health, pp. 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 one, 17(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 Research, 24(11), e42447. doi 10.2196/42447