Clinical Family Assessment the Family at Focus

Clinical Family Assessment

The family at focus in this clinical family assessment is known as T.R.H. who is the center of assessment. T.R.H. has been recently diagnosed with breast cancer. Both T.R.H. And her family are worried about the situation. The mother is undergoing chemotherapy and the teenaged children are fearful and in need of educational information about the situation. The husband is supportive of his wife and family and is holding everything together well. The family addressed in this study is comprised of a mother, father and two children. The Healthy People 2020 has four primary goals including the attainment of lives that are of high-quality and characterized by being free of disease, disability, injury and premature death that is preventable; achievement of health equity, elimination of disparities and improvement of the health of all groups; creation of social and physical environments that promote good health for everyone; and promotion of quality of life, healthy development and healthy behaviors across all life stages. (Centers for Disease Control and Prevention, 2011, p.1)

Assessment Findings: Three Diagnoses

This is a strong family unit with excellent communication skills. The family environment has been assessed and there do not appear to be issues that should be addressed in this area of the family's ability to cope with the mother's health. The following should be addressed in this intervention: (1) The family should be educated on the mother's illness and treatment that she is receiving. This is related to the Healthy People LHI Access to Healthcare; (2) The family should also be counseled on genetic conditions that make the children likely candidates for developing cancer during their lifetime. Health People 2020 in the Topic Area: Genomics G-1 has set the goal of increasing the proportion of women with a family history of breast cancer who receives genetic counseling; and (3) The family should be educated on what they can do to maximize their health and avoid the development of cancer since they are genetically predisposed for cancer. This is related to the Healthy People LHI of Healthy Behaviors.

Watson's Caring Theory Applied

Watson's theory of caring addresses the need for the nurse to cope with the increased anxiety of patients due to the complexity of health care and the changes that have occurred in the health care delivery systems. According to Duquette and Cara (2000) Watson's caring theory enables the nurse to "return to our deep professional roots and values; it represents the archetype of an ideal nurse." (cited in: Cara, nd, p.1) Watson states that the carative factors include the following ten elements: (1) humanistic-altruistic system of value; (2) hope and faith; (3) sensitivity to others and self; (4) helping and trusting in the human care relationship; (5) expression of positive and negative feelings; (6) problem solving in the caring process that is creative; (7) transpersonal learning and teaching; (8) supportive, protective and corrective physical, mental, social and spiritual environment; (9) assistance with human needs; and (10) existential, phenomenological, spiritual forces. (Watson, 1988b, p.75 in: Cara, nd, p.4) From this view, the nurse in this scenario should assist the family with understanding the progression of the illness that the mother of this family will undergo during her battle with cancer. The family should be provided information that will assist them in optimizing the home environment to deal with the diagnosis and treatment of cancer for the mother of this family. The family should be directed and educate on the proper nutrition and behavioral risk factors for developing cancer. The family should be directed as to what cancer screening they should undergo to detect cancer early so that it can be treated.

Watson held that the transpersonal caring relationship is dependent upon the moral commitment of the nurse in the protection and enhancement of the dignity of the person and the caring consciousness of the nurse in preserving the individual's spirit. The nurse goes beyond a mere objective assessment and demonstrates concern about the deeper meaning of the individual concerning their health care. The nurse in this scenario will take time to counsel with the patient and the family members about their fears and concerns and will direct the individuals in this scenario to the proper resources to assist them in understanding the disease, in this case that of breast cancer, and in understanding what the treatments will consist of and the implications for family members in providing assistance to the patient in the home setting that will enable the family and the patient to better cope with the effects of the treatment or that of chemotherapy. In this scenario, it will be important for the family members to understand the effects of chemotherapy and how the patient will feel following these treatments and what they can do to make the patient's home environment more conducive to recovery and healing following chemotherapy treatments. Toward this end, specific resources will be provided to the family to educate and inform them on breast cancer and chemotherapy treatments.

Resources for Education

The resources chosen for educating the family about the mother's illness include the following resources: (1) University of Michigan Comprehensive Care Center: This is located online at: http://www.cancer.med.umich.edu/support/patient_education_resource_center.shtml; (2) American Cancer Society: Patient/Family Education and Support Programs. Located online at: http://www.cancer.org/myacs/highplainshawaiipacific/programsandservices/patient-family-education-and-support-programs; and (3) University of Maryland: Breast Evaluation and Treatment Program. Online at: http://www.umgcc.org/breast_program/patient_education.htm. These resources have been chosen due to their information content, which will assist the family with the necessary information and tools in coping with their mother's diagnosis of breast cancer. Living and working conditions are factors that the family may or may not have a choice in determining. However, the intervention should include information and education about factors in these environments that affect the health of family members. There may be differences in the way that the family members view factors in the environment or factors relating to nutritional information and this may present a conflict with recommendations for healthy behavior provided by the nursing professional.