The modern American nuclear family is one commonly associated with the stresses of daily living, which put a strain on members’ abilities to engage in healthy activities. Time constraints often cause parents in such families to feel rewarded but personally drained. Lack of self-care often involves the avoidance of simple, healthy activities such as proper sleep and dieting. This avoidance causes short term benefits but long term negative health effects, such as diabetes and hypertension.
The family selected for this interview is of mixed race with an Italian-American mother and African American father. The mother is a psychiatric nurse and the father works as a manager for a hotel. The family has three children: two boys (ages 13 and 17) and a girl (age 11). The interview was conducted with the mother and all information expressed is from her perspective.
The interviewee describes her family’s health risks and values as being average, something that is evidenced by her knowledge of her family history of both diabetes and depression. The family is aware that their lifestyle does not always match a healthy pattern of living but view this as a sacrifice to do the things they want in life. Each family member has insurance and visits the doctor two to three times per year for preventative care or response to illness.
The interviewee admits lacking in the preventative care areas of sleep, nutrition, and exercise. The questions regarding nutrition were designed to identify what habits surround eating and if meals are calculated to provide nutrition while avoiding overeating. The interviewee admits that most meals are eaten “on the go.” Food is always available in the house, therefore true meals occur once per day, with snacking accounting for the rest of food consumed. Exercise is not engaged in by the interviewee personally, but the males of the family play basketball regularly and the daughter takes dance lessons. Family activities are usually sedentary events such as playing cards, and outdoor activities are rare and usually involve minimal physical exertion, such as camping. The adults of the family report receiving less than 8 hours of sleep each night due to stress, while the children receive about 8 hours.
The interviewee knew very little about her family’s elimination habits. Interviewee reported eliminating solid waste once per day for herself but could not estimate rates for other family members. Interviewee reported frequent constipation for herself. She was not able to accurately assess how much fiber was in her family’s diet and did not readily know how to check for this information.
Cognitive and emotional functioning seem to be within normal bounds. The interviewee reports a family history of depression, her paternal grandparents both having completed suicide, but says that there are no current signs of depression. She describes her self-esteem as “low but working on it” and attributes this to her constant drive to improve her life and attain increasing levels of success. The interviewee describes no experiences of emotional trauma or need to exercise any coping skills as her grandparents died when she was still very young, and she did not know them. Cognitively, the family appears normal to above average, all of the family members receiving A’s during their time in school. The only cognitive struggle is several diagnoses of ADHD involving difficulty with homework. These instances have been effectively treated with medication and all symptoms managed.
No impairments of the sensory or perception systems exists. Other than depression and ADHD, there has been no evidence of neurological dysfunction in any family members. No biological cause for sexual dysfunction is present, and the interviewee describes low sex drive (once per month) as a normal effect of stress and time constraints.
The interviewee describes the only person who might be sexually active other than her and her husband as their eldest son, but she cannot attest to this. She reports her and her husband being each other’s only sexual partners for more than 20 years. Her son, if sexually active, most likely does not have a high number of partners.
The roles defined within the family appear to be the roles of the standard American nuclear family. The mother is the main income provider due to a recent promotion at her job, though both parents have provided mostly equally during their marriage. The children respect but at times defy the parents. Chores and home responsibilities are described as “chaotic” with no clear delegation of tasks existing. The family seems to have a comfortable relationship with extended family, seeing them on holidays or other rare occasions, and as such does not rely on them as a resource. When the children were younger, the mother’s parents used to watch them, but such support is no longer needed.
The first wellness diagnosis is readiness for enhanced bowel elimination, which is at least pertinent to the mother. While it is not clear if poor elimination of waste affects the entire family, since the mother is the primary provider who determines what kinds of food are consumed, improving her understanding of colon health will have an effect on the entire family. The family is well educated and the interviewee expressed an understanding of a number of nutritional concepts such as cholesterol and saturated fat; however, she seemed to be unaware of the effects of daily fiber in her diet. As a result of this, and possible dehydration due to a busy schedule, she experiences frequent constipation. Since she has the capacity and willingness to learn about nutrition, she shows a readiness to improve her bowel elimination (Weber, 2005).
Continuing with the pattern of a busy schedule interfering with self-care, the interviewee reported both parents receive little sleep each night. The interviewee described a desire to receive more sleep and admitted that both she and her husband are not always so busy that they do not have time for rest, but rather they are often too stressed to sleep or stay up late watching television instead of sleeping. This pattern of behavior and ability to change is evidence for a diagnosis of readiness for enhanced sleep (Weber, 2005).
Finally, the overall pattern of neglecting self-care appears to be related to self-perception. At least with regards to the interviewee, a low assessment of herself and her achievements leads to stresses which cause her to place importance on accomplishing tasks at the expense of her own self-care. Given her family history of depression, she may be at risk of falling into more serious negative patterns of behavior. The interviewee acknowledges a need to improve her self-perception and worries that her children may begin to develop similar patterns of behavior to her own. Therefore, the family presents the criteria for a diagnosis of readiness for enhanced self-perception.
The family health assessment revealed a family with low risk for serious health concerns but areas for improvement. The most common health disparities displayed appear to be linked to a lack of self care brought on by general stresses in life. All negative health concerns noted are ones brought on by the common stresses commensurate with a family of this income level and cultural background. The family is well educated on health issues and is introspective enough to recognize deficits and possesses a willingness to change patterns of behavior. As such, with minimal interventions to sleep, diet, and self-perception, the family would see and improvement in function and quality of life.
Weber, J. R. (2005). Nurses’ Handbook of Health Assessment (5th ed.). Philadelphia, PA: Lippincott Williams & Wilkins.