NURSING ASSESSMENT OF A FAMILY 1
Nursing assessment of a family
In Henderson family scenario, there are quite a number of family issues identified. The main issues are medical (postnatal depression), child neglecting and abuse by harsh disciplining. Postnatal depression is a medical issue that have been in the family for a long time. Postnatal depression is one of the common depression illness (Henshaw, 2003). It occurs at any time during the first year after childbirth but detected four to six weeks after birth. Research have been conducted on the causes of the condition and it is thought that hormone levels are responsible for the change of mood and the effect of oestrogen on mood made women more prone to this condition. Although the research have been conducted, none was conclusive about the cause of the issue. The cause is still unknown. Some mothers do not know the kind of impact that childbirth may cause, some are disappointed by the changes that occur in their body shape and weight. This is thought to be a cause of the postnatal depression. Sleepless nights and waking to look upon the child burdens mothers before they cope with the situation and may result to depression.
Postnatal depression condition is assessed using the Edinburgh Postnatal Depression Scale (Cox et al, 2005) at six to eight weeks and six to eight months. Mothers completes questionnaires at home about the moods and general feelings during a previous seven days period. The final question asks the mother whether she has had thoughts of committing suicide. The aim of the question is to motivate the mother to discuss and suicidal thoughts she may have or have experienced. This process helps the mother to understand herself and assist the health professional to help her. Screening is then conducted to show the probability that the mother is suffering from depression. A score of higher than 12 shows high probability of depression.
Early intervention is the effective way to deal with postnatal depression. Psychological treatment to revive the self-esteem of the mother. The victims are encouraged to attend support groups to share their experiences, which works efficiently to overcome postnatal depression. Many mothers benefit from talking about their experiences and their feeling and innermost thoughts which is therapeutic. Holden et al (2013) stated the listening visits by health victims is effective. Giving mothers’ time to listen to them and help them can be beneficial. In cases of medical intervention, victims may use antidepressants that help reduce depression and helps one relax. Some health practitioners suggest that it is important for depression victims to keep themselves occupied to prevent them from self-thoughts. They should seek organizations where they can help or volunteer.
In this family scenario, child abuse by harsh discipline and neglect is evident. Child neglect is seen where parent goes for long and does not spend time with the children or the family. Child neglect is a mistreatment related to failure to provide needed, age-appropriate care. It is termed as an ongoing habit of inadequate care and has been observed by individuals in close contact with the child. There are many types of neglect: physical, emotional, educational and medical. Emotional neglect is the main one in this family scenario. Physical abuse is also present where child experience harsh discipline that may be more physical and emotional.
Children suffering from neglect from parent and abuse withdraw themselves from friends and usual activities. They lose self-confidence and lose previously acquired developmental skills. They also undergo behavior change and become more aggressive, hostile and hyperactive. Depression comes in handy when the children cannot cope with the situation anymore. They also attempt to run away to flee themselves. Although child health experts condemn the use of violence of any form, some people still use corporal punishment such as spanking as a way of disciplining the children and this may leave scars or injuries even when done in the name of discipline.
There are several strategies and approaches a nurse can apply to prevent child’s emotional abuse. It can be done by helping the parent to change their behavior and helping the child overcome emotional or physical abuse. Parents should know what children could handle at a certain age and this will help them understand a certain behavior in children and handle frustration that may result. Parents should come up with new parenting skills and start learning effective discipline skills and set boundaries for the children. They should also seek professional help on how to control their emotions which at some point they are directed to the child.
Parents, no matter how fixed their schedule is, they should create time to spend with their children as this helps boost the self-esteem of the children and helps strengthen the family bonds. In this family scenario, a parent goes away for a long time and the child grew without the father figure. It is also evident that harsh discipline is practiced where children are given a corporal punishment in the name of discipline. This may cause physical injuries and have emotional impact to the child. It weakens family bonds and denies the child a sense of belonging as it affects them emotionally. Nurses should make a follow up to ensure that the child overcomes such harsh experiences and recovers to a normal life by providing guidance, counselling, and showing them everything is all right and they have done nothing wrong.
Extended families like in this scenario should bring together their children to interact and get to know each other. In this case, some children are fathered not by their real fathers. They should be given a chance to know their stepbrothers and stepsisters as this boosts harmony and understanding among the family. It boosts the self-esteem of children when they engage in activities that bring them closer to the other families. This seems to be lacking in this family scenario.
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