High-Risk Family Assessment

High-Risk Family Assessment and Health Promotion
NUR/542
Sandra Brown
09/22/2014

High-Risk Family Assessment and Health Promotion Assessment is the first step of the nursing process and a basic nursing skill. Sadly, there are too many nurses who fail to realize that addressing the family needs are as important as addressing the needs of the individual patient and that assessment should extend beyond the patient to the entire family unit. This is especially crucial when working with patients in high-risk groups. Woods and Lasiuk (2008) define risk as “the probability that a particular adverse event occurs during a stated period of time, or results from a particular challenge” (p. 1). In health care, then, high-risk families
These can include smoking, social isolation, abuse of alcohol and drugs, reckless activities, such as driving fast or unsafe sex, and violent behavior (USDVA, 2014). The symptoms that veterans may experience and the efforts to relieve them can lead to other significant issues such as depression, anxiety, despair, shame, addiction, chronic pain, employment trouble, and loss of relationships (Mayo Clinic, 2014). The stress of these symptoms and behavior increases the chance of having chronic health issues. Veterans experiencing PTSD can also suffer from hypertension, stroke, digestive disorders, pulmonary disease, diabetes, and cardiovascular disease. Mental health issues can be severe and lead to self-harm and suicide (USDVA, 2014). The behavior of the veteran experiencing these symptoms can severely affect the family. Withdrawal, depression, self-harm, intimacy issues, and parenting issues can cause stress, which frustrates and angers the family, putting all the members at risk of a variety of mental health disorders (USDVA, 2014). The veteran’s substance abuse, violent outbursts, and high-risk, reckless behavior put the entire family in danger of physical
There is a screening tool available from the USDVA that is very quick and very simple to do. It is the Primary Care PTSD Screen (PC-PTSD) and consists of four yes or no questions. If three of the four questions are answered “yes,” then the patient may have PTSD and they and their families should be referred to a mental health professional (USDVA, 2014). Of special concern should be suicidal ideation or reports of violence in the home. Nurses must keep in mind that often veterans and their families are ashamed of how they feel or what is happening. As Briere and Scott (2007) explain, the nurse must be empathetic, avoid judgmental body language, show sensitivity, sense when avoidance is being used, and remember that speaking about past traumatic experiences may cause violent or emotional outbursts from veterans. A useful theoretical framework for family assessment is Hill’s Family Stress Theory. Hill focused his research on wartime separation and reunion, and the stressors that develop with the family. Using this theory, the nurse would focus on the family’s actual and perceived stressors, resources available to the family, coping mechanisms utilized by the family, and how the stressors have disrupted the family (Friedman, Bowden, & Jones,