1. Copyright © 2010, 2006, 2002 by Mosby, Inc., an affiliate of Elsevier Inc. Chapter 19 Family Health Risks Debra Gay Anderson Heather Ward Diane C. Hatton

2. Copyright © 2010, 2006, 2002 by Mosby, Inc., an affiliate of Elsevier Inc. 2 Introduction  A focus on the family is vital in promoting the health of the individual, as well as the health of the community  The family system is a basic unit within which health behavior – including health values, health habits, and health risk perceptions – is developed, organized, and performed  Knowledge of family structure and functioning is fundamental to implementing the nursing process with families in the community

3. Copyright © 2010, 2006, 2002 by Mosby, Inc., an affiliate of Elsevier Inc. 3 Introduction (cont’d)  To reduce family health risks, nurses must go beyond the individual and family and understand the complex environment in which the family functions; categories of risk factors important to family health:  Genetics  Age  Biological characteristics  Personal health habits  Lifestyle  Environment

4. Copyright © 2010, 2006, 2002 by Mosby, Inc., an affiliate of Elsevier Inc. 4 Early Approaches to Family Health Risks  Health of families – traditional focus:  The effect of illness on families  The role of the family in the cause of disease  The role of the family in its use of services  Health of the nation  Increased attention has been given to improving the health of everyone in the United States  Although the family is considered an important environment related to achieving important health objectives, limited attention or research has been devoted to family health risk and the role of society in promoting healthy families

5. Copyright © 2010, 2006, 2002 by Mosby, Inc., an affiliate of Elsevier Inc. 5 Concepts in Family Health Risk  Two things motivate individuals to participate in health behaviors:  A desire to promote one’s own health, using “behaviors directed toward increasing the level of well-being and actualizing the health potential of individuals, families, communities and society”  A desire to protect health, using those behaviors “directed toward decreasing the chances of a specific illness or dysfunction in individuals, families, and communities, including active protection against unnecessary stressors”

6. Copyright © 2010, 2006, 2002 by Mosby, Inc., an affiliate of Elsevier Inc. 6 Concepts in Family Health Risk (cont’d)  An individual can reduce health risk by engaging in health-protecting and health- promoting behaviors  Family health: a condition including the promotion and maintenance of physical, mental, spiritual, and social health for the family unit and for individual family members  Health risks: the factors that determine or influence whether disease or other unhealthy results occur

7. Copyright © 2010, 2006, 2002 by Mosby, Inc., an affiliate of Elsevier Inc. 7 Concepts in Family Health Risk (cont’d)  Health risk appraisal: process of identifying and analyzing an individual’s prognostic characteristics of health and comparing them with those of a standard age-group, providing a prediction of a person’s likelihood of prematurely developing health problems that have high morbidity and mortality in this country  Health risk reduction: application of selected interventions to control or reduce risk factors and minimize the incidence of associated disease and premature mortality; is reflected in greater congruity between appraised and achievable ages

8. Copyright © 2010, 2006, 2002 by Mosby, Inc., an affiliate of Elsevier Inc. 8 Concepts in Family Health Risk (cont’d)  Life-event risk: age-related risks to a person’s health that often occur during transitions from one developmental stage to another  Family crisis: a situation whereby the demands of the situation exceed the resources and coping capacity of the family

9. Copyright © 2010, 2006, 2002 by Mosby, Inc., an affiliate of Elsevier Inc. 9 Major Family Health Risks and Nursing Interventions  Family health risk appraisal  Get to know the family, their strengths, and their needs  Assess biological and age-related risks, environmental risks, and behavioral risks A risk in only one of these areas may not be enough to threaten family health, but a combination of risks from two or more categories could be enough A risk in only one of these areas may not be enough to threaten family health, but a combination of risks from two or more categories could be enough

10. Copyright © 2010, 2006, 2002 by Mosby, Inc., an affiliate of Elsevier Inc. 10 Family Health Risk Reduction: Community-Oriented Approaches  Home visits (rather than clinical visits) provide a more accurate assessment of the family structure, the natural or home environment, and behavior in that environment  Initiation phase  Previsit phase  In-home phase  Termination phase  Postvisit phase

11. Copyright © 2010, 2006, 2002 by Mosby, Inc., an affiliate of Elsevier Inc. 11 Family Health Risk Reduction: Community-Oriented Approaches (cont’d)  Contracting with families: involves a shift in responsibility and control toward a shared effort by the client and the professional, rather than by the professional alone  Contingency contract  Noncontingency contract  Empowering families  Directed toward building nurse-family partnerships  Emphasizes health risk reduction and health promotion

12. Copyright © 2010, 2006, 2002 by Mosby, Inc., an affiliate of Elsevier Inc. 12 Community Resources  Specific resources vary from community to community  General resources  Government resources such as Medicare, Medicaid  Aid to Families With Dependent Children  Supplementary Security Income, Food Stamps, and WIC  Voluntary programs American Cancer Society American Cancer Society American Heart Association American Heart Association American Lung Association American Lung Association Muscular Dystrophy Association Muscular Dystrophy Association

13. Copyright © 2010, 2006, 2002 by Mosby, Inc., an affiliate of Elsevier Inc. 13 Community Resources (cont’d)  Locating and using resources may require skills and patience that a family lacks; nurses work with families to identify community resources; as client advocates, nurses also help families learn to use resources by:  Sharing information with families  Rehearsing with families what questions to ask  Preparing required materials  Making the initial contact  Arranging transportation