Family Concept Application Academic Paper: Lucy Mahingen Case Study
The analytical view of the health of a family in the case study scenario of Mahingen is an example of how the health impact of one family member impacts the family as a whole. Lucy Mahingen is a 75-year-old woman with a diagnosis of stress incontinence. Her condition has caused the reduction of fluid intake as prevention of her frequent falls. The family suggests homecare for Lucy. Lucy refuses and rarely leaves her home. Lucy's Dr. has referred her to a home care nurse for assessment. As the home care nurse, the concept of inquiry should be applied in the assessment process of this family as narrative inquiry holds the keys to answers unknown and will bring answers to the reason Lucy has refused the idea of relocation. The purpose of this paper is to review the case of Lucy Mahingen and her family while applying the concept of narrative inquiry. The implications for family nursing will so be included in this paper.
Concept and family analysis
The assessment of narrative inquiry is an important aspect a nurse can use as part of her assessment of the Mahingen family. According to Pedaste et al, (2015, p.48-51), there are “…five inquiry phases: engagement, exploration, exploitation, elaboration, evaluation”. Inquiry provides the ability to ask questions, plan, observe, communicate, and discuss information. Inquiring by simply asking questions about the family’s narrative context, asking questions driven by not the why, but by what, when, where, allows for the transmission of knowledge on specific health issues needed for patient-centered care (Pedaste et al., 2015 p.48). Asking questions about the family's narrative context provides both family and the nurse the bases for understanding each family's beliefs, worries, and feelings about the entire situation of Lucy's refusal of relocating.
Narrative Inquiry of Family’s Strength
Through narrative inquiring of each member of the Mahingen family, the nurse can gain insight into specific strengths of the family’s internal and external structures. The narrative inquiry of Lucy indicates autonomy for independence, that though she is the only one in her family composition, her extended family is her source of strength (Shajani & Snell, 2019, p.63). The narrative inquiry of the family shows the external structure of support they receive comes from the medical professionals for home care referral.
Resilience
There are numerous definitions of what reliance is. According to Manzini eta al., (2016, p. 703), "resilience is the ability of how individuals learn to deal with unfavorable conditions more efficiently”. Through narrative inquiring of each family member, the nurse can identify that the family's resilience is directly linked in the provision of Lucy's safety. The optimistic views of the health system in trusting and seeking help from medical professionals to provide suitable homecare for Lucy with the hope to prevent future falls is what display of resilience.
Narrative Inquiry of Family’s Challenges
Through narrative inquiry, the nurse can finally come to understand the exact areas of the family's challenges to find solutions towards resolution. Lucy's narrative inquiry will help the nurse understand that the reason Lucy's decision to not move is perhaps due to fears of the loss of independence. Another area of challenge the nurse can come to understand through inquiry is the reason Lucy rarely leaves the house. Could it perhaps be a sign of depression due to her realization of physical decline and the reinforcement of her decline displayed by the pressure she's receiving from family to relocate?
The nurse's narrative inquiry of the family could be at various developmental stages of life. Lucy's sister could be at the developmental stage of phase six where she is experiencing “Physiological decline” (Shajani & Snell, 2019 p.106). While Lucy’s nephew and nieces could presumably be in phase three of, “families with young children” (Shajani & Snell, 2019 p.100). A narrative inquiry of the family can allow for the nurse to assessing for signs of caregiver role strain and can allow the nurse the opportunity to "offer information/resources to help resolve…" (Kim-Godwin & Robinson, 2018 p. 174).
Implication for family nursing practice
Inquiry allows the nurse to better understand the family’s structural, developmental, and functional aspects of their life for the implementation of optimal supporting health. Through narrative inquiry, the nurse can identify the exact reason for Lucy's decline in relocation. It allows the nurse to establish and facilitate an integrative plan for teaching opportunities about what a home care facility is and what the home care facility day to day routines would look like (Goulding et al., 2018). Providing Lucy with facility information could help ease Lucy about fears she may have.
When families have distresses or crisis, nurses take the advantages of family strength conceptual framework as the ultimate mechanism for promoting strong and healthy relationships. For the case of Lucy, affection, and appreciation, commitment, time together, sense of spiritual comfort, positive communication, and the aptitude to cope with crisis and stress are some of the qualities that are required to improve her behavioural, physiological, and psychological status (Milne, 2020). Those attributes will enable her family to reject some of the issues or factors that will contribute to future problems. According to Shajani, & Snell, (2019), "commanding a family's competence…and strength and offering them a new view of themselves,…allows families to discover their solution to problems and enhance healing” (p.150).
Understanding Lucy's family's theoretical framework enables nurses to improve the deficits of her family functioning. Taking into consideration Lucy's family ties enables nurses to enhance their health care by moving away from holism and culture and effectively plan for her care based on the evaluation of the strengths of her family (Milne, 2020). As a result of that, Lucy’s family can have the ability to identify areas of improvement which in return will act as the basis for enhancing positive change. This is what assists in building their dependability, emotional and physical presence, and honesty to Lucy's condition. "The quantitative multi-modal MRI revealed a stronger association between imaging biomarkers in the hippocampus and age-related cognitive decline" (Arbisala, 2107, p. 1290). The relational inquiry is perceived to have the potential enabling nurses to understand the socio-environmental aspects of her family, her lifestyle, medical health, and socio-relational experiences for the provision of the perceived health promotion (Varcoe & Doan, 2018 p.128). Utilizing counselling and community resources is also vital in assisting Lucy and her family to minimize or prevent stressors.
Dedicating time together is one of the most important attributes that assist in sustaining health relationships. Lucy’s family also displays the essence of maintaining physical close contact, celebrating occasions, and remembering the old special occasion (Newell, 2017). Encouraging families and individuals to convey affection and appreciation for aid during sickness is important because it assists to promote caring relationships that are based on mutual support and trust
Conclusion
The five phases of inquiry give nurses the opportunity of identifying the conceptual strength of each family, resilience, and obstacles encountered. Nurses and patients' families are able to communicate as well as discuss important health issues that in return assist in improving the well-being of patients. These considerations are the ones that make a relational inquiry to be regarded as the main driving force for understanding the unique requirements of patients. Nurses are able to develop effective health care interventions that aid in the provision of the necessary health care resources required by patients. As a means of providing optimal health care, relational inquiry enables nurses and families to understand the patients' lifestyle, medical health, and socio-relational experiences which in return foster the provision of quality health care.
References
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- Chapter 4: The Calgary family intervention model (pp. 139-166)
- Chapter 9: How to do a 15-minute (or shorter) family interview (pp. 255-270)
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Pinch table
|
Author(s) & year of publication |
Objectives |
Sample and setting |
Method, design, and variable(s) |
findings |
|
Goulding, Davenport & Newman (2018) |
- to evaluate and understand how positive mental health has the propensity of improving the well-being of patients - to highlight the role played by nurses and family members to foster health care to patients |
-180 randomly selected patients in medical care units -Isolating 100 patients in a medical care facility who are legible for assessment |
-facilitated mental health care plan -a quantitative and qualitative randomized trial - |
-positive mental health is one of the prerequisites for fostering good quality of life for elderly people - the rationale and strategies that are used by nurses and physicians is the one that keeps on improving the behavioural, psychological, and physical well-being of aging
|
|
Milne (2020) |
- to evaluate all the psychological and emotional attributes that affect the health of aging individuals
|
- interviewing 340 eligible elderly patients in a clinical setting |
- using questionnaires to interview the patients in health care facilities -quantitative and qualitative research of the clinical records |
- Mental health and positive psychological well-being of aged patients is the one that improves the quality of life. -The perspectives of ailing older individuals are the one that enables them to have a positive emotional attachment to their families and physicians
|
|
Newell (2017) |
- to evaluate how development psychological distress in elderly individuals has the ability to impact the role played by their families in caring for them -evaluating the factors that cause the development of depression in elderly individuals and the impact of resilience on them |
-quantitative assessment of 400 elderly individuals in a clinical care setting -asking families of an elderly patient who visit them questions regarding their opinions about the therapeutic care give to their patient |
-Asking questions and conducting related assessment enables nurses to understand family strengths which in return assist in improving her everyday life. |
- The general well-being, family functioning, and regular exercises are important factors because they are the ones that affect the development of psychological distress in elderly individuals - The family functioning has the potential of impacting the psychological suffering of elderly patients -Understanding how elderly long-term health levels affect their life satisfaction is one of the factors that enable clinicians and families to come up with holistic approaches to care for them
|
Literature Search
The database jstor.org was searched for peer-reviewed articles ranging from 2017-2020. The key terms used in the research include depression and resilience, relational inquiry, behavioural, physiological, and psychological distress, family functioning, family nursing practice, and mental health. Quantitative and qualitative research was included to collect detailed information regarding the research topic. The original database generated 180 peer-reviewed articles. The main limitation of the database research is the generation of grey literatures that do not provide detailed information regarding the research topic. With regard to the research topic, assessment of abstracts, titles, and inclusion and exclusion of unwanted literature, three articles were selected from the sample articles searched.
