When a child or adolescent experiences a health issue often affects all family members and the functioning of the family unit. In this paper, reference is made to a given family scenario in undertaking family assessment. The main purpose of this paper is to identify some of the actual and potential health and social problems/issues that families experience and how these problems affect the functioning of the family unit. The key points of discussion include, health and social issues/problems experienced by the family, effects of these problems to the functioning of family unit, key strength factors evidence in the given family scenario, and the main nursing goals that the nurse would consider when working with the family. Appropriate nursing intervention method applicable to the given family scenario that can help it overcome the identified issue/problems is also discussed.
Below is a genogram for the family under assessment. The main individual under focus in this scenario is Jalil.
Jalil Biological parents.
Actual and Potential Social and Health Problems Evident in the Scenario.
In this scenario, discrimination is one of the actual social problems, which Jalil is facing. In this case, discrimination is based on Jalil’s religion, Islam. From the case study, it has been mentioned that when Jalil’s family settled in Australia, Jalil had a difficult time in adjusting in school. At school, his classmates taunted him for being a Muslim and they even called him names such as “raghead,” which associated him with his religion. This made Jalil not to be able to make friends with his classmates apart from one young Australian boy from a Christian family, Brett. From the case study, it has been mentioned that Jalil relied a lot on his elder brother, Yayhe, for companionship. This shows that Jalil had developed socialization problem, perhaps because of taunting treatment he received from his classmates at school because he was a Muslim.
In his high school, teachers had noticed that he suffered some form of dyslexia. Dyslexia can be identified as an actual healthy problem that Jalil is suffering from. Another actual healthy problem Jalil is facing is presence of Epstein Barr virus in his body. This is an actual health problem since a diagnosis by a general practitioner confirmed that Jalil had been infected by this virus.
On the other hand, drug abuse can be identified as a potential social problem in this scenario. From the case study, Mansour suspects that the sudden change of behavior in his son could be because of consumption of alcohol or other illicit drugs. This is confirmed when his mother, Assieh finds a bottle of vodka under his bed. Currently, Jalil is exhibiting some kind of behavior, which can be linked to consumption of alcohol or illicit drugs. This includes sudden withdrawal from social activities such playing football and praying, and aggressiveness towards his family members. In many circumstances, cases of drug abuse have been reported to result into drug addiction. Therefore, drug addiction is seen as yet another potential social problem being faced by the family in the scenario.
Alcoholism and Consumption of Illicit Drugs as a Social Problem/Issue
Excessive use of alcohol and other illicit drugs of abuse have been identified as a major health and social problem in Australia (Alcohol Use and Harms in Australia, 2009). This is according to a survey conducted by the commonwealth of Australia in 2005, which was aimed at assisting in development of a national alcohol strategy. Alcoholism and abuse of other illicit drugs is a health issue because it is associated with various chronic illnesses such as kidney failure, stomach cancer, infertility, or low fertility, among others (Alcohol Use and Harms in Australia, 2009). From social context, addiction to alcohol and illicit drugs results into social evils such as crime, violence, and irresponsible sex behaviors. According to Stearne and Saggers (2010), there is high prevalence rate of addiction to alcohol and illicit drugs among the Australians, especially the Aboriginals. A national survey conducted in 2007 revealed that 82.9% of Australians aged 14 years and above had consumed alcohol in the previous 12 months (Stearne & Saggers, 2010). Out of this 82.9%, 23.7% of males and 17.2% of females were found to be consuming alcohol at high-risk levels, which resulted to addiction.
Further survey of families with members suffering from alcoholism or addiction to other illicit drugs showed that these families experienced a lot of family violence. In many cases, family violence is disproportionately directed towards women and children. Cases of homicide, rape, and serious injuries have been reported in families where one member is an alcoholic or a drug user Parental Alcohol Misuse and the Impact on Children, 2006). Homelessness is yet another social problem, which has been seen to arise from alcoholism or drug abuse. In case one of the parents who are the sole breadwinner of the family becomes addicted to alcohol and/or illicit drugs, he/she is unable to provide basic needs such as food, clothing, and shelter to other family members. Lack of shelter may result into homelessness for children. On the other hand, a child may be rendered homeless if the parent dies in the course of addiction to alcohol or other illicit drugs (Parental Alcohol Misuse and the Impact on Children, 2006).
Addiction to alcohol and other illicit drugs has significant effect in the workplace. “Alcohol misuse is frequently implicated in impaired work performance and productivity, absenteeism, workplace injury and premature retirement” (Alcohol in Australia: Issues and Strategies, 2007). Other issues associated with alcoholism and abuse of other illicit drugs includes poor performance in school and dropout for adolescents and teenagers, road accidents, mental health disorder and domestic violence. Given the numerous negative implications of alcoholism and abuse of other illicit drugs, it is clear that that alcoholism and use of illicit drugs is a social as well as a health issue affecting family units in the society today.
Effects of Alcoholism and Consumption of Illicit drugs to the Child and/or Family
In a family setting, alcoholism and use of illicit drugs may results into a number of negative effects. According to Parsons, alcoholism and use of illicit drugs is responsible of more family problems than any other single cause (2003). Studies reveal that for every four families, one has alcoholism or drug abuse problem (Silverstein, 1990; cited in Parsons, 2003). According to Parsons, one of the effects of alcoholism in a family setting is suffering of children (2003). Children born of alcoholic parents suffer from low-esteem, loneliness, guilt, chronic depression, and fear of abandonment. Sometimes, they tend to feel responsible of alcoholism in their parents. As a result, such children may not have friends or become afraid to socialize or go to school. Children of alcoholic parents tend to perform poorly in school (Hutchinson & Mattick, 2006). This is because they are subjected to stressful home environment, which affects their concentration in studies.
Another effect of alcoholism to families is sexual abuse and battering. Children, especially female children are common victims of these effects. According to Parsons, almost 30% of father-daughter incest cases and 75% of child battering involve alcoholic parent (2003). As a result, these children turn to alcohol as a means of escaping from the pain caused to them by their parents. There is high mortality rate among the alcoholics and illicit drug users (Burke, Schmied & Montrose, 2006). Mortality rate is high among these individuals since they are exposed to numerous risks such as road accidents, assault injury, suicide, liver, and heart problems. Such deaths cause misery to families of alcoholics and drug users. For instance, death of an alcoholic parent causes children to suffer as they are left with one or no parent. Consequently, such children may be left with no source of income since parents are the sources of income for their children (Hutchinson & Mattick, 2006). This may cause children to drop out of school, become homeless, or start engaging in criminal activities as a means of survival.
In Jalil’s family setting, if Jalil becomes an alcoholic, his family may suffer a number of effects. His parents may suffer from stressful feelings since they may tend to feel responsible for their son’s indulgence in alcohol. On the other hand, his brothers and sisters may develop socializing problems for the fear of being taunted by their fears because of their brother’s alcoholic behavior. The family may also be financial constrained if Jalil develop chronic illnesses, which are associated with alcoholism. This is because they would have to spend a lot of money in his treatment. In case of death as a result of alcoholism or alcohol related complications, the entire family would suffer loss of one of their member.
According to Bowerman (2011), maintain family strengths are vital in strengthening family bonds, improving communication, trust, and ability to get through tough times. Communication is one way of creating and maintaining family strength. There should be constant communication in a family setting. Family members can arrange weekly or family dinner where they meet and discuss about their interests and struggles. Sometimes, conflicts may occur but this should not discourage communication since conflicts results into improved methods of communication. In Jalil’s family, there is presence of communication among family members. For instance, Assieh, Jalil’s mother confronts her son to ask him what the problem was. It is also mentioned that Jalil confides a lot with his brother Yayhe. Mansour and Assieh also communicate with each other as they try to seek help from the Imam and the school. It is therefore clear that this family has communication as one of their family strengths.
Spending time together as a family contributes significantly in strengthening family members (Talseth & Gilje, 2011). Family members may spend time together through engaging in social or extracurricular activities. It is important for a family to set aside some time at least one in a month where they can spend time with each other. This family strength factor is lacking in Jalil’s family since there is no single time when the family spends time together as a whole.
Focusing on individual family members is also another method of gaining family strength (Bowerman, 2011). This enables family members to know how important they are to each other. Every family member should have one-on-one time with each other. This enhances the ability of every family member to spot behavior or emotional problems of each other. Bowerman states, “Individual attention gives each person a chance to speak his/her mind without worrying about what the rest of the family will think” (2011). This strength factor is present in Jalil’s family since his father tried to find time to attend extracurricular activities of his sons at school. He also ensures that his sons accompany his to the mosque to conduct prayers. This also evident through Jalil’s and Yayhe relationship where Jalil relies on his brother for companionship.
Patient (Child/Family) Care and Nursing Intervention
The most appropriate nursing intervention plan would be undertaking adolescent and adult counseling sessions for Jalil’s family. The main goal of this intervention plan would be to make Jalil’s family more resourceful in dealing with Jalil’s problem and develop variable competencies to meet Jalil’s future needs. Such an intervention proposes residential and non-residential setting for parents and children and significant support persons in the absence of family supports (Sankaran, 2007). Various media of presenting information during the sessions may include art therapy, role-play, screening, storytelling among others (Talseth, & Gilje, 2011).
Objectives to be achieved in this intervention method include, developing appropriate attitude to help Jalil overcome his challenges. Here, the nurse can arrange for psycho-educational sessions for family members where they would be provided with information on problems such as alcoholism, suicidal attempts, stress, and anxiety and information on the best treatment for these problems (Sankaran, 2007). Another objective for this intervention would be to impart skills to improve family interaction, strength rituals, and parenting. Here, more attention may be focused on Jalil’s parents because parents form the basis for foundation of interaction and strength in family setting. Good family interaction and existence of strength would assist in improved understanding to each family member’s challenges as well as improved methods of assisting each other to over the challenges. Final objective would be to equip family members with positive coping skills. The objective addresses the needs of other family members would are not experiencing the problem. For instance, in Jalil’s family, it includes the parents, Jalil’s brothers, and sisters. Positivity is very important as it shields family members from suffering behavior disorders such as stress, anxiety, or fear for the suffering person.
Jalil’s family is undergoing various social and health issues. Alcoholism has been identified as potential social problem, which is likely to affect the family. Adolescent and adult counseling session have been proposed as the best intervention plan that the school nurse can use in assisting Jalil’s family overcome its challenges. In conclusion, if the proposed intervention plan is adopted and the outlined goals are met, Jalil’s family will be able to overcome the challenges it is currently facing.
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Hutchison, D., & Mattick, R. (2006, December 12). The Impact of Alcohol Use Disorders on Family Functioning. Register of Australian Drug and Alcohol Research , pp. 399-412.
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