Cultural Assessment-Family Theory Paper

Cultural Assessment-Family Theory Paper

The family unit remains integral to diversified and concerted efforts towards population health. Ho et al. (2022) note that an individual’s health, health-seeking behavior, and consequent adoption of conservative health measures, are significantly pegged on their interactions and relations with their family members. Family interactions and dynamics differ across families, with the course of the family’s development being influenced significantly by culture. In individualistic cultures, such as Westernized cultures, the impact of family on an individual is less conspicuous than in socialistic cultures, such as Asian cultures. This paper assesses the family dynamic of a Filipino family through the lens of the family assessment model and Andrews/Boyle Transcultural Nursing models.

Identifying Data

The interviewed family is an extended family. S.C. noted that the family is of mixed culture but is predominantly Filipino, except for three Caucasian members (S.C., personal communication, April 1, 2024). The family also has divergent religious affiliations, with the majority subscribing to the Christian religion, specifically Catholic, and two family members not identifying with any religion. The family is in the middle-class category of the social class. The family has experienced an upward mobility over time. His patriarchal grandfather was a low-income earner living in an impoverished neighborhood.

Developmental Stage and History of Family

The family is in the launching adult developmental phase. S.C. noted that he lives with six of his adult sons and daughters. The two daughters are about to be married but still live with him in the same household. His oldest son is married but still lives with him in the same household (S.C., personal communication, April 1, 2024). The developmental task fulfillment assessment revealed close bonds between the father and his sons and two grandchildren. Despite being in a relatively large family, S.C. noted that the family members remain bonded because of the values they attach to the family. All family members can comfortably handle their social and financial needs as well. The family attributes their strong bonds to the diverse activities they execute as a family unit. They eat dinner together and have frequent holiday visits as a family. Assessment of the family’s nuclear family history revealed that S.C. was once in a nuclear family when he immigrated to the US. He lived with his wife in a neighborhood in Oregon, where they brought up their six children (S.C., personal communication, April 1, 2024). The history of the family of origin revealed that S.C. and his wife are from Malaysia. Both were brought up in extended families.

Environmental Data

The family lives in a 6-bedroom mansion in a neighborhood in Los Angeles, CA. The household fits every description of a middle-class family. They have a constant supply of electricity and fresh water. The family owns three cars. The neighborhood and the community, at large, have diverse private schools and healthcare facilities. The family moved from Portland, Oregon, a few years ago. S.C. attributed the move to his early adulthood wish to live in LA and because of a job transfer (S.C., personal communication, April 1, 2024).

Social Life and Networks

S.C. runs a business enterprise in Silicon Valley. He goes to work five times a week. On a typical workday, he leaves for work at around 8 am and returns by 4 pm. His scope of work entails reviewing and approving business orders. His wife is a retired physician. The educational system within the community they live in is organized into private, public, and non-public schools. The public educational system adopts that of the state and follows the K-12 format, as stated in California’s educational codes. Diverse tertiary education sources exist, including community colleges and universities.

The community is sometimes faced with diverse social challenges bordering on crime and theft. Many groups address the social concerns of special groups within the community where S.C. lives. These include the Seeds of Hope and LA Compost, which primarily ensures that people living in all LA neighborhoods have access to food, and the Alliance of Californians for Community Empowerment, which advocates for programs that empower persons with low socioeconomic income, immigrants, and ethnic minority groups. Sporting activities and other recreational activities, such as swimming, are available to community members. Ethnic grocery and stop shops, such as the Indian Sweets and Spices, Cheviot Farms, and Korea Town, can be accessed easily. There is also a Catholic Church and Jewish Temple within the community.

Language and Traditions

The community epitomizes a multicultural setup, drawing different ethnicities and cultures. While Caucasians are the majority, there is a significant number of African Americans, Asian-Americans, and Mexicans within the community. This diversification in ethnicity is evident in the healthcare organizations and local groups within communities as the dialect is often mixed, with a blend of African, Mexican, Caucasian, and Asian dialects characterizing communications within healthcare facilities and other community areas. Most members of the community have attained tertiary educational degrees, with proficiency in writing and reading. Notwithstanding, a significant number of people within the community are school dropouts.

Religious Beliefs and Practices

While the community is predominantly Christian, other religious groups also have a presence within the community. There is a significant proportion of Muslim, Jewish, and Buddhist religions. Religious syncretism is also apparent in the group as some people still subscribe to the indigenous beliefs while identifying as Christians. The influence of religion becomes evident during the traditional days of worship. S.C. noted that in the nearby towns, where Christianity predominates, the towns are usually deserted on Sundays, with movements skewed toward places of worship (S.C., personal communication, April 1, 2024). Religious influences are also evident in healthcare practice, as most healthcare organizations have integrated churches within their complex setups.

The practices surrounding birth, marriage, and death are considerably divergent within the community. While all groups tend to celebrate marriage and birth ceremonies, death events are handled differently, with some groups holding extensive ceremonies and others assuming a rather restricted approach to handling death. Marriage is perceived as a rather extensive and significant social event, drawing multiple people and families among the Asian, Mexican, and African-American cultures. Grieving and mourning after death also vary across groups within the community. Among the Latino and African-American groups, the grieving and mourning processes are accompanied by complex rituals to appease the dead. The black dress code is common among all the groups within the community. The grieving period also varies and tends to be shorter among Islamic community members and longer among Black and Latino groups.

Health Beliefs and Practices

Healthcare beliefs and practices vary among community members. While the majority of the community members subscribe to the Westernized beliefs on illness and disease management, some attribute disease and suffering to supernatural forces such as sorcery and witchcraft. In these groups, supernatural explanations predominating explanations for disease and suffering point to the divergent sources of healing, including prayers, folk medicines, and other alternative modalities for remedying their illnesses. Contrarily, groups that believe in Westernized medicine demonstrate good healthcare-seeking behavior, with many adopting community health resources such as vaccinations and hospital visitations to alleviate their suffering.

Decisions about healthcare seeking and accepting treatment are made differently across groups. In Asian cultural groups, this decision is made by the senior member of the family. S.C. notes that he is usually consulted by all family members on aspects of their health, the need to seek care, and whether or not to accept treatment. In Westernized groups, this decision is made individually. Further, biological variations exist that predispose the family to specific illnesses. (Rivera et al. (2023) note that Filipinos are twice more likely to develop cardiovascular illnesses than the rest of the US population. Additionally, diseases such as gout are more common among these communities. The group’s current health concerns border around hypertension and diabetes. No stores sell medicinal herbs within their neighborhood.

Healthcare Systems

The community healthcare facility provides interpreters. In general, physician offices do not provide educational materials in languages besides English, except for a few that have recently started producing material in Spanish to benefit the Mexican communities within the community. Healthcare facilities are located in accessible communities. Most of them are within the shopping centers and along roads linking various ethnic communities. Several aspects of alternative medicine are incorporated within care organizations in the area. These include acupuncture, massage, and homeopathy. Traditional healers are, however, hard to come by. All the family members have adequate access to healthcare as they are all insured. They also have adequate transportation as they have multiple cars and contact to an emergency ambulance in their possession. The majority of the healthcare facilities in their neighborhood work round the clock, with appointments ranging from 6 am to 11 pm.

Economic Factors

The group does not own or operate its clinic, healthcare center, child or adult care center, long-term care facility, or nursing home. There is, however, a nursing home, a skilled nursing facility, and a healthcare center within the neighborhood. The group pays for their health care services through insurance and out-of-pocket payments.

Theory

The theory that accurately explains the family’s dynamics is the family system theory. The family system theory views the family as an interdependent entity, where each family member depends on another member in a bidirectional manner. In this case, an apparent stressor or situational change affecting one member is likely to impact the family in its entirety (Milberg et al., 2020). This theory is related to the interviewed family as they are aligned with the sociocultural findings in findings in the interviewed family. As evident in the interview, there is a conspicuously close bond between the family members. The unification of the purpose among family members, coupled with their perception of self and other points, aligns its dynamics with the provisions of the family systems theory. Additionally, the family is in a possible completion of expansion phase where one or more family members are likely to depart from the household. This is highly likely to cause a disequilibrium in the family dynamics.

Nursing or Medical Diagnoses for the Family

The apparent nursing diagnoses for the family include anxiety related to a perceived lack of social support and a risk for loneliness related to reduced or lack of family interactions. The family is in the launching phase. Over the next few years, S.C.’s children are likely to depart from the household as his daughter is about to get married, and his sons may opt for opportunities elsewhere. Anxiety, in this case, is related to the perceived lack of social support and is evidenced by the departure of some family members. Ahmadzadeh et al. (2019) report that in closely bonded families, the departure of one member may result in profound anxiety by the remaining family members over the whereabouts of their kin. The risk of loneliness related to a lack of family support may also be apparent when S.C.’s children depart from the household.

Plan of Care

A comprehensive care plan for the family will integrate nursing interventions, social support assessment, patient education, and emotional support. Social support assessment will entail assessing the existing social networks outside of the family members. These include community organizations, friends, and neighbors. These may become handy once S.C.’s children depart. This intervention may give insight into the likelihood of S.C. and the remaining family members remaining lonely when others start to depart (Varghese et al., 2020). The family will also be educated on the significance of psychosocial support systems in mental health wellness. Varghese et al. (2020) note that a dwindling psychosocial support system among older adults is a risk factor for depression and other psychiatric illnesses. The family, having operated in a unified social system, should maintain close ties with each other to further promote their psychosocial wellness, even in separation. This intervention may help prevent potential anxiety and loneliness when some members of the family begin to depart (Varghese et al., 2020). Emotional support is another intervention that may prevent anxiety and loneliness accustomed to a lack of family support. This intervention may be handy in the wake of loneliness and possible anxiety when some members of the family depart.

Conclusion

Analysis of the interview through the lens of the family assessment model gave insight into how family dynamics impact the family’s and individuals’ wellness. As evident in the interview, factors within the family, including their environment, have a predilection on the health and wellness of individual family members. In the resolve to promote family and individual health, identification of possible stressors within the family may help preserve the lives of all the family members within the unit.

References

Ahmadzadeh, Y. I., Eley, T. C., Leve, L. D., Shaw, D. S., Natsuaki, M. N., Reiss, D., Neiderhiser, J. M., & McAdams, T. A. (2019). Anxiety in the family: A genetically informed analysis of transactional associations between mother, father, and child anxiety symptoms. Journal of Child Psychology and Psychiatry, 60(12), 1269–1277. https://doi.org/10.1111/jcpp.13068

Ho, Y.-C. L., Mahirah, D., Ho, C. Z.-H., & Thumboo, J. (2022). The role of the family in health promotion: A scoping review of models and mechanisms. Health Promotion International, 37(6). https://doi.org/10.1093/heapro/daac119

Milberg, A., Liljeroos, M., Wåhlberg, R., & Krevers, B. (2020). Sense of support within the family: A cross-sectional study of family members in Palliative Home Care. BMC Palliative Care, 19(1). https://doi.org/10.1186/s12904-020-00623-z

Rivera, F. B., Cha, S. W., Ansay, M. F., Taliño, M. K., Flores, G. P., Nguyen, R. T., Bonuel, N., (Happy) Araneta, M. R., Volgman, A. S., Shah, N., Vahidy, F., & Cainzos-Achirica, M. (2023). Cardiovascular disease in Filipino American men and women: A 2023 update. American Heart Journal, 266, 1–13. https://doi.org/10.1016/j.ahj.2023.07.015

Varghese, M., Kirpekar, V., & Loganathan, S. (2020). Family interventions: Basic principles and techniques. Indian Journal of Psychiatry, 62(8), 192. https://doi.org/10.4103/_770_19

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Assignment Guidelines:
Choose a family from your practice, clinical site, or community. The family must be from a different cultural/ethnic background than you. You will then schedule an interview with the family and ask assigned questions compiled from sections of The Friedman Family Assessment Model-Short Form (see attachment in Module 6 in the course) and Andrews/Boyle Transcultural Nursing Assessment Guide for Families, Groups, and Communities (see Appendix B in Andrews and Boyle, 2015).

Remember that the information you obtain in the interview should be referenced as a personal communication. Please refer to your APA Manual for the correct format for personal communication. The interview must be written in a paragraph format and NOT in a question-and-answer format.