Provide a brief overview of the family members in the chosen case study. Complete a genogram and ecomap. Explain the key points of therapeutic conversation. Formulate key questions for additional information. Ensure your assessment addresses: Identifying data Developmental stage and history of family Environmental data Family structure Family functions Family stress and coping Family composition

1. Running head: PROMOTING HEALTHY COMMUNITIES 1
Case Study summary
Tsai Lien Yang Shen
NSG/478 Promoting Healthy Communities
February 20, 2017
Dr. Diane Schlicke

2. PROMOTING HEALTHY COMMUNITIES 2
Case Study
In the first case study, the family is Caucasian with no religious affiliations. Bill, a 37-
year-old man lives at home with his 35-year-old wife named Sally, who is currently seven
months pregnant on top of her medical history of DMII, obesity, and PTSD from her father’s
murder. They have two young boys named Aaron and Nathan, ages 4 and 3 respectively. Both of
them suffer from poorly controlled asthma and Nathan has shown signs of developmental delays.
Bill suffers from depression because of a job accident from three years ago which caused a
disability. Fortunately, it at least gets food stamps for his family and welfare for their two
children. His parents passed away from alcohol-related illnesses and his only brother is in jail in
Maine for murder. Due to his depression, Bill smokes one pack of cigarettes and drinks six packs
of beer per day which leads him to being physically and verbally abusive towards Sally. On the
other hand, Sally’s 65-year-old mother has a history of DMII, obesity, and hypertension. Since
her major stroke five years ago, she now lives in a nursing home in Florida. Her father had same
medical records of DMII, obesity, and hypertension but was killed in front of Sally in several
years ago, leading to her PTSD. Finally, her sister has been long missing. Sally shops and cooks
for the family but is unable to provide a healthy diet or snacks. She also tends to do whatever her
husband asked her to do.
Therapeutic Conversation/Key Questions
The nurse receives a permit allowing entry into their house, briefly introduces us, and
explains the reason for the visit and draws a genogram. A family genogram is drawn to identify
unmet needs and plan/prioritize ways to meet them and to discover strengths and define the
problem. (Attached 1). The ecomap element includes a central circle with a family index and
family members’ connected to larger systems called communities. (Attached 2). These give

3. PROMOTING HEALTHY COMMUNITIES 3
visual gestalt while showing illnesses shared between family members (siblings), relationships,
interaction patterns, and significant dates. Genograms explore whether or not the family
members communicate to each other about personal matters and provide schematic drawings of
familial hierarchies. The key of a therapeutic conversation is to use proper verbal communication
and active listening, which means you are actively pursuing practical information. In
combination with a friendly appearance and confident posture, therapeutic conversations allow
the subject to open up more. It’s important to ask questions related to the family assessment,
such as: “how do you, as a couple, usually communicate to solve a problem?”, “what is your
highest degree of education?”, “who might be able to help you with the children when you need
it?”, “are you familiar with food labels/guide and how do you use it in planning a healthy diet for
the family?”, “what is the one question you would most like to have answered during our
assessment right now?”, and “with which of your friends would you like us to (not to) share
information?” Memorial University of Newfoundland, (2013). These key questions focus on
family communication, nutrition, coping and health practices as well as gathers information to
help improve patient conditions.
Bill and Sally rent a modest three-bedroom home that is in poor condition and located in
a high-crime area. They have minimal money for children’s toys, recreational activities, and
healthcare visits (physician, dental, and prenatal). According to Nies, & McEwen, (2015) “The
family develops six sample types of household life cycles following as middle-class North
American, divorce and post-divorce, remarried, professional and low-income, adoptive and
lesbian, gay, bisexual, queer, intersexed, transgendered, and twin-spirited.”(p.122). This case
study on middle-class North American family life cycle’s stage three is a family with young
children. In stage 1, Bill and Sally may accept and establish a stable connection to the

4. PROMOTING HEALTHY COMMUNITIES 4
community and the larger society, but both their parents and/or sibling cannot support their
emotional or spiritual needs. The accident led Bill to lose much of his familial and social
lifestyles. Furthermore, the children require greater household safety and a healthier diet. This
family may need a social worker to help them manage their food vouchers and plan some doctor
visits.
Bill makes all the decisions in the family and controls all the finances, while Sally just
does what her husband tells her to do. On top of their poor coping and parenting skills, Bill
smokes and drinks every day. As a result, he may need a case manager for emotional support or
several clinical visits for his behavior. The couple also needs to learn and be aware of their roles
as parents and their duties to each other as husband and wife. Also, “beliefs” refer to attitudes,
values, or blueprints from which people construct their lives and combine them with the lives of
others.”(Wright, & Leahey, 2000, p.138). How can one help Bill overcome his disability and
depression? Similarly, how can Sally cope with her PTSD?
Conclusion
The Calgary Family Assessment Model (CFAM) consists of three broad categories:
structural, developmental, and functional. They each have several sub-categories that help nurses
understand complex family situations. During the assessment phase, the tool is used to gather
information about the entire family, such as who is making decisions for the family. Also, it can
help identify what needs to be done to meet health needs. A nurse's competencies include critical
thinking and clinical judgment skills, the ability to work in a variety of health care settings, and
effective organizational and communication skills. These ensure that nurses have the knowledge,
attitudes, and skills to work effectively with diverse clients, families, and other healthcare
professionals. Those are imperative to address disparities in health and health equity.

5. PROMOTING HEALTHY COMMUNITIES 5
References
Nies, M.A., McEwen, M. (2015). Community/public health nursing: Promoting the health of
populations. St. Louis, MO: Elsevier.
Wright, L.M. & Leahey, M. (2000). Nurses and Families: A guide to family assessment and
intervention (3rd. ed.). Philadelphia: FA Davis
Wright, L.M., Watson, W.L. & Bell, J.M. (1996). Beliefs: The heart of healing in Families
and Illness. New York: Basic Books.
Memorial University of Newfoundland, (2013). Community and Aggregate Assessment (24
mins) [Video file]. Academic Video Online.