Family Nursing and Obesity Issues

Family Nursing Project
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Part One: Introduction
The problem of overweight commonly known as obesity has become one of the major health issues affecting many people in the United States. The health problems and diseases associated with obesity have significantly seen a rise in health costs among many people. Although it is commonly associated with lifestyle, there are several other factors that contribute to the proliferation of the disease in the human body. Obesity is defined as a chronic disease with a multifactorial causal factors ranging from genetics, the environment, metabolism and behavioral components (Covington, 2017). A 2017-2018 report on the prevalence of obesity in the United States indicated the disease currently stands at 42.4% among adults with no significant differences between men and women. Among men, the prevalence was found to be at 40.3% for those aged 20-39 years, 46.4 % for ages 40-59 and 42% among those aged 60 years and above. Among women, the prevalence of obesity was 39.7% among those aged 20–39, 43.3% among those aged 40–59, and 43.3% among those aged 60 and over (National Center for Health Statistics, 2020). With these figures in mind, I interviewed a family in North Carolina that has two of their members who are obese. My aim was to understand how the condition started, the various challenges that the family goes through in management of the disease and also understand strategies used by the family to manage the condition. I also look forward to interact with the family members in a bid to formulate an evidence-based management plan for the condition.
A close friend of mine referred the family to me and the interview was conducted online via zoom. The questions were based on the Calgary Family Assessment Model (CFAM). Levac, Wright and Leahey (2019) define CFAM as “a comprehensive, multidimensional framework that assists practitioners in collecting, organizing, and categorizing observational and family reported data”. The model is divided into three categories including -structura1, developmental, and functional-along with several subcategories. The first aspect of the interview was to obtain consent of the family. I sent a consent form to the family via email explaining the purpose of the study and sought their permission to participate in the exercise. The family head, Rodgers Mark, signed the form. Rodgers has two sons Michael aged 17 and Kevin aged 22. The two have been obese since they were two years. The consent was signed, scanned and sent to me. The interview took place through the month of November 2020.
Part Two: Family Assessment, Record Family Interview Data and Summarize
The assessment of the chosen family was conducted via zoom. This is because of the corona virus pandemic that has restricted movements with individuals in society encouraged and advised to practice social distance. The zoom meeting and interviews in general started once the consent form was received back from the family in early November. The findings within the assessment are but a glimpse of the family and as such, are subject to change. Similarly, pseudo names were used for purposes of confidentiality.
Structural Assessment
Structural assessment explores in depth the members of a family and their connections. It also focuses on finding links between the family and community (Wright & Leahy, 2019). Structural assessment comprises of three parts or dimensions that will be discussed below in relation to the family.
Internal Structure: The family’s internal composition comprises of the father called Rodger Mark and his two sons Michael and Kevin. The two boys are all adults by account of the age. While Michael is the youngest at 17 years, Kevin is quite mature and is 22 years old. Apart from their father, Michael and Kevin also have strong and deep emotional ties with their aunt, Sophia, who lives a few blocks from their house and was an integral part of their upbringing after the demise of their mother. From the perspective of gender, Rodger has instrumentally performed both roles as mother and father since 2005 when their mother sadly succumbed to cancer.
In terms of rank order, Michael showcased higher levels of responsibility despite being the youngest. He was not only smart but had also taken some personal initiatives to address his obesity including evening walks. Rodger also explained in the interviews how the unfortunate death of his spouse contributed to the current subsystem in the family. He was left to be the primary parental subsystem for both boys and the aunt, Sophia, taking up the role while engaged with work responsibilities. Michael’s high sense of responsibility also came to the fold as he often assumed a surrogate-spouse subsystem whenever his father and aunt were not around. The unfortunate death of his wife, Ruth, left Rodger utterly traumatized and significantly affected his internal and external boundaries. Rodger has not been able to move on and find love again because he faces challenges building trusting relationships. His boundaries are also rigid and he experiences difficult seeking assistance. As such, he is usually fatigued, stressed and unable to satisfactorily manage the diets and health of his children.
External Structure: It comprises of not only the extended family but also larger family systems (Kaakinen, 2018). Rodger is the eldest of two siblings with Aunt Sophia being the youngest. The two have been pretty close since their parents passed away when they were young. They were forced to live with an uncle who mistreated them and physically abused them occasionally. Nonetheless, they were eventually rescued and put in a foster home where they managed to rebuild and shape their lives. Based on the above facts, Rodger lacks any significant extended family members in his life and as such, has become prone to addressing his problems alone.
Since the wife died and they became a single parent family, finances have reduced significantly. The couple had a good arrangement that saw them combine their incomes to provide the best lives for their children. Rodger also resists and distrusts his neighbors because there was a point some of them reported him of neglecting his children. They shared to children services that he was working continuously and hardly had any time to monitor his two young boys. Social workers visited his home severally but found no issues and on the contrary applauded his efforts for enforcing responsibility in the young boys from an early age. Rodger also indicated that he stopped attending church because most of the worshippers were forcing him to remarry and get a woman to assist with the house chores and taking care of the children.
Context: Rodger Mark is a Hispanic male whose parents moved into the US before he was born in search of the American dream. As such, he is an American citizen by birth and so are his two boys. The family is proud of their Hispanic heritage and while they are not entirely fluent in the language, Rodger ensured that the two boys attended Spanish classes in school. Aunt Sophia also ensures to speak with the boys only in Spanish in most of their interactions. She has been instrumental in passing down essential parts and components about their Spanish culture including traditional delicacies and attires. In terms of social class, Rodger shared that money has been particularly tight since his wife passed on and he became a single parent. While he had a decent job, every penny had to count because he was the sole provider. He juggled his income paying school fees, mortgage, dressing the boys and ensuring that they were well fed. Rodger further added that he was looked down upon as a low class citizen because of his Spanish background and heritage. Rodger is highly thankful for being able to take good care of his family with the assistance of his sister Sophia. Furthermore, Kevin has helped to ease some of the burden by acquiring a part-time job whilst attending college.
Additionally, while Rodgers was previously religious, he has since taken a step back. This stems from the fact that he is still bitter that God took his beloved wife. He also considers other worshippers as being too judgmental and pushy. As such, he has also not brought up the two boys spiritually.
Development Assessment
From the facts shared in the previous sections, it is evident that Rodger has not entirely overcome the trauma of losing his wife. It is quite challenging bringing up two boys as a single parent particularly from an early age. They have needs that can only be met by their mother who in this case is not around. According to Årestedt et al. (2015), “single-parent families must accomplish most of the same developmental tasks as families consisting of two parents, with limited resources”. Since the demise of his wife, Rodger uprightly took up the roles of mother and father. As such, he has had to tackle various motherly responsibilities that range from emotional and psychological (Gulanick & Myers, 2013). He was also forced to learn how to feed the boys when young and which is often a responsibility left to mothers.
Functional Assessment
It examines interactions and associations between family members and family functioning (Bastable et al., 2019). It also explores the symbiotic relationship between family and illness. It comprises of the following two parts.
Instrumental Functioning: It encompasses various activities including family routine and activities that support daily living such as shopping and cooking (Ackley, 2017). Rodger was open about how he manages activities of daily living. He shared that he had to adjust and...