Culture, Communication Strategies, and CollaborationIn this third assignment for the Project, your small group will determine how the family’s culture impacts their ability to achieve healthy outcomes
Running head: FAMILY HEALTH AND WELLBEING 1 Family Health and Factors Affecting Health Introduction Family health screening is a very import aspect of health assessment. Family health assessment helps the nurse to assess health needs of a family together with the family, enabling the family to identify services they may require and also provide nurses with information on the needs of the community. In this activity, the writers have selected a Mexican American family with five members, living in MN. The father is aged 56 years, mother is 52 years, their first child is 21 years old, their last child is 17 years old, and the children’s grandmother is 75 years old. The parents both work in healthcare, mom as a nurse and dad as a physician assistant. Both children are attending school, the 21 year-old daughter is in college and the 17 year-old son will finish high school next year. The overall health of the family will be considered first, by assessing their physical health from a personal perspective, by asking each family member individually whether or not they think they are healthy. Getting information on social health, required asking about the factors that influence the health of family member’s experience, for example, environment, housing, occupation and lifestyle factors. Finally, another aspect of family health assessment is gathering information on their access to health services. The first member of the family to be assessed will be the father who needs to be screened for prostate, colorectal, and testicular cancers. As per the American Cancer Society (2019), men above 50 years should undergo flexible sigmoidoscopy every 5 years and colonoscopy after every 10 years. Issues of psychological changes resulting from aging also need to be assessed (Smith, et al., 2016). According to the American Cancer Association (2019), guidelines for women from 30 to 65 years old should have pap smears every 5 years. Cervical cancer screening for women above 65 years old is not encouraged. The mother, who age correlates with the age of when women often experience menopause. She needs to be assessed for the changes that take place for women during menopause, physically and emotionally. The physician will also assess her coping skills to see how she adapts to the information regarding what might occur for her during this phase of her life to determine whether or not additional support is necessary. The first child, who is a female aged 21years of age, needs to have started Pap screening, per the American Cancer Association (2019), which requires women aged 21 to 29 to have Pap smears every 3 years. For the youngest child, male aged 17 years, must be assessed for specific health concerns like drug use, tobacco smoking, and alcohol consumption. Many changes occur at this age that require assessment for how the child is adapting to growing up. For the children, assessment of their reproductive needs is also essential. Biological Factors impacting health and wellness Biological factors affect the health of an individual. Issues of aging and genetic factors profoundly influence health. Genetic factors may influence a person’s susceptibility to certain diseases. Some chronic conditions like cancers may be inherited in genetic makeup. Women who have a family member with breast cancer, may be susceptible to inheriting cancer from the mother. Genetics also influences the susceptibility of diseases like diabetes (Khan, R 2018). Aging also affects the health of an individual. Aging affects the physiological functioning of the body. As people age, they become more susceptible to some health conditions, for example, hearing loss, eye problems, digestive system conditions, and memory loss. As people age, they also need to undergo various types of screening, especially for diabetes, cancer, and cardiovascular risk. Risk of contracting chronic conditions is higher as a person gets older. Other biological factors such sex, male or female, also affect health. Some diseases are specific to gender. This is seen in cases of gender-specific cancers like cervical and prostate cancer. Women are also more susceptible to contracting sexually transmitted diseases because of their biological makeup. In the case of this family, one can see that the family members have different health needs, specifically in the types of screenings needed. Socio-cultural factors Social factors, social support, economic factors, inequalities, social status, and culture profoundly impact the health of a family or community. Cultural issues profoundly affect the health-seeking behavior of individuals. Cultural norms can dictate whether one will go to a health facility or not. Some cultures restrict when people eat; hence, they may suffer from nutritional disorders due to lack of certain essential nutrients. Issues of male masculinity may impact male health-seeking behavior. In most communities, men are treated as masculine; therefore, it is often that they do not openly express pain or emotions, even when they are sick. Frequently, they do not seek medical care until the condition has worsened. (Keogh, E. 2015). Inequalities in society affect people’s health. Issues of difference in social status impact how people access health care. People in high social status are more likely to access quality health services as compared to those in the lower class. Affluent individuals often have better access to basic needs and most times they have higher standards of living; consequently, their circumstances permit a safer, higher quality of living, subjectively. Economic capacity has a high probability to affect a person’s standard of living. People with a higher level of income can afford enough food and a balanced diet, provide quality health services and even afford quality education as compared to people with low income. Better pay means better chances of having good health as compared to having low income. Issues of occupation also impact health in terms of the working environment. Gallagher et al. (2015). Working in toxic environments such as, industries that readily expose its employees to asbestos, for instance, increases the risk of getting cancer. Lifestyle factors People’s living standards and behavior also profoundly impact their health. Lifestyle factors like smoking, alcohol consumption, drug abuse, sexual, and eating habits significantly affect their health. Alcohol consumption increases the risk of getting health complications including erectile dysfunction, liver cirrhosis and cancers of oral cavity, pharynx and gastrointestinal duct (Bagnardi et al. 2015). Tobacco use or smoking has been highly associated with the risk of getting cancer. Tobacco is a risk factor in almost all cancers. Smoking also increases the chances of developing cardiovascular conditions. Adolescents and teenagers are highly susceptible to drug abuse, which impacts their health negatively. Sexual behaviors, for instance, having indiscriminate sex increases the chance of contracting sexually transmitted diseases. Women with multiple sex partners increase their susceptibility to getting cervical cancer. Eating habits impact the nutritional status of an individual. Bad eating habits have been associated with people becoming obese, overweight and having eating disorders. Being overweight has been highly associated with the development of heart diseases due to high cholesterol levels that may clog arteries and cause cancer since cancer cells get most of their energy from sugar, which may be in high supply in an overweight individual. Health Disparity Health differences between groups of people are named health disparities (Medline.gov, 2019). The groups consist of people who have the same race, ethnicity, immigration status, disability, sex or gender, sexual orientation, geography, income and/or level of education and the health differences include (Medline.gov, 2019): How many people of the group are affected by certain diseases The severity of the diseases Number of people will experience complications because of the diseases Number of people who will die from a disease The groups access to health care Number of people will get screened for a disease within the group According to a statement released by the American Heart Association, Hispanics face remarkable health disparities compared to their Caucasian counterparts (American College of Cardiology, 2014). Many of the health disparities that typically affect Hispanics living in America are related to income level and socioeconomic status, which does not seem to be a concern for this family. However, the health disparities present due to biological factors include having higher rates of cardiovascular risk factors, such as high cholesterol, diabetes and obesity (American College of Cardiology, 2014), will require continued attention and perhaps monitoring. According to the American College of Cardiology (2014), research, which will create a better understanding of the impact of heart disease among Hispanics, is key to eliminating the effect of common health disparities among this population. References American Cancer Society. (2019). Insurance Coverage for Colorectal Cancer Screening. Retrieve on April 18, 2019 from https://www.cancer.org/cancer/colon-rectal- cancer/detection-dia.html American Cancer Society. (2019). The Pap (Papincolau) Test. Retrieved on April 18, 2019 from https://www.cancer.org/cancer/cervical-cancer/prevention-and-early- detection/pap-test.html American College of Cardiology. (2014). Reducing Health Disparities in Hispanics and Latinos. Retrieved on April 19, 2019 from https://www.cardiosmart.org/News-and- Events/2014/07/Reducing-Health-Disparities-in-Hispanics-and-Latinos Bagnardi, V., Rota, M., Botteri, E., Tramacere, I., Islami, F., Fedirko, V. & Pelucchi, C. (2015). Alcohol consumption and site-specific cancer risk: a comprehensive dose–response meta-analysis. British Journal of Cancer, 112(3), 580. Gallagher, M., Muldoon, O. T., & Pettigrew, J. (2015). An integrative review of social and occupational factors influencing health and wellbeing. Frontiers in psychology, 6, 1281. Keogh, E. (2015). Men, masculinity, and pain. Pain, 156(12), 2408-2412. Khan, R., & Qureshi, M. S. H. (2018). How the determinants of health determine health? International Journal, 4(3), 46. MedlinePlus.gov. (2019). Health Disparities. Retrieved on April 18, 2019 from https://medlineplus.gov/healthdisparities.html Rector, C. (2018). Community and public health nursing: Promoting the public’s health (9th Ed.). [VitalSource file]. Retrieved from https://bookshelf.vitalsource.com/#/books/97 81496374899/cfi/6/6!/4/[email protected]:0 Smith, R. A., Andrews, K., Brooks, D., DeSantis, C. E., Fedewa, S. A., Lortet‐Tieulent, J. & Wender, R. C. (2016). Cancer screening in the United States, 2016: A review of current American Cancer Society guidelines and current issues in cancer screening. CA: a cancer journal for clinicians, 66(2), 95-114. Health Screening Across A Lifetime Two nursing students at community college in a Community Health course initially assigned to assess a family for factors that affect their health such as age, race or ethnicity, gender, or circumstantial factors such as occupation, smoker, having diabetes mellitus and stress, et al. The family these students chose to assess consists of a 75year-old Caucasian Grandmother (mother of father) whose, now deceased husband, was from Mexico; Mother, 52 years old, from Mexico; Father, 56 years old, raised in Wisconsin, now working as a Physician Assistant. Both parents are working at Minneapolis Children’s Hospital and have two children, a daughter, 21 years old who is attending college at the University of MN and a son, 17 years old who is still living at home and attending his last year of high school. After assessing the family for factors that affect their health the students were invited to consider the types of screenings that would be appropriate for each member of the family. The purpose of a health screening can be categorized as secondary prevention, in other words, screening to detect diseases when they are in their earliest stages, before signs and symptoms manifest, with procedures that include, mammography, regular blood pressure and vision tests (CDC, 2018). The cost is higher, emotionally and monetarily to follow steps to prevent disease than to pay for the treatments and the struggle of losing relationships with illness or death; therefore, keeping up to date on preventative procedures is one critical component to staying healthy (McGill, 2014). A health care system that is performing with a level of functionality that provides for the prevention of disease and assistance to patients to amplify health and capacity over the length of their lives (AHRQ, 2018). Mom, Dad, the 21year old daughter and Grandma since they are each an adult, needs to be watchful of their cardiovascular health and have their blood pressure levels checked at least every two years and their cholesterol levels checked at least every five years (McGill, 2014). However, as stated in a report from the Office of Minority Health (n.d.), generally Hispanic American adults are less likely to have coronary heart disease and are less likely to die from heart disease than non-Hispanic white adults, though only by 10% and 30% respectively. Since these percentages are very minute, the students still recommend the cardiovascular screenings. The students also suggest that Mom, Dad, and Grandma be screened for colorectal cancer since they are over 50, especially if there is a family history (McGill, 2014). Most importantly Grandma must be screened for cardiovascular health since she is obese, which is a contributory factor to heart disease and stroke. According to the Centers for Disease Control and Prevention, colorectal cancer which affects the rectum and colon, is essential since colorectal cancer is the second most deadly cancer that affects both men and women (McGill, 2014). If mom does not have any risk factors, it is the recommendation of these students’ that her to have begun mammograms beginning at the age of 40 to predict a risk for cancer and it would be best for her to continue with regular mammograms every two years until the age of 74 (McGill, 2014). According to the CDC a woman’s risk of dying from breast cancer can decrease exponentially with regular mammograms (McGill, 2014). Because Dad is aging and the most common risk factor for prostate cancer is age and 2-3 men of the 13 out of every hundred men who acquire prostate cancer will die (CDC, 2018), the students recommend that he be screened for prostate cancer. Prostate cancer screening starts with a blood test called the prostate specific antigen (PSA) test, which measures the level of PSA in the blood (CDC, 2018). When a man’s PSA level is high it is more likely that there is a problem with his prostate (CDC, 2018). Since their daughter is 21 years old now, these students recommend that she have a pap test, where her cervical cells are examined for abnormalities. She should have a Pap test every three years until she turns 65 years old to identify cervical cancer (McGill, 2014). Although their son is almost finished with high school and will begin college next year, the students recommend his mental health be screened due to socio-cultural specific risk factors including discrimination and language hassles, along with normative risk factors such as, family conflict (Zeiders, Roosa, Knight, & Gonzales, 2013). Using the person-centered approach allows the researcher examining the interactive and cumulative effects of risk that can impact Mexican American youths’ mental health (Zeiders & et al, 2013). According to the article and his apparent circumstances, their son does not have a high probability of acquiring a mental health disorder and there is no harm in being safe. Lastly, Grandma is getting older and besides the cardiovascular screening mentioned above the students recommend that she be screened for diabetes mellitus type 2, depression (Sazlina, 2015) and perhaps she could have a neuropsychological examination to assess for cognitive deficits that could lead to an inability to remain in the home alone. References AHRQ. (2018). Prevention and chronic care. Retrieved on May 11, 2019 from https://www.ahrq.gov/professionals/-chronic-care/index.html CDC. (2018). Breast Cancer. Retrieved on May 11, 2019 from https://www.cdc.gov/cancer/breast/basic_info/screening.htm CDC. (2018). Prostate Cancer. Retrieved on May 11, 2019 from https://www.cdc.gov/cancer/prostate/basic_info/screening.htm McGill, N. (2014). Preventative screenings: A smart step for your health. Retrieved on May 11, 2019 from http://thenationshealth.aphapublications.org/content/44/1/28 OMH. (n.d.). Heart Disease and Hispanic Americans. Retrieved on May 11, 2019 from https://minorityhealth.hhs.gov/omh/browse.aspx?lvl=4&lvlid=64 Sazlina, S.G. (2015). Health screening for older people-what are the current recommendations? Retrieved on May 11, 2019 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4567887/ Zeiders, K.H., Roosa, M.W., Knight, G.P., & Gonzales, N.A. (2013). Mexican American adolescents’ profiles of risk and mental health: A person-centered longitudinal approach. Retrieved on May 11, 2019 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3743430/