THE C.S.E.

FAMILY
ASSESSMENT
BY
VIDA KWOFIE
CSU-FNP

Gran
d
moth
er

Grand
father

Gran
d
moth
er

Grand
father

C.S.E

N.E

D.E

E.E

IDENTIFYING DATA
FAMILY/CLIENT INITIALS:- CSE
RESIDENCE:- BOWIE, MARYLAND
FAMILY COMPOSITION:- MOTHER, FATHER, CHILDREN (2 BOYS,
AGES 11 AND 8)
CULTURAL BACKGROUND:- NIGERIAN AMERICAN
RELIGIOUS IDENTIFICATION:- CATHOLIC
SOCIAL CLASS STRUCTURE:- MIDDLE CLASS

DEVELOPMENTAL STAGE
FAMILYS PRESENT DEVELOPMENTAL STAGE
MOTHER IN HER 30S-COMPLETED MASTERS DEGREE
FATHER IN HIS 50S- MEDICAL DOCTOR
CHILDREN-

2 BOYS -11YR IN 5

8YR 3

RD

IN GRADE

TH

HISTORY OF FAMILY
NUCLEAR FAMILY HISTORY
MARRIED COUPLE WITH

3 CHILDREN, FOR 12YRS

HISTORY OF FAMILY OF ORIGIN OF BOTH PARENTS

FATHER- WAS BORN IN NIGERIA, CAME TO THE USA IN THE LATE 90S.
FATHERS PARENTS ARE BOTH DECEASED. HIS MOTHER DIED IN HER EARLY

40S. FATHER DIED IN HIS EARLY 50S. HE IS THE FIRST OF 8 CHILDREN

MOTHER- HER PARENTS WERE ORIGINALLY FROM NIGERIA AND SETTLED IN THE
UNITED STATES IN THE

70S.

64,
SHE IS 2 OF 4 CHILDREN
AND MOTHER IS
ND

SHE WAS BORN IN THE USA. FATHER IS

69

ENVIRONMENTAL DATA

CHARACTERISTICS
OF HOME

4 BEDROOM, SINGLE FAMILY HOME

MASTER BEDROOM
2 KIDS HAVE OWN ROOMS/SHARES BATHROOM
2 GUEST ROOMS- ONE UPSTAIRS/ONE IN THE BASEMENT
CHARACTERISTICS OF NEIGHBORHOOD & LARGER COMMUNITIES
PLANNED COMMUNITY, MOSTLY SINGLE FAMILY HOMES IN THE AREA
FATHER WORKS IN THE BALTIMORE AREA, DRIVES ABOUT 28 MILES TO WORK.
THE CHILDREN ATTEND A LOCAL CATHOLIC SCHOOL WHICH IS LOCATED ABOUT 10
MINUTES FROM HOME.
MOTHER DRIVES THE KIDS TO SCHOOL.

FAMILYS ASSOCIATION & TRANSACTIONS WITH COMMUNITY

FATHER- HAS 4 BROTHERS IN THE AREA AND A SISTER IN CALIFORNIA.

BELONGS TO THE LOCAL NIGERIAN GROUP IN THE AREA.

BELONGS TO ST. EDWARDS CATHOLIC CHURCH

USES THE WALK PATHS FOR FAMILY WALKS AND INDIVIDUAL EXERCISE

USES THE LOCAL MALL FOR SHOPPING

USES THE LOCAL GYM

COMMUNICATION PATTERNS
FATHER AND MOTHER SAY THEY SOMETIMES ARGUE OVER ISSUES BEFORE
THEY COME TO A COMMON UNDERSTANDING.
CHILDREN THINK PARENTS HAVE NO PROBLEMS AT ALL
TWO WAYS BETWEEN PARENTS, EXCHANGE WORDS BACK AND FORTH
ONE WAY BETWEEN PARENTS AND CHILDREN. WHAT THE PARENT SAYS TO
THE CHILD IS FINAL

TYPES OF FUNCTIONAL \DYSFUNCTIONAL

COMMUNICATION PROCESSES SEEN IN
FAMILY
DYSFUNCTIONAL
FATHER AT TIMES DOES THINGS WITHOUT CONSULTING MOTHER WHICH
MAKES HER UPSET.
CHILDREN AT TIMES FAIL TO DO THINGS AND HAVE TO BE REMINDED
MULTIPLE TIMES WHICH
MAKES MOTHER VERY UPSET.
MOTHER LIKES TO COMPLAIN TO EXTERNAL FAMILY MEMBERS
FUNCTIONAL
TRAVELING/VACATIONING, GOING FOR OCCASIONS TOGETHER

POWER STRUCTURE/DECISION-MAKING PROCESS

MOST OF THE DECISIONS ARE MADE BY MOM AND DAD

TOGETHER, SOMETIMES AT FAMILY DISCUSSIONS AT
HOME OR OVER THE TELEPHONE.
OVERALL FAMILY SYSTEM AND SUBSYSTEM POWER
. MOTHER THINK THAT SHE HAS MORE POWER AS SHE
CONTROLS MOST THINGS IN THE HOUSEHOLD
FATHER THINKS HE HAS MORE POWER AS HE IS THE
BREAD WINNER.
THE BOYS THINK THEIR FATHER HAS MORE POWER

INFORMAL ROLE STRUCTURE

OLDEST SON ASSUMES FATHERS ROLE WHEN HE IS NOT HOME

ESPECIALLY TRYING TO CORRECT HIS YOUNGER BROTHER WHEN
PARENTS ARE NOT AROUND.
FAMILY VALUES
STRONG FAMILY BACKGROUND. BELIEVES IN THE 2 PARENTS
MARRIED AND LIVING TOGETHER TO RAISE THEIR KIDS.
RELIGION, CATHOLICS,
THE FAMILY BELIEVES IN OBEDIENCE AND RESPECT OF
AUTHORITY

 COMPARE THE FAMILY TO AMERICAN OF FAMILYS REFERENCE GROUP

VALUES AND/OR IDENTIFY IMPORTANT FAMILY VALUES AND THEIR
IMPORTANCE (PRIORITY) IN FAMILY

AMERICAN FAMILY DO STUDY/SLEEP OVERS FOR THE CHILDREN

THE C.S.E FAMILY DOES NOT BELIEVE IN SLEEP OVERS.

MUST PARTICIPATE IN FAMILY RELATED ACTIVITIES (THIS IS NOT BY CHOICE)

PRESENCE OF VALUE CONFLICTS IN FAMILY

MOTHER RAISED IN THE USA, TENDS TO APPLY AMERICAN VALUES EXAMPLE=

TIME OUTS, AMERICAN FOODS,

FATHER RAISED IN NIGERIA, HOLD STRONG BELIEVE IN THE WAY HE WAS

RAISED (SPANKING). DOES NOT BELIEVE IN TIME OUTS, WANTS THE KIDS TO
BE GREAT AND BE RESPECTFUL OF THEIR ELDERS NO MATTER WHAT.

FATHER WANTS THE KIDS TO ATTEND BOARDING SCHOOL IN NIGERIA BUT

MOTHER IS AGAINST IT. SHE WANTS TO HAVE KIDS CLOSE TO HER.

FATHER LIKES TO EAT LOCAL NIGERIAN MEALS, VERY SPICY MOST OF THE
TIME BUT BECAUSE MOTHER DOES NOT LIKE SPICY FOOD THE KIDS WILL NOT
EAT ANY SPICY FOOD.

AFFECTION/MUTUAL CLOSENESS, AND IDENTIFICATION

FAMILY TRAVELS TOGETHER, EATS TOGETHER, ATTENDS CHURCH TOGETHER.

FAMILY CHILD-REARING PRACTICES

EARLY TO BED
SHOWERS IN THE MORNING BEFORE SCHOOL AND AFTER SCHOOL
SCHOOL, HOME WORK, KUMON
THEY ALSO BELIEVE IN ENGAGING THE CHILDREN WITH OTHER ACTIVITIES SUCH AS
TENNIS, BOYS SCOUT, PIANO LESSONS
SOCIALIZING AGENT FOR CHILDREN
MOTHER MAINLY, AS SHE IS THE ONE THAT TAKES THE BOYS TO MOST FUNCTIONS LIKE
BIRTHDAY PARTIES.
THE CHILDREN ALSO OCCASIONALLY MEET WITH THEIR COUSINS

FAMILYS HEALTH BELIEFS, VALUES, AND BEHAVIOR

THE FAMILY BELIEVES PREVENTIVE HEALTH
VERY KNOWLEDGEABLE ABOUT HEALTH ISSUES.
THEY FAMILY TAKES VITAMINS DAILY
EXERCISES REGULARLY

DIETARY HABITS
BREAKFAST-CEREAL, OAT MEAL, APPLE, PINEAPPLE, GRAPES.

SOMETIMES EGG/TURKEY BACON. LUNCH-SANDWICHES, CHICKEN NUGGETS, FISH

RESTAURANTS AND JUNK FOODS AT TIMES

 SLEEP AND REST HABITS

KIDS- BED TIME IS 8-30PM
MOTHER BED TIME 9P
FATHER BED TIME 11P AND UPWARDS

FAMILYS ROLE IN HEALTH CARE PRACTICES

FAMILY COVERED THROUGH FATHERS HEALTH INSURANCE FROM HIS JOB
(PPO COVERAGE)
BELIEVES IN PREVENTIVE CARE
ANNUAL PHYSICALS
ROUTINE DENTAL CARE/CHECKUP THROUGH FAMILY DENTIST.

STRESSORS FAMILY EXPERIENCES

MOTHER FEELS HOME BOUND BEING A HOUSE WIFE

FATHER FEELS HE WORKS TOO HARD TO CATER FOR THE ENTIRE FAMILY

FATHER- HAS SEASONAL ALLERGIES-GETS SHORT OF BREATH WITH COUGH

AND WHEEZING
DX. OF HYPERTENSION.

MOTHER-HAS FOOD ALLERGIES, HAS UTILIZED EMERGENCY ROOMS AND

URGENT CARE FACILITIES SEVERAL TIMES

COPING STRATEGIES UTILIZED

TALKING AND VISITS WITH EXTENDED FAMILY IN THE AREA.
FAMILY FRIENDS
GOING TO CHURCH
PARTICIPATING IN LOCAL ACTIVITIES
TRAVELING AND VACATIONING

 NURSING DIAGNOSIS I
IMPAIRED VERBAL COMMUNICATION RELATED TO INABILITY OR LACK OF DESIRE TO MAINTAIN USUAL
COMMUNICATION PATTERN AS EVIDENCED BY THE COUPLE NOT COMMUNICATING REGULARLY AND
EFFECTIVELY, AND THE WIFE CALLING EXTERNAL RELATIVES TO DISCUSS ISSUES IN HER FAMILY.
EXPECTED OUTCOME/GOAL
THE TWO PARENTS WILL OPEN UP TO EACH OTHER; WILL COMMUNICATE NEEDS AND DESIRES TO
EACH OTHER INSTEAD OF SEEKING ADVICE EXTERNALLY. THE PARENTS WILL INCREASE POSITIVE
INTERACTIONS AT HOME AND SUPPORT EACH OTHERS EMOTIONAL NEEDS.
IMPLEMENTATION
THE TWO PARENTS WILL SIT TOGETHER AS A COUPLE TO IDENTIFY BARRIERS TO GOOD
COMMUNICATION SKILLS. THE FAMILY WAS ENCOURAGED TO SEEK COUNSELING FOR ASSISTANCE
ON HOW THEY CAN OPEN UP TO EACH OTHER EMOTIONALLY AND HONEST. THROUGH MARRIAGE
COUNSELING, THE COUPLE WILL LEARN TO SPEND QUALITY TIME TOGETHER, DEPEND ON EACH
OTHER FOR EMOTIONAL SUPPORT, INSTEAD OF INVITING RELATIVE WHO MAY BE BIAS.

NURSING DIAGNOSIS 2
DECISIONAL CONFLICT RELATED TO UNCERTAINTY ABOUT COURSE OF ACTION TO BE TAKEN AS TO WHERE AND
HOW TO RAISE THE CHILDREN AS EVIDENCED BY THE COUPLES DISAGREEMENT OVER RAISING THE CHILDREN IN
THE USA OR NIGERIA. THE FATHER BELIEVES THAT THE CHILDREN SHOULD LEARN THE NIGERIAN CULTURE AND
AFRICAN VALUES. HE ALSO WANTS THE CHILDREN TO RECEIVE THEIR PRIMARY EDUCATION IN NIGERIA. THE
MOTHER, ON THE OTHER HAND, WANTS THE CHILDREN TO BE RAISED IN THE UNITED STATES SINCE SHE IS A
UNITED STATES CITIZEN.

EXPECTED OUTCOME/GOAL
THE TWO PARENTS WILL COME TO A COMMON UNDERSTANDING WITH THE INTEREST OF THE KIDS BEING THE
ULTIMATE PRIORITY. THE COUPLE WILL MAKE DECISIONS THAT WILL BE IN THE BEST INTERESTS OF THE CHILDREN.

IMPLEMENTATION
THE TWO PARENTS WILL HAVE A FAMILY MEETING AS A COUPLE TO IDENTIFY MEANS OF REACHING A COMMON
AGREEMENT ON WHAT IS GOOD FOR THE CHILDREN. THE FAMILY WAS ENCOURAGED TO SEEK COUNSELING FOR
ASSISTANCE ON HOW THEY CAN REACH AN AGREEMENT IN THE BEST INTERESTS OF THE CHILDREN.

 REFERENCE
FRIEDMAN, M. M., BOWDEN, V. R., JONES, E. G. (2003) FAMILY NURSING
RESEARCH, THEORY, AND PRACTICE. UPPER SADDLE RIVER, NJ: PEARSON
EDUCATION INC.
HERDMAN, T. H., (2012). NANDA INTERNATIONAL NURSING DIAGNOSIS:
DEFINITION AND CLASSIFICATIONS 2014. OXFORD: WILEY-BLACKWELL