Holistic Nursing Care: Family Health Case Study & Plan

Family Health & Wellbeing Case Study

A Holistic Nursing Assessment & Intervention Plan

Narrated Presentation

Differing Definitions: The Adults

Sophie (Cystic Fibrosis)

• Biomedical model focus • Emphasis on disease management & physical function • Metric: Life expectancy & adherence

Claire (Low Mood)

• Biopsychosocial model • Focus on emotional health & sleep hygiene • Stress management as key indicator

Differing Definitions: The Children

Daniel (Anxiety)

• Developmental perspective • Need for emotional security & attachment • Focus on separation anxiety & resilience

Ella (Epilepsy & ID)

• Functional ability & adaptive behavior • Social inclusion for children with disabilities • Impact on caregiver burden

Social, Political & Economic Factors

<strong>Socioeconomic Status</strong><br>Disparity between incomes (Financial advisor vs Teacher) affecting access to private therapies.<br><br><strong>Location (Stevenage)</strong><br>Reliance on local NHS services and housing costs in Hertfordshire.

<strong>Social Support</strong><br>Social isolation due to lack of nearby family and Ella's care demands.<br><br><strong>Workplace & Policy</strong><br>Demanding corporate culture vs. Education sector. Impact of disability benefits legislation.

Intervention for Claire: Low Mood

Symptoms: Insomnia, headaches, palpitations.

• Referral: Cognitive Behavioral Therapy (CBT) • Assessment Tools: GAD-7 (Anxiety) & PHQ-9 (Depression) • Role: Active listening, education, and validation

Justification: NICE guidelines support CBT as first-line treatment for mild-moderate depression/anxiety.

Medication Management: Sophie

Ivacaftor (Cystic Fibrosis)

• Monitoring: Liver function tests required. • Pharmacokinetics: Altered in CF patients; dose adjustments may apply. • Adherence: Critical for efficacy; address barriers like cost or routine complexity.

Assessing Emotional Distress: Daniel

Signs of Distress

Separation anxiety, bedwetting (enuresis), behavioral regression.

Nursing Assessment

Play-based assessment, school nurse observation, trauma-informed approach.

Referrals

Child psychology, parenting support programs.

Monitoring Physical Deterioration: Ella

Epilepsy & Intellectual Disability

• Signs of Decline: Increased seizure frequency, altered conscious state, new neurological deficits. • Functional: Feeding/swallowing difficulties, breathing changes.

Nursing Actions: 1. Neurological Assessment (Glasgow Coma Scale/AVPU) 2. Emergency Medication (if indicated) 3. Urgent Physician Consultation

Holistic Family Support: The Nurse's Role

Beyond the Individual

• Family-centered care: Care for the unit, not just the patient. • Advocacy: Education and resource signposting. • Collaboration: Open communication & care planning.

Challenges

• Conflicting family needs • Time constraints vs. holistic needs • Emotional toll on staff

References

National Institute for Health and Care Excellence (NICE). (2019). Depression in adults: recognition and management.<br><br>Joint Formulary Committee. (2024). British National Formulary (BNF).

World Health Organization. (2020). Standards for improving the quality of care for children and young adolescents in health facilities.<br><br>Public Health England. (2023). Health inequalities: place-based approaches to reduce health inequalities.