Family Assessment Visual Report
The Belcher Family
Introduction
The Belcher family reside above the restaurant they own and operate in a beach side community. Bob and Linda have three children. Tina is the oldest, Gene the middle child and Louise is the youngest member of the family. When the kids aren’t in school they spend the majority of their free time working in their parent’s restaurant. While the family enjoys spending time and working with each other, they each have their own unique hobbies and interests. The family is considered lower middle class and struggle to sell burgers. This American working-class family have hit a rough patch after Tina was diagnosed with asthma. The Belcher culture is very family oriented. Family meals are regular and where everyone talks about their issues. They enjoy celebrating the holidays together, especially Thanksgiving which is a very important tradition. Communication is great between the family members. They are all open to discussion and are willing to offer advice. The family also has effective nonverbal communication such as hugging and kissing.. This family is all about acceptance. Bob and Linda love how weird their kids are and never try to change them. While the family is Catholic, they do not regularly go to church and religion is not a significant aspect of their culture.
Members of the Belcher Family Bob Age: 46
Linda Age: 45
Developmental Stage: Generativity vs. Stagnation
Developmental Stage: Generativity vs. Stagnation
Bob is the chef and owner of Bob’s Burgers restaurant. Bob always means well and tries to be a good father and husband. While he isn’t the most successful businessman, he loves his restaurant and finds joy in cooking. Bob tends to be the calmer and more sensible family member. However, there are times when he does get easily offended
Linda not only cares for her children but also works at the family restaurant. She is a devoted wife and mother. Linda’s personality is extroverted, talkative, and at times overbearing. She can be a pushover sometimes and her kids know it.
Tina
Age: 12
Developmental Stage: Industry vs Inferiority
The Belcher Kids
Tina is the oldest Belcher child and is having a hard time transitioning into adolescence. She is very awkward and lacks basic social skills. At the same time she is very interested in boys and has a serious crush on a boy at school. While she doesn’t know how to show her emotions well, she does keep a diary expressing her feelings and even some erotic friend fiction. Tina’s anxiety tends to get the best of her. Gene
Age: 11
Developmental Stage: Industry vs Inferiority Gene is the only boy out of his siblings but gets along great with his sisters. He is an aspiring musician and enjoys putting together school musicals. He is very flamboyant and creative.
Louise
Age: 9
Developmental Stage: Industry vs Inferiority Louise is the leader of her siblings but also tends to get to them in trouble. Not only is she mischievous but she also has a very controlling, manipulating personality. She is highly intelligent for her age.
Tina Belcher’s Condition Tina was diagnosed with asthma at age 9. She hasn’t had many exacerbations since her diagnosis. It wasn’t until she became a hall monitor at school that she began to have more asthma attacks because of running after students who shouldn’t be in the halls. Tina already doesn’t handle stress well so she becomes very overwhelmed during and after an attack. She loves being a hall monitor but now is worried it’s triggering her asthma attacks. Her anxiety and disturbed body image related to her condition is starting to concern her parents. The Condition Asthma is a disorder that affects the airways of children and adults. This condition is categorized as an obstructive pulmonary disease. It is described as, “reversible bronchospasm, inflammation, and hyperactive airways” (Karch 2013). An attack can be triggered by several things such as allergens, exercise, or even emotions (Karch 2013). The trigger then causes, “an immediate release of histamine, which results in bronchospasm in about 10 minutes. The later response (3-5 hours) is cytokinemediated inflammation, mucus production, and edema contributing to obstruction (Karch 2013). Common signs and symptoms include shortness of breath, wheezing, coughing, and anxiety. Treatment typically includes preventing and treating symptoms of attacks. Medications for long term prophylaxis that have been found effective are leukotriene receptor antagonists. The best treatment for acute attacks are the use of a, “beta-agonist and then a long-acting inhaled steroid or a mast cell stabilizer” (Karch 2013).
Strengths & Challenges of the Belcher Family Strengths
Challenges
● Bob and Linda are very present in Tina’s life and always offer support. ● The family is surprisingly optimistic which helps Tina who tends to get very anxious and overwhelmed around an asthma attack. ● Linda takes Tina to the doctor when needed while Bob looks over Gene, Louise, and the family restaurant.
● The Belcher family is lower middle class so frequent doctor visits and prescription medications have become a burden on Tina’s parents, especially on Bob who already struggles to keep his business running. ● Bob feels like he knows very little regarding Tina’s condition since he doesn’t go to many doctor visits in order to keep the restaurant running. ● Louise and Gene don’t seem to quite accept their sister’s illness. They still want to get into trouble and go on adventures but don’t understand how those activities can trigger an asthma attack. ● Tina’s peers tease her even more now after an attack happened one day during lunch.
Family Theory - Bioecological Systems Theory Assessment Microsystem: This level focuses on factors such as personal experiences and general demographics of the individual and family unit (Kaakinen et al., 2015). The nurse may ask Tina how she is reacting to living with asthma. Does she get frustrated having to be so different from her siblings or is she having any side effects to her medications? How has the family adjusted to Tina’s situation? The nurse can also inquire how Tina’s asthma affects the family’s daily lives. The nurse can assess if Tina’s parents agree over her plan or care or if they are taking the right measures to help Tina avoid irritants or triggers. Mesosystem: The interactions and relationships with peers, family, and school that influence the microsystem (Kaakinen et al., 2015). The nurse may ask if Tina gets support from her peers or is she experiencing any bullying at school. Bob’s landlord frequently comes into the restaurant talking about rent or even raising rent. Exosystem: Refers to the community context and how it directly or indirectly influence Tina and her family (Kaakinen et al., 2015). The nurse can assess whether the Belcher’s business affects Tina or not. For example, does Tina feel guilty that her parents struggle to pay the bills knowing that her doctor visits and medications are expensive. Macrosystem: Takes into account broad cultural attitudes, ideologies that influence the family (Kaakinen et al., 2015). The nurse can make connections between the Belcher culture, social class, and see how it can affect Tina’s condition and her family as a unit. Chronosystem: Critical events and changes in the individual or environment that affect the other systems (Kaakinen et al., 2015). The nurse can determine how Tina’s transition from childhood to adolescence is affecting her illness. Also, has Tina’s condition altered her family’s development?
Interventions & Expected Outcomes 1. Teach the client techniques to self-manage anxiety. Teaching clients anxiety reduction techniques can help them manage side effects with self-care behaviors (Ackley, 2014). Tina will use these techniques to better manage the anxiety she experiences due to her condition. 2. Review trigger awareness with both the child, parents and siblings. Knowing what kind of situations, allergens etc, can trigger a child’s asthma can help both the child and parent with avoidance strategies (Lawlor, 2015). Tina and her family will have increased awareness of what causes her attacks and how to avoid those triggers. 3. Encourage increased father involvement in child’s condition and doctor visits. A systematic literature review article on fathers of children with chronic illnesses found that fathers involvement in children’s health care can have a positive impact on the fathers, mothers, and the children’s well-being and family functioning (Gudnadottir & Svavarsdottir, 2014). Bob will be more involved in Tina’s care which will also give him a better perspective of Linda’s role of being the primary caregiver.
References Ackley, B., & Ladwig, G. (2014). Nursing diagnosis handbook: An evidence-based guide
to planning care (10th ed.). Maryland Heights, Mo.: Elsevier. Gudnadottir, M., Svavarsdottir, E. (2014). Advanced nursing intervention for families of children and adolescents with asthma: the father’s perspective. Nordic Journal
of Nursing Research & Clinical Studies, 34, 49-52. Kaakinen, J., Coehlo, P., Steele, R., Tabacco, A., & Hanson, S. (2015). Family health care
nursing (5th ed.). Philadelphia: F.A. Davis. Karch, M. A. (2013). Focus on nursing pharmacology. (6th ed.). Philadelphia, PA: Lippincott Williams & Wilkins. Lawlor, R. (2015). Management of asthma in children. Practice Nursing, 26 (7), 326-330.
References - Images Belcher kids 2 [Image]. (n.d.) Retrieved from http://img12.deviantart.net/5599/i/2014/211/4/8/belcher_kids_2_by_forget_the_nam e-d7swrvh.jpg
Bob and Linda [Image]. (n.d.) Retrieved from http://cdn.hercampus.com/s3fs-public/2016/10/31/Bob%20and%20linda.jpg Family Banner [Image]. (n.d.) Retrieved from http://bobsburgerslive.com/ The Belcher Family [Image]. (n.d.) Retrieved from https://www.pinterest.com/jiminycrk7/bobs-burgers/ Tina Belcher [Image]. (n.d.) Retrieved from https://www.theodysseyonline.com/finals-week-ft-tina-belcher Why-bobs-burgers-is-better-than-family-guy [Image]. (n.d.) Retrieved from https://www.theodysseyonline.com/why-bobs-burgers-is-better-than-family-guy