Understanding family structure is essential for the nurse in patient and family care. The family I interviewed is the Johansen family. They are comprised of a nuclear setting, involving a husband, 42, a wife, 41, and two female children, ages 13 and 10.
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They are a middle-classed Caucasian family where both parents work, and the children are in the public-school system. The husband is a Physical Therapist and works Monday through Friday and the wife is an RN in a local hospital, working 3 days per week. The 13-year-old is involved in cheerleading and the 10-year-old is involved in volleyball, therefore they are both very involved in physical sports. They do not attend church, as they are not religious, but the parents are a spiritual entity.
This family values family ties and family time. They support one another in life issues and extracurricular activities. Husband or wife, or both when possible, will always attend their children’s activities. Due to all their demanding schedules, they rarely get to eat a meal together, but the parents male sure they touch bases with the children each day via text/phone call or at the end of the day to ask them how their day is going. The 13-year-old thinks this is not necessary, but the parents believe this is essential to the family tie and believe the children will appreciate this when they grow into parenthood themselves. The parents are relatively healthy, and the children have no health issues.
Husband does some sort of exercise each day. He primarily eats a Ketogenic diet and encourages his family to do so also. He believes this is one of the healthiest things they can do for themselves. Wife knows she should lead a healthier life. She is overweight and does not like to exercise. She eats what she wants but has considerably lessened her portion sizes. She too was doing the Keto diet and did feel better but states it’s hard to stay on it. She states that while she was on this diet, she was able to lose weight and did not feel as hungry as she does now. She and her husband do however, practice intermittent fasting, which they feel has made a difference in how they feel. The parents make sure there are always healthy meals and snacks for their children on hand, but when the children are out doing their activities, they eat whatever is available.
Husband and wife both have sleep issues, as they both have problems with anxiety. Husband has a very difficult time going to sleep and most nights it takes him several hours to do so. Wife falls asleep easily and sleeps mostly throughout the night, but due to depression issues, she oversleeps most days off and can easily take naps during the day. Being that the children are so active, they really have no problems with sleep.
Husband has a long history of gastrointestinal problems. Most of what he ate on a traditional diet sent him to the restroom immediately. Upon starting the Keto diet, he noticed a change in his elimination pattern. Sometimes he will feel slightly constipated. Wife and children have normal bowel movements, although wife used to have severe constipation issues. She states she does not know what has changed. Wife also has stress incontinence with heavy coughing or sneezing.
Husband does something active each day, whether it be lifting weights, doing core exercises, swimming, or talking a walk around the neighborhood. He states if he does not do at least something, he will not feel very well. Wife, as stated before, does not do much exercise, but when she does, it will be lifting slight weights or swimming. She says she feels accomplished when she participates in these activities but does not have much motivation to get them started. The children will sometimes go to the gym with their parents or walk around the neighborhood with them, but mostly they get plenty of exercise in their own activities.
Husband and wife both have some problems with remembering things. Mostly the wife, as she says most times when walking into a room to do something, she will forget why she walked in there in the first place. Husband tends to forget where he places his keys. They both, however, are very intelligent and tend to do a lot of reading and podcast listening for personal research on their down time. The 16-year-old, when she was in elementary school, had some issues with math and reading and needed a tutor for a short time.
Husband and wife both feel their sensory and perception are intact. He wears glasses daily and she wears reading glasses sometimes. They both love to taste new foods and try to figure out the ingredients. The 10-year-old may need to start wearing glasses after her next exam. They are not very keen on trying new things like their parents, but their sensory and perception are also intact, they say.
Husband states he feels good about himself and his place in life, although he says it was not always this way. He says he had to deal with balding at an early age and states he had someone in his life who made him feel insecure about himself but says he has worked through those issues and loves himself for what he is. Wife definitely has self-perception issues. She began gaining weight about 7 years ago when she placed on steroids for Rheumatoid Arthritis and she stress eats, so she had put on some weight. She says her hair has also started thinning in the last few years which she says makes her uncomfortable with herself. She says she also is more introverted than she would like to be. She says this makes it hard to make friends. Conversation is hard for her and this makes her feel uncomfortable around people and possibly unlikable. The 16-year-old is having a few problems with a couple of her peers at school. They make fun of her because she is tall. Her parents try to reassure her that she won’t have these problems later in life. That everything balances out once everyone is out of school and worrying about their own lives. The 10-year-old says she likes her hair and can sing well, and these things make her happy.
Husband tends to be the disciplinarian in the household, as he is calm and very patient. Husband and wife both consider themselves bread winners. They cook together when they can and pay the bills together. The children’s roles are to go to school, get good grades, and to help maintain the house.
Husband and wife feel sex is a very important part of their relationship. They feel it keeps them close and connected. The 16-year-old says she has not “done that”, but that if she had, she would not be saying it in front of her parents. Her parents say they want to keep the lines of communication open on this subject, but their daughter just shakes her head no. The 10-year-old does not seem to know what to make of this conversation.
Husband says he sometimes has a hard time coping with the demands of his time between work and family but says exercise and meditation with his wife seem to help. Wife has very limited coping skills. She agrees that exercise would probably help, and that meditation can be difficult due to her mind racing. As a family, they try to cope with stressors together, but say this is not always easy with a teenager.
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