Friedman Family Assessment Model (Short Form)

APPENDIX В Assessment Tools В.2 Friedman Family Assessment Model (Short Form) Before usiпg the following guidelines in completing family assessments, two words of caution are iп order. First, поt а11 areas included Ьelow will Ье germane for each of the families visited. The guidelines are comprehensive and allow depth when probing is necessary. Тhе student should not feel that every subarea needs to Ье covered when the broad area of in­ quiry poses по proЫems to the family or concern to the health worker. Second, Ьу virtue of the interdependence of the farnily system, one will б.пd uпavoidaЫe redundancy. For the sake of efficiency, the assessor should try not to repeat data, but to refer the reader back to sections where this inforrnation has already been described. IDENT/FY/NG DATA 1. Family narne 2. Address апd рhопе З. Family cornposition (see Farnily Cornposition Form оп р.613) 4. 5. 6. 7. 8. Туре of family forrn Cultural (ethnic) background Religious identification Social class status Family's recreational or leisure-tirne activities DEVELOPMENTAL STAGE AND HISTORY OFFAMILY 9. 1 О. 11. 12. Farnily's present developmental stage Extept of developmental tasks fulfillrnent Nuclear family history History of farnily of origin ofЬoth parents ENV/RONMENTAL DATA 13. 14. 15. 16. 17. Characteristics of horne Characteristics of neighborhood and larger cornmunity Farnily's geographic mobility Family's associations and transactions with cornmunity Family's social support network (ecomap) FAMILY STRUCTURE 18. Commurucation patterns Extent offunctional and dysfunctional communication (types of тecurring patteтns) Extent of emotional (affective) messages and how expressed Characteтistics of communu:ation within family subsystems Extent of congruent and incongruent messages 'Iypes of dysfunctional communication processes seen in family Areas of ореп and closed communication Familial and external variaЫes affecting communication 19. Power structure Power outcomes Decision-making process Powerbases VariaЫes affectingfamily power Overal/ family sysrem and subsystem power 20. Role structure Formal то/е structure Informal role structure Лnalysis of role mode/s (optional) VariaЬ/es affecting role structure 21. Farnily values Compare the family to American от family's reference gr, values andlor identify impoтtant family values and importance (priority) in family Congruence between thefamily's values and thefamily's r епсе group or wider community Congruence Ьetween the family's values and family mern values Vaтiah/es influendng family values Values consciously or unconsdous/y held Presence of value conflicts in family Effect of the above values and value conflicts оп status offamily FAMILY FUNCT/ONS 22. Affective function Family's need-response patterns Mutual nurturance, closeness, and identification Separateness апd connectedness 23. Socialization function Family child-reaтing practices AdaptaЬility of child-тeaтing practices for family form and family's situation Who is (are) sodalizing agent(s) for child(ren)? Value of children in family Cultural belieft that influence family's child-reaтing patterns Social class influence оп child-reaтing patterns Estimation about whether family is at risk for child­ reaтing proЫems and, if so, indication of high-risk factors Adequacy of.home environment for children's needs to play 24. Health care function Family's health beliefs, values, and behavior Family's definitions of health-illness and their level of kndwledge Family's perceived health status and illness susceptibllity Family's dietaтy practices Adequacy offamily diet (recommended 24-hour food history record) Function of mealtimes and attitudes roward food and mealtimes APPENDIX В Shopping (and its planning) prш:tices Person(s) responsiЫe for planning, shopping, and prepararion ofmea/s Slup and rest haЬits Physical activity and recreation practices (поt co.vered earlier) Family's drug haЬits ,Family's ro/e in self-care practices Medical/y based preventive measures (physicals, еуе and hear­ ing rests, and immunizations) Dental health practices Family health history (both general and spedjic diseases­ enviтonmentally and genetically related) Health care services received Feelings and perceptions regarding health services Assessment Tools Emergency health services Source ofpayments for health and other services Logistics of receiving care FAMILY STRESS AND COPING 25. Short- and long-term familial stressors and strengths 26. Extent of family's ability to respond, based оп objective appraisal of stress-producing situations 27. Coping strategies utilized (present/past) Differences in family members' ways of coping Family's inner coping strategies Family� external coping strategies 28. Dysfunctional adaptive strategies utilized (present/past; extent of usage) Family Composition Form Name ILast, Firstl 1. IFather) 2.IMother) З. (Oldest child) 4. Б. 6. 7. 8. Gender Re1ationshi Date and Plac:e of Blrth Occu tion Education