bj’s last testimony
DESCRIPTION
BJ’s Last Testimony. Family Medicine Case Presentation 15 January 2010. Asuncion- Dalman - Doromal - Dy - Generoso -Mejia- Ong. Case background. Family system. Family System. Family System. Patient Single, Young adult, Lives alone Several partners Parents - PowerPoint PPT PresentationTRANSCRIPT
BJ’s Last TestimonyFamily Medicine Case Presentation15 January 2010
Asuncion-Dalman-Doromal-Dy-Generoso-Mejia-Ong
CASE BACKGROUND
FAMILY SYSTEM
Family System
Family SystemPatient
◦Single, Young adult, Lives alone◦Several partners
Parents◦Father works as the church minister, ◦Mother is the children’s primary
caregiverFamily
◦Eldest brother, 2 younger sisters
IMPACT OF ILLNESS
Family Life CycleLaunching
◦Goal: Being one’s own person◦Secondary task
Differentiation of self from family of origin Development of peer relationships
APGARAlmost always
Some of the time
Hardly ever
1. I am satisfied that I can turn to my family for help when something is troubling me.
1. I am satisfied that my family talks things over with me and shares problems with me.
1. I am satisfied that my family accepts and supports my wishes to take on new activities or directions.
1. I am satisfied that my family expresses affection and responds to my emotions, such as anger, sorrow and love.
1. I am satisfied with the way my family and I share time together.
Total Score 6/10
Modified from Smilkstein G: The family APGAR: A proposal for family function test and its use by physicians, J . Family Practice 6(6), 1978. Reprinted by permission of Appleton and Lange, Inc
Stakeholder AnalysisStakehold
erInterest in Issue Role Level of
Influence
BJ Getting well, Controlling my illness, Confidentiality
Ally High
Mother Getting my son well, safe and home; Keeping the family together
Ally High
Father Getting my son well, safe and home
Ally Medium
Siblings For my brother to get well and go home soon
Ally Low
Grandmother
Caregiver when the mother needs to rest; For my grandson to get well and go home soon
Resistor
Low
Other Family IssuesOther family issues
◦Religion Iglesia ni Kristo Father is a minister
◦Patient’s decision and confidentiality Only the mother knew
◦Communication to other family members Pneumonia not responding to antibiotics Why the need to confine in an ICU
SCREEMAddressing Disease within a Family Framework
Social-Cultural-Religion-Economic-Education-Medical Tool
Resources PathologySocial Network in the workplace Lack of communication with
familyCultural Harmonious relationship with
colleaguesRespect for parents
Stigma for possible venereal disease
Religion There are no religious differences in dealing with the sick among Iglesia Ni Cristo
Conservative group who would disapprove of the illness
Economic
Personal incomeEmpowerment to make own financial decisionsFamily members are open to financially assisting
Expensive medical care requirementsNo known savings yet
Education
Patient is a college graduate who is able to comprehend the medical needs required for his illness
Medical Health card holder and immediate access to health needs, improving health seeking behavior
Non-coverage for illness related to risky lifestyle behaviorsIn a tertiary hospital with high price for health care without his HMO coverage
MEDICAL ISSUES AND INTERVENTION
PSYCHOSOCIAL ISSUES AND PROPOSED INTERVENTION
Psychosocial IssuesThe Family Profile
◦Cultural and Religious reprisal A lifestyle preached against by church and
family His being as a moral fault His disease speaks against his whole family
◦Financial burden Class C family HMOs do not cover this risqué lifestyle
disease Cannot proceed to church’s hospital for
confidentiality
Psychosocial IssuesThe Family Profile
◦DNR and INC doctrines about life No clear practice on remembering those
who died No doctrine on the issue of DNR
◦Bereavement and Acceptance of loss No clear understanding of how this came
about Difficult to communicate to family
members the reason for BJ’s confinement The issue of communicating his testimony
to their community
FAMILY WELLNESS PLAN
Family Wellness PlanAcceptance of GriefDNR
LEARNING ISSUES