Family Assessment Tools

Objectives of the Subject

• Discuss the significance of family assessment tools in the health care delivery.

• Analyze uses of the different family assessment tools.

• Utilize the most appropriate family assessment tool in a given medical condition.

• Know the extent of the physician’s involvement with the patient’s family

Why do we Need tools to Assess the family?

• assess family functioning• assess coping mechanisms of the family• assess resources• assess family structure • to have a picture of the multigenerational

patterns of behavior or illnesses. • to assess the normal crisis or common illness

to be encountered in each stage of development.

• to provide anticipatory care and guidance.

What do you know about GENOGRAM?

• inheritance patterns

• family illness

• family members

• family relationships

• significant dates

When to use the GENOGRAM?

• Used in all kinds of patients, can be alternative to the narrative personal and social history.

What do you know about FAMILY MAP?

• Family relationships

• Interaction patterns

When to use the FAMILY MAP?

• Psychosomatic disorders

• Difficult patients (poor compliance)

• “Thick file syndrome”

• Alcohol and drug abuse

• Multiple presentations by multiple family members.

• Chronically ill and terminally ill patients.

What do you know aboutFAMILY APGAR?

• Patient’s satisfaction to the family functioning.

• Subjective

• Limited to what the patient want to disclose regarding his family.

When to use FAMILY APGAR?

• Symptoms that manifest as psychosomatic disorder such as frequent headache, anxiety, depression, insomnia, fatigue, and increased pediatric complaints.

• Difficult patients• Marital or sexual difficulties• Multiple presentations by multiple family members.• Drug or alcohol abuse• Evidence of sexual and physical abuse in wife or child• “The thick file syndrome”

What do you know aboutSCREEM?

• Sources of help

• Barriers to patient care

• Relationship of health behaviors, practices and utilization of health services

When to use the SCREEM?

• Chronically ill patients

• Terminally ill patients

• Hospice and palliative care

• Difficult and non-compliant patients

• Caregiver fatigue

What do you know aboutFAMILY LIFELINE?

• Family history

• Significant events

• Significant event that may have an effect on patient’s health.

When to use the FAMILY LIFELINE?

• Long term illness is anticipated

• Presence of difficulty in care giving

• Non-compliance to treatment strategies

• Cases when the doctor needs to “think family” such as inappropriate behavior in the antenatal/postpartum care.

• Drug and alcohol abuse

• Sexual or physical abuse.

Other TOOLS

• DRAFT (Draw a Family Test)

• The Family Circle

Five Levels of Involvement

Level 1: Minimal emphasis on Family on the health care delivery

Level 2: Ongoing medical information and advice. Works collaboratively with patients and families, and understands the triangular nature of MD-Px-Family relationship

Five Levels of Involvement

Level 3: Feelings and support. The physician understands normal family development and how family reacts to stress.

Level 4: Assessment of family dysfunction and provide intervention.

Level 5: Family Therapy