Health Needs Of A Child Case Study Social Work Essay

Health Needs Of A Child Case Study Social Work Essay For the purpose of this essay I will write a critical analysis of a case study assessing the health needs of a child within a family. The case study is of a two parent family of a two year old girl. The family had transferred from another area. Their daughter was born prematurely at thirty one weeks. She didnt offer eye contact and had no voluntary speech. Full permission has been obtained to use the information in the case study. I used firstly Orems nursing model to assess the familys needs. Then a more appropriate framework Family Health Needs Assessment. The model is a behavioural model. Behavioural models are based on the hierarchy of human needs by Maslow (1993). The hierarchy starts at the bottom of a pyramid with essential needs, when these are met the person progresses up the pyramid until full potential is achieved (Maslow, 1993). Orems model is based on societies need for the client to be self caring (Henderson, 1990). Orems (2001) model has a continuum of self care abilities, the aim being to move along this continuum to self care or adapt to a diminishing self care in terminal or chronic ill cases. Orem (2001) states that the family and significant others in a persons life must be involved in their self care. It is a model which values individual responsibility, prevention and health education as key aspects of nursing intervention (Aggleton and Chalmers 2000). Orem lists the following key factors that influence health; 1. Adequate intake of air water and food. 2, Adequate excretion of waste. 3. A balance between activity and rest both mentally and physically. 4. Social interaction and solitude should be optimised. 5. The prevention or avoidance of hazards and danger. 6. The feeling of being and behaving normally leading to stress reduction. By being able to carry out self care in these areas the person fulfils what Orem (2001) calls their Universal Self Care Demands. If there is illness injury or disease the individual has self care demands in three extra areas (Orem, 2001). These are known as the Health Deviation Self Care Demands. i Structure. ii. Functioning. iii. Behaviour. Orem uses the Nursing Process starting with assessment of the family in order to discover their individual problems which are defined in terms of self care deficits (Orem, 2001). The first stage of Orems model identifies both the demands for and the ability to achieve, self care in an individual (Aggleton and Chalmers, 2000). I assessed the family the parents both worked dad is a chef and mum is a carer in a nursing home they are both supported by grandparents who lived across the street. Both were fit and well. The two year old daughter was causing her mother concern in that she was not speaking it was difficult to get her attention with very little eye contact. Using Orems list I asked questions about each of the six activities. The problems identified were related to the two year olds behaviour of pacing around the room not speaking no eye contact and slapping her hands one on top of the other. After gathering information I had to decide why there was a self care deficit. This was difficult using Orems which states the self care deficit should be linked to a lack of knowledge or of skills to a lack of motivation to achieve self care (Aggleton and Chalmers, 2000). These dont seem to apply to a two year old cared for by her parents. But clearly her behaviour was a cause for concern. I had now completed a good deal of paperwork a fault recognised by Fawcett et al (2004) in many instances it has led to nursing models being a bureaucratic chore (Fawcett et al,2004). A checklist method and standard care plans would have allowed for a quick assessment of the Universal self care demands (Kitson, 2001). The next stage is to plan and set goals (Salvage and Kershaw, 1990). The long term goal for each client would be the restoration of a balance between self care ability and self care needs (Salvage and Kershaw, 1990). The implementation of the care plan may involve activities to meet self care demands (Pearson et al, 2004). In addition members of the family, or significant others, may provide some care. Orem (2001) has identified six broad ways in which assistance can be given to implement a care plan. 1.Doing for or acting for another 2.Guiding and directing another. 3.Providing physical support. 4.Providing psychological support. 5.Providing an environment which supports development. 6.Teaching another. However each of these methods of helping requires compliance (Pearson et al 2004). Orems model demands that clients and their families are willing and able to adopt certain roles achieve self care (Aggleton and Chalmers 2000). 3) Evaluation Orem (2001) has suggested that the evaluation of care given should be measured in terms of the clients or families performance of self care. Using Orem we should set out goals in terms of what the family will achieve (Pearson et al, 2004). It was difficult to set goals babies who are born prematurely can suffer from learning difficulties and to investigate the two year olds behaviour was the goal. Orems model didnt seem to fit well with this families care. The major problem with nursing models concerns the relationship with the clients of the service. These are of two kinds. The employer for most nurses in the UK, the employer is the Government. The Government has aims and objectives for its health care system which is to use evidence based practice which may conflict with a particular nursing model or philosophy (Mckenna et al, 2008). Orems model is over fifty years old and is not evidence based. The problems mainly being centered on the daughters behavior the following framework was more appropriate for this family. An evidence based framework The Family Health Needs Assessment was introduced into the health visiting service in 2003 and is based on the Framework for the Assessment of children in need and their families (Department of Health et al, 2000). The Assessment Framework was intended to help practitioners to become child-centered (Horwath, 2010). The aim being to do an assessment of the familys health and parenting needs. A triangle is used as an illustration of the Framework the child being in the centre (Rose, 2009). The three sides of the triangle represent the key factors that influence the Childs health; child developmental needs, parenting capacity and family health and environmental factors. Each one has sub headings specific to the main heading. Childs Development Needs Health Education Emotional Behavioral Development Identity Family Social Relationships Social Presentation Self Care Skills Parenting Capacity Basic Care Ensuring Safety Emotional Warmth Stimulation Guidance Boundaries Stability Family health Family history functioning Wider family Housing Employment Income Familys Social Integration Community Resources The aim of the initial Family Health Needs Assessment (FHNA) is to undertake a full assessment of the familys health and parenting needs. The impact of parenting capacity, family health and environmental factors on the childs health and well-being is assessed to identify children and families who may require additional support to achieve the 5 outcomes identified in Every Child Matters (2004). Being healthy Staying Safe Enjoying and achieving Making a positive Contribution Achieving Economic well-being There is research evidence to suggest that low birth weight and prematurity indicates a greater risk of not achieving the 5 outcomes identified in Every Child Matters (2004). Then a family health plan can be developed to include the familys needs as agreed in partnership with the parent/carer. How the family wishes to address these needs An action plan which identifies specific interventions/support and who this will be provided by as well as the date for review and a review of progress made against the action plan. The assessment took some time I had to reword some of the questions for fear of giving offence. The assessment forms were lengthy and there was some duplication. Emotional warmth under parenting Capacity and Emotional and behavioral development under the heading Childs developmental Needs. I found it difficult to know what to include under some of the headings. In Calders study (2003) the practitioners found the heading for the childs developmental needs the most challenging of the three headings. A number got confused between social presentation and self-care skills and the majority struggled with assessing identity. The task for practitioners is to specify what, in relation to health and development, the child is at risk of and how significant they consider this risk to be (Horwath, 2010). The original Framework for the assessment of children in need and their Families has guidance and support materials which explain the risk of harm, reducing the Framework to the Triangle and a set of descriptions separates the needs from the risk of harm. Which could lead to a loss of focus on the child and their needs (Platt, 2006). Both parents in this case were happy to carry out the assessment some parents can be unco-operative or even hostile Brandon et al, (2009). This could also cause a lack of focus on the needs of children. Brandon et al, (2009) found that good parental engagement can also disguise risk of harm to a child. It is important hear what children have to say (Archard and Skivenes, 2009). I did engage the two year old with my identity badge which she recognized the picture but in this case I wasnt able to interview the child because of her understanding and limited speech. I was able to observe her though and record my observations. Brandon et al. (2009) describe the various ways in which professionals dont include children in the assessment. These include young people and siblings and a failure to address the needs of children who chose not to or are unable to speak because of disability, trauma and fear (Brandon et al 2009). Groups of children in need that are hard to assess included: disabled children; adolescents; children of different cultures and faiths; and children in asylum-seeking and refugee families (Brandon et al, 2009). Another group of children that also has been found to be difficult to assess are children in need from higher socioeconomic groups. These cases were found challenging by social workers because: the parents were more aware of their rights (Brandon et al, 2009). Care must be given to recording accurately what the child says and managing that information, especially if it is negative about the parents so not to expose the child to any more risk Practitioners are responsible for gathering information and they also have to share the findings of the assessment with family members. From the assessment I identified a problem under the heading Child Developmental Needs Health the two year old daughter was growing physically but was not developing speech and had limited eye contact. The family had just moved from another area. Their daughter had been born premature at 31 weeks and she had had follow up appointments at hospital now that they had moved the hospital was too far away. The follow up at hospital was important for her developmental reviews. So the first identified need was to register at the Doctors and explain that she needs a referral to the hospital for a full pediatric review. Speech was a problem in that she was making the occasional sound and not forming her words properly. I made the speech therapy referral and gained assurances that her parents would take her. We discussed taking her to a nursery to mix with other children. After talking it was decided so that mum could go too to join a mother and toddler group. So things moved swiftly we put a time scale on these three major things of three weeks. I arranged to visit again in two weeks.

Food Hygiene Essay

The term â€Å"street foods† describes a wide range of ready-to-eat foods and beverages sold and some times prepared in public places, notably at streets. Like fast foods, the final preparation of street foods occurs when the customer orders the meal which can be consumed where it is purchased or taken away. Street foods and fast foods are low in cost when compared with restaurant meals and offer an attractive alternative to home-cooked food. In spite of these similarities, street food and fast food enterprises differ in variety, environment, marketing techniques and ownership. Foods that are served to the customers should be â€Å"clean† and â€Å"safe†, absence of poisonous substances or contaminants and free from spoilage. If foods are not clean and safe health hazards like headache, stomach pain, vomiting, giddiness and anemia may also occur. Due to the modernization many school children and adults skip their breakfast and they prefer to eat street foods or fast foods or convenient foods. There is mistaken assumption that food contamination is inevitable in street foods. Yet millions of people depend on this source of nutrition. Vendors knew that consumers watch the way food is prepared and notice whether the work area and vendor’s hands and cloths are clean or tidy. The vendors have to satisfy the customers with improved practices in the preparation of foods learned through training in nutrition and hygiene. Since, all categories of people from different socio-economic sectors purchased the street foods; the street foods should not only be cheap but also hygienic and rich in nutrition. The investigators with their nutrition knowledge had an urge to study the nutrition knowledge of the vendors, whether the foods prepared are nutritional sound or not? Are they preparing and serving food hygienically? Etc. Disease could be easily spread through food, water and the place of sales, how it is packed etc. and these questions made the investigators to take up this study. Hence, the investigators were interested to know the answers for the above said questions. Hence, studying microbial quality, nutritional knowledge and food hygienic practices among street food vendors importance at this hour and this paper aims to analyze this. To study the nutritional knowledge and food hygienic practices prevailing among the street food vendors. 200 vendors in Dindigul district, Tamil Nadu, India were selected by using purposive random sampling techniques. The investigators met the vendors and collected the details. Microbial analysis, food adulteration test were done for food samples. Microbial load for the major street foods like bhajji, vada, samosa varieties, roasted corn etc., were tested. Raw materials used for the street foods were collected such as dhal, salt, sugar, oil, pepper, turmeric and chilly powder and there were analyzed for food adulteration. The street food vendors were poor in hygienic practices in food preparation, serving, handling and storing. They were also poor in their nutritional knowledge. It can be concluded that as there is an urgent need for disseminating the knowledge about food safety and disease prevention, nutrition education is the need of the hour. Measures are suggested to improve the dwindling standards of the street food units. This study implies the need of the following measures to be adopted for hygienic food preparation by the street vendors, they are, license must be obtained by the street food vendors and the foods should be frequently inspected by the agencies, nutritionists should take the in-charge of disseminating awareness on hygienic practices, nutrition and health so that it will help in the preparation of nutritious foods. Colleges and other educational institutions also should take part in creating awareness about the street foods, government can encourage the vendors on improving their business by availing loan facilities and the sources of information must be increased to improve the nutrition and hygienic knowledge of the street food vendors. If this will be able to happen I believe that there will be less people having different kinds of sicknesses in the world and less hardships especially to the less fortunate that can’t afford to buy expensive food and medicines for those sicknesses. People need to be educated with the proper food safety hygiene and sanitation to not suffer these illnesses. I have learned that people need to gain more knowledge about Food safety hygiene and sanitation. If all have this knowledge there would be a better environment for everyone. Health is the most important thing in a person’s life, that’s why we should pay more attention in food hygiene. We should teach those around us the proper food hygiene especially vendors and or those people who sell street foods around the corner. In doing this, every person would have a cleaner environment to live in and also will have a healthier life, not only for this generation but also for the health of the future generation. We should make cleanliness a part and habit in our daily lives. Street foods should not just be only clean, but should also have nutrition. There would be no sense in eating clean food that doesn’t contain any nutrients in it. Having clean and nutritious food around us would help our bodies work in a better manner and would give us the right and enough energy for the whole day in our daily activities. We should always think before eat anything from the corner. Eating clean and nutritious food means having a clean and healthier lifestyle, and I believe that is the key to having a good body inside and out and for us to have a longer life.

Orginal Writing: A seventeen year old girl named Laura

A seventeen year old girl named Laura was having the time of her life. She had been with her love Andy for the past four years and she was desperate to know when he was going to ask that life changing question. One night whilst Laura and her sole mate were at a popular night club, ‘The Jump' Laura realised how lucky she was to have such a lovely boyfriend and felt her life couldn't get any better. The music pumped and pounded, the lights flashed and flickered as Laura and Andy danced the night away. Laura's beautiful brown hair shone with the lights as she jumped up and down with the beat with the surrounding teenagers. Laura was having an awesome time and everything around her didn't seem to matter until she smelt smoke which suddenly alarmed her. She immediately turned around to find her beloved boyfriend clasping a cigarette between two fingers. At an instant Laura thought of the worst and began to panic. â€Å"Andy, don't tell me that's a ‘fag' your holding!† Laura shouted shaking her head in disgust. â€Å"Who do you think I am, a 5 year old that can't do his shoelaces up? I can make my own decisions now Laura why can't you just relax a bit!† Andy explained, as his frustration emptied out on Laura. As Andy finished bellowing at Laura, she became even more determined to prove a point to Andy as her fists clenched and her teeth grinded she grabbed the cigarette and clasped it in her fist. Laura was so uptight about Andy not caring how she felt, she acted quickly and doing so didn't think how the cigarette burned into her sweaty palms. â€Å"Arghhh!† she cried in pain as she waved her hand about trying to cool her burn down as fast as possible. â€Å"Look what you've done† she exclaimed pointing at her red throbbing palm. â€Å"Sort yourself out, ok look, I can't be here whilst you're talking to me like I'm some kind of kid, who do you think you are, my mother† as he said this his backed turned on Laura as he disappeared into the crowds shaking his head. As Laura watched his figure fade into the many surrounding bodies a tear ran slightly down her red blossomed cheek. People began to stare at Laura as she wiped her face which was now smeared with the block of mascara she piled on before coming out. She looked at the ground and began to dance a little in embarrassment. As her heart began to beat through her ears, the music sounded quieter as if she was in a world of her own and all the giggling and staring around her seemed like people didn't care about the disco anymore and wanted to look at the miserable tart in the middle of the dance floor. â€Å"Look at her, poor ‘slag'† Laura heard people whisper, but she knew that they meant for her to hear it. The sounds echoed in her mind as her tears began to flow down her face more rapidly, her dancing suddenly began to droop as her shoulders collapsed and her feet felt like chains were attached to them and she couldn't move anywhere. Everywhere she turned people where staring, as it seemed like she was in a box with alien eyes staring at her with a lock on it which she new there was no key to. She began walking through the many crowds of people that seemed to her like aliens and they looked at her up and down like she was some kind of animal. Every step she took seemed like a mile, as her silent tears turned in to crying as she screwed up her face she now began to run, trying to escape what seemed like a never ending maze with no way out. As she sees the door in the distance she begins to run faster her legs now seeming like they are on a treadmill and her body seems to go through the same people over and over again. Her heart sinks as she sees a group of girls that once were close to her in high school. She looks the other way but keeps turning to make sure they don't see her like this puddle of shame. â€Å"Laura! Laura is that you?† one of the girls shouted, as they saw Laura rushing through the herds of people. â€Å"Laura!† they exclaimed again in a more confused way, wondering why Laura was not answering them. Laura heard these immediate calls but did not stop in her paces as she knew if she did she would not even be able to say hello, as there was such a big lump in her throat from anxiety about upsetting Andy. She hadn't ever had an argument with Andy as they were a loving couple who had so much in common it seemed like they were perfect for each other. As Laura finally reached the door she began to slow down as she knew there was a busy road just outside and didn't want to rush out. She began walking past the bouncers who also stared at her like she was some abnormal freak show. As she went to take a step outside which felt like a gasp of freedom there was a tap on her shoulder. Her ears pricked up and a deep breath of anxiety invaded her lungs. â€Å"Laura you alright mate, long time no sees†¦oh, what's the matter? You've got mascara all over your face you silly cow† , one of the high school mates asked changing the tone and meaning of her question as she saw Laura in the state she in. â€Å"Nothing! Nothing alright, why would you care anyway!† Laura exclaimed in a rushed nasty blur as every time her mouth opened she cried as well. â€Å"Just leave me ok!† Laura shouted in a mean way forgetting that her friend was only trying to help. Laura turned and slowly stepped out of the door she looked up and saw the rain pouring down on top of her. â€Å"You've changed!† the girl shouted from inside the hall! Laura took several deep breaths in and out as every time she breathed out anxiety was released in heavy floods of tears which resembled the weather around her. She started walking slowly, down the dark street kicking the wet puddles beneath her. She started regretting being so miss understanding to Andy and felt like she was some uptight annoying girl who needed to start living a little. She also was kicking herself inside for being so ‘bitchy' to her old friend and knew that she had made such a fool out of herself. The street lamps were on a s she slowly struggled by. Rain bounced on the pavements. Rain, endless rain. Doubt, endless doubt. Then suddenly she stayed still, and listened. Immediately she turned and looked down the alley. Fir some reason Andy seemed close as her heart beat rapidly, as the rain began to poor and the mascara now dripping from her face, it masked her ever flowing flood of tears. â€Å"Andy, Andy baby!† a light seemed to be growing in the distance and seconds later, heard the sounds of footsteps coming up the alley. She saw a figure, large built but quite small. Head and shoulders first, walking steadily, there shadow, cast the light behind them reaching out towards Laura, lengthening as they reached the summit. He was nothing, nothing she recognized. A dark figure haloed in light. She waited, and couldn't speak. â€Å"Do you know him?† he asked, pointing up the moonlit alley. Laura stood for a second as she made out a figure lying on the ground wit drops of rain reflecting of them. She squinted and for a second and realised who it maybe. She ran like she had never ran before as she came to terms with Andy lying in the middle of the alley all cut and unconscious like, in a puddle of his own red blood. â€Å"Andy, it's me Laura!† she exclaimed, as she knelt behind him. He didn't reply. There was the heart beat again rushing through her ears. She backed away from him tears springing to her eyes. She turned to the man behind her which in all the rush she didn't know was actually a cop on duty. Now, the cop by her side leaning over Andy drenched in his blood, the cop put his arm around Laura saying â€Å"he's dead†. Silence flooded the area, even sounds of cars disappeared, just the heart beat stayed in contact with her. ‘bub bum, bub bum' pounding through her ears. She stood up in the rain and said nothing, looking at her dead partner on the pavement and looked at the purple jacket screwed up and drenched in water and his diluted blood. The cop picked up the jacket and turned it over in his hands, â€Å"A Royal, huh† he asked as Laura looked at the cop and very quietly in a murmured voice, â€Å"His name is Andy†. The cop flung the jacket over his arm and took out his notebook and flipped it over to a blank page. â€Å"A Royal† he said. Then he began writing. Laura bit her lip and didn't now what to do or what to say. She felt sorrow rush through her body that was filled with an emptiness that made her have no feelings. She could not cry anymore, the shock was so overpowering. Then she looked across at the cop. In his tight pressed trousers there was a gun half out of his pouch wanting to be clasped as the handle was facing up. Laura did not say or move. She stared at it as the cop carried on talking and writing, talking and writing. What he said she heard blurred as her focus was on the gun. The cop looked up at her as he repeated a sentence over and over but Laura still focusing did not reply. She immediately acted on her instinct and grabbed the gun from the tight pouch and†¦

The Power of Light in The Scarlet Letter Essay - 661 Words

The Power of Light in The Scarlet Letter Since the conception of humanity, man has been fascinated with that presence which illuminates, yet cannot be touched. Mankind has brought it into his religions, giving it a great deal of importance in his creed. Following in the footsteps of his ancestors, Nathaniel Hawthorne uses light as a tool of God that illuminates the darkness of human iniquity and exposes its permanence. He studies the psychological theme of the impossibility of eradicating sin from the human heart in his novel The Scarlet Letter. The use of light in order to fortify this psychological theme confirms its significance in the novel. As though he were weaving an†¦show more content†¦Through the narrators words, we see the Governors house as Hester sees it: ...though partly muffled by a curtain, it [the hallway] was more powerfully illuminated by one of those embowed hall windows... (Hawthorne 101). One can envision the brilliant sunlight streaming though the immense window, slicing through the facade of the Governors feigned sanctity. Is not simplicity one of the fundamental tenets of the Puritan faith? Yet Bellingham, the very person that passed judgment on Hester and her sin is laid bare to the readers opened eye. Here, light shows Governor Bellingham to be corrupt due to his improvident lifestyle. In his genius, Hawthorne defines light not only as a presence, but as an animate consciousness. Still acting as a tool of God, light seems to run away from Hester when she tries to touch it. Pearl, in her inexplicable intuitiveness, says to Hester, ...the sunshine does not love you. It runs away and hides itself, because it is afraid of something on your bosom (Hawthorne 180). Although Pearl makes this comment concerning the scarlet A, one may argue that the sunlight is actually afraid of Hesters sin, and not the scarlet A. 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