running head: Community Case Study

Community Case Study

Jaclyn Hirohama
NURS210: Health Promotion Through The Lifespan
Professor Barone

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Community Case Study

As people age and life demands increase, adults are at risk for physical, mental, and
emotional changes. It is important to understand the different attributes of an individuals life
that contributes to their total wellbeing. These attributes include the level of development,
functional ability, culture, family dynamics, and nutrition. J.H., a 59-year-old Japanese female,
was interviewed for this study. She is an administrative secretary with the State of Hawaii
Department of Education. The interview was conducted on September 10, 2013.
Developmental Assessment
J.H. demonstrated psychosocial qualities in Eriksons generativity vs self-absorption and
stagnation stage. In this stage, an individual focuses on supporting future generations
contributing to future generations through parenthood, teaching, and community involvement.
(Potter, Perry, Stockert, & Hall, 2013, pg.132). She is active in her local church and attends
Grace Bible Church Pearlside. In her church, she participates in the youth ministry organizing
fundraisers for camps and donating food to the weekly youth services. Her concern for the
future generation of youth is displayed through her constant participation in events that would
benefit them, though it does not directly provide her with anything in return.
Morally, J.H. seems to be in Kohlbergs stage 5 of moral development. Stage 5 is social
contract orientation. An individual in this stage recognizes that different social groups have
different values but believes that all rational people would agree on basic rights (Perry et al.,
2013, pg.136). J.H. believes that every person is different and must be respected. She believes
that every person is entitled to their own opinions based upon their culture, experience, and
personality.

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Functional Abilities
J.H.s functional abilities are level 0 (Table 2). She is able to feed herself and is the
primary cook in her household. She can shower and use the toilet appropriately without help.
J.H. is able to get out of the bed and dress herself everyday. She is well groomed and pleasant.
As a mother and primary caretaker in the house, J.H. is able to drive to work, walk the dog, clean
the house, pay the bills, and shop for groceries. She is fully independent and does not require
assistance to perform activities of daily living.
Family Dynamics & Culture
She is a mother of two children: one son and one daughter. J.H. is recently widowed after
being married for 29 years. She maintains a stable support system with close family friends and
pastors in her church. She spends time with family friends on the weekends, watching football
games, and maintains a close relationship with her pastor for spiritual counseling. Figure 1
describes these relationships. J.H. is a 4th generation Japanese-American. She does not claim to
hold any specific Japanese beliefs or practices regarding health care. However, when it comes to
illnesses or disease, she believes in seeing a doctor and complying with their instructions (i.e.
taking prescribed medications). J.H. is a Christian and believes in prayer as a method of healing.
She practices prayer regularly and uses it in times of sickness.
Nutritional Assessment
J.H. weighs 167 lbs and is 5 feet tall. Her BMI, through calculations, is about 33. A BMI
this high is considered obesity (Perry et al., 2013, pg.1009). After analyzing her 24-hour diet
recall and fluid intake (Table 1), J.H. has inadequate nutrition and excessive caloric intake. Her
diet does not include an adequate amount of fruits and vegetables, but includes too many

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carbohydrates. Her caloric intake exceeded 2,300 calories. Her total fluid intake was 6.5 cups.
This amount is a little low for her daily intake.
Areas of Need
J.H. is an independent individual who has control of her health conditions, but she is
currently grieving. It has only been 3 months since the loss of her husband and it is normal for
her to grieve. It is important to recognize the grief that she is experiencing because new life as a
widow can invoke physical and psychological responses potentially threatening health.
(Minton, 2009, pg. 1036) She has mentioned a decrease in appetite on some days and described
her psychological stress as depression. As a result of grieving, J.H. has an imbalanced
nutrition (less than body requirements) due to her lack of appetite on some days. It is important
for Joella to continue to maintain a stable system of support to help her cope with her loss. She
should continue to meet with her established group of support and share her thoughts and
feelings. J.H. should also continue to receive spiritual help and guidance. Her spiritual
wellbeing provides restoration of meaning following loss. (Minton, 2009). This can help her
as she begins to move forward into life as a widow.
Conclusion
As a middle age, Japanese-American female, J.H. is healthy but at risk for grieving since
the loss of her husband. As she continues to move on in life as a widow, she must learn to
balance her nutrition to meet her bodys requirements. She also has a steady social support
system and spiritual faith that can continue to help her through the grieving process. These
different aspects of her life contribute to her ability to maintain a physical, emotional, and
psychological state of well-being.

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Appendix

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Appendix

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References

Minton, M. E.-P. (2009). The First Anniversary: Stress, Well-Bring, and Optimism in Older
Widows. Western Journal of Nursing Research , 31 (8), 1035-1056.
Potter, P. A., Perry, A. G., Stockert, P. A., & Hall, A. M. (2013). Fundamentals of nursings (8th
edition ed.). St. Louis, Missouri: Elsevier.

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Student:
Criteria

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Kapiolani Community College
NURS 210 Health Promotions
Community Case Study Paper
Grading Rubric
Instructor:
Pass
Needs
Improvement
Complete Data,
Specific
Missing Data,
description,
Unclear Data,
Examples
Incorrect Data
Score 5

1. Introductory data
2. Developmental
assessment
(psychosocial and
moral development)
3. Functional abilities
assessment
4. Family dynamics
(ecomap)
5. Culture (2 health
care
practices/beliefs)
6. Nutritional
assessment
7. Identification of
area(s) of need
8. Recommendation of
appropriate nursing
interventions for
area(s) of need.
9. Format:
Introduction, Body,
and Conclusion,
page length
10. APA format, cover
page, citation,
grammar, spelling,
reference page, etc.
Grand Total Score

Score 3

Non-Pass
Major Data
Omitted
Vague or Overly
Generalized
Score 1