Case study# P.Q. is a nurse practitioner in a rural, agricultural community. The community is populated mostly by the Hispanic families that work in the fields. Many of the families are migrant workers. They stay in his community during the planting and harvesting seasons and then migrate back to Mexico or to other communities where they can find work.

Many of the families that he helps are struggling to stay together. Many parents must leave their young children behind in Mexico. Husbands and wives are separated frequently, putting additional stress on the family system. As a child of migrant farm workers, P.Q. understands their predicament first-hand and is able to assist the families he serves with viable health-promotion plans.

Questions part 1:

P.Q. uses the following five measures of family functioning to determine the effectiveness of interventions:

• changes in interaction patterns
• effective communication
• ability to express emotions
• responsiveness to needs of members as individuals
• problem-solving ability

Define each one and give clinical examples.

Questions part 2

1. An effective health assessment incorporates not only physiological parameters; please suggest other parameters that should be considered and included on health assessments to reach maximal health potential on individuals.
2. Name the different family developmental stages and give examples of each one.
3. Describe family structure and function and the relationship with health care.