Running head: COMMUNITY CASE STUDY

Community Case Study

Van Mai
Kapiolani Community College
NURS 210 spring 2015

COMMUNITY CASE STUDY

Introduction
The case study involved Mr. NB, a 70 year old male, 170 cm tall and
weight 63 kg, retired Italian American. The interview was conducted at Ilikai
hotel where he lives on April 13 -14, 2015. The interview focused on
identifying psychosocial and moral development, functional abilities, family
dynamics, culture and health care practices, nutritional intake and areas of
needs for interventions that help promoting his health and quality of life.
Psychosocial and Moral Development
Upon interviewing him, he exhibited integrity characteristics as in
Erickson's psychosocial developmental theory. He reviewed his life with a
sense of satisfaction. (Potter &Perry, 2013, p. 132) He spoke about his
military service, and the great pride he took in construction earlier in his life,
where he went into great detail about the great fireplaces he built in homes.
He addressed that hard working rewarded him with many achievements in
his life. He treasured the time he raised a family and a beautiful daughter
who is now a successful businesswoman. Although, he did mention that he
wished he had spent more time with his family.
Regarding moral development, he fell into stage 5, social contract
orientation, of Kohlbergs theory of moral development. In this stage, an
individual follows the society law but recognizes the possibility of changing
the law to improve society. (Potter & Perry, 2013, p 136) Mr. N.B is a good
citizen. He talked about how he always obeys the laws and pays his taxes.
Functional Abilities

COMMUNITY CASE STUDY

To assess functional ability, evaluate vision, hearing, mobility,

continence, nutrition, cognition, environment, social support and basic
activities of daily living (BADLs) and instrumental activities of daily living
(IADLs)(Gidden, 2013, p. 12). Through the interview and observation, Mr.
N.Bs functional abilities were identified at optimal level (see Appendix A for
Functional Ability Evaluation). His vision and hearing are adequate. Hes able
to carry out BADLs and IADLs. In fact, he lives with his fianc and takes care
of her. He takes a bus to supermarket for fresh groceries shopping 2-3 times
a weeks. His fianc is working in property management and quite busy; thus,
he does all of the cleaning in the house, go shopping and prepare meals for
them both.
Family Dynamics
Family dynamics influence a persons health and health care (Gidden,
2013, p. 23). Regarding family dynamics, Mr. NBs wife passed away 20 years
ago due to cancer. He now is living with his fianc. He moved to Hawaii 15
years ago from New York; thus, he has no immediate relatives in Hawaii.
However, he did mention if he should fall ill, or lose significant functional
abilities that would require assistance, his fianc and friends who lives in the
same building with him would be his source of support. He has a positive
family cohesion with relatives in New York and if he ever needs helps they
would come over; in Italian culture, family members take care of each other,
he said.
Culture and Health Care Practices

COMMUNITY CASE STUDY

Cultural norms influence a persons perception of illness, self- care,

medication adherence and making treatment decision (Gidden, 2013, p.29).
In Italian culture, family members take care of each other. He spoke about
how he cared for his wife for 17 months before she died of cancer.
Additionally, he spoke about home remedies. When he was young, he got
very sick for a few days. After taking over the counter medication his
symptoms did not alleviate, thus his uncle made him drank a home-brew
remedy, consisting of boiled wine until it became very thick. Upon
consumption, it relieved his symptoms and cured him. Thus as a result, he
championed home remedies several times during our conversation.
In addition, he did mention that he believes in modern medicine and
routinely goes to the doctor and hospital for screening and examine his
health status. He had a hernia operation three years ago and sometime he
feels discomfort during intense physical activities. Recently through
screening, the doctor found out he has high blood cholesterol level and
prescribed medication to prevent complications. Currently, he is taking 5mg
of Atorvastatin for high cholesterol and 8mg of Aspirin to thin his blood
everyday.
Nutrition
Mr. NB mentioned that he only prepares about 30% of the meals, and
they mostly eat out and have take out food. He loves pizza and has a sweet
tooth. Although Mr. NB is retired, his has a good finance resource. He
receives a steady income from the social security, rental from his condo,

COMMUNITY CASE STUDY

saving and stocks. However, because he doesn't drive, they tend to only
have take-out food in the area. As a result, the foods they eat are pretty
much the same, not a variety.
Below is Mr. NBs 24 hours nutritional and fluid intake recall.
Breakfast: 2 eggs, 2 table spoons of olive oil, 1.5 cup of black coffee,
and an orange
Lunch: 6 oz of chicken, 1cup salad with 2 tablespoons of Italian
dressing, 1 glass of water.
Dinner: A piece of cheese pizza, 1 glass of red wine, ice-cream, 1
glasses of water.
Conclusion
Areas of Need Improvement and Interventions
Base on the information gathered through out the interview from Mr.
NB, the areas that need improvement were identified are nutrition and fluid
intake. According to the United State Department of Agriculture (n.d), 55
year old and older adults should consume 2 cups of fruits, 2.5 cups of
vegetables, 3 ounce of grain, 5.5 ounce of proteins, 3 cups of dairy and 6
teaspoons of oil and 6-8 glasses of water a day. People who are physically
active can consume more than the above recommendation. As an active
man, Mr. NB needs to increase whole grain, proteins, and vegetables, fruits
and water intake to ensure meet his body requirements. Adequate nutritional
intake is very critical because it affect processes of growth and

COMMUNITY CASE STUDY

development, cellular function and repair, and maintenance or promotion of

health status (Giddens, 2013, p.125).
In addition, he needs to adjust to a low fat and cholesterol diet and
increase physical activity level. A balance diet could help controlling his
hyperlipidermia condition and preventing cardiovascular complications.
Moreover, family dynamics showed that Mr. NB is at risk for stroke (see
Appendix B Ecomap). Thus, besides doing housework, at least 150 minutes
of moderate-intensity activity per week (brisk walking, water aerobics,
bicycling) and 2 or more days a week of weight training exercises, (National
Stroke Association, n.d) is recommended for Mr. NB. A balance diet and
exercise reduce risk of stroke and health complications.
Standard preventive care and testing continue to be conducted due to
his age, and that more thorough monitoring for his cardiovascular condition.
Screening tests for elderly are periodically scheduled for Mr. NB to identify an
early state of a disease process to initiate treatment. Early treatment
provides an opportunity to cure, limit disability, or delay consequences of
advanced disease (Giddens, 2013, p.407).

COMMUNITY CASE STUDY

References
Giddens, J. (2013) Concepts for Nursing Practice. Mosby. VitalBook file.
Potter, P., Perry A., Stockert, P., Hall, A. (2013) Fundamentals of Nursing, 8th
Edition. Mosby, VitalBook file.
United State Department of Agriculture (n.d) Retrieved on April 20th, 2015
from http://www.choosemyplate.gov/
National Stroke Association (n.d) Physical activity. Retrieved on April 20th,
2015 from http://www.stroke.org/understand-stroke/preventingstroke/lifestyle-risk-factors

COMMUNITY CASE STUDY

Appendix A for Functional Ability Evaluation

Feeding
Bathing
Toileting
Bed Mobility

0
0
0
0

Dressing

Grooming
General Mobility
Cooking
Home
Maintenance
Shopping

0
0
0
0
0

Functional level codes:

Level 0: Independent
Level I: Requires use of equipment or device
Level II: Requires assistance or supervision from another person
Level III: Requires assistance or supervision from another person and
equipment or device

Van, you wrote a good paper. Points were deducted due to grammar and
spelling. Great ecomap. Suggestion: During the summer, take an online or
physically attend a writing, which emphasizes proper grammar and spelling.
You had the required information- its the grammar & spelling that lowered
your score. Thank you.

Prof. Ferguson

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Appendix B Ecomap

MH
Died
from
stroke at
76

JB
Passed

LM
Passed
away

MJ
Passed

Mom
Died
from
stroke at
age 65

WB
Passed
away
HNT

TB
68 years
old
Obese

KB
70 years
Having a
pacemaker since
45 year old

LD
73 years
old

AK
Died of
cancer
at age
50

Mr. NB
70 years old

EB
45 year
old

COMMUNITY CASE STUDY

Appendix B Ecomap

Female

Male

Female passed away

Male passed away

Married couple

Parents and a child

Engaged couple

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Kapiolani Community College

NURS 210 Health Promotions
Community Case Study Paper
Grading Rubric
Student: Van Mai
Criteria

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,

Pass

Needs
Improvement

Instructor: Ferguson
Non-Pass

Complete
Data, Specific
description,
Examples

Missing Data,
Unclear Data,
Incorrect Data

Major Data
Omitted
Vague or Overly
Generalized

Score 5

Score 3

Score 1

5
5

5
5
5
5
5
5

COMMUNITY CASE STUDY

reference page,
etc.
Grand Total Score

48