* Lab Activity * General learning objective Upon completing this session, the student should be able to create a genogram of patient and family * Specific learning objective * Explain the function of genogram * Describe the steps in creating a genogram * Interpret a given genogram * Given a case, create a genogram * * Task: Please interpret this genogram! Gogon’s Family As of November 1, 2011 D= 2000 Jecko 72 Memet 65 xxx Seni, 45 Jenny 65 Gogon, 43 1995 Raffi, 13 Nunik, 40 Yuni, 10 Red line: living together on week days Green line: living together on weekends * * Genogram The genogram is a biopsychosocial family tree. It records the family in its life cycle, family illnesses and relationships. * Function of genogram The uses of genogram are threefold: * as a quick overview of the interrelationships between family members * as a way of looking at the family medical and psychosocial problems * as a tool for understanding the multigenerational family systems * * Standardized Symbols used in Family Genograms male female d date of divorce D Date of death abortion or miscarriage Sex not specified Deceased/death A Adopted female b date of birth m date of marriage Induced abortion Pregnancy-child in utero Dizygotic twins Monozygotic Twins * Standardized Symbols used in Family Genograms Close relationship 1989 married and year Family living together 1990 1992 Separation and year Divorce and year 1989 Unmarried relationship Conflictual relationship Distance relationship 1989 1992 * Standardized Symbols used in Family Genograms Symbols of diseases or situation Obesity ♥ ♥ Allergy xxx xxx Alcoholism Heart disease Stroke Depression Asthma War Casualty Hypertension ALC Alcoholic GI GI tract disease ALL Allergy HT Hypertension ART Arthritis H MI Myocard Infarction MV P PU D SL E Mitral Valve Prolapse TB Tuberculosis CAD Coronary Artery Disease CVA Cerebrovascular Accident CA Cancer DEP Depression DM Diabetes mellitus Peptic Ulcer Disease Systemic Lupus Erythematosis *Commonly used Abbreviations *GENOGRAM 1. 2. 3. 4. 5. 6. 7. 8. COMPONENTS Symbols Three or more Bakri, as of 8 April 2010 generations The name of family A listing of the first born of each family to the left, with siblings listed sequentially to the right 1969 Ardi,68 I 1970 The names of all family member Age or year of birth of all family members II Any deaths, incl. age of death and cause Dates of marriages and III divorces Nia,64 *GENOGRAM COMPONENTS Bakri, as of 8 April 2010 9. Significant diseases or problems of family 1969 members I 10. Indication of members living together in the same household II 11. A key depicting all symbols used 12. Symbols selected for III simplicity and maximum visibility Ardi,68 1970 Nia,64 Interpretation: From the life cycle perspective…. From type of family… From the psychodynamic…. The risk factors…….. * * * Bobby’s Family As of October 9, 2011 M= 1972 Susilo , 67 Ani, 54 D= 2004, Female cancer xxx Bobby, 37 Ina, 12 Ratna, 36 Andre, 35 Lusi, 33, Fibroadenoma mammae Ima, 5 Widodo, 25 * Case 3.1 * Alice is a 36-year-old single woman was diagnosed with eczema. Her brother, 25 years old had asthma. She has one big brother and 2 youngest sisters. No other family members have had asthma. Her father died at age 61 years old and her mother is post acute myocardial infarction patient. In a maternal aunt, breast cancer developed. Case 3.2 * Mrs. Marni, is a 34-year-old woman was diagnosed with headache and injury in her shoulder. Her husband and 3 children (boy (12), and twin girls (5)) also are seen at the clinic. Two of children (boy and one of the twin) have been diagnosed as attention-deficit/ hyperactivity disorder (ADHD). Her husband has been treated for depression and high blood pressure. Further questioning * Her father had hypertension and her mother had migraine. Both are still alive. * She lives with her husband and her children. She has conflict with her husband and experienced domestic violence. * She is worry about her son because he is always rebelling to his father and influencing her sisters to do so. * Case 3.3 Jojon is a 44-year-old man was diagnosed with chronic obstructive lung disease. His parents are living and both have type 2 diabetes. He has two siblings, both older brothers. One of his brothers died because of traffic accident. His wife died because of alcohol intoxication. He had overt close relationship with his wife. They have no children. He is living alone in his house.