The Kenarban FamilyFrom Malcolm in the Middle
Diana Barnas Family Assessment Visual Report NURS 480 Fall 2022 CSUSM Figure 1 Figure 2
Meet the Kenarbans
Stevie Kenarban
Ste ie, a school-aged boy, is the only child of Abe and Kitty Kenarban. He cannot alk and uses a heelchair due to being paralyzed from the aist do n. He has a diagnosis of se ere asthma and only has one lung; because of this, he speaks ery slo ly and ith difficulty, taking a deep breath e ery fe ords. Ste ie also ears eyeglasses. He is highly intelligent and takes ad anced classes. He enjoys reading comic books and spending time ith his best friend, Malcolm.He expresses his desire to play in sports, but cannot because of his conditions. Due to his health issues, his parents are o erprotecti e and he utilizes his disabilities to gain fa ors from others.
Industry vs. Inferiority: Ste ie prides himself on his intellect and is successful in all of his classes.
He also takes ad anced classes and has goals of attending college (Kaakinen et al., 2015).
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Kitty Kenarban
Kitty, a oman in her 40s, is a teacher and the mother of Ste ie and ife of Abe. She is soft-spoken and is portrayed as repressed for being a mother. She tends to a oid confrontation and is a helicopter parent to Ste ie. Kitty is controlling of her husband and his eight, and she forbids him from eating unhealthy food. She longs to be more outspoken, hich is occasionally translated into her being argumentati e. Kitty separates from Abe and lea es the family in order to pursue experiences that she ne er had before. While a ay, she becomes an adult film actress, an alcoholic, and a criminal. After li ing through these experiences, she returns to Abe and Ste ie, ho elcome her back. After her absence, she appears more at peace and less stressed than before.
Generativity vs. Stagnation: Though Kitty originally exemplifies generati ity by feeling responsible for Ste ie and being o erly caring, she encompass stagnant traits in that she feels that her role as a mother is unfulfilling, leading to her unhappiness and e entual separation from her lo ed ones (Kaakinen et al., 2015).
Abraham “Abe” Kenarban
Abe is a man in his 40s ho is the primary bread inner of the Kenarban family. He is Ste ie’s father and the husband of Kitty. He is o erprotecti e of Ste ie and also experiences asthma attacks hen o er helmed. He is portrayed as ha ing a eak personality and sleeps ith a nightlight. Abe enjoys eating foods that are not healthy, but he hides this fact from Kitty. Kitty ends up lea ing him, hich de astates him and his son. Ho e er, hen she does reunite ith the family, Abe forgi es her out of fear that she may lea e the marriage again.
Generativity vs. Stagnation: Abe cares for his son and at times is ery o erprotecti e. When Kitty lea es, he tries to step-up as a father and be more of a role model for Ste ie (Kaakinen et al., 2015).
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Stevie’s Severe Asthma
Due to his symptoms being continuous and ithout relief, he demonstrates the symptoms of se ere asthma as opposed to moderate, mild, or intermittent asthma. Asthma is the most common chronic illness among children, affecting about 7 million kids orld ide. Asthma is defined as a chronic inflammatory disorder that is characterized by hyperresponsi eness of the bronchi and obstruction of the air ay. Respiratory function is impaired due to bronchial constriction and increased resistance in the air ays, making expiration difficult. Because gas is trapped, the indi idual must breathe at higher lung olumes; furthermore, they ha e difficulty inspiring air. Carbon dioxide retention increases as al eolar entilation decreases.
Exposure to agents that increase inflammation cause the indi idual to experience chest tightness, breathlessness, cough, and heezing. This chronic inflammation can cause air ay remodeling of the structures of the air ay, indicating permanent damage. Allergens, cigarette smoke, exercise, cold air, and intense emotions, among other triggers, can all exacerbate symptoms. Treatment of asthma includes targeting inflammation in the form of antiinflammatory agents such as inhaled corticosteroids, hich is the form of therapy Ste ie utilizes. Asthma can also be hereditary, so it is possible that he inherited this condition from Abe (Hockenberry et al., 2022).
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Culture
Ste ie is being raised by t o parents ho pay extremely close attention to him and are highly protecti e. Both Abe and Kitty are highly ner ous and anxious indi iduals, ho project their emotions and fears onto Ste ie. The family alues education and Ste ie feels proud for being a gifted and intelligent student. The family attends church on Sundays and both Abe and Kitty a oid drinking alcohol. Food is a sensiti e topic in the household, and unhealthy and greasy foods are not allo ed in the home. Friendships are important to all members of the family; Abe, Kitty, and Ste ie all ha e close relationships ith members of the Wilkerson family.
Communication
The Kenarbans lack effecti e communication skills. Abe and Kitty keep in their feelings and opinions to themsel es, and often act passi e aggressi ely to ards one another.. These emotions and feelings of anger and resentment e entually accumulate, leading to explosi e arguments. Kitty is also critical of Abe, insulting his eight and not approaching the topic in a calm and supporti e manner. Kitty also ne er expresses her inner feelings, hich e entually bubble o er, leading to her separating from the family so she can fulfil her o n desires. When she lea es, Abe hides this from Ste ie and is not honest ith him about hat happened to his mother. E en after she reunites ith the family, Abe and Ste ie ne er con ey to her ho hurtful her actions ere.
Ste ie exhibits open communication ith Malcolm, his best friend, and enjoys spending time ith him. He often uses his disabilities to his ad antage to gain fa ors and sympathy from others. He also uses his heelchair as a ay to start con ersations ith girls in order to flirt. Ste ie does not re eal e ery aspect of his life to his parents, as most school-aged children do not. Ste ie ill often oice his disappointment that he cannot al ays participate in other acti ities that his friends can such as bo ling and basketball.
Strengths
Abe and Kitty lo e Ste ie and although it can be seen as o erbearing, they ant to protect him due to him ha ing health problems. Despite his ill-health, they al ays encourage him to participate and to continue pursuing his goals.They are both ery proud of ho intelligent he is and are hopeful that he ill e entually go to a prestigious college. All members of the family are all ery organized and no one ha e any problems ith alcohol or drugs (only during the period Kitty lea es the family). Both Abe and Ste ie ork together to come up ith creati e adjustments in their home to better accommodate Ste ie and his heelchair.
Weaknesses
A primary eakness of the family lies in their lack of effecti e communication. Both Abe and Kitty do not kno ho to approach one another nor ho to del e into topics that may be more challenging. The parents tend to argue, hich e entually does impro e after Kitty returns to the family. Kitty and Abe are also not completely trusting of one another and ill often speak about each other and their marital oes to their friends.
Because of his asthma and paralysis, Ste ie is unable to participate in any sports, hich he expresses to Malcolm as being a challenge and makes him upset. He experiences difficulty expressing himself due to his hea y breathing and inability to erbalize more than 2 to 3 ords at a time. The family struggles to cope
ith Ste ie’s health issues, a stress that creates conflict in the family and leads to arguments and tension bet een the parents.
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Family Assessment and Intervention Model
The Family Assessment and Inter ention Model approaches the family unit as an open and dynamic process in hich each member protects all other family members from external forces that threaten the family’s ellness (Kaakinen et al., 2015). When an extraneous threat penetrates the family’s normal line of defense, problems and tensions arise (Kaakinen et al., 2015). Crisis in the form of health challenges, for example, can disturb the family’s security; the family is then ushered to adapt in order to restore stability (Kaakinen et al., 2015). The process incorporates three areas:Wellness-health promotion acti ities, the reaction of the family at times of instability, and the restoration of stability and functioning to the family (Kaakinen et al., 2015).
The primary focus of this model is identifying hat brings stress and instability to the family and addressing ho to family reacts in response. Identifying the problem allo s for the family to utilize its strengths to o ercome their challenges (Kaakinen et al., 2015).
The Family Assessment and Intervention Model and how it relates to the Kenarbans:
A problem that the Kenarban family has had to adapt to and has consequently reshaped the family dynamic is Ste ie’s se ere asthma. His asthma is a stressor that penetrates the defenses of the family, and in order to cope, Ste ie’s mother and father are o er helmingly protecti e of him. They fear for his safety and feel the need to guard him at all times. Because he is also an only child, Abe and Kitty are hyper focused on him. This stressor is likely a contributing factor to Abe’s and Kitty’s tumultuous relationship, e entually causing the family unit to dismantle hen Kitty lea es the family in pursuit of desires unrelated to motherhood and partnership.
Nursing Interventions
Intervention 1: Help Ste ie identify acti ities he can participate in that ill not exacerbate his asthma and ill also allo him to remain in his heelchair.
Rationale: Children and adolescents ith chronic illness and disabilities must learn to adapt and disco er ays to feel autonomous hile also feeling included as a member of their peer group (Brandão et al., 2022). Participating in extracurricular acti ities is essential in promoting youth de elopment that positi ely influences ell-being and mental health (Oberle et al., 2019).
Outcome: Ste ie ill be able to name three acti ities that he can take part in such as joining a chess club or piano class that can promote socialization, self-esteem, and independence.
Intervention 2: Refer the Kenarban family to a psychological counseling ser ice such as family therapy.
Rationale: Family therapy and other psychosocial inter entions that utilize the family systems approach ha e been sho n to support and impro e the health management of chronically ill children and adolescents (Distelberg et al., 2018). Therapy allo s for the family to feel more understanding of one another and each other's needs, creating stronger family bonds. Consequently, children and adolescents ith chronic illness are sho n to benefit from strong family connections (Nabors et al., 2018).
Outcome: The family ill be able to identify ho Ste ie’s health issues affect their relationships ith one another and identify fun acti ities that they can do as a family to facilitate bonding and open communication.
Intervention 3: Pro ide the family ith asthma education and counseling on effecti e asthma management.
Rationale: Parents’ kno ledge and attitude to ards their child’s asthma is related to the number of exacerbations and asthma-related hospitalizations (Ng et al., 2021). Comprehensi e asthma education for parents including informing them of the importance of medication adherence and symptoms to be a are of decreases the need for medical inter ention for children ith asthma (Baker et al., 2022).
Outcome: Abe and Kitty ill be able to name techniques that can help manage Ste ie’s asthma and ill also be able to identify signs of orsening symptoms.
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References
Baker, J. A., Moore, H. M., Brinton, J. T., & Federico, M. J. (2022). Comprehensi e in-patient education consult for asthma exacerbations. Respiratory Care, 67(6), 682–687. https://doi.org/10.4187/respcare.08778
Brandão, M. B., Bueno, K. M., Sil ério, A. P., Antunes, F. I., Feitosa, A. M., Figueiredo, P. R., & Mancini, M. C. (2022). A qualitati e study of adolescents ith disabilities to help plan a transition ser ice. Child: Care, Health and Development, 48(5), 833–841. https://doi.org/10.1111/cch.12992
Distelberg, B., Tapanes, D., Emerson, N. D., Bro n, W. N., Vas ani, D., Williams-Reade, J., Anspikian, A. M., & Montgomery, S. (2018). Prospecti e pilot study of the mastering each ne direction psychosocial family systems program for pediatric chronic illness. Family Process, 57(1), 83–99. https://doi.org/10.1111/famp.12288
Hockenberry, M.J., Rodgers, C.C., & Wilson, D. (2022). Wong's Essentials Of Pediatric Nursing (11th Ed.). Else ier.
Kaakinen, J., Coehlo, D., Steele, R., Tabacco, A., & Hanson, S. (2015). Family health care nursing: Theory, practice, and research. F.A. Da is. IBSN-13: 9780803639218
Nabors, L., Liddle, M., Gra es, M. L., Kamphaus, A., & Elkins, J. L. (2018). A family affair: Supporting children ith chronic illnesses. Child: Care, Health and Development, 45(2), 227–233. https://doi.org/10.1111/cch.12635
Ng, J. S. K., Chau, J. P. C., Chan, A. W. K., Lui, J. K. C., & Cheng, J. W. C. H. (2021). A nurse-led eb-based home asthma education program for children and their families: A randomized controlled trial. Journal of Pediatric Nursing, 59, 158–163. https://doi.org/10.1016/j.pedn.2021.04.014
Oberle, E., Ji, X. R., Guhn, M., Schonert-Reichl, K. A., & Gadermann, A. M. (2019). Benefits of extracurricular participation in early adolescence: Associations ith peer belonging and mental health. Journal of Youth and Adolescence, 48(11), 2255–2270. https://doi.org/10.1007/s10964-019-01110-2
Image References
Figure 1:Retrie edfrom https://malcolminthemiddle.co.uk/forum/index.php?media/gary-anthony- illiams-and-merrin-dungey-on-the-carni al-2x23-set .9959/
Figure 2:Retrie edfromhttps://sharet .com/sho s/malcolm_in_the_middle/cast/ste ie_kenarban
Figure 3:Retrie edfromhttps://comm3263. ordpress.com/2011/05/02/disability-portrayal-in-malcolm-in-the-middle/
Figure 4:Retrie edfromhttps://malcolminthemiddle.fandom.com/ iki/Ste ie_Kenarban
Figure 5:Retrie edfromhttps://malcolminthemiddle.fandom.com/ iki/Kitty_Kenarban
Figure 6:Retrie edfromhttps://malcolminthemiddle.fandom.com/ iki/Abe_Kenarban
Figure 7:Retrie edfromhttps://medium.com/@fernando. g/keep-calm-a-lesson-from-malcolm-in-the-middle-191eb9475b82
Figure 8:Retrie edfrom https:// .spotern.com/en/spot/t /malcolm-in-the-middle/307203/t inkies-ste ie-kenarban-in-malcolm-1x01
Figure 9:Retrie edfromhttps://malcolminthemiddle.fandom.com/ iki/Ste ie_in_the_Hospital?file=Ste ieinthehospital.jpg