Family Health History: How to Collect It & What to Do With It

The patient intake process is vital to understanding a patient’s concerns and medical needs so that they can get the care most appropriate to their situation. 

In addition to recording a patient’s medical history and current health challenges, a part of the assessment process is recording their family health history. Collecting this vital information can help you and the rest of the health care team provide more tailored care and make more educated diagnoses. Here’s what you need to collect and how to implement the information.

What Is Family Health History?

Family health history is a record of the diseases and health conditions that other people in a patient’s family have had. This could mean siblings, parents, aunts and uncles, and grandparents. 

This information doesn’t just end with genetic conditions. Many intake assessments record information about lifestyle, including exercise, eating habits, and other environmental factors that patients may share with family members. All of these factors can affect a person’s health and should be considered in any plan of care.

When collecting family history from a patient, you’ll want to record relevant conditions that could impact treatment or the patient’s risk for certain issues, including the following:

  • Autoimmune conditions: Both genetic predispositions and environmental triggers play a role in the clinical presentation of autoimmune diseases.
  • Cancer: Patients with certain hereditary conditions or a family history of cancer may be at higher risk of developing cancer during their lifetime. Other types of cancer, such as lung cancer, are more closely associated with environmental factors.
  • Dementia: Although the greatest risk factor for Alzheimer’s disease and other dementias is a patient’s age, their family history and hereditary factors also contribute.
  • Obesity: Behavioral, environmental, and genetic factors all contribute to obesity, which increases or happens in conjunction with conditions like diabetes and cardiovascular disease.
  • Heart disease: Patients with a family history of heart disease, including both genetic and environmental factors, carry a higher risk of getting it themselves. 
  • High blood pressure: Both genes and environmental factors play a role in a patient’s predisposition toward high blood pressure.
  • Mental illness: In addition to brain chemistry, inherited traits and environmental exposures can increase the risk of developing a mental illness.

Why Is Family History Important?

If a patient has a family member with a chronic condition, their chance of contracting it themselves is increased. This risk is increased if more than one close relative has had the disease, or if that relative developed the disease at an early age. 

By recording pertinent family health history, nurses can help patients prevent or manage conditions. This includes deciding which screening tests or treatments should be ordered, monitoring any warning signs, and empowering patients to make healthy decisions to reduce their risk.

How to Collect Family Health History

Collecting a patient’s family health history begins with talking to your patient. A patient questionnaire is a helpful starting point for both parties, but you can ask follow-up questions or encourage additional conversations with family members as needed.

When collecting family history, you’ll want to address the following:

  • First, second, and third-degree relatives: Patients whose first-degree relatives (parents and siblings) have a condition are at a higher risk of having the same condition. However, second-degree relatives (such as grandparents or aunts/uncles) and even third-degree relatives (great-grandparents, great-uncles/aunts, first cousins) should also be accounted for in the family health history.
  • Age (or age at death) and ethnicity of each relative: If your patient has a relative with an earlier age of death from a chronic condition or related complications, they are at higher risk. Additionally, certain genetic diseases are seen more commonly in specific ethnic groups.
  • Presence of chronic conditions (plus age of onset): Additional risk occurs if the family member has been diagnosed with any chronic conditions. An earlier age of onset also carries greater risk for the patient.

Be sure to also ask your patients about their relatives’ lifestyles if they happen to have a condition that may be a result of environmental factors or poor health habits, like lung cancer in those who smoke. This can help you determine whether your patient carries the same level of risk and what they can do to mitigate that risk.

What to Do With Family Health History

Using the information you collected from your patient about their family’s health history will help you and the rest of the health care team make more educated inferences, diagnoses, and treatment plans. 

You can also recommend healthy habits to lower your patient’s risk of developing health conditions, as well as to prevent and/or manage any symptoms.

Additionally, you can use family health history information to order appropriate screening tests. Here are some screening tests and precautionary measures you might order for your patients at risk of certain chronic conditions due to their family health history:

  • Breast or ovarian cancer: Patients with a family history of breast cancer may need to begin mammography screening at a younger age or conduct screenings more regularly. Those with a family history of ovarian cancer or male breast cancer may also benefit from genetic counseling and testing. In some cases, these patients may have the option of preventative medication or surgical procedures.
  • Colorectal cancer: If your patient has a family history of colorectal cancer, you may recommend screenings more frequently or at a younger age. Additionally, you may also recommend genetic counseling and testing.
  • Heart disease: In addition to making healthy lifestyle choices to minimize risk, you may recommend that these patients with a family history of heart disease get screened early and regularly. These screening tests include cholesterol, blood pressure, and blood glucose.
  • Hereditary hemochromatosis: If your patient has a sibling with hereditary hemochromatosis, a patient may strongly consider getting a complete blood count done and being tested for the condition. 
  • Osteoporosis: Osteoporosis is more likely to occur in women, white individuals, and those with a parental family history. For patients with significant risk, you may screen for osteoporosis as early as age 50.
  • Type 2 diabetes: Patients with risk factors for type 2 diabetes, especially those with first-degree relative family history, may need glucose screenings earlier or more frequently than usual in order to detect the development of pre-diabetes or type 2 diabetes. 

By collecting family health history for your patients, you can enable them and the health care team to make informed diagnoses and treatment plans for your patients. Additionally, you can empower your patients to make positive lifestyle choices and take their health in their own hands.

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