Scoring the Family APGAR
The Family APGAR is a brief screening tool that asks a family member how satisfied she is with five areas of family function: adaptation, partnership, growth, affection, and resolve. Each item is scored 2 (almost always), 1 (some of the time), or 0 (hardly ever). This mother's total is 2 + 2 + 0 + 2 + 1 = 7. A total of 7 to 10 indicates a highly functional family, 4 to 6 moderate dysfunction, and 0 to 3 severe dysfunction. Her family is in the functional range. The total shows adequate overall function, while the single low item shows where support is lacking.
What each item asks
Adaptation reflects whether she can turn to her family for help when something troubles her. Partnership reflects how the family discusses problems and shares decisions. Growth reflects whether the family accepts and supports her wishes to take on new activities or directions. Affection reflects how the family expresses love and responds to emotions. Resolve reflects satisfaction with how time, space, and money are shared. Her score of 0 on growth matches her statement that her husband says she should forget about returning to work: the family does not support her personal goal.
| Item | What it reflects | Her score |
|---|
| Adaptation | Help from family when troubled | 2 |
| Partnership | Shared discussion and decisions | 2 |
| Growth | Support for new activities and goals | 0 |
| Affection | Expression of love and emotion | 2 |
| Resolve | Sharing of time, space, money | 1 |
| Total | 7 to 10 = highly functional | 7 |
Why the other interpretations are wrong
Saying she receives little help when troubled misreads the adaptation item, which she scored at the maximum of 2. Saying the couple rarely shows affection contradicts her affection score of 2. Calling the family moderately dysfunctional and in need of referral misapplies the ranges, since 7 falls in the highly functional band; moderate dysfunction is 4 to 6. Watch out! A single zero can tempt the candidate to label the whole family dysfunctional, but the Family APGAR is interpreted first by the total and then by item.
How the nurse uses the result
A functional total with one low item calls for focused support, not referral. The nurse can explore the mother's plans about work, the couple's concerns about infant care and income, and options such as continued breastfeeding through expressed milk or arrangements for child care. Encouraging the couple to discuss the issue together builds on their strong partnership score. Because this is the postpartum period, the nurse also stays alert for signs of postpartum depression, since lack of support for personal goals can add to stress.