1 Change is dependent on context

Question 1

Change Theory - there are 9 concepts. Fuck.
Change is dependent on:
CCP
*
Change:
COIFD

U

Answer 1

• Change is dependent on:
> context
> co-evolving goals for tx
> perception of the problem
*
Change:
• can result from a myriad of causes / reasons
• occurs by “fit” b/w nurse therapeutic interventions and biopsychosocial-spiritual structures of family members
• is determined by structure
• facilitation is the nurse’s responsibility
• does not necessarily occur co-equally in all family members
*
• Understanding does not lead to change

Question 2

Change is dependent on context.
*
Interventions must be planned with…?

Answer 2

sufficient knowledge of contextual constraints and resources

Question 3

Change is dependent on context.
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Interventions must be planned with sufficient knowledge of contextual constraints and resources.
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This is particularly important considering…
ACET

Answer 3

the emphasis in the healthcare industry on
accountability
cost effectiveness
efficiency
time-effective intervention

Question 4

Change is dependent on context.
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Nurses need to be aware of their position in the healthcare delivery system vis-a-vis the family. For example? (3)

Answer 4

• Are there other professional involved?
• If so, what are their roles with the family?
• How are the nurse and family influenced by and influential on the context in which they find themselves?

Question 5

Change is dependent on context.
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Larger systems frequently…

Answer 5

Impose certain “rules” on families that ultimately serve to maintain the larger system’s stability and impede change

Question 6

Change is dependent on context.
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Larger systems frequently impose certain "rules" on families that ultimately serve to maintain the larger system's stability and impede change.
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One example of this is...

Answer 6

the rule of linear blame

Question 7

Change is dependent on context.
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Define linear blame

Answer 7

Institutions tend to blame families for difficulties and tend to make referrals for family tx in order to “cure” or “fix” the family

Question 8

Change is dependent on context.
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Because members of larger systems (read: nurses), become intensely involved w/ pts and fams, they tend to go beyond immediate concerns. What is the result? (2)

Answer 8

• Family inundated w/ services that usurp their own resources
• Family placed in one-down position in terms of articulating what they feel their needs to be

Question 9

Change is dependent on context.
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In some cases, the more serious problem is at the interface of the family w/ other professionals rather than within the family itself. What happens in this case?

Answer 9

Interventions would need to be aimed at the family-professional system before addressing problems at the family system level.

Question 10

Change is dependent on context.
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Another situation that can arise is…

Answer 10

unclear expertise and leadership ~ they may receive many different ideas on how to deal with a particular problem

Question 11

Change is dependent on context.
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Conflicts can also occur b/w larger systems or b/w families and larger systems. Unacknowledged or unresolved conflicts commonly result in?

Answer 11

Triads
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Parents wish to send son to drug rehabilitation centre, but nurse and rehab director have been in conflict about rehab policies. Family is placed in position where they must align with either nurse or rehab director.

Question 12

Change is dependent on context.
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How a family is being influenced by an exerting its influence on their involvement with supra systems is important information. Why?

Answer 12

Change within a family can be thwarted, sabotaged or impossible if the issue of context is not addressed.