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Families > Chapter 1 - Overview > Flashcards

Chapter 1 - Overview Flashcards

1
Q

What is family? Who is included?

A

Whoever the family says it is.

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2
Q

Why do nurses have a ethical and moral obligation to involve families in their health-care practice?

A

Due to evidence that the family has a significant impact on the health and well-being of individual members

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3
Q

Illness needs to be treated as a family affair. This belief invites nurses to?

A

Think reciprocally about families

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4
Q

The dominant focus of family assessment and intervention must be?

A

Reciprocity between health and illness in the family

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5
Q

It is most helpful and enlightening for nurses to assess?

A

~ the impact of illness on the family

~ the influence of the family on the cause, course and cure of illness

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6
Q

The reciprocal relationship between nurses and families is also a significant component of? (2)

A

softening suffering

enhancing healing

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7
Q

CFAM is a multidimensional framework consisting of three major categories

A

structural
developmental
functional

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8
Q

Why is there a question regarding whether or not a particular illness or problem should be approached within a family context?

A

Frequently families believe the illness only involves one family member

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9
Q 
Indications for family assessment
E~fd
*
F~id
*
IC Member
A 
• Emotional/physical/spiritual
suffering/disruption d/t:
~ family crisis
~ developmental milestone
*
• Family 
~ identifies child/teen as having difficulty
~ defines problem as family issue + motivation for family assessment is present
*
• Issues jeopardizing family relationships
• Child admitted to hospital
• Member admitted to hospital or psych
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10
Q

Contraindications for family assessment

A

~ Compromises individuation of a member
~ Context limits leverage (family has constraining belief that nurse is working as an agent of some other institution such as the court

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11
Q

What must happen during the engagement process?

A

Nurses must explicitly present the rationale for a family assessment

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12
Q

The nurse’s decision to conduct a family assessment should be…

A

guided by sound clinical principles and judgment

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13
Q

Define nursing diagnosis

A

the identification of a patient’s problems that a nurse can treat

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14
Q

2 things Wright & Leahey do when assessing a family?

A
  • Generate a list strengths and list alongside problems rather than a dx
  • Conceptualize the list as one observer’s perspective, not as the “truth” about a family
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15
Q

Wright & Leahey stance on nursing dx’s? (2)

A
  • Too rigid and do not include enough consideration of ethnic and cultural issues
  • Focus on client behaviour and are not usually interactional in nature
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16
Q

All of Wright & Leahey’s interventions are interactional. What does this mean?
*
Nursing interventions are actualized only?

A

Not doing to or for the patient but WITH the patient
*
Nursing interventions are actualized only in a relationship.

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17
Q

What are 3 advantages to a strengths/problems list?

A
  • Gives a balanced view of the family
  • Asks nurses not to be blinded by a family’s problems or dx
  • Asks nurses to realize every family has strengths and resources, even in the face of actual or potential health problems
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18
Q

Interventions are normally?

A

purposeful and conscious

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19
Q

Interventions usually involve?

A

observable behaviours of the nurse

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20
Q

Nursing interventions should focus on…

A

the nurse’s behaviour
and the family’s response
followed by the nurse’s response to the family
and so forth

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21
Q

Why do Wright & Leahey believe that nurse-patient r’ships are interactional?

A

b/c nurse behaviours and client behaviours are contextualized in the nurse-client r’ship

22
Q

From the slides:

Context of interventions?

A

All nursing interventions are interactional

23
Q

What is the intent or aim of any nursing intervention? (3)

A

To effect change
Achieve “fit” between intervention offered and family’s biopsychosocial-spiritual structure

Achieve collaborative relationship

24
Q

Describe effective nursing interventions

A

those to which clients and families respond to because of the “fit” b/w
*
intervention offered by the nurse
AND
biopsychosocial-spiritual structure of family members

25
Q

How are nursing interventions determined?

A

The nurse, in collaboration with a specific family, determines what interventions are most useful for a family experiencing a particular illness

26
Q 
From the slides:
Intervention (definition I think it is)
OOO
*
III
A 
• One time act with clear boundaries
• Offering or doing something to someone 
• Occurs in therapeutic relationship
*
Includes clinician actions, responses
Intent is to effect client functioning
I, the clinician, is accountable
27
Q

Conceptualizing Interventions with Families
*
It is unwise to attempt to ascertain what is “really” going on with a particular family or what the “real” problem or suffering is.
What should nurses try to do instead?

A

Recognize that what is “real” to them as nurses is always a consequence of the nurse’s construction of the world

28
Q

Conceptualizing Interventions with Families
*
Say more about realness

A

Executive

29
Q

Conceptualizing Interventions with Families
*
Say even more about realness

A

“Real” is a social construction

30
Q

Conceptualizing Interventions with Families
*
Biology of cognition - individuals (living systems) bring forth reality. They do not construct it and it does not exist independent of them.
*
Implications for clinical work with families? (2)

A

What nurses perceive about particular situations with families is influenced by how they behave.
(interventions)
*
How nurses behave depends on what they perceive.
*
What nurses perceive is influenced by how they behave.

31
Q

Conceptualizing Interventions with Families
*
this is still - Biology of Cognition - i think
*
What is one way to change the “reality” that family members have constructed?

A

assist them with developing new ways to interacting with family

32
Q

Conceptualizing Interventions with Families
*
One way to change the “reality” that family members have constructed is to assist them with developing new ways to interacting with family.
*
Describe the interventions we use in this endeavour.

A 
They focus on changing
cognitive
affective
behavioural
domains of family function
33
Q

Conceptualizing Interventions with Families
*
As family members’ perceptions or beliefs about each other and the illness change, what happens?

A

so do their behaviours

34
Q

What interventions tend of have the most sustaining changes?

A

those directed at challenging the meanings or constraining beliefs about suffering

35
Q

Conceptualizing Interventions with Families
*
Intervention begins with?

A

engagement

36
Q

If engagement and assessment have been adequate…

A

…the interventions are generally more effective

37
Q

After a family assessment, a nurse should decide whether to intervene. The nurse should consider? (3)

A
  • family’s level of functioning
  • her own skill level
  • resources available
38
Q 
Indications for Family Intervention
1 MC
*
11 MC
*
IC
A

• 1st dx of illness in a family member
• Marked deterioration in a member’s condition
• Chronically ill patient dies
*
• Illness in 1 impacts other members
• Improvement in 1 leads to deterioration in another
• Member contributes to another member’s sx
• Child develops problem in context of member’s illness
*
• Important milestone missed or delayed

• Chronically ill member returns to community

39
Q

Contraindications for Family Intervention

A
  • All members do not wish to pursue

* Members would prefer to work with another professional

40
Q 
Nursing Interventions with Families
*
Family:
MII PS
*
C PS
A 
Mobilization
Integrity promotion
Involvement
Process maintenance
Support
*
Caregiver support
Parent education
Sibling support
41
Q

Based on the 1995 study by Robinson & Wright, nursing interventions that made a difference for families fell within 2 stages of the therapeutic change process…

A

1 creating the circumstances for change

2 moving beyond and overcoming problems

42
Q

Creating the circumstances for change (2)

A

• Engaging family in new conversations
• Establishing therapeutic r’ship,
> partic providing comfort and demonstrating trust

43
Q

Moving beyond and overcoming problems (4)

P DIC

A
  • Putting illness in its place
  • Distinguishing strengths/resources of individual/fam
  • Inviting meaningful conversation
  • Careful attn to/exploring concerns
44
Q

Interventions are actualized only within

A

the context of a r’ship b/w nurse and family

45
Q

Because interventions are actualized only within the context of a r’ship b/w nurse and family, it is important to?

A

study the process itself rather than simply the results

46
Q

The CFIM highlights the family-nurse r’ship by focusing on the the intersection between?

A

family member functioning
and
interventions offered by nurses

47
Q

Nursing practice w/ families is directed by whether the concept of family is…

A

defined by
family as context
or
family as client

48
Q

Describe generalists

A

nurses at baccalaureate level

predominantly use the concept of family as context

49
Q

Describe specialists

A

nurses at graduate level (masters or doctoral)

use the concept of family as unit of care

50
Q

use the concept of family as unit of care requires

A

specialization in family systems nursing

Families (22 decks)

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