class 9 Flashcards
what is family structure
the demographics and characteristics of individual members who make up family units
family health
health of a family system that is ever changing and encompasses a holistic focus that include biological, psychological, sociological, cultural, and spiritual factors
-affected by health of individuals & functioning as a unit
CHN and family health
must forecast stresses and developmental changes experienced by families and identify possible solutions
4 approaches to viewing family nursing
1.system
2.component
3.context
4.client
family as context view
the individual is the client and focus of nursing care
-the family is the larger system within which individuals are assessed (but family is secondary)
-family can be a stressor or a resource to an individual
-view taken in the acute care sector
family as client view
the family is the client and focus of care
-inidvidual members, while important, are assessed within the lens of the family as a whole
-focus can be on intra-family interactions or on the family’s interactions within larger society
-view taken in CHN
friedman’s 5 family functions
-affective
-socialization and social placement
-reproductive
-economic
-health care
what are family functions (friedman’s)
behaviours or activities performed to maintain the integrity of the family unit and to meet the family’s needs, individual member’s needs and society expectations
3 family processes
role
communication
power
features of higher functioning families
-stable
-copes with physical, psychosocial, spiritual needs and growth & development needs
-works together, members support each other
-families w children practice positive parenting & discipline
-boundary is flexible to family and external;systems can exchange info
-open and resilient to adapt to demands
characteristics of functional families
-sense of trust
-shares leisure time together
-has traditions & rituals
-privacy is honoured by members
-opens boundaries to admit and seek help w problems
-family is flexible,adaptable, resilient
features of lower functioning families
-unstable structure w ineffective coping
-do not support eachother
-lack of problem solving & decision making
-families w children are too permissive or restrictive
-lack of positive role modeling
-unclear lines of authority
-no respect
-lack of communication
theoretical framework for family nursing
-function is to characterize, explain, or predict phenomena evident within family nursing
-helps nurse understand family functioning & dynamics
structure function theory
-defines family as social systems w members who has specific roles
-open to outside influences yet maintained
-passive in adapting to change rather than being a change agent
focuses on how family functions
-looks at arrangements, relationships, roles within the family
CHN and structure function theory
-assess how a change in health status or determinant of health affects family structure and functions
-intervention is required when the family cannot fulfill functions
-help families adapt structure to improve function
major strength of structure function theory
comprehensive approach that views families in the broader community in which they live
major weakness in structure function theory
has a somewhat static picture of the family which does not allow for change over time
systems theory
a system is a distinct entity made up of interacting elements thatexist within a larger environment
system has sub-systems
focus on interaction between members of system and other systems
can be open or closed
strive to maintain a dynamic balance: depends on pos/neg feedback
change in one member/stressful event influences whole system
CHN and systems theory
Determine the effects of the stressor on the entire family system
response can be adaptive or maladaptive
interventions for individual, subsystem & whole family functioning
major strength of systems theory
views families from both a subsystem of the community and suprasystem of the individual
major weakness of systems theory
focuses on the family unit may diminish care to individual family members which is sometimes more important
developmental theory
-looks at family system over time & different phases that can be predicted with know family transitions based on norms
-at each family life-cycle stage, developmental needs of the family and tasks must be performed
-responsibility of tasks may shift
-developmental tasks are goals to work toward rather than jobs to complete at once
interactional theory
-focuses on the family as a unit of interacting personalities and examines their symbolic communication processes by which family members relate to one another
-the process of role taking is central
role of CHN when working with families
-partner with families to assess strengths and concerns
-assist families to cope by utilizing existing family strengths and community resources
-collaborate with families to develop and evaluate useful interventions
process of family assessment - what
-a systematic process
-based on chosen theoretical framework
-emphasizes family strengths
-identifies family health concerns
-should include cultural aspects
process of family assessment - how
-considers the family as a partner
-usually conducted in a “therapeutic conversation”
-mobilize family resources
-self-reflect about ones own beliefs, values, attitudes, judgments, strengths, and limitations
overall observations during family assessment
-family interactions
-family’s abilities to meet basic needs
-status of home and neighbourhood
-community resources
3 family assessment models
calgary
friedman
mcgill
the calgary family assessment model (CFAM)
family assessment focuses on 3 major categories
1.structure
2.function
3.development
-focus: family unit as a client
-internal, external, and context for each category
structural assessment CFAM
1.internal: the people who are included in the family and how they are connected to one another
2.external: the relationship the family has with people and institutions outside of family unit
3.context: the situation and background relevant to the family, in general & w current health issue
structural assessment CFAM - 5 components of context
-ethnicity
-race
-social class
-religion/spirituality
-environment
developmental assessment CFAM
-families tend to go thru predictable stages
-each with its own tasks,roles,attachments, and challenges
-achieving goals of each stage enables a family to move to the next stage
-important to look at the interaction between individual development and family stage
-knowing stages can help transition
developmental assessment CFAM - tasks, stages, attachments
-stages: 6 stages of family life
-tasks: what family developmental tasks are associated with the stage of the life cycle
-attachments: refers to unique emotional ties between two persons
functional assessment CFAM
-how family members interact
-can be instrumental or expressive
functional assessment CFAM - instrumental
normal activities of daily living: cooking, cleaning, sleeping, homework, health needs, supplying clothing food and shelter
functional assessment CFAM - expressive 10 subcategories
-emotional communication: range & types of feelings expressed
-verbal communication:how they talk to eachother
-nonverbal communication:body language
-circular communication:how communication of one member can affect others
-problem solving: actions taken to resolve situations
-roles: established patterns of behaviour for family members
-influence: methods of affecting or controlling another behaviour
-beliefs: fundamental ideas, values, opinions, and assumptions
-alliances & coalitions:directionality, balance and intensity of relationships between family members or between families and the nurse
freidman assessment model
-draws on structure, function framework, and on systems and developmental theories
-short & long form interview
-nurse is able to assess system as a whole, part of society, and interaction system
6 broad interview categories of friedman assessment
-identifying data
-developmental stage & history of family
-environmental data
-family structure
-family function
-family coping
McGill model of nursing
-nurses role is to engage family members in a learning process to recognize and use their strengths to achieve their health goals
-families are active participants in their care
-explores strengths(internal) and resources(external)
McGill model exploring strengths
-identify family strengths
-help families develop strengths to facilitate copind, problem solving or goal attainment
-offer commendations
McGill model exploring resources
-identify resources(the nurse)
-mobilize resources
-regulating resources
family assessment tools : genogram
a diagram that depicts composition of family over time
-provide info about family relationships using gender, age, relationships & marital status, health status, where they live, and mortality
family assessment tool
: ecomap
-a diagram that represents the family’s contact with other individuals, organizations, and resources in the community
-includes nature & intensity of contact
-depicts current functioning of family within environmental context
-focus on present
recent trends
-families are getting smaller
-multiple-earner families are noew the norm
-women still do most of the juggling involved in balancing work and home
-the future will have more aging families
-family violence is under-reported
