Family and Diversity

Question 1

What is theory based practice?

Answer 1

Theories guide nursing practice by giving a perspective on family life/give basis for family assessment/interventions.

Question 2

Goals of theory utilization?

Answer 2

Describe, explain, and predict. (theories increase knowledge, enhance understanding, and improve care).

Question 3

What do family nursing theories help with?

Answer 3

Understand families, describe fam nursing interventions, and study/evaluate impact of nursing care.

Question 4

CFAM 6 theoretical foundations by Shajani and Shell?

Answer 4

Postmodernisms, systems theory, cybernetics, communication theory, change theory, biology of cognition

Question 5

Postmodernism?

Answer 5

Values pluralism (acknowledges many world view/explanations exists). Debates about knowledge of where it comes from. Seen in CFAM by valuing all versions of story/everyone’s experience of suffering

Question 6

What is systems theory?

Answer 6

System is complex elements in mutual interaction. All parts of system are interconnected, whole is more than sum of parts, systems can be organized into subsystems, boundaries exists between system/its environment.

Question 7

Different types of boundaries?

Answer 7

Open: greater interchange of information, energy, and people
Closed: more isolation and limits passage of energy, ideas, people and information
Flexible: control and selectively open or close to gain balance or adapt to

Question 8

What is cybernetics?

Answer 8

Science of communication and control theory. It shifts focus from substance to form (now what’s being said but how it’s being said). Think about how we say content/how we deliver it.

Question 9

What is communication theory?

Answer 9

All non verbal communication is important. See this in CFAM by paying attention to channels of communication: Digital (verbal message content), and analog (nonverbal and artistic)

Question 10

What is change theory?

Answer 10

2 levels of change are first order change (use same problem solving skills in different situations) and second order change.
9 concepts of CT- Change is dependent on the perception of the problem, Change is determined by structure, Change is dependent on the context, Change is dependent on co-evolving goals for treatment, Understanding alone does not equal change, Change does not always occur equally in all family members, Facilitating change is the nurse’s responsibility, Change occurs by fitting interventions offered by the nurse with the biopsychosocial- spirtitual structures of the family, and Change can have multiple causes.

Question 11

What is biology of cognition?

Answer 11

2 avenues to explain the world: objectivity (we exists independent of observers) and objectivity in parentheses (truths are created/brought forth by observer, nothing is certain certain/everyones view is version of presumably correct interpretation). Says we bring forth our realities through interacting with world/ourselves/others.

Question 12

What is family systems theory?

Answer 12

Assumes individual is both a part/whole in a family. Family systems features designed to maintain stability/families are dynamic/respond to stress from environment. Change in 1 member can affect all members. Nurse goal is help maintain stability of family/achieve level of functioning.

Question 13

4 parts of systems theory?

Answer 13

1. all parts of system are interconnected
2. the whole is more than sum of parts
3. all systems have boundaries between system and environment
4. systems can be divided further into subsystems

Question 14

All parts of system are interconnected?

Answer 14

What influences one part affects all parts of system. The effect varies.

Question 15

The whole is more than sum of its parts?

Answer 15

Family is considered more than individual lives, relationships viewed together, and family as a whole is affected by unexpected events.

Question 16

All systems have boundaries?

Answer 16

Families control info and people coming to the family system to protect. Have open/closed/flexible boundaries.

Question 17

Systems can be further divided into subsystems?

Answer 17

Subsystems take into account structure, function, and processes.

Question 18

What is developmental and family life cycle theory?

Answer 18

Explains changes in family system over time, each family experiences stages uniquely, family behaviour is influenced by past families, families seek to perform certain developmental tasks.

Question 19

What are stages?

Answer 19

Interval of time where relationships between structure/interactions/roles within family are distinct from other periods. (like family with young kids)

Question 20

What are transitions?

Answer 20

They separate each developmental stage from the next. They are normal (functions of different roles/expectations of family members may differ).

Question 21

What are tasks?

Answer 21

Family unit will strives to meet demands/needs of members. Successful achievement contributes to satisfaction/success with tasks.

Question 22

What is disequilibrium?

Answer 22

Occurs in transitioning from one stage to another and family stress is great at this point.

Question 23

7 stages of family life cycle theory?

Answer 23

1. leaving home (emerging young adults)
2. joining families through marriage/union
3. families with young kids
4. family with adolescents
5. launching of children/midlife
6. families in late middle age
7. families nearing end of life

Question 24

Nursing interventions for family development?

Answer 24

What is family structure/where are they on the family life cycle stages, consider developmental tasks to anticipate stressors, provide info about transitions, assist families to move towards completion of developmental tasks, and help families find balance between individual/family needs.

Question 25

What is Mcgill model of nursing?

Answer 25

Shifts focus from deficit to strength based perspective, main goal of nursing is to form partnership with family/patient, also help fam use their strengths/external resources/achieve goals.

Question 26

What is deficit perspective?

Answer 26

Focused on what was wrong/missing/abnormal. Clinicians the expert and negative diagnosis

Question 27

Strength based perspective?

Answer 27

Identifies family strengths with/around person, positive diagnosis, partnership between clinical and family.

Question 28

What is problem orientation approach?

Answer 28

Labels family and causes stigma/alienation from the nurse. Powerless and learned helplessness.

Question 29

4 types of strengths?

Answer 29

Traits (like resilience, optimism, being close knit)
Assets (like finances, information)
Capabilities/skills/competencies (caregiving, problem solving skills)
Qualities (more transient in nature than traits/assets- motivation)

Question 30

4 strategies for working with strengths?

Answer 30

1. Identify strengths- open ended questions to assess (perceptions of concerns, what’s important to them, how they handled previous problems, what’s your family good at doing)
   • 2. Provide feedback- need to be explicit, specific/descriptive, sincere/truthful, commendations (share observations about strength and its effect), can help boost confidence/create context for change if feedback is genuine
   • 3. developing strengths- do by transfer use of strength from one experience to another, cognitive reframing (turn deficit into strength), and develop knowledge/competency (teach new skills, assist to locate/access experiences and materials)
   • 4. Call forth strengths- nurse must consider how strengths could be use to solve problems, say i really appreciated, I have noticed, i see you were able to utilize, you must be proud

Question 31

What is resilience?

Answer 31

Ability to withstand/rebound from disruptive life challenges. Ability to struggle well and surmount obstacles which contributes to positive adaption.

Question 32

Strategies for nurses when working with resources?

Answer 32

Identity resources- explore use of ecomaps, who do you spend time with/what do you spend time doing

Mobilize and use resources- help families identify where there’s a need, together decide the type, determine who to make contact to the resources

Regulate resources- problem solve to minimize problems/maximize benefits, help manage input

Question 33

Assumptions of resiliency model?

Answer 33

Families manage stressful situations over time, unexpected events perceived as stressful, stressful events within fam are more disruptive than stressors outside family, lack of previous experience with stressors leads to increased perception

Question 34

Individual protective factors?

Answer 34

Internal locus of control (how we perceive it), emotional regulation, beliefs/values, self efficacy (self reliant), effective coping skills, health, increased education/skills, temperament (emotions), gender, self esteem

Question 35

Family protective factors?

Answer 35

Family structure, intimate partner relationships, family cohesion, social support, supportive parent-child interaction, stimulating environment, family of origin influences, stable/adequate income, and adequate housing

Question 36

Community protective factors?

Answer 36

Involvement in community, peer acceptance, supportive mentors, safe neighborhoods, access to faulty healthcare, access to quality schools/child care