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Community Health > Family Nursing > Flashcards

Family Nursing Flashcards

1
Q

Family Nursing

A
  • A specialty: contextual, relational and skill-based practice
  • CHNs and families working together to ensure family members adapt to health and illness
  • Assist families to cope with health concerns within the context of the family structure and resources
  • Promote family resiliency
  • Collaboration, referral & facilitation in evaluation of strengths
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2
Q

Family / Family Health

A
  • Families are a foundation of society and create life routines (provide emotional, psychological, and informational support)
  • Family nursing is a provision of care where the nurse uses nursing processes to assist the family and its members in achieving their highest potential health
  • The meaning of family influences the way CHNs provide family health nursing care
  • health of a family system is constantly changing & encompasses a holistic focus (biological, psychological, sociological, cultural, spiritual)
  • Family is: “who they say they are”
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3
Q

Family Nursing Definitions

A
  • “based on the assumption that every person, regardless of age, is a member of some type of family form and carries family experiences that have profound influences on the lives and approaches to health care”
  • “a change in one family member, (a illness or health condition) affects the other family members. Family nursing promotes, supports & provides for the well-being and health of the family & individual family members”
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4
Q

Family Forms

A

patterns of people within a family (defined by the family), each with unique challenges and strengths

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5
Q

Blended Family

A
  • both parents bring children from previous relationships into a new joint living situation
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6
Q

Extended family

A

includes nuclear family and other relatives

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7
Q

Lone-parent family

A

one parent and 1 or more children (d/t death, divorce, desertion or single person adopts a child)

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8
Q

Step-Family

A

at least 1 child in household is from a previous relationship of one of the parents

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9
Q

Traditional Nuclear Family

A

mother, father (married/common-law) and child

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10
Q

Family changes & challenges: influence of Sociocultural contexts

A
  • complex family challenges (violence, addictions, illness, learning disabilities, cognitive decline, dementia, anxiety/depression) in which family members are more vulnerable & socially isolated when support is most needed
  • pregnancy (teens & older moms) health & social concerns for teens with increased risk of living in poverty
  • domestic roles - balancing employment and domestic responsibilities, impact of maternal employment on child development
  • Economic Status: distribution of wealth affects capacity to maintain health
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11
Q

Indigenous Families

A

profound social and health inequities and disparities
- larger family structure, younger members
- own traditions, rituals, relationships & functions
- trying to maintain traditional culture, structure, and function

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12
Q

Family Caregivers: 1 in 7 Canadians is an older person

A
  • aging pop affecting the life cycle as many family members serve as informal caregivers for older persons and those with disabilities
  • balance caring for aging members with ongoing demand of family
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13
Q

Family Structure

A

characteristics and demographics (i.e., gender, age, and number) of individual members who make up the family

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14
Q

Family Functions

A

behaviours or activities performed to maintain the integrity of the family unit and meet each others’ needs, and goals throughout the families developmental stages

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15
Q

Family Assessment Process

A

the nurse facilitates the family in discovering and articulating the assumptions, context, and expectations underlying the perception of reality

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16
Q

Family Health and Functionality: Vanier Institute of the Family
Health Families:

A
  • clearly defined roles and responsibilities
  • division of labour for each member
  • Power structure and communication system are clear and orderly (enhances family relationships, problem solving, coping skills)
  • Socialization of the family unit with the community
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17
Q

Family as a Context of Care

A

Level I-V

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18
Q

Level I

A

Family as context to the client. Focus is on individual within the context of their family or family as a secondary focus

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19
Q

Level II

A

Family as sum of its parts - focus on individual family member with members seen as separate entities (as opposed to interacting units)

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20
Q

Level III

A

Family subsystem as client - family subsystem is focus of care (dyads, triads)

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21
Q

Level IV

A

Family as client - entire family is the unit of care with focus on internal family dynamics, relationships, structure

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22
Q

Level V

A

Family as Component of Society

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23
Q

Family Assessment Theories purpose

A

explain or make-sense of phenomena and guide practice
- theories, frameworks, and assessment models and tools recognize that the CHN and the family must work together
- indigenous ways of knowing
- calgary family assessment model

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24
Q

Structural-Function Theory

A

how a family functions as social system. Family viewed as passive in adapting to outside system

25
Q

Systems theory

A

interactions within/among the family

26
Q

Family developmental Theory

A

family life cycle stages/tasks

27
Q

Indigenous Ways of Knowing PHAC

A

Family -> Self -> community
Conceptualization of family, self and community
Holistic framework identifies criteria associated with good practice in Indigenous settings
Community-based, holistic, integration of Indigenous cultural knowledge, partnership and collaboration
All interventions assessed using a culturally relevant, inclusive and validated framework

28
Q

Calgary Family Assessment Model (CFAM)

A
  • Family systems model
  • Takes holistic approach to assessment of family health
  • Focus on family unit as the client
  • Looks at structural, developmental, and functional assessment of family

Focus of family assessment:
- less on the individual and more on the interaction among all of the individuals within the family.
- a perspective at a particular point in time

29
Q

CFAM Major Categories:
a) structural
b) developmental
c) functional

A

Structural: who? connections among family members and those outside the family & family context
- Three aspects of structure examined: internal, external, and context
Developmental: stages of family, tasks, attachments
Functional:
- instrumental - activities of daily living
- expressive - communication, problem solving, roles, influence and power, beliefs, alliances and coalitions

30
Q

Structural Assessment of Family: Internal Structure

A
  • Family Composition - individuals who form family
  • Gender - a set of beliefs re: masculine/feminine behaviours/experiences
  • Sexual Orientation - heterosexual, gay, lesbian, bisexual, transgender
  • Rank Order - birth order, gender and age difference
  • Subsystems - smaller groups of relationships; mother-child dyad, parents dyad
  • boundaries - defines “who participates and how”; setting limits
31
Q

Structural Assessment: External Structure - connections with persons outside family

A

Extended family (genogram)
- family of origin
- current generation and step relatives
Larger Systems - larger social agencies and personnel with whom family has meaningful contact (ecomap)
- work
- organizations
- health care professionals
- Religious affiliations

32
Q

Structural Assessment: Context (situation/background relevant to the family things that influence how a family believes, feels and behaves)

A
  • Ethnicity: culture, language, ethnic heritage, values, health beliefs
  • race: physical traits, heredity
  • social class: education, income and occupation
  • religion/spirituality: beliefs, rituals, practices
  • Environment: larger community, neighbourhood, home contexts
33
Q

Family in Context

A

Context is the circumstances and experiences that have shaped our lives. For example, our history, our socioeconomic status, and crisis we have experienced
- context is shaped by the larger sociopolitical and economic structure

34
Q

Structural Assessment Tools: Genogram (family tree)

A
  • Sketch of the family structure/composition using specific universal symbols
  • Gender, age, family association, marriage, divorce, death, remarriage, health history, occupation/schooling, religion, ethnicity, relationships, members of the household
  • usually three generations
  • include date of recording, recorder’s name and family name
35
Q

Ecomap

A
  • Visual representation of a family’s connections and the nature & degree of its relationships with the larger community (schools, friends, workplace, social and health agencies)
  • Assess family strengths/available resources and support systems (strains or conflicting relationships experienced by the family)
36
Q

Developmental Assessment of Family

A
  • The interaction between an individuals development and the phase of the family developmental life cycle
  • significant for family functioning
  • this is the unique meaning a family gives to its particular story of development over time as it progresses through expected life stages
36
Q

Developmental Assessment of Family

A
  • The interaction between an individuals development and the phase of the family developmental life cycle
  • significant for family functioning
  • this is the unique meaning a family gives to its particular story of development over time as it progresses through expected life stages
37
Q

Developmental Assessment

A
  1. family life cycles
  2. tasks during each cycle
  3. Attachments during each cycle
38
Q

Developmental Assessment

A
  1. family life cycles
  2. tasks during each cycle
  3. Attachments during each cycle
39
Q

Family Stage 1- leaving home: single young adults

A

accepting emotional and financial responsibility for self
- differentiation of self in relation to family of origin
- development of intimate peer relationships
- establishment of self re: work and financial independence

40
Q

Family Stage 2: Joining of families, marriage: the young couple

A

Commitment to a new system
- formation of the marital system
- realignment of relationships with extended families and friends to include spouse

41
Q

Family Stage 3: Families with young children

A
  • Accepting new members into the system
  • adjusting to marital system to make space for child
  • joining in childbearing, financial, and household tasks
    Early childbearing (infant, toddler)
  • integrating new baby
  • reconcile conflicting needs of various family members
  • develop parental role
  • adjust to changes in marital family
    Situational Needs that alter transition
  • infant behaviour
  • parent roles
  • chronic illness
  • social concerns
    Families with preschool children
  • Foster development of children
  • Create parental privacy
  • Increase competence of child
  • Socialize children
  • Maintain couple relationship
    Situational Needs that alter transition
  • Failure to meet developmental milestones
  • Inadequate educational support for - developmentally delayed children
  • Family social issues and changes
42
Q

Family with young children

A
  • families with school-aged children
    let children go
    balance parental needs with children’s needs
    promote school achievement
  • situational needs that alter transitions
    Family moves/changes
    Family social issues
    Behavioral problems
    Economic concerns
43
Q

Family Stage 4: Families with Adolescents

A

Increasing flexibility of family boundaries to include children’s independence and grandparents frailties
- shifting of parent-child relationships to allow for adolescent independence

44
Q

Family Stage 5: launching children and moving on

A

Accepting exits and entries into the family
- Renegotiation of role as a couple
- Development of adult-to-adult relationships between grown children and parents
- Realignment of relationships to include in-laws and grandchildren
- Dealing with disabilities and the death of parents

45
Q

Family Stage 6: Families in later life

A

Accepting the shifting of generational roles
- Maintaining function in the face of physiological decline
- Support for role of the middle generation
- Supporting the wisdom and experiences of the older generation without over functioning for them
- Dealing with the loss of spouse, siblings and other peers
- Preparing for own death

46
Q

Family Transitions

A
  • Reorganization of family roles and tasks
  • Situational transitions - non normative
  • not expected or anticipated
  • Changes in personal relationships, roles, and status
  • Changes in physical and mental capacities
  • Changes in economics, job or career
  • Changes in environment or location
47
Q

Functional Assessment: functional assessment is assessment of how family members interact and behave toward each other

A

Two subcategories of family functioning that are assessed in the CFAM
1. “Instrumental” Functioning
2. “Expressive” Functioning
- patterns of interaction in the main concept of functional assessment

48
Q

Instrumental Functioning

A

Normal Activities of Daily living (meals, eating, sleeping)
- “What does the average day in your home look like from the time you get up to the time you go to bed?”
- Activities can be a challenge for families with health problems
- Roles may change as family members cope with a relative’s illness/disability (roles, gender expectations, rituals, support from professionals (or lack), and how family life happens including the care for the child with a challenge)

49
Q

Expressive Functioning

A

The ways in which people communicate
Impacts Adjustment to health concern and resiliency
- Emotional communication – expressed feelings
- Verbal communication – clear? Direct?
- Non verbal communication – eye contact, tone of voice
- Circular communication - reciprocal
- Problem solving – how they think about actions to resolve issues
- Roles – established patterns of behaviours of members
- Influence and power – affecting another persons behaviour
- Beliefs about health concern (Wright & Leahey (Box 3-5) pg. 140)
- Alliances/coalitions - balance / intensity of relationships

50
Q

The Calgary Intervention Model (CFIM)

A

Promoting and improving family functioning in three domains
1. cognitive
2. Affective
3. Behavioural

51
Q

Circular Questions

A

Help to understand relationships between individuals, beliefs and events that elicit valuable information to help create change for the family
Assist individuals to make new cognitive connections (invite family members to discover their own answers

52
Q

Linear Questions

A

target specific yes or no answers

53
Q

CFIM: offering commendations

A

statement to emphasize family strengths and abilities. assist family to see their inherent strengths and resiliency

54
Q

CFIM: providing Information

A

Accurate, timely information is necessary for families to make decisions and cope with difficult decisions.

55
Q

CFIM: Validating or Normalizing Emotional Responses

A

can alleviate a family’s feelings of isolation and loneliness. Helps family members make connection between the illness and their own emotional response

56
Q

CFIM: Encouraging Family Support

A

– encouraging and assisting family to listen to each other’s concerns and feelings

57
Q

CFIM: Supporting Family Caregivers

A

to be involved in the care of an ill family member

58
Q

CFIM: Encouraging Respite

A
  • providing care and support for family caregivers

Community Health (11 decks)

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