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NURS 304 > LEC 4: CFIM > Flashcards

LEC 4: CFIM Flashcards

1
Q

Calgary Family Intervention Model (CFIM)

A
  • Builds on a strengths and resiliency perspective.
  • It has 3 dominas: cognitive, behavioral, and affective
    • By addressing all of these three domains, your nursing care will be more holostic.
  • An organizing framework for conceptualizing the intersection between a particular domainn of family functioning and the specific intervention offered by the nurse.
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2
Q

What are the elements found in CFIM?

A
  • Interventions
  • Domains of family functioning
  • Fit or meshing
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3
Q

What does CIFM assist in?

A

Assists in determining the domain of family functioning that predominantly needs changing, usually where there is the greatest suffering, and the most useful interventions to effect change in that domain.

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4
Q

What is the goal of nursing interventions?

A
  • The ultimate goal of nursing interventions is to aid family in descovering new solutions to help soften or alleviate emotional, physical, and/or spiritual suffering.
  • Promote, improve, or sustain functioning in the three domains of family functions.
    • Cognitive, affective, and behavioural
  • One intervention can simultaneously affect all three domains of family functioning.
  • Family focused interventions involve all members of the family.
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5
Q

How do we determin the “fit” of an intervention?

A
  • Therapeutic conversation
  • Collaboration with the family
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6
Q

What does the “fit” involve?

A

Recognizing the recoprocity between RN opinions and ideas and the experiences of the family to the illness/problem.

  • Are the questions I am asking fitting/effective with family/domain?
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7
Q

What is family functioning?

A
  • Generally considered the family’s ability to meet the needs of it’s members
    • This is about family functioning domains
    • This is about our questioning techniques
    • This is about nursing actions and interventions
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8
Q

What are the 3 domains of family functioning?

A
  • Cognitive
  • Affective
  • Behavioral
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9
Q

What is the goal of an intervention within the cognative domain?

A
  • To change the perceptions, beliefs, and understanding of family memebers.
  • Change the way a family perceives a health problem so that family members can discover new solutions to problems.
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10
Q

What are examples of interventions in the cognitive domain?

A
  • Teach patients what they are going through
  • Education
  • Cognitive reframing
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11
Q

What is the foal of an intervention in the affective domain?

A
  • Reduce or increase intense emotions that may be impending efforts around problem solving.
    • To facilitate problem solving.
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12
Q

What type of emotions may impede problem solving efforts?

A

Being overwhelemed, concerned, sad, angery, ect.

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13
Q

What are some examples of interventions in the affective domain?

A
  • Validating/normalizing emotional responses
  • Normalizing/reassuring changes in relationships due to illness
  • Encouraging the sharing of illness narratives
  • Expression of the impact of illness on various family members
  • Drawing forth support
  • Encouraging family members to listen to each other
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14
Q

What is the goal of an intervention in the behavioural domain?

A
  • To help the family to interact with and behave differently in relation to each other
    • Increase supprot
  • To make family behaviours in relation to one another more supportive and accomplished
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15
Q

How can nurses help to make family behaviours in relation to one another more supportive and accomplished?

A
  • Invite family memebers to engage in a specific behavioural task
  • Interventions may be aimed at helping family memebers to behave and interact in ways that are different from their normal pattern
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16
Q

What are some examples of interventions in the behavioural domain?

A
  • Encouraging family members to be cargivers and offering cargiver support
  • Family members may be intimidated by the thought of providing care, a nurse could support them
  • Encouraging respite
  • Devising rituals
17
Q

Interventions with CFIM

A
  • The intervention process provides a context in which the family can make necessary changes that enhance the possibility of healing
  • Interventions crete a context for change
18
Q

What do interventions need to be?

A
  • Purposeful
  • Conscious
  • Observable behaviour by the nurse
19
Q

Key points about interventions

A
  • Interventions promote, improve, or sustain functioning in the three domains of family functioning
    • Cognitive, affective, and behavioral
  • The most profound and sustaining changes are those that occur within the cognitive domain of family functioning
  • One intervention can sumultaneously affect all three domains of family functioning
  • Assessment and interventions can occur simultaneously
    • As you help the family gain an understanding of their health experience, the family may be able to make informed choices.
20
Q

What are types of interventions we can use with families?

A
  • Can be used in all three domains:
    • Interventive questions
  • Can be used in the cognitive domain:
    • Offer information
    • Commend individual and family strengths
    • Validate or normalize emotional response
  • Can be used in the affective domain:
    • Encourage the telling of illness narratives
    • Draw forth family support
  • Can be used in the behavioural domain:
    • Encourage family members to be caregivers and offering cargiver support
    • Encourage respite
    • Devise rituals
21
Q

What are interventive questions

A
  • Simple but most powerful intervention
  • Inteded to effect change in any/all of the three domains of family functioning
22
Q

What are the 2 types of interventive questions?

A
  • Circular questions
  • Linear questions
23
Q

What is the intent of circualr questions?

A
  • Intent:
    • To effect change, to facilitate behavioural change
    • Reveal family’s understanding of a problem
24
Q

What is the intent of linear questions?

A
  • Investigative
  • Explore the discription/perception of a problem
  • Often used to begin the gathering of information
  • Prupose is to informe the healthcare provider
25
Q

What is the effect of circular questions?

A
  • Generative
  • Opens possibilites for new understanding
  • Useful for establishing rapport
  • Get the client’s sotry out
26
Q

What is the effect of linear questions?

A
  • Constrains further understanding
  • May imply the nurse knowns best…risk
27
Q

What is the focus of circular questions?

A
  • Relationships and conncections between individuals
  • Events, ideas, and beliefs
    • Always sought in a context of compassion and curiosity
28
Q

What is the focus of liniar questions?

A
  • Is on cause and effect
  • Problem exploration
  • Linear thinking encouraged
29
Q

What are examples of linear interventive questions?

A
  • When did you notice that Kennedy changed her eating habits?
    • Linear question
  • What do you think caused this change?
    • Cause and effect
  • Infroms the nurse and explores a family memebrs description of the problem
30
Q

What are the 4 types of circualr questions?

A
  1. Dofference questions
  2. Behavioral effect questions
  3. Hypothetical/future-oriented questions
  4. Triadic questions
31
Q

Difference Questions

A

Explores differences between people, relationships, ideas, time, and belifes.

32
Q

Behavioral Effect Questions

A

Explore the effect of one family member’s behaviors on another.

33
Q

Hypothetical/Future-Oriented Questions

A

Explores family options and alternative actions or meanings in the future.

34
Q

Triadic Questions

A

Questions posed to a third person about the relationship between two other people.

35
Q

What are examples of difference questions?

A
  • C: What is the best advice given to you about supporting your son with AIDS? What is the worst advice?
  • A: Who in the family is most worried about how AIDS is transmitted?
  • B: Which family memebr is best at getting your son to take his medication on time?
36
Q

What are exampels of behavioral effect quesrions?

A
  • C: What do you know about the effect of life-threatening illness on children?
  • A: How does your son show that he is afraid of dying?
  • B: What could you do to show your son that you understand his fears?
37
Q

What are examples of hypothetical/future-oriented questions?

A
  • C: What do you think will happen if these skin grafts continue to be painful for Dan?
  • A: If Dan’s skin grafts are not successful, what do you think his mood will be?
  • B: When will your son engae in treatment for his contracture?
38
Q

What are examples of triadic questions?

A
  • C: If your father were not drinking daily, what would your mother think about this receiving treatment for alcoholism?
  • A: What does your father do that makes your mother less anxious about his condition?
  • B: If your father were willing to talk to your mother about solutions to his addiction, what do you think he might say?
39
Q

Questions with a Purpose

A
  • Ask yourself what purpose am I trying to achive with the family through the questions I ask
  • Our goal is to encourage family refelction
  • Our goal is to facilitate understanding in the family
  • Our goal is to create oppurtunity for change

NURS 304 (25 decks)

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