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Families > Roberta's Slides > Flashcards

Roberta's Slides Flashcards

1
Q

p. 1, Nurses and families: A guide to family assessment and intervention.
AND I QUOTE…!

A

“Nurses have an ethical and moral obligation to involve families in their health-care practice.”

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2
Q

Wright and Leahey:

Belief that illness needs to be…?

A

treated as a family affair

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3
Q

Wright and Leahey:

Invite nurses to…?

A

think interactionally or reciprocally about families

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4
Q

Wright and Leahey:

Say that we must…?

A 
assess the impact of illness 
on the family 
and 
the influence of family interaction 
on the cause and cure of illness
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5
Q

Wright and Leahey:

What kind of relationship should be formed b/w nurses and families?

A

reciprocal relationship

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6
Q

Wright and Leahey:

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

A

softening suffering

enhancing healing

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7
Q

What is family? Who is included? How do we define family?

A

Whoever the family says it is.

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8
Q 
In working with families, what is an important tool?
*
To do what?
*
This provides?
.
A

A clear conceptual framework or map, of the family
*
To identify family strengths and resources
*
Provides a focus for intervention

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9
Q

CFAM is a multidimensional framework consisting of three major categories

A

structural
developmental
functional

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10
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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11
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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12
Q

Define nursing diagnosis

A

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

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13
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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14
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
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15
Q

Describe the context of interventions.

A

All nursing interventions are interactional.

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16
Q 
Conceptualizing Interventions With Families
RIB
therefore
F
because
N
A

• “Real” as social construction
• Intervention begins with engagement
• Behaviours change with perceptions
therefore
• Focus on changing cognitive, affective, behavioural domains of family function
because
• New ways of interacting “change reality”

17
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

18
Q

Contraindications for Family Intervention

A
  • All members do not wish to pursue

* Members would prefer to work with another professional

19
Q 
Nursing Interventions with Families
*
Family:
MII PS
*
C PS
A 
Mobilization
Integrity promotion
Involvement
Process maintenance
Support
*
Caregiver support
Parent education
Sibling support
20
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

21
Q

Creating the circumstances for change (2)

A

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

22
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
23
Q

Describe generalists

A

nurses at baccalaureate level

predominantly use the concept of family as context

24
Q

Family as context

A

undergrad focus

25
Q

Describe specialists

A

nurses at graduate level (masters or doctoral)

use the concept of family as unit of care

26
Q

Family as client

A

family systems nursing or grad focus

27
Q

Family Therapy is????????

A

a distinct discipline

Families (22 decks)

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