Tools of Family assessment Flashcards
Situations where family relationships are needed
- Family needed for care
- New patient
- Family in crisis
- Patients with high clinic utilization
Components for See patient only Family-Centered Care
Minor acute problems and self limiting problems (I.e. back pain, fracture)
Components for Family conference desirable
Regular occurrence of symptoms and routine visits
Components for Family involvement essential-chronic
Chronic illness and death
A total evaluation of health care involving family relationships, family social and cultural systems resulting to better evaluation and better health care
FAMILY SYSTEMS MEDICINE
Steps in incorporating the family systems approach to clinical practice
- know the family structure
- Under stand its normal functions
- Learn to assess family structure and function in clinical practice
Components of the Family Genogram
- Pedigree chart or Family tree
- Functional charting containing psychosocial and interactional data
- Medical history of family illness
How to input on the Family Genogram?
- 3 generations
- first born is written in the left
- Family name above each major family unit
- Index patient -arrow
- Date indicated when the chart was developed
Genogram Symbol for male
Square
Genogram Symbol for female
Circle
Genogram symbol for death
Square or circle with a slash over it
Genogram symbol for Pregnancy
Triangle
Genogram symbol for dizygotic twins
two circles with an attachment on top
Genogram symbol for monozygotic twins
two circles with an attachment both top and bottom
Genogram symbol for marriage and year
square and circle with a line between them
Genogram symbol for divorce
square and circle connected with a line with 2 slashes on said line
Genogram symbol for not married/living together
square and circle with dotted line connecting them
Genogram symbol for separation and year
square and circle with a line between them. Said line has 1 slash with the date of separation written below it
Genogram symbol for consanguineous marriage
square and circle with two lines connecting them from below instead from their side
Genogram symbol for Married couple, each with multiple spouses
multiple lines connecting multiple circles or square with slashes between these shapes
Genogram symbol for adopted
Letter A
Genogram symbol for induced and spontaneous abortion
small circle
Genogram symbol for number of births of unknown sex
number indicating how many of these births are unknown sex
is a five-item function screening questionnaire in which the patient is asked to described how family members communicate, eat, sleep and carry out home, school and job responsibilities.
APGAR
Meaning of APGAR
Adaptation, partnership, growth, affection and resolve
involves utilizing and sharing resources
Adaptation
The sharing of decision making measures satisfaction in communication
Partnership
measures the satisfaction of the available freedom to change
Growth
how emotions are shared
Affection
how time, money, space are
shared, measures commitment
Resolve
Range indicating highly functional family
8-10
Range indicating moderately dysfunctional
4-7
Range indicating severely dysfunctional
0-3
Gives a dynamic image of the family, allows one to judge the totality of the family unit, its strengths and weaknesses and ability to withstand future stressful even
Functional chart
Life events and clinical events are put side by side according to _____ showing correlation
Dates of occurrence
Brief graphic method for disclosing, gathering and discussing family dynamics as discussed by 1 or more family members
Family Circle Technique
Meaning of Screem
Social, Cultural, Religous, Education, Economic, Medical
Facilitates the communication of information about the family system and its dynamics in order to address psychosocial issues.
Minuchin’s Family Map
over-involvement with each other
Enmeshment
Symbol for enmeshment
3 parallel lines
isolation from each other or little emotional response
Disengagement
Symbol for Disengagement
dotted lines
Family talk directly to each other,
Triangulation
Symbol for triangulation
an open ended arrow. The open end embracing 2 individuals and the pointed end embracing a 3rd person
when 1 member is siding with another member
Coalition
Symbol of coalition
bracket
A pictorial representation of a family’s connections to persons and/or systems in their environment
Ecomap
3 separate connections of an Ecomap
- Strength of the connection
- Impact of the connection
- Quality of connection
weak connection, draining
Energy/resources, not stressful symbol
arrow pointing from person to source of stress
strong connection, Providing
Energy/resources, not stressful symbol
institution or aspect pointing towards the person
Weak Connection, No impact
on Energy/resources, stressful
Wavy line between person and institution/aspect
Tenuous/Uncertain Connection,
Providing Energy/resources,
Not stressful symbol
Dashed line from insitution/aspect drawn towards the person
6 Domains of the Ecomap
- Neighborhood
- Community services
- Social groups
- Education
- Significant personal relationship
- Employment
Drawing an ecomap
- Target family members are put in the center using genogram symbols
- Domains applying at the household level can be charted at the household level
- Each individual can be brought out of the center to its on circle and domains
- In complex cases- individuals or household can be illustrated on its own in a separate page
- Lines are used to illustrate the existence of a connection and its strength ( dotted line-tenous uncertain, dashed line-weak, straight line-strong
is used to illustrate the impact of the connection in an ecomap
arrow
is used to illustrate a stressful connection in an ecomap
jagged/wavy
Brief summary can be written________ in the ecompa
inside the domain circle
___ should be identified in the ecomap
Domains