Caring for Families

Notes

Need of Family Focus
  • Health and illness behaviors are learned within the context of family.
  • Family units are affected when one or more healthy members experience health problems.
  • Families affect the health of individual members and vice versa .
  • Health care effectiveness is improved when emphasis is placed on the family.
  • Promotion , maintenance and restoration of the health of families is important to the survival of society
Definition of Family
  • The family is a group of persons united by ties of marriage ,blood or adoption , constituting a single household , interacting and communicating with each other in their respective social roles
  • Family health is a dynamic, changing, relative state of well-being which includes the biological, psychological ,spiritual , sociological, and culture factors of the family system.
Structure of Family
Traditional Family
  • It is composed of a father, a mother and their children. These people, married and living together in one house make up the nuclear family. Relatives, such as aunts, uncles, cousins and grandparents, who may or may not live with the nuclear family, are part of the extended family. This family group usually live in close geographic proximity to members of the extended family, who provided a sense of stability and belonging.
Single – Parent Families
  • Single parents may be never – married, separated, divorced or widowed. Most often, the single parent is divorced or widowed, but increasing numbers of never married men and women are choosing to become parents.
Alternate Family Structure
Cohabiting Families
  • It includes those individuals who choose to live together for a variety of reasons: relationships, financial need, changing values
Although the single person is not living with others, he or she is a part of a family of origin, usually has a social network with significant others. Majority of single adults living alone are found in to age groups: the young adult who has achieved independence and enters the work force and the elderly person, left alone through death of a spouse. (Taylor, et.al., 1989)
Family Health Care Nursing
  •  is defined as “the process of providing for health care needs of families that are within the scope of nursing practice .
Conceptual Framework

Concepts of individual , family nursing & society intersect with one another.

Nature of Interventions
  • Family care is concerned with experience of the family over time.
  • Family nursing is considerate of the community and cultural context of the group.
  • Family nursing is directed at families whose members are both healthy and ill.
  • Offered in settings in which individuals present with physiologic or psychological problems.
  • Considerate of the relationships between and among family members.
  • Influenced by any change in its members.
  • Nurse manipulate the environment to increase the likelihood of family interaction.
  • Recognizes that which person in a family is the most symptomatic may change over time.
  • Focuses on strengths of individual family members
  • Define with the family which persons constitute the family and where they will place their therapeutic energies.
Settings
  • Home, clinic, school and workplace
  • Each setting serves its own purpose and has its advantages, disadvantages and limitations
History

Nightingale Era

  • Florence nightingale – Establishment of district nursing of the sick & poor and the work of ‘health missionaries’ through health-at-home teaching.
  • In Early 1900’s and 1960’s- women continued the centuries old traditions
  • 1930
    • Nurses are assigned to families.
    • Psychiatry and mental health disciplines -family therapy focus.•
  • 1960
    • Concepts of maternal,child and family care – incorporated into basic curriculums of nursing schools.
    • Family studies & research produce family theories.
    • Shift from public health to community health nursing occurs.
  • 1970
    • Development of nursing models that consider family as a unit of analysis.
    • Many specialties focus on the family
    • Masters and doctoral programs focus on family.
  •  1980
    • White House Conference on families.
    • Greater emphasis is put on health from very young to very old.
    • Family science develops as a discipline.
    • Family nursing research increases..
  • 1991–Family leave legislation is passed.
  • 1995 – Journal of Family Nursing Research is born
Objectives of Family Health
  • To identify health and nursing needs and problems of each family.
  • To ensure family’s understanding and acceptance of those needs and problems.
  • To plan and provide health and nursing services with active participation of family members.
  • To help families develop abilities to deal with their health needs and health problems independently.
  • To contribute to family’s performance of developmental functions and tasks.
  • To help family make intelligent use of facilities and services in the community.
  • To educate ,counsel and guide family members.
Principles
  1. Family health nursing is family focused.
  2. Must establish good working relationship with the family.
  3. Family health nursing is part of family health care services
  4. Family health nursing services should be realistic in terms of resources available.
  5. Family as a unit is responsible for their members’ health .
  6. Family relates to community where it lives and depends on community in various way.
  7. Health education ,guidance and supervision are integral part of family health nursing.
  8. Continuous services are effective services.
  9. Effective system of record and report of family health nursing service is essential .
  10. Periodic and continuous appraisal and evaluation of family health situation and health services are basic to family health situation.
  11. Family health nursing services should be rendered to all families without any discrimination.
Approaches to Family Nursing
  • Family as the context -Individual as foreground Family as background
  • Family as the client– Family as foreground Individual as background
  • Family as System– Interactional Family
  • Family as Component Of Society- e.g. Bank, Church, Hospital, Family /Home, Schools
Obstacles to Family Nursing Practice
  • The majority of practicing nurses have not had exposure to family concepts
  • Lack of good comphrensive family assessment models ,instruments and strategies.
  • Students believe that study of family and family nursing does not belong to curricula.
  • Medical model has traditionally focused on the individual as client , not the family.
  • Nursing diagnostic systems used in health care are disease-centered /focused on individuals.
  • Traditional charting system in health care has been oriented to individual.
  • Insurance carriers – One identified patient with diagnostic code drawn from an individual disease perspective
  • Increased family care has been the established hours.
Errors In Family Nursing
Failure to create a contest for change
  • Show interest ,concern and respect for each family member.
  • Obtain a clear understanding of the most pressing concern or greatest suffering.
  • Validate each member’s experience.
  • Acknowledge suffering and sufferer.
  • Health provider’s acknowledgement of client’s suffering.
Taking Sides
  • Maintain curiosity.
  • Remember that the glass can be half full and half empty simultaneously.
  • Ask questions that invite an exploration of both sides of a circular interactional pattern.
  • Remember that all family members experience some suffering when there is a family problem or illness.
Advising prematurely
  • Offer advice without believing that the suggestions are the “best” or “better” ideas or opinions.
  • Offer advice, opinions or recommendations only after a thorough assessment.
  • Ask more questions than offering advice during initial conversations with families.
  • Obtain the family’s response and reaction to the advice.
Family Health Nursing Process
Assessment

FAMILY IDENTIFICATION- 1st level Assessment – Planning of Data Collection

  • Data Collection Methods and Techniques
  • Analysis of Data
  • Family Profile and Diagnosis

PLANNING

  • Family Health Nursing Care
  • Plan Formulation
  • Analysis of diagnosed health problems and assessment of family’s abilities- 2nd level assessment
  • Establishing priorities
  • Setting goals and Objectives

ACTION PHASE

  • Plan Implementation
  • Review and Revise
  • Mobilization of resources facilitating work environment
  • Implementing
  • Documentation

EVALUATION

  • Concurrent (Quantitaive)
  • Terminal (Qualitative)
Research Studies
  • In this Canadian study
    • A participatory action research approach
    • To examine the relationships between families of residents of traditional continuing care facilities and the health care team.
    • Results indicate that the resource-constrained context of continuing care has directly impacted family and staff relationships.
Conclusion
  • Working with families helps families live alongside illness and increase their sense of wellness.

 

References

  • Shirley May Harmon Hanson. Family Health Care Nursing, 2nd ed. Philadelphia: F.A Davia Publishers; 2001.p. 4-19.
  • Basvanthappa B T.Community Health Nursing. 2nd ed. New Delhi. Jaypee Publishers; 2008. p. 129.
  • Lorraine M Wright, Maureen Leahley. Nurses and Families. 4th ed. Philadelphia: F.A Davis Company; 2005. p. 277-84.
  • Gulani K K. Community Health Nursing, 4th ed. New Delhi; Kumar Publishing House; 2011. p. 145-74.
  • The Growing Speciality of Family Health Nursing; Available from: http://www.oppapers.com/essays/Family- Health-Nursing/106495: Accessed on June 19,2012.

 

Exam

Welcome to your Caring for Families Practice Exam! This exam is carefully curated to help you consolidate your knowledge and gain deeper understanding on the topic.

 

Exam Details

  • Number of Questions: 14 items
  • Mode: Practice Mode

Exam Instructions

  1. Practice Mode: This mode aims to facilitate effective learning and review.
  2. Instant Feedback: After each question, the correct answer along with an explanation will be revealed. This is to help you understand the reasoning behind the correct answer, helping to reinforce your learning.
  3. Time Limit: There is no time limit for this exam. Take your time to understand each question and the corresponding choices.

Tips For Success

  • Read each question carefully. Take your time and don't rush.
  • Understand the rationale behind each answer. This will not only help you during this exam, but also assist in reinforcing your learning.
  • Don't be discouraged by incorrect answers. Use them as an opportunity to learn and improve.
  • Take breaks if you need them. It's not a race, and your understanding is what's most important.
  • Keep a positive attitude and believe in your ability to succeed.

Remember, this exam is not just a test of your knowledge, but also an opportunity to enhance your understanding and skills. Enjoy the learning journey!

 

Click 'Start Exam' when you're ready to begin. Best of luck!

💡 Hint

Consider the attribute that best represents a family's ability to cope with and adapt to challenging situations effectively.

1 / 14

1. When assessing a healthy family, certain characteristics indicate resilience and adaptability. Which of these traits should be evident in a healthy family?

💡 Hint

Begin by assessing the immediate and available support network around the client to ensure continuous care.

2 / 14

2. When managing the care of a client with severe arthritis who is unable to perform colostomy care independently, it's crucial to ensure continuous and effective support. What should the nurse prioritize as the first step?

💡 Hint

Choose the question that directly explores how decisions are made within the family, indicating roles and influence.

3 / 14

3. When assessing the roles and power structure within a nuclear family during a home visit, it's crucial for the nurse to understand the dynamics of decision-making. Which question would be most appropriate for the nurse to ask the client to gain insight into these dynamics?

💡 Hint

Consider which aspect of communication directly contributes to the family’s ability to address challenges and support each other emotionally.

4 / 14

4. During a home visit, when observing family interactions, the nurse can assess how communication impacts the family's functionality. What is the optimal goal of effective communication within a family?

💡 Hint

Consider the option that most broadly addresses the overall well-being of both the family as a whole and its individual members.

5 / 14

5. Family-centered nursing encompasses various aspects of care, focusing on both the individual and collective needs of the family. Which statement best describes the primary concern of family-centered nursing?

💡 Hint

Consider which option demonstrates a family's ability to manage and thrive amidst unexpected challenges and changes.

6 / 14

6. In assessing the health and functionality of a family, certain characteristics stand out as indicators of resilience and adaptability. Which characteristic should a nurse expect to find in a healthy family?

💡 Hint

Consider the principle that addresses how external relationships and community support may vary significantly as clients age.

7 / 14

7. Understanding gerontological principles related to families is crucial for effective nursing practice in long-term care facilities. Which of the following principles should the nurse recognize as pertinent to this area?

💡 Hint

Focus on the option that empowers the family by enhancing their knowledge and skills for self-management.

8 / 14

8. In implementing family-centered care, the nurse plays a pivotal role in enhancing the family's capacity to care for themselves and their loved ones. Which action should the nurse take to best embody family-centered care principles?

💡 Hint

Begin by assessing the immediate and available support network around the client at home to ensure continuous care.

9 / 14

9. When managing the care of a client with severe arthritis who is returning home after having a colostomy and is unable to perform colostomy care independently, it's crucial to ensure continuous and effective support at home. What should the nurse prioritize as the first step?

💡 Hint

Start with the basics—understand who makes up the family and their collective viewpoints, as this sets the context for deeper exploration.

10 / 14

10. When initiating a family assessment, it's crucial for the nurse to establish a foundational understanding of the family dynamics and structure. Which step should the nurse take first in completing a client’s family assessment?

💡 Hint

Consider the trend that aligns with increasing individualism and changes in personal space preferences in modern society.

11 / 14

11. In today's society, various changes have been observed in how individuals and families structure their lives. Which of the following options reflects a significant current trend in family living?

💡 Hint

Look for the answer that best describes how communication can strengthen emotional and practical aspects of family life.

12 / 14

12. Effective communication is a cornerstone of healthy family dynamics and has several positive outcomes. Which benefit is most directly associated with effective communication within a family?

💡 Hint

Consider the demographic shifts influenced by modern lifestyle choices and social independence.

13 / 14

13. Current trends in family living have evolved over the years. Among the listed options, which reflects a significant change observed in societal behaviors concerning family structure?

💡 Hint

Start with the foundational aspects—understand the family's composition and their collective outlook as this sets the stage for more detailed evaluations.

14 / 14

14. When initiating a family assessment, particularly during a first visit, it is crucial for the nurse to establish a foundational understanding of the family dynamics and structure to effectively tailor care approaches. Which action should the nurse take first in completing a client’s family assessment?