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Transcript of Family Assess

Mosby items and derived items 2006, 2002 by Mosby, Inc.

Slide 1

Objectives1. Explain the importance of family nursing in the community setting. 2. Describe family demographics. 3. Define family, family nursing, family health, and healthy/nonhealthy/resilient families. 4. Analyze changes in family function and structure.

5. Compare and contrast the four family social science theoretical frameworks.6. Explain the various steps of the family nursing process.Mosby items and derived items 2006, 2002 by Mosby, Inc.

Slide 2

Objectives (continued)7. Summarize the importance of the assessment to the intervention outcomes. 8. Compare and contrast the four ways to view family nursing.

9. Explain one assessment model and approach in detail.10. Describe the various barriers to family nursing. 11. Share the implications for family policy. 12. Explore issues of families in the future.Mosby items and derived items 2006, 2002 by Mosby, Inc.

Slide 3

Family Nursing in the Community Family: refers to two or more individuals who depend

on one another for emotional, physical, and/or financial support; members of the family are selfdefined Nurses need to ask people who they consider to be their

family and then include those members in health care planning

Family Nursing: consists of nurses and families

working together to ensure the success of the family and its members in adapting to responses to health and illnessMosby items and derived items 2006, 2002 by Mosby, Inc.

Slide 4

Family Nursing in the Community Family Demographics: study of the structure of families

and households and the family-related events, such as marriage and divorce, that alter the structure through their number, timing, and sequencing Family Functions: six historical functions performed by families are economic survival, reproduction, protection, cultural heritage, socialization of young, and conferring status; contemporary functions involve relationships and health Family Structure: refers to the characteristics and demographics of individual members who make up family units; more specifically, the structure of a family defines the roles and the positions of family membersMosby items and derived items 2006, 2002 by Mosby, Inc.

Slide 5

Figure 18-1 pg. 324Mosby items and derived items 2006, 2002 by Mosby, Inc.

Slide 6

Family Health Family Health: a dynamic changing relative state of

well-being that includes the biological, psychological, sociological, cultural, and spiritual factors of the family system Families are neither all good nor all bad; therefore nurses need to view family behavior on a continuum of need for intervention when the family comes in contact with the health care system All families have both strengths and difficulties All families have seeds of resilience

Mosby items and derived items 2006, 2002 by Mosby, Inc.

Slide 7

Four Approaches to Family Nursing Family as the context, or structure: has a traditional

focus that places the individual first and the family second Family as the client: family is first, and individuals are second Family as a system: focus is on the family as client, and the family is viewed as an interacting system in which the whole is more than the sum of its parts; simultaneously focuses on individual members and the family as a whole Family as a component of society: family is seen as one of many institutions in society, along with health, education, religious, or financial institutions

Mosby items and derived items 2006, 2002 by Mosby, Inc.

Slide 8

Figure 18-2 Pg. 326

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Slide 9

Theoretical Frameworks for Family Nursing Structure-Function Theory: families are examined in

terms of their relationship with other major social structures (institutions) Systems Theory: encourages nurses to view clients as participating members of a family Developmental Theory: looks at the family system over time through different phases that can be predicted with known family transitions based on norms Interactional Theory: views families as units of interacting personalities and examines the symbolic communications by which family members relate to one another

Mosby items and derived items 2006, 2002 by Mosby, Inc.

Slide 10

Working with Families for Healthy Outcomes Care Outcome Present-State Testing Model

(OPT): emphasizes organizing care around what is called the keystone issue that is challenging family health; is an outcome-driven model of care Family story Cue logic Framing Present state and outcome testing Intervention and decision making Clinical judgment ReflectionMosby items and derived items 2006, 2002 by Mosby, Inc.

Slide 11

Family Nursing Assessment Family Nursing Assessment: family problem areas are

identified and family strengths are emphasized as the building blocks for interventions Friedman Family Assessment Model Takes a macroscopic approach to family assessment Views the family as a subsystem of society Enables nurses to assess the family system as a whole, as

part of the whole society, and as an interaction system

Mosby items and derived items 2006, 2002 by Mosby, Inc.

Slide 12

Future Implications for Family Nursing More family-centered research needs to be

conducted by family nurses Government actions that have a direct or indirect effect on families are called family policy Example: Family leave legislation passed in the

1990s was positive for families

Most government policy indirectly affects

families

Mosby items and derived items 2006, 2002 by Mosby, Inc.

Slide 13

Barriers to Practicing Family Nursing Many barriers affect the practice of family nursing

in a community settings Two Significant Barriers to Family Nursing The narrow definition of family used by health care

providers and social policymakers The lack of consensus of what is a healthy family

Mosby items and derived items 2006, 2002 by Mosby, Inc.

Slide 14

Family Health

The family health exercises allow you first to review family development and nursing roles for the various family stages in Stages of Family Development. The Friedman Family Assessment Model provides you with one example of the types of data that need to be collected to conduct a family assessment. Once these are reviewed, you are ready to apply your knowledge in You Conduct the Assessment by assessing one family from three family types: a single-parent family, an aging family, and a multigenerational family. Through photographs and audio and text script, you will learn about each of these families from the family members themselves as they speak about their relationships and lives.

Mosby items and derived items 2006, 2002 by Mosby, Inc.

Slide 15

Case Study

Marty Belfair, a 55-year-old accountant, is the father of three children and has been married to his wife, Joanne, for the past 25 years. Mr. Belfairs children are Joshua, age 20, Mary, age 17, and Kyle, age 14. Mr. Belfairs mother, Delia, has lived in the Belfair household since her husband, Martin, passed away 4 years ago from lung cancer. A few months ago, Mr. Belfair was diagnosed with bladder cancer. After surgery and chemotherapy, the cancer still has not receded. The family physician estimates Mr. Belfair has only 5 months to live. Alex Von Bremen is the hospice nurse working with the Belfair family. Mr.Von Bremen explains to the Belfairs that his goal is to work with the whole family in coping with Mr. Belfairs illness. Mr. Von Bremen asks each family member, How do you feel Mr. Belfairs illness will affect the way in which the members of your family function and interact with one another? Joanne Belfair responds, Right now we do not talk about Marty being sick. It is the elephant in the room. I am afraid that if Marty does not get better, the whole family will fall apart and never see each other. Delia Belfair shared, I do not know where I will live. We dont talk about it. I dont know if Im welcome to stay if Martys not here. Mr. Belfair encourages his family, I know my illness is hard to accept now, but we have been through tough times in the past and the family stayed together then. Remember when I lost my job? We all made sacrifices for the family and were a stronger family as a result.Slide 16

Mosby items and derived items 2006, 2002 by Mosby, Inc.

Which family nursing approach did Mr. Von

Bremen use? Family as the context Family as the client Family as a system Family as a component of society

Mosby items and derived items 2006, 2002 by Mosby, Inc.

Slide 17

The focus is on the family as a client, and the family is

viewed as an interactional system in which the whole is more than the sum of its parts. Because Mr. Von Bremen asked about family interactions and functioning, he is approaching the family as a system. A. Family as a context: The family has a traditional focus that places the individual first and the family second. B. Family as the client: The family is primary and individuals are secondary. D. Family as a component of society: The family is seen as one of many institutions in society, along with health, education, and religious and financial institutions.

Mosby items and derived items 2006, 2002 by Mosby, Inc.

Slide 18

Using the outcome-present-state testing model (OPT), how can Mr. Von Bremen assist this family with the intervention and decision-making step?

Mosby items and derived items 2006, 2002 by Mosby, Inc.

Slide 19

The role of t