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Family Assess
Family Assess
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Objectives
1. 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.
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Objectives (continued)
7. Summarize the importance of the assessment to the intervention outcomes. 8. Compare and contrast the four ways to view family nursing.
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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
working together to ensure the success of the family and its members in adapting to responses to health and illness
Mosby items and derived items 2006, 2002 by Mosby, Inc.
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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 members
Mosby items and derived items 2006, 2002 by Mosby, Inc.
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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
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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
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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
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(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 Reflection
Mosby items and derived items 2006, 2002 by Mosby, Inc.
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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
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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
families
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providers and social policymakers The lack of consensus of what is a healthy family
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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.
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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.
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Bremen use?
Family as the context Family as the client Family as a system Family as a component of society
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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.
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Using the outcome-present-state testing model (OPT), how can Mr. Von Bremen assist this family with the intervention and decision-making step?
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family, provide information, and assist in the planning process. Mr. Von Bremen already has begun to encourage the family to address their communication problems. Mr. Von Bremen can act as a facilitator for the family discussions, provide information on resources in the community, and help the family plan how they will cope with Mr. Belfairs declining health.
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4.
Proper application of interactional theory to family nursing is reflected when the nurse in community health recalls that each family is unique in its composition and complexity of age-role expectations and positions. True or false? List at least eight trends in family life course events that have implications for nurses in community health working with families. Discuss the application of structural-functional theory, systems theory, developmental theory, and interactional theory as frameworks useful for family nursing.
5.
6.
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7. Select one of the following family types: singleparent family, remarried family, or a family that is cohabitating. Discuss the application of the developmental framework to assessment, planning, and intervention with the selected family. 8. List six areas that the nurse must plan for before a visit to a family for data collection.
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9. The definition of a family is which of the following? A. Two or more people who are bonded together by legal blood relationships B. A group of people with whom a person closely identifies C. Two or more people who depend on each other for emotional, physical, and/or economic support D. Two or more people who are related through adoption, guardianship, or marriage
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10. Which of the following is not a barrier to practicing family nursing? A. The traditional charting system in health care has been oriented to the individual. B. A lack of comprehensive family assessment tools exists. C. The nursing diagnostic systems are diseaseand individual-focused. D. Insurance carriers recognize the family as a unit, as well as the individual client.
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11. Pre-encounter data collected before a family interview includes which of the following? A. Referral source B. Family C. Previous records D. A and C E. A, B, and C
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Weblinks
Childstats.gov - America's Children in Brief 2006 Introduction Child Welfare Information Gateway Children's Defense Fund: Children in the States :: CDF http://cdf.convio.net/site/DocServer/Greenbook_2005.p df?docID=1741 CYFERnet - Children, Youth and Families Education and Research Network DOL WHD: The Family and Medical Leave Act of 1993
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Safety How to Impact Public Policy for Families, NCR 443 The National Parenting Center The Urban Institute | National Survey of America's Families Search Results - THOMAS (Library of Congress) Positive Parenting - Main Menu Stepfamily Network Home Page
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EHS: Wong on Web Welcome to ZERO TO THREE's Web Site Archived: Commissioned Papers: Teaching
Parenting and Basic Skills to Parents - What We Know Healthy Teen Network -- Welcome to Healthy Teen Network ScienceDaily: Study: Most kids making bad health choices N C H S - Healthy People 2010 - Focus Areas at a Glance
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Family health (Chapters 18, 19) Family assessment (Chapters 18, 19) Family functions, processes, development (Chapters 18, 19)
Family health (Chapters 18, 19) Family assessment (Chapters 18, 19) Family functions, processes, development (Chapters 18, 19)
You Conduct the Assessment: Single-Parent Family, Aging Family, Multigenerational Family
Family health (Chapters 18, 19) Family assessment (Chapters 18, 19) Family functions, processes, development (Chapters 18, 19, 20)
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