Family Health Care Nursing:

An Introduction
 Family health care
nursing
• An art and a science that has evolved as a way of
thinking about and working with families (Hanson,
2005)

• The process of providing for the health care needs

of families that are within the scope of nursing
practice. This nursing care can be aimed toward
the family as context, the family as a whole, the
family as a system, or the family as a component of
society.
 WHY TEACH NURSES
ABOUT FAMILY NURSING?
• Nurse’s personal experience should not be their only
guide.

Provide client-centered holistic nursing care

effectively with families.
• Families vary in structure and function.
• All families have their own unique culture.
 Family Focus in Nursing
1. Health promotion, health maintenance, and the
restoration of the health of families are important to the
survival of all societies.
2. Health and illness beliefs and behaviors are learned
within the context of family.
3. Family units are affected when one or more members
experience health problems, and families are a
significant factor in the health care and well-being of
their individual members.
4. Conversely, families as a whole also impact how
individual members resolve health problems that arise,
and each individual member’s health events and
health practices affect the family as a whole.
5. Health care effectiveness is improved when emphasis is
placed on the family, rather than just on the individual.
Hanson (2001a, 2001b)
 Family as Context
• The first approach to family nursing care focuses on
the assessment and care of an individual client in
which the family is the context.
• The traditional nursing focus, in which the individual
is foreground and the family is background.
• The family serves as context for the individual as
either a resource or a stressor to their health and
illness.
• Most existing nursing theories or models were
originally conceptualized using the individual as a
focus. Alternative labels for this approach are
“family-centered” or “family-focused.”
 Family as Client
• Family nursing care centers on the assessment of all
individual family members; the family as client is the
focus of care.
• The individuals in the family are in the foreground .
The family is seen as the sum of individual family
members. Each person is assessed, and health care
is provided for all family members.
 Family as a System
• The interactions between family members become the target
for nursing interventions that result from the nursing assessment.
• The family nursing system approach focuses on the individual
and family simultaneously.
• The emphasis is on the interactions between family
members—for example, the direct interactions between the
parental dyad or the indirect interaction between the
parental dyad and the child. The more children there are in a
family, the more complex these interactions become.
• The system approach always implies that when something
happens to one part of the system, the other parts of the
system are affected. So, if one family member becomes ill, it
affects all other members of the family.
Family as a Component of
Society
• The family as a component of society, in which the family is
viewed as one of many institutions in society, similar to the
health, educational, religious, or economic institutions.
• The family is a basic or primary unit of society and is a part of
the larger system of society (Figure1–5).
• The family as a whole interacts with other institutions to
receive, exchange, or give communication and services.
FAMILY HEALTH AND ILLNESS CYCLE
Family health promotion and
risk reduction
• This area emphasizes the environmental, social,
psychological, and interpersonal factors
surrounding the family that help promote health
and reduce health risk.
• These factors include family beliefs and activities
that help family members maintain good health by
avoiding behaviors that increase their likelihood of
becoming ill, such as poor diet, lack of exercise, or
smoking.
• Nurses can do a lot to promote family health and to
reduce risk.
Vulnerability and Disease
onset/Relapse
• Life events and experiences that render family
members susceptible to new illness or relapses of
chronic illness. For example, nurses work with family
stress responses related to relapses or exacerbations
of chronic disorders (e.g., diabetes, schizofrenia).
• The development of support groups would be one
nursing strategy for dealing with family members
who have chronic illness.
 Family illness appraisal
• refers to the family’s beliefs about illness and
family decisions about health care.
• An example :
identifying teens who are at high risk for depression
and suicide and encouraging the family to place their
adolescent into a therapy group for depressed
adolescents
 Family acute response
• Refers to the immediate aftermath of illness and is
an important area of intervention.
• The acute response occurs after an extraordinary
event (ex: a heart attack or a diagnosis of
cancer) Families go through disorganization for a
while, and family nurses can intervene by helping
them cope with the crisis.
 Family adaptation to
illness
• The portion of the cycle refers to the long-term
effects of illness on the family and the role of
families in facilitating recovery of individual
members.
• How do families promote the recovery of ill
members while preserving their energy to nurture
other family members and perform other family
functions? An example of an appropriate
intervention would be to help families find respite
care for family caregivers
 Family Nursing Objective:
Levels of Prevention

1. primary prevention
2. secondary Prevention
3. tertiary Prevention
 FAMILY NURSING ROLES
Each health care setting affects roles that nurses assume with
families, and many of these roles may occur in the same setting
as well
 Family Nursing Roles
1. Health teacher/ Teachereducator
• The family nurse teaches about family wellness,
illness, relations, and parenting, to name a few.
• Examples include teaching new parents how to
care for their infant and giving instruction about
diabetes to a newly diagnosed adolescent boy
and his family members.
 Family Nursing Roles
2. Coordinator, collaborator, and liaison.
• The family nurse coordinates the care that families
receive, collaborating with the family to plan care.
• Ex: If a family member has been in a traumatic
accident, the nurse would be a key person in
helping families to access resources—from inpatient
care, outpatient care, home health care, and
social services to rehabilitation. The nurse may serve
as the liaison among these services.
 Family Nursing Roles
3. Deliverer and supervisor of care and technical
expert.
• The family nurse either delivers or supervises the
care that families receive in various settings.
• The nurse must be a technical expert in terms of
both knowledge and skill.
• Ex: the nurse may be the person going into the
family home on a daily basis to consult with the
family and help take care of a child on a respirator.
 Family Nursing Roles
4. Family advocate.
• The family nurse advocates for families with whom
they work;
• The nurse empowers family members to speak with
their own voice or the nurse speaks out for the
family.
 Family Nursing Roles
5. Consultant.
• The family nurse serves as a consultant to families
whenever asked or whenever necessary.
• In some instances, he or she consults with agencies
to facilitate familycentered care.
• Ex: a clinical nurse specialist in a hospital may be
asked to assist the family in finding the appropriate
longterm care setting for their sick grandmother.
The nurse comes into the family system by request
for a short period of time and for a specific purpose
 Family Nursing Roles
6. Counselor
• The family nurse plays a therapeutic role in helping
individuals and families solve problems or change
behavior.
• An example from the mental health arena is a
family that requires help with coping with a long-
term chronic condition, such as when a family
member has been diagnosed with schizophrenia.
 Family Nursing Roles
7. Case finder and epidemiologist.
• The family nurse gets involved in case finding and
becomes a tracker of disease.
• Example: consider the situation in which a family
member has been recently diagnosed with a
sexually transmitted disease. The nurse would
engage in sleuthing out the sources of the
transmission and in helping to get other sexual
contacts in for treatment.
Screening of families and subsequent referral of the
family members may be a part of this role.
 Family Nursing Roles
8. Environmental modifier.
• The family nurse consults with families and other
health care professionals to modify the
environment.
• For example, if a man with paraplegia is about to
be discharged from the hospital to home, the nurse
assists the family in modifying the home
environment so that the patient can move around
in a wheelchair and engage in self-care.
 Family Nursing Roles
9. Clarifier and interpreter.
• The family nurse clarifies and interprets data to
families in all settings.
• For example, if a child in the family has a complex
disease, such as leukemia, the nurse clarifies and
interprets information pertaining to diagnosis,
treatment, and prognosis of the condition to
parents and extended family members.
 Family Nursing Roles
10. Surrogate.
• The family nurse serves as a surrogate by substituting
for another person.
• For example, the nurse may stand in temporarily as
a loving parent to an adolescent who is giving birth
to a child by herself in the labor and delivery room.
 Family Nursing Roles
11. Researcher.
• The family nurse should identify practice problems
and find the best solution for dealing with these
problems through the process of scientific
investigation.
• An example might be collaborating with a
colleague to find a better intervention for helping
families cope with incontinent elders living in the
home.
SEMOGA BERMANFAAT