Family Nursing – Flashcards
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Family
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2 or more individuals who provide physical, emotional, economical, or spiritual support while maintaining involvement in each others life
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Traditional Families
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Married couples with at least 1 child, husband in work force, wife not employed outside home
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Blended/Step Family
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Single parent marries someone else with or without kids and raises them together
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Extended Family
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Grandparents, aunts, uncles. Sometimes living together in one dwelling.
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Family Nursing
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nursing care that is holistically directed toward the whole family as well as to individual members
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3 perspectives of family nursing
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1) Context 2) Unit of Care 3) System
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Family as the context for care
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Nurse focuses on the one who is ill, views family is either resource or stressor
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Family as Unit of Care
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View family as sum of all individuals Provide assessment and care for all members Direct interventions to individual members rather than the family as a whole
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Family as a system
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Focus on family as a whole and as an interactional system Direct intervention and assessment to communications and interactions between family members Family is embedded in and interacting with a larger community
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Family Systems Theory: Person
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Person, or the family, encounters changes as an inevitable part of "family" over the life cycle Families develop strengths and capabilities to enhance the development of individual members and to protect the family unit during times of transition or change Sub-systems exist within the family
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Family Systems Theory: Environment
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Environment - the family system is viewed as an "open system" and a component of the larger community and society An assumption is that families benefit from and contribute to the network of relationships and resources in the community Harmony is necessary for balance within the individual, family and community Achieving and maintaining harmony with oneself, family, and community are important social goals
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Family Systems Theory: Health
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Health - family "resiliency" or the ability of the family to respond to and eventually adapt to situations and crises encountered over the family's life cycle Resilience is seen as a characteristic families use to achieve balance and harmony If a family is balanced, they are said to be in equilibrium Healthy families are flexible, spontaneous, open to growth and change and responsive to new input In closed family systems, boundaries may be too rigid, making it difficult for other environmental resources to come in Too little input can threaten family stability; depriving individuals of necessary information or support
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Characteristics of Healthy Family Systems:
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Wholeness Interconnectedness Goal setting within the group Boundaries are clear and distinct but not rigid Allows for adaptation Subsystems of the family thrive Spouse subsystems Parent-child subsystems Sibling subsystems Growth and change
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Developmental Family Theory
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Families develop in a logical fashion with predictable stages or milestones along the way At each stage, there are specific tasks that must be accomplished before the family unit can move forward 1) Beginning Family - Marriage 2)Early Childbearing - Having Babies (birth-30 mths) 3)Families with Pre-school children (2 1/2-5) 4)Families with school age children (5-13) 5) Families with Adolescents (13-20) 6) Launching Children 7) Families in the middle years 8) Families in Retirement
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Structural Functional Family Theory
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Structure Elements of the Family: Family Members Family Roles Family Values Family Communication Patterns Family Power Structure Structural elements affect a family's ability to perform functions that ensure continued survival and influence family health Affective, Reproductive, Socialization, Economics, Provision of needs (healthcare)
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Structural Functional Family Theory : Affective
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Meets emotional needs of family
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Structural Functional Family Theory : reproductive
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Ensuring survival of family and society across generations
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Structural Functional Family Theory : Socialization
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to educate family members as contributing members of society and to instill family attitudes and values
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Structural Functional Family Theory : Economics
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To provide family resources sufficient of family needs
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Structural Functional Family Theory : Provision of Need
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to meet family members' needs for food, shelter, clothing, health care (Maslow)
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Challenges to Family Health
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Poverty and Unemployment Infectious Disease Chronic Illness Homelessness Violence and neglect within family
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Genomics
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Study of human genes and their function, including interactions among other genes and the environment
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Genogram
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Pictorial tool use to display the relationship of family members with pertinent health-related information
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Caregiver Role Strain
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caused by physical, emotional, and time demands involved with taking care of family members who are chronically ill, disabled, or frail
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Developmental family theory: Childless and childbearing couples
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Adapting to new roles creates stress due to new marriage, trying to get pregnant, and inexperienced parents Risk of maladaptive coping mechanisms such as alcohol or drugs puts family at risk of abuse and neglect Health risks include miscarriage, issues with pregnancy and birth, genetic defects, mom and baby health and safety
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Developmental Family Theory: Families with Young children
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Financial stress due to childcare major source of financial stress for parents working outside home Parenting concerns: child development, socialization, education, discipline, nutrition, sleeping and toileting Stress of finding time to nurture couples relationship Risk to family health due to contagious disease from other kids at school Importance of immunizations for all children
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Developmental Family Theory: Families with adolescents
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Teen risk taking behavior Developmentally adolescents do not feel threat of risk taking behavior Alcohol, tobacco, drug use and extreme stunts, rebelling, and sexual promiscuity risk parents may be dealing with aging parents at same time Sandwiched between raising children and caring for aging parents leading to stress, especially for women who tend to provide majority of care
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Developmental Family Theory: Families with young adults
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Children move out, may get married and start families of their own children experience tight finances, may result in child moving home which may cause stress on both parents and children with budding family role strain or new opportunity for family attachment Newfound independence may be exhilarating or anxiety provoking boundary between adolescents and adulthood blurred Families must find ways to adapt
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Developmental family theory: Families with middle ages adults
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Time to examine life goals and cope with aging and empty nest spousal relationship quality may take on new importance Issues with own health as well as aging parents take front seat can be satisfying time with career success, financial security, and social comfort self exploration and personal growth some experience emotional strain due to aging, and time of self doubt May experience many losses such as parents, children leaving home, and changes in career Midlife crisis- intense questioning about the meaning of life Longstanding unhealthy behaviors become apparent - tobacco causing lung congestion individual health impacts family health
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Development of families: Families with older adults
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Falls and trauma are common health risk Risk for social isolation and loneliness due to loss of relaitonships Coping with death of spouse family, friends, Prolonged grieving may lead to illness Retirement may bring the simpler life that is desired Functional loss may cause reduction in physical activity Good nutrition and hydration important
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Compromised nutrition of older adults due to:
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forgetting to eat inadequate or unreliable transportation lack of money to buy food physical changes that alter taste loss of appetite poorly fitting dentures
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Developmental Family Theory Tasks: Stage 1 Beginning a Family
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Establish a marriage Develop new extended family networks Engage in family planning
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Developmental Family Theory Tasks: Stage 2 Early Childbearing
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Establish a stable family unit that includes a child/children Reconcile conflict in family and individual tasks Facilitate accomplishment of individual member's developmental tasks
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Developmental Family Theory Tasks: Stage 3 Families with Pre-school children
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Integrate additional children into family Develop new relationships with extended family Distribute child-rearing, household and financial tasks Socialize children to familial and societal roles Begin separation from children
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Developmental Family Theory Tasks: Stage 4 Families with School-age Children
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Increase separation from children Foster education and socialization of children Maintain stability of marital relationship
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Developmental Family Theory Tasks: Stage 5 Families with Adolescents
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Negotiate changes in parent-child relationships to promote independence Maintain family communication channels Maintain family standards Continue work to maintain stability of marriage
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Developmental Family Theory Tasks: Stage 6 Launching Children
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Promote children's independence Integrate children's spouses into family Accommodate in-laws and grandchildren Restore marital relationship Develop outside interests Assist aging parents
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Developmental Family Theory Tasks: Stage 7 Families in the Middle Years
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Accept changes in generational roles Cultivate leisure activities Provide a healthful environment for aging Sustain satisfying relationships with own parents and children
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Developmental Family Theory Tasks: Stage 8 Families in Retirement
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Maintain satisfying living arrangements Adjust to decreased income Adjust to loss of spouse, relatives and friends
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Family Systems Theory
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A goal-directed unit made up of interdependent, interacting parts that endure over a period of time The family is a living system that typically extends over at least 3 generations Open family system - Welcomes new ideas, information, and resources, works through day-to-day issues, perceives change as normal and desirable Closed family system - Views change as threatening and is resistant to it; family may be rigid, and do not seek exchange with other systems to change, adapt and grow Family adaptation is the capacity of the family and its members to modify their behavior to changing demands (inside or outside the family)
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Family Systems Theory 2
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Family consists of subsystems (either individual family members or relational subsystems); including spouse subsystem, parent-child subsystem, and sibling subsystem "Healthy family" - characterized by being highly flexible and tolerant of internal changes, highly autonomous, and has open exchange of resources, energy, and information with the outer environment Stress causes family homeostasis to become precarious and family members try to regain the family unit's balance: Stable family system under stress will move in the direction that tends to minimize stress
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Family Developmental Theory Review
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Family behavior is the sum of the previous experiences of family members as incorporated in the present and expectations for the future. Families develop and change over time in similar and consistent ways. Families and their members perform certain time-specific tasks that are set by them and by cultural and societal contexts. Theorists have identified predictable developmental stages of the family (example: Duvall) Beginning Launching Young Adults Childbearing Middle-aged Parents Preschool Aging School-age Teenagers Serious illness or stressors may impede a family's ability to meet its family developmental tasks. Family nursing interventions are aimed at helping families accomplish the developmental tasks associated with each stage in the family life cycle.
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Structural Functional Theory of Family Review
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Family viewed as open system and a subsystem within society. Family has basic purposes or functions: Affective function Socialization/social placement function Economic function Reproductive function Health Care function It is very important for the family to adequately fulfill each of these functions for the welfare of the family and society. The family has structural dimensions that are interactive and arrange the family system so that it functions as a whole: Family power structure Family role structure Family communication Family values These structural and functional dimensions are very interactive and interdependent on each other.
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Healthy Families:
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Communicates and listens Affirms and supports members Teaches respect for others Develops a sense of trust Has a sense of play and humor/leisure time Balance of interaction between members Demonstrates shared responsibility Teaches sense of right and wrong Participates in celebrations and rituals Shares a religious core Values service to others
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Assessing Family Health
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When working with families, the nurse is often responsible for assessing the health of the family Assessment must be holistic and inclusive of cultural, developmental, and spiritual needs Family health is an attribute of the family as a unit and is more than the sum of the health of individual family members
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Family Assessment
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Relevant medical data, social, family history for individuals within the family Family composition Family genogram identifies health issues Family history and developmental stage Look at environment and surroundings Family structure - communication patterns - power and role structures Family functions Health beliefs - values - behaviors Family strengths Family stressors and coping
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Relationships: The heart of the matter in nursing
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The Family - Nurse Relationship: Reciprocal Non-hierarchical Both have special "expertise in maintaining health and managing health problems Both bring strengths and resources Rely on feedback processes
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Key ingredients of the family Interview
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Manners Therapeutic conversation Family genograms and ecomaps Therapeutic questions Commending individual and family strengths
