Chapter 12 ppt

Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Chapter: 12Family Assessment


Chapter Highlights

• Definitions of family

• Descriptions of the components of family

• Nursing theory in relation to nursing care of families

• Influence of diversity on family health patterns

• Indicators of family health

• Family dynamics and coping styles

• Vulnerable families


Question

Is the following statement True or False?

Family health practices, routines, and responses to difficult situations evolve from simple environmental and interpersonal interactions.


Answer

False

Rationale: Family health practices, routines, and responses to difficult situations evolve from complex, not simple, environmental and interpersonal interactions.


Families in Communities

• Two or more persons who share emotional closeness and identify themselves as members of a family.

• Nurses working with families

– Family assessment

• The process community health nurses make to appraise family health care needs

• Assessment is holistic and includes examination of cultural, spiritual, and developmental needs with biopsychosocial needs


Question


Theory—a group of interrelated statements that is used to explain, predict, control or understand a phenomenon


Answer

False

Rationale: Theory—a system of interrelated statements that is used to explain, predict, control or understand a phenomenon

System—a group that works on the principle that each part contributes to the way the whole functions


System and Theory

• System—a group that works on the principle that each part contributes to the way the whole functions

• Theory—a system of interrelated statements that is used to explain, predict, control or understand a phenomenon


Essence of Family

• Nontraditional families

– Cohabiting couples and families

– Gay and lesbian families


Question

Is the following definition True or False?

Genogram—a diagram used to identify the direction and intensity of family relationships between members and/or community institutions of importance to the family


Answer

False

Rationale: Ecomap—a diagram used to identify the direction and intensity of family relationships between members and/or community institutions of importance to the family

Genogram—a diagram of family relationships between blood relatives that can span two or more generations. Life events such as marriages, divorces, births, and deaths are included in the diagram; it is used to identify relationships as well as possible patterns of disease


Tools That Help Identify Families and Their Relationships

• Ecomap—diagram used to identify the direction and intensity of family relationships between members and/or community institutions of importance to the family.

• Genogram—a diagram of family relationships between blood relatives that can span two or more generations. Life events such as marriages, divorces, births, and deaths are included in the diagram; it is used to identify relationships as well as possible patterns of disease


Nursing Perspectives on the Family and Applications for Assessment

• Joyful events add new dimensions to family interactions.

• Children who live apart from their parents might love their caregivers, yet feel their mother’s absence acutely.

• Family members separated from the nexus of family interaction retain some connections to the family, albeit loosely.

• Deceased family members leave an impression long after their deaths.


Question

What is the time frame that nurses have to complete a focused family interview?

A. 15 minutes

B. 30 minutes

C. 45 minutes

D. 60 minutes


Answer

A. 15 minutes

Rationale: Focused family interviews of 15 minutes or less can yield a wealth of information.


Theoretical Approaches to Family in Community Health Nursing

• Perspectives on family—grand nursing theory

– A nursing theory that is used as a broad explanation of human experience or environment.

• Family assessment

– Family interview

• Informant person who provides information either for himself or herself or for someone who is unable to do so

• Focused family interviews of 15 minutes or less


Five Leading Principles Maximize Information Gleaned in a “15-minute” Family Interview• Manners

• Use of therapeutic conversation

• Ecomaps and genograms

• Use of therapeutic questions

• Acknowledgment of family strengths


Using Conceptual Models of Family Assessment

• Family health routines and rituals

• Functional health patterns


Diversity and Family

• The relationship between culture, diversity, and family

• Diversity: An evolving concept in families

• Diverse families living in diverse culture


Disharmony within the Family

• Discord when families join

– Interracial marriage

– Arranged marriage

• Gay and lesbian family members


Question


Age is commonly overlooked as a form of diversity; it accounts for intergenerational diversity.


Answer

True

Rationale: Age is commonly overlooked as a form of diversity; it accounts for intergenerational diversity.


Intergenerational Diversity

• Baby boom

• War generation

• Generation X

• Generation Y


Families and Health Risk

• Family risk reduction is the process by which either individual family member or family as a group work together toward a goal of reducing the probability of sickness, disability, or death.

• Sources of family risk reduction information


Families with Problems• Stressful life events

• Death of a family member

• Divorce

• Marital/partner strain

• Legal issues and effect on family life

• Illness, disability, and intrafamily strain

• Pregnancy and childbearing

• Work–family interface

• Homeless mothers and children and other displaced families


Community Health Nurses’ Responsibility to Families

• Family assessment requires flexibility to include key informants and for the location and timing of the interview.

• Family health practices, routines, and responses to difficult situations evolve from complex environmental and interpersonal interactions.

• Significant events can put family health at risk.

Chapter 12 ppt

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