NUR1020 Chapter 14(12) Family

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  1. 3 perspectives on family nursing
    • context: context of care for an individual person, focus on the ill person, family is resource or a stressor
    • unit of care: wellness of each member is critical to promote family health
    • system: focus on the family as a whole and an interactional system, communication inside and with a larger community
  2. general systems theorie
    focus on interaction between systems and resulting changes-> interactions  between families inside and with other families
  3. suprasystems
    Systems larger than the family
  4. Subsystems
    • Components that fit inside the family,
    • Each system with a particular function e.g. decision maker, peacekeeper...
  5. Structural-functional theories
    Based on developmental theories of Freud, Erikson, and Havighurst-> family roles and interactions

    • 1. Family is a social system with functional with functional requirements
    • 2. Small group possessing features common to small groups
    • 3.accomplishes functions that serve individual and society
    • 4.individual act according to internalized norms

    Focus on outcome, not on process-> meeting financial needs, caring for the old, socialization of kids,...
  6. Family interactional theory
    • Family as unit of interacting personalities,
    • Focus on family roles
    • De-emphasize influence of extern world
    • Focus on interaction and communication of family members
  7. Developmental theorie
    Focus on stage of family

    • 8 stages (see oldest child)
    • beginning family
    • childbearing
    • preschool
    • school age
    • teenagers
    • Young adults
    • postparental
    • aging

    Some families might be in more than one stage, (children spaced far apart, blended families, stepfamilies)
  8. Risk factors for childbearing families
    • adaption to new role -> stress
    • Use of maladaptive coping mechanisms
    • E.g. use of alcohol for stress
    • Neglect' violence
    • addiction
    • Health risks related to pregnancy...
    • Health and safety for mother and infant after labor
  9. Risk factors for families with young children
    • Stress related to finances
    • childcare
    • Concerns regarding development, socialization, education, discipline, nutrition, safety,...
    • Less time to nurture couple's relationship-> risk for marital discord
    • Diseases brought home from daycare
  10. Risk factors for families with adolescents
    • teen risk taking behaviors
    • Developmentally they do not feel the threat of real danger
    • Tobacco, drugs, sexual promiscuity, rebelling against authority,
    • Same time aging parents or grandparents
    • Women at risk for stress,
  11. Risk factors for families with young adults
    • Moving out of house, end of school
    • Jobs, marriages, childbirth-> financial strain-> move back
    • Role strain and poor communication is common
    • New independence can cause anxieties
    • Boundary between adolescence and adulthood is blurred by societal forces, e.g. economy
  12. Risk factors with middle aged adults
    • Examining life goals
    • aging
    • Empty nest
    • New importance on relationship
    • Satisfaction with career
    • Can be a satisfying time with financial freedom, personal growth,...
    • Some people experience stress because of passing youth, self doubt, menopause, death of parents, change in career or relationship

    Midlife crisis - meaning of life, might show signs of depression, anxiety, rebellion

    Long lasting unhealthy behavior shows in middle age, coughing, high blood pressure, elevated cholesterol
  13. Risk factors for families with older adults
    • Falls and trauma
    • Social isolation, loneliness
    • Death of loved ones
    • -> can effect quality of life and clarity of thinking
    • Prolonged grieving-> illness
    • Loss of daily contact of colleagues
    • Functional losses can limit activities, volunteering,
    • Increase of risk for depression

    Forgetting to eat, transportation problem, no money, alter in taste, poor fitting dentures

    Confusion, lose  ability to reason...

    Caregiver role strain

    need to be informed about resources like meals on wheels and home health aids
  14. Poverty and unemployment
    • Struggle to provide basic needs
    • No health insurance
    • Teenage pregnancy often related to poverty
    • Single parent, seasonal work, minimum wage
    • Government support may be cut
  15. Infectious diseases
    • SARS severe acute respiratory syndrom
    • MRSA
    • West Nile virus
    • H1N1 swine flu
    • HIV
  16. Family assessment should include the following
    • Medical data, social and family history, composition, genogram (with health issues), developmental stage, environment and surroundings
    • Structure, patterns, power and roles
    • functions
    • Health believes, values, behaviors
    • strengths
    • Stressors and coping
    • Abuse, violence
  17. genogram
    • Health history
    • Genetic influence seen on
    • Breast cancer
    • alzheimer
    • diabetes
    • Macular degeneration
    • seizures
    • Inflammatory bowel disease
    • lupus
    • Heart disease...

    • To identify individuals at risk for
    • prevention
    • Early detection
    • Tailoring healthcare
    • Evaluating person's response
  18. Data used in a genogram
    • Cause of death
    • Genetically linked diseases
    • Other important health problems

    Three generations or more for environmental or mental health issues, infections, obesity
  19. Assessing families communication patterns
    • observe family interacting
    • who is primary decision maker in family
    • how are decisions made
    • most frequent means of communication, visits, phone, text messaging, religious activities...
    • some members may not be present
    • information might not be true, usually wants to put on "their best face"
    • watch body language , nonverbal expressions among family members
  20. Assessing the Family's coping process
    • stress might have a negative effect on health and healing
    • observe
    • physical indications of stress, anxiety, or loss of sleep
    • relationship and communication patterns (calm or snapping...)
    • family members who are not coping well might avoid visiting (indicator)
  21. Assessing for caregiver role strain
    • relationships can be compromised
    • financial stress
    • ...
    • difficulty performing adequately in the caregiver role

    • observe for dysfunctional communication (e.g. abusive language and aggression)
    • physical injury on patient
    • emotional withdrawing
    • neglect, isolation
    • depressive symptoms and apathy
  22. characteristics of a healthy family
    • state of wellbeing
    • belonging and connectedness
    • clear boundaries with clear responsibilities,
    • trust and respect
    • honesty and freedom of expression
    • spending time together, rituals,
    • relaxed body language
    • flexibility and ability to stress
    • balance of giving and receiving
    • positive communication
    • health promoting life style
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NUR1020 Chapter 14(12) Family
2014-02-17 03:13:13
NUR1020 Chapter 14 12 Family

NUR1020, Chapter 14(12),Family
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