what is the primary focus of nursing care in the “family as context” approach? This is a topic that many people are looking for. amritsang.org is a channel providing useful information about learning, life, digital marketing and online courses …. it will help you have an overview and solid multi-faceted knowledge . Today, amritsang.org would like to introduce to you Family Dynamics. Following along are instructions in the video below:
Morning nurses im here to talk about family dynamics and were gonna briefly briefly touch on genetics genomics. Very briefly at the end and lots of good information. This power in this powerpoint and in this presentation.
So remember that family really continues to be a central institution in american society. And even though our definition of family might have changed. We still hear a lot of what we do towards family.
So our outcomes. Today are to examine current family trends. Common family forms and life cycles to identify factors that influence family forms to discuss the impact of health and illness on family relationships and roles and hopefully in clinical you got a good start on being able to assess family involvement in care of the residents in the long term care and then to identify genetic factors that influence the health of a family so theres a video here well let me come back here so definition of family is a set of interacting individuals related by blood marriage or adoption.
Who usually live together and fulfill functions of socialization division of labor and economic provisions and cooperatively meet effective emotional needs of the family within the family unit. So it doesnt have to be a legal adoption. Your family can be you can be adopting friends along the way as well so lots of different definitions of family and so as we go through you can think about who is your family who do you include in your family.
What strengths resources weaknesses and challenges are part of your family with which family members do you share health decisions. And thats gonna help think about your experience and how start to consider how those things work in other families your patients families. So here is a video you can watch that on your own with the link in moodle and so well talk about family forms.
So a nuclear family consists of a husband and a wife and maybe one or two or more children extended family includes relatives like aunts uncles cousins grandparents in addition to the nuclear family a single parent family is formed when one parent either. When one parent leaves. The nuclear family because of death divorce or desertion.
Or when a single person has a child whether through birth through adoption through. However a blended family is formed when parents bring unrelated children from prior relationships into a new joint living situation. An alternative family can include a multi adult household.
A skip generation family so an example of that would be grandparents raising grandchildren communal groups with children non families are so just adults living alone together and cohabitating partners family is a network of individuals regardless of actual biological or legal ties family trends and forms in the united states. The impact health care of the family and the individuals in the family divorce. Rates have tripled since the 50s and it is estimated that 50 of all marriages will end in divorce.
So this does affect health of children and of parents. The number of single parent families appears to stabilizing at about 26 of families with children. Although mothers had 83 of single parent households.
Father only families are on the rise 41 of children are living with mothers who have never married many of these children result from adolescent pregnancy. The majority of adolescent mothers continue to live with their families. A teenage pregnancy.
Tends to have long term consequences for the mother. And often severely stresses family relationship and resources. In addition.
Theres an increased risk for content for poverty for the family. Although unable to marry by law in all states homosexual couples define their relationship and family terms as they should approximately half of all gay male couples live together compared with 3 4 of female gay couples so when we look at what what influences family forms in other words. What makes up the family we tend to look at several areas.
The first is almost the biggest which is changing economic status families at the lower end of the income scale or lower socioeconomic status and single parent families are vulnerable they have fewer resources they might have no health insurance or they are under health in short and they have difficulty accessing healthcare. Homelessness is the fastest growing segment of the homeless population as families with children.
Which is really scary. This includes a complete nuclear family and single parent family children of homeless families are often in fair or poor health usually they only have access to health cares through emergency departments. Homeless adults.
Ill tend to have poor nutrition and limited access to health care as well one thing. I want to mention here is dental care for homeless families homeless people they often have poor dental care and poor dental hygiene. Which can lead to increased health problems.
Overall domestic violence. The cause of family violence is complex and multi dimensional stress poverty social isolation psychopathology substance abuse and learned family behavior are all associated with violence. Each family is unique in its structure.
The function of family is also multi dimensional its physical maintenance of the people in the family. It is provides protection provides a nurturing socialization education reproduction and recreation. When we want to look at the family and talk about who is in the family who performs tasks and makes decisions.
Theres a really good table in your textbook on page 651. Which is focused patient and family assessment. And when one of the biggest questions that i have asked as a nurse.
A lot of the time is resources. And theres some really great questions such as do you have relatives and friends who do not live with you in your home who can support you how do you cope. How does your family.
Cope with illness. And those are really good questions to ask especially if you observe a lot of conflict in the family developmental stages of the family. Just like individuals just like we talked about in growth and development families go through meant to and there is a basic pattern and similarity and experience resulting in predictable stages.
And if you look in your textbook. Page 648 stages of the family cycle. Youll see something that looks fairly similar to our growth and development stages.
And you can take a look at those i think it is important to know you know were starting with unattached young adults. Joining of families family with young children family with adolescents. Now there are some families who never end up having children and they are still families they just go through the stages.
Differently. Each of those stages has its own challenges needs and resources and includes tasks that need to be completed both before the family is able to successfully move on to the next stage multiple factors influence the health of a family social resources economic resources location and environment as well as genetic factors family beliefs values culture and practices influence health promotion and disease prevention. Some families do not place a high value on good health whether that could be nutrition exercise smoking oral oral hygiene another example genetic factors reflect a familys heredity or genetic susceptibility to a disease that may or may not result in actual development of the disease.
Hardiness and resiliency are factors that moderate a family stress family hardiness is the internal strength and durability of family of the family unit resiliency helps to evaluate healthy response and coping when individuals and families are experiencing stressful events. There are different approaches for family nursing practice. Family is context.
Where your primary focus is on the health and development of an individual member of the of the family existing within a specific environment. Although you focus the nursing process on the individuals health status. You also assess the extent to which the family provides.
The individuals basic needs. Family is patient the family processes in relationship for example.
Parenting or family caregiving. Are your primary focus of care. So you focus your nursing assessment on family patterns versus individual member characteristics and then family as a system is a newer model and includes both relationship relational and transactional concepts when you care for the family as a system you are caring for each family member.
Which is family as context and the family unit. Which is the family as patient using all community social and psychological resources. So overall.
The family is influenced by resources location and environment beliefs values and culture. Hardiness and resiliency and we can influence family stress. As nurses and then genetic factors.
So i missed a slide here family and health continued. So families are also influenced by acute and chronic illness and as a nurse. We can help the family prevent or manage medical crisis.
We can identify resources for the family or individual members within the family when it comes to trauma. We need to make sure that trauma is an unplanned event and family members need to cope with the challenges of a severe life threatening event. Which can include the stressors associated with an intensive care environment anxiety.
Depression and economic burden. Not to mention the impact on the familys functioning and decision making end of life care at times. A family member becomes terminally ill.
Even if family members are prepared for their loved ones death their need for information. Support assurance and presence are great so remember the nursing process is the same. Whether the focus is family as patient context or system areas included in familys s.
Mint are form structure and function of the family its developmental stage and its progress toward accomplishment of the developmental tasks you begin assessment by considering the views of a patient toward the family family structure. Provides information about composition of the family. So whether its a nuclear family or extended family or skip generation.
Whos the head of the household who earns the money and brings resources into the family. How decisions are made including health decisions. Who maintains the household and environment for the family to assess family functioning.
Ask questions to determine the power structure and patterning of roles and tasks families culture. Influences structure and function. Health practices and family celebrations.
Help you design family centered care to determine the influence of culture on a family. You ask a patient about his or her cultural background. When you establish a relationship with the family.
It is important to identify potential and external resources together with your patient. And his or her family develop. A plan of care that all members clearly understand and on which they mutually.
Agree you base a positive collaborative relationship on mutual respect. And trust.
When assessing a community. You determine the presence of health care resources. Proximity of emergency services and municipal services like meals on wheels low income housing etc.
Families like individual patients have expectations for care. Some families expect to be consulted as a whole unit when discussing care of a loved. One and others wish to have a designated decision maker determining expectations early in the assessment helps to avoid problems resulting from misunderstandings in the future.
So again to assess a family youre gonna use those those focused patient and family assessment on page 651 questions and look at those resources their patterns. And what is the function. Sometimes a family has a short lived function and sometimes its long term.
And you want to know how illness changes that family setting priorities focuses on a patient. A patient family unit or a family alone. It is imperative that family and patient clearly understand and agree on the plan of care and priorities.
Because the priorities for a patient and the priority for the family are sometimes different collaboration with all appropriate family members when planning care is essential by offering alternative actions and asking family members for their own ideas and suggestions you may help reduce the familys feeling of powerlessness collaborating with other disciplines such as physical therapy or social services increases the likelihood of a comprehensive approach to the familys healthcare needs and ensures better continuity of care. So as a nurse activities. Were doing with families and patients and families our health promotion activities and when we think about topics.
But for health promotion activities. It helps to look at that family developmental stage are their young children teenagers and the house are there no children is there a chronic disease in the end the family things like that that we can really help them recognize their strengths. When especially when were using that family centered care and the ability to work together.
And sometimes we can really help a family tear down some walls they have together that synergy model is really believing that when we are providing patient centered and family centered care that we really are integrating our skills and knowledge to have the that what we need is the best care to help that patient and family work together with the nurse and that creates a synergy and the patient outcomes are better. When we have that synergy. Discharge planning.
Which begins on admission definitely in acute care sometimes in long term care. Its not a plan for the patient to be discharged. So that is an option as well communication between decision makers whether thats the head of the household.
The patient or together that communication is very important and then family caregiving. We do a lot of that because we have an aging of our population. And there are a lot of families whose children are taking care of aging parents.
Adult children. Obviously they are we have what we call the sandwich generation. Which is taking care of older parents and younger children.
We have a lot of younger adults who continue to live at home for economic reasons. Mostly and so theres a lot of family nursing. That goes on that we just dont realize when a patients family functions.
As the context. The evaluation focuses on attainment of the patient needs. The evaluation is patient centered.
Although nursing measures have involved helping the family adapt to the new normal when the patient when the fam re when the family is the patient. The measure of family health is more on an evaluation of health of all family.
Members you evaluate a familys change in functioning and its satisfaction with the new level of functioning. When you care for family as a system evaluation focuses on effects that interventions have on the entire family including extended family. Often evaluation is an ongoing process.
It is important to obtain the families perspective of nursing care. How you planned and delivered the care for them whether it was satisfactory whether it you had the outcomes. You were striving for and whether it met the fair.
My goals so i want to switch gears a little bit to talk about genetics and genomics. So first of all genetics is the study of heredity. The study of genes and so examples of that would be studying diseases like huntingtons disease.
Which is the nervous affects the nervous system von willebrands disease which affects blood and you really need to get a thorough family history. When you are studying genetics and its not just blood. Its that family history thats really important so communication.
When youre studying genetics. Extremely important. Theres a really good.
Article in moodle. Thats called genetics in the clinical setting that might help you understand the nursing implications for genetics. A little bit better.
And im gonna talk about genomics for a moment. So. Theres a video for you to watch that help probably explains it much better than i can.
But we know that genomics is not is more than just the study of genetics. So genomics is the study of all the genes in the person. And the interaction of those genes with one another and with that persons environments so genomics influences healthcare because providers can determine how genomic changes contribute to patient conditions and influence treatment decisions.
So and let me answer the next question and then well talk about an example genomics can determine risk for diseases and the patient can receive counseling. Before a disease or process or illness occurs nurses need to learn how this works and continue to stay informed. Because technology is increasing all the time so one example of the study of genomics is generational trauma.
So i dont know if youve heard that term before but generational trauma is something they happens to a group of people. And theres a couple examples out there that we can look at and one is native americans and another would be jewish european jewish population after world war two and when we see those genes. It is not that the genes themselves have changed.
But that there are chemical changes that happen that affect how the genes function and so. The question is is there for example in the european jewish population after world war two and descendants of those people do they have an increased risk for anxiety depression or other mental illnesses. That could have been caused by what happened just before and during world war two to them.
And so theres been a whole list of studies done and theres so much more information coming out about how genomics influences. The health of a person and i hope to continue to learn about that as we go through in time so. Thats it for family dynamics.
And i will see you in class. .
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