Question

How to assess a family in nursing?

Answer 1

Family health care nursing uses (to provide adequate care of diverse family populations):

-Assessment
-Clinical judgement
-Creativity
-Critical thinking
-Evaluation
-Reflective process

Steps of family nursing process:

1. Assessment of family story
-gather data from variety of sources to see whole picture of family experience
2. Analysis of family story
-clusters data into meaningful patterns to see how family is managing health event
-family needs prioritized using Family Reasoning Web
3. Design of family plan of care
-nurse & family determine best plan of care for family to manage situation
4. Family intervention
-nurse & family implement plan of care incorporating most family-focused, cost-effective, & efficient interventions to assist family to achieve best possible outcomes
5. Family evaluation
-nurse & family determine if outcomes are being reached or need to be redesigned
-care plan working, new care plan, or nurse/family relationship need to end?
6. Nurse reflection
-critical, creative, & concurrent reflection (yourself, own family experience, family client & work w/ family)

- The family assessment begin at the moment of contact or referral.

Assessment of family in Nursing:

Family Assessment & Intervention Model

1. Family system stressors- general
2. Family stressors- specific
3. Family system strengths

Friedman Family Assessment Model: categories

1. ID data
2. Developmental stage & family Hx
3. Environmental
4. Family structure
5. Family functions
6. Family stress & coping

Friedman Family Assessment Model: Assumptions

1. family is social system w/ functional requirements
2. family is small group possessing certain generic features common to all small groups
3. family is a social system accomplishes function that serve the individual & society
4. individuals act in accordance w/ set of internalized norms & values that are learned primarily through socialization

Calgary Family Assess Model: framework

1. family system is part of larger suprasystem is also composed of many subsystems
2. family > as a whole than sum of parts
3. change in one family member affects all family members
4. family able to create balance b/t change & stability
5. family members' behaviors are best understood from perspective of circular rather than linear causality

Appropriate assessment instrument selection:

-written in uncomplicated language (5th grade level)
-10-15 min. in length
-easy to score
-valid data to base decisions
-sensitive to sex, race, social class, & ethnic background

Family Genogram & Family Ecomap benefits

-visual diagrams of current family story & situation
-help guide family plan of action & selection of interventions
-therapeutic for family

Family Genogram

-records info about family members & relationships over at least 3 generations
-helps nurses & families see & think systematically about families
-addresses impact of health event on: family structure, function & process
-diagramming of family generations must adhere to specific rules & symbols (assures all parties involved have same understanding & interpretations)
-NOT a family genetic pedigree

Family Genogram Interview data collections:

1. Identify
-who is in immediate family
-person who has health problem
-all people who live w/ immediate family
2. Determine how all people are related
3. Gather info on each family member
-age
-sex
-correct spelling of name
-health probs
-occupation
-dates of relationships (marriage, separation, divorce, living together)
-dates & age of death
4. same info for all family members across each generation for consistency & reveal patterns of health & illness
5. add info relative to situation (geographic location & interaction patterns)

NANDA nursing Diagnosis relevant to family nursing:

-risk for impaired parent/infant/child attachment
-caregiver role strain
-risk for caregiver role strain
-parental role conflict
-compromised family coping
-disabled family coping
-readiness for enhanced family coping
-dysfunction family process: alcoholism
-readiness for enhanced parenting
-impaired parenting
-risk for impaired parenting
-relocation stress syndrome
-ineffective role performance
-ineffective family therapeutic regimen management

Family Nursing Interventions

1. Brief therapeutic conversations in acute care
2. Home visits & telephone support
3. Self-care talk for family caregivers

Family Nursing Evaluation

1. measured outcomes vary
2. simplify daily charting
3. team revision & modification to action plan
4. barriers to outcomes

Family Nursing Reflection
(final step)

1. facilitates evaluation
2. increases expertise of nurse
3. learn from mistakes