Chapter 18

Family Development and

Family Nursing Assessment

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 Objectives
 Explain the importance of family nursing in the
community setting.
 Describe family demographics.
 Define family, family nursing, family health, and
healthy/non-healthy/resilient families.
 Analyze changes in family function and
structure.
 Compare and contrast the four family social
science theoretical frameworks.

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 Objectives (Cont.)
 Compare and contrast the four ways to view
family nursing.
 Explain one assessment model and approach in
detail.
 Describe the various barriers to family nursing.
 Share the implications for social and family
policy.
 Discuss issues of families in the future.

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 Introduction
 Trend to move health care to community settings
 Family nursing is a specialty area that has a
strong theory base and is more than just
“common sense” or viewing the family as the
context for individual health care.
 Family nursing consists of nurses and families
working together to ensure the success of the
family and its members in adapting to responses
to health and illness.

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 Family Nursing in the Community
 Family Nursing: consists of nurses and families
working together to ensure the success of the
family and its members in adapting to responses
to health and illness
 Nurses are responsible for the following:
 Helping families promote their health
 Meeting family health needs
 Coping with health problems within the context of the
existing family structure and community resources
 Collaborating with families to develop useful
interventions

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 Family Demographics
 Family Demographics: study of the structure of
families and households and the family-related
events, such as marriage and divorce, that alter
the structure through their number, timing, and
sequencing
 An important use of family demography by
nurses is to forecast stresses and
developmental changes experienced by families
and to identify possible solutions to family
problems.

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 Definition of Family
 Family: refers to two or more individuals who
depend on one another for emotional, physical,
and/or financial support; members of the family
are self-defined
 Nurses need to ask people who they consider to
be their family and then include those members
in health care planning

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 Family Functions
 Economic function
 Reproductive function
 Socialization function
 Affective function
 Health care function

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 Family Structures
 Married family
 Single-parent family
 Multiadult household (with or without children)
 No “typical family” model exits

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 Family Health
 Family Health: a dynamic changing relative state
of well-being that includes the biological,
psychological, sociological, cultural, and spiritual
factors of the family system
 Families are neither all good nor all bad.
 All families have both strengths and difficulties.
 All families have seeds of resilience.

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Four Approaches to Family Nursing
 Family as the context, or structure
 Family as the client
 Family as a system
 Family as a component of society

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 Theoretical Frameworks
for Family Nursing
 Family Systems Theory
 Family Development and Life Cycle Theory
 Bioecological Systems Theory

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 Working with Families
for Healthy Outcomes
 Pre-encounter data collection
 Determine where to meet the family
 Making an appointment with the family
 Planning for your own safety
 Interviewing the family: defining the problem
 Designing family interventions
 Family nursing diagnosis
 Evaluation of the plan

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 Family Nursing Assessment
 Family Nursing Assessment: family problem
areas are identified and family strengths are
emphasized as the building blocks for
interventions.
 Family Assessment Intervention Model
 Family Systems Stressor Strength Inventory
(FS3I)
 Friedman Family Assessment Model

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 Social and Family Policy
Challenges
 Family Medical Leave (1993)
 Social Security and Temporary Assistance to
Needy Families
 Challenges
 Social policies
 Teen pregnancy prevention policies
 School immunization laws
 Medicare and Medicaid (1965)
 Affordable Care Act (2010)

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 Healthy People 2020
 Emphasizes individual and community issues
 Some objectives relate specifically to families or
homes
 See Healthy People 2020 box

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