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FAMILY NURSING

ASSESSMENT
Kurnia Rachmawati, Ns., MNSc
Introduction
• Central to the delivery of safe and effective family
nursing care is the nurse’s ability to make accurate
assessments & identify health problems
• Systematic approaches to assess family is
important:
(1) to ensure that the needs of the family are met
(2) to uncover any gaps in the family plan
(3) to offer multiple supports and resources to the family.
Characteristics of Healthy Family:

1. A facilitative process of interaction exists among


family members.
2. Individual member development is enhanced.
3. Role relationships are structured effectively .
4. Active attempts are made to cope with problems
5. There is a healthy home environment and
lifestyle .
6. Regular links with the broader community are
established .
Family Nursing Process

• Family nursing process. Source: Ross (2001).


FAMILY NURSING
ASSESSMENT
MODELS AND INSTRUMENTS
FAMILY NURSING
ASSESSMENT
MODELS AND INSTRUMENTS

Source: Family health care nursing 5th ed, Kaakinen & Tabacco, 2015
Family Genogram
• The family genogram is a format for drawing a family tree that
records information about family members and their
relationships over at least three generations
• It displays the family visually and graphically in a way that
provides a quick overview of family complexities
• How a person fits into his or her family structure influences its
functioning, relational patterns, and what type of family he or
she will carry forward into the next generation
• Families repeat themselves over generations in a phenomenon
called the transmission of family patterns (Bowen, 1985). What
happens in one generation repeats itself in the next
generation; thus, many of the same strengths and problems
get played out from generation to generation. These include
psychosocial and physicaland mental health issues.
Family Genogram
• The diagramming of family genograms must adhere
to specific rules and symbols to ensure that all
parties involved have the same understanding and
interpretations

Source: Family health care nursing 5th ed, Kaakinen & Tabacco, 2015
Source: Family health
care nursing 5th ed,
Kaakinen & Tabacco,
2015
Family Ecomap
• A family ecomap provides information about
systems outside of the immediate nuclear family
that are sources of social support or that are
stressors to the family.
• The ecomap is an overview of the family in its
current context, picturing the important
connections among the nuclear family, the
extended family, and the community around it
Family Ecomap
• The blank ecomap form consists of a large circle with
smaller circles around it
• the family is placed in the center of the larger circle
• The smaller outer circles represent significant people,
agencies, or institutions with which the family interacts
• Lines are drawn between the circles and the family
members to depict the nature and quality of the
relationships, and to show what kinds of energy and
resources are moving in and out of the immediate
family.
Source: Family health
care nursing 5th ed,
Kaakinen & Tabacco,
2015
Source: Family
health care
nursing 5th ed,
Kaakinen &
Tabacco, 2015
The Friedman Family Assessment
Model
• IDENTIFYING DATA
• 1. Family Name
• 2. Address and Phone
• 3. Family Composition: The Family Genogram
• 4. Type of Family Form
• 5. Cultural (Ethnic) Background
• 6. Religious Identification
• 7. Social Class Status
• 8. Social Class Mobility
The Friedman Family Assessment
Model
• DEVELOPMENTAL STAGE AND HISTORY OF FAMILY
• 9. Family’s Present Developmental Stage
• 10. Extent of Family Developmental Tasks
Fulfillment
• 11. Nuclear Family History
• 12. History of Family of Origin of Both Parents
The Friedman Family Assessment
Model
• ENVIRONMENTAL DATA
• 13. Characteristics of Home
• 14. Characteristics of Neighborhood and Larger
Community
• 15. Family’s Geographical Mobility
• 16. Family’s Associations and Transactions With
Community
The Friedman Family Assessment
Model
• FAMILY STRUCTURE
• 17. Communication Patterns
• Extent of Functional and Dysfunctional Communication
(types of recurring patterns)
• Extent of Emotional (Affective) Messages and How Expressed
• Characteristics of Communication Within Family Subsystems
• Extent of Congruent and Incongruent Messages
• Types of Dysfunctional Communication
• Processes Seen in Family
• Areas of Closed Communication
• Familial and Contextual Variables Affecting Communication
The Friedman Family Assessment
Model
• 18. Power Structure
• Power Outcomes
• Decision-making Process
• Power Bases
• Variables Affecting Family Power
• Overall Family System and Subsystem Power (Family Power
Continuum Placement)
• 19. Role Structure
• Formal Role Structure
• Informal Role Structure
• Analysis of Role Models (optional)
• Variables Affecting Role Structure
The Friedman Family Assessment
Model
• 20. Family Values
• Congruence Between the Family’s Values and the
Family’s Reference Group or Wider Community
• Disparity in Value Systems
• Presence of Value Conflicts in Family
• Effect of the Above Values and Value Conflicts on Health
Status of Family
The Friedman Family Assessment
Model
• FAMILY FUNCTIONS
• 21. Affective Function
• Mutual Nurturance, Closeness, and Identification
• Separateness and Connectedness
• Family’s Need-Response Patterns
• 22. Socialization Function
• Family Child-rearing Practices
• Adaptability of Child-rearing Practices for
• Family Form and Family’s Situation
• Who Is (Are) Socializing Agent(s) for Child(ren)?
• Value of Children in Family
• Cultural Beliefs That Influence Family’s Child-rearing Patterns
• Social Class Influence on Child-rearing Patterns
• Estimation About Whether Family Is at Risk for Child-rearing Problems and If So,
• Indication of High-Risk Factors
• Adequacy of Home Environment for Children’s Needs to Play
The Friedman Family Assessment
Model
• 23. Health Care Function
• Family’s Health Beliefs, Values, and Behavior
• Family’s Definitions of Health-Illness and Its
• Level of Knowledge
• Family’s Perceived Health Status and Illness
• Susceptibility
• Family’s Dietary Practices ■ Adequacy of family diet (recommended
• 3-day food history record) ■ Function of mealtimes and attitudes
• toward food and mealtimes ■ Shopping (and its planning) practices ■ Person(s) responsible for planning, shopping,
and preparation of meals
• Sleep and Rest Habits
• Physical Activity and Recreation Practices
• Family’s Therapeutic and Recreational
• Drug, Alcohol, and Tobacco Practices
• Family’s Role in Self-care Practice
• Medically Based Preventive Measures (physicals, eye and hearing tests, immunizations, dental care)
• Complementary and Alternative Therapies
• Family Health History (both general and specific diseases—environmentally and genetically related)
• Health Care Services Received
• Feelings and Perceptions Regarding Health Services
• Emergency Health Services
• Source of Payments for Health and Other Services
• Logistics of Receiving Care
The Friedman Family Assessment
Model
• FAMILY STRESS, COPING, AND ADAPTATION
• 24. Family Stressors, Strengths, and Perceptions
• Stressors Family Is Experiencing
• Strengths That Counterbalance Stressors
• Family’s Definition of the Situation
• 25. Family Coping Strategies
• How the Family Is Reacting to the Stressors
• Extent of Family’s Use of Internal Coping
• Strategies (past/present)
• Extent of Family’s Use of External Coping
• Strategies (past/present)
• Dysfunctional Coping Strategies Utilized (past/present; extent of
use)
The Friedman Family Assessment
Model
• 26. Family Adaptation
• Overall Family Adaptation
• Estimation of Whether Family Is in Crisis
• 27. Tracking Stressors, Coping, and Adaptation Over
Time

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