Chapter 12 ppt

Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
Chapter: 12
Family Assessment

Chapter Highlights
• Definitions of family
• Descriptions of the components of family
• Nursing theory in relation to nursing care of families
• Influence of diversity on family health patterns
• Indicators of family health
• Family dynamics and coping styles
• Vulnerable families

Question
Is the following statement True or False?
Family health practices, routines, and responses to
difficult situations evolve from simple environmental and
interpersonal interactions.

Answer
False
Rationale: Family health practices, routines, and
responses to difficult situations evolve from complex, not
simple, environmental and interpersonal interactions.

Families in Communities
• Two or more persons who share emotional closeness and
identify themselves as members of a family.
• Nurses working with families
– Family assessment
• The process community health nurses make to
appraise family health care needs
• Assessment is holistic and includes examination of
cultural, spiritual, and developmental needs with
biopsychosocial needs

Question
Theory—a group of interrelated statements that is used
to explain, predict, control or understand a phenomenon

Answer
False
Rationale: Theory—a system of interrelated statements
that is used to explain, predict, control or understand a
phenomenon
System—a group that works on the principle that each
part contributes to the way the whole functions

System and Theory
• System—a group that works on the principle that each
part contributes to the way the whole functions
• Theory—a system of interrelated statements that is used
to explain, predict, control or understand a phenomenon

Essence of Family
• Nontraditional families
– Cohabiting couples and families
– Gay and lesbian families

Question
Is the following definition True or False?
Genogram—a diagram used to identify the direction and
intensity of family relationships between members and/or
community institutions of importance to the family

Answer
False
Rationale: Ecomap—a diagram used to identify the
direction and intensity of family relationships between
members and/or community institutions of importance to
the family
Genogram—a diagram of family relationships between
blood relatives that can span two or more generations.
Life events such as marriages, divorces, births, and
deaths are included in the diagram; it is used to identify
relationships as well as possible patterns of disease

Tools That Help Identify Families and
Their Relationships
• Ecomap—diagram used to identify the direction and
intensity of family relationships between members and/or
community institutions of importance to the family.
• Genogram—a diagram of family relationships between
blood relatives that can span two or more generations.
Life events such as marriages, divorces, births, and
deaths are included in the diagram; it is used to identify
relationships as well as possible patterns of disease

Nursing Perspectives on the Family and
Applications for Assessment
• Joyful events add new dimensions to family interactions.
• Children who live apart from their parents might love
their caregivers, yet feel their mother’s absence acutely.
• Family members separated from the nexus of family
interaction retain some connections to the family, albeit
loosely.
• Deceased family members leave an impression long after
their deaths.

Question
What is the time frame that nurses have to complete a
focused family interview?
A. 15 minutes
B. 30 minutes
C. 45 minutes
D. 60 minutes

Answer
A. 15 minutes
Rationale: Focused family interviews of 15 minutes or
less can yield a wealth of information.

Theoretical Approaches to Family in
Community Health Nursing
• Perspectives on family—grand nursing theory
– A nursing theory that is used as a broad explanation
of human experience or environment.
• Family assessment
– Family interview
• Informant person who provides information either
for himself or herself or for someone who is unable
to do so
• Focused family interviews of 15 minutes or less

Five Leading Principles Maximize
Information Gleaned in a “15-minute”
Family Interview
• Manners
• Use of therapeutic conversation
• Ecomaps and genograms
• Use of therapeutic questions
• Acknowledgment of family strengths

Using Conceptual Models of Family
Assessment
• Family health routines and rituals
• Functional health patterns

Diversity and Family
• The relationship between culture, diversity, and family
• Diversity: An evolving concept in families
• Diverse families living in diverse culture

Disharmony within the Family
• Discord when families join
– Interracial marriage
– Arranged marriage
• Gay and lesbian family members

Question
Age is commonly overlooked as a form of diversity; it
accounts for intergenerational diversity.

Answer
True
Rationale: Age is commonly overlooked as a form of
diversity; it accounts for intergenerational diversity.

Intergenerational Diversity
• Baby boom
• War generation
• Generation X
• Generation Y

Families and Health Risk
• Family risk reduction is the process by which either
individual family member or family as a group work
together toward a goal of reducing the probability of
sickness, disability, or death.
• Sources of family risk reduction information

Families with Problems
• Stressful life events
• Death of a family member
• Divorce
• Marital/partner strain
• Legal issues and effect on family life
• Illness, disability, and intrafamily strain
• Pregnancy and childbearing
• Work–family interface
• Homeless mothers and children and other displaced families

Community Health Nurses’ Responsibility
to Families
• Family assessment requires flexibility to include key
informants and for the location and timing of the
interview.
• Family health practices, routines, and responses to
difficult situations evolve from complex environmental
and interpersonal interactions.
• Significant events can put family health at risk.

Chapter 12 ppt

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