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65 Cards in this Set
- Front
- Back
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What can be defined as a "Social Construct"? a.) Individual People b.) Groups of People c.) A Unit d.) Family |
d.) Family |
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What is the difference between structure and function?
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Function: What do they do? |
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According to the census definition (structural definition) All of these family dynamics are correct except? a.) An intact family where children came BEFORE the current relationship. b.) Common- law couple (with/without children) c.) A lone parent with one or more children (any status) d.) Common- law or married couple of the same sex e.) Married couple (with/without children) |
a.) An intact family where children came BEFORE the current relationship. |
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According to Wright and Leahey (2013 p. 24) In accordance with the functional definition: There are 5 critical attributes that define what a family is. Which is not one of them? a.) The family is a system or unit. b.) It's members may or may not be related and may or may not live together. c.) The family is who they say they are. d.) The unit may or may not contain children. e.) There is a commitment and attachment among unit members that include future obligation. f.) The unit careging functions consist of protection, nourishment, and socialization of it's members. |
c.) The family is who they say they are. ~ Correct but this is the definition NOT one of the 5 characteristics. |
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What is a border baby? a.) A baby who is thought have borderline personalities. b.) A baby who is born and is then given up for adoption. (the family of this baby are the nurses) c.) A baby who's adoption is planned. d.) A baby who stays with the biological parents. |
b.) A baby who is born and is then given up for adoption. (the family of this baby are the nurses)
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Family health is a dynamic changing state of well- being, which includes....
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Psychological Spiritual Sociological Cultural Factors - of individual members and the whole family system. |
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What are the5 critical attributes of a family? |
1. Family isa system or unit 2. Itsmember may or may not be related or living together 3. The unitmay or may not contain children 4. There iscommitment and attachment among unit members that include future obligation 5. The unitcaregiving functions consist of protection, nourishment, and socialization ofits members |
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What isfamily health? |
Familyhealth is a dynamic state of well-being which includes the biological,psychological, spiritual,sociological, and cultural factors of an individual members and whole familysystem. |
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What does the nurse examine when working with families? |
In nursing families, the nurse examines individual health and how family health influences the individual and vise versa |
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What are theRNAO best practice guidelines for supporting and strengthening families through unexpectedevents? |
1. Developan empowering partnership with families 2. Assessfamilies in the context of the event (perceptions, structure, environment and strengths) 3. Identifyresources and supports 4. Education 5. Sustainfamily-centered practice 6. Implementinterdisciplinary family-centered practice in the health care setting 7. Advocatefor change in public policy |
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What are thefour approaches to Family nursing practice? |
1. Family ascontext 2. Familyunit as client 3. Familysystems nursing 4. Familygroups |
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Describe family as context |
nursing care focuses on the individual as client, family as context of the individual, family may be a stressor or a resource, also called family-centered care |
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Describe Family unit as client/patient |
members assessed separately, NP practice, community care |
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Family Systems Nursing |
family is the client, viewed as an interactional system, reciprocity, impact. |
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Family Groups in Society |
families are a subsystem of larger systems in the community, society, common issues, trends |
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Whichapproach to family nursing do we use? |
Familysystems nursing (family is the client, viewed as an interactional systeminvolving reciprocacityand impact) |
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What are thesix theoretical foundations of CFAM? |
1. Postmodernism 2. Systemstheory 3.Cybernetics 4.Communication theory 5. Changetheory 6. Biologyof cognition |
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What ispost-modernism? |
- Valuespluralism – acknowledges that many world views and explanations exist. - It is adebate about knowledge – question assumptions. Question knowledge - Used inCFAM: value all versions of the story and everyone’s experience ofillness/suffering |
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describe systems theory |
- A systemcan be defined a complex of elements in mutual interaction. - Allows usto view family as a unit, rather than focusing on individuals only - A familysystem is part of a larger suprasystem and is composed of many subsystems. Seen inCFAM: 1.Individuals and the whole - subsystem; parent-child, marital, sibling - these subsystems are composed of subsystems of individuals which are further divided (physical, cognitive/psychological) 2. Family asa whole is greater than the sum of its parts - Context,emphasize wholeness 3. Change in1 family member affects all 4. Familiescreates balance between change and stability - Familiesare in a constant state of flux. 5. Familiesmember’s behaviors are best understood from a view of circular rather than linearcausality Basicconcepts; 1. All partsof the system are interconnected 2. The wholeis more than the sum of its parts 3. Allsystems of some form of boundaries or borders between the system and itsenvironment 4. Systemscan be further organized into subsystems |
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Discuss theuse of boundaries in Systems theory |
Allsystems have some form of boundaries or borders between the system and theenvironment Familiescontrol the information and people coming into its family system to protectindividual familymembers or family as a whole Boundariesare a continuum from permeable to limiting Toopermeable and the system loses identity and integrity (members too open tooutside input) Toolimiting and necessary interaction with outside world is shut off Flexibleboundaries; allow control and selectively open or close to gain balance or adaptto the situation |
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“________”are understood best within their larger context a. Families b.Individuals c. Societies d. Systems |
Answer; B By studyingthe whole family it is possible to observe interaction among family memberswhich more oftenfully explains family member functioning |
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What is thegoal of systems theory? |
Help familyreach stability by building on strengths as a family, using knowledge of thefamily as a socialsystem, and understanding how family is interconnected whole that is adaptingto health eventof a family member. |
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What iscybernetics? |
Science ofcommunication and control theory - Shiftsfocus from substance (what is being said) to form (how it’s being said) 1. Familysystems possess self-regulating ability (feedback loops) 2. Feedbackprocesses can simultaneously occurs at several system level within family |
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Describecommunication theory |
Focuses onhow individuals interact with one another Allnon-verbal communication is meaningful Digital;verbal communication Analog;non-verbal communication A dyadicrelationships has varying degrees of symmetry and complementarity Allcommunication has two levels 1.Complementary relationship unequal. One appears superior eg; mother-child 2.Symmetrical relationship; ppl behave as though they have equal status.Competitive 1. Content;what is being said 2.Relationship; the relationship of those interacting |
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DescribeChange theory |
* Firstorder change; the system remains unchanged but the elements or parts undergosome type ofchange; eg limiting money as punishment * Secondorder change; actual changes in the rules governing the system must occur.Structure is transformed 9 conceptsof change theory; 1. Change isdependent on perception of the problem. 2. Change isdetermined by structure 3. Change isdependent on the context 4. Change isdependent on co-evolving goals for treatment 5.Understanding alone does not equal change 6. Changedoes not always occur equally in all family members 7.Facilitating change is the nurse’s responsibility 8. Changeoccurs by fitting interventions offered by nurse with biopsychosocial spiritual 9. Changecan have causes or reasons |
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What is thebiology of Cognition? |
There aretwo avenues that we can use to explain our world Objectivity; one way to view the world Objectivity in parentheses; truth are created by the observer. Many differentrealities based on ourinteractions with the world, ourselves and others through language |
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What are the 6 types of family life cycles? |
1.Middle-class North American Family life cycle 2.Differentiation of self 3. Remarriedlife cycle 4.Professional and low-income family life cycle 5. Adoptivefamily life cycle 6. Lesbian,gay, bisexual, queer, intersexed, twin-spirited family life cycle |
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Describe atraditional North American family life cycle |
1. Leaving home, emerging young adult 2. Joiningof families through union 3. Familieswith new babies 4. Families with adolescents 5. Launchingchildren and moving on at midlife 6. Familiesin late middle age 7. Families nearing the end of life |
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When is family stress the greatest as a family changes over time? |
During transition points as families adapt to achieve stability, redefine their concept of family and realign relationships. This is a time of disequilibrium. |
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What is theMcGill Model? |
A strengthbased approach to family nursing - Shifts focus from deficit to strength perspective - Strengths enable families to cope, change and develop. - Made up of potentials (could be developed into a strength) and resources assets external or available to the family. Goal; help families use their strengths and external resources to cope, achieve goals, and develop. 4 types of strengths (assets which are internal to family system) 1. Traits(optimism, resilience) 2. Assets(finances) 3.Capabilities or competencies (problem solving skills) 4. Qualities(motivation) |
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Ininterviewing using the McGill model a nurse should |
1. Identify strengths 2. Provide feedback (commendations), boosts confidence, creates context for change 3.Developing strengths - Helping transfer use of a strength from one experience to another - Cognitive reframing; turning a deficit into a strength - Developing knowledge or competency; learning 4. Callingforth strengths Identify resources Movilizeand use resources Regulate resources |
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What isResilience and how do we foster it? |
Resilience is how a family manages stressful situations over time Build on the complex interactions between an individual, family and community - Develops through evasion of adverse events and successful use of protective factors to cope with these events and become stronger - Identify areas of risk and develop clinical interventions base on risk factors and protective factors Emphasis on prevention and health promotion strategies |
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What are thedifferent types of protective factors? |
Canbe individual, family or community protective factors |
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What are stages? |
Stages:An interval of time where the relationships between the structure, interactions and roles within the family are both qualitatively and quantitatively distinct from other periods(ex. Families with preschool children) |
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What are Emotional Process of Transition |
• Emotional Process of Transition: Separate each developmental stage from the next. |
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What are Second-Order Changes/Tasks? |
Second-Order Changes/Tasks: Issues dealt with and tasks often accomplished in each stage |
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List the individual protective factors |
internal locus of control emotional regulation belief system self-efficacy (individual's judgement of ability to succeed) effective coping skills increased education, skills, and training health temperament gender |
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list the family protective factors. |
family structure intimate partner relationship stability family cohesion supportive parent-child interaction stimulating environment social support family of origin influences stable and adequate income adequate housing |
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list community protective factors |
involvement in the community peer acceptance supportive mentors safe neighborhoods access to quality schools and child care access to quality health care |
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What are the four pillars of patient and family centered care? |
1. Respectand Dignity: Staff,physicians and volunteers actively listen to and honor patient and family perspectives,beliefs, and choices and incorporate these into the planning and delivery ofhealth care services 2. Information Sharing:Timely, complete, unbiased, evidenced-based information is provided to patients and families in ways that they understand so they can effectively participate in their own care and decision making. 3. Participation:Patients and families are supported and encouraged to participate in their own care and decision-making at the level they choose. 4. Collaboration: Patients and families work collaboratively withcare providers in numerous ways |
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What are ways in which families work collaboratively with care providers? |
a. policyand program development b. implementation and evaluation c. Healthcare facility design d. professionaleducation |
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what are the different types of driving forces in health care? |
· System-Centered Driving Force: The priorities of the system and those who workwithin it drive the delivery of health care. · Patient- Focused Driving Force: The patient is the focus or unit of care. Interventions are done to and for him/her,instead of with the patient. The patientis not viewed within the context of family or community. · Family-Focused Driving Force: While the family is the focus or the unit of care, interventions are done to and for them, instead of with them.· Patient- and Family-Centered Driving Force: The priorities and choices of patients andtheir families drive the delivery of health care.i |
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What are the three categories of CFAM? |
structural assessment developmental assessment functional assessment |
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what is developmental assessment? |
involves exploring the developmental life cycle assessment includes 1. stages 2. tasks 3. attachments eg; north american life cycle; stage; family with young children tasks; adjusting marital system to make space for child. joining in childbearing, financial and household tasks attachments; children require support and warmth, marital bonds need time for adult conversations and privacy |
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What does functional assessments include? |
Instrumental; activities of daily living expressive; 1. emotional communication 2. verbal communication- oral or written 3. nonverbal communication - body language 4. circular communication (reciprocal communication) - can be demand/withdraw (eg one gets angrier as the other withdraws) or adaptive 5. problem-solving 6. roles 7. influence and power 8. beliefs 9. alliances/coalitions |
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What are the stages of a family interview? |
engagement assessment intervention termination |
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what happens during the 'engagement' part of the family interview? |
engagement: - invite all members of family who are concerned or involved to attend explain the purpose, length and structure of interview start with introductions and structural assessment bring relevant resources cultural sensitivity |
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what happens during the 'assessment' part of the family interview? |
explore the components of CFAM to assess strengths and problem areas ask each family member to share their understanding inquire about differences in the experience confirm strengths and problems identified |
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what happens during the 'Intervention' part of the family interview? |
encourage family members to explore possible solutions plan, cognitive, affective and behavioural interventions provide information validate their emotional responses assign tasks/build skills |
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what happens during the 'termination' part of the family interview? |
know when to refer provide information mobilize supports summarize positive efforts (commendations) |
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What is the purpose of a genogram? |
· “The purpose of doing an genogram is so that I can understand who makes up yourfamily and your family’s health history. This will help me to work alongsideyour family and to have a visual reminder of who your family is. Together wewill draw a 3 generation family tree to see who is in your family” |
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What makes up the three major categories of CFAM? |
structural developmental functional |
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what makes up the elements of the structural categories of CFAM? |
1. internal structure - family composition - gender - sexual orientation - rank order - subsystems - boundaries 2. external structure - extended family - larger systems (eg; church) 3. context - ethnicity - race - social class - religion and/or spirituality - environment |
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What makes up the developmental category in CFAM? |
1. stages 2. tasks 3. attachments |
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what makes up the functional category in CFAM? |
insturmental; activities of daily living expressive; ◦ Emotionalcommunication ◦ Verbalcommunication ◦ Nonverbalcommunication ◦ circularcommunication ◦ Problemsolving ◦ Roles ◦ Influenceand power ◦ Beliefs(about health problems) ◦ Alliancesand coalitions |
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What is a nursing intervention? |
Nursing Interventions: An action or activity done by the nurse for,with, or on behalf of patients (includes clients, families, or communities).Action involves application of cognitive, verbal and/or physical functions.Thought and rationality is involved. Interventions are given in response to aproblem, in order to achieve beneficial outcomes for patients |
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what is an interventive question? |
· InterventiveQuestion: A simple but powerful intervention, intended to effect change inany or all of the 3 domains of family functioning. Both circular and linearquestions can be interventive questions. ]&X |
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what is a circular question? |
· CircularQuestion: designed to reveal information, generate new understandings, andfocus on relationships and connections between individuals, events, ideas and beliefs,for example: “Who in your family is suffering the most as a result of thishospitalization?” U.X |
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what is a linear question? |
· LinearQuestion: focus is on cause and effect, constrains understanding and mayimply the nurse knows best, for example: “When did your current family conflictbegin?” aA"X |
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what are some types of interventions that we can use with families? |
· Interventive questions · Offerinformation · Commendindividual and family strengths · Validate or normalize emotional response · Encourage the telling of illness narratives · Drawforth family support · Encouragefamily members to be caregivers and offering caregiver support · Encouragerespite · Devise rituals |
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How do wedetermine the “fit” of an intervention? · |
How do wedetermine the “fit” of an intervention? · “Fit” is determined through therapeuticconversation and collaboration with the family…· “Fit” involves recognizing the reciprocitybetween our opinions and ideas (as the nurse) and the experiences of the family(as it relates to the illness/problem) |
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CognitiveDomain What is the goal of an intervention within the cognitive domain? · |
To change the perceptions and beliefs of family members · By changing the way a family perceives a health problem so that family members can discover new solutions to problems |
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AffectiveDomain; What is the goal of an intervention in the affective domain? |
o Reduce or increase intense emotions that may be impeding efforts around problem solving (to facilitate problem solving) o What type of emotions may impede problem solving efforts? |
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BehaviouralDomain What is be the goal of an intervention in the behavioural domain? · |
To help the family to interact with and behave differently in relation to each other (increase support etc.) · How can nurses help to accomplish this goal? Invite family members to engage in a specific behavioural task · Interventions may be aimed at helping family members to behave and interact in ways that are different from their “normal” pattern R={X |
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What are the different types of circular questions? |
CircularQuestions: There are four types of circular questions 1. DifferenceQuestions: Explore differences between people, relationships, ideas, time,beliefs 2. Behavioral effect Questions: Explore theeffect of one family member’s behaviors on another 3. Hypothetical/future-oriented Questions: Explorefamily options and alternative actions or meanings in the future 4. Triadic –question posed to a third person aboutthe relationship between 2 other people hat (nfX |
