We are Family!
http://en.wikipedia.org/wiki/File:Sister_Sledge_-_We_Are_Family.ogg
The Family Guy©
E. Heim
Fall 2015
RANC Objectives







Define family dynamics.
Assess family structure and roles through review of health history.
Demonstrate health promotion education activities with a focus on
the family, through a concept map, care plan and teaching plan.
List factors affecting family response to health alterations and
disparities.
Identify therapeutic nursing interventions to assist families during
response to a health alteration.
Evaluate the family’s response to the total treatment plan following
an alteration in health.
Identify the Health People 2010 Leading Health Indicators for the
nation and your county of residence.
The Family



Central institution of society
Cultural, regional, &
religious variances
Durable, dynamic & diverse




Make-up
Structure
Function
Coping capacity (resilience)
The Simpsons ©
Family-Centered Nursing



GOAL: Promote, support, & provide for the
well-being & health of the family & each of its
individual members
Family Dynamics
Family Health System Model





Interactive
Developmental
Coping
Integrity
Health
What is a Family?




Biological
Legal
Social
Related by





Marriage
Birth
Adoption
Diversity
Uniqueness
Pets!
Family Forms





Nuclear
Extended
Single-parent
Blended
Alternative patterns of
relationships





Homosexual
Grandparenting
Foster care
Communes
“Live-in” BF/GF
Box 10-1
Family Culture

Culture






Race
Ethnicity
Religion
Sexuality
Family-core beliefs
Values
Effects of Society




Economic Status
Homelessness
Domestic violence
Illness



Acute
Chronic
Terminal
Stages of Family Life Cycle

Developmental stages







Table 10-1
Single adults leave home
These adults join families through marriage or
committed relationships
Newborns are made
Adolescence occurs
Launching children
Later years
A Child Learns What He Lives









If children live with criticism,
they learn to condemn.
If children live with hostility,
they learn to fight.
If children live with ridicule,
they learn to feel shy.
If children live with shame,
they learn to feel guilty.
If children live with tolerance,
they learn patience.
If children live with praise,
they learn appreciation.
If children live with fairness,
they learn justice.
If children live with security,
they learn to have faith in themselves and in those about them.
If children live with friendliness,
they learn the world is a nice place in which to live.

Copyright © 1972 by Dorothy Law Nolte. PhD
Family Structure & Roles

Structure






Relationships & Roles
Patterns of behaviors
Interactions
Rigid vs. Flexible
Open vs. Closed
Function







Reproduction
Socialization
Relationship to society
Communication
Care-giving & nurturing
Values and ideals
Resources
ABCD’s




Adjusting & Adapting
Ability
Being “Balanced”
Cool Communication
Skills
Demand-handling &
Decision-making
Skills
Approaches to Family Nursing

Family as Context


Family as Client


Focus: health & development of individuals
Focus: family processes & relationships
Family as System

Focus: BOTH!
www.familynursingresources.com
Assessment & Planning


Every family is different
Three factors to organize the process:






View all individuals within their family context
Families have an impact on individuals
Individuals have an impact on families
Assess pt’s “family” history—not the diseases alone,
but the relationships & experiences of the pt
Assess the culture, communication techniques, etc
(see previous slides)
Plan with the patient to establish REALISTIC, TIMEFRAMED, & MEASURABLE goals/outcomes.
Family-Focused Nursing Dx










Caregiver Role Strain
Ineffective or Compromised (Individual, Community,
or Family) Coping
Dysfunctional Family processes (R/T alcoholism,
drug use, homelessness)
Grieving
Delayed Growth & Development
Ineffective Role Performance
Impaired Parenting
Readiness for Enhanced Parenting
Impaired Home Maintenance
Health-seeking Behaviors
pp250-251
Nursing Interventions

Health Promotion




Acute Care




Based on family’s perceptions & strengths
Teaching
Access of care
Community nursing
Home care
Referrals
Restorative & Continuing Care

Family vs. Facility
Evaluation of Family’s Response


Follow-up in a timely manner is essential!
Are the Goals met?


New approaches to care


May have changed in the dynamic family process
Use critical thinking skills
Revision of plan of care prn
Healthy People 2020
http://www.healthypeople.gov/LHI/lhiwhat.htm

The Leading Health Indicators:

Are based on Healthy People 2020 objectives




(IOM, Nat’l Academy of Science reports)
Reflect major health concerns in US
Are used to measure the health of our Nation
Selected on ability to motivate action, the availability
of data to measure progress, & their importance as
public health issues
Leading Health Indicators










Access to Health Care
Physical Activity
Overweight and Obesity
Tobacco Use
Substance Abuse
Responsible Sexual Behavior
Mental Health
Injury and Violence
Environmental Quality
Immunization
Focus of HP 2020 Goals &
Leading Health Indicators

Focus:







Public health infrastructure
Disease
Lifestyle Choices
Maternal & Child health
Nutrition
Mental Health
Follow the link below and think about how these
indicators relate to families:

http://www.healthypeople.gov/LHI/Touch_fact.htm
North Carolina
HP 2020 Health Goals






1. Increase the span of healthy life of citizens of NC
2. Remove health disparities among the disadvantaged
3. Promote access to preventive health services
4. Protect the public’s health
5. Foster positive & supportive living and working
conditions in our communities
6. Support individuals to develop capacities & skills to
achieve healthy living
http://www.healthycarolinians.org/2020objectivs/hlthgoals.htm
Health Carolinians
http://www.healthycarolinians.org/2015objs/userguide.htm

Click the button to go to this website:



http://www.healthycarolinians.org/assess.htm
Open the Annual Inventory tab to identify the
LHI for your county:
Open the County Health Databook tab to explore
the Disease Statistics website



http://www.schs.state.nc.us/SCHS/data/databook/
Also see this page for ots of good data!
http://www.schs.state.nc.us/SCHS/
The End
All pictures in this PowerPoint are intended for educational purposes only and have been obtained
through internet search engines such as Google & MSN Live Search. I take no individual credit for
content other than assembling them for presentation and learning opportunities.
eheim productions 