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Family Assessment

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by

Jocelyn Rempel

on 1 October 2013

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Transcript of Family Assessment

Assessment and Communication within the Context of Family
Structural
Internal
Developmental
Stages
Functional
Instrumental
Family Assessment
Calgary Family Assessment Model
Wright and Leahey (2009)
Focus on the whole family system, relationships, patterns and interactions
"Think Interactionally" to raise delivery of health care from individual to family (interaction) level
Conceptualize and respond to effect of health problem or illness on family and effect of family on health problem or illness
External
Context
Family Composition
Gender
Sexual Orientation
Rank Order
Subsystems
Boundaries

Extended Family
Larger Systems
Ethnicity
Race
Social Class
Religion and Spirituality
Environment
17 year old male
Admitted for internal fixation fractured fibula
Aspires to be a police officer
Straight A Student
Accepted to U of C
Carl, Age 17
Carl, Age 27
Social Environment and Support
Father beating mother
Escaped to shelter after discharged
Friends are contacts on teh street
Lost contact with parents
Personal Health Practices and Coping
Education and Literacy
Psychological
Early Childhood
Father Alcoholic
Pt drinks beer to “calm nerves” when parents fighting
Isolates himself to avoid conflict in home
Alcohol and food
Unable to concentrate at school
Dropped out of highschool
Self concept largely derived from image of himself as police officer
Feels worthless
Depressed
Has watched his father physically and emotionally abuse his mother since he was a young child
Sexually assaulted by his uncle at age of 12
SES
$800/month income
Drugs covered by AISH
Physical Environment
Home is filthy - unable to clean
Biology and Genetics
TypeII Diabetes - eats junk food
Wheelchair Bound
350 Pounds
Composition
1. Family is a system or unit
2. Members may or may not live together and may or may not be related
3. Children are not necessarily present
4. Commitment and attachment among members that include future obligation
5. Functions? Nourishment, protection, socialization
Tasks
Attachments
Expressive
Emotional Communication
Verbal Communication
Nonverbal Communication
Circular Communication
Problem Solving
Roles
Influence of Power
Beliefs
Alliances and Coalitions
Cognition (Belief)
Affect (Emotion)
Behaviour
Behaviour
Nursing as Relational Practice
Health AND Nursing occur in relationships with other human beings
Things to Consider:
Personal aspects/preferences
Context of situation
Relationships with other people
Understanding the Context
of Families
Families "speak themselves into existence"
NURSE'S ROLE
Engage in Conversation
HOW?
Explore how their lives are structured and influenced by their environment and history
Understand how individual health is achieved in the context of family AND....
how family is achieved in the context of each individual's health, illness and healing
FAMILY ATTRIBUTES
Reciprocal Influence of Health
Collaborative Partnership Model
Power Sharing and Sharing of Expertise
Mutually defined purpose, person-centered goals
Dynamic and requires active participation agreement
Relational Nursing and Collaborative Partnerships
Gottlieb L. & Feeley, N. (2005). The collaborative partnership approach to care: A delicate balance. Toronto: Elsevier Mosby.
Collaboration - identifying what the client and their family members have as goals for their health, working with them, enlisting their help, providing expertise, and finding a way to work together to achieve those goals - (Nurse Joann Creager)
Benefits of Collaborative Partnership?
Facilitates Reflection
Leads to awareness and change
Awareness necessary for change
Facilitates ownership,
responsibility
and self care
Facilitates making more realistic plans
more likely to follow-through with change
Circular Questions:
Difference
Behavioural Effect
Hypothetical/Future Orientated
Triadic
Full transcript