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CFAM and CFIM:
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CFAM and CFIM:
High Risk Pregnancy
- Medical model: treats illness and deficiency
- trend in healthcare moves away from medical model to a focus on strengths and resiliency
- CFAM and CFIM provide assessment and intervention models that promote this trend
Case Study
- 20-25% of pregnancies are considered high-risk, or diagnosed with complications
- CFAM tasks: introduction of new family member, shifting of roles, care of sick family member
-Other Stressors: guilt, treatment, unfamiliar surroundings, helplessness, loneliness, loss of control
HM is a mother of 9, admitted to hospital in labour with her 10th child. She was admitted to obstetric ICU with excessive vaginal bleeding, due to low-lying placenta. It was determined that a C-section was necessary to maintain the health of mother and fetus. A baby girl was born successfully via C-section. There was some difficulty delivering the placenta, ultimately necessitating hysterectomy. Following surgery, the anaesthesiologist was unable to extubate. HM was transferred to ICU to maintain ventilation. Baby girl was healthy, but as she was preterm, she was brought to the NICU. Ultimately, the family was able to interact with both HM and baby in the hospital. All nine children, HM's husband, and several other family members were present.
Promotion of Family-Centered Care
CFAM
- commending family strengths
-providing information and education
- validating emotions of patient and family
-offering support, encouraging family support
-allow pt and family to share experience
-story telling
-encourage respite
-maintain/adjust family rituals
-provide resources
-assess structural, developmental, and functional dimensions
-STRUCTURAL: which family members are present? Who does the patient consider family?
-DEVELOPMENTAL: what stage of family development? How do family members feel about the new baby?
-FUNCTIONAL: how do the family members interact?
CFIM
- COGNITIVE: provide information on condition of HM
-AFFECTIVE: validate emotions and encourage family support
BEHAVIOURAL: encourage positive family interactions