FAMILY MANAGEMENT STYLE FRAMEWORK (FMS)
Integration of chronic disease management into daily routines
of families
FMS FRAMEWORK and The Jones Family
KEY COMPONENTS
Strengths and Weaknesses
Accounts for emotional strain of the family as well as giving supportive care individually to each of the family members themselves.
Helps nurses focus on the family as a group as well as provide care for each individual family member
originally developed by Deatrick and Knafl in 1990; has been carefully refined over the last 27 years to become the largest longitudinal study of family assessment.
ORIGIN:
Strengths
Weaknesses
utilizes a pattern approach to explain how families can manage family life and a child's chronic illness simultaneously
-pattern approach studies identify dimensions of an average family, organize dimensions into categories, and finally, develop typology.
- Allows for an understanding of each family's individualized situation
- Identifies cognitive aspects, behavioral aspects, and factors predictive for family strengths and problems
- Nurses can make interventions unique for each family and even individuals in each family
FMS and Group Care
- researchers found patterns in familial reactions to adverse situations: issues common to all families in difficult circumstances and needs specialized to certain "types" of families.
FMS and Individual Care
- Requires ability to assess family dynamics and processes while assessing family’s needs and providing counseling and education
- Child may learn parents have negative perspectives about them or their illness
- Predictable and consistent routines are strongly associated with successful family management
-this allows improved care planning: promotes the development of generalized interventions that will assist all families in difficult situations and individualized care based on the specific family "type" and catering to specific needs.
- Linda
- Fear and guilt from chronic progressive Illness
- Robert
- Marital strain
- Amy
- Tentatively planning on giving up her scholarship
- Katie
- Declining grades
- Travis
- difficult transition to preschool
- Elise
- transitioning into Jones family to support Linda and Travis
families adopt a management style based on how the family members define and manage the consequences of the situation.
- Linda's diagnosis of Multiple Sclerosis
- Family's fear of death and loss
- Family financial situation
- Family pays 20% of hospital bills
- One parent financially supporting 5 family members
- Robert needs to work to financially support the family
- A week of unpaid vacation
- Uncertain about when to take vacation
MANAGEMENT STYLES ARE AS FOLLOWS:
THRIVING: parents view child from the lens of normalcy/ see child as being as capable as other children.
RECOMMENDATIONS FOR MANAGEMENT TECHNIQUES:
chronic health condition is incorporated into daily life. The child is the foreground and health condition is background. They create a new normal
Consistent and stable treatment routines allow for equilibrium in daily life.
ACCOMMODATING: parents usually see child as being normal/ capable.
View the child's chronic illness as an aspect balanced with other responsibilities rather than as a central family feature or organizing focus.
mothers are confident in providing care for child, father's are not as confident. Fathers are ususally proactive in problem solving. Parents have a generalzi
ENDURING: parents view of child fluctuates between normal and tragic
STRUGGLING: parents are inconsistent in how they view child; mostly focuses on the child's vulnerabilities. Parents do not share same viewpoints on management techniques.
parental conflict is the overriding theme.
FLOUNDERING: parents have primarily negative view of child and see situation as tragic.
see child as a burden with a sense of hatefulness about having to manage illness.