Family Nursing Assessment

Question 0

Calgary Family Assessment Model

Answer 0

Concept
-family as a system

Model has three branches –
Structural – Composition
Internal - Family composition, gender, sexual orientation, rank order, subsystems, boundaries
External – extended family, larger systems
Context – ethnicity, race, social class, religion and/or spirituality, environment

Developmental - Family stages and tasks

Functional - Behaviour in relation to one another
Instrumental – activities of daily living
Expressive – emotional, verbal, nonverbal and circular communication, problem-solving, roles, influence and power, beliefs and alliances/coalitions
Nurses may assess in all areas for a macroview of the family, or only one area for a microview

Strengths
Conceptually sound model that incorporates multiple aspects into working with families

Weakness
Must be intimately knowledgeable with the model and the interventions, it is difficult to implement in acute care settings

Question 1

Compare and contrast the family nursing process with nursing process

Answer 1

Assessment
Diagnosis
Planning
Intervention
Evaluation
Modification

NURSING PROCESS
A structured process that allows us to assess one individual and includes the above steps

Family nursing process is more complex and extensive than individual nursing process because:
Working with a number of individuals and relationships

Question 2

Friedman Family Assessment Model

Answer 2

• based on the structural-functional framework and developmental and systems theory
• based on family as a society
• enables nurses to assess the family as a whole, society, and as an interactional system

Long-form and short-form
Consists of 6 broad categories -
Identification data (name, genogram, form, cultural/ethnic background, religion, social class and social class mobility)
Developmental stage and history of the family
Environmental data (characteristic of home, neighbourhood and larger community, geographical mobility and association and transaction with community.)
Family structure (role structure, family values, communication patterns, power structure)
Family functions (affective, socialization, and health care functions)
Family stress, coping and adaptation

Strengths:
It addresses a comprehensive list of areas to assess the family, and that a short assessment form has been developed to highlight critical areas of family functioning

Weakness:
Can generate large quantities of data with no clear direction as to how to use all the information in diagnosis, planning, and intervention

Question 3

Family Assessment and Intervention Model

Answer 3

Berkey and Hanson developed the family systems stressor-strength inventory –
Focuses on strengths/stressors
Strengths help to buffer the family from stressors
Divided into three sections
Family stressors- general
Family stressors – specific
Family system strengths

Strengths
Both quantitative and qualitative data are used to determine the level of prevention and intervention needed: primary, secondary or tertiary. The instrument is brief , is easy to administer, and yields data to compare one family member with another member and one family with another family

Weakness
This model focus only on family strengths and stressors rather than all the dimensions of the family as a unit

Question 4

Discuss the potential pitfalls of using a structured assessment tool when practicing family nursing

Answer 4

Can limit the relational connection between families and nurses
Can hinder full and accurate understanding of families health/illness experience
Decontextualize families and family nursing.
Make assessment an intrusive experience for families

Question 5

Describe common family nursing intervention

Answer 5

• Commending family and individual strengths
• Offering information
• Validating and normalizing emotional responses
• Encouraging the telling of illness narratives
• Drawing forth family support
• Encouraging respite
• Genograms and ecomaps