LEC 4: CFIM Flashcards
(39 cards)
1
Q
Calgary Family Intervention Model (CFIM)
A
- Builds on a strengths and resiliency perspective.
- It has 3 dominas: cognitive, behavioral, and affective
- By addressing all of these three domains, your nursing care will be more holostic.
- An organizing framework for conceptualizing the intersection between a particular domainn of family functioning and the specific intervention offered by the nurse.
2
Q
What are the elements found in CFIM?
A
- Interventions
- Domains of family functioning
- Fit or meshing
3
Q
What does CIFM assist in?
A
Assists in determining the domain of family functioning that predominantly needs changing, usually where there is the greatest suffering, and the most useful interventions to effect change in that domain.
4
Q
What is the goal of nursing interventions?
A
- The ultimate goal of nursing interventions is to aid family in descovering new solutions to help soften or alleviate emotional, physical, and/or spiritual suffering.
- Promote, improve, or sustain functioning in the three domains of family functions.
- Cognitive, affective, and behavioural
- One intervention can simultaneously affect all three domains of family functioning.
- Family focused interventions involve all members of the family.
5
Q
How do we determin the “fit” of an intervention?
A
- Therapeutic conversation
- Collaboration with the family
6
Q
What does the “fit” involve?
A
Recognizing the recoprocity between RN opinions and ideas and the experiences of the family to the illness/problem.
- Are the questions I am asking fitting/effective with family/domain?
7
Q
What is family functioning?
A
- Generally considered the family’s ability to meet the needs of it’s members
- This is about family functioning domains
- This is about our questioning techniques
- This is about nursing actions and interventions
8
Q
What are the 3 domains of family functioning?
A
- Cognitive
- Affective
- Behavioral
9
Q
What is the goal of an intervention within the cognative domain?
A
- To change the perceptions, beliefs, and understanding of family memebers.
- Change the way a family perceives a health problem so that family members can discover new solutions to problems.
10
Q
What are examples of interventions in the cognitive domain?
A
- Teach patients what they are going through
- Education
- Cognitive reframing
11
Q
What is the foal of an intervention in the affective domain?
A
- Reduce or increase intense emotions that may be impending efforts around problem solving.
- To facilitate problem solving.
12
Q
What type of emotions may impede problem solving efforts?
A
Being overwhelemed, concerned, sad, angery, ect.
13
Q
What are some examples of interventions in the affective domain?
A
- Validating/normalizing emotional responses
- Normalizing/reassuring changes in relationships due to illness
- Encouraging the sharing of illness narratives
- Expression of the impact of illness on various family members
- Drawing forth support
- Encouraging family members to listen to each other
14
Q
What is the goal of an intervention in the behavioural domain?
A
- To help the family to interact with and behave differently in relation to each other
- Increase supprot
- To make family behaviours in relation to one another more supportive and accomplished
15
Q
How can nurses help to make family behaviours in relation to one another more supportive and accomplished?
A
- Invite family memebers to engage in a specific behavioural task
- Interventions may be aimed at helping family memebers to behave and interact in ways that are different from their normal pattern
16
Q
What are some examples of interventions in the behavioural domain?
A
- Encouraging family members to be cargivers and offering cargiver support
- Family members may be intimidated by the thought of providing care, a nurse could support them
- Encouraging respite
- Devising rituals
17
Q
Interventions with CFIM
A
- The intervention process provides a context in which the family can make necessary changes that enhance the possibility of healing
- Interventions crete a context for change
18
Q
What do interventions need to be?
A
- Purposeful
- Conscious
- Observable behaviour by the nurse
19
Q
Key points about interventions
A
- Interventions promote, improve, or sustain functioning in the three domains of family functioning
- Cognitive, affective, and behavioral
- The most profound and sustaining changes are those that occur within the cognitive domain of family functioning
- One intervention can sumultaneously affect all three domains of family functioning
- Assessment and interventions can occur simultaneously
- As you help the family gain an understanding of their health experience, the family may be able to make informed choices.
20
Q
What are types of interventions we can use with families?
A
- Can be used in all three domains:
- Interventive questions
- Can be used in the cognitive domain:
- Offer information
- Commend individual and family strengths
- Validate or normalize emotional response
- Can be used in the affective domain:
- Encourage the telling of illness narratives
- Draw forth family support
- Can be used in the behavioural domain:
- Encourage family members to be caregivers and offering cargiver support
- Encourage respite
- Devise rituals
21
Q
What are interventive questions
A
- Simple but most powerful intervention
- Inteded to effect change in any/all of the three domains of family functioning
22
Q
What are the 2 types of interventive questions?
A
- Circular questions
- Linear questions
23
Q
What is the intent of circualr questions?
A
- Intent:
- To effect change, to facilitate behavioural change
- Reveal family’s understanding of a problem
24
Q
What is the intent of linear questions?
A
- Investigative
- Explore the discription/perception of a problem
- Often used to begin the gathering of information
- Prupose is to informe the healthcare provider
25
What is the effect of circular questions?
* Generative
* Opens possibilites for new understanding
* Useful for establishing rapport
* Get the client's sotry out
26
What is the effect of linear questions?
* Constrains further understanding
* May imply the nurse knowns best...risk
27
What is the focus of circular questions?
* Relationships and conncections between individuals
* Events, ideas, and beliefs
* Always sought in a context of compassion and curiosity
28
What is the focus of liniar questions?
* Is on cause and effect
* Problem exploration
* Linear thinking encouraged
29
What are examples of linear interventive questions?
* When did you notice that Kennedy changed her eating habits?
* Linear question
* What do you think caused this change?
* Cause and effect
* Infroms the nurse and explores a family memebrs description of the problem
30
What are the 4 types of circualr questions?
1. Dofference questions
2. Behavioral effect questions
3. Hypothetical/future-oriented questions
4. Triadic questions
31
Difference Questions
Explores differences between people, relationships, ideas, time, and belifes.
32
Behavioral Effect Questions
Explore the effect of one family member's behaviors on another.
33
Hypothetical/Future-Oriented Questions
Explores family options and alternative actions or meanings in the future.
34
Triadic Questions
Questions posed to a third person about the relationship between two other people.
35
What are examples of difference questions?
* C: What is the best advice given to you about supporting your son with AIDS? What is the worst advice?
* A: Who in the family is most worried about how AIDS is transmitted?
* B: Which family memebr is best at getting your son to take his medication on time?
36
What are exampels of behavioral effect quesrions?
* C: What do you know about the effect of life-threatening illness on children?
* A: How does your son show that he is afraid of dying?
* B: What could you do to show your son that you understand his fears?
37
What are examples of hypothetical/future-oriented questions?
* C: What do you think will happen if these skin grafts continue to be painful for Dan?
* A: If Dan's skin grafts are not successful, what do you think his mood will be?
* B: When will your son engae in treatment for his contracture?
38
What are examples of triadic questions?
* C: If your father were not drinking daily, what would your mother think about this receiving treatment for alcoholism?
* A: What does your father do that makes your mother less anxious about his condition?
* B: If your father were willing to talk to your mother about solutions to his addiction, what do you think he might say?
39
Questions with a Purpose
* Ask yourself what purpose am I trying to achive with the family through the questions I ask
* Our goal is to encourage family refelction
* Our goal is to facilitate understanding in the family
* Our goal is to create oppurtunity for change
