Unit 2: Theory in Nursing Practice Flashcards
(196 cards)
1
Q
What are 5 relational assumptions in family nursing?
A
- reciprocity in relationship
- non-hierarchial power
- family and nurse have expertise
- family and nurse bring strength and resources
- interactive feedback processes/blurred boundaries can happen simultaneously
2
Q
9 Roles of Family Nurse
A
- Health educator
- Care provider and supervisor
- Family advocate
- Case finder and epidemiologist
- Researcher
- Manager and coordinator
- Counselor
- Consultant
- Environmental modifier
3
Q
7 Obstacles to Family Nursing as a Specialty
A
- Lack of literature
- Lack of comprehensive family assessment models
- It’s just “common sense”
- Historical ties with medical model
- Traditional charting systems
- Diagnosis systems
- Health care service hours
4
Q
8 principles of Patient-Centred Care (RNAO)
A
- Respect for patient’s values, preferences, and expressed needs
- Coordination and integration of care
- Information and education.
- Physical comfort
- Emotional support and alleviation of fear & anxiety
- Involvement of family and friends
- Continuity and transition
- Access to care
5
Q
Purpose of conceptual and theoretical frameworks
A
provide a rationale and guide for decision-making in a range of practice situations
6
Q
How dos theory guide nursing practice?
A
giving us a perspective on situations we encounter in practice
help us have a basis for nursing assessment and nursing interventions.
help us characterize, explain, and predict – provides a common language
7
Q
4 Family Nursing Theoretical Perspectives
A
- Exploring structure, function, and development
- Family systems theory
- Developmental and family life cycle theory
- Strengths and resiliency
8
Q
3 things family nursing theories help us do:
A
- Understand families
- Describe and plan for family interventions
- Study and evaluation the impact of nursing care
9
Q
Theoretical Pluralism
A
The selection and use of multiple theories for practice in accordance with the demands of the situation
10
Q
Intersectionality
A
inequities are never the result of single, distinct factors. Rather, they are the outcome of intersections of different social locations, power relations and experiences.
11
Q
Define cultural safety
A
Addresses power differences inherent in health service delivery and affirms, respects and fosters the cultural expression of clients. This requires nurses to reflect critically on issues of racialization, institutionalized discrimination, culturalism, and health and health care inequities and practice in a way that affirms the culture of clients and nurses.
12
Q
6 Theoretical Foundations of CFAM
A
- post modernism
- systems theory
- cybernetics
- communication theory
- change theory
- biology of cognition
13
Q
what does post modernism theory value?
A
pluralism – acknowledges that many world views and explanations exist
Realities are constructed and there is multiplicity in interpretation.
14
Q
what do postmodernists debate
A
knowledge – where does it come from, postmodernists question taken for granted ideas/assumptions
15
Q
How do we see postmodernism in CFAM
A
2 members of the same family can interpret something completely different
Value all versions of the story and everyone’s experience of illness/suffering
16
Q
What is systems theory?
A
A system is a complex of elements in mutual interaction
17
Q
4 Main Concepts of Systems theory
A
- All parts of the system are interconnected
- The whole is more than the sum of its parts
- Boundaries between the system and its environment are on a continuum from closed to open
- Systems can be further organized into subsystems
18
Q
How do we see systems theory in CFAM?
A
family as greater than sum of parts; dynamic and respond to external and internal stressors
19
Q
How are behaviours best understand from a systems theory perspective?
A
Circular instead of linear in causality
20
Q
All systems have some form of _______ between the system and its environment
A
boundaries/borders
21
Q
Describe boundaries/borders in systems theory in application to CFAM
A
Families control the information and people coming into its family system to protect individual family members or family as a whole.
Boundaries are physical or imaginary lines that are used as barriers to entry in the family system
22
Q
Closed, open, and flexible boundaries in systems theory
A
- Closed: More isolation and limits passage of energy, ideas, people and information
- Open: Greater interchange of information, energy, and people
- Flexible: Control and selectively open or close to gain balance or adapt to the situation.
23
Q
What is cybernetics theory?
A
Science of communication and control theory
Importance of context of message - not what is being said but how it is said
Moves from substance to form
24
Q
What is communication theory?
A
All nonverbal communication is meaningful
25
How do we see communication theory in CFAM?
1. attention to channels of communication
2. all communication has 2 levels
3. explore circularity in communication
26
2 channels of communication according to communication theory
1. digital: content of verbal message
2. analog: nonverbal.artistic/aesthetic
27
2 levels of communication according to communication theory
1. content
2. relationship
28
2 levels of change according to change theory
1. First Order: system, as a whole, remains unchanged but components/individuals undergo a change
doing more or less of something, always reversible
2. Second Order: system change; a change in level of functioning
29
What does first order change usually involve according to change theory
usually involves us using the same problem solving strategies over and over (with slight difference i.e. discipline – restricting computer usage to restricting allowance – same restriction), usually change in quantity not quality
30
According to change theory, change is dependent on
the perception of the problem
31
According to change theory, change is determined by ____ and dependent on _____
structure
context
32
According to change theory, ______ alone does not equal change
understanding
33
Change does not always occur________in all family members
equally
34
Facilitating change is the________ responsibility
Nurses
35
Change occurs by __________ offered by the nurse with the biopsychosocial-spiritual structures of the family
Fitting interventions
36
According to biology of cognition theory, what 2 avenues can we use to explain our world?
1. objectivity
2. objectivity in parentheses
37
Define objectivity according to biology of cognition
one domain of reference explains the world – we exist independently of observers
38
Define objectivity in parentheses according to biology of cognition
truths are created and brought forth by observer ---- nothing is certain, everyone’s view is version of a presumably correct interpretation
39
What are the 3 categories/components of CFAM?
* Structural Assessment
* Developmental Assessment
* Functional Assessment
40
3 structural assessment components of CFAM
internal, external, context
41
describe internal structural CFAM assessment
1. Family Composition: Who is in this family? Who does this family consider to be “family”? Any changes in family composition, losses, serious illnesses, grief and loss
2. Gender & gender identity, sexual orientation
3. Rank order
4. Subsystems
5. Boundaries
42
describe external structural CFAM assessment
Connections to extended family
Larger systems such as work, school, social media, other support systems
43
describe context structural CFAM assessment
ethnicity, race, social class, spirituality, environment
44
3 parts to developmental assessment using CFAM
1. stages: stage of the family
2. tasks: developmental task associated with stage
3. attachments: relatively enduring, unique emotional tie between 2 specific people
45
What is a developmental task
Growth responsibilities that arise at certain stages in the family’s life cycle
46
What is family development?
◦ The UNIQUE path constructed by a family
◦ The interaction between the development of the individual and the phase of the family developmental life cycle
47
What is a family life cycle?
◦ The TYPICAL path that most families go through
◦ Emotional and intellectual stages from childhood until retirement
48
The family life cycle often has to do with:
The coming and going of family memebers
49
Family life cycle is generally ______ despite cultural and ethnic variations
predictable
50
True or false: transitional crisis is a normal part of family development
True
51
7 Phases of the family life cycle
1. Leaving home/emerging young adults
2. Couple formation/Joining of families (e.g., marriage, cohabitation)
3. Families with young children
4. Families with adolescents
5. Launching children and moving on
6. Families in later middle age life
7. Families nearing end of life.
52
5 Nursing Interventions for Family Development
1. assess family structure and where they are on family life cycle continuum
2. consider associated developmental tasks and anticipate stressors
3. provide anticipatory guidance about these tasks and stressors
4. assist in moving towards completion of developmental tasks
5. balance between family and individual needs
53
Criticisms of Developmental Family Assessment
* Heavily relies on upon traditional or culture specific assumptions regarding family structure
ü What constitutes the family…various forms…various cycles
ü The experiences that families will have
ü When they will occur
ü Does not address intergenerational family issues
ü Does not embrace the diverse family forms present in Canada
54
2 components of functional family assessment
1. instrumental
2. expressive
55
What is family functioning?
The family's ability to meet the cognitive, affective, and behavioral needs of its members
56
What are instrumental aspects of family functioning?
The roles and activities of daily living
57
What are the 9 components of expressive functioning in families?
1. Emotional communication
2. Verbal communication
3. Nonverbal communication
4. Circular communication
5. Problem solving
6. Roles
7. Influence and power
8. Beliefs
9. Alliances and coalitions
58
What is emotional communication?
Includes the RANGE and TYPES of emotions/feelings that are expressed/observed
59
When assessing verbal/non verbal communication, what are the 2 focusses?
the meaning of the message in terms of the relationship
Effectiveness of communication (i.e. clear/direct vs. unclear/indirect)
60
What is the circular communication?
reciprocal communication between people with each person influencing the behavior of the other person
61
What is a circular communication pattern diagram?
A schematic diagram that represents a communication event for functional assessment to conceptualize discussion and think interactionally
someone behaves > someone thinks something about it > they behave > other person thinks something about it
62
3 limitations of circular pattern diagram
1. tempt us to look within families for collaborative causation of the problem
2. may encourage nurses to believe they are outside the family system (you can't deconceptualize the family from their surroundings)
3. Ignore power differentials between parties
63
Define reflection in action
the ability to think about what we're doing as we're doing it
64
* Have I effectively established rapport?
* Am I listening fully? Fully present?
* Is everyone involved?
Are examples of ....
Reflection IN action
65
Define reflection on action
the reflection after the event - conscious and documented
66
Is everyone involved?
What worked in the situation?
What didn’t work in the interview?
What will you do differently next time?
Are examples of...
Reflection ON action
67
Define CFIM
Calgary Family Intervention Model
Assists in determining the domain of family functioning that predominantly needs changing
68
Ultimate goal of family nursing interventions
Promote, improve, or sustain functioning in the three domains of family functioning
* Cognitive
* Affective
- behavioural
69
True or false: One intervention can simultaneously affect all three domain of family functioning
True
70
The most profound changes occur
Cognitively
71
What interventions target all 3 functional domains?
Interventive questions
72
Interventions for cognitive domain
▫ Offer information
▫ Commend individual and family strengths
73
Interventions for affective domain
▫ Validate or normalize emotional response
▫ Encourage the telling of illness narratives
▫ Draw forth family support
74
Interventions for behavioural domain
▫ Encourage family members to be caregivers and offering caregiver support
▫ Encourage respite
▫ Devise rituals
75
Data Collection for Genograms
- index person
- age, sex, names, health concerns, occupation, dates and nature of relationships
- left to right = oldest to youngest
76
Data collection for ecomaps
* Zoning in on index person and immediate supports; not 3rd generation
Where do they seek outside help?
What community groups are they involved in?
What roles do they play outside of your family unit?
77
What needs to be included on legend of ecomap?
- how to identify the strength of each relationship (weak or strong)
- the flow of energy between each item and the family member
- whether stress or tension exists in the relationship or not
78
4 Considerations when Interviewing Families
1. Maximize your time-effectiveness (can be done in 15 minutes)
2. Strengths and problems focused
3. Multiple realities, openness to differences, diversity
4. Skills and competencies need time to be developed (labs, clinical setting, writing)
79
3 skill types required for nurses for family interviewing
perceptual, conceptual, executive
80
Perceptual Interview Skills
relate to our ability to perceive what is happening in the interview and to make relevant observations. Our perceptions are influenced by our own experiences.
81
Conceptual Interview Skills
relate to what we think as nurses. It is how we give meaning to what we are observing. Need to recognize that our interpretation is never “the truth” but a captured interpretation in time.
82
Executive Interview Skills
the observable therapeutic interventions that we purposefully engage in or enact; the actual execution of skills
83
Why use a 15 minute interview approach for family interview? (4 reasons)
* Changes in health care delivery
* Budget constraints
* Increased acuity
* Staff shortages
84
Overview of 15 Minute Interview (6 points)
1. Begin a therapeutic conversation with a purpose/build rapport
2. Use manners to engage/reengage – introduce purpose of your 15 minutes
3. Assess key areas of internal/external structure and function
4. Ask 3 questions of family members (one thing about structure, one thing about development, one thing about function)
5. Commend the family on 1-2 strengths
6. Evaluate usefulness and conclude
85
5 Key Ingredients to 15 minute interview
1. Therapeutic interview/conversation
2. Manners
3. Genograms and ecomaps
4. Therapeutic questions
5. Commending family strength
86
What is therapeutic conversation?
Powerful component of the human experience is the need to communicate what it is like to live our individual, separate worlds of experience, particularly in the world of illness.
87
How to make the most of time in 15 minute interview
INTEGRATION of TASK-ORIENTED patient care with interactive, PURPOSEFUL CONVERSATION is the distinguishing factor
Can be done during admission information, discharge information, teaching the family about new medications, discussing the impact of an upcoming procedure with the family
88
True or false: purpose of 15 minute interview is to fix problem
False - Art of listening equally important (not always have to fix it – sometimes just listening is essential)
89
Describe manners as a key ingredient to the 15 minute interview
- simple acts of courtesy
- introductions: ± Explaining role, procedure, use names, speaking directly to patients/families (not around them), eye contact, encourage participation
90
Why do we care about manners in 15 minute interview?
± Contributes to the growth of a trusting relationship
± Not attending to these things can damage the relationship with a patient/family
91
How are genograms useful in 15 minute interview?
- important if caring for patients for more than one day
- good starting point to engage family, groundwork, familiarity
- provides essential information
92
3 Types of therapeutic questions during 15 minute interview
linear, circular, interventive
93
Miracle questions and one question question are examples of:
linear questions
94
What is the miracle question?
if you could wave a magic wand…
95
What is the one question question
If there is one thing you want to achieve with me today…
96
How many questions should you have prepared for 15 minute interview
at least 3 key questions (one for each domain)
97
Basic themes your questions should address for 15 minute interview
* Sharing of information
* Expectations of hospitalization
* Clinic/home care visits
* Challenges, suffering, patient experience
* Most pressing concerns
98
Commendation vs Compliment
Commendation: Observation of behavior across time/patterns of behavior
Compliment: observation of a one-time occurrence
99
Why utilize commendations?
Internalized by the family – may affect a family's engagement, uptake, utilization of resources, also helps the family to view themselves differently
100
Considerations when offering a commendation?
1. be a strength detective
2. ensure there is enough evidence for commendation
3. offer within 10 min to increase receptivity of family
101
3 common errors in family interviewing
1. Failing to create a context for change
2. Taking sides
3. Giving too much advice prematurely
102
How to avoid failing to create change in interviewing
1. Show interest, concern and respect for each family member
2. Obtain a clear understanding of the most pressing concern or greatest suffering
3. Validate each member’s experience
4. Acknowledge suffering and the sufferer
103
What not to do in relation to failing to create change in family nursing?
❌ Poor listening
❌ Lack of curiosity
❌ Empathetic response
104
Poor listening is an example of poor _____ skill
Perceptual
105
Lack of curiosity is an example of poor ______ skill
Conceptual
106
Lack of empathetic response is an example of poor ________ skill
Executive
107
What is the most common, unintentional error in family interviewing?
Taking sides
108
What to do avoid taking sides in family interviewing?
ü Maintain curiosity
ü Remember that the glass can be half full AND half empty at the same time
ü Ask questions that invite an exploration of both sides of a circular interactional process
ü Remember that all family members experience some suffering when there is a family problem
ü Give equal time and interest to each family member
ü Remember that information is “news of a difference”
ü Avoid allowing family members to “tell” on others (avoid side conversations)
109
Why is giving too much advice prematurely a common problem in family interviewing?
1. Nurses are in a socially sanctioned position that involves offering advice, information, opinions
2. Families are often keen and receptive to nurse’s knowledge
3. Timing and judgment are critical in deciding when, how, and what type of advice is offered
110
4 ways to avoid giving premature advice in family nursing
✅ Offering advice, opinions or recommendations only AFTER A THOROUGH ASSESSMENT
✅ Offering advice WITHOUT believing that your suggestions are the BEST IDEAS or opinions
✅ Ask MORE QUESTIONS than offering advice during initial conversations
✅ Obtaining the FAMILY'S RESPONSE and reaction to the advice
111
4 Stages of a Family Interview
1. Engagement
2. Assessment
3. Intervention
4. Termination
112
Purpose of engagement stage of family interview
- Establish a therapeutic relationship
- show willingness to listen
- recognize strengths and resources
- prevent future misunderstandings
113
7 things to consider in engagement phase of family interview
* Explain the purpose, length, and structure of the interview
* Start with introductions and a structural assessment
* Address all attendees (include children)
* Provide structure
* Bring relevant resources
* Context of change
* Cultural sensitivity
114
6 Guidelines for Assessment stage of family interview
1. problem/opportunity identification
2. relationship between family interaction and health problem
3. explore how health issue affects family life and relationships
4. differences in individual's experiences
5. goal exploration
6. what outcomes are family seeking
115
3 Types of Conclusions to draw following assessment stage of family interview
1. actual problem
2. risk for
3. wellness/opportunities to grow
116
What occurs in the intervention stage of family interviewing?
1. Encourage family members to EXPLORE possible SOLUTIONS
2. Plan cognitive, affective and behavioural INTERVENTIONS
3. Provide INFORMATION
4. VALIDATE their emotional responses
5. Assign TASKS or build SKILLS aimed at improving family functioning
117
Cognitive interventions involve
thinking differently – may involve information
118
Affective interventions involve
different affective expressions – reduce/increase emotions - may involve: validating emotions
119
Behavioural interventions involve
help individuals interact/ behave differently with one another – may involve: changing how things are done/said/acted on
120
_________ and _________ can occur simultaneously
Assessment
intervention
121
Interventions should be ________
Targeted: they promote, improve, or sustain functioning in the three domains of family functioning (cognitive, affective, and behavioral)
122
What 2 intervention domains overlap and why?
Often the cognitive and affective domain overlap because what we think closely affects what we feel.
Domains between heart (affective) and head (cognitive) are intertwined
123
Why must questions be asked with a purpose during intervention stage of family interview
- encourage reflection
- faciliate understanding
- create opportunity for change
124
Define interventive questions and 2 type
Simplest but most powerful intervention is the questions you ask!
Intended to effect change in any/all of the three domains of family functioning
Circular and Linear
125
Intent of circular questions
Reveal Explanation/understanding
- To effect change, to facilitate behavioural change
- Reveal a family’s understanding of a problem
- Targeting a domain/purposeful to understand functioning of domain
126
Effect of circular questions
- generative, opens possibilities for new understanding
127
Focus of circular questions
relationships and connections between individuals, events, ideas and beliefs (always sought in a context of compassion and curiosity)
128
Intent of Linear Questions
- Investigative/Journalistic
- Explore the description/perception of a problem
- Often used to being gathering information
- Firm answer
- Comfortable
129
Effect of linear questions
constrains further understanding
May imply the nurse knows best....risk!
130
Focus and purpose of linear question
on cause and effect
Provide nurse with description of problem
131
How long has your mother had problems with her memory? When were you diagnosed? How long have you been off work?
are examples of
Linear questions
132
Who is most affected in the family by your mother’s memory problems?
is an example of
Circular question
133
3 Types of Circular Questions
difference
behavioural effect
hypothetical/future oriented
134
Define difference question
Explore differences between people, relationships, ideas, time, beliefs
Does the question highlight variations or distinctions between family members' perspectives?
Is there a focus on identifying differences in the ways family members express their emotions?
135
Define behavioural effect question
Explore the effect of one family member’s behaviors on another
Is the question centered around observable actions or patterns of behavior within the family?
Can you recognize questions that prompt discussion about specific actions or changes in behavior?
136
Define hypothetical/future oriented question
Explore family options and alternative actions or meanings in the future
137
What is the best advice given to you about supporting your son with AIDS? What is the worst advice?
is a ______ question in the ______ domain
difference
cognitive
138
Who in the family is most worried about how AIDS is transmitted?
is a ______ question in the ______ domain
difference
affective
139
Which family member is best at getting your son to take his medication on time?
is a ______ question in the ______ domain
difference
behavioural
140
What do you know about the effect of life-threatening illness on children?
is a ______ question in the ______ domain
behavioural effect
cognitive
141
How does your son show that he is afraid of dying?
is a ______ question in the ______ domain
behavioural effect
affective
142
What could you do to show your son that you understand his fears?
is a ______ question in the ______ domain
behavioural effect
behavioural
143
What do you think will happen if these skin grafts continue to be painful for Dan?
is a ______ question in the ______ domain
Hypothetical/Future-Oriented Questions
cognitive
144
If Dan’s skin grafts are not successful, what do you think his mood will be? Angry? Resigned?
is a ______ question in the ______ domain
Hypothetical/Future-Oriented Questions
Affective
145
When will your son engage in treatment for his contractures?
is a ______ question in the ______ domain
Hypothetical/Future-Oriented Questions
Behavioural
146
If you see if/when in a question, this indicates what question type?
Hypothetical/Future-Oriented Questions
147
If you see mood/worry in a question, this indicates what domain the question is targeting?
affect
148
What is a triadic question?
how two affect another
questioning invites reflection regarding how two people’s actions impact the behavior or mood of another
149
What are triadic questions used to assess?
how families respond to their members in different situation
150
Considerations for termination stage of family interview
- know when to refer
- provide information
- mobilize supports
- commendations/summarize positive efforts
151
What is service learning?
1. Family & Community engagement pedagogies
2. Is experiential
3. Combines learning goals with civically responsible service
4. Enhances student growth and common good
152
What is visiting?
Includes information, storytelling, complaining but its almost always around food, home and surrounding a sense of gift giving. When there's laughter and teasing, thats when I know things are humming because my students are clearly making engagements with the community then
153
Cultural Competence as an organization
to provide services that demonstrate respect for diversity and cultural, ethnic, spiritual, emotional and age-specific differences
154
Cultural competence as an individual
respecting, understanding and accommodating the needs of our patients
155
Define culturally competent care
The ability to provide care with a client-centered orientation, recognizing the significant impact of cultural values and beliefs as well as power and hierarchy often inherent in clinical interactions, particularly between clients from marginalized groups and health care organizations.
156
Define cultural awareness
recognizing that difference and similarities exist between cultures, and becoming aware and sensitive to your own biases and assumptions.
157
Define cultural humility
is a life long journey of self-evaluation, reflection, and learning to deepen our understanding of how our life experiences influence how we understand and interact with others.
158
Define cultural safety
Addresses power differences inherent in health service delivery and affirms, respects and fosters the cultural expression of clients. This requires nurses to reflect critically on issues of racialization, institutionalized discrimination, culturalism, and health and health care inequities and practice in a way that affirms the culture of clients and nurses
159
Power differentials are measured by a patient’s _________ capacity to influence the ______________
perceived
decision-making encounter
160
Cultural safety concepts are about shifting power from the _______ to ________
nurse
the recipients of care
161
2 Themes that emerged from expressions of cultural safety in PHN practice
1. the use of manners
2. working with people/families
162
Manners are socially, historically and politically _________
constructed
163
Cultural safety guides the nurse to ________ rather than _________
ask & listen
assume
164
the second theme "working with people/families" key points from expressions of cultural safety in PHN practice study
- family as experts
- facilitate families to empower themselves
- power differentials
165
3 Steps to Become Culturally Competent (diversity lens toolkit)
1. lead self
2. engage others
3. Achieve Results, Develop Coalitions, Systems Transformation
166
Describe the Illness Belief Model
Our beliefs are the intersection of our own beliefs, our family's beliefs and our HCP beliefs, all of with are influenced by the beliefs of society/culture
167
4 Key Ideas of Illness Belief Model
1. illness is family affair
2. beliefs have huge impact on narrative
3. therapeutic change occurs by exploring beliefs through reflection and curious questioning
4. embrace (objectivity in parenthesis) through curious compassion
168
Constraining vs Faciliating Beliefs
Constraining beliefs - fixed mindset: increase suffering
Facilitating beliefs - growth mindset; soften suffering
169
Objectivity without Parentheses
Value Imposition/lack of bracketing
Holding an opinion to be true such that another’s opinion is not only untrue but must change
170
Objectivity in parentheses
Non-Violent Loving Interactions
Nurses engage in loving interactions when they open space to the illness beliefs and illness suffering of family members
Nurses listen in a manner that enables what the family member relates as true/what the family believes to be truth is their truth
171
How do you create a reality of curious compassion?
Asking questions that bring forth loving and compassionate beliefs about one another
172
Why is curious compassion key in family interviewing?
“the more curious we are about a family members’ illness suffering, the more we can dissolve our own judgements and practice in a space of curious compassion”
173
What is a deficit perspective
Focused on what was wrong, missing or abnormal
Clinicians were the expert
Negative Diagnosis
174
What is the McGill Model?
Strength Based Approach
Shifts focus from Deficit perspective to Strength-based perspective
Main goal of nursing: form a partnership with person/family.
Goal: Help families use their strengths and external resources to cope, achieve goals, and develop.
175
Strengths are _______ to the family system
Internal
176
Examples of family strengths (internal)
- traits
- assets
- capabilities, skills, competencies
- qualities
177
Resources are ______ to family system
External
178
Potentials are _____ that could be developed into a strength
precursors
179
3 roles of the nurse for working with resources
1. Identify resources
2. Mobilize and use resources
3. Regulate resources
180
When the family arranges contact with the speech language pathologist to assist their son’s stuttering, the family is:
a) Identifying strengths
b) Developing strengths
c) Mobilizing resources
d) Regulating resources
c) Mobilizing resources
181
What is resilience?
“The ability to withstand and rebound from disruptive life challenges”
The ability to “struggle well” and surmount obstacle
182
5 assumptions of resiliency model
1. stress is managed over time
2. unexpected/unplanned events are stressful
3. stressors within family are more disruptive than stressors outside
4. lack of previous experience with stressor can lead to increased perception of stress
5. ambiguous are more stressful than non-ambiguous
183
What are the 3 types of protective factors for resilience?
Individual, family, community
184
Individual protective factors for family resiliency
* Internal locus of control
* Emotional regulation
* Belief systems, values
* Self-efficacy,
* Effective coping skills
* Increased education, skills and training
* Health
* Temperament
* Gender, roles
* Self concept and self esteem
185
Family protective factors for family resiliency
* Family structure
* Intimate partner relationship stability
* Family cohesion
* Supportive parent-child interaction
* Stimulating environment
* Social support
* Family of origin influences
* Stable and adequate income
* Adequate housing
186
Community protective factors for family resiliency
* Involvement in the community
* Peer acceptance
* Supportive mentors
* Safe neighborhoods
* Access to quality schools, child care
* Access to quality health care
187
If a family is lacking resilience, assess if:
- it is individual, family, or community related
- has trauma impacted the family?
188
What is trauma?
Single/repeated experiences overwhelming one's ability to cope
189
Trauma Informed Care
Providing care in a manner that is welcoming and appropriate to the needs of those affected by trauma
190
4 Principles of TIC Practice:
1. Trauma Awareness
2. Emphasis on safety and trustworthiness
3. Creating opportunity for choice, collaboration, and connection
4. Strengths-based and skill building
191
TIC posits moving from “What is wrong with you?,” shift to ___
“What has happened to you?”
192
After ABC assessment consider assessing DEF =
D - distress
E - emotional support
F - family
193
4 Roles of Nurse Related to Strengths
1. Identifying family strengths
2. Providing feedback on the strengths
3. Developing strengths
4. Calling forth strengths
194
3 approaches to developing strengths
1. Helping transfer the use of a strength from one experience to another context
2. Cognitive reframing – turning a deficit into a strength
3. Developing knowledge or competency – teaching new skills, assisting them to locate and access experiences and materials
195
Complementary Relationships
Characterized by high degree of trust and intimacy
Like peanut butter and jelly
196
Non complementary relationships
independent of one another
not necessary for survival
