This week, you read about the theoretical foundations for the nursing of families. These theories include:
Family Systems Theory
Developmental and Family Life Cycle Theory
Family Health and Illness Cycle Model
Bioecological Theory
Family Assessment and Intervention Model
In a 2-3 page paper in APA format, compare two of these theories and discuss their strengths and weaknesses.
By understanding theories and models, nurses are prepared to think creatively and critically about how health events affect the family. Chapter 2 of Family Health Care Nursing lays the theoretical groundwork needed to practice family nursing. The introduction builds a case for why nurses need to understand the interactive relationships among theory, practice, and research. It also makes the point that no single theory adequately describes the complex relationships of family structure, function, and processes. The chapter then continues by delineating and explaining relevant theories, concepts, propositions, hypotheses, and conceptual models. Selected for this textbook, and explained in this chapter, are three theoretical/conceptual models specific to family nursing: Family Systems Theory, Developmental and Family Life Cycle Theory, and Bioecological Theory. Using a family case study, the chapter explores how each of the three theories could be used to assess and plan interventions for a family. This approach enables learners to see how different interventions are derived from different theoretical perspectives.
Family Systems Theory
Developmental and Family Life Cycle Theory
Family Health and Illness Cycle Model
Bioecological Theory
Family Assessment and Intervention Model
Chapter 5 of Family Health Care Nursing presents a systematic approach to develop a plan of action for the family with the family, to address its most pressing needs. This chapter is built on the traditional nursing process model to create a dynamic systematic family nursing assessment approach. Assessment strategies include selecting assessment instruments, determining the need for interpreters, assessing for health literacy, and learning how to diagram family genograms and ecomaps. The chapter also explores ways to involve families in shared decision making and explores analysis, a critical step in the family nursing process that helps focus the nurse and the family on identification of the family’s primary concern(s). The chapter uses a family case study as an exemplar to demonstrate the family nursing assessment and intervention.
In addition to the Family Nursing Process model, this chapter also outlines the Family Reasoning Web (shown to the right). The Family Reasoning Web is a systematic method used to ensure that families are viewed in a holistic manner, which also helps to keep the interventions oriented to a family strengths orientation. Family interventions need to be tailored to each individual family, with consideration of the family’s structure, function, and processes. By subscribing and selecting a theory-based approach to assessment, and formulating mutually derived intervention strategies, families are more likely to be committed and follow through with family plans and interventions.
The second section of the chapter provides a broad view into the workings of families with specific focus on families who are experiencing a health event in one of its members. Nursing interventions offer nurses ideas about actions that support families. Family health care nursing is at the core of all nursing practice everywhere and at any time. Because health and illness are family events, nurses interfere with families at these crossroads, and the informed nursing care of families makes a difference for all.
You will also continue reading The Shelter of Each Other: Rebuilding Our Families. In Chapter 4, Mary Pipher takes a look at the process of comparing different times, past and present. She posits that some things have changed for the better and some for the worst. The expectations of what families need to be happy have changed. In the 1930s people worried about survival – food, shelter, and warmth. Now people worry whether they are sufficiently self-actualized. Being successful now demands different skills than it did in the past; coping skills, anger management, and communication skills. The expectation of civil behavior has also changed from then until now. Teachers agree that children are also having a tougher time now than before, partly because of the much greater degree of sexualization. But the past had racism, a lack of antibiotics, and women and children had virtually no rights. Today, families are more confused about who the enemy is.
In Chapter 5, the demographic changes of the last fifty years are discussed including the homogenization of cities and towns as people have left the agrarian culture and moved to the cities. With this has come a lack of closeness where we don’t know our neighbors’ names. Communities have lost the sense that the people who live there are “all in this together.” The internet has proven that people can keep or delete relationships with the click of a mouse. The world is a scarier place now which has implications for children who need to feel safe. Pipher goes on to discuss the function of television, advertising, and the resulting pursuit of money and their effect on values.
The final chapter for this week, Chapter 6 in The Shelter of Each Other: Rebuilding Our Families begins with a brief history of therapy and leads into Ten Mistakes That Therapists Make. These include: (1) the family is the cause of all problems; (2) therapy has been hard on women; (3) therapy has pathologized ordinary human experience and taught that suffering needs to be analyzed; (4) we have focused on weakness rather than resilience; (5) some of our treatments have created new problems; (6) we have encouraged narcissism and checked basic morality at the doors of our offices; (7) we have focused on individual salvation rather than collective well-being; (8) we have confused ethical and mental health issues, empathy, and accountability; (9) some therapists abuse their power; and (10) we’ve suggested that therapy is more important than real life.
Learning Objectives
Upon successful completion of this week, you should be able to:
Analyze the various family theories and models and the importance of integrating them into family nursing.
Explain how health events affect families.
Differentiate the relationship between theory, practice and research.
Describe a family genogram and ecomap and explore their uses in family assessment.
Describe family assessment strategies used in nursing.
Readings
You are responsible for reviewing the following materials:
Kaakinen, J.R., Coehlo, D.P., Steele, R. & Robinson, M. (2018). Family Health Care Nursing. (6th ed.). F.A. Davis.
Chapter 2: Theoretical Foundations for the Nursing of Families
Chapter 5: Family Nursing Assessment and Intervention
Lecture Notes
Chapter 2: Theoretical Foundations for the Nursing of Families
Chapter 5: Family Nursing Assessment and Intervention
Pipher, Mary. (2008). The Shelter of Each Other: Rebuilding Our Families. Ballantine Books.
Chapter 4: Then and Now
Chapter 5: One Big Town
Chapter 6: Therapy, The Trojan Horse
