Family Nursing

Module 4: How to care for family and society? (interventions)

Planning & Intervention

• Planning
• Developed with the family
• Focus on most pressing concerns
• Pros and cons of options weighed (cost benefits, convenience, financial costs) (Kaakinen et al., Box 5-4, p. 137)
• Values and preferences considered
• Ability and confidence to act
• Being more specific leads to more positive outcomes
• Who needs to do what by when and timeframe for nurse follow-up

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• Intervention
• Provision of direct care
• Removal of barriers to needed services
• Improve family capacity to act on their own and assume responsibility
• Improve health outcomes of ill member, family caregiving outcomes, or both
• Nurse-family relationship is an intervention

(Kaakinen et al., 2018, p. 125-126)

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• Family Constructs and Family Focused Nursing Actions (Eggenberger et al., 2014)

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Goal Development

Models for Interventions

Calgary Family Interventions

• Interventive Questioning
• Effect change in cognitive, affective and behavioral domains of family functioning
• Cognitive
• Commend strengths
• Offer information and opinions
• Affective
• Validate or normalize emotional responses
• Encourage telling of illness narrative
• Draw forth family support
• Behavioral
• Encourage caregiver support
• Encourage respite
• Devise rituals

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Family Intervention: Denham

• Designed based on thorough understanding of family contexts and functional core processes
• Caregiving
• Cathexis
• Celebration
• Change
• Communication
• Connectedness
• Coordination
• Family health routines

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Family Health System Interventions

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• Goal for intervention is optimal response in each of the realms of the family experience

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• Tomlinson, P.S., Peden-McAlpine, C., & Sherman, S. J (2012). A family systems nursing intervention model for paediatric health crisis. 68(3):705-14. doi: 10.1111/j.1365-2648.2011.05825.x.

• Family emotional closeness
• Mutually supportive relationships
• Caregiver skills
• Clear family coordination
• Direct communication

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Risk Factors

Protective Factors

• Isolation
• Stressors
• Family rigidity
• Family Conflict

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(Weihs, Fisher, Baird, 2002; Chesla, 2010)

Contexts to Consider

Evaluation & Reflection

• Evaluation
• Proceed as originally planned?
• Modify the family action plan?
• Revisit the family story?
• Appropriate time to end relationship?

• Reflection
• Families and Nurse
• Part of evaluative process for determining if family outcomes were met
• Helps nurse to increase expertise through self-reflection and self-evaluation

Question to Ponder

• If nursing is “the diagnosis and treatment of responses to actual or potential health problems”, then family nursing is “____________________________”.
• What differentiates a family level or family unit intervention from an individual intervention?

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