Health promotion for individuals - what needs to be considered?
Family
How do you define family? What has shaped your definition? What are your assumptions and views about family and family life?
Definition of Family Health
"The health of a family system that is ever changing and encompasses a holistic focus that includes biological, psychological, sociological, cultural, and spiritual factors"
Family Health and Functionality
"functional" (autonomy, responsive to individual needs) vs "dysfunctional" (decreased communication & support) suggests pathology with deficits rather than family strengths, and therefore encourages helplessness in the family
Resiliency
Coping with expected and unexpected stressors
Factors that promote family resiliency: Positive outlook, Family time, Flexibility, Shared recreation, Communication, Routines and Rituals, Support networks, Financial management, Spirituality, Family member accord
Approaches to Family Nursing
Family as the context/structure
Family as client
Family as a system
Family as a component of society
The Calgary Family Assessment Model (CFAM)
This family systems nursing model focuses on the family unit as client
This approach consists of a structural, developmental, and functional assessment of the family
The first nursing family intervention model
Designed to help nurses facilitate family functioning in the cognitive, affective, and behavioural domains
Family strengths are identified and reinforced through the use of commendations
Stages and Activities of a Home Visit (Using CFAM and CFIM)
1. Engagement
2. Family assessment
3. Family intervention
4. Termination and evaluation
5. Post-visit documentation
Health Risk Appraisal
Biological and age-related risks (genogram)
Environmental risks (social and physical - ecomap)
Behavioural risks (lifestyle assessment of family unit)
Genogram
Assesses biological and age-related risks
Ecomap
Assesses environmental risks (social and physical)
Behavioural Risk
Nutrition
Family activities
Monitoring health of family members
When to seek health care
Sleep patterns
Empowerment
A strategy nurses use to promote and protect the health of families, to encourage autonomy and active involvement of families in their own health choices, and to provide families with information so that they can make informed choices about their health
Characteristics of Empowerment
Access and control over needed resources
Decision-making and problem-solving abilities
Abilities to communicate and obtain needed resources
Nursing Process for Family Health Promotion
Families responsible for own health
Families can change in constructive ways
Families have a right to health information
Health-seeking process occurs in relationships
Families will only adopt behaviours compatible with lifestyle
Families have potential to improve health, and this can be enhanced by a caring nurse
5 Principles that guide and enhance family nursing practice
Work with the family collectively
Start where the family is
Adapt nursing intervention to the family's stage of development
Recognize the validity of structural variations
Emphasize family strengths
As part of her nursing practice course Lisa is working with a family in the community. The family consists of a single mother and three school-aged children. During one of the visits she accompanies the mother to the grocery store. While there, she watches the mother, who is on social assistance and therefore has a very limited budget, fill her grocery cart with what Lisa describes as "junk food". In seminar with the rest of her peers she expresses her feelings of both dismay and uncertainty about what she "should have done" and what she "needs to do now" to be a health promoting nurse with this family. Lisa states that with the knowledge that she now has of nutrition and for children's nutritional needs, it makes her cringe at the thought of the family eating the prepackaged, processed food that she observed in the cart.