Episodic Health Challenge Within the Context of Family
Family refers to a “set of relationships that each patient identifies as family or as a network of individuals who influence each other’s lives” (West & Jakubec, 2014, p.274). In nursing, it is considered that individuals cannot be completely understood in solitude but instead are better comprehended within the context of their family, as a shift in one member’s health status impacts other members of the family (West & Jakubec, 2014). Moreover, each individual’s thoughts about health and health-related behaviours evolve out of his or her family’s beliefs, values, and practices (Doane & Varcoe, 2005, 2006 as cited in West & Jakubec, 2014). Therefore, in this paper, through the use of the
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M has an admitting diagnosis of acute dyspnea compounded by pleural effusion secondary to chronic heart failure. Heart failure is defined as diminished cardiac pumping or filling. It presents as ventricular dysfunction, reduced exercise tolerance, decreased quality of life, and a shorter life span (Bouffard, 2014). Left-sided heart failure, which is most prevalent, is caused by left ventricular dysfunction and results in blood moving back up into the left atrium and then into the pulmonary veins. This results in increased pulmonary capillary pressure and development of pleural effusion (Bouffard, 2014). Dyspnea, also known as shortness of breath, is often a symptom of chronic heart failure. It results from elevated pulmonary pressure that is due to fluid accumulation in the interstitial and alveolar space (Bouffard, 2014).
Calgary Family Assessment Model
The Calgary Family Assessment Model was designed to help nurses better grasp the “relationships that family members share, what the illness means to family members, how the illness has influenced family functioning, how the family has been affected by the illness, and the support that the family is most in need of” (Neabel et al., 2009; Wright & Leahy, 2009 as cited in West & Jakubec, 2014, p.278). The model assesses 3 aspects of family life: structural, developmental, and functional.
Structural
Many people have many different definitions of a family. Some include family as the people they live with, some include their entire extended family, and some include friends, neighbors, coaches, and teachers. According to the Vanier Institute (2013), a family is “a combination of two or more persons who are bound together over time by ties of mutual consent, birth, and/or adoption” (para. 2). Whichever way you look at it, families often play a major role in life. It only makes sense that when a person begins to go through a drastic change in life such as illness, the family will be involved. This is why it is important that nurses learn how to provide suitable client and family centered care. They can do this by following the four
Including the client as an expert member of the team creates an enhanced quality of care (Coad, Patel & Murray, 2014). In pediatrics, parents are often at the center of the child’s care. When asked to define what made the client care experience positive, parents stated that sensitivity, empathy and honesty were key factors (Coad, Patel & Murray, 2014). Working in healthcare, nurses can become desensitized to difficult experiences because they deal with them daily. Integrating the client and family as part of the healthcare team, allows the nurse to see the patient and family as a people first. By avoiding using illness as context, and instead using person as context, care will be more holistic (Coad, Patel & Murray, 2014). A family-focused approach helps to ensure that the whole family feels a part of the experience and is valued. In the case of bereavement, family centered care is particularly important. If the family is not included in the care from the start, it can provide barriers for grieving and impact how the family deals with loss (Jones, Contro & Koch, 2014). Nurses have an opportunity to help support the family through the grief process (Jones, Contro & Koch, 2014). Families have a significant impact on how the client heals, so by caring for the family’s needs, the nurse is indirectly caring for the patient. It is in the client’s best interest for the care to be holistic for the patient as well as the family (Jones, Contro & Koch, 2014). All
Family theories help explain the family’s impact on an individual’s wellbeing and offer different approaches to managing one’s health with a family-focused perspective. They provide a foundation for practice and enhance one’s understanding of family processes and dynamics. These theories address the family as the unit of care and enable nurses to empathize, comprehend, and collaborate with the family providing strategies in practice and improving care (Denham, Eggenberger, Young, & Krumweide, 2016). Two family theories that have sparked my interest are the Bowen’s Family Systems Theory (FST) and the Illness Beliefs Model (IBM). This paper will discuss each theory, including the strengths and weaknesses of each. A fictional family case
New norms of what is perceived as a family are emerging, according to Kaakinen, each distinct, with its own set of characteristics defining a healthy family (Kaakinen, Coehlo, Steele, Tabacco, & Hanson, 2015, pg. 37). Based on current demographic indicators, nursing must adapt to these evolving changes, to effectively identify real and potential risks affecting both the health and safety of the family unit.
According to Stanhope and Lancaster (2008) “Each family is an unexplained mystery, unique in the ways it meets the needs of its members and society” (p. 550). Family nursing is a special field that involves the nurse and family working together to achieve progress for the family and its members in adjusting to transitions and responding to health and illness. The Friedman Family Assessment Model serves as a guide in family nursing to identify the developmental stage of the family, environmental data, family structure, composition, and functions as well as how the family manages stress and their coping mechanisms. From this data, three nursing diagnoses with interventions are developed.
It also shows that not every family has the same strengths and how the every family’s strengths can differ from each other’s. Which allows the nurse to use this tool to identify their strengths as a family to help them to set a family goal to achieve together and formulate a problem solving plan. It’s an easy tool because the questions are straightforward and it is a child friendly tool, suitable for any age not just the adults. It is a family assessment therefore the children’s feelings shall not be neglected. External family members can take part in this assessment as well, not only will it improve the family members’ relationship with each other and as a family but also help build a trusting relationship with the nurse which will allow the family members to voice out or share anything without feeling uncomfortable. (Smith LM
In this view, the healthcare provider may include the family in terms of socioeconomic and functional support, but really focus on the patient as an individual (p.36-37, 2003). Family as Sum of its Members sees each member of the family in the foreground and care is provided to all family members. (p.37, 2003). Family Subsystem looks at the significant relationships in the family; parent-child, marital interactions, caregiving issues, bonding-attachment concerns (p.37, 2003), where Family as Client looks further into family’s internal dynamics, relationships, structure and functions and its relationship with the outer environment (p.37, 2003).
The purpose of this paper is to incorporate one family's experience of living with multiple chronic illnesses into the Calgary Family Assessment Model (CFAM) and Rolland's Chronic Health Challenge Framework. CFAM was developed by Dr. Lorraine M. Wright, a professor Emeritus of nursing and by Dr. Maureen Leahey, a manager of a mental health outpatient program both have over 25 years experience while still managing to supervise, teach, consult, write, and maintain a part-time clinical practice in individual, couple, and family therapy (Moxie, 2007). CFAM allows nurses to assess families during interviews. CFAM is a multidimensional framework consisting of three major categories: structural, dimensional and functional. (Wright & Leahey, 2005)
The family has various functions that include teaching members’ values, morals and beliefs as they relate to health practices. Health can be defined as a complete state of wellbeing and not merely the absence of disease. Gordon’s functional health patterns are a methodology developed by Marjorie Gordon in 1987 to be used as a guide to establish a comprehensive nursing database (Kriegler & Harton, 1992). Gordon’s eleven functional health patterns are; health perception/ health
The purpose of this paper is to display how such assessment is essential not on an individual basis, but rather on a larger scale in relation to family nursing. Family nursing “centers on the family as a unit of care, addressing family needs in response to a member’s illness or threat to health, rather than focusing on the individual. An understanding of families’ needs at particular developmental stages, how they communicate and function, and an ability to undertake a family assessment is foundational knowledge for family nursing” (St John, 2009, p.6). Often, nurses encounter the families of their individual patients on a daily basis, yet family assessments are not performed. This is because nurses often feel there is little time to engage families effectively, and in fact lack of time, has been identified by nurses as the primary barrier to engaging families (Kaakinen, 2015, p.109). Evidence based practice however, has proven that “a 15 minute, or even shorter, family interview can be purposeful, effective, informative, and even healing” (Wright, 2013, p.264). This 15 minute interview has been adopted in many acute care settings in involves five key components; manners, therapeutic conversation, key questions, commendation, and the genogram. These ideas represent the theoretical underpinning and are a condensed version of the Calgary Family Assessment Model (Wright, 2013). This model is large, but can be customized and adapted to the function of each individual
I knew college was going to change me in many ways. Yet, after my family and I restructured our collective and individual emotional reactivity over the three years that I was away at school, I believed my work in that department was done. I thought transiting into college was difficult, however, I found myself once again unprepared for the aftershock that rocked my family once I return from school. I left college a strong, independent, mature, and differentiated person, or at least I kind of did.
Leading to dyspnea, which is defined by the American Thoracic Society (ATS) as ‘a subjective experience of breathing discomfort that consists of qualitatively distinct sensations that vary in intensity’. Almost all patients with IPF experience progressive dyspnea, resulting in a major impact on their quality of life. Dyspnea is a sign of serious disease of the airway, lungs, or heart. The onset of dyspnea should not be ignored; it is reason to seek medical attention. Later leading to more severe symptoms, such as always being tired, from lack of oxygen in the body, resulting in patients contracting pulmonary hypertension, heart failure, and pneumonia. Patients diagnosed with IPF have a long fight ahead, they will need their loved ones full support going through treatment and day to day
My resource family involved an adult woman known as Louiza. Louiza was a patient diagnosed with Hodgkin Lymphoma disease. The first interview began by looking at the family situation, and the risks associated with the disease. The interview process was crucial in understanding the nature and lifestyle of the family. The sampling method reflected aspects of motivational interview questions designed to collect qualitative data. The data helped to ascertain the feelings of the subject toward the situation. The data collection exercise commenced with sending a notification alert to Louiza. The notification expressed my intention and permission to assess the health problem in the family. The notification note also requested
According to the Registered Nurses Association of Ontario (RNAO) it is important to analyze and assess families as a whole in order to come up with a working diagnosis and nursing plan (RNAO, 2006). Families are important because they play a huge role in the patients recovery as they can affect the clients health in a positive or negative way. When caring for a client it is good to include the family in your care plan, because family centered care looks at the patient from a holistic angle (Hutchfield, 1999). The care plan not only focuses on the clients disease, it is also considers the surrounding systems. This paper will discuss the results of two home visits I conducted' after getting the clients' (Mrs.
One parent family as a household with at least one child and a parent by Online Dictionary. Like other growing problems, one parent families are an important raising situation in the United States. Some everyday struggles and disadvantages are experienced by single parents today. Problems such families have to face can range from expensive day care, economic hardship, hurdles in balancing both home and work, and ability to spend limited quality time with children and finical difficulties (Ambert, 2005). The disadvantage for kids in a one parent family is the absence of a mother or father. Being raised by one parent can have a significant impact on children. I chose the social problem of one parent families because of it’s widespread effects and consequences and that’s rapidly increasing in the United States.