Using CFAM And CFIM To Conduct A Family Interview

From a pediatric perspective, the family is an integral part of the healthcare team. Parents are the primary ally and resource in providing individualized care for their child. Even in adult patients, who they are is impacted by the relationships that they have. Serious or chronic illnesses and injuries affect the entire family. The family, then, becomes the patient, particularly when it is necessary to make lifestyle changes.

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

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.

Family Assessment The family chosen for this assignment are family friends who agreed to conduct the interview and discuss any health issues they had. Because some of the questions were fairly invasive into their private lives, no names are given. There are five members in the family, and they all participated in the interview. Questions are based on the eleven functional health patterns.

Using the CFAM to conduct a family interview, I identified a nursing diagnoses and interventions for the family I interviewed.

Families always affect one another, even when they feel distanced. The family unit can promote health or it can be a source of stress. It is the nurse's task to use family relationships to act as health facilitators for the patient, and, if necessary, treat the family as part of the patient's social environment. The family creates the patient's environment just as much as a clean room or an accessible place to exercise or access to appropriate medication.

All health care providers are familiar or have some idea of what family focused care entails. Family focused care can be practiced in any settings in healthcare, and nurses are familiar with this concept as this strong theory based teaching is emphasized throughout the nursing curriculum. With the trend of health care delivery shifting towards home based or community setting, it is now more than ever important for nurses and advance practice nurses (APN) to incorporate family nursing practice for improved outcomes for the patient and their families. This paper will discuss one of the many family nursing theory and its impact on the family nursing practice now and in the future.

-A succinct philosophy of family nursing is seen in The Association for the Care of Children’s Health standards stating the expectation for healthcare providers to facilitate family/professional collaboration at all levels of care, and to recognizing family as the constant in the patient’s life whereas the healthcare providers will fluctuate (p.40, 2003).

A comprehensive family assessment provides a foundation to promote family health, Edelman & Mandle, C. L., (2011). This assessment of family health offers many approaches that involve getting to know the strengths and weaknesses of the family. According to Stanhope & Lascaster (2010), the family nursing assessment is the cornerstone for family

Think back to when you were a child and you became ill. All you wanted was the protection and guidance of your mother to take care of you. If you had older siblings, maybe they were the ones that helped make you feel better. Even as we grow older, we rely on our family for support when we are not well. When a family member is ill, it is not just that one person that suffers. When an illness strikes a family member, it oftentimes includes the whole family to deal with the illness also. There are different approaches that a nurse can utilize when dealing with family nursing. Approaches include family as context, as a client, system and a component of society. In this paper, I will discuss where and how these approaches are utilized.

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 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

Using Gordon’s functional health patterns to assess a family will guide the nurse in developing a comprehensive nursing assessment that is holistic in nature. Gordon’s functional health patterns are founded on 11 principles that are incorporated within the nursing practice. These 11 principles serve as a framework for a thorough nursing assessment in which to build a holistic and individual family care plan (Grand Canyon University, 2011). The author has developed family-focused questions for each of the 11 principles and utilized these questions as a tool to assess her own family. This paper will summarize the family assessment that was performed by the author and discuss two wellness nursing diagnoses that

▪ It is a family’s duty to take care of their loved ones, even when one member may become extremely ill.

The role and definition of family can vary from one culture to another. Generally speaking, the culture in the United States places a lot of emphasis on individuality and personal freedom. In many cultures, the family unit has a very strict and defined hierarchy. Often the Father is seen as the head of the household and is responsible for much of the decision making. This can include decisions concerning the health care of a family member. It could also result in reluctance for the head of the family to place himself in a position of relying on others for care, a perceived position of weakness. In many cultures, the family goes beyond the nuclear family, and extends to the community, friends and neighbors. These are strongly held beliefs, and we must refrain from judging them as right or wrong based on our own culture. Rather, weneed to find ways to work within the framework of the family structure of the patient. ( Falvo, pp.186-187)