1. Delmar Learning Copyright © 2003 Delmar Learning, a Thomson Learning company Chapter 24 Frameworks for Assessing Families

2. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 24 Family as context Emphasis on individual Family as client Emphasis on family unit

3. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 24 Definition of Family Traditional families  Based on blood or legal relationships Wider family  Independent of biological or kin connections

4. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 24 Types of Families Nuclear family Family of origin Family of procreation Extended family Blended family

5. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 24 Varieties of Family Forms Legally married Dual-career Adoptive Foster

6. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 24 Varieties of Family Forms Voluntary childlessness Unmarried Formally married Multi-adult household Extramarital sex

7. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 24 Major Issues in Remarriage Initial family issues Developing family issues Feelings about self and others Adult issues

8. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 24 Theoretical Foundations in Family Nursing Neuman’s System Model King’s Open Systems Model Roy’s Adaptation Model Rogers’ Life Process Model

9. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 24 Social Science Theories Developmental theory  Life cycle approach  Successive stages

10. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 24 Family Life Spiral Based on stages of life/life events Marriage Birth Child rearing Retirement

11. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 24 General Systems Theory Describes family interactions with self and society Nurses are part of the family system

12. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 24 Systems Theory Applied to Families Structural-Functional Conceptual Framework Family Interactional Theories Family Systems Theories

13. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 24 Interaction between the Family and the Social System Ecological approach  Ecosystem Mesosystem Exosystem Macrosystem Microsystem

14. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 24 Network Therapy Natural relationship systems of individuals and families Assess family network  Functional  Dysfunctional

15. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 24 Transactional Field Approach Individual viewed within context of transactional field Family viewed in interaction with other groups

16. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 24 Caring and Family Nursing Primary caregiver Stages  Encounter  Enduring  Exit

17. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 24 Cultural Considerations – Family Style Traditional-oriented non-resistive Integrated bicultural Assimilated Separatist Marginalized

18. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 24 Partnerships in Family Nursing Nurse and family work in partnership Mutual respect and cooperation Recognize family rights Nursing role – facilitator

19. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 24 Family Assessment Structural Developmental Functional

20. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 24 Family Environment Physical Psychological Social

21. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 24 Family Strengths Ability to  Meet basic needs  Communicate effectively  Maintain growth-producing relationships  Respect individuality of family members  Accept help

22. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 24 Family Assessment Tools Genogram  Describes family structure, relationships, and information Ecomap  Visual depiction of contact with a larger system

23. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 24 Family Diagnosis NANDA System  Individual focus within context of family Omaha System  Family focus, diagnoses problems and strengths

24. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 24 Four levels of Omaha System Domain Problem Modifiers Signs and symptoms

25. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 24 Omaha System Interventions Category Target Client-specific information

26. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 24 Problem Rating Scale for Outcomes Evaluates client’s problem specific knowledge, behavior, status Five degrees of response Most negative to most positive

27. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 24 Levels of Prevention Primary Secondary Tertiary

28. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 24 Evaluation Measures achievement of outcomes Process is ongoing