Comm Health - Family Nursing: Assessment
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- Process of Family Assessment
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- systematic process
- based on chosen theoretical framework
- identifies family health concerns
- emphasizes family strengths
- include cultural aspects - Overall Observations
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- status of home & neighbourhood
- family interactions
- ability for family to meet basic needs
- resources available (windshield survey) - 3 Family Theoretical Models
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1. Structural-Functional Theory (ex. Friedman Assessment Model)
2. Systems Theory
3. Family Developmental Theory (McGill Model of Nursing)
*CFAM - focuses on structure, function and development - Structural-Functional Theory
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- family is a system that performs certain functions
- How well does the family perform its functions?
- identify ways of coping, communicating, and caring
- how does health status or determinants of health affect structure or function?
- assist families to adapt structure to improve function (by redistributing roles or strengthening coping skills) - Systems Theory
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- focuses on family interactions (between themselves and others)
- change in one member influences the entire system
- assess how change in health status or determinant of health affects the system
- is the family an open system?
- assess relationships (internally & externally)
- facilitate open communication - Family Development Theory
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- focuses on changes that occur over time within the family system
- families develop in similar & consistent ways
- assess family history & present developmental stage
- assist family members to assume roles to meet the developmental tasks of their current stage - Friedman Assessment Model
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- focuses heavily on structural-functional perspective (also includes system and development theories)
- views family as an open social system & subsystem of society
- explores internal family dynamics & relationships to other social systems
- 6 Broad Caterogies of Friedman Model
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1. Identifying data
2. Developmental family stage & history
3. Environmental data
4. Family Structure
5. Family Functions
6. Family Coping - McGill Model of Nursing
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- primarily focuses on developmental theory
- focuses on strengths and resources to cope, achieve their goals & higher development
- nurses role is to engage family in learning process to achieve goals
- partnership - Calgary Family Assessment Model (CFAM) ***review this model for exam (p.615)
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Focuses on:
1. Structure
- internal (composition, gender, sexual orientation, rank order, subsystems, boundaries regarding decision making)
- external (extended family, larger systems)
- context (ethnicity, race, social class, environment, religion/spirituality)
2. Function (Instrumental-ADL, Expressive-9 subcatergories)
3. Development (stages, tasks, attachments)
- Expressive Functioning (Assessment component of CFAM)
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1. Emotional Communication (range & type of feelings expressed)
2. Verbal Communication (clear & directed?)
3. Nonverbal Communication (body language)
4. Circular Communication (communication between family members-adaptive or maladaptive circular communication)
5. Problem Solving
6. Roles
7. Influence (or power) - 3 types of influence (Instrumental, psychological, corporal)
8. Beliefs (opinions & assumptions)
9. Alliances & Coalitions (direction, balance, and intensity among members ex. parents vs. kids) - 3 Types of Influence (power) *component of CFAM
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1. Instrumental - privileges/rewards
2. Psychological - praise for good behaviour
3. Corporal (physical) - hugs or corporal punishment (hitting)