2 - CHN II FAMILY HEALTH NURSING.ppt rural health

Family nursing
Home based nursing
Care

1. FAMILY DYNAMICS: Family
processes
27/9/2022

2. FAMILY PROCESSES
•DEFINITION:
–Family process is the ongoing interaction
between family members through which they
accomplish their instrumental and expressive
tasks.
–This makes every family unique within its own
particular culture.
•Alterations in family processes may occur
when family faces a transition due to
developmental changes

3. FAMILY PROCESSES
•Family processes can be understood and
explained under the following:
1.FAMILY ROLES (Spouse/partner)
2.OTHER ROLES ISSUES IN THE FAMILY:
•Sick role
•Role strain, conflict and role overload
3.FAMILY COMMUNICATION
4.FAMILY DECISION MAKING
5.FAMILY RITUALS AND ROUTINES

4. FAMILY PROCESSES
•Family roles (with regards to spouse/partner) -
Provider role, Housekeeper role, Child care role,
Socialisation role, Sexual role, Therapeutic role,
Recreational role, Kinship role
•OTHER ROLE ISSUES IN THE FAMILY:
–Sick role
–Role strain, conflict and role overload
•FAMILY COMMUNICATION
•FAMILY DECISION MAKING
•FAMILY RITUALS AND ROUTINES

5. FAMILY PROCESSES
•READ AND WRITE NOTES ON THE
FOLLOWING FAMILY PROCESSES:
1.OTHER ROLE ISSUES IN THE FAMILY:
1.Sick role
2.Role strain, conflict and role overload
2.FAMILY COMMUNICATION
3.FAMILY DECISION MAKING
4.FAMILY RITUALS AND ROUTINES

6. FAMILY HEALTH RISKS

7. CONCEPTS IN FAMILY HEALTH
RISKS -1
•Family health risks
–The factors that determine or influence
whether disease or other unhealthy results
occur in the family

8. CONCEPTS IN FAMILY HEALTH
RISKS - 2
•Risk appraisal
–The process of identifying and analysing an
individual’s prognostic characteristics of health and
comparing them with those of age group in order to
predict a person’s likelihood of prematurely
developing the health problems
•Risk reduction
–Application of selected interventions to control or
reduce risk factors and minimize incident of
associated disease and premature mortality.

9. CONCEPTS IN FAMILY HEALTH RISKS -3
Life events – can increase the risk for illness
and disability
Normative life event are those expected to occur at a particular
stage of development or of the life span. E.g. a child leaving
home to go to college, retirement from work, starting a first job.
Non-normative events are unpredictable. E.g. divorce, death of
a child.
HOLMES-RAHE LIFE STRESS INVENTORY: Life
Events Stress Test – can be used to assess individual’s
risks arising from life events
•Life event risks
–Age-related risks to a person’s health that often occur
during transitions from one developmental stage to
another.

10. CONCEPTS IN FAMILY HEALTH
RISKS - 4
•Family Crisis
–A situation in which the demands of the
situation exceeds the resources and coping
capacity of the family which becomes
disorganized or dysfunctional
•Families attempt to gather their resources
to deal with the demands created by the
situation or event.
•Q. What are the possible family resources
for dealing with a crisis?

11. Major family health risks and
nursing interventions -1
•Biological risks
–Examples – heart disease, hypertension,
diabetes, cancer.
–Q. What are possible nursing interventions?
•Age related risks (during transitions)
–Life-event risks – divorce, death of a child,
loss of family income, etc.

12. Major family health risks and
nursing interventions -2
•Environmental risks
•High crime neighborhoods
•Inadequate health resources or recreational
facilities
•noise pollution
•Behavioural (lifestyle) risks
–Poor sleep patterns
–Unhealthy eating habits
–Risky sexual behaviours

13. FAMILY HEALTH RISK REDUCTION:
Approaches
•Home visiting approach
–Purposes
–Advantages & disadvanges
–Process of home visiting
•Contracting with families
–Purpose
–Process
–Advantages and disadvantages
•Empowering families by improving their:
–Access and control over needed resources
–Decision-making and problem-solving abilities
–The ability to communicate and to obtain needed
resources

14. FAMILY HEALTH RISK: Clinical
Application exercise
•The Chuka County health department was notified that
Jane Waigwe, age 16, had been referred to by the
school counsellor at the local high school for prenatal
supervision. Jane was 4 months pregnant, in apparently
good health, in form 3, and living at home with her
mother, stepfather, and younger sister. The family lived
in a rural area outside of a small farming community. The
father of the baby also lived in the community and
continued to see Jane on regular basis. The referral
information provided the nurse with a beginning, but
limited, assessment of the family situation.

15. CASE STUDY QUESTIONS
1.What would you do first as the nurse assigned
to this family?
2.How would you help this family empower itself
to take responsibility for this situation?
3.After the initial contact, how would you extend
the assessment to the entire family system?
4.Would you contract with this family? If so, how?
On what terms?

16. Reference
1.Stanhope, M. & Lancaster, J. (2010).
Foundations of nursing in the
Community: Community-oriented
practice (3
rd
edition) Pp.330-349

17. Family-Centred Nursing Process

18. FAMILY NURSING AND
FAMILY-CENTRED
NURSING PROCESS

19. Learning Objectives
1.Define the terms family,, family health, family nursing, healthy/non-
healthy and resilient families.
2.Explain the importance of working with the families and its
challenges in the community setting
3.Describe current and future trends in family and family
demographics in Kenya and other parts of the world (with special
emphasis on American families as examples).
4.Analyze changes in family function and structure
5.Compare and contrast the four ways to view family nursing (i.e.
approaches to family nursing).
6.Identify the major risks to family health
7.Explain the application of the nursing process to reducing family
health risks and promoting family health
8.Describe the family-centered nursing process
9.Apply Gordon’s Functional Health Pattern model to assess and care
for a family and immediate community.
10.Describe the barriers to effective family nursing practice.

20. Family-Centered Nursing
Process
•Defn. Family-Centered Nursing Process -
is a systematic approach to scientific
problem-solving involving consisting of a
series of circular, dynamic actions –
assessing, analyzing, planning,
implementing, evaluating and terminating
- for the purpose of facilitating optimum
family (client) functioning
•It involves deliberative and not intuitive
decisions or action

21. PHASES OF FAMILY-CENTRED
NURSING PROCESS
1.Assessing – process of obtaining a database
2.Analyzing and diagnosing – a cognitive data
ordering process for the purpose of identifying nursing
diagnoses
3.Planning – formulation of desired family/client
outcomes goals and identification of intervention
strategies (actions) to achieve the goals
4.Implementing – a systematic approach to action used
by the family and nurse to achieve desired family
outcomes.
5.Evaluating – a continuous concurrent process used to
critique each component of the nursing process
6.Terminating – a therapeutic process which helps the
client and the nurse to end their relationship.

22. PHASES OF FAMILY-CENTRED NURSING
PROCESS: Principles
•The principles applied in all phases of the
nursing process individualization:
Individualization
Active participation by the family and the nurse
Self-determination of the family, and
Confidentiality.

23. PHASES OF FAMILY-CENTRED NURSING
PROCESS: Usefulness to the Nurse
•The family-centered nursing process
assists the nurse in:
–helping the client to mobilize personal
strengths that will enhance the client’s self-
care capabilities
–It provides the nurse with a framework for
facilitating client decision making about health
care matters

24. THE ROLES OF THE NURSE IN FAMILY-
CENTRED NURSING PROCESS
1.HEALTH EDUCATOR
2.COORDINATOR OF HEALTH CARE
3.DELIVERER AND SUPERVISOR OF PHYSICAL
4.CLIENT ADVOCATE – as she speaks for and on
behalf of the family.
5.COLLABORATOR AND TEAM MEMBER
6.CONSULTANT
7.COUNSELOR
8.CASE FINDER/EPIDEMIOLOGIST
9.ENVIRONMENTAL MODIFIER

25. HOME VISING IN FAMILY-CENTRED
NURSING PROCESS
•Home work
•Review the process of home visiting from
the Nursing Council of Kenya Procedure
Manual (2019)