We are delighted that these DVDs are being utilized by faculties and
schools of nursing worldwide; educational programs complement this text,
Nurses and Families,by demonstrating family interviewing skills in action.
Further tangible evidence of the expansion of family nursing assessment
models worldwide is that the Calgary Family Assessment Model (CFAM)
continues to be widely adopted in undergraduate and graduate nursing
curricula and by practicing nurses. The CFAM is utilized in curricula
throughout North America, Australia, Brazil, Chile, England, Iceland,
Japan, Korea, Taiwan, Thailand, Finland, Portugal, Scotland, Spain, and
Sweden. With this expansion, we have had to revisit and revise our think-
ing about the CFAM in order to acknowledge, recognize, and embrace the
evolving importance of certain dimensions of family life that influence
health and illness, such as class, gender, ethnicity, race, family development,
and beliefs.
A significant amplification in our text was the development of a frame-
work and model for interventions, namely the CFIM, which was introduced
in the second edition. This was done in recognition of the need to give just
as much emphasis to intervention as there had been on assessment of fam-
ilies and to provide a framework within which to capture family interven-
tions. This change was clearly influenced by the advances in family nursing
research, education, and practice from a primary emphasis on assessment
to an expanding and equal emphasis on intervention.
Perhaps a more subtle but equally significant development is our ever-
changing and evolving relationship with the families with whom we work.
This change is reflected in our choice of language to describe the nurse–family
relationship that we deem most desirable. Our preferred stance/posture
with families has evolved into a more collaborative, consultative, relational,
and nonhierarchical relationship over the past 25 years. When we adopt
this stance, we notice greater equality, respectfulness, and status given to the
family’s expertise. Therefore, the combined expertise of both the nurse and
the family form a new and effective synergy in the context of therapeutic
conversations that otherwise did not and could not exist.
Another subtle development evolving throughout our five editions has
been the movement toward a postmodernist worldview. We embrace the
notion that there are multiple realities in and of “the world,” that each family
member and nurse see a world that he or she brings forth through interact-
ing with themselves and with others through language. We encourage an
openness in ourselves, our students, and the families with whom we work to
the many “worlds,” differences, and diversity between and among family
members and among health-care providers.
We have also been influenced by dramatic restructuring in health care
that has occurred over the past 15 years in Canada and the United States.
With massive restructuring in health-care institutions and community clin-
ics, budgetary constraints, and managed care, many nurses feel they cannot
afford the opportunity to get involved in or attend to the needs of families
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