Families Can Be Identified in Two Ways: Family As Context and Family As Client
Key Concepts
Families can be identified in two ways: family as context and family as client.
The wider family concept addresses changing family forms and takes into account lifestyles that are independent of biological or kin connections.
It is important to understand a variety of family theories because they give direction to nursing care of families, and no one theory addresses all dimensions of the family or fully explains family dynamics and behavior.
Some nursing theories have enlarged their conceptual base to include the family as client.
Four theories from the social sciences have major relevance to nursing. They are developmental, general systems, structural-functional, and interactional theories.
The stages of family development and the accompanying tasks of each stage guide the nurse in assessing the family.
Rather than a linear event, the family life cycle can be conceptualized as a life spiral wherein family members move closer together or farther apart depending on the life events that are occurring.
Ecological approaches to the family focus on the way the family interacts with their environment.
The cultural milieu within the family develops from the blending of patterns of the two families of origin within the context of the larger society.
Family caregiving must be considered from the point of view of both the nurse as caregiver and the family as caregiver to family members.
To provide effective and acceptable care, the provider must work in partnership with the family in an atmosphere of mutual respect and cooperation.
Family assessment includes an assessment of internal family functioning and of the relationship of the family to community resources and activities.
In order to understand the way a family works, the nurse must assess family strengths as well as problems and conflicts.
Two of the most useful assessment tools for families are the genogram and the ecogram.
The Omaha system of nursing diagnoses is more useful to community health nurses working with families than is the NANDA system of nursing diagnoses.
It is critical that the nurse work with family members to identify their concerns and to plan intervention strategies, rather than focusing on concerns from the nurse’s perspective.
Evaluation is an ongoing process in that every new piece of data adds a dimension to that which is already known and forces a new evaluation of the status of needed family care.
Note: The author acknowledges Joan Heron, retired Professor of Nursing, California State University, Fresno, for her significant contributions to the development of this chapter.