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Test Bank Of Family Health Care Nursing Theory Practice 5 Ed by Joanna Rowe Kaakinen, Deborah Padgett Coehlo
Chapter 1
Family Health Care Nursing: An Introduction
This chapter provides an introduction to and broad overview of family health care nursing, explaining why this information is important to nurses who care for todays families. Family nursing is a scientific discipline based in theory, and Chapter 1 introduces theoretical concepts important to the nurses understanding of how to care for groups. It also provides definitions of family, family health, family health care nursing, and traits healthy families exhibit. It describes the evolution in the past few decades of family nursing as its own specialty as well as the many roles for nurses within this discipline. The concepts of family structure, function, and process are reviewed, as are family roles. Chapter 1 emphasizes both the historical and evolving value of family as a basic unit of human society and as a unit of analysis. It approaches health and illness as family events, with changes in the individual affecting the entire familys functioning. This chapter lays the foundational knowledge of the nature of interventions in family nursing.
Critical Concepts
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generalized and in specialized settings.
Review of Key Terms
Contemporary family: Generally refers to the changing structure and function of todays families, including single-headed households, cohabitating couples and parents, blended families, same-sex couples and parents, and grandparents raising grandchildren. Family functions have expanded from a focus on reproduction, socialization of the young, economic survival, and health care functions. The functions have shifted to include intimate relationships, communication, and shared responsibilities with the larger society.
Family: Two or more individuals who depend on one another for emotional, physical, and economic support. The members of the family are self-defined (Hanson, 2005).
Family as a component of society: Care that views the family as one of many institutions in society, similar to the health, economic, educational, or religious institutions.
Family as a system: Care that focuses on the interaction between and among family members, including subsystems within the family (e.g., dyads such as motherfather and parentchild) and outside the family (e.g., schools, churches, and community agencies).
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Family as client: Care that focuses on the family members as a unit rather than any one individual.
Family as context: Care that focuses on the individual but considers the familys influence on the individual.
Family functions vs. family functioning: Family functions are all the ways that families serve their members, related to prescribed social and cultural obligations and roles of family in society. Denham (2003) described family functioning as individual and cooperative processes used by developing personas to dynamically engage one another and their diverse environments over the life course (p. 277).
Family health: A dynamic, changing state of well-being that includes the biological, psychological, spiritual, sociological, and cultural factors of individual members and the whole family system.
Family health nursing: The process of providing for health care needs of families within the scope of nursing practice. Nursing care can be designed with the family as context, the family as a whole, the family as a system, or the family as a component of society.
Family process: The ongoing interaction between family members through which they accomplish their instrumental and expressive tasks (Denham, 2005).
Family structure: The ordered set of relationships within the family and between the family and other social systems. Genograms and ecomaps are tools used for the assessment of who comprises the family unit and the interactions between family members and other systems. Health function of families: Refers to historical and contemporary tasks of family members providing care for the health and illness of one another; vitally important as a resource to the larger society.
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Healthy families: Optimally functioning families have the ability to negotiate; communicate in clear, open, and spontaneous ways; have respect for each other; encourage autonomy; accept responsibility; demonstrate warmth; and express optimism and enjoyment of shared experiences. Traditional family: Usually refers to a more traditional concept of family structure including a husband, wife, and biological children.
U.S. Census definition of family: A group of persons united by ties of marriage, blood, or adoption, constituting a single household; interacting and communicating with each other in their respective social roles of husband and wife, mother and father, son and daughter, brother and sister; and creating and maintaining a common culture.
Terms Used to Describe Family Nursing Roles
Case finder and epidemiologist: The family nurse gets involved in case finding and becomes a tracker of disease. For example, consider the situation in which a family member has been recently diagnosed with a sexually transmitted disease. The nurse would engage in sleuthing out the sources of the transmission and in helping get other sexual contacts in for treatment. Screening of families and subsequent referral of the family members may be a part of this role. Case manager: Included in the contemporary understanding of this nursing role is coordination and collaboration between a family and the health care system. The case manager has been formally empowered to be in charge of a case. For example, a family nurse working with seniors in the community may become assigned to be the case manager for a patient with Alzheimer disease.
Clarify and interpret: The nurse clarifies and interprets data to families in all settings. For example, if a child in the family has a complex disease, such as leukemia, the nurse clarifies and
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interprets information pertaining to diagnosis, treatment, and prognosis of the condition to parents and extended family members.
Consultant: The family nurse serves as a consultant to families whenever asked or whenever necessary. In some instances, he or she consults with agencies to facilitate family-centered care. For example, a clinical nurse specialist in a hospital may be asked to assist the family in finding the appropriate long-term care setting for their sick grandmother. In this role the nurse comes into the family system by request for a short period and for a specific purpose.
Coordinator, collaborator, and liaison: The family nurse coordinates the care that families receive, collaborating with the family to plan care. For example, if a family member has been in a traumatic accident, the nurse would be a key person in helping families access resourcesfrom inpatient care, outpatient care, home health care, and social services to rehabilitation. The nurse may serve as the liaison among these services.
Counselor: The family nurse plays a therapeutic role in helping individuals and families solve problems or change behavior. An example from the mental-health arena is a family that requires help with coping with a long-term chronic condition, such as when a family member has been diagnosed with schizophrenia.
Deliverer and supervisor of care and technical expert: The family nurse either delivers or supervises the care that families receive in various settings. To do this, the nurse must be a technical expert both in terms of knowledge and in skill. For example, the nurse may be the person going into the family home daily to consult with the family and help take care of a child on a respirator.
Environmental specialist: The family nurse consults with families and other health care professionals to modify the environment. For example, if a man with paraplegia is about to be
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discharged from the hospital to home, the nurse assists the family in modifying the home environment so that the patient can move around in a wheelchair and engage in self-care. Family advocate: The family nurse advocates for families with whom he or she works; the nurse empowers family members to speak with their own voices, or the nurse speaks out for the family. An example is the nurse who is advocating for family safety by supporting legislation that requires wearing seat belts in motor vehicles.
Health teacher: The family nurse teaches about family wellness, illness, relations, and parenting, to name a few topics. The teachereducator function is ongoing in all settings in both formal and informal ways. Examples include teaching new parents how to care for their infant and giving instruction about diabetes to a newly diagnosed adolescent boy and his family members.
Researcher: The family nurse should identify practice problems and find the best solution for dealing with these problems through the process of scientific investigation. An example might be collaborating with a colleague to find a better intervention for helping families cope with incontinent elder adults living in the home.
Role model: The family nurse is continuously serving as a role model to other people through his or her activities. A school nurse who demonstrates the right kind of health practices in personal self-care serves as a role model to parents and children alike.
Surrogate: The family nurse serves as a surrogate by substituting for another person. For example, the nurse may stand in temporarily in the role of a loving parent to an adolescent who is giving birth to a child alone in the labor and delivery room.
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Quiz and Exam Questions
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Reflection Questions
Note: All chapters of the instructors manual include reflective questions as means of evaluating learning. A deep understanding of family requires more than simply choosing an answer in a multiple-choice format. Reflective writing or in-depth thought about ones assumptions, values, and belief systems can result in both personal and professional growth for students and nurses alike.
Answer: The family as a client centers on the assessment of all individual family members where the family is in the foreground and individuals are in the background. The family is the sum of individual family members with a focus on each and every individual such as one may see in a family medical practice office. The family as system views the family as an interactional system whereby the interactions between family members become the target for nursing interventions. The nurse focuses on the individual and family simultaneously.
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Answer:
Student Learning Activities
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Answer: Answers from the following are acceptable: communicates and listens to one another, affirms and supports one another, teaches respect for others, develops a sense of trust in members, displays a sense of play and humor, exhibits a sense of shared responsibility, teaches a sense of right and wrong, has a strong sense of family in which rituals and traditions abound, has a balance of interaction among members, has a shared religious core, respects the privacy of one another, values service to others, fosters family table time and conversation, shares leisure time, or admits to and seeks help with problems.
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families have improved many of the conditions most damaging to individuals (child abuse, child labor, etc.) but have increased other areas (i.e., depression and suicide rates).
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