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Community Health Nursing

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Family and care plan: FAMILY ROLE ... No _____ Public ... Verdana Arial Wingdings Calibri Times New Roman Profile 1_Profile Community Health Nursing ... – PowerPoint PPT presentation

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Title: Community Health Nursing


1
Community Health Nursing
  • Chapter 23
  • Assessment of Families

2
Effects of family health on individual and
community
  • The health of each family member effects the
    other members and contributes to the level of
    family health .
  • Family Function .
  • Family health standards .
  • Healthy family influences community positively
    and vice versa.

3
Characteristics of Healthy Family
  1. A facilitative process of interaction exists
    among family members.
  2. Individual member development is enhanced.
  3. Role relationships are structured effectively .
  4. Active attempts are made to cope with problems .

4
Characteristics of Healthy Family
  1. There is a healthy home environment and lifestyle
    .
  2. Regular links with the broader community are
    established .

5
Characteristics of Healthy Family
  • Healthy interactions among members
  • Healthy families communicate
  • Interactions are frequent and assume many forms
  • Healthy family use frequent verbal communication
  • Effective communication is necessary for a family
    to carry out basic function .

6
Characteristics of Healthy Family
  • Enhancement of individual development
  • Healthy families are responsive to the needs of
    individual members and provide the freedom and
    support necessary to promote each members
    growth.
  • Pattern for promoting individual member vary from
    one family to another.

7
Characteristics of Healthy Family
  • Effective Structuring of relationship
  • Healthy family structure role relationships to
    meet changing family needs over time.
  • Changing life cycle stages require alterations in
    the structure of relation

8
Characteristics of Healthy Family
  • Active coping effort
  • Healthy family actively attempt to overcome
    lifes problems and issues.
  • Coping skills are needed to deal with emotional
    tragedies.
  • Healthy families cope with less dramatic ,
    day-to-day changes.

9
Characteristics of Healthy Family
  • Healthy environment and lifestyle
  • Healthy family creates safe and hygienic living
    conditions for their members
  • A healthy family lifestyle encourages appropriate
    balance in the lives of its members .
  • The emotional climate of a healthy family is
    positive and supportive of growth.

10
Characteristics of Healthy Family
  • Regular links with the broader community
  • Healthy families maintain dynamic ties with the
    community
  • An unhealthy family has not recognize the values
    of establishing links because of
  • Knowledge Deficit.
  • Previous negative experience.
  • A lack of connection because of family
    expectation or cultural practice.

11
Family Health Practice guidelines
  • Family Nursing is a kind of nursing practice in
    which the family is the unit of services.
  • Not merely family oriented
  • Holistic approach

12
Family Health Practice guidelines
  • Five principle guide and enhance family nursing
    practice
  • Work with the family collectively .
  • Start where the family is .
  • Adapt nursing intervention to the family stage of
    development.
  • Recognize the validity of family structural
    variations.
  • Emphasize family strength

13
Five principle guide and enhance family nursing
practice
  • Work with the family collectively
  • Set aside usual focus on individual
  • View the family as one unit
  • Community health nurses want to involve all of
    the family during nurse-client interaction.
  • Encourage everyones participation.

14
Five principle guide and enhance family nursing
practice
  • Start where the family is
  • Begin at the present level of functioning
  • Conduct a family assessment to ascertain the
    members needs and level of health
  • Determine collective interests, concerns and
    proprieties

15
Five principle guide and enhance family nursing
practice
  • Adapt nursing intervention to the familys stage
    of development
  • Awareness of familys developmental stage enables
    the nurse to assess the appropriateness of the
    familys level of functioning and to tailor
    intervention accordingly.

16
Five principle guide and enhance family nursing
practice
  • Recognize the validity of family structural
    variations
  • Two important principles to remember
  • What is normal for one family is not necessarily
    normal for another .
  • Families are constantly changing.

17
Five principle guide and enhance family nursing
practice
  • Emphasize family strengths
  • Too often, nurse focus on family weaknesses (
    Negative emphasis ) this is not truly
    therapeutic.
  • Families need their strength reinforced .
  • Emphasizing a family strength makes people feel
    better about themselves.
  • The nurse lists positive points about an
    otherwise negative situation.

18
Family Health Assessment
  • To assess a familys level in a systematic three
    tools are needed
  • A conceptual framework on which to base the
    assessment.
  • A clearly defined set of assessment categories
    for data collection.
  • A method for measuring familys level of
    functioning.

19
Family Health Assessment
  • Conceptual Framework is a set of concepts
    integrated into a meaning explanation that helps
    one interpret human behavior or situation.
  • Three framework that are particularly useful in
    community health nursing
  • The interactional framework.
  • The structural-functional framework.
  • The developmental framework.

20
1. Conceptual Framework
  • The Interactional framework describes the family
    as a unit of interacting personalities and
    emphasize communication, roles, conflict, coping
    pattern, and decision making process.
  • This framework focuses on the internal
    relationships but neglect the family interaction
    with the external environment .

21
1. Conceptual Framework
  • The structural framework describes the family as
    a social system relating to other social system
    in the external environment.
  • This framework examine the interacting functions
    of society and the family (External), consider
    family structure and analyze how a familys
    structure affects its function .

22
1. Conceptual Framework
  • The developmental framework studies families from
    a lifecycle perspective by examining members
    changing roles and tasks in each progressive
    life-cycle stage.
  • This framework incorporate elements from
    interactional and structural-functional
    approaches so that family structure function, and
    interaction are viewed in the context of the
    environment at each stage of family development .

23
2. Data collection categories
  • There are 12 categories
  • Family demography .
  • Physical environment .
  • Psychological and spiritual environment.
  • Family structure and roles.
  • Family function.
  • Family values and beliefs.

24
2. Data collection categories
  1. Family communication pattern
  2. Family decision-making patterns
  3. Family problem solving patterns
  4. Family coping pattern
  5. Family health behavior
  6. Family social and cultural patterns.

25
3. Assessment Method
  • Three well-known graphic assessment tools are
  • Eco-map is a diagram of the connection between
    the family and the other system in its ecologic
    environment.
  • Fig. (23 1)

26
3. Assessment Method
  • The genogram displays family information
    graphically in a way that provides a quick view
    of complex family pattern.
  • Fig. (23 2)

27
3. Assessment Method
  • Social network support map ( Grid )gives
    details about the quality of social connection.
  • Fig. (23 3)

28
Guide lines for family health assessment
  • Focus on the family as total unit.
  • Ask goal-directed questions.
  • Collect data over time.
  • Combine quantitative and qualitative.
  • Exercise professional judgment.

29
Family care plan
  • Family assessment and planning instrument
  • This is an assessment and planning instrument to
    help you to organize your data . Its not be taken
    into a home as an interviewing instrument.

30
Family and care plan
  • FAMILY ROLE-RELATIONSHIP PATTERN
  • Initial of family ________
  • surname ________
  • Persons living in the house hold
  • Given name only ________
  • Date of birth ________
  • Age ________
  • Sex ________
  • Relation to head of Household ________
  • Occupation ________

31
Family care plan
  • FAMILY ROLE-RELATIONSHIP PATTERN
  • Identify primary care giver ________
  • Members of family not living in household
  • Significant others ________
  • Pets ________
  • Occupation history of each adult member (
    Past/Present ) ________
  • Job Identification ________
  • Exposure to health hazards ________
  • Family dynamics ________

32
Family care plan
  • Communication pattern
  • Expression of feelings ( happiness , sadness ,
    fear , anger )
  • Verbal and non-verbal
  • How are message transmitted ?

33
Family care plan
  • Social relations
  • Who do the family members interact with outside
    the immediate family , and what community
    activities do they participate in ?
  • Extend family ________ , Neighbors ________ .
  • Friends ________ , Mosques ________ , Clubs
    ________ .
  • Community activities ( list ) ________ .

34
Family care plan
  • Income
  • Family income ________ .
  • Source salary ________ , saving ________ ,
    investment ________ .
  • Others ________ .
  • Contribution of working members
  • Member ________ , Amount ________ (JD, SH
    )
  • Are expenses greater , less than or equal to
    income ________
  • Who plans how the money is spent ?

35
Family care plan
  • FAMILY COGNITIVE / PERCEPTION PATTERN
  • Educational level , What is the highest grade
    completed ?
  • Adults ________ Children ________
  • Members of the family with learning or
    developmental disabilities ?
  • Decision making Who make the decisions ? Give
    examples

36
Family care plan
  • FAMILY SELF PERCEPTION / SELF CONCEPT PATTERN
  • Family's perception of their ability to maintain
    their family unit
  • Family's pride in their home
  • Family residence
  • Type Single ________ ,
  • Multifamily ________ ,
  • Own ________ , Rent ________ Describe
  • condition of home inside and outside
  • Number of rooms ________

37
Family care plan
  • Space Adequate ________, Inadequate
    ________
  • Furniture Adequate ________ , Inadequate
    ________
  • Accident hazards ________
  • Neighborhood ________
  • Residential ________ . Industrial ________ .
    Rural ________ .
  • Urban ________ . Suburban ________. Other
    ________ .
  • Condition of dwellings and streets

38
Family care plan
  • Accessibility of
  • Play area Yes ________ . No ________
  • Health facilities ( List ) Yes ________ .
    No________
  • Mosques , Churches Yes________ . No ________
  • Schools Yes ________ . No ________
  • Public transportation ? Type ? ________
  • Family's method of transportation ________
  • Neighborhood health hazard ________
  • Family's perception of safety in the neighborhood
    ?

39
Family care plan
  • FAMILY NUTRTIONAL-METABOLIC PATTERN
  • Observation about kitchen and mealtimes
  • Who does the grocery shopping ?
  • Who does the cooking ?
  • Therapeutic diets
  • Observation of family member of nutritional
    24-hrs food/fluid intake Break fast , Lunch ,
    Dinner , Snacks
  • Analyze if diet provides nutrients ?
  • How is food stored ?
  • Water supply Municipal , Well , Other.

40
Family care plan
  • FAMILY ELIMINATION PATTERN
  • Compliance with garbage regulations ?
  • Yes ________ . No ________ . If no , explain ?
  • Rodents ?
  • Yes ________ . No ________ .
  • Insects ?
  • Yes ________ . No ________ .
  • Toilet facilities ?
  • Yes ________ . No ________ .

41
Family care plan
  • FAMILY ACTIVITY-EXERCISE PATTERN
  • Adults leisure ________ . Children leisure
    ________ .
  • Shared family activities ________ .
  • Type of activities required for family roles
    ________________ .
  • Adults ________ . Children ________ .
  • Describe pace of family life
  • Fast ________. Moderate ________ . Slow
    ________.

42
Family care plan
  • FAMILY ACTIVITY SLEEP-REST PATTERN
  • Which family member sleep alone ?
  • What type of bed does each have ?
  • What are the usual hours of sleep ?
  • Bedtime , arising , rest periods for adult and
    children ?
  • Are they any disturbances in family sleep pattern
    ?

43
Family care plan
  • FAMILY SEXUALITY-REPRODUCTION PATTERN
  • Sexual relationships
  • Family planning
  • Sex education of children

44
Family care plan
  • FAMILY VALUE AND BELIEF PATTERN ?
  • Ethnic background ________ . Influence on health
    behavior .
  • Religious affiliation ________ . Degree of family
    involvement ________ .
  • Influences on health behavior
  • Family's definition of health
  • Health beliefs and attitudes
  • Folk medicine
  • Use of non-traditional healing methods
  • Acceptance / non-acceptance of help from
    community agencies ?

45
Family care plan
  • FAMILY COPING STRESS TOLERANCE PATTERN
  • How has the family managed in previous situation
    of illness or crises ?
  • Own resources ________ . Extended family
    ________ .
  • Other relatives ________ . Friends ________ .
    Neighborhood ________ .
  • Significant others ________ . Health professional
    ________. Other ________ .
  • Caregiver's perception of their ability to deal
    with crises
  • Client perception of caregiver's / family ability
    to deal with demands of care

46
Family care plan
  • FAMILY HEALTH PERCEPTION HEALTH MANAGEMENT
    PATTERN
  • Reason for visit
  • Family's perception of their level of health
  • Medical diagnosis of each family member
  • Familial disease ( heart , cancer , stroke ,
    anemia , .. etc )
  • History of past significant illness and accident
    of each family member
  • Risk factors ( tobacco , alcohol , obesity , lack
    exercise )

47
Family care plan
  • Family health practice
  • Immunization status of each family member
  • Self exam ( breast , testicular , .. etc )
  • Preventive exams ( dental , colon/rectal )
  • Names of physician / date of last appointment and
    next scheduled appointment for each family member
  • Medication is any family member taken any
    medication ? Yes ------. No ------ .

48
Family care plan
  • If yes ( including over the counter drugs )
  • Name of the drug _______ .How often taken
    ______.
  • Drug action ________ .Side effects ________ .
  • Date of prescription ________ .Number of
    refills ___ .
  • Physician ________ .Pharmacist ________ .
  • Treatment prescribed for family members
  • Level of compliance with prescribed medication
    and treatments

49
Family care plan
  • Financing health care
  • Health insurances ________ .
  • Private insurances ________ .
  • Own finance ________ .

50
Family nursing diagnosis
  • Examples for family nursing diagnosis
  • Family Processes, Dysfunctional Alcoholism (
    substance abuse ).
  • Family Processes, Interrupted.
  • Family Processes, Readiness for Enhanced.
  • Family coping, ineffective.
  • Family coping, potential for growth.

51
Family nursing diagnosis
  • Examples for family nursing diagnosis
  • Parental role conflict.
  • Parent/infant/child attachment, altered, risk
    for.
  • Parenting, altered.
  • Parenting, altered, risk for.
  • Role performance, altered
  • Social interaction, impaired.
  • Social isolation.
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