C/F Essay Example

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Nursing Family Intervention

Nursing Family Intervention

In family assessment, the family unit is the client and the primary resource for supporting family members’ illness and healthcare through teaching, role modeling, and learning of self-care strategies and health promotions behaviors when families experience ongoing and episodic health challenges (Lundy & Janes, 2001). Family assessment differs from individual assessment in that in individual assessment, focus is on an individual instead of the entire family unit. One member of the family is identified as the client or patient in order to receive nursing care. The individual client or patient may have an identified health problem (for instance, a recent discharge from hospital after suffering a stroke) or a potential problem (for instance a new mother requiring education on infant care) or a chronic illness, which requires continuous monitoring. Individual assessment varies with age and particular health status of the person and may include physical or comprehensive health assessment, developmental level assessment, mental status assessment, focused information in the specific health problem or assessment of adaptation and coping (Lundy & Janes, 2001).

Family assessment entails gathering information on the entire family, which allows the nurse, as well as the family to identify family needs together and to plan care than will allow the family to work towards optimal health for individual family members as well as for the family as a whole (Potts,2012). In the measurement of family influences, the assessment focus involves individuals, relationships between two (dyads) or more members, the whole family of the interface between the extra familial and family environment. Individual assessment entails traditional tests of psychopathology or personality, including both projective and objective procedures-instruments that offer important data on the psychosocial and psychiatric status of the individual members.

In family assessment, the entire family is considered greater than the sum of all its components and a change in one family member is considered to affect all the other members (Hanson, Gadaly-Duff & Kaakinen, 2005). The family is considered as a social system with functional requirements. Families as a whole usually influence the way individual members resolve health issues that arise and every individual member health event and health practices have an impact on the entire family (Hanson, Gadaly-Duff & Kaakinen, 2005). As a result, in family assessment, health care effectiveness is placed on the family instead of just an individual. In individual assessment, healthcare is concentrated on a sole individual without considering the impact of other members of his immediate or extended family. In family assessment, family units are considered an important factor in the well being and healthcare of the individual members.

The most appropriate family assessment tool for family case scenario is the Calgary Family Assessment Model (CFAM). This model will help to build a strong family. DeFrain and Asay (2008) argued that healthy individuals in healthy families are fundamentally at the core of a healthy society. The model combines family and nursing therapy concepts and is based on systems, communication, cybernetics as well as change theories. It consists of functional, developmental, and structural categories and the assessment questions are usually organized into these groupings. This model is important in this case scenario one as it provides a map of the family so that family strengths and problems can be identified (Wright & Leahey, 2005). It can also be used by nurses in a wide range of primary care contexts and offer practical guidelines to practitioners who are committed to provide family centered case. Practitioners and family members are supposed to work together to create solutions to condition-related issues. Feeley and Gottlieb (2000) noted that a strength based nursing approach in working with family is characterized by a focus on the family or client resources, capacities, and competencies.

One limitation of this model is that it is predicated on the assumption that both families and practitioners have important areas of expertise that are related to the family illness experiences. Various categories of data will be relevant in every major aspect of the family life-structural, functional, and developmental. For instance, structural family data should focus on information on the internal family, external family and the family social context (for instance spirituality, ethnicity) (Potts, 2012). On the internal family, the child and family health nurse should focus on gender, family composition, rank order, gender orientation, boundaries, and subsystems. For instance, “Ruth Garraway nuclear and extended family, its composition (the husband, sister, mother, brother in law, nephew, niece, father in law, mother in law, and brother in law”). When it comes to context, the nurse should focus on the extended family and the larger system. On the external family, the nurse should focus on the ethnicity, race, social class, environment, and religion and spirituality aspects. For instance, Ruth’s father has married an Indonesian wife. John’s parents, Henry (64 years old) and Marcia (59 years old) are divorced. Both live in Perth and have remarried in the last five years. John’s older brother Max, who has remained single, works as an engineer in India. These are important aspects to take into consideration when undertaking the family assessment.

Developmental assessment should direct the practitioner towards the tasks, which are associated with the different stages of the life cycle of the family whereas function assessment will enable the practitioner to focus on the routine aspects of daily living. For instance, meal preparation, treatment regiment management and the interactions and roles associated with carrying out the usually family activities. The CFAM model provides a wide-ranging “menu of possibilities” for assessment; however, there is need to be selective in determining the ones, which are appropriate and relevant areas for assessment in a given family (Potts, 2012). For instance, the assessment of developmental issues in this case should include stage of the family and associated tasks. A three-generation family genogram and ecomap are useful strategies for engaging the family in the assessment process as well as eliciting e considerable information regarding the key aspects of family life. The ecomap is a diagram of every family member ties to persons and systems outside of the family. Together the ecomap and the genogram would effectively summarize considerable information on the family internal and external structure.

When it comes to the functional category, the nurse should focus on both instrumental and expressive factors (Potts, 2012). Instrumental factors includes the activities of daily living, for instance, Ruth is a florist and plans to resume work at five months whereas John is a mechanic; Ruth likes to keep fit and hopes to join a new parents walking group to meet new mums whereas John has taken up surfing in his spare time. He has joined the local Surf Club and plans to take the family there for lunch soon; he also likes cooking and helps with the cooking in the evenings.

The nurse should mostly focus on expressive factors in Ruth’s family such as verbal communication, emotional communication, roles, problem solving, nonverbal communication, circular communication, influences and power, alliances and coalitions as well as beliefs. For instance, Ruth and John finances are tight since they moved to a larger three-bedroom home. In addition, Ruth’s younger sister has agreed to take care for the twins until they are 12 months old. Ruth has also arranged for someone to manage her business for six months. Marion, Ruth’s mother, is also supportive of the Ruth and her husband and plans to help with the children. Ruth’s father and his new Indonesian wife usually visit Australia twice a year. John’s parents are divorced; however, they have remarried. John has a good relationship with his brother who works in India who was protective of him from a younger age as his father was a disciplinarian. Nonetheless, John has not seen his parents or brother for more than a year although he has told them about the twins. In addition, Ruth and John do not have many friends in Gold Coast; however, John has joined the local Surf Club in order to meet like-minded persons. Ruth has also declined to make love with John and John hopes that by taking time off work, she will be rested, more relaxed and willing to recommence sex. John is looking forward to family time and planning to help with the cooking.

By assessing the structural, functional, and developmental areas in Ruth’s family, the nurse will develop a macro view of the family. The model will provide a concrete strategy by which nurses will improve, promote, and sustain effective family function in the behavioral, affective, and cognitive domains. This will also help Ruth and John to parent effectively. According to Kralik and Van Loon (2011, p.329) “community nurses can effectively raise various predictable issues regarding parenting to open the discussion about how these are managed, and look at supportive parenting strategies that can help people to parent effectively”. The nurse will also identify strengths within the individuals in the family creating a context for change (Wright & Leahey, 2009).


DeFrain, J. & Asay, S. (2007) Strong Families around the World. Marriage & Family Review, 41(1-2), 1-10.

Feeley, N., & Gottlieb, L. (2000). Nursing Approaches for working with Family Strengths and Resources. Journal of Family Nursing, 6(9): 9-24

Hanson. S., Gedaly-Duff. V., & Kaakinen, J. (2005). Family health care nursing: theory,

practice, and research. 2nd ed. Philadelphia : FA. Davis.

Kralik, D., & Van Loon, A. (2011). Community Nursing in Australia. 2ed. Milton, Qld: John Wiley.

Lundy, K., & janes, S. (2001). Community Health Nursing: Caring for the Public’s Health. London, UK: Jones and Bartlett Publishers International

Potts, N. (2012). Pediatric nursing: caring for children and their families. 3ed. New York: Cengage Learning.

Wright, L., & Leahey, M. (2009). Nurses and families: A guide to family assessment and

interrention.5ed. Philadelphia: FA Davis.

Wright, L.M., & Leahey, M. (2005). Nurses and families: A guide to family assessment and intervention.4ed. Philadelphia: F.A.Davis.