Using the Family Health Model for

Family-Focused Nursing Care

SharonA.Denham,PhD,RN,CNE
Professor,HoustonJ.&FlorenceA.DoswellEndowedChairinNursingforTeaching
Excellence
TexasWoman'sUniversity,CollegeofNursing,DallasCampus
 Objectives
Identify ways to use the Family Health Model and provide family-
focused nursing care.

Discuss use of family-focused care with acute and chronic conditions.

Explain relationship between family-focused care and population

health.

Identify relationships among family-focused care and wellness, health

promotion, and prevention.
 Family
Basic Unit of Society

Coontz (1992) - No traditional family arrangement provides a

workable model for how we organize family relations in a
modern world.

Two or more people related biologically, legally, or emotionally.

A collection of persons who call themselves family and have a

general commitment to the care and well-being of one another.
 Family-Focused Nursing Care
Care for ALL Families
Think family - Intentionally & purposively guides all nursing
actions

Family ALWAYS viewed as the unit of care (ALWAYS viewed in

present tense)

Value unique needs of individuals & their family units

Look beyond acute episodic needs & see the continuum of

health & wellness for the family unit

Relationship based - Fosters collaboration & partnerships

 Being a Family - Focused Nurse
Avoid biased assumptions & prescriptive solutions

Use personal strengths in empowering ways

Value reflection & knowing oneself

Look beyond the immediate situation & take a long view of

potential possibilities

Build trusting & respectful relationships

Understanding Family Health
How do we decide who is healthy & who is sick?

Are people with chronic illness unhealthy?

What factors influence sickness? Wellness?

Is it better to focus attention on fixing after problems occur

or on preventing them from occurring?
www.diabetesfamily.net/family/family-health-model/
 Clarrisa Green (1997)

amilies to develop skills & confidence in managing illness experienc

Focus on - - - -

Factors shaping the situation & related history

Coping with difficulties over time

Family behaviors
 Ecological Model
Shared & separate events

Individual & collective experiences

Interactive behaviors within & outside family household

Influence of social networks, communities & environments

Values, beliefs, perceived meanings

Interdependent factors linked with health & illness

 Family Context
First Family Assessment Area

Who is in the family - Caregiver(s)

Family household (neighborhood)

Culture, ethnicity

Available resources

Social networks

Time factors
 Family Functions
Developing Individuals

CORE PROCESSES
Roles & expectations
Cathexis
Members communicative
interactions (within &
Communication
outside the family) Caregiving

Extended family Celebration

influences
Change
Exchange ideas that
Connections
influence health & illness
Coordination
 Family Structure
Behavioral Patterns

Routines
Habits Meanings

Rituals & traditions Types

Individual routines Characteristics

Family health routines Purposes

Participants

Timing of actions
Family-Focused Nursing Roles
Think family - Intentional care

Doing For vs. Being With

Engage in therapeutic conversations

Be present

Collaborate with others

Family Care in Acute Situations

Family stress

Family uncertainty

Family suffering

Family decision - making

Other household demands

 Family Care in Chronic Situations
The Diagnosis

Care coordination

Financial costs

Caregiving tasks

Potential risks

Physical & emotional challenges

Family resilience
 Family Context
Acute
Resources
54 year old male suffers an acute MI
Caregiver needs

Rehabilitation

Chronic
Resources
54 year old male suffers a stroke
Family needs with right side paralysis
Rehabilitation
 Family Functions
Acute
Roles
54 year old male suffers an acute MI
Communication

Knowledge

Chronic
Roles
54 year old male suffers a stroke
Communication
with right side paralysis
Knowledge
 Family Structure
Acute
Rituals & traditions

Routines 54 year old male suffers an acute MI

Family health routines

Chronic
Rituals & traditions

Routines 54 year old male suffers a stroke

with right side paralysis
Family health routines
 Family & Population Health
Define Population of Interest
Think beyond medicalized care

Social justice - Equitable distribution of resources

Family context & lifestyle behaviors (vulnerability)

Identify associated risks (prevention)

Consider social determinants of health

Family Care: Wellness, Health
Promotion & Prevention
Think Family Health

Goal of nursing (Loveland - Cherry, 1996)

Facilitate complex member interactions linked with family

household to maximize individual & family wellness
(Denham, 2003)

Maximize member potentials that contribute to family unit

health & wellness