NUR/542 Dynamics of Family Systems
January 25, 2015 Tracy Kramer RNC FNP
Family values are the basis for a great many decisions, especially those that may affect one’s health and the health of their family. A family’s system, support, resources and perceptions have considerable influence over health outcomes and adaptations to changes. Nurses must consider family influences when devising and carrying out a plan of care. A nurse can better formulate an appropriate care plan with an understanding of the different concepts of family and family nursing theories that apply to particular practice settings. These topics will be discussed as they pertain to trauma care in an acute care setting. Family as a System
A family is a system that feeds off of one another and is affected by the each other’s decisions. When examining a family as a system, the individual is assessed and the family as a whole is assessed as well, how the individual affects the whole family and vice versa. “Relationships between people…reciprocally influence health/illness” (Bell, 2009, p. 126). Health promoting behaviors and health risk behaviors are learned, reinforced or objected by family. The support of family serves as a positive reinforcement of health promoting behaviors such as healthy food choices, as well as adaptations to illness. Neglecting to recognize or correct a risky health behavior serves as a negative reinforcement to continue bad choices. A family can also work as a system while interacting with society and choosing the types of groups and activities to engage in within the community. Whether within the home or outside of it, good choices influence the health of the whole family. Concept of Family used in Trauma Care
The concept of family and the degree of family centeredness varies depending on nursing specialty area and environment. Family as context is a concept of family where the family is viewed in relation to an individual. In the family as context concept, nursing care is centered on an individual and the family is a resource (Friedman et al., 2003). Typically, family is an important factor for an individual’s wellbeing; however, family can also be a source of stress (Segaric & Hall, 2005). When using this concept the nurse should assess the degree of family involvement, methods for how to involve family and inhibitors and facilitators for family involvement (Segaric & Hall, 2005). A traumatic injury is always an unexpected disruption to someone’s everyday life, which typically takes weeks if not months to recuperate from. For this reason, a strong support is needed; for most people that support system is their family. Family as context is the concept of family most often used in acute trauma care because the patient is the primary focus and the family is a secondary focus as a resource for the patient. Family education and support are valued aspects of promoting a strong rehabilitation plan. Important elements for embracing family as context are partnership, collaboration, participation and communication (Segaric & Hall, 2005). Within the acute care setting family as context is the most appropriate family concept because care of the individual remains the focus for plans and interventions. Other concepts of family move the whole family or family systems into the foreground of care, which would be difficult to maintain in the acute setting where all family members are not present and involved all the time. Family Nursing Theories and Trauma Care
The family stress theory is most conducive to family nursing for trauma patients in the acute care setting. St John and Flowers’s (2009) study showed that family nursing was more often implemented in areas dealing with serious or life-threatening illnesses. The family stress theory is comprised of several variables,...
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