Nursing and Family Stress Theory

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Critique and Analysis of Family Stress Theory

Nursing theory explains the relationship between concepts to enhance understanding and knowledge about a phenomenon (Walker & Advant, 2005). Theoretical frameworks for nursing of families provide a foundation for guiding the development of family centered care and research (Friedman, Bowden, & Jones, 2003).The application of theory helps to guide nursing practice, education, and research and supports the development of evidence-based nursing strategies and interventions for both the individual and the family as the client.

This paper will critique and provide an analysis of the family stress theory. A brief introduction of the history and author of this theory will be provided and the major concepts and assumptions of the theory described. The rationale for selecting this theoretical model as it relates to family nursing practice will be provided and its strengths and weaknesses identified. In addition, a discussion of the application of the Family Stress Theory in current nursing research will be presented. Finally, ideas for future research needed to continue to develop this theory for its application in family nursing practice will be explored.

Family Stress Theory

The family stress theory was introduced by Professor Reuben Hill in the late1940s after the Great Depression (McDonald, n.d.). McDonald (n.d) explains that Hill based his observations on families who survived the economic challenges of the Great Depression and those families who did not. Friedman, Bowden, and Jones (2003), explain that Hill based his research on the effects of separation and reunions as a result of war time on families. In both cases, the Family Stress Theory helps to explain why some families are able to adapt and survive when faced with stressors while other families encounter crisis. Hill’s Family Stress Theory has served as a framework for the development of more contemporary family stress models, such as the Resiliency Model, and as a foundation for clinical practice and crisis intervention (Friedman, Bowden, and Jones, 2003).

Major Concepts

Hill describes the importance of social relationships and positive perceptions which serve as buffers in protecting the family from crisis (McDonald, n.d.). In developing the family stress theory, Hill formulated an ABCX framework which helps to define the stress, identify the family resources, explore the family’s perception of the stressor, and the crisis. The A variable is identified as the provoking stressor or event that the family encounters. Family experiences and strengths as well as family and community resources represent the B variable. This variable includes the family’s social support structure, both internal and external, which impact the magnitude of the stress on the family (McDonald, n.d.). The family perception of the degree of stress produced by the provoking stressor or event represents the C variable. Combined, these three variables influence how a family copes, reacts, and manages the situation and determines whether or not the situation becomes a crisis, the X variable. Past experiences, adequate and available resources, time, and support all impact how a family is able to adapt and change to the situation.

The application of the family stress theory helps to predict the potential for a family crisis. According to McDonald (n.d.), “the combination of high stress with social isolation (the “B” variable) for families has been highly correlated with many forms of dysfunctional family outcomes” (para.5). Hill’s family stress theory provides a framework for a family as client focused assessment and the development of evidence-based nursing interventions that strengthen the family and promote positive outcomes.

Family Stress Theory’s assumption about Family and Nursing

The Family Stress theory is middle range theories developed by Hill and as the variability of families are recognized through research,...
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