Family Child Health Nursing

1. Family Child Health Nursing By Nataliya Haliyash, MD,PhD,MSN Ternopil State Medical University Institute of Nursing

2. A major task of families is to nurture children tobecome healthy, responsible, and creative adults. • Most parents learn the parenting role “on the job,”relying on memories of their childhood experiencesin their families of origin to help them. • Parents, as primary caretakers of their children, arecharged with keeping children healthy, as well ascaring for them during illness.

3. Lecture objectives Discussion of an information about: • a brief history of family-centeredcare of children; • a familyinteraction model that can be used to guide nursingpractice with families with children; • implications for nuring practice; • implications forresearch,education, and policy.

4. Definition • Family child health nursingis using nursing actionsthat consider the relationship between family tasksand health care and their effects on family well-beingand children’s health. • Nurses care for children: • withinthe context of their family, • and by treating the family as a whole or the family asclient.

5. Family-Centered Care • Family-centered care is a system-wide approach tochild health care. • It is based on the assumption thatfamilies are their children’s primary source of strengthand support. • Family-centered care hasemerged in response to increasing family responsibilitiesfor health care.

6. Family-Centered Care “Families acknowledge the uncertaintythat surrounds their child’s disease, but theywant to be informed partners of the healthteam in decision making and valuedcollaboratorsin the care of their child.” (Griffin,2003) • Family-centered care brings attention back to theimportance of families in health care.

7. FAMILYINTERACTION MODEL • The family interaction model must beapplicable to all the family situations (Gedaly-Duff &Heims, 2001). • By using the family interaction model,nurses help families understand and prepare for normaland situational transitions in diverse family situations. • The family interaction model is derived fromsymbolic interaction theory and developmental theory.

8. FAMILYINTERACTION MODEL • Themodel assumes that: • (1) meaningsand responses to health, disease, and illness are createdthrough interactions among family members andbetween the family and society, and • (2) families’ meaningsand responses are influenced by family and individualdevelopment (Figure 11–1).

9. Family interaction model

10. Family interaction model • The family interaction model uses three concepts toguide nursing care: (1) family career, which includesdynamic and unique developmental and situationalexperiences of a family’s lifetime represented by familystages and family transitions; (2) individual development,which is the expected changes in each memberassociated with growth and development; (3)patterns of health, disease, and illness, which areexpected behaviors in these health situations. • Knowledge of these three concepts and their interactionswith each other provides nurses with an understandingof the effects of health and illness on familyinteractions.

11. Family Career • is the dynamic process of change thatoccurs during the life span of the unique group calledthe family. • incorporates stages, tasks,and transitions. • is similar to familydevelopment theory in that it takes into accountfamily tasks and raising children.

12. Family Stages • Knowledge of family stageshelps nurses anticipate the family reorganizationnecessary to accommodate the growth and developmentof family members. • For example, families withschool-age children expect children to be able to takecare of their own hygiene, whereas families withinfants expect to do all the hygiene care.

13. Family Tasks • Across all family stages, there are basic family tasks thatare essential to survival and continuity (Duvall &Miller, 1985): • (1) to secure shelter, food, and clothing; • (2) to develop emotionally healthy individuals who canmanage crisis and experience nonmonetary achievement; • (3) to ensure each individual’s socialization inschool, work, spiritual, and community life; • (4) tocontribute to the next generation, by giving birth,adopting a child, or foster-caring for a child; • (5) topromote the health of family members and care forthem during illness.

14. Family transitions • Family transitions are events that signal a reorganizationof family roles and tasks. • Developmental(normative) family transitionsare predictable changes that occur in an expected time line congruent with movement through the eight family stages. • Situationalfamily transitionsinclude changes in personalrelationships, roles and status, the environment, physicaland mental capabilities, and the loss of possessions. • These are also called non-normative transitions. • Not all families experience each situational transition.

15. Individual Development • When nurses review with families the individualfamily members’ developmental stages that are occurringconcurrently among children and adults, theyassist families in their interactions. • Through thisreview process, nurses assist families to accommodateto children’s and adults’ changing abilities. • Nurses should consider three dimensions of individual development: • social-emotional, • cognitive, • and physical.

16. Patterns of Health, Disease, and Illness • Healthy behaviors promoteoptimal physical and social-emotional well-being. • Disease is pathology. • Illness represents the familyactivities associated with managing disease. • Familyinteractions shape these patterns. • As caretakers, families promote health and copewith acute, chronic, life-threatening, and end-of-lifeillnesses in their children.

17. FAMILY CHILD HEALTH PRACTICEAND INTERVENTIONS • Family childhealth care nurses can teach and support families infour areas: • healthpromotion, • acute illness, • chronic illness, • and lifethreateningillness.

18. Health Promotion • Patterns of family wellbeingare facilitated by balancing the needs of individualsand the family with the resources and optionsavailable to meet these needs. • Nurses help familiesintegrate physical, social-emotional, and cognitivehealth promotion into family routines. • Theyalso affirm positive patterns of health or providealternative ones. • Nurses reduce the risk of illness and injury by shapingthe family routines, rituals, and environment toencourage optimally healthy behaviors. • Nursesassess for, identify, and provide interventions toreduce risk factors associated with morbidity andmortality.

19. Acute Illness • Families with children frequently experience acuteillness and injury. • Acute illness in children is characterizedby the sudden onset of signs and symptoms;treatment can usually restore the children to thepredisease state. • To help families experiencing acute illness, nursesmust: • become aware of families’ past experienceswith and knowledge about acute illness. • alert families to potential disruptionsamong parents and siblings because of conflictsbetween family members’ needs. • teach families to recognizethe patterns and potential complications of acuteillness. • plan withfamilies how to alter family routines to accommodatethe temporary changes required by the acute illness

20. Chronic Illness • Health conditions that • (1) limit children’s daily activitiessuch as playing and going to school, • (2) arelong-term, • (3) are not curable or require specialassistance in function are considered chronic.

21. Chronic Illness (cont.) • Families accommodate tothe effects of chronic illness on their child. • The meaningof an illness can change for a family over time(Patterson & Garwick, 1994). • The family’s response tothe illness evolves with the developmental progressionof the child (Meleski, 2002). • Initially, families mayexperience disbelief because they have assumed thatchildren are healthy and will grow up to be independent.

22. Chronic Illness (cont.) • Nursing interventions: • helping family members to recognize their flexibility, byasking a family to describe how family routines havechanged; • assisting the family to create newroutines to accommodate disease and continue withthe family’s life. • making family familiar with community resourcesin order to facilitate family health. • helping families to look at how eachmember (e.g., father, mother, sibling, grandparent) is affected anddiscuss how to help each member of the family and thepeople in the community adjust to the child with adisability or chronic condition. • Nurses can reduce the stress for sick children,demystify theexperience for their siblings, educateparents and grandparents about the children’s disease,provide anticipatory guidance, and support the familyas a whole during hospitalization.

23. Life-Threatening Illness and End of Life • Besides teaching families home care, includingadequate pain management, nurses often find themselves helpingparents, siblings, and grandparents work through life-and-death issues in the hospital and intensive care aswell as in the home.

24. Life-Threatening Illness and End of Life Nurses can use the family interaction model tosupport families during life-threatening illnesses andend of life. • Nursesshould assess families’ past experienceswith a child’s death. Generally families havefew models for learning how to cope with this situation. • Nursesshould help families learn howchildren understand and cope with life-threateningillnesses. • Nurses can teach them strategies for comfortcare, help themanticipate the signs and symptoms of body failure theywill experience, and plan support for these families atthe point of death of their child. • Nursescanfacilitate families’ grieving and mourning of the child’sdeath through discussions about each person’s needsand interpretations of the behaviors of familymembers.

25. NURSING IMPLICATIONS • Family nurses interact with families and other healthprofessionals and use a family perspective to guide • (1) health care delivery and practice; • (2) education,both for families and for other health care providers; • (3) research, to systematically explore family childhealth nursing; and • (4) health policy proposals andevaluation.

26. Summary • Family health nurses focus on the relationship offamily life to children’s health and illness, andthey assist families and family members toachieve well-being. • Through family-centered care, family childhealth nurses enhance family life and the developmentof family members to their fullestpotential. • The family interaction model incorporates relevantcomponents of family life and interaction,family development and transitions, and familyhealth and illness and helps nurses take acomprehensive and collaborative approach tofamilies. • The family interaction model enables nurses toscreen for potentially harmful situations, instructfamilies about health issues, and help familiescope with acute illness, chronic illness, andlifethreateningconditions.

27. Thank you for attention! Q & A ?