Family Child Health Nursing

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Family Child Health Nursing

• By Nataliya Haliyash,
• MD,PhD,MSN
• Ternopil State Medical University
• Institute of Nursing

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• A major task of families is to nurture children
  to become healthy, responsible, and creative
  adults.
• Most parents learn the parenting role on the
  job, relying on memories of their childhood
  experiences in their families of origin to help
  them.
• Parents, as primary caretakers of their children,
  are charged with keeping children healthy, as
  well as caring for them during illness.

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Lecture objectives

• Discussion of an information about
• a brief history of family-centered care of
  children
• a family interaction model that can be used to
  guide nursing practice with families with
  children
• implications for nuring practice
• implications for research, education, and policy.

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Definition

• Family child health nursing is using nursing
  actions that consider the relationship between
  family tasks and health care and their effects on
  family well-being and childrens health.
• Nurses care for children
• within the context of their family,
• and by treating the family as a whole or the
  family as client.

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Family-Centered Care

• Family-centered care is a system-wide approach to
  child health care.
• It is based on the assumption that families are
  their childrens primary source of strength and
  support.
• Family-centered care has emerged in response to
  increasing family responsibilities for health
  care.

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Family-Centered Care

• Families acknowledge the uncertainty that
  surrounds their childs disease, but they want to
  be informed partners of the health team in
  decision making and valued collaborators in the
  care of their child.
• (Griffin, 2003)
• Family-centered care brings attention back to the
  importance of families in health care.

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FAMILY INTERACTION MODEL

• The family interaction model must be applicable
  to all the family situations (Gedaly-Duff
  Heims, 2001).
• By using the family interaction model, nurses
  help families understand and prepare for normal
  and situational transitions in diverse family
  situations.
• The family interaction model is derived from
  symbolic interaction theory and developmental
  theory.

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FAMILY INTERACTION MODEL

• The model assumes that
• (1) meanings and responses to health, disease,
  and illness are created through interactions
  among family members and between the family and
  society, and
• (2) families meanings and responses are
  influenced by family and individual development
  (Figure 111).

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Family interaction model
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Family interaction model

• The family interaction model uses three concepts
  to guide nursing care
• (1) family career, which includes dynamic and
  unique developmental and situational experiences
  of a familys lifetime represented by family
  stages and family transitions
• (2) individual development, which is the expected
  changes in each member associated with growth and
  development
• (3) patterns of health, disease, and illness,
  which are expected behaviors in these health
  situations.
• Knowledge of these three concepts and their
  interactions with each other provides nurses with
  an understanding of the effects of health and
  illness on family interactions.

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Family Career

• is the dynamic process of change that occurs
  during the life span of the unique group called
  the family.
• incorporates stages, tasks, and transitions.
• is similar to family development theory in that
  it takes into account family tasks and raising
  children.

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Family Stages

• Knowledge of family stages helps nurses
  anticipate the family reorganization necessary to
  accommodate the growth and development of family
  members.
• For example, families with school-age children
  expect children to be able to take care of their
  own hygiene, whereas families with infants expect
  to do all the hygiene care.

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Family Tasks

• Across all family stages, there are basic family
  tasks that are essential to survival and
  continuity (Duvall Miller, 1985)
• (1) to secure shelter, food, and clothing
• (2) to develop emotionally healthy individuals
  who can manage crisis and experience nonmonetary
  achievement
• (3) to ensure each individuals socialization in
  school, work, spiritual, and community life
• (4) to contribute to the next generation, by
  giving birth, adopting a child, or foster-caring
  for a child
• (5) to promote the health of family members and
  care for them during illness.

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Family transitions

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

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Individual Development

• When nurses review with families the individual
  family members developmental stages that are
  occurring concurrently among children and adults,
  they assist families in their interactions.
• Through this review process, nurses assist
  families to accommodate to childrens and adults
  changing abilities.
• Nurses should consider three dimensions of
  individual development
• social-emotional,
• cognitive,
• and physical.

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Patterns of Health, Disease, and Illness

• Healthy behaviors promote optimal physical and
  social-emotional well-being.
• Disease is pathology.
• Illness represents the family activities
  associated with managing disease.
• Family interactions shape these patterns.
• As caretakers, families promote health and cope
  with acute, chronic, life-threatening, and
  end-of-life illnesses in their children.

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FAMILY CHILD HEALTH PRACTICEAND INTERVENTIONS

• Family child health care nurses can teach and
  support families in four areas
• health promotion,
• acute illness,
• chronic illness,
• and lifethreatening illness.

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Health Promotion

• Patterns of family wellbeing are facilitated by
  balancing the needs of individuals and the family
  with the resources and options available to meet
  these needs.
• Nurses help families integrate physical,
  social-emotional, and cognitive health promotion
  into family routines.
• They also affirm positive patterns of health or
  provide alternative ones.
• Nurses reduce the risk of illness and injury by
  shaping the family routines, rituals, and
  environment to encourage optimally healthy
  behaviors.
• Nurses assess for, identify, and provide
  interventions to reduce risk factors associated
  with morbidity and mortality.

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Acute Illness

• Families with children frequently experience
  acute illness and injury.
• Acute illness in children is characterized by the
  sudden onset of signs and symptoms treatment can
  usually restore the children to the predisease
  state.
• To help families experiencing acute illness,
  nurses must
• become aware of families past experiences with
  and knowledge about acute illness.
• alert families to potential disruptions among
  parents and siblings because of conflicts between
  family members needs.
• teach families to recognize the patterns and
  potential complications of acute illness.
• plan with families how to alter family routines
  to accommodate the temporary changes required by
  the acute illness

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Chronic Illness

• Health conditions that
• (1) limit childrens daily activities such as
  playing and going to school,
• (2) are long-term,
• (3) are not curable or require special assistance
  in function are considered chronic.

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Chronic Illness (cont.)

• Families accommodate to the effects of chronic
  illness on their child.
• The meaning of an illness can change for a family
  over time (Patterson Garwick, 1994).
• The familys response to the illness evolves with
  the developmental progression of the child
  (Meleski, 2002).
• Initially, families may experience disbelief
  because they have assumed that children are
  healthy and will grow up to be independent.

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Chronic Illness (cont.)

• Nursing interventions
• helping family members to recognize their
  flexibility, by asking a family to describe how
  family routines have changed
• assisting the family to create new routines to
  accommodate disease and continue with the
  familys life.
• making family familiar with community resources
  in order to facilitate family health.
• helping families to look at how each member
  (e.g., father, mother, sibling, grandparent) is
  affected and discuss how to help each member of
  the family and the people in the community adjust
  to the child with a disability or chronic
  condition.
• Nurses can reduce the stress for sick children,
  demystify the experience for their siblings,
  educate parents and grandparents about the
  childrens disease, provide anticipatory
  guidance, and support the family as a whole
  during hospitalization.

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Life-Threatening Illness and End of Life

• Besides teaching families home care, including
  adequate pain management, nurses often find
  themselves helping parents, siblings, and
  grandparents work through life-and-death issues
  in the hospital and intensive care as well as in
  the home.

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Life-Threatening Illness and End of Life

• Nurses can use the family interaction model to
  support families during life-threatening
  illnesses and end of life.
• Nurses should assess families past experiences
  with a childs death. Generally families have few
  models for learning how to cope with this
  situation.
• Nurses should help families learn how children
  understand and cope with life-threatening
  illnesses.
• Nurses can teach them strategies for comfort
  care, help them anticipate the signs and symptoms
  of body failure they will experience, and plan
  support for these families at the point of death
  of their child.
• Nurses can facilitate families grieving and
  mourning of the childs death through discussions
  about each persons needs and interpretations of
  the behaviors of family members.

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NURSING IMPLICATIONS

• Family nurses interact with families and other
  health professionals 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
  child health nursing and
• (4) health policy proposals and evaluation.

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Summary

• Family health nurses focus on the relationship of
  family life to childrens health and illness, and
  they assist families and family members to
  achieve well-being.
• Through family-centered care, family child health
  nurses enhance family life and the development of
  family members to their fullest potential.
• The family interaction model incorporates
  relevant components of family life and
  interaction, family development and transitions,
  and family health and illness and helps nurses
  take a comprehensive and collaborative approach
  to families.
• The family interaction model enables nurses to
  screen for potentially harmful situations,
  instruct families about health issues, and help
  families cope with acute illness, chronic
  illness, and lifethreatening conditions.

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Thank you for attention!

• Q A ?