12 Communicating with families

Objectives
Define and describe family Identify theoretical frameworks used to study family communication and family dynamics Apply the nursing process in caring for the family as client Identify selected communication strategies to use in interacting with families
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Family

1.How do you think about the definition of family? 2.What shall you do realize a family?
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, What s the Family?

p.220

Family is defined as "a self-identified group of two or more individuals whose association is characterized by special terms, who may or may not be related by bloodlines or law but who function is such a way that they consider themselves to be a family. "
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Family

Family Definitions
Definitions

Family Family Family Family

Structure Function Process Stages

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Family Structure
Box13-2 Forms of Family Units Nuclear Common law family Extended No kin Three generational Polygamous family Dyad Gay Single parent Commune Stepfamily Group marriage Blended

p.221

Family function

p.221

1.Family function is a broad term used to describe how a family normally interacts with each other to achieve identifiable goals. 2. The term can include family activities such as protecting, socializing, working, or reproducing.
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Family function

p.222

3. Challenges to the functioning of the family system can include expected normative crises such as divorce, retirement, marriage, or remarriage or placement of an elderly parent in a nursing home. Alternatively, the challenge can relate to unexpected disruptions such as sudden job loss, trauma, or the untimely death of an important family member.
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Family function
The nurse will want to assess the familys functioning in the current nursing situation as well as inquire about past patterns.

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Family process

p.222

1.A process is a phenomenon that occurs over a period of time. 2.The term process imp lies change, but within every change there are often patterns and connections wit h events in the past that are likely to recur. Family members continually create shared meanings as their interaction unfolds over time, and family process describes the predictable and repetitive interaction patterns of families.
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Family Stages
Box13-4 Eight-Stage Family Life Cycle and Family .Beginning families .Child-bearing families .Families with preschool-age children .Families with school-age children .Families with teenagers .Families launching young adults .Middle-age parents .Family during retirement and aging
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p.228

p.223

Family communication can be direct or indirect. Communication styles within the family are further defined as symmetrical or complementary exchanges.

Family Communication
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Family Communication

p.223

Functional communication is direct communication. The message is clear enough that the receiver is able to understand both the literal meaning of the message and the emotional interpretations implied within the message. Functional communication is based on valid assumptions that are supported by evidence and confirmed through feedback.
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Family Communication
Dysfunctional communication usually includes the use of assumptions ,with the speaker taking for granted that he or she knows what the receiver is feeling or thinking and that the receiver understands the sender's message without validation.
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Application
Assessment : 1.Indications for Family Assessment 2.Family Assessment Tools 3.Family Interview Planning
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p.230

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Indications for Family Assessment

Healthy People 2000 consider the family as an important resource in health promotion and disease prevention. Families introduce their members early in life to health values and choices that will influence their health throughout life. Illness is usually a family event rather than an individual one.
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Family Assessment Tools

Genograms Family Time Lines Ecomaps
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p.232

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Family Interview
The nurse 's role with family issues: Engaging the Family Clarifying Purpose Clarifying Boundaries Setting Limits Identifying Family Strengths
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p.233

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p.235

Application
Planning

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Summary

p.241

Families have a structure, defined as the way in which members are organized. Family function refers to the roles people take in their families. Family process describes the communication that takes place within the family. Family stages identified in the chapter

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Summary

p.242

Family Assessment Tools include genogram, a time line and ecomap. Nursing interventions are aimed at strengthening family functioning and may include guiding family change, educating and problem solving during developmental crises, supporting family coping, enlisting the aid of family members in caring for family members, and helping family members coordinate resources.
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