Family Nursing Assessment - Essay Example

Running Head: Family Health Nursing Family Health Nursing of Family Health Nursing Introduction Families approach in all figures and sizes. What do they have in ordinary? Families are a collection of two or more populace that relies on one another for monetary, moving, and physical support. The dynamics in families might vary, but the fundamentals are the similar. The family is where persons learn to be accountable, to put away toys, spotless up messes, study etiquette, and state love. Family is where populace learn the education of life(Gregory A. Bechtel, 1996). If we analyzed then we come to know that family is ones personal the past and significance. It is not only a rest to go house to, its a place to approach from, out into the earth. From the primary day of school to the primary job, the family is the collection that says "go for it, you be able to do it!" Family is where a being is believed in, nurture, and scolded all towards creation him the best possible populace he can be. Its the work of the family to twist out causal human organisms(Kudakwashe Godwill Mapanga, Claire M. Andrews 1995). Avoidance of family and psychosocial problems connected to early days diabetes in an ideal world should begin right away following analysis. This time is dangerous for interference with families since during this phase, new pattern of collaboration and communication have to be erudite to successfully put together the diabetic action regimen into every day routines. Moreover, winning adaptation throughout the early phase of the illness may reduce prospect family troubles and illness complications(Carole Nettle, Jean Pavelich, 1993). A critical result of this stage is the familys aptitude to medically run the childs diabetes. The diabetic act regimen is many-sided and includes various every day injections, blood glucose monitor several period a day, nutritional considerations, work out, and cautious concentration to the timing and harmonization of all of these everyday jobs. Thus, the relations may knowledge substantial levels of stress connected to the crash of diagnosis and the stress of mastering the action regimen throughout the first year following analysis(Debra L Dillon, Kathleen Sternas 1997). Family health nursing is a demanding specialty since of the vast dissimilarity in the families seen in physical condition care today. Any "dysfunction", severance, disease, or wound, inside the family that have an effect on one or additional family members almost certainly will have an consequence on other family member and the family as a entire. The wellness of the family is also needy on the role of the family members in every feature of health care, from avoidance to treatment. The level of wellness of the complete family can be raised from side to side care that reduces way of life and ecological risks by emphasize health endorsement, self care, health teaching, and family therapy. Family nurses can get together the challenge of family care through a diversity of interventions. Interventions such as the subsequent are holistic in bearing in mind the wants of the entire family(Diane Feeney Mahoney, 1994). Diabetes There are a lot of diseases that affect human beings all approximately the earth. Some of these diseases are caused by grassroots diets, surroundings, or their heritage. My investigate is based on what reasons diabetes and whether it is genetically inclined (Bill Rados, 2004). Before I obtain into the genetics of Diabetes I want to give details what it is. The piece of script "Diabetes Explained" describes what it is by proverb; "Diabetes (Diabetes Mellitus) is a harsh, life-threatening state in which the body loses its aptitude to turn glucose as of foodstuff into usable power." It is sometimes, incorrectly, called "Sugar" Diabetes since glucose is a sugar. This piece of writing gets into more features in explanation what Diabetes and states, Family Assessment and Measurement Approaches One must distinguish flanked by assessment and dimension and flanked by qualitative and quantitative appraisal strategies. Assessment is a incessantly evolving procedure of data compilation, whereby the evaluator, by sketch on the past and the there, is able to diagram and Predict for the fiture (John T. Pardeck, Francis K. O. Yuen, 1999). In difference to appraisal, dimension is distinct as "the process of by a rule to assign information to objects or proceedings which represent the quantity .and/or kind of particular attribute obsessed" (Family Health, 2003). Measurement necessitates a formal tool that gives arithmetical values to or quintets, the character being deliberate and that gives a quantitative consequence when a exacting quality is examined. Dimension is frequently considered a narrower feature of .appraisal that centers on more exact concepts or character (Kathleen Bachmeier 2002). Assessment is the primary step the family treatment procedure, and the information it yields are frequently qualitative or evocative in nature. Clinical appraisal often engages the employ of a qualitative meeting guide; in difference, dimension often involves the management of weighing machine and other insauments that give way quantitative data. During famiy appraisal, data about the family are methodically collected, using prearranged guidelines or query, and then secret and examine according to their connotation. Family Nursing Assessment Models Three family appraisal models and approaches have been urbanized by M y nurses: the Family appraisal and interference Modeland the Family Systems Stressor-Strength record (FS31), the Friedman Relations Assessment Representation and Form, and the Calgary Family Appraisal Model (CFAM). Nurses are confident to learn every of the thee move toward and to choose the Representation that most excellent hysterics their attitude and put into practice. The subsequent conversation of every model assists in that procedure. Genetic Study A genetic learn done by researchers at the Joslin Diabetes middle and the Childrens Hospital Boston Informatics Agenda, has discovered a collection of genes that are concerned in Type 2 Diabetes and demonstrates that the action of these genes alters still previous to diabetes develops, which is give details in the piece of writing "Type 2 diabetes connected to family of metabolic genes." The pieces of writing describe these two genes, PCG1-alpha and PCG1-beta that show abridged activity not merely in the populace with Diabetes, but also in persons with pre-Diabetes. This reduces in activity come into views to lead to abridged action of a better collection of genes concerned in the metabolism of fats and carbohydrates. These genes system for proteins in the mitochondria, cell arrangements that play an significant role in power metabolism. Reduced movement of these genes may grounds an imbalance to augment insulin confrontation, or an incapability of the bodys cells to use insulin correctly, which is the primary metabolic imperfection to Type 2 Diabetes. CASE STUDY: MEDICAL FAMILY – DIABETES We shall now assess the family using the “Calgary Family Assessment Mode”. Case Scenario Joey is a 15 year-old Caucasian gentleman, bend framed and center group of students with new beginning Diabetes Type 1, who was having indications of recurrent urination, extreme thirst, and extreme lack of food, increased sweating, and feel as although his spirit was thrashing out of his upper body. These indications were happening for over three days previous to he knowledgeable his parents. His parents are extremely full of activity attorneys by means of a big firm, so they spend a huge deal of time absent from house. Joey is an only youngster and is more frequently than not self enough, and does not like to trouble his parents if not essential. This is why he waited so extended to tell his parents how he was emotion. His parents took him to see his relations physician, and he exposed that Joey had ketones in his urine, and a blood darling stage of 350mg/dl. Of course this alerted the MD of an imminent Diabetic Ketoacidosis (DKA), so he ran a major blood gas and electrolyte board. His blood gases demonstrate a pH of 7.33, and a HCO3 of 17mEq/L, and a potassium level of 3.3mg/dl. Although Joey was not yet in DKA he was in hazard of this state unless his blood sugars and electrolytes were manage. Joeys physician decided to confess him into the pediatric concentrated Care Unit (ICU) where his blood darling and electrolytes might be stabilizing. Once his blood darling and electrolytes were stabilizing Joey and his parents had to be meetings and cultured about the new analysis and its organization. The Interview Information Joey and his parents were primary asked concerning what they know of the illness. Unfortunately, they did not know a great deal, apart from that Joeys fathers look after died of complication of diabetes. The only belongings they might tell the Diabetic teacher was that they knew bonbon was no longer an alternative and that a particular go on a diet would have to be followed but they were hesitant of what the go on a diet would consist of. The look after was concerned concerning what types of foodstuff she be supposed to cook for Joey, as she expend a great contract of time absent as of house, and meals are more often than not amazing that she picks up on her way house from labor. They were all conscious that insulin shots would contain to be known, but hesitant as to why. They did not appreciate the illness procedure, but did have the same estimation that the illness was serious. Joey was particularly worried with have to give himself shots as he have a fear of unprovoked, and spoken some concern concerning the limits to his go on a diet. He loves to eat quick food and food and drink a huge deal of Coca-Cola. On the similar note he did say that he would be eager to regulate his diet if he knows how but was motionless doubtful of the unprovoked. The parents are eager to do what needs to be complete to help their son from side to side this illness procedure. Readiness and Needs Assessment Readiness: The relations and the customer were very eager to learn about the illness, and all that it necessary for organization. Joey and his parents are healthy verbal, and well cultured, and seem as although they were ravenous for in order and were ready to be acquiescent with a diagram of care for Joeys free house. Needs: leading is their need for information (Knowledge Deficit), so teaching on the disease procedure will be figures one. Since of Joeys age he is with no trouble unfocused in spite of his motivation, so all teaching will need to be acoustic, tactile and on paper, as to strengthen each pace he is knowledge. The parents seem unlock to spoken cues and similar to to contain written in order to help out them in their information bottom. The family and the customer will pay attention to a teacher, and ask questions or give criticism on what they have erudite. Then, they will be known written in order on the topic and asked to appraisal it previous to Joey is at large home. Joey will too be predictable to read the in order so he can assimilate it and inquire any question he may have concerning the sickness. From this point the customer and the relations will be enroll in Diabetic Teaching classes that will educate them about the illness, diet, work out, medications, accu-checks, base care, sick days, and inoculation site turning surrounding. This determination be listed for when the client is releases, and a RN will follow-up with the relations to make certain they create this first group of students and a follow-up by means of their main care MD. It will be significant for nursing to follow-up with these relations, as they contain very busy schedule, and will need some assistance in regard to time. Previous to Joey is free home he will be trained how to do his Accu-Checks and inoculations. Joey is afraid of unprovoked, so he will put into practice sketch up his insulin in a needle and charitable the inoculation to a carroty. This will help out in his soothe level of treatment and inject unprovoked; he will then be predictable to inject himself and conquer his fear. It will be significant for Joey to be clever to do his possess injections since his parents are not house a immense contract, so he cannot depend on single of them to give his inoculations. He will contain to sense at ease with this prior to release. His medicine routine will be appraisals with him and his relations orally and written downward for simple orientation. Once this has been complete a Dietician will appraisal diet options with Joey and his parents. A example diet plan will be known by means of the carbohydrate connections, along with an clarification of what the connections denote and how they can have an effect on his blood sugar. From that tip the client will be ask to decide his possess meal diagram to assess whether those options are ones that are best right for him. Some needed correction to his options will be made and explained to him on why he be supposed to not have selected those substance. Joey will also be known a fast food diabetic swap menu, so that he can motionless eat quick food, with improved choices in brain. As far as the beverage is concerned, he determination be instruct on the significance of go on a diet soda against regular soda and an add to in his daily use of water to maintain hydration. The look after is worried concerning how to heat for Joey, so meal choices will be reviewed with her plus a conversation of how to get ready them. A example of a diabetic bill of fare will be known to her, the length of with a catalog of fast food seats that have diabetic connections for Joey. Given her full of activity agenda this will be easier for her to do than cook, but teaching on foods and cookery is still have to for persons days she does cook and at what time she grocery shops for Joey. Healthier options have to be more obtainable to him while he is at house alone. This is a preliminary tip for the customer and his relations, but the customer will need a number of in-depth therapies to help him in flattering self-sufficient in his diabetes runnings. Conclusion One common difficulty in studying cope and version to physical sickness is obtaining an adequate example size. This difficulty is compounded when the studys center is on recently or recently diagnosed persons, because the occurrence of illness is not beneath the investigators manage. The small example size is a curb of the current learn in that the example might not represent lately diagnosed diabetic relations; the present example also is mainly pallid and extremely cultured, further warning the generalizability of the answer. In termination, families are altering. Health care is altering. The two entities are quick flattering a collaborative team. Populace tends to live longer and need more care. Since of rising healthcare costs, the majority of the care will be in the house. "While the familys job is to get together the ill people medical and other caregiving needs, the moving well being of the whole scheme is challenged. This may guide to couple or family disagreement that carry on decreasing health position which in turn unenthusiastically affect family dynamics (Atwood and Weinstein). The well life form of the family is careful along with the physical condition and wellness of the person. The objective of the family nurse centers on the health requirements of the whole being in the background of their families and surroundings and addresses their exact health response and anxieties in an equally acceptable method. Book References John T. Pardeck, Francis K. O. Yuen , (1999). Family Health: A Holistic Approach to Social Work Practice. Publisher: Auburn House. Place of Publication: Westport, CT. Geertje Boschma (2003), The Rise of Mental Health Nursing: A History of Psychiatric Care in Dutch Asylums, 1890-1920. Publisher: Amsterdam University Press. Place of Publication: Amsterdam. John T. Pardeck (2002), Family Health Social Work Practice: A Macro Level Approach. Publisher: Auburn House. Place of Publication: Westport, CT. Publication Michael Sheppard (1991), “ Mental Health Work in the Community: Theory and Practice in Social Work and Community Psychiatric Nursing”. Publisher: Falmer Press. Place of Publication: London. Dorothy A. Whyte (1997), “Explorations in Family Nursing”. Publisher: Routledge. Place of Publication: London. Article References Gregory A. Bechtel, Mary Anne Shepherd, Phyllis W. Rogers (1996). Family, Culture and Health Practices Among Migrant Farmworkers. Journal Title: Journal of Community Health Nursing. Volume: 12. Issue: 1. Page Number: 15. Kudakwashe Godwill Mapanga, Claire M. Andrews (1995). “The Influence of Family and Friends Basic Conditioning Factors and Self-Care Agency on Unmarried Teenage Primiparas Engagement in Contraceptive Practice”. Journal Title: Journal of Community Health Nursing. Volume: 12. Issue: 2. Carole Nettle, Jean Pavelich, Nancy Jones, Carol Beltz, Priscilla Laboon, Pauline Pifer (1993). “Family as Client: Using Gordons Health Pattern Typology”. Journal Title: Journal of Community Health Nursing. Volume: 10. Issue: 1. Debra L Dillon, Kathleen Sternas (1997). “Designing a Successful Health Fair to Promote Individual, Family and Community Health”. Journal Title: Journal of Community Health Nursing. Volume: 14. Issue: 1. Diane Feeney Mahoney, Raelene Shippee-Rice (1994). “Training Family Caregivers of Older Adults: a Program Model for Community Nurses”. Journal Title: Journal of Community Health Nursing. Volume: 11. Issue: 2. Bill Rados (2004). “Womens Health; on Avoiding the Nursing Home”. Magazine Title: FDA Consumer. Volume: 20. Publication Date: September 1986. Page Number: 30+. copyright 1986 U.S. Government Printing Office; copyright 2004 Gale Group Kathleen Bachmeier (2002) Correctional Nursing Practice: What Makes This Practice Different?. Magazine Title: Corrections Today. Volume: 63. Issue: 5. Publication Date: August 2001. Page Number: 84. copyright 2001 American Correctional Association, Inc.; copyright 2002 Gale Group Appendix Note: Following is a copy of all references along with genuine article details. Article References Article Title: Family, Culture and Health Practices Among Migrant Farmworkers. Contributors: Gregory A. Bechtel - author, Mary Anne Shepherd - author, Phyllis W. Rogers - author. Journal Title: Journal of Community Health Nursing. Volume: 12. Issue: 1. Publication Year: 1995. Page Number: 15. Family, Culture, and Health Practices Among Migrant Farmworkers By Gregory A. Bechtel, PhD, RN, Georgia Southern University , Mary Anne Shepherd, RN, FNP-C , Ellaville Primary Medicine Center , Ellaville, GA, Phyllis W. Rogers, RN, MA, Newnan Hospital , Newnan, GA Migrant farmworkers and their families have restricted access to health and human services because of their frequent relocation between states, language and cultural barriers, and limited economic and political resources. Living and working in substandard environments, these families are at greater risk for developing chronic and communicable disease. In an assessment of health patterns among 225 migrant workers and their families, using personal observations, unstructured interviews, and individual and state health records, childrens immunizations were found to be current, but dental caries and head lice were epidemic. Among adults, almost one third tested positive for tuberculosis exposure. Urinary tract infections were the most common health problem among women. Primary and secondary prevention were almost nonexistent because funds for these services were not readily available. The patriarchal system contributes to these problems by limiting access to family-health and social service needs. Although providing comprehensive health care to migrant communities presents unique challenges, nurses can demonstrate their effectiveness in reducing morbidity through strategic interventions and alternative uses of health delivery systems. Article Title: The Influence of Family and Friends Basic Conditioning Factors and Self-Care Agency on Unmarried Teenage Primiparas Engagement in Contraceptive Practice. Contributors: Kudakwashe Godwill Mapanga - author, Claire M. Andrews - author. Journal Title: Journal of Community Health Nursing. Volume: 12. Issue: 2. Publication Year: 1995. The Influence of Family and Friends Basic Conditioning Factors and Self-Care Agency on Unmarried Teenage Primiparas Engagement in Contraceptive Practice by Kudakwashe Godwill Mapanga, PhD University of Zimbabwe Claire M. Andrews, PhD, CNM, FAAN Case Western Reserve University BACKGROUND One in 10 teenagers age 15 to 19 becomes pregnant each year in the United States and 5 in every 6 of those pregnancies are unintended ( Scott, 1983; Trussell, 1988); only 6% are due to failure of the contraceptive used ( Cobliner, 1981). The birth rate among teenagers is increasing ( National Center for Health Statistics, 1990), as are repeated pregnancies in unmarried teenage primiparas ( National Academy of Sciences Symposium, 1987). A previously pregnant teenager has a greater likelihood of becoming pregnant again than a never-pregnant counterpart ( Miller, 1983; Polit & Kahn, 1986), and the likelihood of repeated pregnancy is further increased if the first pregnancy is carried to term ( Koenig & Zelnik, 1982). Repeated pregnancies in unmarried teenage primiparas are associated with higher infant mortality rates, decreased likelihood of completing high school, and increased unemployment rates and welfare dependency ( Ford, 1983). Thus, failure to engage in contraceptive practice to prevent repeated pregnancies among unmarried teenage primiparas is a major problem. Researchers have attempted to use contraceptive practice models involving attitudes and plans, but these have not been successful in predicting contraceptive use. Article Title: Family as Client: Using Gordons Health Pattern Typology. Contributors: Carole Nettle - author, Jean Pavelich - author, Nancy Jones - author, Carol Beltz - author, Priscilla Laboon - author, Pauline Pifer - author. Journal Title: Journal of Community Health Nursing. Volume: 10. Issue: 1. Publication Year: 1993. Family as Client: Using Gordons Health Pattern Typology Carole Nettle, RN, MSN, Jean Pavelich, RN, MSN, Nancy Jones, RN, MSN, and Carol Beltz, RN, MSN by Kent State University Priscilla Laboon, RN, MSN, Ravenna, OH, Pauline Pifer, RN, MSN, Clearwater Beach, FL The community health nursing faculty at Kent State University organized a family assessment instrument in accordance with the health pattern typology described by Gordon ( 1982 ). Students use the instrument with traditional and nontraditional families at every stage of the family life cycle. Reasons for initial visits to the families range from newborn health promotion to skilled nursing for acute and chronic conditions. The instrument helps students conceptualize the family as client and explore the concept of family nursing diagnoses. Community health nurses have long recognized the value of the family as a unit of service. The family defines health, makes decisions regarding health practices, and is the most frequent provider of health care to family members ( Freeman, 1970; Stanhope & Lancaster, 1992; Whall, 1986b). For example, family caregivers provide most of the long-term care for the elderly who live in the community and an estimated 80% of home health care is provided by families ( Coulton, 1988; Stone, Cafferata , & Sangl, 1987). Community health nursing educators are expected to help nursing students conceptualize the family as a unit of nursing service as a basis for nursing practice ( Clark, 1992; Clemen-Stone, Eigisti, & McGuire, 1987; Cookfair, 1991; Saucier, 1991; Spradley, 1985; Stanhope & Lancaster, 1992). Family assessment is considered core content of baccalaureate education and is a required competence of the nurse generalist according to the American Nurses Association Standards of Community Health Nursing Practice ( 1986 ). Article Title: Designing a Successful Health Fair to Promote Individual, Family and Community Health. Contributors: Debra L Dillon - author, Kathleen Sternas - author. Journal Title: Journal of Community Health Nursing. Volume: 14. Issue: 1. Publication Year: 1997. Designing a Successful Health Fair to Promote Individual, Family, and Community Health Debra L. Dillon, MSN, RNC School of Nursing University of Maryland, Kathleen Sternas, PhD, RN School of Nursing Georgetown University A health fair is a community health strategy used to meet community members needs for health promotion, education, and prevention. In this article we focus on the importance of partnerships in designing a health fair; essential components; and steps in planning, implementing, and evaluating a health fair. The Healthy People 2000 framework can be used to guide the development of objectives and content for a health fair. We present a list of topics for exhibits and a Health Fair Evaluation Questionnaire used to measure outcomes of a health fair on participants health beliefs and practices. Implications for nursing practice, education, and research include increasing nurses awareness of community problems, health beliefs, and practices; networking opportunities that provide knowledge of new resources; service learning experiences for students; and opportunities for research on how health fairs meet health care needs and promote changes in health knowledge, beliefs, and practices. Article Title: Training Family Caregivers of Older Adults: a Program Model for Community Nurses. Contributors: Diane Feeney Mahoney - author, Raelene Shippee-Rice - author. Journal Title: Journal of Community Health Nursing. Volume: 11. Issue: 2. Publication Year: 1994. Training Family Caregivers of Older Adults: A Program Model for Community Nurses by Diane Feeney Mahoney, PhD, RNC, GNP, Boston College, Raelene Shippee-Rice, PhD, RN, University of New Hampshire A community-based program for family caregivers of impaired older adults was designed and implemented to teach caregiving skills and techniques. The purpose of the program was to enhance caregivers sense of competency in performing caregiving tasks and to reduce their risk of physical strain. A gerontological nurse specialist facilitated the group process, taught, and then demonstrated the caregiving skills. Participants highly valued the opportunity to discuss specific health concerns and practice caregiving skills with a professional nurse. Similar community-based programs managed by nurses are recommended to support nonprofessional caregivers. Older adults first turn to their families and friends when they need help ( Chappell, 1990; Stone, Cafferata, & Sangl, 1987; Sussman, 1976). We know that families provide 60% to 80% of the total care received by impaired older adult relatives ( Cantor , 1983; Mutschler, 1985; Rivlin & Wiener, 1988; Shanas, 1979; Stone et al., 1987). Marks ( 1987 ) reported that families provide an average of 120 hr per week of extensive physical care: helping older family members with eating, walking, dressing, taking medications, and managing chronic health problems such as incontinence. As the number of adults age 85 and over escalates, the need for more physical care and assistance from family members will also increase ( Bould, Sanborn , & Reif, 1989; Fischer & Eustis, 1988; Shaughnessy & Kramer, 1990). Article Title: Womens Health; on Avoiding the Nursing Home. Contributors: Bill Rados - author. Magazine Title: FDA Consumer. Volume: 20. Publication Date: September 1986. Page Number: 30+. COPYRIGHT 1986 U.S. Government Printing Office; COPYRIGHT 2004 Gale Group Womens Health; on Avoiding the Nursing Home. by Bill Rados Womens Health: On Avoiding The Nursing Home Noting that three out of four nursing home patients are female, a top U.S. health official recently urged women to take steps when they are young to prevent the illnesses that require long-term care later in life. Women also should help in finding alternatives to long-term institutional care, the high cost of which is "shocking, said Don M. Newman, undersecretary of health and human services. He said that, because of a lack of coverage by private health insurance or Medicare, two-thirds of those who enter nursing homes spend all their assets within three months. Newman made the remarks at the National Conference on Womens Health last June 18 in Bethesda, Md. The conference was sponsored by FDA and the Public Health Service Coordinating Committee on Womens Health Issues. "Becoming immobilized through stroke, hip fracture, heart disease, or any other acute condition--immobilized to the point that we can no longer get around by ourselves, feed ourselves, or dress without help--is a terrible thing to consider, Newman told the audience of some 600 specialists in womens health. "While it is true that some preventive health measures can be taken by the elderly, we must start educating women about what they can do before they get too old to avoid the severe disabilities we see among the elderly today. Article Title: CORRECTIONAL Nursing PRACTICE: What Makes This Practice Different?. Contributors: Kathleen Bachmeier - author. Magazine Title: Corrections Today. Volume: 63. Issue: 5. Publication Date: August 2001. Page Number: 84. COPYRIGHT 2001 American Correctional Association, Inc.; COPYRIGHT 2002 Gale Group. CORRECTIONAL Nursing PRACTICE: What Makes This Practice Different? by Kathleen Bachmeier Correctional nursing practice is not for the fainthearted but can be quite manageable with a common sense approach. The obvious difference between correctional and noncorrectional nursing is the patient we care for. Or is it? Perhaps it is the environment in which we practice nursing. The correctional setting certainly is not the traditional model of nursing practice. The greatest difference, in reality, is how inmates constitutional rights and court principles interact with nursing practice in the correctional setting. This difference exists because inmates have lost their rights to basic freedoms and live under supervision and government control. Book References Book 1 John T. Pardeck, Francis K. O. Yuen , (1999). Family Health: A Holistic Approach to Social Work Practice. Publisher: Auburn House. Place of Publication: Westport, CT. FAMILY HEALTH A Holistic Approach to Social Work Practice Edited by John T. Pardeck and Francis K. O. Yuen AUBURN HOUSE Westport, Connecticut • London -iii- 1 A Family Health Approach to Social Work Practice Francis K. O. Yuen and John T. Pardeck Family health is an emerging practice orientation in the profession of social work. Even though the profession has always stressed the importance of the family system in practice and policy development, the concept of family health is new to the profession. Given the fact that family health is a new innovation to the field, the following serves as a guiding definition for this emerging practice approach: Family health is a state of holistic well-being of the family system. Family health is manifested by the development of, and continuous interaction among, the physical, mental, emotional, social, economic, cultural, and spiritual dimensions of the family which results in the holistic well-being of the family and its members (School of Social Work, Southwest Missouri State University, 1996). The goal of this chapter is to develop the philosophical basis of family health and offer the theoretical underpinnings of this innovative approach to practice and policy development. Book 2 Geertje Boschma (2003), The Rise of Mental Health Nursing: A History of Psychiatric Care in Dutch Asylums, 1890-1920. Publisher: Amsterdam University Press. Place of Publication: Amsterdam. The Rise of Mental Health Nursing A History of Psychiatric Care in Dutch Asylums, 1890-1920 Geertje Boschma AMSTERDAM UNIVERSITY PRESS Introduction Mental health nursing emerged as a new occupational field in the late nineteenth century in the context of the rise of scientific psychiatry. Based on new understandings of mental illness and new forms of psychiatric treatment, asylum physicians legitimized and initiated the introduction of mental nursing in asylums, which restructured a field of work that had hitherto been the domain of lay attendants. In light of the new significance that skilled nursing care had acquired in the context of general hospital reform, psychiatrists, themselves a rising professional group, argued that more refined and better trained personnel would greatly improve psychiatric care. Shifting social and gender relationships, particularly the changing social position of middleclass women, constructed and shaped mental nursing. The emergence of mental nursing mirrored larger social changes for lower middle- and working-class men and women and their work illustrates the social complexity of the care of the mentally ill. Book 3 John T. Pardeck (2002), Family Health Social Work Practice: A Macro Level Approach. Publisher: Auburn House. Place of Publication: Westport, CT. Publication FAMILY HEALTH SOCIAL WORK PRACTICE A Macro Level Approach Edited by John T. Pardeck AUBURN HOUSE Westport, Connecticut • London 1 An Introduction to Macro Level Family Health Social Work Practice John T. PardeckSince its inception, the profession of social work has focused on the role that the family system plays in shaping the overall well-being of individual family members. Even though this system has always been a core focus of treatment for social workers, its framing from a family health perspective is new to the field. The purpose of this chapter is to present the family health perspective with an emphasis on macro level social work practice. Family health is grounded in a biopsychosocial model and views the family system as a powerful force on individual social well-being. In this book, family health is defined “as a state of holistic well-being of the family system. Family health is manifested by the development of, and continuous interaction among, the physical, mental, emotional, social, economic, cultural and spiritual dimensions of the family which results in the holistic well-being of the family and its members” (Pardeck & Yuen, 1999, p. 1). A number of basic premises guide family health social work practice; these include (Pardeck & Yuen, 1999): 1. Family health social work practice is based on a biopsychosocial approach that assesses problems confronting families within a social systems context. Practitioners grounded in the family health approach view the locus of family health social work practice as promoting and maintaining the total well-being of the individual and the family system. Book 4 Michael Sheppard (1991), “ Mental Health Work in the Community: Theory and Practice in Social Work and Community Psychiatric Nursing”. Publisher: Falmer Press. Place of Publication: London. Mental Health Work in the Community: Theory and Practice in Social Work and Community Psychiatric Nursing Michael Sheppard The Falmer Press (A member of the Taylor & Francis Group) London · New York · Philadelphia Chapter 1 Introduction The context for the practice of social work and community psychiatric nursing (CPN) as well as the development of community mental health centres (CMHC) is provided by the increasing emphasis since 1945 on community care of the mentally ill. To a large degree this arose from the development of psychotropic drugs in the 1950s, which revolutionized the control of major mental illness, such as schizophrenia, creating an atmosphere of therapeutic optimism. This was allied to a growing disenchantment with hospitals as an appropriate setting for managing mental illness, and the potential debilitating effect of institutional care (Goffman, 1961). The term ‘institutional neurosis’ described a process by which hospital regimes created individuals with characteristics such as submissiveness, apathy and a shuffling gait (Barton, 1959). Closely associated with this was the preferred notion of ‘normalization’: ‘The conviction that if people with handicaps are treated like everyone else, their handicaps will cease to be of importance to them and to society’ (Jones, 1988, p. 90). In political terms the focus for decarceration of patients was most evident in Powell’s well known speech as Minister of Health planning to halve the number of hospital beds in fifteen years (Powell, 1961), which was followed by the ‘Hospital Plan’, which envisaged the run down and eventual closure of existing hospitals and their replacement by short stay psychiatric units and community care facilities provided by local authorities (Ministry of Health, 1962). Figures for bed occupancy reflect the subsequent reduced emphasis on institutional care: average daily bed occupancy reduced from 118,800 in 1966 to 83,800 in 1976 and 61,500 in 1986 (Department of Health, 1988). Book 5 Dorothy A. Whyte (1997), “Explorations in Family Nursing”. Publisher: Routledge. Place of Publication: London. Explorations in Family Nursing Edited by Dorothy A. Whyte London and New York Chapter 1 Family nursing A systemic approach to nursing work with families Dorothy A. Whyte THE CASE FOR FAMILY NURSING A young wife had battled over the years to support her husband through the trials of chronic renal failure, haemodialysis, failed kidney transplant and an increasing disability which was psychological and social as well as physical. Finally, exhausted and demoralised, their relationship destroyed, she could take no more. She left him./Some months later he took his own life. The staff of the renal unit shared her grieving. She writes: The above account makes the case more eloquently than I ever could for family nursing. Why was it that nurses (and others) who were expert in technical care were so unaware of and uninvolved in the effects of illness on human relationships central to their patient’s well-being? Did their responsibility end with the management of dialysis? Were they so keen for treatment to be successful that they refused to see the disintegration of personality and relationship being played out before them? Did they prefer not to look beneath the surface of apparent ‘coping’? And is it not true that such accounts could be repeated endlessly by people who have not had the support they needed when faced with the illness of a loved one? Read More