FAMILY NURSING

 "Family nursing is the process of providing for the health

care needs of families that are within the scope of
nursing practice.
 This nursing care can be aimed toward the family as
context, the family as a whole, the family as a system, or
the family as a component of society."
OBJECTIVES
 1. To identify health and nursing needs and problems of each family.
 2. To ensure family's understanding and acceptance of these needs and
problem.
 3. To plan and provide health and nursing services with the active
participation of family members.
 4. To help families develop abilities to deal with their health needs and
health problems independently.
 5. To contribute to family's performance of developmental functions and
tasks.
 6. To help family make intelligent use of promotive, preventive,
therapeutic and rehabilitative health and allied facilities and services in
the community.
 7. To educate, counsel and guide family, members to cultivate good
personal health habits, practice safe cultural practice and maintain
wholesome physical , psychosocial and spiritual environment.  
GENERAL PRINCIPLES
Family Based on
focussed
Good IPR health needs

Should be Family relates to Full

realistic in terms community participation in
of sources where it lives decision making

No
Health education,
guidance and supervision Continous
are integral part of family
discrimination health nursing services

Effectibve system Periodic and

of records and continous appraisal
 DIMENSIONS OF FAMILY HEALTH:-
In this section three main components are discussed. These are
 1. How we define "family"

 2. How we define "family health"

 3. What constitute a "healthy family".

WHAT IS FAMILY
 LEGAL:- relationship through blood ties, adoption,
guardianship, or marriage
 BIOLOGICAL: genetic biological networks among
people
 SOCIOLOGICAL: groups of people living together

 PSYCHOLOGICAL: groups with strong emotional ties.

 
WHAT IS FAMILY HEALTH?

 "Family health is a dynamic changing state of well-

being, which includes the biological, psychological,
spiritual, sociological, and cultural factors of individual
members and the whole family system".
WHAT ARE HEALTHY FAMILIES?
 

 It is possible to define "family health", but what about "healthy

families"? According to Becvar and Becvar(2000), Gladding
(1998), and Stinnett and Defrain (1985), healthy families have
a number of characteristics in common:
Stable and consistent sharing of nurturing
behaviour
Effective and stable child-rearing and
marriage maintenance practices
A set of goals toward which the family and
each individual work
 Sufficiently flexibility and adaptability to accommodate
normal developmental challenges as well as unexpected
crisis
 Commitment to the family and its individuals

 Appreciation for each other(i.e, a social connection)

 Willingness to spend time together

 Effective communication patterns

 A high degree of religious/spiritual orientation

 Ability to deal with crisis in a positive manner(i.e.

adaptabilty)
 Encouragement of individuals

 Clear roles
ADVANTAGES OF FAMILY NURSING:-

 Family health assessment

 Neighbourhood

 Interact with other members

 Feasible to plan and provide comprehensive care with

major emphasis on promotive and preventive care
 Active participation

 Members are relaxed

 Direct observation

 Maintain continuit of family health care.

APPROACHES TO FAMILY NURSING:-
THERE ARE 4 DIFFERENT APPROACHES

1. Family as the
context for 2. Family as a
individual client
development

3. Family as a
4. Family as a
component of
system. 
society
LEVELS OF FAMILY CARE

Leve
l1
Leve
l2
Leve
l3
Leve
l4
Leve
l5
ROLE OF A NURSE IN FAMILY NURSING:-
 HEALTH TEACHER/EDUCATOR
 COORDINATOR, COLLABORATOR, AND LIAISON

 DELIVERER AND SUPERVISOR OF CARE AND

TECHNICAL EXPERT:-
 FAMILY ADVOCATE

 CONSULTANT

 COUNSELOR

  CASE FINDER AND EPIDEMIOLOGIST

 ENVIRONMENTAL MODIFIER

 CLARIFIER AND INTERPRETER:-

 RESEARCHER

 ROLE MODEL

 CASE MANAGER
FAMILY HEALTH NURSING PROCESS

Assesme
nt phase

Evaluati Plannin
on phase g phase

Implem
entatio
n phase
ASSESSMENT
 Planning of data collection
 Data collection methods and techniques

 Observation

 Questioning

 Listening

 Review of family health records

 Examination and investigation

 Analysis of data

 Family profile and diagnosis

PLANNING PHASE
 Analysis of diagnosed health problems and assessment
of family's abilities to resolve problems i.e making
second level of assessment.
 Establishing priorities.

 Setting goals and objectives.

 Formulating family health and nursing care plan.

IMPLEMENTATION PHASE:-
 REVIEW OF PLAN AND MOBILIZATION OF
RESOURCES

 IMPLEMENTATION AND DOCUMENTATION:-

EVALUATION PHASE:-

 A standard refers to the desired or expected level of

performance whereas criteria refers to signs/indicators
of expected level of performance (standard) against
which actual performance of nurse or client or both is
compared to determine the extent of achievement of
goals and objective e.g:- one of the client centred
standard (goal) could be "after nursing intervention the
mother will be able to provide need based care to
malnourished children to improve their malnutrition
status from moderate to normal within six month period.
  QUANTITATIVE AND QUALITATIVE EVALUATION:
 . QUANITITATIVE EVALUATION:-

  

 Quantitative evaluation determines the extent of services rendered to

family. It accounts for the number of family visits, clinic visits, number
of immunizations completed, and reduction in morbidity and mortality.
  

 2. QUALITATIVE EVALUATION:-

  

 Qualitative evaluation determines the appropriateness, adequacy,

efficiency and efficacy of the nursing interventions planned and
implemented. Qualitative evaluation also determines adequacy of
resources in terms of equipments and supplies; manpower-their
preparation, organization, interest, job description, and efforts put in
organization's philosophy, policies, laid down standards and budget
etc.
  
 Qualitative evaluation is related to three dimensions. These are:-
 a) Structure evaluation

 b) Process evaluation

 c) Outcome evaluation

 

 a) Structure evaluation:- Structure evaluation measure the existing and

adequacy of the resources in terms of manpower, material, time, efforts etc;
Organisation structures, the administrative support etc.
 

 b) Process evaluation:- Process evaluation measures the appropriateness and

adequacy of the nurse's actions and activities implementing each component of
the nursing process to achieve the set objectives.
 

 c) Outcome evaluation:- Outcome evaluation measure the end results of the

care given to the client i.e family in terms of change in family health status,
family's ability to perform health task and change in health behaviour.
 
 
METHODS AND TOOLS FOR EVALUATION:-

 Direct observation
 Questioning

 Record review
FORMATIVE AND SUMMATIVE EVALUATION:-

 Formative evaluation:-
 Summative evaluation:-