Just as the concept of family used in one area of nursing practice may not be appropriate or helpful for a different area of practice, the theoretical foundation of family nursing used in one area may not be applicable in another. Family Working as a System According to Friedman, Bowden, and Jones (2003), because the family unit is the most rudimentary unit of today’s society, “…it is the social institution that has the most marked effect on its members” (p. 4). For most, family is the most basic and lasting social connection.
Family is also “…the fabric of our day-to-day lives and shapes the quality of our lives by influencing our outlook on life, our motivations, our strategies for achievement, and our styles for coping with adversity” (Fontaine, 2009, p. 37). A person’s success or failure in life can be determined by the quantity and the quality of influence the family has had on his or her development. There is a strong correlation between the family unit and the health status of its members. The role of the family is vital during every aspect of health promotion of its members.
A family works as a system to promote the health of its members by having: open family communication; clear boundaries for familial roles; a moderate level of family cohesion and flexibility; emotional availability between members; and family competency (the family’s relational resources and adaptive abilities to manage stress productively) (Fontaine, 2009). For family members to attain an ideal level of wellness, evaluating and providing family health care is fundamental. Concept of Family
Friedman, Bowden, and Jones (2003) have provided five ways, or concepts, how family nursing is conceptualized. Family as context, family as sum of its members, family subsystem as client, family as client, and family as a component of society are methods in which family nursing is perceived. In my position as a faculty member for Associate’s in Science, Nursing program, I am currently teaching Mental Health Nursing. The textbook used for this course is Mental Health Nursing, 6th edition, by Karen L.
Fontaine (2009). Fontaine views the concept of family from the family as client perception. According to Friedman et al. , 2003, this concept of family sees the entire family unit as the principal focus of care with individual family members in the background. “The focus is on internal family dynamics and relationships, the family’s structure and functions, as well as the relationships of family subsystems with the whole” (Friedman et al. , 2003, p. 38).
According to Fontaine, to understand the intricacy of family systems, it must be understood how the members of the family communicate, how boundaries are formed and upheld, how interrelated yet flexible the family members are, and how emotionally accessible they are to other members of the family (Fontaine, 2009). In the context of mental health nursing, this concept is the most helpful when considering family in mental health nursing practice because although there may be only one member of the family with a mental illness diagnosis, each member of the family is affected by the illness.
When the family is viewed as an interactional system, there is an emphasis placed on the core family aspects and relationships. Connections can be made and assessed between illness, family members, and the family. Once these connections are made, they can be incorporated into treatment plans (Friedman et al. , 2003). Family Nursing Theories To guide family nursing practice and study, it is essential to adopt conceptual models and theories as a background to practice. “This background is even more critical with respect to family nursing because thinking interactionally and systematically in family nursing requires a paradigm shift from the individual-as-client approach to that of family as client” (Friedman et al. , 2003, p. 62). Leahey and Svavarsdottir (2009) suggested that “Improving and speeding the circularity between knowledge translation and clinical practice (in mental health) reaps benefits for patients, families, health care providers, and the health care system” (p. 445). In 1981, Imogene King developed her Theory of Goal Attainment. Initially, the goal of nursing in this theory was to “…help individuals maintain their health so they can function in their roles” (Friedman et al. , 2003, p. 65), which is more closely related to the family as context approach to family nursing. King’s theory can be related to the family as client concept in mental health nursing in that her theory guides nurses to assist families to identify problems and goals. King’s theory also helps nurses to describe the impact of the mental illness on the social system of the family.
King’s theory can be extended to include the family in the way that her model takes into account philosophies applicable to families, such as insight, collaboration, communication, growth and development, and stress (Friedman et al. , 2003). Fontaine (2009) states that “…nurses must…develop a collaborative partnership with clients and their families. This collaborative relationship means that the family is viewed as the unit of care and as partners in treatment and rehabilitation” (p. 46). Conclusion
According to Hunter (1994) in Friedman et al. (2003), the family appears to be “…an institution under siege” (p. 28). The debate over family matters, changes to the meaning of the family unit, and the future of the family as one of the basic components of present society has been seen from both the viewpoints of optimists and pessimists. Regardless of the differing viewpoints, both groups agree that the family holds pronounced significance in the health and well-being of humanity. References