Family Child Health

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

Mosby items and derived items 2005, 2001 by Mosby, In

 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.

Mosby items and derived items 2005, 2001 by Mosby, In

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 wellbeing 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.

Mosby items and derived items 2005, 2001 by Mosby, In

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.

Mosby items and derived items 2005, 2001 by Mosby, In

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).

Mosby items and derived items 2005, 2001 by Mosby, In

Family interaction model

Mosby items and derived items 2005, 2001 by Mosby, In

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.

Mosby items and derived items 2005, 2001 by Mosby, In

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.

Mosby items and derived items 2005, 2001 by Mosby, In

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.

Mosby items and derived items 2005, 2001 by Mosby, In

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.

Mosby items and derived items 2005, 2001 by Mosby, In

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.

Mosby items and derived items 2005, 2001 by Mosby, In

FAMILY CHILD HEALTH

PRACTICE
AND 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, socialemotional, 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.

Mosby items and derived items 2005, 2001 by Mosby, In

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.

Mosby items and derived items 2005, 2001 by Mosby, In

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.

Mosby items and derived items 2005, 2001 by Mosby, In

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.

Mosby items and derived items 2005, 2001 by Mosby, In

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 wellbeing.
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.

Mosby items and derived items 2005, 2001 by Mosby, In

Thank you for

attention!
Q&A?

Mosby items and derived items 2005, 2001 by Mosby, In