Different Approaches to Family Nursing

Family as a Context 

In this approach, the family is considered a vital factor to the wellbeing of the patient. Here, the patient is at the center or focus of nursing care while the family is at the background. Alazzam (2016) adds to this literature by corroborating that the family has a significant potential of impacting or contributing to the individual’s illness or concerns and that the individual as the foreground could as well affect family relationships and interactions negatively, which could cause the family to be a significant stressor to his or her wellbeing.

In a particular instance of a family of four, the daughter to the family was diabetic comorbid with high blood pressure. The patient was a seventeen-year-old daughter who based on her condition, needed regular blood sugar and pressure check. She also required daily insulin injections and a regular routine of hydration. The mother was mainly vested in the daughter’s wellbeing, always checking on her and ensuring she had her medicine and water bottle every day before leaving for school. The father, while often busy, usually dropped her off to school and went by to check on her during the day at least once before picking her up together with the brother from school. The younger, sibling seemingly feeling forgotten and loved less did not care much about what was going on in his sister’s life and always kept to himself. However, once in a while when his sister would have an attack, he would take her a glass of water after her injections, asking if she was okay. While everybody had seemingly different roles and ideas about caring for her, they all agreed on changing the diet for her sake.

Family as a Client 

Here, the family members are in the foreground, whereby the nurse assesses how they are affected by the ill member. According to Clay & Parsh (2016), as medical care continues to be collaborative, the importance of family-centered care regarding both the health and wellbeing of the patients and family members in a mutually beneficial relationship cannot be overlooked. Coyne (2015) adds to these sentiments by ascertaining that family-centered care ensures that care is planned around the entire family where all members are recognized as care recipients and not just the individual.

In a particular instance of a family of five, the mother is diagnosed with stage three lung cancer requiring home-based ventilation. Within a month of the diagnosis, all the family members suffered from depression and registered for family therapy. Notably, the last child, who was particularly close to the mother, was affected the most. He became withdrawn, quiet, and introverted. The father, while putting on a brave face for the kids, suffered emotional distress directing it inwards and usually broke down in separate sessions with the therapist. The firstborn son knew he had to be strong but was emotionally drained and would spend hours in his mother’s room on her bedside talking to her. The second child of the family developed anxiety, always jumpy. Thus, in addition to therapy alongside his family, he needed anxiety medications.

Family as a System 

In this approach, the focus is simultaneously on the family as a whole as well as the individual. According to Dai & Wang (2015), the family is a salient platform for individual mental and physical development, and as such, it affects the growth of each member and therefore the normal operations of the family as a system. As such, when one part of the system is affected by an illness, then the rest is also compromised.

In a particular instance, a family of four goes into shock when the father is admitted and confined to the hospital with stage four brain tumor. The doctor in charge informed the family that he had three months at most before his whole system shut down and died. At first, the family mourned together but shortly afterward, they stopped interacting or communicating dealing with the stress separately. On hearing the news, the first child cried in denial saying “no” “no” as she ran out of the hospital. The second child broke into tears and hugged his mother tight, who sobbed quietly. However, as the mother, she took on the responsibility of the support system for the kids trying to make things normal. On the other hand, the first child still in denial always passed by the hospital after school to check on the father, often saying, “You can fight this dad, don’t leave me.” The mother would usually join her from picking her brother and would all sit around the father expressing their emotions often crying.

Family as a Component of Society 

In this approach, the family is considered one of the several institutions in society, such as educational, economic, and religious. Here, the family interacts with the other institutions to give communications and services.

In a particular instance of a family with an alcoholic father, the family through the wife sought outside help from alcohol support groups. Further, she arranged for therapy sessions with the husband not only to show her support of his wellbeing but to ensure he was getting proper help. Also, the wife, through a family meeting, informed them that she was arranging for the husband to be admitted to rehab. After a year of rehab and group support, the father was recovering progressively with his health generally improved. Thus, the family was happy to see that the rehab was effective and would visit him often to show support. Initially, when contemplating rehab and informing the extended family, the husband’s family was adamant and against the idea which proffered a substantial snag. Further, registering him for rehab, therapy, and support groups, though at different stages of his recovery, was costly and almost unaffordable which strained the family.

In conclusion, for holistic nursing care and healthcare provision, all the four approaches or aspects are equally fundamental and should be incorporated simultaneously to ensure positive patient outcome and the wellbeing of the family as the basic unit of society.

References

Alazzam, M., Albashtawy, M., Manal, A. K., Eshah, N., Baker, O., Alomari, O., & Alkhawaldeh, A. (2016). Advantages and Disadvantages of Studying the Family as a Context Approach When Dealing with a School-Aged Child Diagnosed with Attention Deficit Hyperactivity Disorder.  Iranian journal of public health ,  45 (10), 1369-1370. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5149503/pdf/IJPH-45-1369.pdf 

Clay, A. M., & Parsh, B. (2016). Patient-and family-centered care: It’s not just for pediatrics anymore.  AMA journal of ethics ,  18 (1), 40-44. Doi: 10.1001/journalofethics.2017.18.1.medu3-1601

Coyne, I. (2015). Families and health‐care professionals' perspectives and expectations of family‐centered care: hidden expectations and unclear roles.  Health Expectations ,  18 (5), 796-808. Doi:  10.1111/hex.12104 

Dai, L., & Wang, L. (2015). Review of family functioning.  Open Journal of Social Sciences ,  3 (12), 134. http://dx.doi.org/10.4236/jss.2015.312014