Teaching family nursing: strategies and experiences

The traditional hospital-based approach to Australian nurse education curricula was primarily based on the medical model and directed towards the preparation of nurses who were able to give care to individual clients The major focus was on the needs of the individual A notable absence in curricula was any consideration of the role or importance of families to individual and family health This was despite the continuing involvement that nurses have in their practice with the families of their clients This paper describes the experiences of introducing a family nursing subject in an undergraduate, preregistration nursing programme which focuses on the family as a unit of care Educational strategies, clinical experiences, and evaluation of the unit of study are discussed     

Family nursing education and family nursing practice in Nigeria

A survey of six Nigerian nursing program curricula was conducted to determine the extent to which family nursing theory was used as a reference for conceptualizing nursing care in Nigeria. In addition, 25 nurse clinicians were purposely selected from three levels of primary, secondary, and tertiary health care units in Ile-Ife, Nigeria, and were interviewed to determine the extent to which nurses in practice reported using family assessment tools in their practice. The survey of the postgraduate curricula showed that master's and doctorally prepared nurses specializing in community health nursing have a theoretical base in family nursing theory. The limited focus on family nursing theory in basic, postbasic, and first-degree nursing curricula was deemed inadequate to develop the knowledge and skills necessary for all practicing nurses to embrace family-focused care in Nigeria. In nursing practice, families were seen to be involved in nursing care only to the extent of meeting financial and physical care needs of their family members. Findings from this study point to the need for a reorientation of the nursing curricula in Nigeria to include more family nursing theory. Specialized education of family nurse practitioners who would function at all levels of care also is a desirable goal to provide holistic health care to Nigerian families.     

COE Final Report: Chiba University

Background: The Center of Excellence (COE) program for the Creation and Dissemination of a New Japanese Nursing Science at the Chiba University School of Nursing aims to develop nursing science that is appropriate for Japanese culture and to internationally disseminate the importance of culturally based care. The object of this culturally appropriate nursing is not only clients/families but also nurses themselves, because although the cultural aspect of a nurse is tacit, it has deep influence on nursing care. Method: We organized our research subprojects from the viewpoint of “Interpersonal Helping,” which is different from the former approach of nursing, and we conducted research study on these subprojects. We conducted our research studies to clarify culturally appropriate nursing by the qualitative meta‐synthesis method. We performed international comparative research study on culturally appropriate nursing and conducted international conferences to elaborate and disseminate our outcomes. Results: Fourteen outcomes of meta‐synthesis studies have already been published until now, and more than 200 primary research studies have been conducted. We developed mainly 2 education programs and adopted them practically. From the inductive analysis of all our primary researches, we derived 4 viewpoints that clarify cultural aspect in nursing. The Cultural Nursing Society was established in 2007. Conclusions: We finally named this culturally appropriate nursing which respected the difference of individual culture “Cultural Nursing”. The importance of Cultural Nursing will further increase in the near future. We plan to establish and systematize this Cultural Nursing Science, which is based on the outcome of our program, and enroll researchers and nurses who have the ability to study and practice Cultural Nursing from both interdisciplinary and international aspects.     

Nurses attitudes towards the importance of families in psychiatric care following an educational and training intervention program

This study measures the attitudes of the psychiatric nurses, after having received an education and training intervention program (ETI-PROGRAM) in family systems nursing, towards the importance of the families in their care. Nurses' knowledge of the impact that family nursing intervention can have on family members may increase positive attitudes towards families. However, little is known about the impact that education and training intervention can have on nurses' attitudes, towards families in clinical practice. Quasi-experimental design was used to assess the change in nurses' attitudes towards families in psychiatric care after the intervention, which included a one-day seminar on the Calgary family nursing conceptual frameworks and skills training with clinical vignettes of families from psychiatry. The Families Importance in Nursing Care - Nurses' Attitude questionnaire was used to evaluate nurses' attitudes. A total of 81 nurses (65%) working in psychiatric care responded to the questionnaire. Nurses with more than 15 years of work experience were significantly more supportive of families in their care compared with less experienced nurses. Out of the 81 nurses, 52 (64%) answered the questionnaire again 14 months later. Furthermore, psychiatric nurses saw families significantly less burdensome after having participated in the ETI-PROGRAM.     

护理服务中心护理人员的心态与需求的调查分析

目的：为提高护理服务中心的护理服务质量，完善护理服务的管理。对护理服务中心从事护理服务的226人进行调查。结果显示护理人员均有一定的心理压力，需要学习与护理相关的法律知识，制订各种疾病规范化护理的要求。     

The impact of a family systems nursing educational program on the practice of psychiatric nurses: a pilot study

A pilot study was conducted to examine the impact of a Family Systems Nursing educational program on the practice of psychiatric nurses and to explore the nurses' perceptions of the educational program. One year after the program, six nurses were asked to complete logbooks and to participate in an individual semistructured interview based on open-ended questions and on the critical incident approach to describe their family nursing interventions and to explore their perceptions on how the educational program influenced their practice of family nursing care. Content analyses indicated that participant nurses integrated systemic family interventions in their practice and were satisfied with the program.     

Nursing contribution to the rehabilitation of older patients: patient and family perspectives

tyrrell e.f., levack w.m., ritchie l.h. & keeling s.m. (2012)?Nursing contribution to the rehabilitation of older patients: patient and family perspectives. Journal of Advanced Nursing68(11), 2466-2476. ABSTRACT: Aims. This article reports a study of the perspective of older patients and their family members on the role of nurses in inpatient rehabilitation. Background. Rehabilitation services are used increasingly by older patients as life expectancy increases. The role of rehabilitation nurses in the multidisciplinary team has, however, yet to be clearly articulated. Previous research has focussed on the views of health professionals about nursing involvement in rehabilitation, but none has sought family members' perspectives. With the expectation of patient-centred care, it is important to consider what older patients and their families expect and require from nurses. Design. Grounded theory was used to collect and analyse data from interviews in an inpatient rehabilitation unit in New Zealand with seven patients, aged 72-89?years, and six family members, during 2009-2010. Findings. A substantive theory was developed which recognizes that the older patient values the relationship they build with nurses more than any specific role nurses perform. Participants acknowledged that rehabilitation nurses' roles included 'looking after', 'stepping in' and 'coaching independence' but 'best fit' nurses were identified by patients based on their 'nature', 'being available' and 'being attuned' to the patient's individual needs. If a 'connection' was formed, then this 'best fit relationship' maximized the older person's motivation to participate in his or her rehabilitation therapy. Conclusion. Patients and family members appreciate 'best fit relationships' where nurses seek to enter into the older person's world of disability to form a partnership which enhances their motivation to achieve independence.     

Criteria for evaluating the clinical and practical utility of models used by nurses

Arguably, nursing, like all health care disciplines, is an applied science. Essentially, this refers to the application of theory in order to understand and respond to the health problems of clients. These theories may be drawn (borrowed) from any applied science, or generated inductively from clinical nursing practice. Alternatively, nurses may attempt to apply deductive theory (global theoretical frameworks) known as nursing models. In this paper, all theoretical approaches, irrespective of origin, are referred to as models used by nurses. Thirteen criteria by which clinicians, and others, can evaluate the clinical and practical utility of models used by nurses which are expressed in the form of questions are identified and discussed. The criteria are an extension, both in detail and in number, of those developed by Reynolds and Cormack and subsequently applied by those writers to the Johnson Behavioural System Model of Nursing. The value, or otherwise, of individual models, or of models in general, will not be discussed in this paper. However, the authors propose that if the evaluation criteria described here are applied to existing models, serious deficits will be identified in relation to their clinical and practical utility.     

Spirituality and family nursing: spiritual assessment and interventions for families

AIM: The aim of this paper is to propose a guideline for spiritual assessment and interventions explicitly for families, while considering each family member's unique spirituality. BACKGROUND: Spirituality's positive effect is pervasive in health care and in the lives of many families; therefore, there is a need to integrate spiritual assessment and interventions in total family care. DISCUSSION: The majority of published guidelines on spiritual assessment and interventions are designed predominantly for individuals. They fail to differentiate between individual and family spirituality or offer only brief discussions on family spirituality. Such guidelines are potentially problematic. They may lead nurses to focus only on individual spirituality and neglect to discern family unit spirituality or recognize the presence of conflicts in spiritual perspectives within the family. While other disciplines such as social work and family therapy have several guidelines/strategies to assess family spirituality, there is a dearth of such guidelines in the family health nursing and spirituality literature, in spite of the rhetoric about incorporating spirituality as part of total family assessment. As a beginning solution, guidelines are proposed for spiritual assessment and interventions for the family as a unit, and the category of spiritual interpretation to represent diagnosis is introduced. Case studies exemplify how to integrate the guideline, and illustrate elements that may favour specific interpretations which would guide the interventions. CONCLUSION: As nurses continually strive to assist families with their health needs, they must also attend to their spiritual needs, as one cannot truly assess a family without assessing its spirituality.     

The practice of patient education: the theoretical perspective

Effective nursing practice is based on an understanding of the theoretical basis of nursing. Similarly, to be effective patient educators, nurses must be familiar with the theoretical basis of patient and family education. Theories provide the framework from which nurses use tools that can be adapted to each patient. Nurses may educate their patients and families using any combination of theories to achieve best results. Through this process arises the opportunity for the achievement of optimal patient outcomes. This article highlights theories originating from communications, psychology, education, sociology, and nursing.     

The current state of the center for the creation and dissemination of new Japanese nursing science: The 21st century Center of Excellence at Chiba University School of Nursing

Aim: The Center of Excellence for the Creation and Dissemination of a New Japanese Nursing Science at Chiba University School of Nursing is now in its third year of operation. This center aims to develop nursing science that is appropriate for Japanese culture and to internationally disseminate the importance of culturally based care. Our project seeks to systematically transform the art of nursing practise into a nursing science. Method: To date, multiple frameworks have been created through the qualitative meta‐synthesis of research on effective nursing care. To create a nursing science, these frameworks derived from meta‐synthesis must be verified and internalized in nursing practise. Results: After three years of research, the following findings are emerging: professional care relationships in nursing practise in Japan are characterized by the bidirectional process between the nurse and the client, in which both gradually undergo a transformation in order to establish a collaborative, therapeutic relationship; Japanese nurses emphasize the importance of understanding adolescent clients’ subjective understanding of their own life with self‐care, as well as social support; and the priority for community health nurses in Japan is to create support systems in the community, regardless of whether the intended client is an individual, a family, a specific group, or the community as a whole. Conclusions: Our future efforts will focus on verifying our findings through interdisciplinary and international comparative research and by integrating various frameworks in order to create a new Japanese nursing science.     

A Family-Focused Perspective on Chronic Illness

The care of the chronically ill traditionally has focused on the individual who has the illness. Nursing has always emphasized including the family in care, but very few protocols dealing with chronic illness focus on the family as the unit of care. In this article, the author presents a new approach to the care of families affected by chronic illness, applying concepts of the family health system (Anderson & Tomlinson, 1992) to chronic illness. The protocol described, which includes nursing assessments and interventions, groups areas of family experience into five types of processes: interactive, developmental, coping, integrity, and health processes. The protocol presented is an example of an innovative, holistic, family-focused perspective on the care of those with chronic illness.     

Community nursing: redesign in Scotland

The report 'Visible, accessible and integrated care' (VAIC) proposes a new Community Health Nurse (CHN) model which involves the combination of the four current disciplines of district nursing, public health nursing (health visiting and school nursing) and family health nursing into a single generic role (Scottish Executive, 2006b). The Queen's Nursing Institute in Scotland (QNIS) wished to identify the implications of the VAIC report; a series of national focus groups were held throughout Scotland during 2007 with key stakeholders, initially including managers and senior nurses, practitioners, staff nurses and educationalists, and later family health nurses, practice nurses, school nurses, and General Practitioners. Finally, a patient and carers' focus group was held to establish a public perspective on the changes. This article summarizes the key findings from the QNIS focus groups and highlights the emerging themes concerning the implementation of VAIC.     

Nurses' attitudes about the importance of families in nursing care: a survey of Swedish nurses

The purpose of this study was to investigate the attitudes of registered nurses (RNs) about the importance of involving families in nursing care. A sample of 634 randomly selected Swedish RNs completed the instrument, Families' Importance in Nursing Care-Nurses' Attitudes (FINC-NA), and reported holding supportive attitudes about families. High scores were found for the subscales: family as a resource in nursing care, family as a conversational partner, family as a burden, and family as its own resource. Variables that predicted a less supportive attitude about involving families in nursing care included being a newly graduated nurse, having no general approach to the care of families at the place of work, and being a male nurse.     

Social support and the chronically ill individual

Nurses caring for the chronically ill need to be alert for the problems of social isolation and social impairment. Families often respond initially to serious illness by becoming over-protective and fostering dependence and a sense of impaired competence in the ill person. As the illness continues, families often experience exhaustion because of the demands of new roles, depleted finances, and other aspects of a changed lifestyle. Feelings of anger, guilt, and helplessness occur in the network, often leading to withdrawal of support--especially as the ill person's ability to reciprocate support is impaired. Nursing interventions in situations of social isolation focus on reducing isolation by promoting social interaction as appropriate, and by directly or indirectly mobilizing or expanding the social network. The problem of impaired social interaction may occur secondary to the personality changes that often accompany chronic illnesses, or as a function of the chronic illness or disability itself, as in the case of mental illnesses. Social impairment is an appropriate nursing diagnosis in abusive families. Nursing interventions range from educational programs for social skill development to reduction of the amount of contact within the network to involvement of protective and psychotherapy services. Chronic illness has profound effects on social support and the social network of both the ill person and his or her family. As both long-term illnesses and family involvement in care giving increase, nursing care in situations of chronic illness must include attention to issues of social support. Nursing diagnosis provides a framework for nurses to include social support in their care of the chronically ill patient. Social isolation and social impairment can be reduced by nursing interventions.