Instr. Manual: Family Health Care Nursing, Theory Practice and Research 4th edition Kaakinen 978-0803621664

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  • Instr. Manual: Family Health Care Nursing, Theory Practice and Research 4th edition Kaakinen 978-0803621664
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  • Published: 2009
  • ISBN-10: 0803621663
  • ISBN-13: 978-0803621664
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Instr. Manual: Family Health Care Nursing, Theory Practice and Research 4th edition Kaakinen 978-0803621664

Instructor’s Manual Introduction
Author: Deborah Padgett Coehlo, PhD, RN Contributors: Diane Bauer, MS, RN, and Kari Firestone, MSN, RN

This Instructor’s Manual is designed to provide strategies for teaching family nursing to undergraduate and graduate nursing students, and to already practicing professional nurses who are learning to be more family centered in their nursing care. The editors of this textbook and Instructor’s Manual believe that the best nurses are those who expand their scientific knowledge through creative and reflective thought, behavior, and experiences using evidence-based practices. The authors of this Family Health Care Nursing: Theory, Practice and Research, Fourth Edition, Instructor’s Manual utilize the University of British Columbia (UBC) Model of teaching (Thorne, Chillings, Ellis, & Perry, 1992), which incorporates activities for understanding, reflection, behavioral experiences, and growth throughout this manual. This UBC model, originally designed for nursing care of individuals, has been adapted for this Instructor’s Manual to be applied to families, recognizing the uniqueness of each individual family and the nursing role in providing care during critical periods in the family life cycle. Family nurses’ many roles assist families in strengthening their abilities, enhancing protective strategies, sustaining strengths, and developing positive coping strategies through therapeutic communication and holistic care. By teaching and guiding undergraduate and graduate nursing students, as well as practicing professional nurses, to explore individual and family meanings to events, this textbook and Instructor’s Manual can help to shape unique and shared ideas, develop trust, and nurture therapeutic relationships between the health care system and families. Five primary theoretical approaches are introduced and used throughout the Family Health Care

Nursing: Theory, Practice and Research, Fourth Edition: Family Systems Theory, Family Life Cycle Theory, Family Health and Illness Cycle Model, Bioecological Theory, and Family Assessment and Intervention Model. These five theoretical approaches are applied to several case studies within the text, and this Instructor’s Manual demonstrates clinical applicability of critical concepts.

This Instructor’s Manual is written to fit into a wide range of curriculum frameworks of Family Nursing Curriculum at a variety of levels, such as stand-alone family nursing courses or integrated within other nursing courses. If you review the Foreword to the textbook that leads to this Instructor’s Manual, you will also note that it is written for several levels of nursing students (undergraduate/graduate nurses), as well as practicing or graduate nurses.

Each chapter in this Instructor’s Manual includes:

  • An introductory paragraph summarizing the contents of each chapter
  • A PowerPoint presentation
  • Discussion questions and activities surrounding the case study
  • Quiz and exam questions to evaluate beginning knowledge
  • Suggestions for expanded activities taking knowledge to new settings, acrossexperiences, and across time
  • Case studies1The instructors using this manual are encouraged to read the chapters in the Family Health Care Nursing: Theory, Practice and Research, Fourth Edition, text before using the teaching strategies described in the Instructor’s Manual. A PowerPoint slide show has been created for each and every chapter in this textbook. The four editors encourage teachers to1 Case studies are included in all of the chapters except Chapters 1, 2, 3, and 19

personalize the PowerPoint presentations and adapt them to fit your own personal teaching needs and styles. Ancillary documents in this Instructor’s Manual are provided to help expand ideas through activities that enhance learning, promote changes in professional behavior, and promote reflections as a way to deepen understanding of family nursing. This Instructor’s Manual provides levels of activities from preoperational cognitive knowledge (i.e., quiz questions and definition of terms) to higher level formal cognitive understanding (i.e., analysis and critique of case studies and other readings, and synthesis of concepts into broadening topics from an individual family perspective to a global application). Each chapter is designed to provide many options to accommodate individual learner needs and to accommodate different learning systems.

The editors of Family Health Care Nursing: Theory, Practice and Research and the authors of its accompanying Instructor’s Manual have provided a manual that supports each faculty members’ teaching styles, helps students develop critical thinking, fosters unique dialogues between instructors and students, explores rigorous conceptual reflections, and helps students value the nursing of families. These goals, in the end, will promote healthy families, and discourage poor health outcomes and harmful health disparities.

Table of Contents Chapter 1: Family Health Care Nursing: An Introduction

  • Introductory Paragraph Summarizing the Contents of the Chapter
  • PowerPoint Presentation
  • Introduction
  • Critical Concepts
  • Review of Key Terms
  • Reflection Questions
  • Student Learning Activities
    Chapter 2: Demography and Family Health
  • Introductory Paragraph Summarizing the Contents of the Chapter
  • PowerPoint Presentation
  • Introduction
  • Critical Concepts
  • Review of Key Terms and Concepts
  • Quiz and Exam Questions
  • Student Learning Activities
  • Case StudyChapter 3: Theoretical Foundations for the Nursing of Families
  • Introductory Paragraph Summarizing the Contents of the Chapter
  • PowerPoint Presentation
  • Introduction
  • Critical Concepts
  • Review of Key Terms
  • Quiz and Exam Questions
  • Student Learning Activities
  • Case StudyChapter 4: Family Nursing Process: Family Nursing Assessment Models

• Introductory Paragraph Summarizing the Contents of the Chapter

  • PowerPoint Presentation
  • Introduction
  • Critical Concepts
  • Review of Key Terms
  • Quiz and Exam Questions
  • Student Learning Activities
  • Case StudyChapter 5: Family Social Policy and Health Disparities
  • Introductory Paragraph Summarizing the Contents of the Chapter
  • PowerPoint Presentation
  • Introduction
  • Critical Concepts
  • Review of Key Terms
  • Quiz and Exam Questions
  • Student Learning Activities
  • Case StudyChapter 6: Culturally Sensitive Nursing Care of Families
  • Introductory Paragraph Summarizing the Contents of the Chapter
  • PowerPoint Presentation
  • Introduction
  • Critical Concepts
  • Review of Key Terms
  • Quiz and Exam Questions
  • Student Learning Activities
  • Case StudyChapter 7: Canadian Context of Family Nursing
  • Introductory Paragraph Summarizing the Contents of the Chapter
  • PowerPoint Presentation
  • Introduction
  • Critical Concepts
  • Review of Key Terms
  • Quiz and Exam Questions
  • Student Learning Activities
  • Case StudyChapter 8: Genomics and Family Nursing Across the Life Span
  • Introductory Paragraph Summarizing the Contents of the Chapter
  • PowerPoint Presentation
  • Introduction
  • Critical Concepts
  • Review of Key Terms
  • Quiz and Exam Questions
  • Student Learning Activities
  • Case StudiesChapter 9: Family Health Promotion
  • Introductory Paragraph Summarizing the Contents of the Chapter
  • PowerPoint Presentation
  • Introduction
  • Critical Concepts
  • Review of Key Terms
  • Quiz and Exam Questions
  • Student Learning Activities
  • Case StudyChapter 10: Families With Chronic Illness
  • Introductory Paragraph Summarizing the Contents of the Chapter
  • PowerPoint Presentation
  • Introduction
  • Critical Concepts
  • Review of Key Terms
  • Quiz and Exam Questions
  • Student Learning Activities
  • Case StudiesChapter 11: Families in Palliative and End-of-Life Care
  • Introductory Paragraph Summarizing the Contents of the Chapter
  • PowerPoint Presentation
  • Introduction
  • Critical Concepts
  • Review of Key Terms
  • Quiz and Exam Questions
  • Student Learning Activities
  • Case StudyChapter 12: Family Nursing with Childbearing Families
  • Introductory Paragraph Summarizing the Contents of the Chapter
  • PowerPoint Presentation
  • Introduction
  • Critical Concepts
  • Review of Key Terms
  • Quiz and Exam Questions
  • Student Learning Activities
  • Case StudyChapter 13: Family Child Health Nursing
  • Introductory Paragraph Summarizing the Contents of the Chapter
  • PowerPoint Presentation
  • Introduction
  • Critical Concepts
  • Review of Key Terms
  • Quiz and Exam Questions
  • Student Learning Activities
  • Case Study

Chapter 14: Nurses and Families in Adult Medical-Surgical Settings

  • Introductory Paragraph Summarizing the Contents of the Chapter
  • PowerPoint Presentation
  • Introduction
  • Critical Concepts
  • Review of Key Terms
  • Quiz and Exam Questions
  • Student Learning Activities
  • Case StudyChapter 15: Gerontological Family Nursing
    • Introductory Paragraph Summarizing the Contents of the Chapter
    • PowerPoint Presentation
    • Introduction
    • Critical Concepts
    • Review of Key Terms
    • Quiz and Exam Questions
    • Student Learning Activities
    • Case StudyChapter 16: Family Mental Health Nursing
    • Introductory Paragraph Summarizing the Contents of the Chapter
    • PowerPoint Presentation
    • Introduction
  • Critical Concepts
  • Review of Key Terms
  • Quiz and Exam Questions
  • Student Learning Activities
  • Case StudyChapter 17: Families and Community/Public Health Nursing
  • Introductory Paragraph Summarizing the Contents of the Chapter
  • PowerPoint Presentation
  • Introduction
  • Critical Concepts
  • Review of Key Terms
  • Quiz and Exam Questions
  • Student Learning Activities
  • Case StudyChapter 18: Nursing Care of Families in Disaster and War
  • Introductory Paragraph Summarizing the Contents of the Chapter
  • PowerPoint Presentation
  • Introduction
  • Critical Concepts
  • Review of Key Terms
  • Quiz and Exam Questions
  • Student Learning Activities

• Case Study
Chapter 19: Advancing Family Nursing

  • Introductory Paragraph Summarizing the Contents of the Chapter
  • PowerPoint Presentation
  • Introduction
  • Critical Concepts
  • Review of Key Terms
  • Quiz and Exam Questions
  • Student Learning ActivitiesAppendix A: Family Systems Stressor-Strength Inventory (FS3I)
    Appendix B: The Friedman Family Assessment Model (Short Form) Appendix C: Bio-Poem for Family Assessment: Student Learning Activity Appendix D: General Student Learning Resources
    Additional References for Instructor’s Manual and PowerPoint Presentations

Chapter 1

Family Health Care Nursing: An Introduction

This chapter provides an introduction and broad overview to family health care nursing and why this information is important in nursing care of today’s families. The chapter explores definitions of family, family health, family health care nursing, and healthy families. It discusses theoretical concepts important to the nursing of families, as well as the history of families in the United States and the development of family nursing. Key concepts explored throughout this chapter include family, family care, healthy famlies, and family structure, function, and processes. Family nursing is an evolving practice as our families and surrounding society evolve. Yet, families have been and remain our greatest resource for health care. This chapter emphasizes this idea, exploring different methods, settings, research topics, and educational needs facing family nurses today.

Critical Concepts

  • Family health care nursing is an art and a science that has evolved as a way of thinking about and working with families.
  • Family nursing is a scientific discipline based in theory.
  • Health and illness are family events.
  • The term family is defined in many ways, but the most salient definition is, “the family iswho the members say it is.”
  • An individual’s health (on the wellness-to-illness continuum) affects the entire family’sfunctioning, and in turn, the family’s ability to function affects each individual member’s health.
  • Family health care nursing knowledge and skills are important for nurses who practice in generalized and in specialized settings.
  • The structure, function, and processes of families have changed, but the family as a unit of analysis and service continues to survive over time.
  • Nurses need to practice in ways that impact families’ structure, function, and processes.
  • Nurses should intervene in ways that promote health and wellness, as well as prevent illnessrisks, treat disease conditions, and manage rehabilitative care needs.
  • Knowledge about each family’s structure, function, and process informs the nurse in how tooptimize nursing care in families and provide individualized nursing care, tailored to the uniqueness of every family system.Review of Key TermsContemporary family: Generally refers to the changing structure and function of today’s families, including single-headed households, cohabitating couples and parents, blended families, same-sex couples and parents, and grandparents raising grandchildren. The functions have shifted to include intimate relationships, communication, and shared responsibilities with the larger society.Family as a component of society: Care that views the family as one of many institutions in society, similar to the health, economic, educational, or religious institutions.
    Family as a system: Care that focuses on the interaction between and among family members, including subsystems within the family (i.e., dyads such as mother-father, parent-child) and outside the family (i.e., schools, churches, community agencies).

Family as client: Care that is focused on the family members as a unit rather than any one individual.
Family as context: Care that is focused on the individual but considers the family’s influence on the individual.

Family: Family refers to two or more individuals who depend on one another for emotional, physical, and economic support. The members of the family are self-defined.
Family health: A dynamic, changing state of well-being that includes the biological, psychological, spiritual, sociologic, and cultural factors of individual members and the whole family system.

Family health nursing: The process of providing for the health care needs of families that is 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. Health function of families: Refers to the growing need of family members to care for the health and illness of each other as a resource to the larger society.

Healthy families: Optimally functioning families who have the ability to negotiate; communicate in clear, open, and spontaneous ways; have respect for each other; encourage autonomy; accept responsibility; demonstrate warmth; and express optimism and enjoyment of shared experiences.
Traditional family: Generally refers to the traditional concept of family structure, including a husband, wife, and biological children.
U.S. Census definition of family: A group of persons united by ties of marriage, blood, or adoption, constituting a single household; interacting and communicating with each other in their

respective social roles of husband and wife, mother and father, son and daughter, brother and sister; and creating and maintaining a common culture.

Terms Used to Describe Family Nursing Roles

“Case finder” and epidemiologist: The family nurse gets involved in case-finding and becomes a tracker of disease. For example, consider the situation in which a family member has been recently diagnosed with a sexually transmitted disease. The nurse would engage in sleuthing out the sources of the transmission and in helping to get other sexual contacts in for treatment. Screening of families and subsequent referral of the family members may be a part of this role. Case manager: Although case manager is a contemporary name for this role, it involves coordination and collaboration between a family and the health care system. The case manager has been formally empowered to be in charge of a case. For example, a family nurse working with seniors in the community may become assigned to be the case manager for a patient with Alzheimer disease.

“Clarify and interpret”: The nurse clarifies and interprets data to families in all settings. For example, if a child in the family has a complex disease, such as leukemia, the nurse clarifies and interprets information pertaining to diagnosis, treatment, and prognosis of the condition to parents and extended family members.

Consultant: The family nurse serves as a consultant to families whenever asked or whenever necessary. In some instances, he or she consults with agencies to facilitate family-centered care. For example, a clinical nurse specialist in a hospital may be asked to assist the family in finding the appropriate long-term care setting for their sick grandmother. The nurse comes into the family system by request for a short period and for a specific purpose.

Coordinator, collaborator, and liaison: The family nurse coordinates the care that families receive, collaborating with the family to plan care. For example, if a family member has been in a traumatic accident, the nurse would be a key person in helping families to access resources— from inpatient care, outpatient care, home health care, and social services to rehabilitation. The nurse may serve as the liaison among these services.
Counselor: The family nurse plays a therapeutic role in helping individuals and families solve problems or change behavior. An example from the mental health arena is a family that requires help with coping with a long-term chronic condition, such as when a family member has been diagnosed with schizophrenia.
“Deliverer” and supervisor of care and technical expert: The family nurse either delivers or supervises the care that families receive in various settings. To do this, the nurse must be a technical expert both in terms of knowledge and skill. For example, the nurse may be the person going into the family home on a daily basis to consult with the family and help take care of a child on a respirator.
“Environmental specialist”: The family nurse consults with families and other health care professionals to modify the environment. For example, if a man with paraplegia is about to be discharged from the hospital to home, the nurse assists the family in modifying the home environment so that the patient can move around in a wheelchair and engage in self-care. Family advocate: The family nurse advocates for families with whom they work; the nurse empowers family members to speak with their own voice, or the nurse speaks out for the family. An example is the nurse who is advocating for family safety by supporting legislation that requires wearing seat belts in motor vehicles.

Health teacher: The family nurse teaches about family wellness, illness, relations, and parenting, to name a few topics. The teacher-educator function is ongoing in all settings in both formal and informal ways. Examples include teaching new parents how to care for their infant and giving instruction about diabetes to a newly diagnosed adolescent boy and his family members.
Researcher: The family nurse should identify practice problems and find the best solution for dealing with these problems through the process of scientific investigation. An example might be collaborating with a colleague to find a better intervention for helping families cope with incontinent elder adults living in the home.
Role model: The family nurse is continually serving as a role model to other people through his or her activities. A school nurse who demonstrates the right kind of health in personal self-care serves as a role model to parents and children alike.
Surrogate: The family nurse serves as a surrogate by substituting for another person. For example, the nurse may stand in temporarily as a loving parent to an adolescent who is giving birth to a child by herself in the labor and delivery room.

Reflection Questions

(Note: This chapter of the Instructor’s Manual includes reflective questions as means of evaluating learning. A deep understanding of “family” requires more in-depth thought and reflection on one’s assumptions, values, and belief systems rather than choosing an answer in a multiple-choice format.)

1. Consider one’s own family. As a starting point, students should be asked to think about whom they consider family members. Have students working in a clinical site ask their patients who is in their family.

2. Stated in Chapter 1, Hanson (2005) defines family as “two or more individuals who depend on one another for emotional, physical, and economical support. The members of the family are self-defined.” Have students discuss this definition in small groups and then report back to the larger class how they feel about this definition when applied to their own personal or professional lives, or both.

3. List five traits that are common in healthy families.

Answer: Any of the following answers are acceptable: communicates and listens to one another, affirms and supports one another, teaches respect for others, develops a sense of trust in members, displays a sense of play and humor, exhibits a sense of shared responsibility, teaches a sense of right and wrong, has a strong sense of family in which rituals and traditions abound, has a balance of interaction among members, has a shared religious core, respects the privacy of one another, values service to others, fosters family table time and conversation, shares leisure time, or admits to and seeks help with problems.

4. Define family health care nursing.

Answer: Definitions may be tailored by the individual nurse to fit his or her practice. Hanson (2005) defines family health care nursing as “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.”

5. Which of the following statements is true about family nursing practice?
a. Family care is concerned with the experience of the family over time.
b. Family nursing is directed at families whose members are both healthy and ill.
c. The family nurse is responsible together with the family itself for defining who is the

family.
d. If family nursing practice is successful, the family members will simultaneously

achieve maximum health.

e. All of the above.

6. Describe the difference between family as a client and family as a system.

Answer: The family as a client centers on the assessment of all individual family members where the family is in the foreground and individuals are in the background. The family is the sum of individual family members with a focus on each and every individual such as one may see in a family medical practice office. The family as system views the family as an interactional system whereby the interactions between family members become the target for nursing interventions. The nurse focuses on the individual and family simultaneously. 7. Name and describe three of the many roles that nurses can assume with families.

Answer: Any of the following three roles are identified and discussed.

  • Health teacher: The family nurse teaches about family wellness, as well as family illness.
  • Coordinator/collaborator/liaison: The family nurse coordinates the care that families may receive, collaborating with the family in the planning of this care.
  • Deliverer/supervisor of technical care: The family nurse delivers or supervises the actual physical/mental care that families receive in various settings.
    • Family advocate: The family nurse advocates for families by speaking out for them or by empowering families to speak for themselves.
    • Consultant: The family nurse consults and advises families or agencies to facilitate family-centered care.
    • Counselor: The family nurse plays a mental health therapeutic role by helping families solve problems or change behavior in coping with health and illness issues.
    • Case finder/epidemiologist: The family nurse is involved in case finding or is a tracker of disease/problems.
    • Environmental modifier: The family nurse consults with families or other professionals to modify the larger or small environment that impacts family health.
    • Clarifier-interpreter: The family nurse clarifies and interprets data to family members pertaining to diagnosis, treatment, and prognosis of health and illness conditions.
    • Surrogate: The family nurse may substitute for another person in the family system.
  • Researcher: The family nurse identifies practice problems and through the process of scientific investigation, finds solutions.
  • Role model: The family nurse serves as a role model to other people through her activities.
  • Case manager: The family nurse provides coordination and collaboration between a group of families and the health care system.9. Which of the following nursing specialties have historically focused on the quality of family health?a. Maternity nursing
    b. Pediatric nursing
    c. Public health nursing d. All of the above10. Family health care nursing is a specialty that started near the end of the 20th century. a. Trueb. False (Family nursing has roots in society from prehistoric times. Most notable ofthe earlier writings came from Florence Nightingale.)

    11. Discuss three traditional functions performed by families over history that still exist today. 12. What are two functions that have become more meaningful in modern times?
    Answer:

    Families existed to achieve economic survival.
    Families existed to reproduce the species.
    Families existed to provide protection from hostile forces. Families passed along the religious faith (culture).

Families educated their children (socialization).

Families conferred social status on their children. Answer to Question 12:

In modern times, the building of relationships and healthcare function of families have received more attention.

Student Learning Activities

1. Have students write down and then discuss their own definition of family. Have students save this definition until the end of the course and then reflect and compare their initial definition with the definition developed as they complete this course.

2. Have students learn how agencies in which they are assigned clinical experiences define family. Have students interview nurses on assigned units to learn what kinds of ethical dilemmas or legal considerations, or both, the nurses have faced in their practice.

3. Have students discuss the implications for nursing care when the agency’s definition of family is not congruent with those of the patient or nurse, or both. Alternatively, students may be able to describe and reflect on their own personal experiences as a student nurse depending on where they are at in their program of study.

4. Have students list characteristics they believe constitute a healthy family. Have students compare this list with Box 1-1: Traits of a Healthy Family.

5. Have students read the book Shelter for Each Other by Mary Pipher (1997) to explore past traditional families with contemporary families. Discuss the changes that are positive and those that have risks to our future (i.e., more understanding of intimacy but more involvement with television and video games).

6. Have students explore the history of families, choosing a specific topic to follow across time. Topics of interest include child abuse, domestic violence, unwed mothers, women and work, child labor, alcohol dependency, juvenile delinquency, and mental health (particularly depression and suicide). This exercise emphasizes that contemporary families have improved many of the conditions most damaging to individuals (child abuse, child labor, etc.) whereas increasing other areas (i.e., depression and suicide rates).

Instr. Manual: Family Health Care Nursing, Theory Practice and Research 4th edition Kaakinen 978-0803621664