NSG 432: Module 1 - Theories of Family and Health Across the Lifespan


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Multidimentional construct with Social, Psychological, Bio-medical, and Ecological perspectives.

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What is disease? Biomedical construction focused on Pathology

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How is sickness different from disease? …Social Role with associated responsibilities and privilege Responsibility to seek competent help and Desire to get well Right to be cared for Exemption from normal responsibilities Impaired role - Gordon No exemption from normal responsibilities Expectation of Normalization

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What is illness? Human experience/meaning influenced by: Recurrent or continuing symptoms Visibility Perceived seriousness Perceived availability of help Knowledge of symptoms and potential disease Cultural and social expectations

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Has acute phase with complete recovery.

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Trajectory – course of illness over time plus actions taken to manage illness Irreversible Permanent Residual disability Nonpathological alteration Required rehabilitation, supervision, observation, and care (disease management)

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Can someone be unhealthy because they do not have adequate resources for living? Even if they have no pathology?

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Wellness is not synonymous with health – Wellness can be viewed in 3 different ways: As goal attainment As a process As a personal perception

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Welcome to NSG 432: Theories of Family & Health Across the Lifespan Winter 2012 Ronald Graf DNSc., APN, FNP-C

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Course Description: An analysis and application of theories related to health and health promotion within the context of the family and community. Concepts and theories related to prevention and health as well as social, cultural, and economic aspects of wellness-illness are explored

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Central Concepts & Theories Concepts of Diversity, Cultural Competence, & Social Justice Theories of Family & Family Nursing Systems Theory Structural Functional Theory Developmental Theory Stress and Coping Theories of Health Promotion, Disease Prevention, & Crisis Intervention

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Why is theory so important?

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Nursing Metaparadigm Health Person Nursing Environment Diversity Cultural Competence Family Community Health Counseling Crisis Intervention Health Promotion Disease Prevention Illness Social Justice Society

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Ethical Concepts Related to Family Health and Illness throughout Lifespan What is fair? (fairness) What is deserved? (payback) What is right? (entitlement) What is needed? (equity) What is good? (virtue) What is legislated (law)

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What you will do… Construct a family genogram & ecomap using accepted symbols and computer software drawn from your assessment of a specific immigrant family. Complete a comprehensive family assessment reflecting the main family theories used in family nursing. Complete a family crisis intervention plan to resolve an assessed family crisis or family health promotion education plan for a family health issue.

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Family Genogram combines… Pedigree Health history Relationships http://www.genopro.com/genogram/ http://www.genopro.com/academic/

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Family Ecomap: family/environmental influences

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Family Assessment Categories Outline of family data gathered during interview Identifying data Family composition including genogram Family form Cultural/Ethnic Background Spiritual beliefs

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Family Assessment (cont) Development of family Stage Task fulfillment Goals for future Environmental data Description of home Description of neighborhood Geographic mobility Eco-Map

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Family Assessment (cont) Family structure Communication patterns Power structure Role structure Family values Family functions Affective ties Socialization Health care

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Family Assessment Categories Family stress, coping, & adaptation Stressors, strengths, and resilience Coping strategies used Overall adaptation Potential health issues: present and future concerns Lifespan health assessment

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Crisis Intervention Plan Identification of a Family Crisis Developmental stage & theoretical concept/construct to condition or concern expressed by family Family response & actual/potential impact to health & quality of life Plan including goals, specific interventions, and measureable evaluation of outcomes

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Family Health Promotion Education Plan Description of the Problem Significance of the Problem Specific Aims of the Proposal Conceptual and Theoretical Framework Action Plan to include specific objectives and strategies Evaluation Design using the health education promotion framework Appendices to include promotional and educational materials References

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How would you evaluate your… Health? Wellness? Capacity for health? Family ?

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What is Health? Bio-medical Construction State of Being Absence of disease Ability to function Social Construction Fulfill social responsibilities Take care of self/others Media/Culture Psychological Construction Perception Feelings Attitudes & Beliefs Ecological Construction Capacity to sustain and grow Power and Resources

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Disease is … Biomedical Construction Pathology

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Sickness is… Social Construction Responsibilities Get well Seek competent help Privileges/Rights Exempt from daily responsibilities – NA in chronic illness Care by others

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Illness is… Psychological construction Human experience Personal meaning influenced by perceptions of : Symptoms Visibility Seriousness Need for professional Knowledge of dx Social & cultural expectations

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Acute Illness - Trajectory

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Chronic Illness - Trajectory Pre trajectory Onset Acute Death Stable Unstable Irreversible Permanent Residual Disability Required Rehabilitation

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Capacity for Health Ecological Balance Creating resources for living Building on strengths Valuing diversity Fostering capacity Sharing power Empowering others

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Wellness ≠ Health Goal Attainment Self-actualization Complete bio-psycho-social well-being Process Decision-making Self-responsibility Personally Defined

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Health Insurance Reform 2010 and Effects on Family Health More people are being covered More mandated insurance coverage All children should be covered Pay for performance in Medicare providers Families can extend insurance to 26 year old adult children **More Preventative Health Screening Coverage**

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Summary What family theories affect health? What are family concerns at the main stages of life? What are the primary family health issues that nurses should be focused on during the next decade?

Summary: Ron Graf

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