Family Theory, Family Centered Care, & Family Assessment

Family Theory Objectives Define family. Identify family theories as a key component of family nursing. Family Centered Care Objectives Describe the key elements of family-centered care. Describe different styles of parenting. Family Assessment Objectives Describe key elements of the family assessment and interview. Demonstrate ability to develop a genogram and an ecomap.

Define Family

traditionally been viewed as the primary unit of socialization

define family theory

can be used to describe families and how the family unit responds to events both within and outside the family. Each family theory makes certain assumptions about the family and has inherent strengths and limitations.

Identify family theories as a key component of family nursing.

• family systems theory

• family stress theory

• developmental theory

family systems theory

The family is viewed as a whole system, instead of the individual members.

• A change to one member affects the entire system.

• The system can both initiate and react to change.

• Too much and too little change can lead to dysfunction.

Family stress theory

explains how families react to stressful events and suggests factors that promote adaptation to stress

Developmental theory

addresses family change over time, using Duvall’s family life cycle stages. This theory is based on the predictable changes in the family’s structure, function, and roles, with the age of the oldest child as the marker for stage transition.

• Emphasizes similarities and consistencies in how families develop and change.

• How the family functions in one stage have a direct effect on how the family will function in the next stage.

Describe the key elements of family-centered care.

• Agreed-upon partnerships between families of children, nurses, and providers, in which the families and children benefit.

• Respecting cultural diversity, and incorporating cultural views in the plan of care.

• Understanding growth and developmental needs of children and their families.

• Treating children and their families as clients.

• Working with all types of families. 

• Collaborating with families regarding hospitalization, home, and community resources.

• Allowing families to serve as experts regarding their children’s health conditions, usual behaviors in different situations, and routine needs.

Traditional nuclear family:

Married couple and their biologic children (only full brothers and sisters)

Nuclear family:

Two parents (married/unmarried) and their children (biologic, adoptive, step, foster)

Single-parent family:

One parent and one or more children

Blended family (also called reconstituted):

At least one stepparent, stepsibling, or half-sibling

Extended family:

At least one parent, one or more children, and other individuals (related/unrelated)

LGBTQIA families:

Two people, who identify as parents/partners, to children in which there could be legal or common-law tie

Foster family

A child or children who have been placed in an approved living environment away from the family of origin, usually with one or two parents

Binuclear family

Parents who have terminated spousal roles but continue their parenting roles

Communal family:

Individuals who share common ownership of property and goods, and exchange services without monetary consideration

Polygamous family:

Spouse with polygamous partner and children in which all may/may not reside in the same household

Authorian parents

try to control their children’s behavior and attitudes through unquestioned mandates.

ex:The child is never allowed to watch television on school nights.

permissive parents

parents exert little or no control over their children’s actions.

ex: The child assists with deciding whether they will watch television

authoriatative parents

combine practices from both permissive and authoritarian They direct their children’s behavior and attitudes by emphasizing the reason for rules and negatively reinforcing deviations.

• The child can watch television for 1 hr on school nights after completing all homework and chores.

Uninvolved

Parents are indifferent and emotionally removed.

ex: The child may watch television whenever they want.

Describe key elements of the family assessment and interview.

• History

• Structure

• Developmental tasks: Tasks a family works on as the child grows (parents helping a school-age child develop peer relations)

• Family characteristics: Cultural, religious, and economic influences on behavior, attitudes, and actions

• Family stressors: events that cause stress

• Environment: Availability of and family interactions with community resources

• Family support system: Availability of extended family, work and peer relationships, as well as social systems and community resources to assist the family in meeting needs or adapting to a stressor

A nurse is assisting a group of guardians

of adolescents to develop skills that will

improve communication with the family.

The nurse hears one guardian state, “My

kid knows they better do what I say!”

Which of the following parenting styles is

the parent exhibiting?

a. Authoritarian

b. Authoritative

c. Permissive

d. Uninvolved

Authoritarian

Which of the following phrases is an
example of Authoritative parenting
style?
a. STOP! Because I said so!
b. I understand that you are upset, but it is not
safe to jump from the top of the stairs, so
you need to stop.
c. Johnny.... Johnny...... Johnnnnnnnnnnny.....
Oh ... it’s fine. He’ll be ok.

STOP! Because I said so!

Which parenting style is
recommended over the others?
a. Authoritarian
b. Authoritative
c. Permissive
d. Uninvolved

Authoritarian

Structural Assessment

 Members (internal and external)
 Relationships, boundaries, subsystems
 Context (ethnicity, race, religion, spirituality, SDoH, environment)
 Genograms and ecomaps useful

Development Assessment

 Stages (as families change)

 Tasks

 Attachments

Functional Assessment

 ADL

 Communication

 Family problem solving

The family assessment components

 History: Medical for parents, siblings, and grandparents

 Structure: Family members (who is family, what are their roles)

 Developmental tasks: Tasks family works on as child grows (achieving

developmental stages and mile-stones)

 Family characteristics: Culture, religious, and economic influences on behavior, attitudes and actions

 Family stressors: Expected, unexpected, events that cause stress

 Environment: Family interactions with the community

 Family support system: who supports family? Extended family, friends, work

peers. What social supports does the community have for family.