NURS 304: Lecture 6 - Clinical Judgement, Family Strengths, and CFIM (still refining it)

What is the primary focus of evidence-based practice in family nursing?

Meeting the needs of families.

What model is used to apply interventive questions and advanced nursing skills in family nursing?

Calgary Family Intervention Model (CFIM).

What are the key components of Tanner's Clinical Judgment Model?

Noticing, Interpreting, Responding, and Reflecting.

What does the NCSBN Clinical Judgment Measurement Model emphasize?

Recognizing cues, analyzing hypotheses, generating solutions, taking action, and evaluating outcomes.

In the context of clinical judgment, what does 'noticing' involve?

Focused observation and recognizing deviations from the norm.

What is the role of reflection in nursing practice?

To think about actions during and after patient care, adjusting as needed.

What is the goal of the McGill Model of Nursing in family nursing practice?

To support family health by helping families learn to cope and encouraging growth.

What is a strength-based approach in family nursing?

Recognizing and optimizing positive aspects and resources within the family.

What is the difference between strength perspective and deficit perspective?

Strength perspective focuses on family strengths, while deficit perspective focuses on what is wrong or missing.

What are some internal strengths that can be assessed in families?

Traits (e.g., optimism), assets (e.g., finances), and skills (e.g., problem-solving).

What is cognitive reframing in the context of developing family strengths?

Turning a perceived deficit into a strength.

How can nurses effectively call forth strengths in families?

By using specific, appreciative language and recognizing their coping mechanisms.

What is the purpose of using an ecomap in family nursing?

To explore the family's social network and identify resources.

What are the three approaches to developing strengths in families?

Transferring strengths between contexts, cognitive reframing, and developing knowledge or competency.

What outcomes can result from effective strength-based family nursing?

Families gain insight, feel collaborative, and experience empowerment.

What is the significance of the clinical judgment skill for nurses?

It influences how nurses perceive and respond to patient situations.

What is the role of effective communication in clinical judgment?

To ensure clear understanding and facilitate intervention planning.

What does 'in-action' reflection involve?

Thinking while doing during patient care.

What does 'on-action' reflection involve?

Thinking after an event to review what was learned.

What does 'for-action' reflection involve?

Planning ahead to improve future actions.

What is the importance of recognizing cues in clinical judgment?

It helps in prioritizing data and making informed decisions.

What should nurses do to provide feedback on identified strengths?

Be explicit, specific, and sincere in their commendations.

What is the role of relationship in clinical judgment according to Lasater?

It influences the nurse's perception and response to patient situations.

What is the primary goal of mobilizing and using resources in family nursing?

To help families identify needs and decide on specific resources to address those needs.

What is the role of the nurse when working with families to mobilize resources?

The nurse acts as a coach, facilitating contact and encouraging family involvement to build their confidence.

What is the focus of strengths-based practice in nursing?

To identify and capitalize on families' strengths to enhance their ability to cope with life events, including illness.

What does the Calgary Family Intervention Model (CFIM) provide?

An organizational framework to conceptualize the intersection between family functioning and nursing interventions.

What are the key characteristics of the Calgary Family Intervention Model?

It is strengths-based, resiliency-oriented, and emphasizes collaboration rather than demanding changes.

How is the 'fit' of an intervention determined in CFIM?

Through therapeutic conversation and collaboration with the family, recognizing the reciprocity between nurse and family experiences.

What are the three domains of family functioning in CFIM?

Cognitive, Affective, and Behavioral.

What is the goal of interventions within the cognitive domain?

To change perceptions and beliefs of family members regarding health problems to discover new solutions.

What types of emotions may impede problem-solving efforts in the affective domain?

Emotions such as being overwhelmed, concerned, sad, or angry.

What is the goal of interventions within the behavioral domain?

To help families interact and behave differently to increase support among members.

What are some examples of interventions in the cognitive domain?

Offering new ideas, information, and beliefs about health issues.

How can nurses help families in the affective domain?

By reducing or managing intense emotions that may hinder problem-solving efforts.

What is the purpose of nursing interventions according to CFIM?

To create a context for change that enhances the possibility of healing.

What is a commendation in the context of nursing interventions?

An observation of a pattern of behavior that occurs over time, aimed at recognizing family strengths.

How can nurses validate or normalize emotional responses?

By reassuring families that their feelings are normal and acknowledging changes in relationships due to illness.

What is the significance of encouraging family members to share illness narratives?

It allows for the expression of the impact of illness on various family members, beyond just the medical aspects.

What is the role of respite for family caregivers?

To provide caregivers with a break, which is often hindered by feelings of guilt.

What types of rituals should nurses inquire about with families?

Daily, yearly, or culturally significant rituals that families engage in.

What is the ultimate goal of nursing interventions according to Shajani & Snell?

To aid family members in discovering new solutions to alleviate emotional, physical, and spiritual suffering.

How can one intervention affect family functioning according to CFIM?

One intervention can simultaneously influence all three domains of family functioning: cognitive, affective, and behavioral.

What may interrupt rituals in families dealing with chronic illness?

Hospitalization

What are the two types of interventive questions in nursing?

Linear and Circular

What is the intent of linear questions?

To investigate and explore the description/perception of a problem

What effect do linear questions have on understanding family issues?

They constrain further understanding and may imply the nurse knows best

What is the focus of linear questions?

Cause and effect

What is the intent of circular questions?

To effect change and facilitate behavioral change

How do circular questions differ from linear questions?

Circular questions seek relationships and connections between individuals, events, and beliefs

What are the four types of circular questions?

Difference, Behavioral Effect, Hypothetical, and Triadic

What do difference questions explore?

Differences between people, relationships, ideas, time, and beliefs

What do behavioral effect questions investigate?

The effect of one family member's behaviors on another

What do hypothetical/future-oriented questions ask about?

Family options and alternative actions or meanings in the future

What is the focus of triadic questions?

The relationship between two other people, posed to a third person

What is essential for determining the fit of family nursing interventions?

Interventions must be tailored to the family's unique situation

How should nurses approach family interventions?

Through collaborative decision-making with the family

What is the goal of family nursing interventions?

To enhance family strengths, resilience, and coping strategies

What does 'fit' mean in the context of family interventions?

The intervention resonates emotionally and practically with the family's experience

How should nurses respond to family suffering and challenges?

By promoting healing and reducing suffering, not just solving problems

What is the significance of systems theory in family nursing?

It views the family as a system where changes in one part affect the whole

What are some IFNA generalist competencies related to family nursing?

Demonstrating nurse/family partnership, empowering families, and evaluating interventions

What should nurses continuously evaluate in family interventions?

The adequacy and success of the interventions based on feedback and outcomes

What is the importance of using research in family nursing?

To support family assessment, interventions, and care

What is the focus of the CFIM in nursing practice?

To integrate family dynamics into care in various settings

What should nurses practice with patients and families in clinical settings?

Interventive questions

What is the role of therapeutic conversations in family nursing?

To co-create interventions ensuring mutual agreement and relevance

What is a key aspect of behavioral effect questions?

They often include phrases like 'do you' or 'feel'

What hints can help identify difference questions?

Look for words like 'best' or 'most'