peds
UNIT 1
CHAPTER 1: FOUNDATIONS OF PEDIATRIC NURSING
SECTION: PERSPECTIVES OF PEDIATRIC NURSING
Family-Centered Nursing Care
Definition of Family: Family is defined as what an individual considers it to be. Common characteristics may include:
Individuals linked by biological, marital, or adoptive relationships.
Individuals with a strong emotional bond and commitment to one another.
Household: Due to the evolving concepts of family, the term 'household' is also utilized.
Characteristics of Positive Family Relationships:
Parent-child interactions characterized by mutual warmth and respect.
COMPONENTS OF CARE
Key Components of Family-Centered Nursing Care:
Partnerships: Establish agreed-upon partnerships among families of children, nurses, and providers—to ensure that both families and children benefit from the care.
Cultural Diversity: Respect and incorporate cultural views into the care plan.
Growth and Development: Understand the growth and developmental needs of children and their families.
Client Treatment: Treat children and families as clients in their own right.
Collaboration: Work with various family types and collaborate regarding care settings including hospitalization, home, and community resources.
Family Expertise: Acknowledge families as experts concerning their children's health, usual behaviors, and routine needs.
PROMOTING FAMILY-CENTERED CARE
Nursing Actions:
Perform comprehensive family assessments to identify strengths and weaknesses within families.
Characteristics of Healthy Families:
Family members communicate effectively and listen to each other.
There is affirmation and support for all family members.
A clear set of family rules, beliefs, and values exist.
Teaching respect for others is common.
A sense of trust permeates the relationship.
Humor and play are shared among members.
Active interaction among members occurs regularly.
Responsibility is shared among family members.
Traditions and rituals enrich the family dynamic.
Adaptability and role flexibility are present in family functioning.
Families seek help when facing problems.
SOCIAL DETERMINANTS OF HEALTH (SDOH)
Definition: SDOH refer to conditions in which children are born and raised that affect their overall health and well-being, requiring assessment by healthcare professionals.
Components of SDOH: SDOH are categorized into six strata:
Neighborhood and Built Environment
Social and Community Context
Economic Stability
Health Care Access and Quality
Education Access and Quality
Neighborhood and Built Environment
Factors Include:
Geographical layout of the neighborhood
Rate of crime
Quality of air and water
Living arrangements in the home
Accessible outdoor spaces
Impact on Pediatric Health and Well-Being:
Rate of Crime: Higher crime rates may restrict outdoor activities for children, increasing obesity risk and related health issues.
Quality of Air: Poor air quality correlates with increased respiratory illnesses (e.g., asthma).
Social and Community Context
Factors Include:
Relationships and interactions with others
Food insecurity
Impact on Pediatric Health and Well-Being:
Impaired parent-child relationships (e.g., due to incarceration) may lead to behavioral issues, developmental lags, and incarceration risk for children.
Food insecurity negatively impacts children's health and academic performance.
Economic Stability
Key Elements:
Ability to seek healthcare
Employment status
Availability of childcare
Impact on Pediatric Health and Well-Being:
Economic instability limits access to care, placing both parents and children at higher risk for diseases.
Health Care Access and Quality
Factors Include:
Availability of healthcare services
Health insurance coverage
Screening service availability
Impact on Pediatric Health and Well-Being:
Many children lack adequate health insurance, leading to insufficient access to primary care—an issue particularly prominent among families below the federal poverty level.
Education Access and Quality
Factors Include:
Level of education
Quality of the educational system
Presence of social discrimination
Impact on Pediatric Health and Well-Being:
Lower parental education levels correlate with reduced income and household stability, adversely affecting child health, literacy, and adherence to healthcare recommendations.
Higher quality educational opportunities lead to increased likelihoods of graduation and reduced poverty risks.
FAMILY THEORIES
Family Systems Theory
Overview: Families are regarded as whole systems rather than isolated individuals; changes in one member affect all.
Dynamics of Change: Families can initiate or react to changes, and both excessive and insufficient changes may cause dysfunction within the family unit.
Family Stress Theory
Concept: Stress is inevitable and can stem from expected or unexpected sources.
Family Response: Focuses on family reactions to stress and adapting strategies to manage it.
Developmental Theory
Focus: Treats families as social units that evolve over time, emphasizing familiar patterns across the developmental cycle.
Duvall's Family Life Cycle Stages: Each stage impacts future functioning.
FAMILY COMPOSITION
Types:
Traditional Nuclear Family: Two parents married with their biological children.
Nuclear Family: Married or unmarried parents with their biological, adoptive, or stepchildren.
Single-Parent Family: One parent raising one or more children.
Blended Family: Includes at least one stepparent or stepsibling.
Extended Family: Comprises at least one parent, one or more children, and other family members.
LGBTQIA Families: Parents or partners who may have legal ties to children.
Foster Family: Children placed away from their biological family.
Binuclear Family: Split parenting responsibilities after parental separation.
Communal Family: Shared property rights and communal living arrangements.
Polygamous Family: Families where one spouse has multiple partners.
OTHER FAMILY SITUATIONS
Adoption:
Involves a legal bond between non-biological parents and children.
Potential behavioral issues may arise when older children are adopted.
Divorce:
Parental separation impacts children's social, emotional, and physical health.
Single Parenting:
Can result from death, divorce, or separation with financial instability risks.
Birth of New Child:
Changes in parental roles and increased financial responsibilities occur, affecting family dynamics.
PARENTING STYLES
Types:
Authoritarian: High demands with low responsiveness; strict rules with no exceptions.
Permissive: Few demands on the child with high emotional warmth; children make decisions with little guidance.
Authoritative: Reasonable demands and high responsiveness; rules provided with rationales.
Uninvolved: Indifference to child’s needs; little emotional involvement.
GUIDELINES FOR PROMOTING ACCEPTABLE BEHAVIOR IN CHILDREN
Set clear, realistic limits based on developmental appropriateness.
Validate children's feelings and provide explanations.
Role model desired behaviors and reinforce them.
FAMILY ASSESSMENT CRITERIA
History: Include medical histories relevant to all family members.
Structure: Analyze family composition.
Developmental Tasks: Identify family tasks based on children's growth stages.
Family Characteristics: Consider cultural, religious, and economic influences.
Family Stressors: Differentiate between anticipated and unexpected stressors.
Environment: Evaluate available community resources and family interactions.
Family Support System: Assess availability of social systems and community resources for support.
ACTIVE LEARNING SCENARIO
Example of Composition Assessment:
Describe a household with a mother, toddler, older brother, and grandmother.
Detail parenting strategies and methods for acceptable behavior in children.
Identify two additional family assessments to be addressed by the nurse during care planning.