Introduction
The word family is very well understood when we use it, however it is certain that many people have various opinions on its definition. Hayford (1988) provides his view of the concept of family from five different perspectives. He claims that family equally implies to ancestors and parents, siblings, relatives, spouses and children. It appears that family implies to the most intimate and important relationships in our personal lives.
Keller (1997) tells us that the family is considered the basic unit of society that serves it as an essential element and depends upon the stability of this society. Minuchin (1974) saw that the family is accommodating to society, and proposed that the family is determined by the surrounding culture and does not simply exist in a social vacuum. The family can be thought of as looking inward and outward.
It inner traditions and values are existing within the members of this family, and then are released into the society, so that that they could be recreated in the future. Society is the mirror that always reflects changes in families, and in its turn, families induce changes of society.
Main body
Family is a very important focus of the nurses. For a long time the health nurses have recognized the family’s value as an essential service unit. The family defines health, makes decisions regarding health practices, and is the most frequent provider of health care to family members (Freeman, 1970; Stanhope & Lancaster, 1992). According to Coulton (1998), the caregivers within the family are providers of the majority of the long-term care for elderly persons who reside in the community.
In fact, family members provide 80% of the home health care. The assessment of families by nurses is considered to be the core of baccalaureate education and is a required competence of the nurse generalist according to the American Nurses’ Association Standards of Community Health Nursing Practice (1986).
In order to underline the importance of families in nursing practice, several family assessment models should be mentioned. It is certain that any family should be assessed for the purpose of determining what constitutes the family.
There are several assessment tools that can manage this task. For example, Friedman (1986) had developed an instrument that evaluates the family according to certain categories, such as history and developmental stages, environment, structure of the family, coping and functions of the family. Each category has its own subcategories which makes this tool very comprehensive. The author of this tool stresses the fact that there is no need for the nurse to assess each category and subcategory, as each case should have its own criteria that must be assessed in order to reach the family’s goals.
Another author had developed a guide of assessment that included such categories as structural characteristics, relationships and external systems, environmental characteristics, and process characteristics Clemen-Stone et al. (1987). This expert introduces a scale that identifies and rates the strengths, problems, areas for anticipatory guidances, as well as those problems that at this point a family does not choose to change.
It is not hard to make a conclusion that both these assessment tools focused on evaluating the same object are employing pretty much the same methods. There is however another tool that includes such evaluation criteria as family health behavior (Stanhope & Lancaster, 1992). It should be noted that all these evaluation tools are directed at choosing separate method for each family that is being evaluated, so that individual family needs could be sufficiently met.
Today’s family is a social institution that plays a vital role in the nursing practice. The family is interweaved into the fundamental basis of life activity, and forms basic predispositions for the functioning of the social medium through physical and sociocultural replacement of generations due to childbirth and support of all its members. The fact of one family member supporting another implies and explains why the family unit is an essential element in nursing care.
The today’s family includes various components which are linked to physiological processes, psychological relational dynamics, norms and values of culture, demographic modifications, and also institutions that provide health care to members of the family. It should be said that each family as a whole, as well as each of its members separately is characterized by own health behavior. For example many families have ethical standards and values that oblige family members to care for each other in the times of trouble.
Furthermore, each family member as an individual is characterized by own internal interpretation of an illness. For example some people could be hypochondriac and experience constant anxiousness towards their subjective morbid sensations, some might be sensitive and be concerned by the impression their disease makes on the people that surround them, while others might be rejecting the thought that they are sick at all.
These and many other types of attitudes towards a disease can determine how one will cope if a member of his/her family has a serious illness and requires continuous nursing care, however it more the job of psychologists to study these phenomena.
A good example of that illustrates the horridness that can possibly occur during unsuccessful family nursing would be a young wife with a husband suffering from chronic failure of the kidney. Her husband underwent haemodialysis, an unsuccessful renal transplant, and his disability was increasing in terms of not just physical, but also social and psychological factors. The wife was so exhausted and demoralized, that she thought their relationship was destroyed, and left her spouse, and he committed suicide a few months later. After this tragic event, the nursing staff of the hospital helped share her grieving and this drew them together. Afterwards the woman wrote that if she would have this support from the beginning, the tragedy could be avoided.
Conclusion
I believe that the concept of family health nursing is directed at making nurses aware of what effects the illness has on relationships within the family, as these ties are crucial to patient’s well being. Modern nurses are in a unique position among all health care professionals, as they are at constant proximity of the patient with a long-term health issue during his stay at the hospital or at home. It is important to mention that family nursing should treat the patient, and not his illness.
In other words, a nurse must make consideration of the fact that any patient has a life which is beyond his disease. Unfortunately so far not many nurses recognize the above, and therefore it is essential to consider the patient’s family and make the nurses aware of the need of addressing this issue, as there is no doubt that illness of one person irreversibly changes the lives of its family members.
Works Cited
American Nurses’ Association. (1986). Standards of community health nursing practice. Kansas City, MO: Author.
Clemen-Stone, S., Eigisti, D., & McGuire, S. (1987). Comprehensive family and community health nursing (2nd ed.). St. Louis: McGraw-Hill.
Coulton, C. (1988). Prospective payment requires increased attention to quality of post hospital care. Social Work in Health Care, 13(4) 330-339.
Friedman, M. (1986). Family Nursing: Theory and assessment (2nd ed.). Norwalk, CT: AppletonCentury-Crofts.
Freeman, R. (1970). Community health nursing practice. Philadelphia: Saunders.
Stanhope, M., & Lancaster, J. ( 1992 ). Community health nursing: Process and practice for promoting health (3rd ed.). St. Louis: Mosby.