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• Exam 1 for N480 covers Robinson Chapters 1-5, 7-9 and Denham Chapters 1, 2, 5, 6, 7.
• The exam consists of 30 questions and lasts for 40 minutes.

Definitions

• Family consists of two or more self-defined individuals who depend on each other for emotional, physical, and economic support.
• Family health is a dynamic state of well-being that includes biological, psychological, spiritual, sociological, and cultural factors of individual members and the whole family system.
• Assessing family health involves gathering data about the health and functional status of each individual and the family system
• Family-focused care acknowledges that families influence health care process/outcomes
• Knowledge of family structure and function informs nursing to optimize care and provide individualized approaches, focusing on the individual client within the family context

Influence of Family on Health/Illness

• Factors in family health to consider are education, resources, and support
• Families provide knowledge about nutrition, disease prevention, and the importance of medical care, influencing health behaviors.
• Health literacy determines understanding of conditions, medications, and treatments.
• Misinformation or lack of awareness may lead to poor health choices, non-compliance, and delayed medical attention.
• Socioeconomic status affects access to healthcare, food, housing, and medical services.
• Financial stability allows families to afford insurance, medications, and preventive care; financial constraints create barriers.
• Access to transportation, technology, and community resources is important in managing health conditions.
• Emotional and psychological support improves coping mechanisms during illness.
• Family caregivers assist with daily activities, medication adherence, and appointments.
• A lack of support causes stress, poor mental health, and non-adherence.
• Strong family support improves recovery rates, reduces hospital readmissions, and enhances overall well-being.
• Dysfunctional family dynamics worsen health conditions.
• Decision-making involvement in chronic/terminal illnesses is crucial for advanced care planning.

Traits of a Healthy Family

• Communicates and listens effectively.
• Fosters quality time together.
• Affirms and supports each other.
• Develops trust within the family.
• Shares laughter and playfulness.
• Maintains a balance of interaction.
• Teaches right and wrong.
• Upholds rituals and traditions.
• Shares a religious core.
• Respects each member's privacy.
• Values service to others.
• Admits to problems and seeks help.
• Manages conflicts and crises.
• Offers forgiveness along with comfort and support.

Family Functions

• Reproduction ensures societal continuation through having children.
• Socialization teaches children cultural norms and values.
• Affective function provides emotional support and nurturing.
• Economic function offers financial support and resources.
• Healthcare function maintains the health of family members.

Family Processes

• Provision provides necessary resources like food, shelter, and clothing.
• Housekeeping manages household tasks to keep a clean home.
• Child care includes support for health, education, and emotional needs.
• Socialization helps members learn social skills and norms.
• Sick or illness support means caring for ill family members.
• Sexual needs of partners within the family are met.
• Therapeutic support offers emotional and psychological.
• Recreational activities promote fun and relaxation.

Family Dynamics

• Include diverse structures
• Increased mobility, and changing roles and expectations.

Theory and Framework

• Theory in family nursing provides a basis for understanding interactions and development of interventions
• Framework is a structure that organizes concepts/variables and provides overall context for assessment and interventions
• Theories and frameworks are used in family nursing to:
• Guide assessment via systematic data collection and analysis
• Inform effective intervention designs, tailored to needs
• Enhance understanding of family dynamics, behaviors and health event impacts
• Promote consistency, for improved collaborations among healthcare providers

Family Systems Dynamic

• Family Systems Theory allows nurses to assess families as interactive and interdependent systems.
• Concepts and propositions provide a system-based framework
• System features maintain stability whether it is adaptive or maladaptive.
• Family systems increase complexity and adaptability over time.
• Nurses view each client as part of a larger system, and changes in one member affects all.
• Nursing goals are to maintain and restore family stability, emphasizing the whole. All parts of the system are interconnected
• A health event impacts the entire family
• Each member's roles shift, indicating how one person’s illness affects the whole family.
• The family as a whole is more impactful than simply the sum of its parts
• One member's chronic illness impacts everyone, causing stress
• Families maintain boundaries and border control to manage the entry of information and people
• Can be closed, flexible, or open

Development and Life Cycle Theory

• A framework to understand family changes throughout members’ lives.
• Assesses individuals and families as developing/changing entities
• Views the evolving needs and the family.
• Addresses understanding of families rather than of individuals.
• Systematic and Predictable Transitions: adolescence and more autonomy.

Table 2-5 Traditional Family Life

• Marriage involves establishing the relationship
• Childbearing creates tasks of adjusting to pregnancy and new roles and maintaining intimacy.
• Preschool Children tasks include understanding normal growth, coping with energy depletion, and maintaining relationship.
• School-Age Children tasks involve working out authority and supporting outside needs.
• Adolescents task's include allowing own identities while still parenting, and thinking about the future.
• Young Adults require reallocation of roles and supportive home base.
• Mid-Aged Parents require refocus on relationship and ensuring security after retirement.
• Aging Families require adjusting to new roles, retirement, and possibly the death of a spouse.

Table 2-6 Family Life Cycle for Divorcing Families

• Divorce involves accepting the inability to resolve issues and one’s part in the failure of the marriage.
• Planning the breakup involves cooperation on custody and visitation issues.
• Separation requires restructuring relationships
• Post-Divorce includes maintaining parental contact and rebuilding financial/social networks.

Bioecological Systems Theory

• Microsystems are immediate environments affecting a child, like family and school.
• Mesosystems: Interactions are the relationship between family and school/teacher.
• Exosystem: Indirectly affect person, like job or government policies.
• Macrosystem: The beliefs shaping things such as religion or politics.
• Chronosystem is the influence of events and historical/social changes.
• Theory emphasizes development is based on layers over time.

Family Nursing - Assessment & Intervention Model

Jones’ Levels of Racism Model.

• Framework that is able to help in understanding health disparities by addressing economic, social, cultural, and physical components
• Institutionalized Racism affects access to services, resources, and opportunities
• Examples include healthcare disparity, unequal access to healthcare facilities/coverage
• Personally Mediated Racism is what is causing prejudices and bias
• Examples include bias in healthcare, assumptions, or even unequal treatment causing worse helth outcomes
• Internalized Racism is the acceptance of negative racial stereotypes.
• Examples include not seeking equal healthcare, or not even having self esteem
• Nurses must join institutional committees to create an awareness and acceptance
• Conceptualize and assess the helth status of families to be an instrument to allow for policy decisions

Cultural Factors That Contribute to Health Status

• Cultural norms influencing the values in using health resources
• Cultural beliefs and practices shaping attitudes towards healthcare - shape development of individuals, families, and communites
• Economic opportunities from social factors
• Education in contexts
• Housing of different groups
• Public safety in different locations
• Resources, and support system

Health policy, including implicit and explicit:

• *These policies aim to promote, safeguard and bolster families in areas such as economic,education,caregiving etc:
• Implicit policies consist of zoning / traffic /criminal / environmental / and voting laws.
• Explicit policies consist of policies, programs, and laws around marriage /divorce/ adoption/ childcare/ family leave/, and reproductive rights,.

Social determinants of health

• Family lives /learns and works
• All social factors/ race/ ethnic /gender national origin /residental ability/ body size and more:
• Access to and different resources.
• Policies of social meanings and cultural norms.
• Health literacy degree of individuals:
• Health literacy is needed in order to receive needed information in order to make rational decisions::
• Low heath/ less management/less participation/ less support/ lower use of primary services/ and overall healthcare services/ urgent care
• Genes refer to individual units of heredity made up of DNA determining specific traits or functions.

Genetics

• A genetic mutation in a single gene can cause Huntington's Disease: This is caused by single gene disorder from a mutation in the HTT gene

• Genomes encompass the complete set of genes in genetic material Study of genes and environmental interactions can be multiple things like diabetes/

• Examples: Prenatal testing/ predictive testing/ pre-symptomatic

• Advantages are knowing/ relieving to negative/ to reproduce

• Disadvantages increased anxiety/ loss of hope/discrimination/ attitudes/ guilt/

Genetics Decisons

• Disclose/ private/ confidential/ immediate
• In addition a nurse has the right to use its to understand its risks and support genetic factors
• Diagnostic s/s are there/ to know you have
• Carriers no s/s are there/ but have mutation with normal gene/sons are 50 perceng/so are daughters
• Pharmacogentic- How they move and used in body what to do with them
• Ethical- Privacy must be there/ nurses cannot just speak their mind from patients perspective: