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Parenting with Families: Family-Centered Care

Debra M. Giusto RN MSN IBCLC

Learning Outcomes 1.  Describe Key Concepts of Family-

Centered Care 2.  Identify Characteristics of Different

Types of Families 3.  Contrast Four Different Parenting Styles

and Analyze Their Impact on Child Personality Development

4.  Explain the Effects of Major Family Changes on Children

Learning Outcomes (cont’d)

5.  List the Categories of Family Strengths that Help Families Develop and Cope with Stressors

6.  Identify Family Support Services that Might be Available in a Community

7.  Summarize the Advantages of Using a Family or Cultural Assessment Tool

Learning Outcomes (cont’d)

8.  Develop a Family-centered Nursing Care Plan for a Child and Family

9.  Examine the Role of the Nurse in Promoting Cultural Competence

10.  Describe the Cultural Influences on the Family’s Beliefs About Health, Illness, and Treatments

Learning Outcomes (cont’d)

11.  Discuss Nursing Interventions for Providing Culturally Sensitive and Competent Care to the Child and Family

Family-Centered Care O Provider and Family Mutually Respected

Partners O Opposite of family-focused care

O “Family-focused”: Provider directs care

O Collaboration Between Providers and Families Promotes Best Outcomes for Children

O Exchange of Information

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Family-Centered Care (cont’d)

O Improves Outcomes O Increases Compliance with Recommended

Therapies O Reduces Anxiety of Patients and Families

Family

O What’s your definition of family?

Definition of family

O Basic social unit consisting of parents and their children, considered a group, whether dwelling together or not –traditional family

O Social unit consisting of one adult together with children

O Group related by blood O Group with a common interest O Mafia or Cosa Nostra – one leader

Dictionary.com

Legal implications of family

O Obtaining information O Visiting rights

O A voice in child’s care

Family

O Traditional nuclear family O Nuclear family O Blended family O Extended family O Binuclear family O Gay or lesbian family

Table 2-2 Characteristics of Significant Parenting Attributes"

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Table 2-3 Parenting Styles by Level of Warmth and Control"Family Functioning

O Changes in Family Functioning Can Impact Children

O Nurses Assist Families By Inquiring About the Circumstances and Changes the Child Experiences

Parenting Styles O Authoritarian

O Rigid; sets rules O Authoritative

O Sets limits; listens to child O Permissive

O No limits; child sets rules O Indifferent

O Little interest in child

Special Family Changes O Divorce O Stepparenting O Foster Care O Adoption

Table 2-4 Potential Effects of Divorce on Children of Different Ages"

Table 2-4 (continued) Potential Effects of Divorce on Children of Different Ages

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Table 2-4 (continued) Potential Effects of Divorce on Children of Different Ages

Family Strengths O Family Strengths Help Support Families

During Times of Change and Adversity O Four Types of Strengths:

O Traits, such as Optimism or Resilience O Assets, such as Finances O Skills and Competencies, such as Problem

Solving O Motivation

Box 1-1 Family Strengths Helpful in Managing Stressors Table 2-5 Eight-Stage Family Life Cycle"

Family Support Services O Positive Family Relationships O Parental Competencies O Health and Development

O Child and parents

Family nursing interventions

O Behavior modification

O Case management and coordination

O Collaborative strategies

O Family crisis intervention

O Networking – self-help groups

O Providing information

O Community-based Services

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Figure 2-8 An ecomap illustrates the family’s relationships and interactions with groups and individuals in the immediate external environment"

Culturally Sensitive Family Care

O Identify Primary Decision Maker O Assess Health Beliefs and Practices O Consider Family’s Ethnic Background and

Religious Beliefs

Table 2-6 Cultural Assessment Models" Table 2-6 (continued) Cultural Assessment Models

Family-Centered Care Plan O Assess and Help Families Identify

Strengths and Resources O Determine How Child’s Condition Affects

Family Functioning O Establish a Therapeutic Relationship with

Child and Family O Assist Family in Planning for Ongoing Care

Promoting Cultural Competence

O Assess the Influence of Culture on the Child and Family

O Help Families Determine how to Incorporate Prescribed Therapy with Health Care Beliefs and Practices

O Families Are More Likely to Comply When Cultural Values Are Incorporated into the Care Plan

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Cultural Influences on Family Beliefs

O Culture Determines Family Goals, Family Member Roles, and Childbearing Practices and Beliefs

O Communication and Language Impact Ability to Understand and Follow Treatment Recommendations

O Cultural Practices Include Diet and Family Eating Patterns

O Alternative Therapies

Culturally Competent Nursing

O Collaborate with the Child and Family O Assist Family to Identify and Select

Resources

Critical thinking

O You are assigned to care for a Vietnamese boy who is in traction, hospitalized for a fractured femur. He speaks his native language as well as English. His caregivers, who also speak both languages, are present in the child’s room when you enter to perform an initial nursing assessment. What considerations are important in order to perform culturally care?

Summary O In Family-Centered Care, Provider and

Family Are Mutually Respected Partners O Collaboration Between Providers and

Family Promotes the Best Outcomes for Children

O Families Are More Likely to Comply with Treatment Recommendations When Cultural Values Are Incorporated into the Care Plan

Summary

O No agreement about the definition of the family

O Family is what an individual considers it to be

O Nurses need to be advocates for families

O Nurses play an important role in the well-being of families and their children

Nurses

O Need to recognize the influence of family dynamics on child health & well being

O Focus on the family as an element of optimum child health and development

O Examination of families and its function should be incorporated into your assessment

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Resources O nstitute for Patient- and Family-Centered

Care http://ipfcc.org/ Provides essential leadership to advance the understanding and practice of family-centered care.

O Home Observation Measure of the Environment http://ualr.edu/case/index.php/home/home-inventory/

Resources (cont’d) O Child Welfare Information Gateway –

Family Assessments http://www.childwelfare.gov/famcentered/casework/assessment.cfm

O National Center for Complementary and Alternative Medicine http://nccam.nih.gov/ Provides information and supports research in complementary and alternative medicine.

Resources (cont’d) O National Foster Parent Association

http://www.nfpainc.org National organization that supports foster parents and remains a consistently strong voice on behalf of all children.

O Center for Cross-Cultural Health http://www.crosshealth.com/ Supports the integration of cultural competency into health and human services.

Adoption Resources O National Adoption Clearinghouse

http://www.adoption.org/adopt/national-adoption-clearinghouse.php

Adoption Resources (cont’d)

O American Academy of Pediatrics Section on Adoption and Foster Care http://www.aap.org/sections/adoption/

O Adoptive Families Magazine www.adoptivefamilies.com

O Parent Network for the Post-Institutionalized Child http://www.pnpic.org/ (cut and paste link in browser window)

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Adoption Resources (cont’d)

O Joint Council on International Children’s Services http://www.jcics.org/

O North American Council on Adoptable Children http://www.nacac.org/