PENGKAJIAN KELUARGAFERY MENDROFA, Mkep, Sp.Kom

THE INDICATIONS FOR A FAMILY ASSESSMENT (CLARKIN, FRANCES, MOODIE, 1979)A FAMILY IS EXPERIENCING EMOTIONAL DISRUPTION CAUSED BY A FAMILY CRISIS.A FAMILY IS EXPERIENCING EMOTIONAL DISRUPTION CAUSED BY A DEVELOPMENTAL MILESTONE.A FAMILY DEFINES A PROBLEM AS A FAMILY ISSUE, AND THERE IS MOTIVATION FOR FAMILY ASSESSMENT.A CHILD OR ADOLESCENT IS THE IDENTIFIED PATIENT.THE FAMILY IS EXPERIENCING ISSUES THAT ARE SERIOUS ENOUGH TO JEOPARDIZE FAMILY RELATIONSHIPS.A FAMILY MEMBER IS ABOUT TO BE ADMITTED TO THE HOSPITAL FOR PSYCHIATRIC TREATMENT.

ASSESSMENT MODELTHE FRIEDMAN FAMILY ASSESSMENT MODELTHE CALGARY FAMILY ASSESSMENT MODEL

GUIDELINES FOR ASSESSMENTENGAGEMENT STATEASSESSMENT STAGE- Problem identification - Relationship between family interactions and health problem- Attempted solutions- Goal explorationTERMINATION STAGE

THE THEORETICAL FOUNDATIONSSYSTEMS THEORYA family system is part of a larger suprasystem and is also composed of many subsystem.A family is a whole is greater than the sum of its parts.A change in one family member affects all family members.The family is able to create a balance between change and stability.Family members behaviors are best understood from a view of circular communication rather than linear causality.

CYBERNETICS1. Family posses self-regulating ability through the process of feedback.2. Feedback process can simultaneously occur at several different systems levels with families.

COMMUNICATION THEORY1. All non verbal communication is meaningful.2. All communication has 2 major channels for transmission: digital and analogic.3. A dyadic relationship has varying degree of symmetry and complementary.4. All communication consists of 2 levels: content and relationship.

CHANGE THEORY

1. Change is dependent on the perception of the problem.2. Change is dependent on context.3. Change is dependent on coevolving goals for treatment.4. Understanding alone does not lead to change.5. Change does not necessarily occur equally in all family members.6. Facilitating change is the nurses responsibility.7. Change can be due to a myriad of causes.

OUTLINE PENGKAJIAN MODEL FRIEDMANTAHAP I I. DATA UMUM 1. NAMA KEPALA KELUARGA 2. ALAMAT 3. KOMPOSISI KELUARGA (DALAM TABEL) LENGKAPI DENGAN GENOGRAM 4. TIPE KELUARGA 5. SUKU 6. AGAMA 7. STATUS SOSIAL EKONOMI KELUARGA 8. AKTIVITAS REKREASI KELUARGA

PENGKAJIAN DATA UMUMII. RIWAYAT DAN TAHAP PERKEMBANGAN KELUARGA 9. TAHAP PERKEMBANGAN KELUARGA SAAT INI 10. TAHAP PERKEMBANGAN KELUARGA YANG BELUM TERPENUHI 11. RIWAYAT KELUARGA INTI 12. RIWAYAT KELUARGA SEBELUMYA (PIHAK SUAMI DAN ISTRI)

PENGKAJIAN DATA UMUMIII. LINGKUNGAN 13. KARAKTERISTIK RUMAH 14. KARAKTERISTIK TETANGGA DAN KOMUNITAS RW 15. MOBILITAS GEOGRAFIS KELUARGA 16. PERKUMPULAN KELUARGA DAN INTERAKSI DENGAN MASYARAKAT 17. SISTEM PENDUKUNG KELUARGA

PENGKAJIAN DATA UMUMIV. STRUKTUR KELUARGA 18. POLA KOMUNIKASI KELUARGA 19. STRUKTUR KEKUATAN KELUARGA 20. STRUKTUR PERAN (FORMAL DAN INFORMAL) 21. NILAI ATAU NORMA KELUARGA

V. FUNGSI KELUARGA 22. FUNGSI AFEKTIF 23. FUNGSI SOSIALISASI 24. FUNGSI PERAWATAN KELUARGA

PENGKAJIAN DATA UMUMVI. STRES DAN KOPING KELUARGA25. STRESOR JANGKA PENDEK DAN PANJANG SERTA KEKUATAN KELUARGA26. KEMAMPUAN KELUARGA BERESPONS TERHADAP SITUASI/STRESOR27. STRATEGI KOPING YANG DIGUNAKAN28. STRATEGI ADAPTASI DISFUNGSIONAL

VII. PEMERIKSAAN FISIKVIII. HARAPAN KELUARGA

PENGKAJIAN MODEL CALGARYTHREE MAJOR CATEGORIESSTRUCTURALDEVELOPMENTAL FUNCTIONAL

STRUCTURAL ASSESSMENTINTERNAL STRUCTUREFamily compositionGenderRank orderSubsystemBoundaryTools: genogram and ecomap

STRUCTURAL ASSESSMENTEXTERNAL STRUCTUREExtended familyLarger system

CONTEXTEthnicityRaceSocial classReligionEnvironment

DEVELOPMENTAL ASSESSMENTSTAGESTASKSATTACHMENT

FUNCTIONAL ASSESSMENTINSTRUMENTAL FUNCTIONINGActivities daily livingEXPRESSIVE FUNCTIONINGEmotional communicationVerbal communicationNon verbal communicationCircular communicationProblem solvingRolesInfluenceBeliefsAlliances/coalitions

OUTLINE PENGKAJIAN MODEL CALGARYNama KK:Tgl:Anggota klg yg hadir:Pengkaji:Tempat pengkajian:Masalah kesehatan dan rujukanKomposisi keluargaKeterikatan keluargaRiwayat kesehatan dan tumbuh kembangKekuatan keluarga dan masalahHipotesis/kesimpulanTujuan dan rencanaTanda tangan pengkaji:

MASALAH-MASALAH YANG SERING MENGHAMBAT PENGKAJIANPADA ENGAGEMENT STAGEPersiapan perawat untuk menghadapi keluarga belum optimal, seperti penguasaan form pengkajian; gambaran kebutuhan keluarga tidak diketahui.Perawat cenderung menempatkan diri sebagai expert.Tidak bertemu dengan seluruh anggota keluarga.

MASALAH-MASALAH YANG SERING MENGHAMBAT PENGKAJIANPADA ASSESSMENT STAGEPerawat belum melakukan komunikasi efektif untuk menggali data.Perawat belum mendapat kepercayaan penuh dari keluarga sehingga keluarga belum menceritakan masalahnya secara terbuka.Kemampuan perawat dalam merangkai informasi belum terlatih.

MASALAH-MASALAH YANG SERING MENGHAMBAT PENGKAJIANPADA TERMINATION STAGEPerawat tidak menyimpulkan hasil pengkajiannya untuk keluarga.Perawat tidak menginformasikan pada keluarga langkah berikutnya.

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