Formulating a Family Nursing Care Determinants of Family Health Needs

Plan
Four sources of Family Health Needs:
● It is the blueprint of the care that
the nurse designs to systematically 1. Health situation itself
minimize or eliminate the identified
health & family nursing problems 2. Environment
through explicitly formulated
outcomes of care ( goals and 3. Socio-cultural setting
objectives) & deliberately chose set
of interventions, resources & 4. Patterns of behavior that are
evaluation criteria, standards, characteristics of patient & his/her
methods 7 tools family

Features of FNCP
Stages in Developing the Family Nursing
1. Focuses on actions which are Care Plan
designed to solve or minimize
existing problems.

2. A product of a deliberate
systematic process

3. Relates to the future.

➔ It projects what would
happen if the problem is not
corrected

4. Based upon identified health and

nursing problems

5. Means to an end, not an end itself.

➔ Goal is to provide the most
appropriate care to the
client by eliminating barriers
to family development, if After the assessment phase, the nurse
not, it become useless together with the family may identify
health problems which can not be dealt
6. A continuous process, not a with at the same time considering the
one-shot-deal. available resources of the nurse and
➔ The results of the evaluation family. Seeing this situation, the nurse can
of the plan’s effectiveness rank or prioritize the problems, to which
trigger another cycle of the should be addressed first using criteria
planning process until the
health & nursing problems
are eliminated.
Criteria for priority setting d. Foreseeable Crisis
● Anticipated periods
1. Nature of the problem of unusual demand
a. Wellness State or condition on the individual or
● This is stated as family in terms of
potential or adjustment and
readiness family resources
Example:
● This is a nursing ● Marriage
● Pregnancy
judgment based on
● Parenthood
client’s performance,
competencies or
2. Modifiability of the Problem
clinical data
Example:
● Healthy lifestyle ● It refers to the probability of success
● Spiritual well-being in minimizing, alleviating or totally
● Health management eradicating the problem through
● Parenting nursing intervention

Example as Family nursing problem: Factors affecting priority setting:

● Potential for enhanced capability Modifiability of the problem:

in parenting
1. Current knowledge, technology
● Readiness for enhanced capability and interventions to manage the
in parenting problem

When there is no explicit expression of desire 2. Resources of the family

from client use “potential”, if there is an explicit
expression of desire to achieve a higher level of
3. Resources of the nurse
state or function from the client, use
“readiness”
4. Resources of the community
b. Health threat
3. Preventive potential
● It is a condition that
are conducive to
disease, accident or ● It refers to the nature & magnitude
failure to realize one’s of future problems that can be
health potential minimized or totally prevented if
Example: Faulty eating habit intervention is done on the
problem under consideration.
c. Health Deficit
● Instances of failure in
health maintenance
Example: anorexia
Factors to consider: 1. Decide on a score for each of the
criteria
a. Gravity or severity of the problem
● Refers to the progress of the 2. Divide the score by the highest
disease or problem possible score and multiply by the
indicating the extent of weight (score/highest possible
damage to patient/family score) x weight.
The most severe the problem is, the lower its
preventive potential 3. Sum up the scores of all the criteria.
The highest score is 5 (total weight)
b. Duration of the problem
● Refers to the length of time
the problem has been
existing

c. Current management
● Refers to the presence and
appropriateness of
intervention measures to
enhance the wellness or
remedy the problem

d. Exposure of any high risk group

increases the preventive potential
of a problem

4. Salience of the problem Example:

● Refers to the family’s perception Prioritized health problems:

and elevation of the problem in
terms of seriousness & urgency of
Prioritized health
attention needed.
problems

Malnutrition 4
Scoring
Possible 4
preeclampsia

Family size 3.17

beyond family
resources

Inadequate living 2.67

space
Formulation of goals and objectives Example:
➔ A mother may perceive the need for
of care
immunization for the children but her
household chores take precedence over
Goals the concerns.
● Is a general statement of the
condition or state to be brought 3. Sometimes the family perceives the
about by specific courses of action. existence of a problem but does not
see it as serious enough to warrant
Example: attention.
➔ After nursing interventions, the family
will be able to take care of the disabled
Example:
child competently.
➔ Common cold-that is all too often taken
for granted
Cardinal Principle in goal setting ➔ Intestinal parasitism-regarded as a
normal affliction of childhood
● Goals must be set jointly with the
family 4. The family may perceive the
presence of the problem & the
● Ensures the family’s recognition & need to take action
acceptance of existing health needs
& problems ● According to Freeman,
refusing to face & do
● The nurse must ascertain the something about the
family’s knowledge & acceptance of situations offers the
the problem as well as the desire to following reasons for this
take actions to resolve them kind of behavior.

a. Fear of consequences of taking

Barriers to joint goal setting between action
the nurse & family:
Example:
1. Failure on the part of the family to ➔ diagnosis of disease condition
may mean expense of social
perceive the existence of the
stigma for the family
problem
b. Respect for tradition
Example:
● Elders play a part in decision
➔ Seen only by the nurse but the family is
satisfied w/ the existing problem
making

Example:
2. The family realizes the existence of
➔ Couple may not accept the goal
a health condition or problem but it of limiting to just 3 children if
is too busy at the moment w/ other their parents do not approve of
concerns & preoccupations. the contraceptive practice
 c. Failure to perceive benefits of Example:
action ➔ After nursing intervention, the weights
● Proposed of the malnourished preschool
members of the family will increase of
● Client’s previous experience
at least one pound per month
w/ health workers & their
services
Short-term or immediate objectives
● Are formulated for problem
Example:
situations which require immediate
➔ Going to a health center, advice
attention, & results can be observed
frequently given by nurses,
when this does not yield
in a relatively short period of time.
beneficial results from the point
of view of the family it will be Long term or ultimate objectives
ignored the next time it is ● Require several nurse-family
beneficial offered. encounters & an investment of
more resources
5. Big Barrier
Stating goals/objectives
● Failure to develop a working Basic parts:
relationship ● performance/behavior
● criterion/degree
● The elements of mutual trust & ● Condition
confidence are crucial to the
success of the nurse-family Characteristic
endeavors toward better health S-M-A-R-T

● Goals should be realistic & Example:

attainable ➔ After nursing intervention (condition),
the weights of the malnourished
● Best stated in terms of client preschool members of the family will
outcomes, whether individual, (performance/behavior) increase to at
least one pound per month (criterion)
family or community levels.

SMART
● Specific:
➔ malnourished preschool
Objectives
member of the family as the
● More specific statement of the
target client
desired results or outcomes of care
● Measurable
➔ 1 pound per month increase
● Degree of effectiveness of care are
after nursing care
to be measured
● Attainable
➔ The family is given 30 days
● Goals-tell whether family is going
or enough time and the
expectation is not high
● Objectives-are the milestones to
reach the destination
 ● Realistic 4. Observational measures
➔ There are interventions
available to solve the 5. Anticipatory guidance
problem or meet the
objective 6. Health teaching or education
● Time-bounded
➔ After a month, after nursing 7. Counseling
care
8. Motivation and support

9. Environmental manipulation.
Nursing Interventions Modification or improvement
● Are actions or measures taken by
the nurse to achieve certain 10. Referral
predetermined objectives of care.
Such actions are in accord with Categories of Interventions
current prevailing scope and ● Promotive
standards of nursing practice and ● Curative
nurse’s defined roles and functions. ● Preventive
● Rehabilitative
There are two kinds of nursing
interventions Examples:

1. Anticipatory intervention Preventive

measures ● Blood pressure, diabetes, and
2. Compensatory intervention cholesterol tests.
measures
● Cancer screenings, mammogram
Anticipatory and colonoscopy
● Health promotive measure/action
● Preventive measure/action ● Counseling on quitting smoking,
losing weight, eating healthfully,
Compensatory treating depression, and reducing
● Curative measure alcohol use.
● Rehabilitative
● supportive/palliative treatment ● Regular well-baby and well-child
● Care measures/action visits.

Types of Nursing Interventions ★ To prevent mental disorders, arisen

or recurrence of mental disorders,
1. Administration of medical reduce the risk factors of mental
treatments disorders in community

2. Direct nursing care ★ To prevent the impact of

psychosocial problems in
3. Indirect nursing care community
 ★ Preparing and giving trust to
Promotive people with mental disorders so
● Community-based parenting they can live independently in the
education community in terms of psychiatric,
psychosocial and social.
● Health education
Example of Family Nursing Interventions
★ To maintain and escalate the
society mental health scale, remove 1. Inquire and observe the family’s
the stigma, discrimination and food selection and preparation; and
violation of the rights of people eating habits or practices
with mental disorder
2. Discuss to the family the nature,
★ To improve community cause and effect of malnutrition
understanding involvement and
acceptance of mental health 3. Discuss to the family the reasons of
maria’s malnutrition
Curative
● Provision of nursing care 4. Discuss to the family the courses of
action open to them such as
● Medications and therapies budgeting family income, planning
for a nutritious but within the
● Surgery family’s budget meals.

★ Provide health services to people 5. Make proper referral to existing

with mental disorders that include agencies or NGOs
the process of diagnosis and
appropriate management for
healing, recovering, suffering
reduction so that people with
mental disorders can live properly
in their society

Rehabilitative
● Physical therapy after stroke

● Occupational therapy for a child

with disability

★ Preventing and controlling

disabilities

★ Restoring social function

★ Restoring social occupational