“Review the concept of family in contemporary society, describe family strengths as a framework and discuss how it can be applied as an approach to use in health care practice.”
When reviewing the concept of family in Australia a contemporary lens must be adopted. Australia has moved away from the traditional notion of family and as such the definition of family varies depending on the individual’s opinion and experiences. Regardless of an individual’s situation, a nurse must be responsive to these differences. Moreover, when adopting a Family Strengths approach a nurser is able to provide a care plan to promote positive health outcomes for the whole family. In practice the Family strength framework supports the inclusion of family members and assists nurses with empowering families to overcome the health care situations they are facing together.
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To define family as a concrete term with contemporary society would unavoidably leave out a number of possible family configurations. The Australian Bureau of Statistics have attempted to define family and have included opinions such as: Two or more persons, over 15 years of age, relations of blood, marriage, adoption, step or fostering and household residential address (ABS, 2016). In contemporary society, these definitions do not remain relevant. For example, more children are living in out of home care arrangements such as residential care (Australian Institute of Family Studies 2018). A more contemporary understanding of family requires nurses to be aware of the bias and beliefs they hold when providing care to a patient (Mirlashari et al. 2018). When supporting children in these family models, it is important to remember their right to choose who they consider their family to be (United Nations 1989). This can include but is not limited to, friends, blood relatives, married/de facto relationships and foster care families (Smith & Ford, 2013). As a student nurse, reflecting on the concept of family, most significantly I have learned that family is a fluid concept. Patane and Forster (2017) support this thought when they discuss family developmental stages. Throughout a person’s life their definition of family or who they choose to include as family is subject to change based on the developmental stage of the family and nurses must be responsive to this (Patane & Forster 2017).
When working with families, it is important to work with their current strengths. One way of doing this is to work within the Family Strengths Framework. The Family Strengths Framework is a positive approach towards health care that focuses care plans on the whole family unit (Smith and Ford 2013). To support the implementation of the Family Strengths frameworks the Australian Family Strengths Nursing Assessment Guide (Assessment Guide) was developed. The Assessment guide describes nine family strengths – Communication, Togetherness, Sharing activities, Affection, Support, Acceptance, Commitment, Resilience and Spiritual Wellbeing and provides example questions for nurses to ask (Smith and Ford 2013). The Family Strengths Framework supports the identification of existing relationships and processes that have maintained the family unit in the past and which may be useful in the current situation (Well et al 2014; Smith and Ford 2013). While the aim of the Family Strengths Framework is to empower families by drawing on their existing strengths, the process also provides an opportunity for nurses to identify what a family may need in order to further support to each other (Smith and Ford 2013)
The Family Strengths Framework in practice allows Nurses the opportunity to work within a Family Partnership Model, to draw on the family’s strengths through family assessment (Smith and Ford 2013). Through genuine conversations and interactions, nurses are able to ascertain family strengths that build a ‘toolkit’ of relevant coping strategies for the family (Smith and Ford 2013). During this process nurses are working with families as partners to explore how their strengths can support each other. In practice, this assessment is not intended a clinical questionnaire (Patane & Forster 2017). The Assessment of a family is completed in a more conversational manner, over a period of time and may not be completed in one sitting (Smith and Ford 2013). At any time of change, it is important that nurses reflect on their assessment to ensure that the care plan they have developed still reflects the strengths of the patient and their family.
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In conclusion, for nurses to implement a Family Partnership Model they must work within a Family strengths framework without bias or judgement. Each individual has their own concept of family and in contemporary Australia a one size fits all approach to health care is not conducive to positive induvial health outcomes. By using each family’s strengths, nurses can work alongside families to build resilience and include the whole family in the care of a patient.
- Australian Bureau of Statistics (ABS) 2016,2901.0 – Census of population and housing: census dictionary, viewed 8 August 2019, ABS, https://www.abs.gov.au/ausstats/abs@.nsf/Lookup/2901.0Chapter32102016
- Australian Institute of Family Studies (AIFS): Child Family Community Australia 2018, Children in care, AIFS, viewed 11 August 2019, https://aifs.gov.au/cfca/publications/children-care.
- Patane, I and Forster, E 2017, ‘Family and community’, in J Fraser, D Waters, E Forster and N Brown (eds.), Paediatric nursing in Australia principles for practice, Cambridge university Press, Victoria Australia, pp. 38-54.
- Smith, L and Ford, K 2013, ‘Communication with children, young people and families – a family strengths-based approach’, in M Barnes and J Rowe (eds), Child, youth and family health: strengthening communities, Elsevier, Australia, pp. 91-110.
- United Nations 1989, Convention on the rights of the child, United Nations General Assembly, viewed 10 August 2019, https://www.ohchr.org/EN/ProfessionalInterest/Pages/CRC.aspx
- Mirlashari, J, Brown, H, Fomani, F K, de Salaberry, J, Zadeh, T K & Khoshkhou, F 2019, ‘The challenges of implementing family-centered care in NICU from the perspectives of physicians and nurses’ Australian Journal of Child and Family Health Nursing, doi: 10.1016/j.pedn.2019.06.013.
- Wells, G, Hauck, Y, Bennett, E, Shields, L, & Johnson, K 2014, ‘Nurses’ experience of using a strengths-based framework to facilitate change with families’ Australian Journal of Child and Family Health Nursing, vol. 11, no. 1, pp. 17–24, viewed 11 August 2019, https://search-informit-com-au.ezproxy.usc.edu.au/fullText;dn=658083409312839;res=IELHEA
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