This analysis provides an overview of approaches in family nursing with an example of four key nursing interventions or approaches. Each of these approaches provides a different view of the patient, along with the family as approaching healthcare from the perspective of the individual and family, along with other supporting members of the community. The four approaches explored include (1) family as context, (2) family as client, (3) family as a system, and lastly (4) the family as a component of the community. Each of these approaches has benefits, and the potential to support the individual or client (affected member of the family) and the family as a unit, along with the family as a member of society. The role of the nursing care specialist or nursing provider can only be achieved when the nursing professional understands each of these approaches. Examples are given of each of these experiences using accurate examples.
In family nursing, approaches and interventions may require a review of many different perspectives. These approaches may include consideration of the family as context, the family as a system, the family as a client, and lastly, as a component of the system. Each of these approaches is described below, with examples of how they apply to personal experience or the practice setting.
In the family as a context environment, the focus is on the context of the family with the individual at the front and family in the background (Kaakinen et al., 2015 p. 9). The family provides the context for the individual which can serve as a resource for the family or as a stressor (Kaakinen et al., 2015 p. 9). Alazzam et al., (2016) stated that the family as context approach is a focus on family members of the individual and the family as a subgroup, where relationships among family members are set at the front of the environment (p. 1369).
In this context, an example of an intervention used with family as context is a situation where my cousin was having difficulty breathing. My aunt rushed him to the clinic, and he was subsequently diagnosed with asthma. Following this, the family worked with other members of the family and the child, along with the school to develop a care plan that included regular follow-ups, assessment of the care plan and consistent re-evaluation. Other considerations included the members of the household that would assist with caring for the cousin when the parents were away to ensure that the child consistently took their asthma medication.
Kyler (2006) alludes to the family as a client in client-centered practice, noting that in client-centered practices, health providers are positioned to consider new and relationship-oriented care for their clients and families. In this setting, the family as a whole is assessed, with consideration to each individual. An example of this approach is a mother of four children who was brought in by her boyfriend. In the process, in addition to her children and immediate partner, the ex-husband was involved in the care and his wife, who was a stepmother to the children. The members of the family, including the stepparent were intimately involved in the care of the children.
The family as a system focuses on the patient, while family members may be targeted for specific interventions (Kaakinen 2015, p. 10). An example of this in practice is when a brother came into practice with a broken wrist. The sister and brother in the family were part of a duo during band, and the broken wrist meant the brother would not be able to partner up with his sister for practice for many weeks. The sister didn’t want to engage either, following this. Fortunately, this issue was resolved by the children working with their parents and speaking to a guidance counselor, who suggested the brother still participate in the duo, in a supportive role, while the sister became more engaged by going with her brother to follow-up care appointments.
An example of this setting is a family member that sought care for community resources for their mental health problems. In this setting, the community resources provided social support for the family (Roxana, 2013). According to Roxana (2013), negative impacts may occur among people and on their quality of life when the community is not considered in care; in environment’s like this, a “social price” of changes may occur depending on whether family experiences positive or negative outcomes (p. 266). This means ensuring that family members receive appropriate care for not only physical illness, but also in mental illness. In the practice setting, the nurse can help by supporting the family in understanding the support needed not only for the family member with a mental illness, but also support for family members impacted by the disease.