Family strength assessment is integral for nursing practice to engage in problem oriented care. It is a type of strength based approach to care that focus on assessing values and strength of family to promote health of patients. Nurses who have knowledge regarding family strength assessment are able to use the information to optimize family functioning and increase support for the individual patient. Another advantage of focusing on family strength assessment is that it enables nurses to provide culturally competent and holistic care (Sittner, Hudson and Defrain 2007). This post gives more detailed understanding regarding the impact of family strength assessment and its impact on family health by giving examples from PEP and supporting the argument with research evidence.
The main goal of family strength assessment is to identify elements in the family that could optimize their function and develop skills to manage illness and disease of other family members. From my own practice experience, I can say that focusing on family strength can promote recovery and improve clinical outcomes of patient. Family assessment is the process that that is in direct alignment with the principles of strength based nursing care (SBNC) principles. SBNC is a both a philosophy and value-driven approach where the principles of patient-centered care, empowerment and relational care is applied to promote health and well-being (Gottlieb, 2014). Family functioning is promoted in this approach with the belief that all family have some strengths and they can use those strength to meet their basic needs, achieve their goals and promote recovery of family members (Walsh, 2015). Assessment of problems in a patient is not the first step towards family-professional interaction. Instead, the process starts with communicating with family members of the patient to understand how they have managed problems in the family so far. This process has helped me to identify resource that can act as building blocks and use them as tool to optimize care.
Family strength assessment can be done by nurse with the use of structured tools or with the application of strength based elements in patient care. However, for nurses who need assistance in conducting family strength assessment, the Australian Family Strength Nursing Assessment tool (AFSNA) can be a useful tool to identify eight qualities of strong Australian. The eight quality elements of strong family include communication, togetherness, affection, sharing activities, support, acceptance, commitment and resilience (Barnes & Rowe, 2013). During my placement in a mental health unit of Royal Prince Alphred Hospital, I was able to use AFSNA to identify strength in patient families and implement appropriate care plan for the recovery of patient. For example, during my placement, I was assigned to take care of a 35 year old patient named Tracy (fictional name), who was admitted to the hospital following episodes of depression and social isolation. The patient was avoiding interaction with anyone and it was difficult to understand the cause behind depression in patient. Hence, I decided to interact with Tracy’s husband to understand the ways to manage the condition of Tracy. The positive thing about interaction between Tracy’s husband was that I found that he was very much interested in providing any kind of support to manage her illness. He was very supportive and he was the only person whom Tracy trusted and interacted with without any difficulty. Therefore, by engaging in regular meeting with Tracy’s husband, it became possible to identify cause behind depression and identify activities or motivations that would distract Tracy from her life stressors. Regular cues and ideas from Tracy’s husband helped me to identify appropriate care plan for Tracy’s recovery and empathy and affection of her husband helped Tracy to overcome the crisis. Ellis et al. (2016) also supports the fact that developing care plans based on family strengths can improve coping skills, self-efficacy and clinical skills of patient.
The advantage of using AFSNA tool in improving clinical outcome of patient is also understood from another of my placement experience. Philips (fictional name), a 11 year old patient came to the mental health unit after diagnosis of attention deficit hyperactivity disorder. Her mother complained regarding poor grades and poor concentration of her son. She was very worried regarding the future of her son. I used the questions from the AFSNA guide to understand family strength elements like togetherness and sharing activities. For example, ‘I asked Philips’s mother how often she spend time with her son?. She replied that she meets him only in the evening as she has work commitments. To assess their togetherness, I asked ‘Do you see Philips happy when you share activities together’. Using this cues, I convinced her mother that Philips need some support from her so that he can manage the crisis in his life. I also gave her education regarding some activities to increase the attention level of Philips. Smith, Swallow and Coyne (2015) supports that actively involving parents in decision making is important particularly in long-term conditions so that day-to-management of care becomes easier.
Hence, based on my experience with two patients, I can say that AFSNA tool is effective in taking appropriate feedback and vital patient information and using those elements to plan and resolve patient issues. Furthermore, good communication skills and application of strength based elements helped me to support families to identify their strength and use them (Thomlison 2015). Bidrectional interaction between nurse-patient relationship and well-being outcome is also understood from the fact that negotiation with Philips mother helped in planning effective activities to increase concentration and promote well-being of Philips. In the case of Tracy, involvement of Tracy’s husband in the care process through regular meeting helped Tracy to accept the treatment and comply with them to achieve positive mental health outcomes.
References:
Barnes, M., & Rowe, J. (2013). Child, youth and family health: Strengthening communities. Elsevier Health Sciences.
Ellis, L., Gergen, J., Wohlgemuth, L., Nolan, M.T. and Aslakson, R., 2016. Empowering the “cheerers”: role of surgical intensive care unit nurses in enhancing family resilience. American Journal of Critical Care, 25(1), pp.39-45.
Gottlieb, L.N., 2014. CE: Strengths-based nursing. AJN The American Journal of Nursing, 114(8), pp.24-32.
Sittner, B.J., Hudson, D.B. and Defrain, J., 2007. Using the concept of family strengths to enhance nursing care. MCN: The American Journal of Maternal/Child Nursing, 32(6), pp.353-357.
Smith, J., Swallow, V. and Coyne, I., 2015. Involving parents in managing their child's long-term condition—A concept synthesis of family-centered care and partnership-in-care. Journal of pediatric nursing, 30(1), pp.143-159.
Thomlison, B., 2015. Family assessment handbook: An introductory practice guide to family assessment. Nelson Education.
Walsh, F., 2015. Strengthening family resilience. Guilford Publications.
