Fluent Essays

attached is the assignmentNot more than 500 words and APA format. 1. What are the barriers/challenges described in your readings that you also face in your environments as you attempt to provide family focused nursing? (e.g. family as client, family as context, family as barrier, family as caring process, family as resource) 2. Review the power point: Family Nursing Background and Understandings. Reflect on nursing practice that views family as the unit of care and nursing practice that views family as contextual to the individual patient. Do you believe that current nursing practice most often views family as the unit of care or family as a context to the situation? How do these two views differ. 3. Develop 5 questions focusing on one of Denham’s Core Processes.  Interview a client in your workplace or within your community and describe their answers to your questions.  Identify family routines and factors related to family health routines. 4. From the Khalili article, what were the most significant aspects of the illness transition for the family? What resources did the family need/want? What were the barriers and facilitators to obtaining the needed resources or supports? What may have changed in the care situation for the family if the family would have been viewed as the unit of care? 5. Using one of the family theories/frameworks described in the literature reflect on an illness experience in a family. (You can reflect on a family you have cared for in your nursing practice.) Consider how family structure, function, and process influenced the family health experience and outcomes. Analyze the experience from a family theory/framework perspective. 6. Use your reading on a One Question Question by Duhamel et al (2009) to practice this questioning strategy with a family. Share your reflections and outcome.http://jfn.sagepub.com/ Journal of Family Nursing http://jfn.sagepub.com/content/15/4/461 The online version of this article can be found at: DOI: 10.1177/1074840709350606 2009 15: 461Journal of Family Nursing Fabie Duhamel, France Dupuis and Lorraine Wright Nursing Reflections for Clinical Practice, Education, and Research in Family Families and Nurses Responses to the One Question Question: Published by: http://www.sagepublications.com can be found at:Journal of Family NursingAdditional services and information for http://jfn.sagepub.com/cgi/alertsEmail Alerts: http://jfn.sagepub.com/subscriptionsSubscriptions: http://www.sagepub.com/journalsReprints.navReprints: http://www.sagepub.com/journalsPermissions.navPermissions: http://jfn.sagepub.com/content/15/4/461.refs.htmlCitations: What is This? - Oct 26, 2009Version of Record >> at MINNESOTA STATE UNIV MANKATO on August 6, 2013jfn.sagepub.comDownloaded from http://jfn.sagepub.com/ http://jfn.sagepub.com/content/15/4/461 http://www.sagepublications.com http://jfn.sagepub.com/cgi/alerts http://jfn.sagepub.com/subscriptions http://www.sagepub.com/journalsReprints.nav http://www.sagepub.com/journalsPermissions.nav http://jfn.sagepub.com/content/15/4/461.refs.html http://jfn.sagepub.com/content/15/4/461.full.pdf http://online.sagepub.com/site/sphelp/vorhelp.xhtml http://jfn.sagepub.com/ Journal of Family Nursing 15(4) 461 –485 © The Author(s) 2009 Reprints and permission: http://www. sagepub.com/journalsPermissions.nav DOI: 10.1177/1074840709350606 http://jfn.sagepub.com Families’ and Nurses’ Responses to the “One Question Question”: Reflections for Clinical Practice, Education, and Research in Family Nursing Fabie Duhamel, RN, PhD,1 France Dupuis, RN, PhD,1 and Lorraine Wright, RN, PhD2 Abstract The “One Question Question,” first coined by Dr. Lorraine M. Wright in 1989, is an interventive question designed to elicit family members’ most pressing needs or concerns within the context of a therapeutic conversation. In this article, two clinical projects analyzed the responses to this unique interventive question. The first project analyzed the responses of 192 family members experiencing illness who were asked the question in the context of a therapeutic conversation; families focused on their need to deal with the impact of the illness on the family. The second project examined responses of 297 nurses who were asked the question prior to a 1-week Family Systems Nursing training program; nurses wanted to know how to deal with conflictual relationships between families and health care professionals and how to offer families time-efficient interventions. The responses from both 1University of Montreal, Montreal, Quebec, Canada 2University of Calgary, Calgary, Alberta, Canada Corresponding Author: Fabie Duhamel, Faculty of Nursing, University of Montreal, C.P. 6128, Succursale Centre-vilFamily Nursing : Background and Understandings Sandra K. Eggenberger, RN, PhD Professor School of Nursing MSUM Family Health Care Nursing Art and Science Way of Thinking about Family and Working with Family Philosophy and a Practice (Harmon Hanson, 2005) Family Nursing Scientific Discipline Based on Theory Specialty Growing Body of Knowledge Building Family Nursing Science Through Research Developing and Testing Theories that Improve Nursing and Family Interactions in Health and Illness Supporting Practice and Influencing Social Policy (Harmon Hanson, 2005) Origins of Family Nursing Prehistoric Times (Harmon, Hanson & Boyd, 1996) Caring for Ill Individuals that were bonded to others Florence Nightingale (Eggenberger, 2005) Efforts to care for families of soldiers who returned from Crimean War Depression and World War II Nursing Practice moved from Homes to Hospitals during depression and World War II Family Nursing Hospital development caused families to be excluded and nursing care became individual focused In 1950’s critical care areas developed and became more technologically and medically-oriented with a limited attention to family needs Family in adult illness is often viewed as contextual to individual needs (Eggenberger, 2005) Family nursing scholars developing and building a body of knowledge in recent years BUT in infancy stages of development Family theory is in early stages of development (Baumann, 2000) Concerns Research describes deficiencies in family nursing care with illness (Chesla & Stannard, 1997; Gilliss & Knafl, 1999; Hupcey, 1998; Soderstrom, Benzein, & Saveman, 2003 ) Few nurse educators skilled in family care contributes to lack of knowledge Lack of nursing theory of family contributes to lack of nursing interventions (Craft & Willadsen, 1992) Very few nursing interventions tested so limited evidence-based family care (Chesla, 1996) Professional Organization beginning to further address Family International Council of Nurses published The Family Nurse: Frameworks for Practice (2001) American Association of Critical Care Nurses (2002) address family care American Association of Emergency Room Nurses position statement on family presence during invasive procedures (2001) Major Historical Contributors to Family Theory and Models Family Social Science Theories Family Therapy Theories Family Nursing Theories Family Theories Family Systems Concepts View system as a whole-rather than parts Relationships of sub and supra system Example: patient (sub) nurse (supra) Interdependence and Mutual influence Interaction among themselves and environment Symbolic Interactionism Shared meanings – humans/families act on the basis of the meanings that things have Meanings arise is the process of interaction between them Interpretation process modifies meaning Interactions is central to this theory Human EcologiAXON • Volume 28, Issue 3 • Spring 2007 5 Abstract Although primary malignant brain tumours represent only 1.4\% of all cancers, it is considered one of the most devastat- ing types of cancers in adults. From the time of diagnosis, the patient and family embark on a “roller coaster” ride of uncertainty, fear and hope. Despite improved medical out- comes, patients often experience severe functional impair- ment, as well as behavioural and cognitive dysfunction. Subsequently, they suffer from greater dependency and hope- lessness than other cancer patients. The family caregivers are faced with multiple demands such as taking on new roles within the family and caring for their loved one while griev- ing the loss of the person they knew. The role of the nurse is to support the patient and the family throughout the illness trajectory, identify and promote their strengths and mobilize the necessary resources to facilitate patient and family cop- ing. The purpose of this paper is to present, via a detailed case study, the impact of a malignant brain tumour on the patient and the family. The nursing strategies used to help them make the necessary transitions throughout the illness trajectory are discussed. Introduction The impact that brain tumours have on patients’ function, quality of life and the lives of their families is tremendous. This impact continues today with recent studies indicating that only 18\% of patients with primary brain tumours were able to return to work as a consequence of their ongoing symptoms (Armstrong, 2004). The incidence of primary tumours in the United States is 14 per 100,000 with a slight- ly higher incidence in males than in females (Doolittle, 2004). Although primary malignant brain tumours represent only 1.4\% of all cancers diagnosed in the United States (Armstrong, 2004), they are one of the most aggressive can- cers to treat and most challenging for patients and their fam- ily members (Graham & Cloughesy, 2004). More than half of the 18,400 primary malignant brain tumours diagnosed each year in the United States are malignant gliomas that not only confer high risk for death and severe disability, but also threaten to steal what is held so highly as the essence of human life: the mind and spirit (Fisher & Buffler, 2005). Gliomas are the most common form of primary brain tumours in adults and they occur most frequently in persons aged 45 to 55 years (Fisher & Buffler, 2005). Amongst the gliomas, glioblastoma multiforme (GBM) is the most com- mon and most malignant type of tumour. The treatment of malignant gliomas has traditionally been maximal resection of the tumour, if feasible, followed by radiation therapy and adjuvant chemotherapy (Fisher & Buffler, 2005). Despite these treatments, however, the median survival is less than one year from time of diagnosis and, even in the most favourable situations, most patients die within two years (DeAngelis, 2001; Gupta & Sarin, 2002). More recently, there is great optimism a