TABLE OF CONTENTS. CHAPTER 1 Health Care Needs for the 21st Century 1. CHAPTER 2 Moving to Family-Focused Care 25

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1 TABLE OF CONTENTS CHAPTER 1 Health Care Needs for the 21st Century 1 Introduction 1 Understanding Global Trends and Their Health Effects 2 Global Infectious Disease Threats 5 The Global Economy, Globalization, and Health Care 6 Global Changes in Demographics 8 Health Care Trend Influences on Practice 12 Recognizing Family and Community Links in Care 16 Coordinated Care: An Important Family Role 16 Chapter Summary 20 CHAPTER 2 Moving to Family-Focused Care 25 Introduction 25 Understanding Family Health Terminology 25 Thinking Family 28 Models for Understanding Family 32 Moving Toward Family-Focused Care 38 Realizing Family-Focused Care 43 Chapter Summary 46 CHAPTER 3 Thinking Family to Guide Actions 49 Introduction 49 Differentiating Among Health and Illness Perspectives 49 Think Family and Improve Societal Health 53 Needs of a Nation s Families 57 Family Content in Education 60 Approaches to Family Care 62 Chapter Summary 69 CHAPTER 4 Communication With and About Families 73 Introduction 73 Providing Effective Communication 74 Communication and Practice 76 Communication: A Basic Tool for Exchanging Information 79 Theoretical Perspectives of Communication 87 Relationship-Focused Communication 90 Complex Communication in Family-Focused Care 93 Developing Relationship-Based Care 95 xi

2 xii Table of Contents Creating Therapeutic Conversations 99 Chapter Summary 100 CHAPTER 5 Family Assessment 107 Introduction 107 Process 108 Moving From an Individual to a Family Assessment 109 Completing a Family Assessment 114 Moving From Family to Community Assessment 124 Tools to Guide Assessment 128 Chapter Summary 137 CHAPTER 6 Cultural and Diversity Aspects of Health and Illness Care Needs 141 Introduction 141 Cultural Distinctiveness 142 Using a Family Lens to Understand Cultural Diversity 143 Cultural Competence in the Delivery of Family Care 148 An Increasingly Diverse World 153 The Power of Family Stories for Learning About Cultural Needs 157 Culture and Communication Barriers 161 Chapter Summary 163 CHAPTER 7 Using Family Theory to Guide Practice 165 Introduction 165 Family Theories: What They Are and How They Help 166 Usefulness of Family Theories and Models 167 Family Theories and Models 168 Major Realms of Family Science Important for Family-Focused Care 172 Chapter Summary 191 CHAPTER 8 Developing a Family-Focused Practice 195 Introduction 195 Family-Focused Care 196 Steps in Delivering Family Care 202 Family Practice and Assessment Processes 205 Additional Family Assessment Tools 209 Family Practice Models 211 Chapter Summary 220 CHAPTER 9 Family and Nurse Presence in Family-Focused Care 223 Introduction 223 The Concept of Presence 225

3 Table of Contents xiii Family Research Team: Family Transitions and Illness Experiences 231 Family Caring Strategies 232 Family Connecting, Relating, Pondering, and Struggling 236 Living Within the Context of Chronic Illness 238 Visual Interpretations Evoke Family Emotions 240 Transforming Health Care Systems to Embrace Family and Nurse Presence 244 Chapter Summary 246 CHAPTER 10 Family-Focused Care in Acute Settings 253 Introduction 253 Acute Care Settings 254 Family Illness Experience During a Family Member s Acute Illness 254 Ecological Perspective of the Family Acute illness Experience 261 Practice in Acute Care Settings 262 Case Study Phase I: Introduction 265 Case Study Phase II: Acute Illness Requires Hospitalization 267 Case Study Phase III: Family Assessment and Communication 269 Case Study Phase IV: Stress, Uncertainty, and Suffering in Deteriorating Condition 270 Case Study Phase V: Family Presence During a Serious Illness 272 Case Study Phase VI: Information Exchange and Family Conflicts 275 Case Study Phase VII: Transfers in Acute Care Settings and Discharge to Home 276 Delivery of Family-Focused Care: Environmental Factors in Acute Care Setting 278 Moving Family-Focused Care in Acute Care Settings Forward 278 Chapter Summary 284 CHAPTER 11 Family-Focused Care and Chronic Illness 293 Introduction 293 Defining Chronic Illness and the Associated Needs 294 Management of Chronic Conditions 296 Chronic Conditions and Family Care 298 Diagnosis 302 Importance of School for Children With Chronic Conditions 305 Family Functioning With a Chronically Ill Member 306 Obstructed Routines of Families With Chronically Ill Members 308 Family Stress and Uncertainty With Chronic Conditions 310 Hearing the Story 313 Overcoming Barriers During Chronic Illness 316 Caring for the Caregivers of Those With a Chronic Illness 318 Chapter Summary 319 Chapter Recognitions 319 CHAPTER 12 Family-Focused Care to Meet Population Needs 325 Introduction 325 A Brief History of Population Health in the United States 326 Infrastructure Elements and Environmental Health 328 Population Health Perspectives 329

4 xiv Table of Contents Fairness in the Distribution of Goods and Services 330 Population-Based Health Actions 332 Vulnerable Populations and Family Health 336 Public and Family Health 337 Theoretical Frameworks for Family and Societal Health Care 339 The Role of the Government in Population Health and Its Financing 340 Health Policy Development and Nurses Roles 344 Chapter Summary 345 CHAPTER 13 Doing For Versus Being With 351 Introduction 351 Understanding the Concepts 352 The Practice of Doing For and Being With 355 Ways of Caring 357 Barriers to Caring and Nurse-Family Relationships 360 Doing For and Being With Means Knowing Oneself 366 Taking Care of Oneself 368 Chapter Summary 371 CHAPTER 14 Family-Focused Actions 375 Introduction 375 Family-Focused Actions 376 Core Family Processes 378 Intentional Actions to Guide Core Family Processes 380 Core Processes and Family Meetings 400 Chapter Summary 403 CHAPTER 15 Teaching Family Members Supportive Care 409 Introduction 409 Care and Supportive Actions 410 Types of Support 413 Purposes of Support 419 Nurses Roles in Family Support 422 Meeting Family Support Needs 425 Helping Families Manage Care Needs 431 Supports for Family Nurses 437 Chapter Summary 438

5 CONTRIBUTORS Kathryn Hoehn Anderson, PhD, RN, ARNP, LMFT Professor Georgia Southern University Statesboro, GA Sue Ellen Bell, PhD, RN, PHCNS-BC Professor, Graduate Programs Coordinator Mary Bliesmer, DNSc, RN Emerita Professor, School of Angela Christian, DNP, RNC Clinical Practice and Education Specialist Allina Health, Minneapolis, MN Jennifer M. Demma, MSN, RN, CNM Clinical Faculty Director Nurse-Midwifery/Women's Health Nurse Practitioner Program Georgetown University, Washington, DC Hans-Peter de Ruiter, PhD, RN Patricia Earle, PhD, RN Professor Emerita Julia Hebenstreit, EdD, RN, CNE, School of Chairperson Marianne Kriegl, RN, Mag. phil. Professor, Dean, Department Health Sciences Programme Director, Advanced Practice University of Applied Sciences, Krems Krems, Austria Kelly Ann Krumwiede, PhD, RN, PHN Susan Lampe, MS, RN Nancyruth Leibold, EdD, RN, PHN, LSN Linda L. Lindeke, PhD, RN, CNP, FAAN University of Minnesota, School of Pediatric Nurse Practitioner, NICU Follow-up Program University of Minnesota, Masonic Children s Program Minneapolis, MN Wendy Sue Looman, PhD, RN, PNP University of Minnesota, School of Minneapolis, MN Sonja J. Meiers, PhD, RN Professor and Director, Graduate Programs in Winona State University, Rochester Rochester, MN xvii

6 xviii Contributors Colleen Royle, EdD, RN, Learning Resource Center, Simulation Coordinator Joachim Schulze, RN, Dipl. - Pflegewirt FH Professor, Programme Director General University of Applied Sciences, Krems Krems, Austria Marcia S. Stevens, PhD, RN Professor Stacey Van Gelderen, DNP, RN Laura Marie Schwarz, DNP, RN, CNE

7 REVIEWERS Laura Blank, RN, MSN, CNE Assistant Clinical Professor Northern Arizona University Flagstaff, AZ Shannon Burton, MS, APRN (Clinical) University of Utah College of Salt Lake City, UT Barbara M. Carranti, MS, RN Clinical, Department of Le Moyne College Syracuse, NY Maryanne Davidson, DNSc, APRN, CPNP Southern Connecticut State University New Haven, CT Laura Dulski, RNC-HROB, CNE, MSN Resurrection University Chicago, IL Kay Foland, PhD, RN, PMHNP-BC, PMHCNS-BC, CNP Professor South Dakota State University College of Rapid City, SD Patricia Frohock Hanes, PhD, MSN, MAED, RN, CNE Azusa Pacific University School of Azusa, CA Brenda L. Hage, PhD, CRNP, Director of Graduate Programs Misericordia University Dallas, PA Susan Haussler, EdD, RN, CNE, Retired University of Massachusetts, Boston Boston, MA Deborah S. Janssen, MS, RN Capital University Department of Columbus, OH Lee-Ellen Charlotte Kirkhorn, PhD, RN Professor of University of Wisconsin Eau Claire Eau Claire, WI Heather Meyerhoff, RN, MSN, Trinity Western University Langley, British Columbia, Canada Treva V. Reed, BScN, MSN, PhD Professor of Collaborative BScN Program Canadore College/Nipissing University North Bay, Ontario, Canada Dawn Rigney, PhD, RN University of Virginia Charlottesville, VA xix

8 xx Reviewers Joy Shewchuk, RN, BSc, BSN, MSN Professor, Humber College Toronto, Ontario, Canada Vita Wolinsky, RN, BS, MA, CNS:BC of Dominican College Orangeburg, NY Linda D. Wagner, EdD, MSN, RN Professor, Chairperson, Department of Central Connecticut State University New Britain, CT