NURSES AND FAMILIES. A Guide to Family Assessment and Intervention

To add to the small, but growing, number of literature reviews of family interventions in health care, a systematic literature search of Family Systems Nursing intervention research resulted in the inclusion of 17 empirical research reports. Family Systems Nursing intervention research to date has primarily used qualitative methods and a few quasi-experimental designs using pre-post outcome measures. Families' responses to Family Systems Nursing interventions were categorized in this integrative review using the cognitive, affective, and behavioral domains of family functioning proposed by Wright and Leahey. Family response in the cognitive domain found improved understanding, capability, and enhanced coping. The affective response categories showed caring more about each other and the family, improved family emotional well-being, and improved individual emotional well-being. Finally, family responses in the behavioral domain comprised caring more for each other and the family, improvement in interactions within and outside family, and healthier individual behavior. These findings may guide the design of future family nursing intervention research and the selection of family outcome measures to examine the usefulness of Family Systems Nursing interventions. More intervention research using experimental and quasi-experimental designs is needed to strengthen the evidence for Family Systems Nursing practice.

Examining Family Responses to Family Systems Nursing Interventions: An Integrative Review

Para los profesionales de enfermeria, la muerte es la mayor villana de su trabajo, una vez que, de manera general, son educados para cuidar solamente de la vida. El objetivo de este estudio es investigar como los profesionales de enfermeria vivencian el luto frente a la muerte de ninos/adolescentes hospitalizados. Asi, fue utilizada una investigacion descriptiva exploratoria con abordaje cualitativo. La recoleccion de datos fue realizada a traves de entrevistas con profesionales de enfermeria que trabajan en clinicas con camas pediatricas en un hospital escuela. Los datos empiricos evidenciaron que esos profesionales necesitan de soporte emocional para experimentar el luto y prevenirse del Sindrome de Burnout. Recomendamos que el tema muerte sea incluido en los curriculos y que las instituciones hospitalarias busquen la educacion permanente como estrategia para promover cambios de actitudes y comportamientos de los profesionales ante el paciente que esta muriendo.

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Luto del equipo: revelaciones de los profesionales de enfermería sobre el cuidado a niños/adolescentes en el proceso de muerte y morir

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Medical Nemesis The Expropriation Of Health

In this article we present an overview of the publication about the health care in the family context. We developed a bibliographical research taking as source the following databases: SciELO, MEDLINE and Lilacs using the keywords: health care and family caregivers considering the period from 1995 through 2007. We realized that there are few studies on the subject and some of them are quite superficial in their approach. Our focus was directed to the understanding of: types of methodologies applied; theoretical approach; "care" concepts; analysis of culture and social class; references to networking; gender considerations and finally consensus and gaps in the studies. The results show that most of the studies assume a qualitative methodology compatible with the high complexity level of the studied subject and theoretical approaches of comprehensive character exploring meanings and conceptions. The discussion of the role of culture, social class distinctions and gender relations in the production and sourcing of health care arise once in a while but without the proper depth. The importance of the role of woman-mother in producing and providing health care is generally disregarded of criticism. We noticed a trend to use broader health care concepts that synthesize material, affective and social aspects, although without a discussion in a concrete way.

https://www.scielosp.org/pdf/csc/2010.v15suppl1/1497-1508/pt

Produção de conhecimento sobre cuidados da saúde no âmbito da família

This qualitative study aimed to apprehend the meaning of adolescents’ pregnancy for their families, using semistructured interviews and collective subject discourse. Adolescent pregnancy is represented as a problem to be faced with family support. The families worry and are mobilized to solve adversities. Besides the shock about the news, impotence as to pregnancy prevention, conformism, happiness and improvement in family relationships due to the baby’s arrival, participants evidenced frustration due to the interruption/change in the family life project in terms of the adolescent being pregnant without a stable relationship with the child’s father. In valuing the family perspective on adolescent pregnancy, professional care to pregnant adolescents and their families can be delivered in partnership with the family and social context, making it easier to cope with conflicts and recognizing the family as an active subject in this process.

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A gravidez na adolescência sob a perspectiva dos familiares: compartilhando projetos de vida e cuidado

/pdf/el-embarazo-en-adolescencia-en-la-perspectiva-de-los-4bgagyovdo.pdf

El embarazo en adolescencia en la perspectiva de los familiares: compartiendo proyectos de vida y cuidado

Objective: This qualitative study intends to identify how a family system reacts before the situation of dependence of a senior family member, which resources it uses to maintain the stability and the nursing attendance made available in this context. Methods: The approach of the family systems was used as the theoretical reference, and action-research as the method. The data were collected in the period from November/2004 to January/2005, through the construction of a genogram, an ecomap and problem definition. Results: Main family demands: anticipated mourning, overload on the role of caregiver, lack of knowledge regarding the disease and family maladjustment before the crisis. Main interventions: motivating the family to speak openly about the illness, offering suggestions and information, praising the family strength and ensuring prompt service. Conclusions: With family attendance as the systemic focus, it was possible to propose

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Encontrando-se em casa: uma proposta de atendimento domiciliar para famílias de idosos dependentes*

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Encontrándose en casa: una propuesta de atención en el domicilio para las familias de ancianos dependientes

O objetivo deste estudo foi identificar o significado e as intervencoes de enfermeiros que atuam em oncologia pediatrica na promocao de morte digna da crianca. Utilizaram-se como referencial teorico e metodologico o interacionismo simbolico e a pesquisa de narrativa. Os dados foram coletados junto a oito enfermeiros de uma unidade de oncologia pediatrica de um hospital publico de Sao Paulo, por meio de entrevistas semiestruturadas. A analise dos dados permitiu a identificacao de cinco categorias: sentir-se sem autonomia para a tomada de decisao; cuidar da familia; oferecer conforto fisico; valorizar o cuidado humanizado e aprender a lidar com a morte e o morrer. Este estudo contribui para ampliar a compreensao do processo de cuidar e permite avancar na postulacao de um quadro teorico que contemple a integracao de saberes e acoes que constituem uma assistencia integral, transcendendo o atendimento de necessidades apenas clinicas e biologicas.

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Lucía Silva

Papers

A gravidez na adolescência sob a perspectiva dos familiares: compartilhando projetos de vida e cuidado

El embarazo en adolescencia en la perspectiva de los familiares: compartiendo proyectos de vida y cuidado

Encontrando-se em casa: uma proposta de atendimento domiciliar para famílias de idosos dependentes*

Encontrándose en casa: una propuesta de atención en el domicilio para las familias de ancianos dependientes

Morte digna da criança: percepção de enfermeiros de uma unidade de oncologia