Family Dynamics (Nursing)

00:01 Hi, today we are gonna be talking about Family Dynamics.

00:05 My Name is Jill Beavers-Kirby.

00:08 So what do we wanna access in Family Dynamics? We will access the emotional changes, behavioral changes, the family's vulnerability, changes in body image and self image, the impact on the family and nursing diagnosis.

00:25 So what are some of the possible emotional changes? The family needs to support each other.

00:31 They support each other by listening to tone and attitude towards one another.

00:37 But nurse will need to watch for these behaviors.

00:41 They need to be empathetic with one another.

00:44 They need to be able to reach out to one another.

00:47 The nurse needs to observe all of these issues in a family dynamics.

00:52 How are the family members communicating with each other? What is the family's coping mechanism? Are they stand by the bedside 24 hours a day? Are they going out and drinking too much or have other restless behaviors? What are some of the behavioral changes? Well, with an acute illness, on that is short term.

01:12 The changes may be short term.

01:14 These changes may be lack of energy or lack of patience.

01:19 They get tired of being sick and tired.

01:21 With the chronic illness, the family must attain a new base line of functioning.

01:27 This can be difficult for many families.

01:30 Chronic illness may be seen as a loss.

01:34 So if you are chronically ill from emphysema you may see your loss of respiratory function as a hindrance.

01:42 Changes in base line functioning will affect the family members.

01:46 Terminal illness may cause short bouts of shock and anger, denial or withdrawal.

01:54 The family has to adjust to a new baseline this can be really tough for a lot of families.

01:59 They may experience anticipatory grieving.

02:02 The families may go through the entire 5 stages of grieving when they are coping with these chronic losses.

02:11 So family members may feel vulnerable during this time.

02:14 If the illness is hereditary family members may be worry that they are gonna have the same disease, the same trajectory.

02:21 The nurse needs to help family understand this.

02:25 This can be done by encouraging participation and group and/or family therapy.

02:30 Improving communication skills with your family, your healthcare providers and the nurse.

02:35 And identifying a good support system.

02:40 So what are some changes in image? Family reactions may vary depending on the type of change.

02:47 Is it the loss of a limb? Loss of an organ? Loss of functioning of part of a limb? The patient may go through stages of grieving.

02:56 What about the changes in soft image? This may be due to the patient's inability to take care of the family.

03:03 This will cause the family member's roles to change.

03:06 Whereas one family member is may have been the breadwinner, and now they aren't.

03:10 This may lead to depression, tension in the family or conflict in the family.

03:17 So how do all of these changes impact the family? The family may face changes in their roles and functioning.

03:25 For example, someone may become the breadwinner while the other person becomes the caregiver.

03:31 Family members will react differently to all of these role changes.

03:35 They may also experience economic problems and interruptions in their career development; because, they are not able to give 100% anymore.

03:44 So the nursing assessment will includes structure and function of the family.

03:49 Is this a traditional family? A blended family? Who is the head of household? Cultural aspects cannot be ignored.

03:59 Cultural understanding is essential for the family's assessment.

04:03 This will help the nurse understand the family's grief and expectations.

04:10 There are also psychosocial needs that need to be addressed.

04:14 What is the family's ability to cope with these changes? Does the family have appropriate goals in coping with these changes? Will they understand that somebody else may become the breadwinner or somebody else becomes the caregiver? And finally sample nursing diagnosis may include altered family process related to diagnose of terminal cancer of a family member.

04:39 Compromised family coping related to anticipatory grief.

04:45 And finally ineffective performance related to changes in the family's roles due to progressive physical feasibility.