2. This involves
selection of
appropriate
nursing
interventions
based on the
formulated goals
and objectives.
3.
4. Home visit
Clinic conference
Visit in the work place
EXAMPLES OF RESOURCES
A. MATERIAL
Supplies
Equipment
Teaching aids
5. B. HUMAN
Other health team members
Development workers
Community leaders
6. 1. Analyze with the family the current
situation and determine choices and
possibilities based on a lived experience
of meanings and concerns.
2. Develop/enhance family’s
competencies as thinker, doer and
feeler.
7. 3. Focus on interventions to help perform the
health tasks.
4. Catalyze behaviour change through
motivation and support.
8. The appropriateness of the nursing
intervention is, therefore, DEPENDENT
UPON THE LIVED MEANING OF THE
EXPERIENCES OF FAMILY MEMBERS
WITH EACH OTHER AND WITH THE
NURSE, given the current situation and
possibilities in health and illness realities.
9. Nurse is given a choice of
possibilities that helps her and the
family gain a clearer understanding
of the self as a THINKER, DOER and
a FEELER.
10. Developing and maximizing the skills
and communication competencies of
the family as DOER enhance confidence
in carrying out the needed interventions
to initiate and sustain change for:
a.) health promotion and maintenance
b.) accurate disease/problem
management.
11. As a FEELER:
-affective competencies- be
developed
-to acknowledge &
understand motions generated
by family life or health-illness
situations *
12. *This positive
ability may provide
respite and offer
perspective during a
time of negative
feelings such as fear
and anxiety.
13. The nurse needs to focus her choice
of interventions on helping the
family minimize or eliminate the
possible reasons for or causes of
the family’s inability to the health
tasks:
14. 1. HELP THE FAMILY RECOGNIZE THE
PROBLEM.
Examples of interventions:
Increasing the family’s knowledge on
the nature, magnitude and cause of the
problem.*
Helping the family see the implications
of the situation, or the consequences of
the condition.*
15. Encouraging positive or
wholesome emotional attitude
toward the problem by affirming
the family’s
capabilities/qualities/resources
and providing information on
available options.
16. 2. GUIDE THE FAMILY ON HOW TO DECIDE
ON APPROPRIATE HEALTH ACTIONS TO
TAKE.
This can be done through:
a.) identifying or exploring with
the family
- courses of action available and the
needed resources for each.*
17. b.) discussing the
consequences of each course
of action available
c.) analyzing with the
family the consequences of
inaction.
18. 3. DEVELOP THE FAMILY’S ABILITY AND
COMMITMENT TO PROVIDE NURSING
CARE TO ITS MEMBERS.
Nurse can increase the family’s confidence
- to provide nursing care through
demonstration and practice sessions on
procedures, treatments or technique
utilizing readily available, low-cost
materials and equipment and other
resources*
19. CONTRACTING
- Is creative intervention that can maximize
opportunities to develop the ability and
commitment of the family to provide nursing
care to its members.
- It is an intervention whereby the nurse
creates a situation in order that the client
learns to achieve a health-related behaviour.*
20. -
- Contracting provides a systematic
method of increasing desirable
client behaviour through the use
of the PRINCIPLE OF POSITIVE
REINFORCEMENT.
21. - In order to make this intervention effective,
the necessary elements of the desired
behaviour must be MADE EXPLICIT AND
MUST BE WRITTEN IN THE FORM OF AN
AGREEMENT.
- To make the behaviour consciously reinforced
it must be observable and measurable.
22. 4. ENHANCE THE CAPABILITY OF THE
FAMILY TO PROVIDE A HOME
ENVIRONMENT CONDUCIVE TO HEALTH
MAINTENANCE AND PERSONAL
DEVELOPMENT.
The family can be taught specific competencies to
ensure such a home environment through:
Environmental modification
Manipulation or management to minimize or
eliminate health threats or risks
Install facilities for nursing care
23. 5. FACILITATE THE FAMILY’S CAPABILITY TO
UTILIZE COMMUNITY RESOURCES FOR
HEALTH CARE
- involves maximum use of available
resources through the COORDINATION,
COLLABORATION AND TEAM WORK
provided by an effective referral system.
- Easy access to available health and socio-
economic resources starts with
maintaining an updated file that lists such
resources, their addresses or telephone
numbers and specific services offered.
24. A sample format of the file or index of
community resources
Name of Office and email Type of client and Requirem
agency and addresses/telephone specific ents/proc
person to number services/schedule edures for
contact referral
25. A TWO-WAY REFERRAL SYSTEM can
facilitate mobilization of resources for
families.
An effective two-way referral system
ensures: a. monitoring of the case, problem
or situation
follow-up of required interventions, case or
services
evaluation of the client’s status or family’s
problem/situation.
26. To bring about self-directed change, people
must learn to learn from their experiences.
In order to help people lower their defenses
and allow themselves to experience the
needed change, it is necessary to have a
learning environment that
nurtures the change.
27. The change agent can help the client put to
maximum use valid knowledge through
concern for:
a.) Human needs or the “use-value” of a given
piece of knowledge
b.) security, trust, self-esteem, self-identity,
group esteem and group identity
c. Accurate and appropriate preparation and
transmission of messages
28. To catalyze the change, SUPPORT
IS NEEDED*
In family health nursing practice,
the family as a system needs
OPTIMUM REALITY-ORIENTATION
in its adaptation to its changing
internal and external environment.
29. To catalyze the behaviour
change towards problem-solving
competencies , a THEORY OF
FAMILY HEALTH NURSING
INTERVENTION was developed
by Maglaya.
30. COMPONENTS
Motivation
Support
MOTIVATION
- As conceptualized the intervention theory is any
experience or information that leads the family
to desire and agree to undergo the behaviour
change or proposed measure and take the initial
action to bring about the change.
31. SUPPORT
- As an intervention
- any experience or information that:
a. maintains, restores or enhances the
capabilities
b. resources of the family complete the
change process.
The intervention leads the family to feel
“secured” or “ in control of the situation*
32. Was adapted using the
motivation-support intervention.
Families were guided through the
behaviour change process:
1.Constructing the intention to
initiate/sustain the change
33. 2. Translating the intention inot actions,
and
3. To integrate the actions/change into
existing lifestyle
CRITERIA FOR SELECTING THE TYPE OF
NURSE-FAMILY CONTACT
1. Effectivity
2. Efficiency
3. Appropriateness
34. Is an effective and appropriate type of
nurse-patient contact if the objectives and
outcomes of care require accurate
appraisal of family relationships, home
and environment, and family
competencies.
Expensive in terms of time, effort and
logistics for the nurse
35. Less expensive
Provides opportunity to use equipment
that cannot be taken to the home
Other team members in the clinic may be
consulted or called in to provide additional
service
Emphasizes to the family the importance
of empowerment and assuming
responsibility for self-help.
36. May be effective, efficient and appropriate if :
-objectives and outcomes of care require immediate
access to data, given problems on distance or travel
time
Data include monitoring of health status or progress
during:
- acute phase of an illness state
- change in schedule of visit or family decision,
- updates on outcomes or responses to care or
treatment.
37. less time-consuming option for the nurse
a. when there are a large number of families
needing follow-up : problems of distance
and travel time.
If the family is motivated enough and
independent enough- nurse can use the
advantage of placing responsibility for
action on the family, a letter, note and
learning materials are appropriate.
38. Health Family Goals Objectives Intervention Method Resources
Problem Nursing of of Care Measures Of Required
Care
problems Nurse
Family
Contact
Notas do Editor
When you move to the implementation process, you face a lot of challenges which may somehow make you frustrated, to the extent of inaction or may encourage you to try new, creative ways….in this process, it takes a lot of time, of effort, patience for you to carry out effectively the plans you have set… Since there will be a lot of interaction between you and the family membrs, this is the time where you come to know a lot of perceptions, ideas, emotions, concerns towards the family. So what is important is a positive attitude, a dynamic mind and body…and an active and dynamic involvement of both parties: the family and you as their student nurse. The nursing care plan focuses on actions which are designed to solve or minimize existing problem. The plan is a blueprint for action. The core of the plan are the approaches, strategies, activities, methods and materials which the nurse hopes will improve the problem situation. The nursing care plan is based upon identified health and nursing problems. The problems are the starting points for the plan, and the foci of the objectives of care and intervention measures. The nursing care plan is a means to an end, not an end in itself. The goal in planning is to deliver the most appropriate care to the client by eliminating barriers to family health development. Nursing care planning is a continuous process, not a one-shot-deal. The results of the evaluation of the plan’s effectiveness trigger another cycle of the planning process until the health and nursing problems are eliminated.
………… must be specified in the plan to ensure that necessary preparations, coordination and collaboration are done before the implementation phase. …
methods of nusring family contact: home visits, visit in the workplace, school visit, telephone call, group approach like health classes ……… .reasons- material; supplies, equipment, teachings aids (visual materials, hand outs, charts) -
Appropriateness of the intervention- dependent on the lived experience of family members with each other.. So as what I always reiterate, the active participants are the nurse and the family members…if one of these people fail to do their part, the whole process will put to waste and the goals will not be materialized. Both need to explore, analyze and understand the current health/illness situation as the family experiences it. Hence, there should be what? DYNAMIC,ACTIVE, MutuaL INTERCHANGE OF REALITIES, CONCERS AND RESOURCES----IN OTHER WORDS, MAGTINABANGA
With goal in number 1, as to the lived experience and the appropriateness of the interventions, the nurse has a lot of….CHOICES! These choices will help us understnd the family as a system and its individulaity of the members. As a THINKER: nursing interventions should enhance this competency- outcome: make data readily available and accessible – to understand better the current situations … you make them good or critical thinkers- how? First- identify level of understanding (ask questions to assess if they do undrstand the illness, the causes, from that, make them undertand, and teach them how to solve the given problem, prevention so that the next time around they encounter parallel problems, they know (as good thinker) what to do…. Both need to explore, analyze and understand the current health/illness situation as the family experiences it.
AS doer: nurse must devlop – you help the communication and skills in carrying out the interventions: when you instruct the patient or refer to the hospital, you accompany her first and explain the things she must do- she must communicate clrealy with the physicians,, verbalize the signs and symptoms, how they develop… you intrsuct her as you explore this intervention together…so that the next time she needs to do this, she has the courage and idea what to do, what to say, how to say it… Relate to A and B
… like fear, anger, anxiety, jelousy, guilt…. In other words, pagbati bati…because it is by feeling and recognizing that you feel it that you accept the existing emotion, by that you find ways on how to manage such emotions…prevent further problems, right? After that, there will be growth promoting choices and actions coz you don’t have grudges against othr family member…work relations are better…
The ability of understanding the meanings of our feelings, we can gain the skill to rehearse and rturn to positive felings…you get over it…and be back to the positive feelings of joy, contenment and comfort… Okay, cry ko karon kay sakit kau but after this move on…I have choices…to be happy or not, which is better?
Nature of the problem…is it a health threat, deficit, forseeeable crisis… If dili mareapir and broken stairs, what will happen? … .3 rd one is Relating healt
Example: what the family can do…available resources…..the stairs are broken, faulty eating habits?
Consequence or benefits: if not to repair the stairs or to repair it
What are the available resources…outside the house… Relate sa reapir of stairs Scabies-use of kalatsusi- how to prepare and apply….
Contract_ agreement…..to make this intervention efffective- the necessary elemnts … .. through a sequentially arranged explicit steps and conditions or elements jointly identified by both parties
This behaviour uses reinforcement contracts on a variety of health-related behaviour requiring complex behavioural changes such as: adherence to diet, medications and other treatment regimens to maintain desirable laboratory values, lose weight, and control blood pressure.
People-learned to defend against potential lessons of the experience- when thse threaten potential equilibria…
so that an otherwise insecure, threatened or anxious client who is faced with the stresses of the change process can experience stability to sustain actions and complete the behaviour change. … .. This is done by DEVELOPING AND INSTITUTIONALIZING its own PROBLEM-SOLVING STRUCTURES AND PROCESSES through the performance of the family health tasks.
…… “ in the face of the uncertainties, stresses, blocks or barriers to the solution of the health condition or problem or threats to self-esteem and affection or danger to life. Example with mother whose child has diarrhea…nurse…teach mother : the cyclical relatinship of the diarrhea and malnutrition Cause of diarrhea during oral feeding To develop competency as doer: Teach mother how to administer ORAL rehydration slowly Demonstrate to mother how to prepare easily digested rice with chon like powdered beans, toastd dry small fish What are the support of the nurse to mother? Physical and psychological availabily and accesibilty