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.