NUR1 221 Lecture Notes - Lecture 7: Antihypertensive Drug, Social Learning Theory, Family Values
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Families: Values, Beliefs, Spirituality, Decision-Making
During morning report, the nurse completing the night shift stated that NT’s BP was 199/ 105 and the patient
refused to take the anti-hypertensive medication but he didn’t say why.
You are assigned to this patient – you know that NT is 43 years old, originally from Rwanda and lives in Montreal x 4
months. She was diagnosed with HIV/AIDs in 2008. She was raped and her 2 brothers and in-laws were killed during
the Tutsi and Hutu genocides in 1994.
She is married x 17 years to BU, mother to 2 children ages 11 and 9.
BU immigrated first to Canada in 2008- worked “under the table” and sponsored his family to come to Canada . He
is working as a volunteer at the YMCA and will attend U of M Social Work program in the fall.
NT has strong faith, goes to church every Sunday and is a homemaker while waiting for her work permit.
The family lives on welfare.
Factors Influencing Family Behaviours
Family value system
o “Value is an enduring belief that a specific mode of conduct or outcome…is …preferable to the opposite…”
o Values serve as guides to action and guides to behaviour and are enduring.
o Within the family, values guide the development of family beliefs, norms or rules.
o Values are not static, and hierarchical – some more central to family lifestyle and daily functioning.
o Value – relative worth, merit or importance.
o Examples – cleanliness, freedom, education, privacy, hard work
o “beliefs are the lenses through which we view the world”
o Confidence in the truth or existence of something which is not immediately available for rigorous testing.
o Belief systems organize family functions, tasks and how to approach a crisis situation or normative
o Beliefs have social and cultural roots. Different cultures have strong beliefs about illness, cause and
o Past experiences have effect on beliefs.
o Families generally have strongly held beliefs about spirituality and religion
o Influence on beliefs (Social Learning Theory)
How much an individual believes they can influence or control health through own action – self
Internal locus of control – take initiative for health care, seek information – may be associated with
higher self-esteem, purpose in life, sense of well-being, self-reliance.
External locus of control- health is controlled by outside forces – influence on response to illness,
Sense of coherence – search for understanding of problem, confidence in ability to manage the
problem, stressors viewed as challenges- fosters healthy adaptation to unexpected or chance
events, family feels grounded, family learns may coping and self-regulation strategies.
The notion of controlling an illness is intertwined with the belief about what needs to be healed.
What are person’s beliefs about healing?
Presenting options about how to manage illness is itself one way of increasing individual control.
o Investment in internal values that bring a sense of meaning, inner wholeness & connection with others.
o May involve a set of values towards which one is striving; belief in a supreme power; oneness with nature
and the universe.
o Spirituality and religion are understood as distinct from one another but interconnected.
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