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Wright, L. & Leahy, M. (2009) article summary

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NUR1 221
Shari Gagne

Wright, L. & Leahy,M. (2009). The Calgary family assessthnt model. In Nurses and families: A guide to family assessment and intervention. (5 ed., pp. 47-91). Philadelphia: F.A. Davis 213 The Calgary Family Assessment Model (CFAM) is an integrated, multidimensional framework based on the foundations of systems, cybernectics, communication, and change theory and influenced by postmodernism and biology of cognition. It is recognize as one of the four leading family assessment models in the world. It has three major categories: SRUCTURAL, DEVELOPMENT, FUNCTIONAL, each of them has subcategories, and they dont need to be all assess depending on the FAMILY and depending on the POINT IN TIME, and because not all the questions are appropriate for every family. This diagram helps to conceptualize the three categories and its subcategories. It is important for the nurses to go back and forth to able to draw together all of the relevant information into an integrated assessment. It is important to recognize that a family assessment is based on the nurses personal and professional life experiences, beliefs, and relationships with those being interviewed. itshould not be considered as the truth about the family but rather one perspective at a particular point in time. The focus of this model is less on the individual but more on the INTERACTION among all the INDIVUDALS within the family. STRUCTURAL ASSESSMENT Who is the family, what is the connection among family members with those outside the family, and what is it the familys context. The structural assessment has the three aspects where each of them has their own subcategories: INTERNAL STRUCTURE, EXTERNAL STRUCTURE, and CONTEXT. INTERNAL STRUCTURAL ASSESSMENT Subcategories: Family composition, gender, sexual orientation, rank order, subsystems, boundaries. Family composition Family = a group of individuals who are bound by strong emotional ties, a sense of belonging, and a passion for the being involved in one anothers lives. Family is a system or unit, members may or may not be related and may or may not live together, the unit may or may not include children, there is commitment and attachment among unit members, the unit caregiving functions consist of protection, nourishment, and socialization of its members. Term as couple, nuclear family or single-parent family specifies attributes of membership, and they are not more or less families by reason of labeling. Affection, strong emotional ties, a sense of belonging, and durability of membership determine family composition. Family is who they say they are, with this definition nurses can honor individual family members idea about which RELATIONSHIP are significant to them and their EXPERIENCE of health and illness. It is not just the length of the relationship that is important, but also the quality of the relationship. Gays and lesbians often refer to their friendship network as family, and that for many gay and lesbians this family is often as crucial and influential as their family of origin and at times, even more so. Their familys definition is more based on the familys conception of family rather than on who lives in the household. Changes in the family can be permanent as well as transient. Losses tend to be more severe depending on: o The younger some of the family members are o The smaller the family o The greater the numerical imbalance btw male and female members of the family The extent of the impact of a death on the family depends on the social and ethnic meaning of death, the history of previous losses, the timing of the death in the life cycle, and the nature of death. Gender Gender is important for nurses to consider because the difference in hoe men and women experience the world is at the heart of the therapeutic conversation. We can help families by assuming that differences btw women and men can be changed, discarding unhelpful cultural scripts for both gender, and recognizing and attending to hidden power issues. The problem described both gender commonly include unspoken conflicts btw their perceptions of gender this is, how their FAMILY, CLASS, SEXUAL ORIENTATION and SOCIETY or CULTURE tell them that men and women should fell, think, and behave and their own experiences. Couples may desire to establish more equal relationship, with characteristics such as: o Partners hold equals status (equal entitlement to personal goals, needs, and wishes) o Accommodation in the relationship is mutual (schedules are organized equally around each partners needs) o Attention to the other in the relationship is mutual (equal displays of interest in the others needs and desires by both partners) o Enhancement of the well-being of each partner is mutual (the relationship supports the psychological health of each equally) Sexual orientation It includes sexual majority and sexual minorities populations. Heterosexism, the preference of heterosexual orientation over other sexual orientation, is a form of multicultural bias that has the potential to harm both families and health-care providers. LGBQITT o Lesbian o Gay o Bisexual o Queer = individual whose gender identity doesnt strictly conform with societal norms traditionally ascribed to either males or female and who defines themselves outsides of these definitions. o Intersexed = individual with ambiguous genitalia or chromosomal abnormalities. o Transgender o Two-spirited people = Aboriginal with close ties to the spirit world and who may or may not identify as being lesbian, gay, bisexual, or transgender. It is useful to reflect critically on attitudes about sexual orientation. When comparing lesbian couples with heterosexual couples, we use parallel terms as opposed to normal couples. Rank Order Birth orders, gender, distances in age between siblings are important factors to consider when doing an assessment. Sibling position is an organizing influence on the personality, but it is not a fixed influence. With time, multiple influences in addition to sibling constellation - timing of each siblings birth, the childs characteristics, the familys idealized program for the child, and the parental attitudes and biases regarding sex difference - can affect personality organization. Subsystems Term used to discuss or mark the family systems level o
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