Families and Communication
Family Rituals – The Family Meal
Anthropological studies show:
o Meals are important symbols of social connections and are central to human communication.
o Transactions surrounding food have been considered the glue of the social system.
o Family meals are defined as eating food together and have long been considered essential for the unity of
the family and a symbol for family interactions.
o The family meal can be a code for communicating love, as well as information, and can provide
opportunities for parents to give children attention, to talk and listen to them, to give them sociable
experience in conversation, and teach manners.
o Family meals can also transmit cultural and ethnic heritage and serve as the basis of ‘‘food memories’’
formed in childhood and carried throughout life.
Family Communication – Nursing Assessment
Because communication facilitates all family functioning, intervention efforts need to focus on increasing family
members’ abilities to express and respond to needs and concerns, and to negotiate system change to meet new
Family communication scale (Olson, Barnes, 2006)
Assessment of Family Communication and Health Outcomes
Nurse needs to take time to invite family to tell their story.
To share their unique perspectives and lived experiences of how they perceive their patterns of communication
promoting or inhibiting family health.
Family health nurses should offer appropriate referrals when working with families with communication problems.
Sample questions (Crawford & Tarko, 2004, p. 173)
o To what extent are family members able to clearly state their individual needs and desires using “I”
statements, clarifying and verifying messages, inviting feedback, and being open to receiving feedback from
other family members?
o To what extent are family members able to listen to others without making judgments or interrupting
o How often are clarifying statements made or how often do family members check out perceptions of what
was said or what was heard?
o What degree of openness do family members have in expressing thoughts, ideas, and feelings?
o Who in the family has the primary responsibility for communicating important messages?
o How does the family use problem-solving as a method to resolve family issues?
o How do family communication patterns change during a time of crisis?
o Informal teaching, role modeling, cognitive intervention, affective intervention, behavioural intervention,
collaborative plan, supporting and commending change, feedback and evaluation of change outcome
Applying therapeutic communication skills to client/family
o Warmth/empathy, respect, concreteness, genuineness, self-disclosure, confrontation, immediacy, problem-
solving, conflict resolution
o Therapeutic communication skills and strategies are the foundation in positioning the nurse as a role model,
teacher, mentor, mediator, and negotiator.
Situational problem solving
o Aims to explore with families what events or stressors led to the problem
o How family members responded to the situation?
o What previous experience the family has had in managing this type of problem-situation? o What coping strategies the family has used in the past and what has been effective and what has not been
effective for the family?
o What coping strategies are currently effective and currently ineffective?
o What new or alternative coping strategies that the family is interested in exploring?
Interpersonal problem solving (Crawford & Tarko, 2004, p. 180)
o How important is it for the family to solve the problem?
o Is the problem solvable?
o If one or more family members are in agreement about solving the problem…can ask:
o Tell me how the problem looks to you right now?
o Describe for me how are you involved in the problem?
o Tell me how you feel about the problem?
o Tell me how you react to or behave in response to the problem?
o Tell me how you think you contribute to the problem?
o When family members try to protect one another from painful or threatening information through silence,
secrecy, or distortion.
o Health care professionals who make assumptions about client situations (Faulkner, 1998)
Healthy families strike a balance.
Conflict is vital form of human interaction.
Conflict resolution is a key interaction task in families.
The process of making major life decisions or resolving crisis situations often involves intense feelings.
Tolerance for conflict allows for overt disagreement, compromise or reframing of the problem.
o Demonstrate effective conflict resolution without sacrifice of empathy.
o Families acknowledge many aspects o