Nurses guide to family

assessment and
intervention
 Different Roles of A Public Health Nurse

• Health educator
• Counselor
• Family advocate
• Environmental modifier
• Care provider and supervisor
• Manager and coordinator
• Case finder and epidemiologist
 EVOLVING STAGES OF FAMILY NURSING INTERVIEWS

• Engagement
• Assessment
• Intervention
• Termination.
 Family Interview Skills

1. Recognize that an individual family member is best understood in the context of the family
2. Appreciate that initial efforts to involve both spouses/parents enables, from the onset, a more
holistic view of the family and increases engagement.
3. Recognize that providing a clear structure to the interview reduces anxiety and increases
engagement.
 TYPES OF SKILLS
Cleghorn and Levin’s (1973) identification and categorization of these three skill types are considered
a seminal contribution.

 Perceptual skills relate to the nurse’s ability to make relevant observations

 Conceptual skills involve the ability to give meaning to the observations that the nurse
made. They also involve the ability to formulate one’s observations of the family as a whole, as a
system.

 Executive skills are the observable therapeutic interventions that a nurse carries out in an
interview.
 Preconceptual /Conceptual skills
Assessment 1. Realize the importance of having a conceptual assessment map
to understand family dynamics.
2. Realize the importance of beginning a family assessment by
obtaining a detailed description and history of the presenting
problem, concern, or illness.
3. Realize that the presenting problem is commonly related to
other concerns in the family.
4. Realize that eliciting differences generates more specific
information for family assessment
Executive Skills
Explore the components of the structural,
developmental, and functional aspects of
the family to assess strengths and
problem areas
Ask each family member, including the
children, to share his or her knowledge
and understanding of the presenting
concern.
Explore with the family if there are other
problems or concerns connected to the
presenting problem.
Inquire about differences between
individuals, between relationships, and
between various points in time.
 Preconceptual Skills
Assessment 5. Use the information obtained from the family assessment to
begin formulating hypotheses in the form of a strengths and
problems list.
6. Assess whether any of the identified problems are beyond the
scope of the nurse’s competence.
7. Recognize that a more extensive inquiry into the most pressing
problems is necessary before intervention plans can be
implemented
Executive Skills
Obtain verification of the nurse’s
understanding of strengths and problems
by listing them to the family for their
agreement and eventually recording them
Tell the family whether you will continue
to work with them on problems. (If a
decision is made to refer them to another
professional, proceed to Stage
Termination.)
Seek the family’s opinion of which issue
they perceive as most important and/or
where there is the greatest suffering, and
explore it in depth. If the family cannot
agree, then discuss the lack of consensus.
 Preconceptual Skills Executive Skills

Intervention Recognize that families possess problem-solving abilities. Encourage family members to explore
possible solutions to problems and to
soften suffering.

Recognize that interventions are focused on the cognitive, Plan interventions to influence any one or
affective, and behavioral domains or areas of functioning in all three of the domains of functioning
families

Recognize that lack of information of an educational nature can Provide information to family members
inhibit the family’s problem-solving abilities. that will enhance their knowledge and
facilitate further problem solving

Recognize that suggesting specific tasks or assignments can often Assign tasks or assignments aimed at
provide a new way for family members to behave in relation to one improving family functioning.
another that will improve problem-solving abilities
 Preconceptual Skills
Termination Recognize that families appreciate additional
professional resources when problems are quite
complex.
Recognize the importance of evaluating the family
interviews or meetings at regular intervals.
Recognize when dependency on the nurse
inadvertently may have been encouraged
Recognize family members’ constructive efforts to
solve problems or soften suffering
Executive Skills
Refer individual family members or the
family for consultation or ongoing
treatment
Obtain feedback from family members
about the present status of their problems
or level of suffering and initiate
termination when the contracted
problems have been resolved or
sufficient progress has been made
Mobilize other supports for the family if
necessary, and begin to initiate
termination by decreasing the frequency
of sessions.
Summarize positive efforts of family
members to resolve problems and lessen