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Family Nursing: Research, Theory, and Practice / Edition 5

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Overview

This popular book addresses the full practice of family nursing—identifying the family as a whole—and teaches a holistic, philosophical approach. The reader is guided through generalized concepts and theoretical foundations, reality-based applications, case studies, thorough and updated discussions, assessment, and nursing diagnoses. Well-organized and complete, this edition includes foundations in family theory and family nursing—essential in preparing a comprehensive family nursing assessment and planning appropriate interventions. A four-part organization covers introductory concepts, theoretical foundations of family nursing, family nursing practice, and cultural diversity among families. For pediatric nurses, nurse practitioners, family counselors, clinical nurse specialists, and anyone planning for a career in family or community cursing.

The book is printed in blue ink and contains blue-and-white illustrations.

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Editorial Reviews

Doody's Review Service
Reviewer: Penny Wolfe Moore, RNC, PhD (Southwestern Adventist University)
Description: As theory and practice in family nursing have grown and changed, this book has been updated to remain current. This 714 page, fifth edition is packed full of the basics of family nursing. There are no pictures or illustrations in this black-and-white book, but there are some tables and other organizational features. The first edition appeared in 1980.
Purpose: The text's focus . . . includes nursing diagnoses and interventions. . . The family assessment model is based primarily on three theoretical perspectives: a systems perspective, a structural-functional perspective, and a family developmental perspective. A multicultural perspective is also integrated throughout." Further, "We hope this text is able. . .[will] give you the foundations to practice more comfortably and effectively with families." The content reflects the authors' objectives and purposes well.
Audience: This text is intended for undergraduate and graduate family nursing students and practitioners who are not practicing advance family therapy or family systems nursing . . . [the interventions] are insufficient for working with the very complex family in which more sophisticated, indirect interviewing and advanced counseling skills are required." I agree that additional information might be needed for some family intervention scenarios. However, this book is very complete and would be most useful in a situation where intervening on the family level was a serious goal. The authors are well qualified by education and practice.
Features: The book is divided into four parts: introduction, basic theoretical foundations, family nursing process and cultural differences. Chapter 17 on family stress, coping, and adaptation is particularly well done, as is the section on cultural diversity among families. The assessment tools, study questions, and glossary of terms all add learning value to this text. Each chapter has learning objectives but most are written on the lower cognitive level.
Assessment: This is an excellent resource. I use it to augment the couple of classes on family nursing in the community nursing course I teach. If I were to teach a whole course on just family nursing; this would be my choice of textbooks. It should be in every library where nursing students or nurses go for information.
Margaret A. Holder
This book provides a foundational knowledge base for the practice of basic family nursing. As increased emphasis is placed on the family unit as an integral component in healthcare, readers will find this a valuable resource in addressing the complex issues in family nursing. The purpose is to provide in-depth information on the gamut of the emerging roles and goals of the family nurse. The author addresses the basic theoretical approaches used in family nursing practice and provides family nursing interventions that are basic and straightforward. The book provides students with the information needed to deliver a family-centered approach to care. There is special emphasis given to primary prevention, particularly health promotion. This book is intended for undergraduate and graduate students who hope to practice basic family nursing. It is not designed for those who are practicing advanced family therapy or family systems nursing. Five major issues related to family nursing are addressed in this book: the importance of the family in healthcare, with succinct definitions of the varied family unit; an explanation of the basic theoretical approaches used in family nursing practice; an introduction to family assessment tools and models for family interventions; general family nursing interventions; and information on cultural issues pertinent to family nursing care. Learning objectives are provided for each topic. Self learning modules and case studies are incorporated in many of the chapters throughout the book. Each chapter provides study questions for the student to address. This easy to use and straightforward approach to family nursing will make this a valuable resource for thebasic family nursing student. The material is concise and well organized. It provides much needed clarification on the concept of family nursing.

4 Stars! from Doody
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Product Details

  • ISBN-13: 9780130608246
  • Publisher: Prentice Hall
  • Publication date: 8/8/2002
  • Edition description: Subsequent
  • Edition number: 5
  • Pages: 714
  • Sales rank: 69,224
  • Product dimensions: 8.00 (w) x 9.70 (h) x 1.20 (d)

Read an Excerpt

As readers of the fifth edition, we think you will be pleased with the changes and additions that have been made. Much of this is due to the fact that two new co-authors have been added to the text. As the first author, I feel profoundly blessed to have two gifted and caring family nurses join me in updating and enriching the fifth edition's content and presentation. Dr. Vicky Bowden is a well-known nursing author, practitioner, and educator. Dr. Elaine Jones is also very experienced and expert in family nursing education, practice, and research with families with deaf members. Their positive contributions have made revising this text an exciting and very positive endeavor. We each revised about one third of the chapters, but carefully reviewed and made suggestions to the primary revisor on the other chapters to make them more comprehensive and relevant.

Great strides have been made in the field of family nursing since this text's inception in 1980 and the additions and changes in this text parallel family nursing's growth. There has been a proliferation of texts in family nursing that contain in-depth discussions of theories, research, and practice. The increase in publications about family nursing; the inception of the Journal of Family Nursing in 1995; the growing incorporation of family nursing into ANA Standards of Nursing Practice, NANDA nursing diagnoses, and the Nursing Intervention Classification (NIC); the holding of national and international family nursing conferences; the continuing activity of the family and health section of the National Council for Family Relations; and the increase in family nursing courses and content in both undergraduate and graduate nursing programs present strong evidence of the development of family nursing as both an integral part of generalist practice and as a specialty area in advanced practice nursing. Moreover, there is a growing consensus that family nursing is conceptually and empirically distinct from nursing of family members. And due to the profound influence of family therapy and the application of systems theory, family nurses are increasingly "thinking interactionally" in their writings and conversations about families and family nursing practice.

The text's focus in the fifth edition includes nursing diagnoses and interventions. In this edition, as previous editions, the same basic comprehensive family assessment tool is presented, with some modification. The family assessment model is based primarily on three theoretical perspectives: a systems perspective, a structural-functional perspective, and a family developmental perspective. A multicultural perspective is also integrated throughout.

This text is intended for undergraduate and graduate family nursing students and practitioners who are not practicing advanced family therapy or family systems nursing. Advanced family nursing practice requires the completion of a specialized program at the master's level. Hence, we included family nursing interventions that are basic and straightforward; these suggested interventions, although certainly necessary within family nursing practice, are insufficient for working with the very complex family in which more sophisticated, indirect interviewing and advanced counseling skills are required.

NEW FEATURES IN THE FIFTH EDITION

In the fifth edition of this text, the following new features have been added:

  • Content outlines have been added at the beginning of each chapter.
  • A bulleted summary at the end of each chapter highlights the key ideas within the chapter.
  • A glossary containing the major terms used in each of the chapters augments comprehension.
  • More tables and figures have been added to graphically depict key points.
  • As part of the review questions at the end of each chapter, a family vignette has been added, which addresses chapter content and augments critical thinking skills.
  • Chapters addressing practice areas include family assessment, family diagnoses, and family nursing interventions.
  • In the family nursing practice chapters, three variables are considered: gender differences, sociocultural variation, and differences created by health alterations.
  • Statistics and references have been carefully updated.
  • The latest NANDA (North American Nursing Diagnosis Association) and NIC (Nursing Interventions Classification) descriptions are incorporated.
CONTENT NEW TO THE FIFTH EDITION

This book is subdivided into four broad sections. Part I includes two introductory chapters that discuss the family's importance and family definitions (Chapter 1) and family nursing's evolution, focus, and goals (Chapter 2). In Chapter 1, the sections outlining demographic trends impacting the family and the varied family forms have been updated and enlarged. The chapter on family nursing (Chapter 2) covers the gamut of emerging goals and roles of the family nurse from health promotion through rehabilitation. The rising costs of medical care; the implementation of managed care; the rising proportion of older, chronically ill individuals; and the recognition that many chronic illnesses can be prevented or ameliorated with lifestyle changes are prominent trends that have greatly expanded the role of the family nurse in both health promotion and acute and long-term care. Several major current issues facing family nursing facilitate our understanding of the status of family nursing today.

Part II addresses the basic theoretical foundations of family nursing (Chapters 3 through 6) . Chapter 3, "Theoretical Foundations of Family Nursing," reviews the various theories used in family nursing practice, with much better coverage of nursing theories than in the previous edition. Integrated family nursing theories are also described and advocated. Chapter 4 is a short chapter describing structural-functional theory and how it has been applied in this text. Chapter 5, "Family Developmental Theory" has been revised and updated to include a broader range of developmental theories. In this chapter, family developmental theory is applied to single-parent and stepparent families, in addition to the two-parent nuclear family. Chapter 6, "Systems Theory," contains greater coverage of holism, cybernetics, and communication theory as more focused, midrange theories subsumed under general systems theory.

Part III introduces the reader to the family nursing process as well as the actual family assessment model or tool (located within each of the individual chapters), family nursing diagnoses, and family nursing interventions. Chapter 7, "The Family Nursing Process," has been updated and revised, combining two chapters from the previous edition of the text into one chapter that is more comprehensive and includes a very thorough discussion of family nursing interventions. Chapter 7 covers the new literature appearing in the counseling, education, case management, and family nursing process areas. Chapter 8, "Family Identifying Data: Sociocultural Assessment and Intervention," discusses family nursing in the context of sociocultural diversity. Updating of statistical data and literature on the significant demographic changes taking place in America provide a greater understanding about the urgency of practicing competently with families from diverse backgrounds.

In the remainder of the practice chapters (Chapters 9 through 16) pertinent research, theory, and practice implications have been incorporated. These chapters address family structural dimensions; family functions; and family stress, coping, and adaptation. Family structural dimensions are crucial to family nursing practice, since they cover family dynamics as seen in family communication patterns and processes (Chapter 10), family power and decision making (Chapter 11), the family role structure (Chapter 12), and family values (Chapter 13). The affective function (Chapter 14), family socialization function (Chapter 15), and the health care function (Chapter 16) are the three most relevant family functions to assess in family nursing. Family stress, coping processes, and adaptation (Chapter 17) are also essential components within family nursing assessment and intervention.

Chapter 9, "Family Environmental Data," has new sections on resources in the home (such as Internet access), discussion of differences in rural versus urban family environment, an updated section on the effects of homelessness on family health, and a new section focusing on the sociopolitical environment as an important factor in family health.

Chapter 10, "Family Communication Patterns and Processes," contains both classic and recent research and theoretical content related to functional and dysfunctional family communication patterns. This chapter also discusses the influence of cultural beliefs, family life cycle stage, gender, family form, and family mini-culture on- family communication patterns.

Chapter 11, "Family Power and Decision Making," presents foundational concepts in family power. Discussion of family violence is now included in this chapter, with specific sections addressing intimate partner abuse, child and adolescent abuse, sibling abuse, parent abuse, and elder abuse.

Chapter 12, "Family Role Structure," focuses on research on family role changes during illness, with an expanded discussion about the family caregiver role, and the role of the father in contemporary families. A particular strength is the expanded section about grandparents' roles in families, especially grandmothers who are involved in raising grandchildren.

Chapter 13, "Family Values," contains new information regarding changes in family values that have emerged in recent years as a result of societal changes. Disparities in value systems are discussed, especially those that exist between the family and the health care professional.

Chapter 14, "The Family Affective Function," reviews essential components of the affective function. The chapter covers the process of family bereavement more thoroughly than in the previous editions.

In Chapter 15, "The Family Socialization Function," findings are incorporated from the latest socialization research. There is also broadened coverage of multicultural aspects of parenting, and unique socialization issues for single-parent families, stepparent families, and families with gay or lesbian parents.

In Chapter 16, "The Family Health Care Function," the critical thrust of family health promotion is clearly evident, with Pender's revised Health Promotion Model providing the theoretical foundation for identifying the multiple factors influencing family health promotion. Recent research findings on health care practices among families, such as lifestyle practices and the use of medically based and alternative/complementary health care, have also been incorporated.

A major revamping of the content within Chapter 17, now titled "Family Stress, Coping, and Adaptation" occurred. The Resiliency Model of Family Stress, Adjustment, and Adaptation is fully described, and other research and theoretical developments in the area of family stress and coping have been updated. Family resiliency, family coherence, and factors influencing coping are emphasized. In addition, social support research, theory, and clinical application have been added to this chapter.

In Part IV (Chapters 18, 19, and 20), cultural differences among families from the three largest minority groups in the United States, Latino, African-American, and Asian-American, are addressed. Current literature about each of these families, coupled with an expanded description of family nursing assessment and interventions that are culturally sensitive and appropriate, make these chapters quite useful for working with culturally diverse clients. Chapter 20, "The Asian-American Family," was a new chapter in the fourth edition, and is a reflection of the growing presence of Asian-Americans in the United States today. Their Eastern legacy is so disparate from our Western tradition that family nurses who work with traditional Asian-Americans need to be sensitive to these profound cultural differences.

The Appendices contain the Friedman Family Assessment Model (long form and short form), a family case description and the use of the family nursing process in the case example, as well as answers to the family vignettes and study questions. The family nursing example is included to give students a concrete model of family nursing practice and also an opportunity to retest themselves on the use of the Friedman Family Assessment Model and application of the family nursing process. Chapters in Part III describe the knowledge base needed to complete the family assessment and to develop family nursing diagnoses and intervention guidelines.

THE NEW EDITION: A REFLECTION OF EXPANDED VISTAS IN FAMILY NURSING

Our ardent belief is that health professionals, regardless of the setting, must broaden their commitment so that they serve families as units, as well as family subsystems (e.g., parental subsystems) and individual family members. It is well recognized that a considerable gap exists between the ideal (what ought to be) and the real (the actual practice of nursing today). In spite of nursing's and health care's shortcomings, family nursing continues to be a very exciting and rewarding dimension of professional nursing, as well as an emerging, vital, advanced practice nursing area. We hope this text is able to convey some of our excitement about family nursing to you, as well as give you the foundations to practice more comfortably and effectively with families. Happy reading!

Marilyn M. Friedman, Vicky Bowden, and Elaine Jones

Read More Show Less

Table of Contents

I. INTRODUCTORY CONCEPTS.

1. Introduction to the Family.

2. Family Nursing: Focus, Evolution, and Goals.

II. THEORETICAL FOUNDATIONS OF FAMILY NURSING.

3. Theoretical Foundations for Family Nursing.

4. Structural-Functional Theory.

5. Family Developmental Theory.

6. Systems Theory.

III. FAMILY NURSING PRACTICE.

7. The Family Nursing Process.

8. Family Identifying Data: Sociocultural Assessment and Intervention.

9. Family Environmental Data.

10. Family Communication Patterns and Processes.

11. Family Power and Decision-Making.

12. Family Role Structure.

13. Family Values.

14. The Family Affective Function.

15. The Family Socialization Function.

16. The Family Health Care Function.

17. Family Stress, Coping and Adaptation.

IV. CULTURAL DIVERSITY AMONG FAMILIES.

18. The Latino Family.

19. The African-American Family.

20. The Asian-American Family.

APPENDICES.

A. The Friedman Family Assessment Model (Long Form).

B. The Friedman Family Assessment Model (Short Form).

C. Case Study of the O'Shea Family.

D. Family Nursing Process Example: The O'Shea Family.

E. Answers to Vignette and Study Questions.

References.

Glossary.

Index.

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Preface

As readers of the fifth edition, we think you will be pleased with the changes and additions that have been made. Much of this is due to the fact that two new co-authors have been added to the text. As the first author, I feel profoundly blessed to have two gifted and caring family nurses join me in updating and enriching the fifth edition's content and presentation. Dr. Vicky Bowden is a well-known nursing author, practitioner, and educator. Dr. Elaine Jones is also very experienced and expert in family nursing education, practice, and research with families with deaf members. Their positive contributions have made revising this text an exciting and very positive endeavor. We each revised about one third of the chapters, but carefully reviewed and made suggestions to the primary revisor on the other chapters to make them more comprehensive and relevant.

Great strides have been made in the field of family nursing since this text's inception in 1980 and the additions and changes in this text parallel family nursing's growth. There has been a proliferation of texts in family nursing that contain in-depth discussions of theories, research, and practice. The increase in publications about family nursing; the inception of the Journal of Family Nursing in 1995; the growing incorporation of family nursing into ANA Standards of Nursing Practice, NANDA nursing diagnoses, and the Nursing Intervention Classification (NIC); the holding of national and international family nursing conferences; the continuing activity of the family and health section of the National Council for Family Relations; and the increase in family nursing courses and content in both undergraduate and graduate nursing programs present strong evidence of the development of family nursing as both an integral part of generalist practice and as a specialty area in advanced practice nursing. Moreover, there is a growing consensus that family nursing is conceptually and empirically distinct from nursing of family members. And due to the profound influence of family therapy and the application of systems theory, family nurses are increasingly "thinking interactionally" in their writings and conversations about families and family nursing practice.

The text's focus in the fifth edition includes nursing diagnoses and interventions. In this edition, as previous editions, the same basic comprehensive family assessment tool is presented, with some modification. The family assessment model is based primarily on three theoretical perspectives: a systems perspective, a structural-functional perspective, and a family developmental perspective. A multicultural perspective is also integrated throughout.

This text is intended for undergraduate and graduate family nursing students and practitioners who are not practicing advanced family therapy or family systems nursing. Advanced family nursing practice requires the completion of a specialized program at the master's level. Hence, we included family nursing interventions that are basic and straightforward; these suggested interventions, although certainly necessary within family nursing practice, are insufficient for working with the very complex family in which more sophisticated, indirect interviewing and advanced counseling skills are required.

NEW FEATURES IN THE FIFTH EDITION

In the fifth edition of this text, the following new features have been added:

  • Content outlines have been added at the beginning of each chapter.
  • A bulleted summary at the end of each chapter highlights the key ideas within the chapter.
  • A glossary containing the major terms used in each of the chapters augments comprehension.
  • More tables and figures have been added to graphically depict key points.
  • As part of the review questions at the end of each chapter, a family vignette has been added, which addresses chapter content and augments critical thinking skills.
  • Chapters addressing practice areas include family assessment, family diagnoses, and family nursing interventions.
  • In the family nursing practice chapters, three variables are considered: gender differences, sociocultural variation, and differences created by health alterations.
  • Statistics and references have been carefully updated.
  • The latest NANDA (North American Nursing Diagnosis Association) and NIC (Nursing Interventions Classification) descriptions are incorporated.

CONTENT NEW TO THE FIFTH EDITION

This book is subdivided into four broad sections. Part I includes two introductory chapters that discuss the family's importance and family definitions (Chapter 1) and family nursing's evolution, focus, and goals (Chapter 2). In Chapter 1, the sections outlining demographic trends impacting the family and the varied family forms have been updated and enlarged. The chapter on family nursing (Chapter 2) covers the gamut of emerging goals and roles of the family nurse from health promotion through rehabilitation. The rising costs of medical care; the implementation of managed care; the rising proportion of older, chronically ill individuals; and the recognition that many chronic illnesses can be prevented or ameliorated with lifestyle changes are prominent trends that have greatly expanded the role of the family nurse in both health promotion and acute and long-term care. Several major current issues facing family nursing facilitate our understanding of the status of family nursing today.

Part II addresses the basic theoretical foundations of family nursing (Chapters 3 through 6) . Chapter 3, "Theoretical Foundations of Family Nursing," reviews the various theories used in family nursing practice, with much better coverage of nursing theories than in the previous edition. Integrated family nursing theories are also described and advocated. Chapter 4 is a short chapter describing structural-functional theory and how it has been applied in this text. Chapter 5, "Family Developmental Theory" has been revised and updated to include a broader range of developmental theories. In this chapter, family developmental theory is applied to single-parent and stepparent families, in addition to the two-parent nuclear family. Chapter 6, "Systems Theory," contains greater coverage of holism, cybernetics, and communication theory as more focused, midrange theories subsumed under general systems theory.

Part III introduces the reader to the family nursing process as well as the actual family assessment model or tool (located within each of the individual chapters), family nursing diagnoses, and family nursing interventions. Chapter 7, "The Family Nursing Process," has been updated and revised, combining two chapters from the previous edition of the text into one chapter that is more comprehensive and includes a very thorough discussion of family nursing interventions. Chapter 7 covers the new literature appearing in the counseling, education, case management, and family nursing process areas. Chapter 8, "Family Identifying Data: Sociocultural Assessment and Intervention," discusses family nursing in the context of sociocultural diversity. Updating of statistical data and literature on the significant demographic changes taking place in America provide a greater understanding about the urgency of practicing competently with families from diverse backgrounds.

In the remainder of the practice chapters (Chapters 9 through 16) pertinent research, theory, and practice implications have been incorporated. These chapters address family structural dimensions; family functions; and family stress, coping, and adaptation. Family structural dimensions are crucial to family nursing practice, since they cover family dynamics as seen in family communication patterns and processes (Chapter 10), family power and decision making (Chapter 11), the family role structure (Chapter 12), and family values (Chapter 13). The affective function (Chapter 14), family socialization function (Chapter 15), and the health care function (Chapter 16) are the three most relevant family functions to assess in family nursing. Family stress, coping processes, and adaptation (Chapter 17) are also essential components within family nursing assessment and intervention.

Chapter 9, "Family Environmental Data," has new sections on resources in the home (such as Internet access), discussion of differences in rural versus urban family environment, an updated section on the effects of homelessness on family health, and a new section focusing on the sociopolitical environment as an important factor in family health.

Chapter 10, "Family Communication Patterns and Processes," contains both classic and recent research and theoretical content related to functional and dysfunctional family communication patterns. This chapter also discusses the influence of cultural beliefs, family life cycle stage, gender, family form, and family mini-culture on- family communication patterns.

Chapter 11, "Family Power and Decision Making," presents foundational concepts in family power. Discussion of family violence is now included in this chapter, with specific sections addressing intimate partner abuse, child and adolescent abuse, sibling abuse, parent abuse, and elder abuse.

Chapter 12, "Family Role Structure," focuses on research on family role changes during illness, with an expanded discussion about the family caregiver role, and the role of the father in contemporary families. A particular strength is the expanded section about grandparents' roles in families, especially grandmothers who are involved in raising grandchildren.

Chapter 13, "Family Values," contains new information regarding changes in family values that have emerged in recent years as a result of societal changes. Disparities in value systems are discussed, especially those that exist between the family and the health care professional.

Chapter 14, "The Family Affective Function," reviews essential components of the affective function. The chapter covers the process of family bereavement more thoroughly than in the previous editions.

In Chapter 15, "The Family Socialization Function," findings are incorporated from the latest socialization research. There is also broadened coverage of multicultural aspects of parenting, and unique socialization issues for single-parent families, stepparent families, and families with gay or lesbian parents.

In Chapter 16, "The Family Health Care Function," the critical thrust of family health promotion is clearly evident, with Pender's revised Health Promotion Model providing the theoretical foundation for identifying the multiple factors influencing family health promotion. Recent research findings on health care practices among families, such as lifestyle practices and the use of medically based and alternative/complementary health care, have also been incorporated.

A major revamping of the content within Chapter 17, now titled "Family Stress, Coping, and Adaptation" occurred. The Resiliency Model of Family Stress, Adjustment, and Adaptation is fully described, and other research and theoretical developments in the area of family stress and coping have been updated. Family resiliency, family coherence, and factors influencing coping are emphasized. In addition, social support research, theory, and clinical application have been added to this chapter.

In Part IV (Chapters 18, 19, and 20), cultural differences among families from the three largest minority groups in the United States, Latino, African-American, and Asian-American, are addressed. Current literature about each of these families, coupled with an expanded description of family nursing assessment and interventions that are culturally sensitive and appropriate, make these chapters quite useful for working with culturally diverse clients. Chapter 20, "The Asian-American Family," was a new chapter in the fourth edition, and is a reflection of the growing presence of Asian-Americans in the United States today. Their Eastern legacy is so disparate from our Western tradition that family nurses who work with traditional Asian-Americans need to be sensitive to these profound cultural differences.

The Appendices contain the Friedman Family Assessment Model (long form and short form), a family case description and the use of the family nursing process in the case example, as well as answers to the family vignettes and study questions. The family nursing example is included to give students a concrete model of family nursing practice and also an opportunity to retest themselves on the use of the Friedman Family Assessment Model and application of the family nursing process. Chapters in Part III describe the knowledge base needed to complete the family assessment and to develop family nursing diagnoses and intervention guidelines.

THE NEW EDITION: A REFLECTION OF EXPANDED VISTAS IN FAMILY NURSING

Our ardent belief is that health professionals, regardless of the setting, must broaden their commitment so that they serve families as units, as well as family subsystems (e.g., parental subsystems) and individual family members. It is well recognized that a considerable gap exists between the ideal (what ought to be) and the real (the actual practice of nursing today). In spite of nursing's and health care's shortcomings, family nursing continues to be a very exciting and rewarding dimension of professional nursing, as well as an emerging, vital, advanced practice nursing area. We hope this text is able to convey some of our excitement about family nursing to you, as well as give you the foundations to practice more comfortably and effectively with families. Happy reading!

Marilyn M. Friedman, Vicky Bowden, and Elaine Jones

Read More Show Less

Introduction

As readers of the fifth edition, we think you will be pleased with the changes and additions that have been made. Much of this is due to the fact that two new co-authors have been added to the text. As the first author, I feel profoundly blessed to have two gifted and caring family nurses join me in updating and enriching the fifth edition's content and presentation. Dr. Vicky Bowden is a well-known nursing author, practitioner, and educator. Dr. Elaine Jones is also very experienced and expert in family nursing education, practice, and research with families with deaf members. Their positive contributions have made revising this text an exciting and very positive endeavor. We each revised about one third of the chapters, but carefully reviewed and made suggestions to the primary revisor on the other chapters to make them more comprehensive and relevant.

Great strides have been made in the field of family nursing since this text's inception in 1980 and the additions and changes in this text parallel family nursing's growth. There has been a proliferation of texts in family nursing that contain in-depth discussions of theories, research, and practice. The increase in publications about family nursing; the inception of the Journal of Family Nursing in 1995; the growing incorporation of family nursing into ANA Standards of Nursing Practice, NANDA nursing diagnoses, and the Nursing Intervention Classification (NIC); the holding of national and international family nursing conferences; the continuing activity of the family and health section of the National Council for Family Relations; and the increase in family nursing courses and content in both undergraduate andgraduate nursing programs present strong evidence of the development of family nursing as both an integral part of generalist practice and as a specialty area in advanced practice nursing. Moreover, there is a growing consensus that family nursing is conceptually and empirically distinct from nursing of family members. And due to the profound influence of family therapy and the application of systems theory, family nurses are increasingly "thinking interactionally" in their writings and conversations about families and family nursing practice.

The text's focus in the fifth edition includes nursing diagnoses and interventions. In this edition, as previous editions, the same basic comprehensive family assessment tool is presented, with some modification. The family assessment model is based primarily on three theoretical perspectives: a systems perspective, a structural-functional perspective, and a family developmental perspective. A multicultural perspective is also integrated throughout.

This text is intended for undergraduate and graduate family nursing students and practitioners who are not practicing advanced family therapy or family systems nursing. Advanced family nursing practice requires the completion of a specialized program at the master's level. Hence, we included family nursing interventions that are basic and straightforward; these suggested interventions, although certainly necessary within family nursing practice, are insufficient for working with the very complex family in which more sophisticated, indirect interviewing and advanced counseling skills are required.

NEW FEATURES IN THE FIFTH EDITION

In the fifth edition of this text, the following new features have been added:

  • Content outlines have been added at the beginning of each chapter.
  • A bulleted summary at the end of each chapter highlights the key ideas within the chapter.
  • A glossary containing the major terms used in each of the chapters augments comprehension.
  • More tables and figures have been added to graphically depict key points.
  • As part of the review questions at the end of each chapter, a family vignette has been added, which addresses chapter content and augments critical thinking skills.
  • Chapters addressing practice areas include family assessment, family diagnoses, and family nursing interventions.
  • In the family nursing practice chapters, three variables are considered: gender differences, sociocultural variation, and differences created by health alterations.
  • Statistics and references have been carefully updated.
  • The latest NANDA (North American Nursing Diagnosis Association) and NIC (Nursing Interventions Classification) descriptions are incorporated.

CONTENT NEW TO THE FIFTH EDITION

This book is subdivided into four broad sections. Part I includes two introductory chapters that discuss the family's importance and family definitions (Chapter 1) and family nursing's evolution, focus, and goals (Chapter 2). In Chapter 1, the sections outlining demographic trends impacting the family and the varied family forms have been updated and enlarged. The chapter on family nursing (Chapter 2) covers the gamut of emerging goals and roles of the family nurse from health promotion through rehabilitation. The rising costs of medical care; the implementation of managed care; the rising proportion of older, chronically ill individuals; and the recognition that many chronic illnesses can be prevented or ameliorated with lifestyle changes are prominent trends that have greatly expanded the role of the family nurse in both health promotion and acute and long-term care. Several major current issues facing family nursing facilitate our understanding of the status of family nursing today.

Part II addresses the basic theoretical foundations of family nursing (Chapters 3 through 6) . Chapter 3, "Theoretical Foundations of Family Nursing," reviews the various theories used in family nursing practice, with much better coverage of nursing theories than in the previous edition. Integrated family nursing theories are also described and advocated. Chapter 4 is a short chapter describing structural-functional theory and how it has been applied in this text. Chapter 5, "Family Developmental Theory" has been revised and updated to include a broader range of developmental theories. In this chapter, family developmental theory is applied to single-parent and stepparent families, in addition to the two-parent nuclear family. Chapter 6, "Systems Theory," contains greater coverage of holism, cybernetics, and communication theory as more focused, midrange theories subsumed under general systems theory.

Part III introduces the reader to the family nursing process as well as the actual family assessment model or tool (located within each of the individual chapters), family nursing diagnoses, and family nursing interventions. Chapter 7, "The Family Nursing Process," has been updated and revised, combining two chapters from the previous edition of the text into one chapter that is more comprehensive and includes a very thorough discussion of family nursing interventions. Chapter 7 covers the new literature appearing in the counseling, education, case management, and family nursing process areas. Chapter 8, "Family Identifying Data: Sociocultural Assessment and Intervention," discusses family nursing in the context of sociocultural diversity. Updating of statistical data and literature on the significant demographic changes taking place in America provide a greater understanding about the urgency of practicing competently with families from diverse backgrounds.

In the remainder of the practice chapters (Chapters 9 through 16) pertinent research, theory, and practice implications have been incorporated. These chapters address family structural dimensions; family functions; and family stress, coping, and adaptation. Family structural dimensions are crucial to family nursing practice, since they cover family dynamics as seen in family communication patterns and processes (Chapter 10), family power and decision making (Chapter 11), the family role structure (Chapter 12), and family values (Chapter 13). The affective function (Chapter 14), family socialization function (Chapter 15), and the health care function (Chapter 16) are the three most relevant family functions to assess in family nursing. Family stress, coping processes, and adaptation (Chapter 17) are also essential components within family nursing assessment and intervention.

Chapter 9, "Family Environmental Data," has new sections on resources in the home (such as Internet access), discussion of differences in rural versus urban family environment, an updated section on the effects of homelessness on family health, and a new section focusing on the sociopolitical environment as an important factor in family health.

Chapter 10, "Family Communication Patterns and Processes," contains both classic and recent research and theoretical content related to functional and dysfunctional family communication patterns. This chapter also discusses the influence of cultural beliefs, family life cycle stage, gender, family form, and family mini-culture on- family communication patterns.

Chapter 11, "Family Power and Decision Making," presents foundational concepts in family power. Discussion of family violence is now included in this chapter, with specific sections addressing intimate partner abuse, child and adolescent abuse, sibling abuse, parent abuse, and elder abuse.

Chapter 12, "Family Role Structure," focuses on research on family role changes during illness, with an expanded discussion about the family caregiver role, and the role of the father in contemporary families. A particular strength is the expanded section about grandparents' roles in families, especially grandmothers who are involved in raising grandchildren.

Chapter 13, "Family Values," contains new information regarding changes in family values that have emerged in recent years as a result of societal changes. Disparities in value systems are discussed, especially those that exist between the family and the health care professional.

Chapter 14, "The Family Affective Function," reviews essential components of the affective function. The chapter covers the process of family bereavement more thoroughly than in the previous editions.

In Chapter 15, "The Family Socialization Function," findings are incorporated from the latest socialization research. There is also broadened coverage of multicultural aspects of parenting, and unique socialization issues for single-parent families, stepparent families, and families with gay or lesbian parents.

In Chapter 16, "The Family Health Care Function," the critical thrust of family health promotion is clearly evident, with Pender's revised Health Promotion Model providing the theoretical foundation for identifying the multiple factors influencing family health promotion. Recent research findings on health care practices among families, such as lifestyle practices and the use of medically based and alternative/complementary health care, have also been incorporated.

A major revamping of the content within Chapter 17, now titled "Family Stress, Coping, and Adaptation" occurred. The Resiliency Model of Family Stress, Adjustment, and Adaptation is fully described, and other research and theoretical developments in the area of family stress and coping have been updated. Family resiliency, family coherence, and factors influencing coping are emphasized. In addition, social support research, theory, and clinical application have been added to this chapter.

In Part IV (Chapters 18, 19, and 20), cultural differences among families from the three largest minority groups in the United States, Latino, African-American, and Asian-American, are addressed. Current literature about each of these families, coupled with an expanded description of family nursing assessment and interventions that are culturally sensitive and appropriate, make these chapters quite useful for working with culturally diverse clients. Chapter 20, "The Asian-American Family," was a new chapter in the fourth edition, and is a reflection of the growing presence of Asian-Americans in the United States today. Their Eastern legacy is so disparate from our Western tradition that family nurses who work with traditional Asian-Americans need to be sensitive to these profound cultural differences.

The Appendices contain the Friedman Family Assessment Model (long form and short form), a family case description and the use of the family nursing process in the case example, as well as answers to the family vignettes and study questions. The family nursing example is included to give students a concrete model of family nursing practice and also an opportunity to retest themselves on the use of the Friedman Family Assessment Model and application of the family nursing process. Chapters in Part III describe the knowledge base needed to complete the family assessment and to develop family nursing diagnoses and intervention guidelines.

THE NEW EDITION: A REFLECTION OF EXPANDED VISTAS IN FAMILY NURSING

Our ardent belief is that health professionals, regardless of the setting, must broaden their commitment so that they serve families as units, as well as family subsystems (e.g., parental subsystems) and individual family members. It is well recognized that a considerable gap exists between the ideal (what ought to be) and the real (the actual practice of nursing today). In spite of nursing's and health care's shortcomings, family nursing continues to be a very exciting and rewarding dimension of professional nursing, as well as an emerging, vital, advanced practice nursing area. We hope this text is able to convey some of our excitement about family nursing to you, as well as give you the foundations to practice more comfortably and effectively with families. Happy reading!

Marilyn M. Friedman, Vicky Bowden, and Elaine Jones

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