Nurse's Pocket Guide

today, such as biological, nuclear, single-parent, step-family,
communal, and same-sex couple or family. A better way to
determine a family may be to determine the attribute of
affection, strong emotional ties, a sense of belonging, and
durability of membership.
• Identify participating members of family and how they define
family. Establishes members of family who need to be
directly involved/taken into consideration when developing
plan of care to improve family functioning.
• Note stage of family development (e.g., single, young adult,
newly married, family with young children, family with adolescents,
grown children, later in life).
• Ascertain motivation/expectations for change.
• Observe patterns of communication in the family. Are feelings
expressed? Freely? Who talks to whom? Who makes decisions?
For whom? Who visits? When? What is the interaction
between family members? Identifies possible weaknesses to
be addressed, as well as strengths that can be used for
improving family communication.
• Assess boundaries of family members. Do members share
family identity and have little sense of individuality? Do they
seem emotionally connected with one another? Individuals
need to respect one another and boundaries need to be clear
so family members are free to be responsible for themselves.
• Identify “family rules” that are accepted in the family. Families
interact in certain ways over time and develop patterns
of behavior that are accepted as the way “we behave” in this
family. “Functional family” rules are constructive and promote
the needs of all family members.
• Note energy direction. Efforts at problem solving and resolution
of different opinions may be purposeful or may be
scattered and ineffective.
• Determine cultural and/or religious factors influencing family
interactions. Expectations related to socioeconomic beliefs
may be different in various cultures. For instance, traditional
views of marriage and family life may be strongly
influenced by Roman Catholicism in Italian-American and
Latino-American families. In some cultures, the father is
considered the authority figure and the mother is the homemaker.
These beliefs may change with stressors/circumstances
(e.g., financial, loss/gain of a family member, personal
growth).
• Note health of married individuals. Recent reports have
determined that marriage increases life expectancy by as
much as five years.
Information in brackets added by the authors to clarify and enhance
the use of nursing diagnoses.
Diagnostic Studies Pediatric/Geriatric/Lifespan Medications 305
readiness for enhanced FAMILY PROCESSES