ch 2 Family centered care and cultural considerations

parenting styles

-authoritarian -permissive -authoritative -indifferent

single-parent family

head of the household is widowed, divorced, abandoned, or separated.

gay and lesbian families

two adults of the same gender live together as domestic partners with or without children, and those in which a gay or lesbian single parent rears a child.

Discipline & limit setting

- Discipline is a method for teaching the rules that govern behavior or conduct. -Punishment is the action taken to enforce the rules when the child misbehaves. -Punishment helps children learn that there are consequences for misbehavior, and that other individuals may be affected by that behavior.

Stereotyping

- assuming that all members of a group have the same characteristics.

race

- group of people who share biologic similarities such as skin color, bone structure, and genetic traits. -Examples of races include White (sometimes called Caucasian or European American), Black (sometimes called African American in the United States), Hispanic, Natives

family assessment

-To identify strategies for coping (the use of learned behavioral and cognitive strategies to manage or relieve perceived stress), nurses must be able to assess family strengths and support mechanisms and to determine when families have overextended their resources and need additional support. -Stressors & strengths -stressors: stressor demands a response from the family members that can change the way they interact with each other and with other people; Nurses need to identify and assess how families respond to the stress of illness or injury of a child or other family members

parental warmth - high level

-Warm, nurturing -Express affection and smile at children frequently -Limit criticism, punishment -Express approval of child

step parenting

-When divorced or widowed parents remarry, the child may respond with ambivalence, divided loyalty, anger, or uncertainty -Blending two families often results in the need to identify or negotiate new customs, traditions, rituals, and routines for the family. Children may fear or experience losses -Stepparents must adjust to the habits and personality of the child and then work to gain trust and acceptance. If the child has not accepted the divorce or loss of a biologic parent, the stepparent faces more challenges in developing a trusting, affectionate, and respectful relationship. - Stepparents are additional parents, not replacement parents. The stepparent and the child need to adjust to each other. - In most stepparent families, discipline is a challenge. Family members must agree on standards of behavior, as well as the type of discipline and who carries it out -Contact with the biologic parent often continues through custody arrangements, financial support, and visitation. -Power conflicts may emerge if the biologic parents do not make efforts to cooperate in parenting decisions.

Heterosexual cohabiting family

-a heterosexual couple who may or may not have children and who live together outside of marriage.

nuclear family

-children live in a household with both biologic parents and no other relatives or persons. -One parent may stay home to rear the children while one parent works, but more commonly, both parents are employed by choice or necessity.

Family strengths helpful in managing stressors include the following:

-communication skills -shared family values & beliefs -intrafamily support -self care abilities -problem solving skills -community linkages

indifferent parents

-display little interest in their children or in their roles as parents; They do not demonstrate affection or approval of the children, nor do they set limits or controls on the children; No limit setting; Lacks affection for the child; Focused on stress in own life -Children who experience this style of parenting often have the worst outcomes, such as destructive impulses and delinquent behavior

Family Systems Theory

-focuses on the family as an "organized whole and/or as individuals within family units who form an interactive and interdependent system" -A family is a living social system, consisting of a small group of individuals who are closely interrelated and interdependent while collaborating to attain family functions and goals. -any change or stressor experienced by one or more family members affects the entire family and causes disruption. - From a systems perspective, the family may or may not exchange materials, energy, and information with its physical, social, and cultural environments. An open family seeks information and resources and actively interacts with the community to solve problems. A closed family views change and offered support as a threat -Family systems theory encourages nurses to see the child and parents as participating members of a whole family -the nurse can assess the effects of illness or injury on the entire family system and the reciprocal effects of the family on the illness or injury. Assessing how open or closed the family is to information and resources is important in planning nursing care.

foster parenting

-must provide for daily needs of children as well as support them emotionally - When the child has complex problems or needs, the challenge of caring for the foster child is even greater. - Some foster parents leave the system due to lack of adequate support. -Much of the child's adjustment rests with the stability of the family and available resources. Even though foster care is intended to be a temporary short placement—until the child can be returned home or an adoptive home is found—placed children may actually reside with the foster family for a lengthy time -Foster parents caring for children need to provide continuity, consistency, and predictability. It is essential that foster parents provide a nurturing environment for these children and show love and affection toward them. Developmentally appropriate activities are also essential

Family composition

-nuclear -child free -extended -extended kin network -single parent -single mother by choice -blended or reconstituted nuclear -binuclear family -heterosexual cohabitating -Gay & lesbian families

Eight-Stage Family life cycle

1-Begining family, newly married couples 2-Childbearing family 3-Families with preschool children oldest is between 2.5 and 6 years old 4-Families with school-age children oldest is 6-13 yrs old 5-Families with teenagers 13-20 yrs old 6-Families launching young adults, all children leave home 7-Middle-aged parents, empty nest through retirement 8-Family in retirement and old age, death of both spouses

Single mother by choice family

a family composed of an unmarried woman who chooses to conceive or adopt without a life partner

child free family

a family is child free by choice; in other cases, a family is child free because of issues related to infertility.

extended family

couple shares household and childrearing responsibilities with parents, siblings, or other relatives

Extended kin network family

two nuclear families of primary or unmarried kin live in proximity to each other.

Culture - family roles & organization

- A family's organization and the roles played by individual family members are largely dependent on cultural influence. -culture may determine who has authority (head of house-hold) and is the primary decision maker for other members of the family. -Nurses should be alert for roles and functions in families. -Culture also defines gender roles and the roles of the elderly and of extended family. In some cultures, major decisions for the family, including a child's health care, involve input from grandparents and other extended family members -Family goals are also determined by cultural values and practices, as are family member roles and childrearing practices and beliefs. -In some families, children are expected to take on responsibilities early and may be expected to perform tasks such as management of their own chronic disease and nutritional intake.

Legal aspects of adoption

-Adoption is controlled by individual state law. -Most adoptions are arranged through an authorized agency, such as a licensed social service agency - Birth mothers and birth fathers are each required to relinquish legal rights to a child before an adoption can occur. -Efforts are made to ensure that the birth mother is not coerced into relinquishing legal rights to the child immediately after birth. -In an open adoption, the birth mother and adoptive parents often have contact with each other prior to the birth and have jointly planned potential future contacts between the child and biologic mother.

responses by adopted children

- Children under 3 years of age do not recognize a difference between being adopted into a family versus being a biologic child in the family. -Starting at about 3 years of age, children like to hear about their adoption story and they begin to ask what adoption means. -By 5 years of age, adopted children begin to recognize they are different from most of their peers who were not adopted.; feeling of responsibility for their biological parent's decision -School-age children may fantasize about their biologic family and what their life might have been like if they were not adopted. -Adolescents may continue to fantasize about the "ideal" biologic family and try out identities similar to what they know or imagine about their biologic parents. They may also become angry that their own life experience is different from societal norms. -Children who are older when adopted must also make the commitment to the family relationship. They often have a memory of parents and other caregivers, so developing a close relationship with the adoptive parents takes more time

Planning & implementation

- Families need support to increase resources and coping behaviors so they can successfully manage the multiple stressors of daily living along with a child's chronic condition -Establishing a therapeutic relationship with the family is an important intervention. This relationship should be characterized by empathy and trust, as well as the development of mutually identified goals for the child's care. -focus on family competence and strengths. -Acknowledge and validate their emotions. -Provide information in a clear, timely, and sensitive manner. -Ask questions that help direct the family's thinking rather than providing them with all the answers. -Teach families to identify solutions until they are able to independently problem solve.

Assessing family strengths

- Family strengths are the relationships, processes, and resources that families can use during times of adversity and change to manage stressors. -Strengths that enable families to develop and adapt to stressors include: • Resources such as education, prior experiences, and finances; Effective communication and collaborative problem solving; Being emotionally aware and working to maintain emotional stability ; developing shared meaning about the experience - Identify a family's resilience—the family's capacity to develop strengths and abilities to "bounce back" from stress and challenges. -Most families have the capacity to develop resilience; nursing support may be needed to help family members learn new skills, make adaptations, and gain confidence in their abilities to manage the challenges of the child's health condition. - Functional families use their strengths and a variety of coping strategies to successfully reduce stress. Coping strategies of dysfunctional families are generally defensive -After developing a rapport and relationship with the family, the nurse can help families identify their strengths and areas for improvement that can lead to increased resilience.

Authoritarian

- High control; Low warmth -Highly controlling, issues commands and expects them to be obeyed; Little communication with the child Inflexible rules; Permits little independence -child may become fearful, withdrawn, and unassertive; Girls often passive and dependent during adolescence; Boys often rebellious and aggressive; do not develop the skills to examine why a certain behavior is desirable; no opportunity to participate in the family decisionmaking process

Nurse's role in parental divorce

-Nurses can assist families who are experiencing divorce by inquiring about the circumstances and changes that the child is undergoing. Talk with parents about the child's fears of abandonment and concerns, reminding parents that even infants and toddlers can sense tensions in the home. -Remind parents about the need to keep children out of the middle of confrontations and to maintain limits of acceptable behavior. -Encourage parents to avoid saying negative statements about the other parent and encourage them to make every effort to maintain the relationship with the children. -Help parents recognize their child(ren)'s needs for love and security during this difficult period.

planning for ongoing care using family centered principles

- Identify the primary decision maker for the child's health care. • Discuss the family's goals for managing the child's care in the home setting. • Consider how the family's strengths and previous problem-solving experiences can be integrated into the intervention. • Consider the family's ethnic and religious background in developing intervention recommendations. • Ask questions in a respectful and nonjudgmental manner to help identify a family's use of CAM, encouraging the parent to share the information. • Offer the family one or more potential interventions rather than trying to force one intervention. • Identify the type of support or assistance the family would like to have. • Identify potential resources in the community that match the child's and family's needs for support. • Make sure the family has a care coordinator, especially when a family member seems to be unable to assume the case management role initially. • Refer families with moderate or severe dysfunction to community resources for social support and counseling, as appropriate.

transition to parenthood

- Mothers may be eager to have a child but be concerned about fulfilling all the expectations of others - Fathers anticipate increased responsibility and many are concerned about their ability to provide adequate support for the family -At the time of birth, the parents experience stresses and challenges along with feelings of pride and excitement. -Both mothers and fathers make adjustments to their lifestyles to give priority to parenting. - Several factors influence how well the parents adjust to their new role: Social support provided to the mother, Marital happiness during pregnancy, Infants with significant health conditions or those with difficult temperaments -With the birth of the first child, both mothers and fathers have challenges related to renegotiating their employment to accommodate family and childcare time.

culture and nutrition

- Nutritional practices begin even before birth, as many cultural groups have beliefs that determine foods that are healthy to eat or should be avoided during pregnancy -Certain cultures and religions have restrictions on or prescriptions about specific foods and preparation methods. -Additionally, some cultures value large size or may associate a healthy child with being "large." Other cultures value slimness and look down on individuals who are obese - Health problems associated with specific cultures that may require dietary changes are also identified.

Parental influences on the child

- Positive family relationships are characterized by parent-child warmth and supportiveness. -Warm parent-child relationships can buffer children from stress and promote positive cognitive and social outcomes. -Parents who are warm and place high demands on their children for appropriate behavior have children who tend to be content, self-reliant, self-controlled, and open to learning in school. -Mothers and fathers each contribute to the psychologic, emotional, and social health and development of their children. -Both parents provide affection, nurturing, and comfort

Parental control - high level

- Restrictive control of behavior -Survey and enforce compliance with rules -Encourage children to fulfill their responsibilities -May limit freedom of expression

Concepts of Family-Centered Care

- The family is acknowledged as the constant in the child's life and a partner in the child's health care. - The family, child, and health professionals work together in the best interest of the child and the family. - Health professionals listen to and respect the skills and expertise that the family brings to the relationship. - Trust is a fundamental element of the relationship between the family, child, and health professionals. - Communication occurs in an open, unbiased manner and is ongoing. - Families, children, and health professionals make decisions regarding the child's care in a collaborative manner in all healthcare settings and for all types of health care needed -The child is supported to learn about and participate in his or her health care and decision making. -The racial, ethnic, cultural, and socioeconomic back-ground of the family and child, as well as family traditions, are honored - Family-to-family and peer support are encouraged. - Healthcare settings develop policies, procedures, practices, and systems that are family friendly and family centered -Health information for children and families is available and provided to match the range of cultural and linguistic diversity in the community as well as the health literacy levels.

culture

- combination of a body of knowledge, a body of belief, and a body of behavior. -It involves a number of elements, including personal identification, language, thoughts, communications, actions, customs, beliefs, values, and institutions that are often specific to ethnic, racial, religious, geographic, or social groups.

Family Stress Theory

- focuses on the family's ability to cope and adjust to stressful events, such as having a child with a significant health condition -Nonroutine stressors (such as surgery or the birth of a child) and unexpected events (a child's sudden illness or injury) are often more stressful because the family has not had time to review resources and prepare a response. -By identifying how families respond to the stress of a child's illness or injury, nurses can provide support that may reduce the impact on the entire family

complementary and alternative medicine (CAM)

- healthcare approaches that are not considered to be part of conventional Western medicine -A complementary therapy may be defined as any procedure or product that is used as an adjunct to conventional medical treatment -alternative therapy is usually considered a substance or procedure that is used in place of conventional medicine

family assessment tools

- help in gathering information about the family's functioning. -Some tools specifically focus on family strengths, coping strategies, and family stresses. -genogram: a pedigree that displays information about a family's health history over at least three generations -family ecomap: an illustration of a family's relationships and social networks that may be prepared by nurses in partnership with family members. The nurse may learn information about how the family perceives or receives social support and the strength of family relationships -calgary: three categories of information (structural, developmental, and functional family data) to assess a family's strengths and problems; enables collection of extensive family information, and it can facilitate assessment of family challenges -Home observation for measurement of environment: assessment tool developed to measure the quality and quantity of stimulation and support available to a child in the home environment; parental responsivity, acceptance of child, the physical environment, learning materials, variety in experience, and parental involvement; identify nursing interventions that promote the child's growth and developmen

family theories

- helpful in comprehending family functioning, environment-family interchange, family changes over time, and family response to health and illness. - provides a context about family functioning that can assist with planning nursing care and developing future partnerships with families and their children. -Each family has structure and functions to help it maintain stability while responding continuously to various stresses and strains within the family and in the family's interactions and functioning within the community

family size

- influences the amount of attention given to children. In small families, parents often have more time to give attention to the children, to encourage achievement, to meet family expectations, and to support involvement in community activities. -Children in larger families are encouraged to be cooperative so that the family group functions well. The child usually receives less personal attention from the parents and must often turn to others in the family for support; limited family finances -may adopt a specialized family role to gain recognition

family centered care

- mutually beneficial partnership develops between families and the nurse, and also other health professionals. -In this way the priorities and needs of the family are addressed when the family seeks health care for the child. -Each party respects the knowledge, skills, experience, and cultural beliefs that the other brings to the healthcare encounter.

cultural competence

- the ability of the nurse to understand and effectively respond to the needs of patients and families from different cultural backgrounds - nurse should also consider the potential that an extended family member may need to be consulted regarding the treatment plan for the child -Nurses demonstrate appropriate strategies for delivering culturally sensitive care when they develop techniques in assessing the influence of culture on the child and family and incorporate that information into an individualized plan of care. - Culturally competent nurses find effective ways to work with the family to determine how they can incorporate prescribed therapies with their healthcare practices

Blended or reconstituted nuclear family

- two parents with biologic children from a previous marriage or relationship who marry or cohabit. -better financial support and a new supportive role - lack of a clear role for the stepparent, lack of acceptance of the stepparent, financial stresses when two families must be supported by stepparent

ethnicity

-"cultural group's sense of identification associated with the group's common social and cultural heritage" -Examples of ethnic groups include Hmong, Jews, and Irish Americans.

Adoption preparation

-Adopting parents often benefit from preadoption counseling, which may help provide the support and reassurance needed -about parenting and the adoptive process, as well as make connections with support groups or other families with adopted children. -Preadoptive parents may wonder about their ability to love and parent the child and may have concerns about the responses of relatives, other children, and friends -Children already present in the family need to be reassured that they will not be displaced by the new child. -Families need information about the child's understanding of what adoption means

Culture and Communication

-Children are most likely to speak both the language of the parents and the healthcare providers and may appear to be likely interpreters. However, it is recommended that children never be used to interpret in healthcare situations due to the confidentiality needs of both parent and child. -Signs, posted literature, and brochures should be available in the languages of the children and families served - Language can also affect health literacy skills, as a large number of instructions are given in writing; Verify what the child and family can read and whether alternative methods should be used. -The nurse's use of nonverbal communication may hinder or help communication. Gestures and body language may be misunderstood or misinterpreted; Watch for patterns in various cultures and alter your approach to be more congruent. -Touch is another form of nonverbal communication. The appropriateness of touch varies by culture; Watch for responses from the child and family

Culture assessment

-Collect the psychosocial history and daily living patterns data from the family and child. -Assessment of the culturally diverse child and family includes determining the family's healthcare practices such as health traditions, health beliefs, health-seeking behaviors, healthcare practitioner, and religion or spirituality. -Select the appropriate family assessment tool to collect information that can help evaluate the family's strengths and resources. -• Determine how this condition influences family functioning. • Identify how all the family members have responded to the child's acute condition and disability. -Obtain information about how the family is considering management of the child's care at home. • Determine if other family issues or stressors must be integrated into the plan of care. • Identify the family's expectations of different health professionals and facilities to help manage the child's care. • Prepare an ecomap and genogram.

Parental warmth - low level

-Cool, hostile -Quick to criticize or punish -Ignore children -Rarely express affection or approval -Rejection may be seen

key elements of culture

-Culture is based on shared values and beliefs. -Culture is learned and dynamic. A child is born into a culture and starts learning the beliefs and practices of the group from birth. - Culture is integrated into life and uses symbols

Culture & time orientation

-Cultures have specific values and meanings regarding time orientation. Cultural groups may place emphasis on the events of the past, those events that occur in the present, or those events that will occur in the future - Cultures that are oriented predominantly to the past may want to begin healthcare encounters with lengthy descriptions of past healthcare treatments, family history of diseases, or individual past experiences with health. - For cultures that are oriented predominantly to the present, little consideration may be given to either the past or the future; adolescents commonly focus on the present and may not engage in preventive health practices for longterm health -Cultures that are oriented predominantly to the future, such as European American, may not focus on what is important at the present time; the family focusing on the future may focus on the dreams they had for a child's education or sports performance and have trouble setting present goals for treatment of a disease such as juvenile arthritis -the predominant culture respects being on time and considers time valuable and not to be wasted. Other cultures may not emphasize a concern for time.

collecting data for family assessment

-Establish a trusting relationship with the child and family to obtain an accurate and concise family assessment. -Identify the primary concerns of the parent(s) and child, noting that they may be different -information about the family is collected continuously during the healthcare process, through interviews, observations of family interactions, reports from other healthcare providers or agencies working with the family, and with a family assessment tool. -Observation of the home and family members is recommended in some cases

promoting family centered care

-Families have important knowledge to share about their child, their child's health condition, and how their child responds to various actions and events. -They also need access to information that will make it possible for them to fully participate in planning and decision making. -Parents have a role in developing an effective collaborative relationship with nurses and other health professionals. -must learn to communicate effectively with the health professionals caring for their child, and in the process develop a trusting relationship. - children and parents can participate in the development of policies and guidelines for family-centered care in all types of healthcare settings - Taking parents' perspectives into consideration can be critical for staff and hospital administrators in providing quality patient care and achieving successful patient satisfaction - Parents can also serve a valuable role in family-to-family support networks as mentors to new families entering the healthcare system for a new chronic condition. Some parents may help raise awareness about specific healthcare issues, serve as advocates for public policy issues, and assist with fundraising activities. - consider how a healthcare setting's written policies, procedures, and literature for families refer to families and what attitudes these materials convey; Words such as guidelines, working together, and welcome communicate an openness and appreciation for families in the care of their children

Increase in CAM therapies

-Increased consumer awareness of the limitations of conventional Western medicine • Increased international travel • Increased media attention • Advent of the Internet

Divorce and its effects on children

-Many children believe they are at fault for the separation and divorce, having said or done something to make the parent leave. -When one parent leaves, the children may feel abandoned and divorced by that parent. -They may also fear being abandoned by the remaining parent. -Children might become engaged in the disputes of parents, and they experience conflicts of loyalty when parents fight for their affection. -When they must make a lot of changes in their lives in addition to the parents' separation (new home, different school), their adjustment is made more difficult because their sense of order is upset. - parents are so stressed that their customary parenting styles become inconsistent. They may be unable to provide the warmth, affection, and support that the children need during this time. -Children do better when both parents remain involved with their children and cooperate with each other after divorce

Assessing parent styles

-Nurses can assess parenting styles by asking families how they handle situations that require setting limits. - Keep in mind that no two children are alike, and parents often must vary their parenting styles for different children in the family.

transition to parenthood - nurses role

-Nurses can help new parents through this important transition by listening to the challenges they describe during the infant's first health visits -Encourage fathers and mothers to attend and participate in health promotion visits with the healthcare provider -Answer questions and offer ideas to address described problems -frustrations and feelings they have regarding the challenges of infant care are normal and expected -Encourage both parents to become active in caring for the infant and to gain comfort in that care -Help each parent find activities that she or he enjoys with regard to infant care

international adoptions

-Nurses work with families that have adopted children from other countries to provide a comprehensive evaluation of the child to detect potential developmental problems and health conditions as soon as the child is brought into the country. - Emotional and psychologic problems may be the result of long-term institutionalization in an orphanage, such as inconsistency in interpersonal development and delayed developmental milestones. -Children need a transition period of several months to adjust to a different daily routine and to bond with the parents. Exposing the child to large numbers of family members or to busy environments may be stressful to the child. -The nurse may become involved in providing counseling to the family when it is trying to integrate the adopted child into the family's life and routine

parent adaptability

-Parents who are able to adapt their behavior to meet the needs of children at different developmental stages are also more effective. -Parenting styles may change as the child grows older

Parental control - low level

-Permissive, minimally controlling -Make fewer demands -Fewer restrictions on behavior or expression of emotion -Permit freedom in exploring environment

health status of foster children

-Physical health problems, as well as developmental, behavioral, and emotional problems, are common in children in foster care - Every child entering foster care should receive an initial health screening, followed by a more comprehensive health assessment within a month.

discipline strategies used by parents

-Reasoning: Explaining why a behavior or action is inappropriate or describing how limit setting is important -Behavior modification: Giving positive rewards (such as treats or privileges) or reinforcement for good behavior or consistently ignoring inappropriate behavior to minimize the behavior. -Experiencing consequences: Allowing the child to learn important lessons associated with misbehavior -Corporal punishment: Spanking, slapping, or inflicting pain with a paddle, whip, or other object. -Scolding or yelling: Using harsh language to verbally reprimand the child.

sibling relationships

-Siblings are the first peers of a child and often have a lifelong relationship lasting up to 70 or more years. -Siblings, especially those of the same gender, who are closer in age tend to have a closer relationship because they often share many common experiences through childhood and adolescence. -Sibling rivalry exists between children at times in all families, but most children learn to share, compete, and compromise with their siblings. -Some sisters and brothers take on roles such as protector, problem solver, friend, and supporter for dealing with issues in the family and in the environment. -Children develop different personalities because of the need to establish a distinct identity for themselves and to be seen as unique in the family. Siblings may share some experiences, but they are often exposed to different environmental experiences that also help shape their personalities.

transition to permanent placement

-The Adoption and Safe Families Act of 1997 led to significant changes in child welfare and was enacted to increase well-being, safety, and permanence. -Timelines were shortened for decision making about permanent placement of children, and incentives were established for states to encourage adoption. -states were given guidelines regarding when reasonable efforts to reunite children with birth parents are no longer necessary, and when action is required in certain circumstances to terminate parental rights -Legal guardianship (a permanent placement option for the child, often with relatives, in which parental rights are not terminated) was established as an alternative to adoption (a legal relationship between the child and parents not related by birth in which the adoptive parents assume all legal and financial responsibility for the child) -For those children with kinship foster care, adoption is often not perceived as the best option. Legal guardianship enables the child to retain legal connections with the birth family and relationships with the extended family.

culture & health beliefs

-The family members' health beliefs influence their approaches and practices regarding health and illness. -The young child has a view of health and illness connected with developmental understanding and gradually takes on the family's cultural view while growing older. -some families, when faced with a life threatening illness of their child, may seek alternative health practices that are not considered part of their cultural heritage. -Nurses and other healthcare professionals should learn about the family's belief system and integrate all types of care that the family wishes as long as there is no danger to the child. -Faith-based belief and practice is an integral part of culture for some families. Views of religion and spirituality can shape their approaches and responses to a child's illness and guide practices to maintain health. -Faith and spirituality can be a source of great comfort and support for children who are ill and their families -Religion, commonly referred to as faith-based belief, is an organized system of shared beliefs regarding the significance of the nature, cause, and purpose of life and of the universe - Spirituality refers to an individual's experience and own interpretation of a relationship with a Supreme Being

Permissive parents

-show a great deal of warmth but set few controls or restraints on the child's behavior; Parents are so intent on showing unconditional love that they fail in performing some important parenting functions; discipline is inconsistent, and parents may threaten punishment but not follow through -child does not learn socially acceptable limits of behavior; child ends up controlling the parent; become rebellious, aggressive, socially inept, self-indulgent, or impulsive; May be creative, active, and outgoing

Acculturation

-the process of modifying one's culture to fit within the new or dominant culture. - occurs when people leave their country of origin and immigrate to a new country. -associated with improved health status and health behaviors

safety issues concerning CAM therapies

-The misleading claims of usefulness, dosing safety of some products, and lack of manufacturing standards of natural products -Interaction with prescribed medications (interferes with metabolism of medication or increases the effect of the prescribed medication, like an overdose) • Side effect or allergic reaction directly associated with the product • Substitution of the product for a prescribed medication that is potentially lifesaving • Toxic effects because of contaminants or other additives in the product, or if the plant used for the herb was incorrectly identified -The use of CAM in the care of children must be addressed because of the limited research with this age group and developmental variations that may influence efficacy and safety -Complementary and alternative modalities must be assessed for safety, including positive and negative benefits, cost, efficacy, and clinical usefulness. -Determine the family's use of complementary and/or alternative medicine such as the type of remedies and healthcare practices used. -determine the side effects, risks, and other implications to the child receiving this type of therapy

Parenting

-a leadership role in the family in which children are guided to learn acceptable behaviors, beliefs, morals, and rituals of the family and to become socially responsible contributing members of society. - have responsibility for providing stability to children with a nurturing, safe, and structured environment. - parents must have a certain flexibility that enables the family to adapt and adjust to family changes with time and other significant stressors and challenges -To be successful parents, implement reasonable limit setting (established rules or guidelines for behavior) on children's autonomy while they learn values and self-control.

Family

-as two or more individuals who are joined together by marriage, birth, or adoption and live together in the same household -membership often changes over time. -Families are guided by a common set of values or beliefs about the worth and importance of certain ideas and traditions. -beliefs are greatly influenced by external factors, including cultural background, social norms, education, environmental influences, socioeconomic status, and beliefs held by peers, coworkers, political and community leaders, and other individuals outside the family unit

Adoption

-couples have infertility problems and are unable to have a biologic child. - A desire to provide a home to a child who needs one or to have a larger family without additional biologic children • Fertility issues requiring invasive medical procedures that are too extensive, expensive, or psychologically overwhelming for a subsequent pregnancy -Adoption of a foster child with whom the family has established strong bonds • Adoption by a family relative or stepparent -The supply of healthy infants available for adoption is much smaller than the number of families who want to adopt. -Most children in the United States available for adoption are older children, often of minority populations or of mixed races, and those with special healthcare needs.

subgroups of complementary health approaches

-natural products and mind and body practices. -Natural products include herbs, vitamins, minerals, and probiotics (also referred to as dietary supplements). -Examples of mind and body practices include acupuncture, massage therapy, meditation, relaxation, yoga, healing (therapeutic) touch, and hypnotherapy.

binuclear family

-postdivorce family in which the biologic children are members of two nuclear households, with coparenting by the father and the mother. -The children alternate between the two homes, spending varying amounts of time with each parent in a situation called coparenting, usually involving joint custody.

foster care

-provision of protection and shelter for a child in an approved living situation away from the family of origin. -It is legally coordinated by the state's child welfare system. - Children enter the foster care system for many reasons. -The primary reason is child abuse and neglect. Other reasons include parental problems such as abandonment, illness, alcohol/substance abuse, incarceration, and death. -state guidelines that are used when investigating the home often include an interview with the interested adults to check for readiness to be a foster parent, health of all family members, legal background checks, and safety of the residence. -Foster parents may be relatives (kinship care) or unrelated families with whom the child has a strong emotional bond; Kinship placement is frequently viewed as a better alternative, providing a more stable environment for the child -Kinship providers are frequently older, in poorer health, have less income, and more likely to be single than nonkinship foster parents

history of family centered care

-recognized that families had a significant role in promoting the psychosocial and developmental needs of children in the hospital. -When parents were initially allowed to stay with hospitalized children, nurses and other health professionals noticed that children were quieter, happier, and recovering sooner. -Research confirmed that children as well as parents had decreased anxiety when the parents were allowed to be present during their child's painful procedures. -philosophy is also becoming more widely accepted by other health professionals. Parents are now recognized as partners in their child's care. not just visitors

family development theory

-use a framework to categorize a family's progression over time according to specific, typical stages in family life - Duvall's (1977) eight stages in the family life cycle of a traditional nuclear family have been used as the foundation for contemporary models of the family life cycle that describe the developmental processes and role expectations for different family types. - Nurses can assess families by their developmental stage, how well they are fulfilling the tasks of that stage, and the availability of resources to accomplish developmental tasks. -The stages provide a method for anticipating transitions and potential stressors with family role changes that occur at different points along the developmental continuum for different family types -nurse can analyze the family growth and health promotion needs and identify developmental transitions and potential stressors.

authoritative parents

-use firm control to set limits, but they establish an atmosphere with open discussion, or are more democratic; Parents provide explanations about inappropriate behaviors at the child's level of understanding; parents make it clear that they are the ultimate authority for decisions. -child is encouraged to talk about why certain behaviors occurred and how the situations might be handled differently another time; allowed to express their opinions and objections, and some flexibility is permitted when appropriate; develop a sense of social responsibility; best adjusted, self-reliant, self-controlled, and socially competent; Higher self-esteem Better school performance

Assimilation

acculturation and is described as adopting and incorporating traits of the new culture within one's practice

Roles of the family

• Caring, nurturing, and educating children • Maintaining the continuity of society by transmitting the family's knowledge, customs, values, and beliefs to children • Receiving and giving love • Preparing children to become productive members of society • Meeting the needs of its members • Serving as a buffer between its members and environmental and societal demands while advocating or addressing the interests and needs of the individual family members - Individual family members take on certain social and gender roles and hold a designated status within the family based on the values and beliefs that bind extended families together. -Parental roles, including childrearing practices and beliefs, are usually learned through a socialization process during childhood and adolescence. - parents work to successfully nurture and rear children and to help them meet role expectations. Parents must also meet the needs of the family unit and provide economic support for the family. - family is a child's source of strength and support, the major constant in the child's life. -Families are intimately involved in their children's physical and psychologic well-being, and they play a vital role in the health promotion and health maintenance of their children.