Patient Education and Family Systems

Abstract

ABSTRACT.- physical therapy professionals are giving increased emphasis to including,ffimiky members and caregivers as partners in the patient education process, Physical therapy students and professionals can greatly benefit from being exposed to a family systems approach of patient education in both their academic and clinical education. A family systems approach to patient education is described as applied to various aspects of physical therapy practice. Physical therapy educators can play an important role in assisting students to appreciate the value of an expanded family approach to patient education. Suggestions for incorporating this approach in classroom and clinical education experiences are discussed. Physical therapy professionals have recognized the importance of patient education for many years. Clinicians working in pediatric, geriatric, or hospice practice are especially attuned to the value of family-centered patient care.1,2 Recently, there has been an increased emphasis across the profession of including family members and caregivers as partners in the patient educational process.3-9 Inclusion of family in patient-related education or instruction can enhance patient knowledge, decision making, progress, and safety.4 However, family dynamics such as family nonparticipation or ineffective participation can be problematic for practitioners in patient education endeavors.5 The focus of this article is to situate patient education within a larger social systems context so that patient education is extended to the family unit, a more inclusive and dynamic approach than the traditional medical model of including only the patient and professional health care provider. The family is broadly defined as the social group into which an individual is born or adopted (family of origin), or the social group created after leaving the family of origin (family of creation). Thus, family is not always composed exclusively of blood or marriage-related kin but rather should be thought of in very broad terms by health care providers. Because academic and clinical physical therapy educators have a powerful impact on how physical therapist students conceptualize patient education, this article will present patient education within an expanded family context. The frame of reference throughout the article is the physical therapy practitioner and how a family approach can inform and enhance patient education efforts. This frame of reference was chosen to match that typically utilized in classroom and clinical education settings. Additionally, some suggestions are included for physical therapy educators. DEFINING A FAMILY SYSTEM The definition of a family as a system is helpful in understanding the tasks and challenges individual family members face as they move through their individual and collective phases of the developmental process. As a system functioning within the larger social contexts of extended family, culture, and community, the family unit can be viewed as having characteristics and functions of a system. As a system, the family is a unified whole consisting of interrelated parts, functions according to a set of defined rules, processes information, and adapts to changing circumstances with the intent of preserving homeostasis, or balance, among its parts. The nuclear family of the past is no longer the typical family arrangement of today.10,11 Some patients live with their family of origin, some live with their family of creation, and others are living temporarily with family members due to disablement. Additionally, patients may be dealing with both of these families simultaneously; for example, a mother diagnosed with an orthopedic problem may have the responsibility of caring for young children as well as caregiving responsibilities for a disabled, frail parent or relative from the extended family system. FAMILY SYSTEM CHARACTERISTICS Just as an organization is composed of various parts and components striving to function as an integrated system to accomplish its mission, every family is composed of various members who attempt to function as a system with some level of integration. …