Family Health Promotion Research Articles

Family health

Ainna Fawcett-Henesy outlines the WHO initiative to promote family health nurses

Part 3: Family Health in an Economically Disadvantaged Population

An ethnographic study completed in an Appalachian county in southeastern Ohio included eight families (N = 25) and community informants. The purpose of the study was to identify ways economically disadvantaged families with young children defined family health within household contexts. Families were recipients of public assistance and entitlement programs. Taped and later transcribed data were gathered through a series of home interviews with multiple family members. Family health was nestled within unique member perspectives and described as a dynamic household construction affected by the community. Subjects described health routines as patterns affected by the household context. Mothers played key roles as health leaders, caregivers, and gatekeepers in family health. Study implications include guarding against semantic slippage when using the term family health, developing family-focused care models where mothers are pivotal, identifying the contextual factors most predictive for promoting family health, and including health routines in plans of care.

School-based approaches for preventing and treating obesity.

Schools have the potential to make valuable contributions to both the prevention and treatment of childhood obesity. This article reviews the research on school-based interventions to prevent and treat obesity. A literature search from 1965 to the present on school-based treatment of obesity, identified 11 controlled experimental studies. The results show positive, though modest short-term results. Relatively few primary prevention research studies, targeted specifically to preventing obesity, have been conducted. Therefore, efficacy has not been established. Both primary and secondary obesity interventions have a role in schools. A comprehensive, integrated model for school-based obesity prevention is presented. This model, building upon the comprehensive school health program model, consists of eight interacting components: health instruction; health services; school environment; food service; school-site health promotion for faculty and staff; social support services; physical education classes; and integrated and linked family and community health promotion efforts. While multi-faceted community-wide efforts are needed to address the growing problem of obesity, schools are in a unique position to play a pivotal role in promoting healthy lifestyles and helping to prevent obesity.

Development of bilingual tools to assess functional health patterns.

The theory and process of developing bilingual assessment tools based on Gordon's 11 functional health patterns. To facilitate assessing the individual, family, and community in a student clinical practicum in a Spanish-speaking country. Multiple family and community health promotion theories; translation theories, Gordon's Manual of Nursing Diagnosis (1982); translation/back-translation involving Ecuadorian faculty and students; student community assessments; faculty and staff workshops in Ecuador. Bilingual, culturally sensitive health assessment tools facilitate history taking, establish nursing diagnoses and interventions, and promote mutual learning. These outcomes demonstrate potential application to other systems in the international nursing community.

Book Review: Nurses and Family Health Promotion

Book Review: Nurses and Family Health Promotion

Ethnography: studying the fate of health promotion in coronary families.

The concept of the 'mindful body', 'coronary candidacy' and "prevention paradox' are three of many interesting themes explored in this paper which examines how, and to what extent, health information is received and translated into the daily domestic setting by coronary family groups. Taking an ethnographic approach to collecting data highlights both the advantages and disadvantages of this methodology in practice. Certainly, the emergence of a health promotion orientation in health care is an area which is intimately connected to aspects of human culture and society that have long been a central concern of anthropologists. This mini-ethnography provides an anthropological understanding of the knowledge, beliefs and behaviours associated with heart disease and its prevention. The concept of the 'mindful body' is provided as a critical interpretive approach to analysing the potential outcome of prescribed lifestyle changes, as given to coronary sufferers and their families during the period following coronary artery bypass surgery. Data drawn from this study confirms the evidence of lay epidemiology which works within the cultural field of fate, luck and destiny, and which has interesting implications as to how nurses might plan for their health promotion strategies in the future.

Designing a Successful Health Fair to Promote Individual, Family, and Community Health

A health fair is a community health strategy used to meet community members' needs for health promotion, education, and prevention. In this article we focus on the importance of partnerships in designing a health fair; essential components; and steps in planning, implementing, and evaluating a health fair. The Healthy People 2000 framework can be used to guide the development of objectives and content for a health fair. We present a list of topics for exhibits and a Health Fair Evaluation Questionnaire used to measure outcomes of a health fair on participants' health beliefs and practices. Implications for nursing practice, education, and research include increasing nurses' awareness of community problems, health beliefs, and practices; networking opportunities that provide knowledge of new resources; service learning experiences for students; and opportunities for research on how health fairs meet health care needs and promote changes in health knowledge, beliefs, and practices.

Daughters and Caregiving

The purpose of this study is to identify the stressors experienced by caregiving daughters of frail, elderly parents and the coping skills used to manage those stressors. The differential effects of paid employment on caregiving daughters are also examined to explore the relationship between work force participation and caregiving stress. Data were collected from a non-random sample of 21 caregivers selected from the caseloads of a home health agency and a state continuity of care association. Two instruments were administered to caregiving daughters: the Caregiver Stress and Coping Instrument, and Lawton and Brody combined ADL and IADL instruments to assess functional level of parents. Finding included: 1) employed caregiving daughters had significantly higher stress scores (M = 52.9) than unemployed caregiving daughters (M = 46.8, p < .05); and 2) there was no significant relationship between stress scores and combined ADL and IADL scores. The stressors most often identified were needing help with recreational activities for the care recipient, and worrying about the future. The findings from the study can be used to plan nursing interventions specific to caregiving daughters, develop employee assistance programs promoting family health care or on site adult day care, and reduce costs by increasing employee productivity and retention.

Family Health- promotion Proj ects

The concept of the family health-promotion project is introduced as a means of describing and analysing health-promoting processes in a family. We suggest that an action-theoretical conceptualization provides a language for dealing with socially embedded human behaviour. The levels of project organization are described and the issues discussed are: hierarchical organization, communication, goal structure, steering, control, regulation, energizing, perspectives and construction, group or joint action, three-dimensional structure of group action, dual enfolding of group actions, properties of group action and of family projects. The research design and methods of a current study on a family health-promotion project are presented and explained.

Health Ahead—The Heart Smart Family Approach to Prevention of Cardiovascular Disease

The Heart Smart Family Health Promotion program is a unique approach to education and skills development aimed at improving the cardiovascular health of entire families. By including the entire family system, rather than singling out one individual for behavior change, social support and self-confidence are enhanced and the probability for maintenance of behavioral skills is increased. The Family Health Promotion program uses a format that minimizes lecture and maximizes awareness, skills development, problem-solving, and real-life application over a 12- to 16-week agenda. Behavioral counseling and contingency contracting provide opportunities for the practice and reinforcement of new behaviors. Initial evaluations of the program model developed with cardiovascular high-risk children and their parents indicated that parents significantly increased health knowledge, lowered blood pressure, became more physically active, and decreased their intake of total fat, saturated fat, and sodium. A clinically significant reduction in children's blood pressure also was observed. Children's weight (adjusted for height) remained stable. The Family Health Promotion program resulted in positive changes in cardiovascular risk factors and can be adapted to any clinical or health-promotion setting.

195 HEALTH KNOWLEDGE, ATTITUDES AND BEHAVIOURS IN FAMILIES WITH PRE-SCHOOL AGE CHILDREN

OBJECT: To asses current practices of health promotion in families with preschool age children: the parents and children's knowledge on healthy lifestyle, their attitude and behaviour, social values relating to good health, the content and nature of health education. METHOD: Health knowledge, attitudes, behaviourial indicators in families were estimated before and after one year health teaching course in experimental and control groups. RESULTS: We questioned 6 year old children (N=442) and their parents (N=409). Health knowledge before education in families was quite good and relates to common education. More than 50% of the respondents knew the right answers. Health attitudes and health behaviours were very poor. After one year of health education only the health knowledge of fathers and mothers improved 10,4%. Health attitudes and health behaviours in families were without changes too. CONCLUSION: Due to our survey, health knowledge does not relate to health attitudes and health behaviours.

Nurses and family health promotion: Concepts, assessment, and interventions

Nurses and family health promotion: Concepts, assessment, and interventions

The pediatric nurse practitioner and the physician assistant: How are we different?

Changing health care needs over the past 30 years have created new roles for professionals in advanced health care practice settings. As new roles continue to evolve, educational preparation and clinical experiences must be considered when determining the most appropriate health care provider for a particular specialization. Although similarities exist between the PA and PNP, the extent of pediatric didactic and clinical experiences is limited in most PA programs. Only once program is identified by the American Academy of PAs as a child health PA program. PNP education provides the nurse in an advanced preactice role with an extensive background in normal growth and development, family counseling, health promotion, and management of common pediatric problems and chronic illnesses. The PNP is a registered nurse who is experienced in the care of children before pursuing an advanced degree as a PNP. In comparison, many PAs are not required to hold a professional degree before enrollment in a PA program. Although students entering PA programs may have experience in health-related fields before enrollment, few are specialized in the care of children. The PA program is designed to prepare the sutdent to assist the physician with diagnosis and treatment in primary care with limited exposure to pediatrics. In comparisons, the PNP spends the entire educational program of studying gaining expertise in the care of children from infancy to adolescence. Because of advanced educational prepration, the PNP is in a unique position to contribute substantially to the total car eof the child and family.

Nurses and family health promotion: Concepts, assessment, and interventions

Nurses and family health promotion: Concepts, assessment, and interventions

Initial findings on preventive intervention for families with parental affective disorders.

The purpose of this study was to develop a clinician-based cognitive, psychoeducational, preventive intervention for families with parental affective disorder that would be suitable to widespread use, test its feasibility and safety, and define the areas affected by the intervention. The intervention was designed to increase understanding of parental illness and resilience in the children. The authors studied the first seven families (14 parents) to receive the intervention. Enrollment criteria included affective disorder during the preceding year in at least one parent, presence of at least one child between the ages of 8 and 14 years who was not psychiatrically ill at the time of participation, and willingness to participate in the research study. The intervention consisted of parent, child, and family sessions. Assessment included semistructured interviews with parents about affective disorders, standard ratings of marital satisfaction and therapeutic alliance, and a recently developed semistructured interview to assess response to the intervention. Overall satisfaction with the intervention was rated moderate to high by parents. No harm was reported. Ten of 14 parent subjects reported five or more behavior and attitude changes that they attributed to the intervention. The most frequent behavior and attitudinal changes reported were increased discussion of the illness and related issues and increased understanding of information about affective illness. The authors conclude that the intervention is safe and feasible in families with parental affective disorder.

Working with men: an analysis of health visiting practice in families with young children

The purpose of this paper is to explore health visitors' work with men as uncovered in their detailed descriptions of actual cases. The study used the grounded theory approach to data collection and analysis. Forty-five health visitors were interviewed using the conversational interview and 111 cases of their work with young families discussed. Findings indicate that health visitors' work with men was influenced by both their conceptualization of men within family-focused health visiting practice and contextual factors in the actual client-health visitor situation which enhanced or restricted interventions with men. Four approaches to working with men were identified and classified as: (1) high conceptualization and high intervention, (ii) high conceptualization and low intervention, (iii) low conceptualization and high intervention, and (iv) low conceptualization and low intervention. This paper contributes to our understanding of the health visitor's role in family health promotion.

Cardiovascular Intervention for High-Risk Families: The Heart Smart Program

The Heart Smart Family Health Promotion Program is a multidisciplinary, school-based program for cardiovascular risk reduction among high-risk children and their families. As a program that includes young adults at high risk, it is adaptable to a clinical practice. Nineteen fourth and fifth graders were selected as probands for elevated risk factors after a general screening to identify families for an intervention program. Twenty-three parents participated in a 12-week program focused on eating, exercise, and smoking behavior changes enhanced by behavicral support strategies. Weekly sessions were held in the auditorium/cafeteria of the elementary school and consisted of orientation and presentations, cardiovascular (CV) screening with medical feedback, activities, self-monitoring, counseling, and contingency contracting. Information gathered before and after the program included medical history, CV health knowledge and relevant behavior, blood pressure, serum lipid and lipoprotein values, anthropometric measurements, and urine electrolyte excretion. Both children and parents showed positive changes in eating habits and physical activity and significant changes in knowledge and blood pressure levels, while the children halted their weight gain. We believe this multidisciplinary, behavior-oriented, school-based program can be an effective cardiovascular risk intervention adaptable for a clinical office practice.

Nursing and Family Health Promotion: Concepts, Assessments, and Interventions, Perri J. Bomar (Ed.). Williams and Wilkins, Baltimore, MD (1989)

Nursing and Family Health Promotion: Concepts, Assessments, and Interventions, Perri J. Bomar (Ed.). Williams and Wilkins, Baltimore, MD (1989)

Perspectives on family health promotion

Associate Professor Family Health Nursing Philip Y. Hahn School of Nursing, University of San Diego San Diego, California

Resource Reviews: Nutrition, Hypertension &amp; Cardiovascular Disease, Nurses and Family Health Promotion: Concepts, Assessment and Interventions

Resource Reviews: Nutrition, Hypertension &amp; Cardiovascular Disease, Nurses and Family Health Promotion: Concepts, Assessment and Interventions