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Introduction
Family assessment is inevitable for nurses practicing family nursing. Therefore, it is important for such nurses to be well equipped with the right knowledge and skills about different approaches that can be used in family assessment. In this study, we shall focus on Doane and Varcoes approach to relational nursing practice and De Mols approach to family assessment.
Values, Beliefs and Assumptions that Underpin these Approaches
According to Doane and Varcoes approach of relational practice, nurses should rationally engage with families in the process of family assessment (Doane & Varcoe, 2005).This approach also opposes following a predetermined method of assessment. Instead, it recommends a health-promoting relational practice that involves collaboration with families, rationally inquiring about their experiences in context and giving feedback on what arises through the relational process (Doane & Varcoe, 2005). Inquiry is the structure that underpins this approach.
The main assumption of Doane and Varcoes approach is that a nurse should not take the role of an expert in family assessment as it is believed that patients and their families also have some knowledge about their conditions. Thus family assessment should be a dynamic process that is carried out with an open mind.
On the other hand, De Mols approach of family assessment believes that each persons thoughts, feelings and perceptions in a family should be measured so as to obtain full information. This approach also assumes that since a family is composed of persons who are interdependent, there is no way an individuals behavior and functioning can be understood without considering his or her immediate social context, which is the family (De Mol et al., 2010).However, it is not assumed that all family relationships are always interdependent (De Mol et al., 2010).
Theoretical Frameworks
Doane and Varcoes approach of family assessment recommends that nurses carrying out inquiry should be open to learning and accommodating others knowledge; including family knowledge (Doane & Varcoe, 2005).Feedback should also be allowed in case of any mistakes since it is an open process. This approach also views family assessment as a dynamic process of knowing that supports collaborative knowledge development.
Although Doane and Varcoes approach as opposed to a prescribed method of assessment, it is usually structured. The structure in this case does not follow predetermined methods but includes a thoughtful process of interpretive critical and spiritual inquiry (Doane & Varcoe, 2005).The nurse plays the role of a mediator in the approach. The nurse is also expected to respond to what arises by making flexible decisions on the way forward. Questions are formulated to follow the lead of the family.
On the other hand, De Mols approach of family assessment recommends that an individuals behavior be assessed in regard to the individuals primary social context, which is the family (De Mol et al., 2010). According to this approach, the thoughts, feelings and perspectives of every family member need to be measured. These types of measures are known as relationship-specific measures (De Mol et al., 2011).In most cases, every member of the family is found to interact with the rest, resulting in a round robin design (De Mol et al., 2010).
Definition of Family and Health in the Approaches
Both approaches define a family as a system that consists of a mother, father and children and health as the physical, psychological, social and spiritual wellbeing.
Ways in which each of the models attended to the relational nature of families and their everyday living experience.
Doane and Varcoes approach recognized that the patient and his family were knowledgeable, hence using an open method in inquiry. The approach also recommended that the nurse follows the lead of the family while asking questions.
On the other hand, De Mols approach recognized that members in a family were interdependent, hence there was a need to measure the thoughts, feelings and perspectives of every member in the family (De Mol et al., 2010).
How each of the approaches enhanced or constrained my ability to attend to the context.
Doane and Varcoes approach enhanced my ability to see and respond to the socio-historical location of the family since I was able to interact openly with the family.
On the other hand, De Mols approach restricted me from seeing and responding to the socio-historical location of the family since the assessment was pre-determined.
How the approaches attended to diversity.
Doane and Varcoes approach attended to diversity in that it gave room for the patient and family to freely express themselves with no restrictions to pre-set questions.
On the other hand, De Mols approach attended to diversity in that it took into consideration the feelings and thoughts of every family member.
How the approach attended to power relations.
Doane Varcoes approach gave the patient and the family power to decide what was discussed as the nurse followed the lead of the family in asking questions.
On the other hand, the nurse was in full control of De Mols approach as she set the assessment to be carried out on the family members.
How the approach supported and directed me to be with the family relationally.
The Doane Varcoe approach directed me to be with the family relationally as I mediated in the narration of family experiences.
On the other hand, De Mols approach supported and directed me to be with the family relationally as I assessed the thoughts and feelings of the family members.
How the approach helped me to truly listen and learn about the family.
Doane Varcoes approach made me keenly listen to the familys experiences because as a mediator in the process, I had to be attentive so as to be able to develop questions from the lead of the family.
On the other hand, De Mols approach made me keenly listen so as to derive accurate information from relationship-specific measures.
How the approach helped me to attend to what was meaningful to the family.
Both approaches enabled me to attend to what was meaningful to the family because I was able to respond to the patients needs after understanding the familys experiences.
How the approach enhanced my existing capacity to be in relation.
Doane Varcoes approach enabled me to be in relationship through engaging in an inquiry with the patient and his family.
De Mols approach enabled me to be in relationships as I assessed the thoughts and feelings of the family members.
How the approach supported my response-ability to the family.
Both approaches made me understand the feelings and the experiences of the patient and his family. This helped me a lot in making clinical decisions.
Conclusion
In conclusion, both Doane and Varcoes approach of relational nursing and De Mols approach are significant family assessment approaches. However, the two approaches differ in terms of their structure and application.
References
De Mol, J., Buysse, A., & Cook, W. L. (2010). A family assessment based on the social relations model. Journal of Family Therapy, 32, 259-279.
Doane, G.H., & Varcoe, C. (2005). Family nursing as relational inquiry: developing health-promoting practice. Philadelphia: Lippincott
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