Establishing and Sustaining a Family Nursing Center for Families with Chronic Illness: The Wisconsin Experience

Abstract

Illness has a significant impact on the family. Uncertainty, health-related changes, financial concerns, fears, role changes, and family changes are sources of stress for families during chronic illness. In a large regional medical complex serving rural Wisconsin communities, excellent medical care for diseases exists. However, a consistent way to assist families to cope with illness and the family illness responses did not exist. The Family Nursing Center (FNC) was created to provide family intervention services by advanced practice nurses to entire families to assist them to cope with chronic illness and its ramifications. This article focuses on the process of establishing an independent FNC in a large medical complex. Integration of the FNC into the operations of the medical complex, efforts at sustainability in a physician-dominated referral system, identification offamily chronic illness issues, outcomes offamily nursing interventions, systemic evaluation outcomes, andfuture plans are discussed.

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References

Anderson, K. H. (1993). The relative contribution of illness stress and family system variables on family quality of life during early chronic illness (Doctoral dissertation, University of Minnesota, 1993). Dissertation Abstracts International, 54-06B, 2991.

Anderson, K. H. (1994). The relationship between family sense of coherence and family quality of life after illness diagnosis. In H. I. McCubbin , E. A. Thompson , A. I. Thompson , & J. Fromer (Eds.), Sense of coherence and resiliency: Stress, coping, and health. Madison: University of Wisconsin System.

Anderson, K. H. (1998). The family health system approach to family systems nursing. Unpublished manuscript, University of Wisconsin-Eau Claire, Eau Claire, WI.

Anderson, K. H. , & Tomlinson, P. S. (1992). The family health system as an emerging paradigmatic view for nursing. Image: Journal of Nursing Scholarship, 24(1), 57-63.

Anderson, K. H. , & Valentine, K. L. (1996). Family Nursing Center Referral Checklist. Marshfield, WI: Family Nursing Center.

Brooten, D. , & Naylor, M. D. (1995). Nurses' effect on changing patient outcomes. Image: Journal of Nursing Scholarship, 27(2), 95-99.

Campbell, T. (1986). The family's impact on health: A critical review. Family Systems Medicine, 4(2 & 3),135-328.

Clawson, J. A. (1996). A child with chronic illness and the process of family adaptation. Journal of Pediatric Nursing, 11(1), 52-61.

Ell, K. (1996). Social networks, social support and coping with serious illness: The family connection. Social Science & Medicine, 42(2), 173-183.

10.

Fink, S. V. (1995). The influence of family resources and family demands on the strains and well-being of caregiving families. Nursing Research, 44(3), 139-146.

11.

Jamerson, P. A. , Scheibmeir, M. , Bott, M. J. , Crighton, F. , Hinton, R. H. , & Cobb, A. K. (1996). The experiences of families with a relative in the intensive care unit. Heart & Lung, 25(6), 467-474.

12.

Loos, F. , & Bell, J. M. (1990). Circular questions: Afamily interviewing strategy. Dimensions in Critical Care Nursing, 9(1), 46-53.

13.

Patterson,J. M. , Jernell,J. , Leonard, B. J. , & Titus,J. C. (1994). Caringformedicallyfragile children at home: The parent-professional relationship. Journal of Pediatric Nursing, 9(2), 98-106.

14.

Tomlinson, P. S. , Kirschbaum, M. , Harbaugh, B. L. , & Anderson, K H. (1996). The influence of illness severity and family resources on marital uncertainty during critical pediatric hospitalization. American Journal of Critical Care, 5,140-146.

15.

Tomm, K. (1987). Interventive interviewing: Part II. Reflexive questioning as a means to enable self-healing. Family Process, 26,167-183.

16.

Tomm, K. (1988). Interventive interviewing Part Iml. Intending to ask lineal, circular, strategic, or reflexive questions? Family Process, 27, 1-15.

17.

Valentine, K. L. (1988). Advancingcare and ethics inhealthmanagement: An evaluation strategy. In M. Leininger (Ed.), Care: Discovery and uses in clinical and community nursing (pp. 151-167). Detroit, MI: Wayne State University Press.

18.

Valentine, K. L. (1997). Exploration of the relationship of care and cost. Holistic Nursing Practice, 11(4), 71-81.

19.

Valentine, K. L. , Stiles, M. K. , & Mangan, D. B. (1995). Values, vision, and action: Creating a-re-focused nursing practice environment. In A. Boykin (Ed.), Power, politics and public policy: Amatter of caring (pp. 99-115). New York: National League for Nursing.

20.

Woods, N. F. , Yates, B. C. , & Primono, J. (1989). Supporting families during chronic illness. Image: Journal of Nursing Scholarship, 21(1),46-50.

21.

Wright, L. M. , & Leahey, M. (1990). Trends in nursing of families. In J. M. Bell , W, L. Watson , & L. M. Wright (Eds.), The cutting edge offamily nursing (pp. 5-16). Calgary, Canada: Family Nursing Unit Publications.

22.

Wright, L. M. , & Leahey, M. (1994). Nurses andfamilies: A guide tofamily assessment and intervention (2nd ed.). Philadelphia: F. A. Davis.

23.

Wright, L. M. , Watson, W. L. , & Bell, J. M. (1996). Beliefs: The heart of healing in families and illness. New York: Basic Books.