Date of Award

2014

Degree Type

Dissertation

Degree Name

Doctor of Philosophy in Nursing

Department

Nursing

First Advisor

Laurie Lauzon Clabo

Abstract

The prevalence of diabetes, a chronic illness, is expected to substantially rise over the next fifteen years (Whiting, Guariguata, Weil, & Shaw, 2011). One approach to ease the burden on the US health care system is the involvement and participation of family in care of the hospitalized adult. There is increasing evidence that involvement of family during exacerbations and hospitalizations increases client and family satisfaction during admissions and may also decrease length of stay and therefore cost (Powers & Rubenstein, 1999). The purposes of this study were to examine family members’ perceptions of family functioning, family health and the social support received from nurses when an older adult family member with diabetes is hospitalized. Also examined were nurses’ critical appraisals of their family nursing practice, as well as their experiences of the reciprocity and interaction in the nurse-family relationship. This study further explored the relationships between nurses’ critical appraisals of their family nursing practice and nurses’ experiences of the interaction and reciprocity in the nurse-family relationship with families’ perceptions of family function, family health and perceived social support from nurses. Finally, this study examined if nurses’ critical appraisal of their family nursing practice, and nurses’ experience of the interaction and reciprocity in the nurse-family relationship, differed across nursing units, and what the impact was on families’ perceptions of family function, family health and social support received. Wright and Leahey’s Calgary Family Intervention Model (CFIM) (1994) undergirded this descriptive study, which was conducted on four medical-surgical units in a community hospital. Sixty registered nurses and sixty family members of older adult patients participated. Two instruments were used to address the variables of interest in this study. Family member participants completed the Family Function, Family Health and Social Support Instrument (Astedt-Kurki, Tarkka, Paavilainen, & Lehti, 2002; Astedt-Kurki, Tarkka, Rikala, Lehti, & Paavilainen, 2009) as well as a demographic questionnaire. Registered Nurse participants completed demographics and the Family Nursing Practice Scale (Simpson & Tarrant, 2006). Significant variation was found across the four study units in how nurse participants reflected on their experiences with interaction and reciprocity in the nurse-family relationship. However, family member participants had no significant variation in their perceptions of family functioning, family health and social support received from nurses. This research informs practice by providing insight into nurses’ perceptions regarding the advantages and the disadvantages of working with families. Additionally, this study contributes evidence of what nurses are currently doing to include families in their nursing practice. More research is needed which focuses on collaboration and inclusion of families in care of their loved one.

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