Legitimizing: A Meaningful but Underappreciated and Underutilized Family Systems Nursing Intervention

2021 ◽  
pp. 107484072199551
Author(s):  
Fabie Duhamel

Legitimizing is a Family Systems Nursing (FSN) intervention that is more than active listening and validating to comfort individuals and families who experience suffering. Based on a postmodern paradigm, this intervention consists of acknowledging that a person’s ideas/experience make sense, given their context or circumstances. This concept is often mentioned when discussing the theoretical components of FSN, but little has been written about how to apply it in clinical practice. In therapeutic conversations, once family members’ ideas/experience have been “legitimized” by the nurse and by other family members, the greater the chances are of working together to find solutions to their problem. The purpose of this article is to provide an embellished description, theoretical background, and clinical examples of this underappreciated and underutilized FSN intervention.

1986 ◽  
Vol 67 (5) ◽  
pp. 299-305 ◽  
Author(s):  
Ronald R. Van Treuren

The assessment technique described here meets the need for a tool to elicit from family members their own perceptions of their family's internal functioning and organization around a presenting problem. A paradigm of diagrammatic assessment is discussed, and its use is illustrated with an example from the author's clinical practice.


2021 ◽  
pp. 096973302110102
Author(s):  
Ka Young Kim ◽  
Jeong Sil Choi

Background: The global COVID-19 pandemic has increased cyber communication, causing nursing students’ clinical practice to be held in cyberspace. Thus, it is essential to ensure that nursing students develop comprehensive cyber ethics awareness. Moreover, cyberbullying is becoming more widespread and is an increasingly relevant new concept. Objectives: This study aimed to assess the experiences of cyberbullying among nursing students during clinical practice and determine the effects of cyberbullying victimization and cyber environments on their cyber ethics awareness. Research design: Data for this descriptive cross-sectional study were collected in July 2020 using a self-reported questionnaire and analyzed using hierarchical regression. Participants and research context: The study included data from 291 nursing students with more than 6 months of clinical experience who were enrolled in two nursing universities in two cities in South Korea. Ethical considerations: This study was conducted after obtaining approval from the Institutional Review Board of G University. Written, informed consent was obtained from all participants. Results: Cyberbullying victimization experiences during clinical practice were few. The most common cyberbullies of work- and person-related cyberbullying were nurses and classmates, respectively. Discussion: Cyber ethics awareness was affected by cyber anonymity and the perceived seriousness of cyberbullying; cyberbullying related to clinical practices was a new factor that significantly affected cyber ethics awareness. Conclusions: Hospitals and nursing universities should develop a multi-dimensional, comprehensive, and effective nursing intervention education program to be integrated into the nursing curriculum to enhance cyber ethics awareness and reduce cyberbullying of nursing students.


BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e030290 ◽  
Author(s):  
Fiona J Kinnear ◽  
Elaine Wainwright ◽  
Rachel Perry ◽  
Fiona E Lithander ◽  
Graham Bayly ◽  
...  

ObjectivesIndividuals with heterozygous familial hypercholesterolaemia (FH) are at high risk of developing cardiovascular disease (CVD). This risk can be substantially reduced with lifelong pharmacological and lifestyle treatment; however, research suggests adherence is poor. We synthesised the qualitative research to identify enablers and barriers to treatment adherence.DesignThis study conducted a thematic synthesis of qualitative studies.Data sourcesMEDLINE, Embase, PsycINFO via OVID, Cochrane library and CINAHL databases and grey literature sources were searched through September 2018.Eligibility criteriaWe included studies conducted in individuals with FH, and their family members, which reported primary qualitative data regarding their experiences of and beliefs about their condition and its treatment.Data extraction and synthesisQuality assessment was undertaken using the Critical Appraisal Skills Programme for qualitative studies. A thematic synthesis was conducted to uncover descriptive and generate analytical themes. These findings were then used to identify enablers and barriers to treatment adherence for application in clinical practice.Results24 papers reporting the findings of 15 population samples (264 individuals with FH and 13 of their family members) across 8 countries were included. Data captured within 20 descriptive themes were considered in relation to treatment adherence and 6 analytical themes were generated: risk assessment; perceived personal control of health; disease identity; family influence; informed decision-making; and incorporating treatment into daily life. These findings were used to identify seven enablers (eg, ‘commencement of treatment from a young age’) and six barriers (eg, ‘incorrect and/or inadequate knowledge of treatment advice’) to treatment adherence. There were insufficient data to explore if the findings differed between adults and children.ConclusionsThe findings reveal several enablers and barriers to treatment adherence in individuals with FH. These could be used in clinical practice to facilitate optimal adherence to lifelong treatment thereby minimising the risk of CVD in this vulnerable population.PROSPERO registration numberCRD42018085946.


2021 ◽  
Vol 23 (Supplement_2) ◽  
pp. ii31-ii32
Author(s):  
L Pointon ◽  
R Grant ◽  
S Peoples ◽  
S Erridge ◽  
P Sherwood ◽  
...  

Abstract BACKGROUND Most primary brain tumour patients rely on informal caregivers (i.e. family members or friends) for practical and emotional support. While caregiving can be rewarding, it also commonly leads to significant burden. In developing support for caregivers, it is vital to distinguish between caregivers’ unmet needs, and their actual wish for support to resolve unmet needs. We aimed to 1) identify the presence and magnitude of unmet needs; 2) examine associations between unmet needs and desire for support; 3) evaluate perceived usefulness of caregiver needs screening in clinical practice. MATERIAL AND METHODS Family caregivers of patients with primary brain tumours were recruited and asked to complete an adapted version of the Caregiver Needs Screen (CNS). This covered the level of distress resulting from 33 common issues in neuro-oncology caregiving (scale 0–10), and wish for information or support for any issue (yes/no). In addition, participants were asked to rank (0–7) their experience of using the CNS based on items covering ‘ease of us’, ‘usefulness’ and ‘satisfaction’. Descriptive and correlational analyses were applied. RESULTS Caregivers (N=79) reported between 1–33 unmet needs (M=17.20, sd=7.98) but did not always wish for support for each need (range 0–28, M=4.71, sd=6.63). Most distressing items were patient’s fatigue (M=5.58), recognising signs of disease progression (M=5.23), changes in patients’ thinking or behaviour (M=5.04), patient distress or sadness (M=4.68), and changes in caregivers’ own emotional health (M=4.44). A weak correlation was found between the total number of unmet needs and the desire for support (r=0.296, p=0.014). Caregivers most often desired support with recognising disease progression (N=24), managing medications and side-effects (N=18), and least often with managing spiritual issues (N=0), communication with (grand)children (N=2) and communication with family members and friends (N=3). Caregivers evaluated the CNS tool positively (mean item scores ranging 4.19–6.21 out of 7). CONCLUSION Family caregivers of brain tumour patients experience distress resulting from many neuro-oncology specific needs, but this is not directly related to a wish for support or information. Caregiver needs screening could be useful to tailor support or information to suit caregivers’ preferences in clinical practice.


RMD Open ◽  
2020 ◽  
Vol 6 (2) ◽  
pp. e001344
Author(s):  
Rosaria Talarico ◽  
Diana Marinello ◽  
Stefano Bombardieri ◽  
Gerd Burmester ◽  
Joao Fonseca ◽  
...  

IntroductionThe European Reference Network (ERN) ReCONNET is the ERN aimed at improving the management of rare and complex connective tissue and musculoskeletal diseases (rCTDs) across the European Union (EU). In the mission of ERN ReCONNET, clinical practice guidelines (CPGs) play a crucial role, representing a valid tool towards the harmonisation of the management of rCTDs while improving effectiveness and quality of care delivered to patients.MethodsERN ReCONNET developed two surveys to map the adherence to rCTDs CPGs among healthcare providers and to assess the knowledge and awareness of CPGs for their diseases among patients, family members and caregivers.ResultsThe results of the surveys highlighted that healthcare professionals find it useful to apply CPGs in clinical practice (93%), while 62% of them experience difficulties and barriers in the application in their centres. Healthcare professionals also highlighted the need to develop CPGs for all rCTDs and to implement the use of the existing CPGs in clinical practice. On the other hand, patients, families and caregivers are relatively aware of the purpose of CPGs (51%) and 62% of them were aware of the existence of CPGs for their disease. Patient-friendly versions of CPGs and patients’ lifestyle guidelines should be systematically developed contributing to the empowerment of patients in the disease management.ConclusionERN ReCONNET is addressing the main issues identified in the results of the survey, promoting practical actions for the local adaptation of CPGs across Europe, improving their routine clinical use and increasing the awareness on CPGs among rCTDs patients, family members and caregivers.


2016 ◽  
Vol 25 (3) ◽  
pp. 346-358 ◽  
Author(s):  
Maria Sagrario Acebedo-Urdiales ◽  
Maria Jiménez-Herrera ◽  
Carme Ferré-Grau ◽  
Isabel Font-Jiménez ◽  
Alba Roca-Biosca ◽  
...  

Background: The acquisition of experience is a major concern for nurses in intensive care units. Although the emotional component of the clinical practice of these nurses has been widely studied, greater examination is required to determine how this component influences their learning and practical experience. Objective: To discover the relationships between emotion, memory and learning and the impacts on nursing clinical practice. Research design: This is a qualitative phenomenological study. The data were collected from open, in-depth interviews. A total of 22 intensive care unit nurses participated in this research between January 2012 and December 2014. Ethical considerations: The School of Nursing Ethics Committee approved the study, which complied with ethical principles and required informed consent. Findings: We found a clear relationship between emotion, memory and the acquisition of experience. This relationship grouped three dimensions: (1) satisfaction, to relieve the patient’s pain or discomfort, give confidence and a sense of security to the patient, enable the presence of family members into the intensive care unit and provide family members with a realistic view of the patient’s situation; (2) error experience, which nurses feel when a patient dies, when they fail to accompany a patient in his or her decision to abandon the struggle to live or when they fail to lend support to the patient’s family; and (3) the feel bad–feel good paradox, which occurs when a mistake in the patient’s care or handling of his or her family is repaired. Conclusion: Emotion is a capacity that impacts on nurses’ experience and influences improvements in clinical practice. Recalling stories of satisfaction helps to reinforce good practice, while recalling stories of errors helps to identify difficulties in the profession and recognise new forms of action. The articulation of emotional competencies may support the development of nursing ethics in the intensive care unit to protect and defend their patients and improve their relationships with families in order to maximise the potential for patient care.


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