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Familial Research Reveals New Practice Model

Denham, Sharon A. RN, DSN


Three ethnographic studies investigated how families define and practice family health within their household and community settings. Synthesis of these findings prompted the Family Health Model. It suggests ways to dialogue about the complex variables associated with family health and approaches to family-focused practice.

Family has been sorely neglected as individuals continue to be emphasized in practice by nurses and other health care professionals. A recent report by the Institute of Medicine suggests “patient-centered care addresses the need to manage smooth transitions from one setting to another or from a health care to a self-care setting.” 1(p50) Most care is delivered in single institutions with little continuity in communication when care is provided across multiple settings. Discharge to home can be fraught with frustrations resulting from inadequate discharge planning that fails to realistically address the needs likely to be encountered in the home setting. The Institute of Medicine report stated that accommodating patients' families and friends by including them in decision making, welcoming them in care delivery settings, supporting their needs as caregivers, and viewing them as integral to patient care is needed. Including the family as client rather than the background for care of individuals is often ignored when care is provided and discharge to home planned. 2

The Institute for the Future, an independent research firm engaged by the Robert Wood Johnson Foundation to forecast the future of health and health care in America through the year 2010, has identified critical factors influencing outcomes during this next decade. 3 A key issue is a growing number of better-informed consumers who are more involved in choices, attainment, and use of health care services. Consumers are assuming “a new culture of assertive skepticism” that is “replacing the old culture of passivity and respect” and resulting in empowerment related to “choice, self-care, and shared decision making.” 3(p124) Consumers could be viewed as family members interested and invested in the individuals that comprise their families.

The Ohio University School of Nursing, Athens, Ohio.

Corresponding author: Sharon A. Denham, RN, DSN, Ohio University School of Nursing, Athens, Ohio (e-mail:

© 2003 Lippincott Williams & Wilkins, Inc.