Academic journal article Journal of School Health

Nurses' Involvement in Interdisciplinary Team Evaluations: Incorporating the Family Perspective into Child Assessment

Academic journal article Journal of School Health

Nurses' Involvement in Interdisciplinary Team Evaluations: Incorporating the Family Perspective into Child Assessment

Article excerpt

As educational systems continue to modify the planning process for children with special educational and health care needs, school nurses face increasing opportunities to provide input and expertise. Many nurses feel uncertain about their role within this team effort, especially when obvious physical problems are not present. Nevertheless, the nurse's holistic integration of health and a family-centered approach provide a unique perspective that broadens the team's understanding and facilitates planning for each child's needs.

Centrality of the family in a child's life, and the complex interaction of child and family strengths and needs, greatly affect the health and education of a child. Integration of the family perspective into assessment and planning allows coordination of the child's educational and health needs, facilitating more effective plans while minimizing health disruptions between home and school. This process necessitates broadening nursing assessment skills to gain the family's perspective. Through integrating the child and family health assessments, the family perspective evolves in an appropriate, validating, and noninvasive manner. This article addresses the process of blending the family perspective into the health assessment of the child with special educational needs to develop a coordinated plan between school and family.

FAMILY HEALTH NURSING AND THE FAMILY PERSPECTIVE

Traditionally, nursing and education focused on the individual within the context of family, as opposed to the family unit. However, the mutual influence of families and children, within health as well as within illness, is receiving increasing attention.[1] Family processes, including interaction, development, coping, health, and efforts to maintain family integrity,[2] support the educational functioning of children. While the school setting continues to focus primarily on the individual child, the need to shift focus to the family unit is increasingly apparent as complex family issues surface.[3-5]

Incorporating the family perspective is not an external process that professionals "assess" or "do to" families. Rather, mutual exploration and sharing of the family perspective helps create an understanding atmosphere between home and school. Exploration with the family of their priorities, their strengths in facilitating growth and development of their child, their daily health patterns that interact with those of the child, and their need for information, ideas, support or services, offer a mutual understanding from the family's point of view, rather than one professionally imposed. This differentiates a level of school nursing family assessment different from what might be needed in other settings, such as in family counseling.

Through development of family health nursing theory, categories of systematic family assessment have evolved that assist the school nurse in framing the family perspective.[6,7] These categories provide information at the family level similar to that obtained at an individual level in the health history. Through integration of family assessment categories within the child health history, the family perspective can emerge in a way that increases understanding and yet is logically tied to the child assessment. Not only will the school nurse obtain the child's medical history through this combined approach, but valuable information also emerges regarding the interacting child and family strengths and needs. This integrative approach reflects nursing's holistic scope toward understanding, planning, and implementing necessary services, and expands nursing's unique contribution to the interdisciplinary evaluation.

CATEGORIES FOR ASSESSMENT OF THE FAMILY PERSPECTIVE

Understanding of family assessment categories offers the school nurse awareness of the meaning of information shared during the information gathering process. The assessment process leads to insight into the structural, functional, and developmental aspects of the family and mutual understanding of the family component of child health and educational issues. …

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