Karen Flowers and Winsome St John
The family is foundational to the health of individuals and groups. The family impacts on the health of individual family members, while individuals' health may have a major impact on the family. Further, we learn about health and illness behaviours within the context of the family. The family plays a key role across the continuum of health care provision, including health promotion, primary care, acute care, rehabilitation and palliative care. Because of the importance of families to health and health decision-making, health care is more effective when individuals are understood within the context of their families, and the impact of the health issue on the whole family is addressed. Family-focused care can help to promote health and minimise the impact of health problems for individuals and their families.
Working with families is an integral part of day-to-day community nursing practice. Community nurses are often in direct contact with families through home visits (discussed in Chapter 13) or consultations. Despite the day-to-day nature of community nurses' work with families and a belief that families are important to practice, unless there is an understanding of family theory, family assessment and intervention, community nurses may base their work with families only on the knowledge they have gained through experience. Family nursing is an emerging area, and conceptual frameworks have been developed to assist understanding of families and to guide practice and research. This chapter provides a theoretical basis for working with families, and provides information that will encourage community nurses to reflect on and enhance their work with families. It draws on literature from the developing specialty of family nursing to