Page 214 - Encyclopedia of Nursing Research

FAMILy HEALTH n 181

(c) cultural influences, and (d) the physical, respond to the increased awareness of risk,
social, economic, and political environments, new genetic risk information, or even the ear-
including resources. researchers have shown liest occurrence of symptoms. Families may F
that health and risk factors cluster in families need to accept increased surveillance, adhere
because members often have similar diets, to changes in health behaviors, or accept
activity patterns, and behaviors, such as interventions that may potentially delay the
smoking and alcohol abuse as well as a com- onset or progression of the disease. A genom-
mon physical environment. Identification ics context for the health of families can alter
of health in families has focused on family lifestyle and health behaviors, affect repro-
interaction patterns, family problem solving, ductive decision making, alter family rela-
and patterns of responses to changes in the tionships, and have familial implications.
family system. These definitions and con- researchers have focused on family
cepts of family health provide a framework responses to specific illnesses resulting in
for determining measurable outcomes of a body of literature reporting that the inter-
family health while also accounting for the actions within the family system affect
diversity in family structure (Feetham, 1999, the health outcomes of family members.
2000, 2001). research of family responses to illness in
In 2003, we entered the genomic era, family members and the role of the family in
with findings from genomic research and adaptation to illness and recovery provides
advances in genetic technologies requiring a further evidence of the importance of family
reframing of how we think of the continuum and the health of family members.
of health and illness, and even the concept of From the time of Florence Nightingale,
disease. The ways in which diseases are cate- nurses have been encouraged to consider
gorized, and ultimately how they are treated family members as important for nursing care
and managed, are changing (Feetham & (Whall & Fawcett, 1991, p. 9). However, the
Thomson, 2006). No longer named by their interdependence and importance of health
symptoms (such as asthma), diseases will and the family is accepted in theory but is not
be more specifically identified by knowing evident in research. Although our knowledge
the genetic and environmental causes lead- of this relationship has increased, it has also
ing to more focused treatments (Hamburg been limited in that research continues to
& Collins, 2010).These advances may affect focus more on measures of the negative out-
the concept of family health. Individuals comes (e.g., depression) of illness and injury
and families will be faced with reframing on the family and family members. This focus
their concept and experience with diagno- on the individual as the unit of measure, and
sis, treatment, and prevention to include the conducting research of families with physical
term “genetically linked” disorder, with the and/or mental pathology, less knowledge has
blurring of the boundary between health been generated about health, how the family
and illness (Feetham & Thomson, 2006). functions, and the strengths and resources
Genetic information may result in the need of families responding to acute and chronic
to extend the concept of “illness time” phases illness. Grzywacz and Ganong (2009) sug-
to include knowledge of a risk state, or in gest that family research should result in
some cases, a nonsymptomatic phase with a knowledge and strategies for protecting and
knowledge of risk (rolland & Williams, 2005; promoting health across the life span while
Street & Soldan, 1998). The risk state refers distinguishing the interdependence of activ-
to the time before a statistical risk is known ities of family to the health of the family and
or acknowledged or the point in time when individual family members. Effective inter-
symptoms occur. The risk state may require ventions with families incorporate an under-
interventions for individuals and families to standing of what health means to individual