Family Health Experience and Outcomes Essay

1. What are the barriers/challenges described in your readings that you also face in your environments as you attempt to provide family focused nursing? (e.g. family as client, family as context, family as barrier, family as caring process, family as resource)
2. Review the power point: “Family Nursing Background and Understandings.” Reflect on nursing practice that views family as the unit of care and nursing practice that views family as contextual to the individual patient. Do you believe that current nursing practice most often views family as the unit of care or family as a context to the situation? How do these two views differ.
3. Develop 5 questions focusing on one of Denham’s Core Processes.  Interview a client in your workplace or within your community and describe their answers to your questions.  Identify family routines and factors related to family health routines.
4. From the Khalili article, what were the most significant aspects of the illness transition for the family? What resources did the family need/want? What were the barriers and facilitators to obtaining the needed resources or supports? What may have changed in the care situation for the family if the family would have been viewed as the unit of care? Family Health Experience and Outcomes Essay.
5. Using one of the family theories/frameworks described in the literature reflect on an illness experience in a family. (You can reflect on a family you have cared for in your nursing practice.) Consider how family structure, function, and process influenced the family health experience and outcomes. Analyze the experience from a family theory/framework perspective.
6. Use your reading on a One Question Question by Duhamel et al (2009) to practice this questioning strategy with a family. Share your reflections and outcome.

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The Nurses Project: Nurses’ Responses to the OQQ
There was a great variation of answers in nurses’ responses to the OQQ at the
beginning of a one week workshop/training program in Family Systems Nursing. However, four theme questions in response to the OQQ did emerge and
are listed with the frequency and percentage of total responses in Table 2. The
themes were as follows: (a) “How to intervene in specific clinical situations?”
(b) “What are the most efficient family interviewing skills?” (c) “What is the
nurse’s role in family care and in relation to the other professionals?” and
(d) “ How do we involve the family in the care of the patient?”
How to intervene in specific clinical situations? The most frequent type of
nurses’ questions pertained to the need to be effective and brief when dealing
with challenging situations related to (a) conflictual relationships between
families and professionals, (b) families with specific health problems (e.g.,
schizophrenia, noncompliant families), (c) conflicts between family members (e.g., display of anger, aggression), (d) ethical questions, confidentiality
issues, and transmission of information, (e) loss and grief, (f) crisis situation,
perception of suffering, (g) family members in “denial,” (h) placing a parent
in a nursing home, and (i) feelings of guilt and overprotection.
In this first theme, we noted that the largest percentage of responses
(14.6% or 43 questions) was related to conflicts between family members
and health professionals. These questions pertained to the difficulty in
dealing with families whom the nurse perceived as being “demanding,”
continually dissatisfied, complaining about the care, lacking respect, and/or
showing arrogance and anger. The next most frequent set of responses to the
OQQ reflected the nurses’ need to learn more about specific health issues or
problems and how to deal with families experiencing these problems. Family Health Experience and Outcomes Essay.  These
issues included reconstituted families, noncompliant families, and diagnoses
such as schizophrenia and psychosomatic symptoms.
Conflict between family members was another important source of questioning for nurses, especially when the family members expressed anger or
hostility toward one another in front of the sick family member. The next
most common responses focused on ethical issues of confidentiality and
sharing patient information with family members, documentation of family
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470 Journal of Family Nursing 15(4)
concerns in patient charts, and end-of-life decisions. Regarding these issues,
nurses’ concerns were embedded in the following types of questions:
How do we approach family members who are unreasonable, want
their way no matter what, and become aggressive toward nurses?
How can nurses prevent burn-out when families show continuous dissatisfaction and make unrealistic demands?
Table 2. Nurses’ Responses to the One Question Question
Number of
Theme Questions Questions Frequency (%)
1. “How to intervene in specific clinical situations?” 130 44.2
Looking for strategies to deal with:
a. Conflictual relationship between families 43 14.6
and professionals
b. Families with specific health problems 19 6.5
(schizophrenia, noncompliant)
c. Conflicts between family members 15 5.1
(anger, aggressiveness)
d. Ethical questions, confidentiality issues, 14 4.7
and information transmission
e. Loss and grief 13 4.5
f. Crisis situation, perception of suffering 11 3.7
g. Family members in “denial” 8 2.7
h. Placing a parent in a nursing home 4 1.4
i. Feelings of guilt and overprotection 3 1.0
2. “What are the most efficient family 107 36.7
interviewing skills?” How to . . .
a. Engage, assess, and intervene with families 69 23.5
in an efficient manner
b. Explore the impact of the illness 17 5.7
on the family
c. Explore and challenge beliefs 12 4.0
and cultural issues
d. Interview children 9 3.0
3. “What is the nurse’s role in family care and 29 9.8
in relation with the other professionals?”
4. “How do we involve the family in the care 27 9.3
of the patient?”
Total 293 100
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Duhamel et al. 471
How do we deal with families who refuse the prescribed treatment for
their child?
How do we intervene when conflicts between family members affect
the patient’s health?
What type of information regarding the patient’s health issue can offer
to the family without impinging on confidentiality rights?
Another set of nurses’ questions under this same theme were related to
emotionally difficult situations such as families who face a crisis and/or a
loss and who express grief and suffering. Nurses inquired about strategies
to explore, prevent, and comfort family members’ emotional suffering.
They also requested guidance to help families whom they perceive as being
“in denial” and not responding to their expectations. Nurses also had
questions about how to support families who experience hardship when
having to place their loved one in a nursing home. Feelings of guilt and
perceptions of overprotection in families were another source of concern
when working with families. All these concerns were expressed in the
following questions: Family Health Experience and Outcomes Essay.
What is the best way to intervene when the family is in crisis or in shock
after learning about a serious prognosis or the death of a loved one?
How do we deal with family members when they are in denial that their
loved one is dying?
How can we alleviate families’ suffering and help them accept the
placement? How can we help them with their feelings of guilt?
How do I interview a family? Almost one third of nurses’ questions related
to the skills required to conduct a family interview (107 questions). The four
subthemes included how to (a) engage, assess, and intervene with families;
(b) explore the impact of the illness on the family; (c) explore and challenge
beliefs and cultural issues; and (d) interview children.
1. How to engage, assess, and intervene with families? In this subtheme, nurses’ questions reflected their learning needs about
which family members should be present in family meetings, and
when,
what kind of questions to ask the family in order to collect pertinent
information,
how to identify “the real problem” in the family,
how to resolve different problems within the family,
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472 Journal of Family Nursing 15(4)
how to reassure family members and strengthen their relationships, and
how to challenge family members’ beliefs.
Specific examples of questions in this theme are as follows: “How do we
keep neutral when parents do not agree?”; “How can I feel more at ease in a
family meeting?”; “How do we explore a family problem without jeopardizing
our trusting relationship with the family?”; “How do we help families adapt
to their illness?”
2. How to explore the impact of the family on the illness? Through their
OQQ, nurses expressed their need to learn more about how family
dynamics affect the patient’s health, emotional experience (e.g.,
stress, guilt), adaptation to the illness, and decision making, including choice of treatment. Questions were presented as follows:
How does the family influence the patient’s health condition?
Can the family influence patients’ choices and his decision making?
Can the family influence the parent/child attachment process in a
perinatal context?
3. How to explore and challenge beliefs and cultural issues? This subtheme relates to the nurses’ questions regarding cultural diversity
and health behaviors as well as family reactions to a health problem
within a cultural context that is unfamiliar to nurses. Nurses required
knowledge and strategies to support families from a different cultural background than their own. Some of the questions were
How do we approach a family with different cultural beliefs than
ours without making them feel threatened or intruded upon in
their intimacy (private life)?
How do we help a family better understand the illness when their
cultural beliefs make mental illness a taboo and do not want to
talk about it?
There were only a few questions regarding families’ existential issues.
They related to reassuring families without giving false hope and one question
on how to respond to families who ask existential questions. The two questions in this theme were verbalized as such
How realistic is it to reassure the family of a terminally ill resident
without giving false hope?
What do we tell a family who has a young baby who is dying?
How do we respond to their question: “Why us?”
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Duhamel et al. 473
4. How to interview children? There were a few nurses who inquired
about how to approach the children of a parent who is suffering
from a serious illness, dying, or is affected by an illness that brings
shame and embarrassment with their peers. The questions were
How do we help children whose parent is dying?
How do we approach adolescents who have to learn to cope with a
parent’s chronic illness and with his friends or peers’ prejudices
related to the illness?
What is the nurse’s role in family care and in relation to other health care
professionals? Several nurses questioned their role in family care. They asked
what their specific responsibility toward the family is and who between the
patient and the family should they privilege or side with, if any. Through
their responses to the OQQ, they also showed their confusion about issues
of roles and responsibility between health professionals who assist families.
Their questions were formulated as such
What is my role toward the family; where and when does it start and
when does it end? Family Health Experience and Outcomes Essay.
What distinguishes my role from other health professionals like social workers and psychologists or physicians when working with
families?
How do we involve family members in patient care? The fourth most frequent
type of question asked by nurses in response to the OQQ referred to family
members’ participation in patient care. Nurses inquired about how and when
they should involve the family without making them feel too responsible,
burdened, or worthless if family members do not have a chance to
collaborate. In this matter, nurses asked the following questions:
How do we sensitize the family to the importance of their involvement
in the long term care of their child?
How do we keep them motivated in patient care in a chronic illness
situation?
When is the best time to integrate the family in the patient’s care?
Reflections and Discussion
These findings generated reflections about families’ experiences with health
problems and about the learning needs of nurses caring for families that could
inspire education, research, and practice in the nursing of families.
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474 Journal of Family Nursing 15(4)
Families’ Experiences With Health Problems
It is important to keep in mind that the families who participated in the
Family Project responded to the OQQ at a time when the member with the
health issue was living at home and therefore had more limited access to
health professionals than if the ill family member was an inpatient in a clinical setting. The type of questions formulated by family members might have
been different if asked during another episode of their illness, a different time
in the illness trajectory, or in a different context. Family responses in this clinical project corroborate what has already been reported in the literature with
regard to families’ needs when one member is experiencing health problems
(Clayton, Butow, & Tattersall, 2005; Eriksson & Svedlund, 2006; Habermann
& Davis, 2005). Interestingly, the information provided by the participants in
the Family Project was not based on a checklist of possible needs that could
have prompted their responses, but represents families’ spontaneous answers
to the OQQ asked within a therapeutic conversation. The families’ responses
to the OQQ identified instrumental, emotional, and relational challenges
which are also reported in the literature. In spite of the fact that the specific
needs of families experiencing illness have been identified in the nursing literature for many years, families’ responses to the OQQ indicate that their
needs are still not being adequately addressed and they are often left to their
own resources to deal with their illness challenges. This underscores the
importance, once again, of the need for nurses to explore family members’
experiences to determine if there is undue distress, anguish, or suffering before
and after the ill family member returns home. Moreover, this project generated specific information that helps to clarify the type of support that nurses
might offer families and for which nurses need to be educated.
Health problems seem to challenge families’ abilities with communication and relational issues. These findings corroborate other studies or clinical
cases that report on the reciprocal relationship between illness and family
dynamics (Duhamel, 2007; Wright & Bell, 2009; Wright & Leahey, 2009). In
the Family Project, families’ questions about how to manage the illness seem
to reflect their lack of confidence regarding their ability to solve problems or
care for an ill family member. In addition, their questions regarding their
future and existential and spiritual issues may indicate a perception of the
severity of the disruption that the illness creates in their life and their feelings
of uncertainty and lack of control. Quinn (2003) and Wright (2005) suggest
that serious illness often leads patients and families to reconsider life’s meaning and purpose. If one believes that “talking is potentially healing” (Wright,
2005), the use of the OQQ allows families to raise questions that might otherwise have been left unspoken.
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Duhamel et al. 475
Not surprisingly, families had questions about the normalcy of their experience, looking for acknowledgement and reassurance about their behaviors
and feelings. These results support several other authors who have acknowledged how persons with chronic health problems often feel “abnormal” as
described by feeling isolated, alienated, and stigmatized (Joachim & Acorn,
2000; Petersen, 2006; Royer, 1998).
Finally, 25% of the families were in search of both instrumental and/or
psychological resources to provide the necessary illness management. Information about these resources might serve to strengthen their sense of security
and/or sense of control over the illness situation. The family members’ desire
for information about illness, treatment, and for more support may suggest
that the required resources are either scarce or unknown to the families. These
family concerns could inform nursing interventions that might be offered.
Questions from families about the reasons and usefulness of the family
meetings at the Denyse-Latourelle Family Nursing Unit (4.2%) indicated
that families are not used to being offered family meetings to discuss their
experiences when illness arises. Families may be unaware or confused about
the role of nurses in family care.
Nurses’ Learning Needs
Nurses’ responses to the OQQ helped to identify their primary needs and concerns about working with families. It appears that nurses’ most pressing needs are to acquire more clinical skills to deal with conflicts between families and health professionals, “crisis” situations, and family communication
problems in a short amount of time. Nurses’ concerns may be related to
their work context where there is an increasing level of complexity and
acuity in patient care. This, coupled with nursing staff shortages in many
clinical settings, generates a high level of stress for both families and nurses.
Thus, nurses are requesting additional knowledge and skills to deal with this
stressful context and ensure efficiency and helpfulness in their nursing care,
especially when they perceive families as being “in crisis” or in “denial.”
From the way nurses formulated some of their responses to the OQQ, we can
hypothesize about their epistemological perspective on family conflict.
A “positivist” or “linear” perception seemed to influence the manner in
which questions were formulated. Families labeled as demanding, complaining about care, lacking respect, and showing arrogance and anger suggest that
nurses perceive these problems and challenges as unrelated to the relational
aspect of care. They tend to overlook the interactional or circular principle in
the relationship between themselves and the family and between family members (Wright & Leahey, 2009). Attending a Family Systems Nursing workshop
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476 Journal of Family Nursing 15(4)
has the potential to alter their conceptualization of nurse/family relationships
and enter into a more interactional, relational practice (Doane &Varcoe, 2005;
Wright & Bell, 2009; Wright & Leahey, 2009).
The second most important series of questions asked by nurses referred to
theoretical concepts and to perceptual, conceptual, and executive skills of
family nursing (Wright & Leahey, 2009). There was an emphasis on requiring executive skills for engaging and maintaining a therapeutic relationship
with families with a health problem and/or with children. Although family
nursing or family-centered care is part of the curriculum in most undergraduate nursing programs, it appears that nurses still experience the need for more
education and mentoring about how best to involve families in their practice. Family Health Experience and Outcomes Essay.
Many factors may explain these learning needs, such as no adequate role
modeling by nurses who are competent and confident in family nursing skills
and perhaps no standardized teaching, expectation of family involvement,
and practice format in family nursing in most clinical contexts.
Furthermore, nurses tend to express confusion about the nature of their role
with families compared with other health care professionals. This data may
suggest a sense of helplessness and/or inadequacy and raise questions about
nurses’ comfort, confidence, and competence level in providing family care.
As for their perceptions on families’ caregiving role, these nurses may believe
that taking part in the care of the patient could provide family members with
comfort and a sense of control. Therefore, they may tend to encourage family
members to participate in the family member’s care. However, they are also
sensitive to the impact of illness and of the possible long-term effects of caregiving activities on the family members’ experience (e.g., burden, fatigue,
despair), prompting questions about how to best assist families with participating in patient care in times of chronic illness. This type of questioning may
reflect a hesitation to invite the family to take part in decision making regarding the patient’s care. We suggest that the nature and timing of the family’s
involvement in care, on a long term basis, should be determined through an
ongoing assessment made by family members and nurses in the context of a
collaborative relationship. Using the OQQ can be a useful and time efficient
aspect of the family assessment.
Congruencies and Disparities Between
Nurses and Families’ Responses to the OQQ
As we examined the lists of themes reported by families and nurses, we also
looked for congruencies and disparities. While acknowledging the lack of a
traditional scientific basis for comparing these two heterogeneous groups, it
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Duhamel et al. 477
is still interesting to note that there are four common themes that emerged
in both groups: (a) the impact of the illness on family members, especially
in time of conflicts; (b) dealing with children; (c) family members as caregivers; and (d) nurses’ role in family care. In the first common theme, it
appears that families as well as nurses express feelings of helplessness and
inadequacy when dealing with the impact of chronic illness on the family,
especially in times of “crisis.” Some of the participants referred to a “crisis”
as being a time when families are facing traumatic events such as learning
that one family member is diagnosed with a life-threatening illness or has
died suddenly. This finding underscores the importance of the impact that
illness has not only on families (Duhamel, 2007; Wright & Leahey, 2009) but
also on how nurses take care of these families. Thus, it begs the question:
“What are the basic knowledge and skills that every nurse needs to possess in
order to be of assistance to families?”
Another reflection from the responses to the OQQ suggests a certain
degree of angst and suffering in both groups of families and nurses although
not necessarily named, labeled, or described as such in their questions. Suffering often accompanies the experience of illness and is most essential that
nurses know how to soften suffering and promote family healing (Daneault,
2006; Wright, 2005, 2008). A study exploring the experience of transition to
adulthood of adolescents living with cystic fibrosis and their families found
that the parents’ suffering was mostly unrecognized and unacknowledged by
professionals (Dupuis, 2007). Professionals were able to disassociate themselves from the illness experience, thus allowing a certain “protection”
against suffering. It is well-known that health care professionals can experience difficulties in dealing, on a day to day basis, with the suffering of their
clients (Daneault, 2006; Morasz, 1999). This could perhaps explain, in part,
why nurses in this project expressed a need for “complex interviewing
techniques” to deal with families’ distress and suffering. They did not seem
to have the knowledge, understanding, or recognition that deep listening,
compassion, and being fully present (Duhamel & Dupuis, 2004) in their
relational practices with families can often soften suffering and promote
healing (Wright, 2005).
The second common theme of both groups relates to dealing with children in times of illness. Both families and nurses seem to be concerned with
their ability to approach children in the most comforting way. Communicating with children about parental illness is a difficult issue for parents and
health care professionals particularly when parental illness is potentially life
threatening. This suggests the need for educational input for both groups on
this issue.
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478 Journal of Family Nursing 15(4)
Families as well as nurses are preoccupied by the impact that the caregiver
role can have on that family member. This observation also indicates the need
to address this issue with the family and explore the impact that this role may
have on the family caregiver’s health, whether it appears to be positive, negative, or both and what other resources might be available to the family.
Finally, the data show that it is still very important for nurses to clarify
their role in caring for families. Responses to the OQQ indicated that there
was a perception of ambiguity regarding the role of the nurse in family care
and that nurses themselves questioned their role with families. Even though
the International Council of Nurses, published a monograph entitled “The
Family Nurse,” and discussed the important role of involving families in
health care, (International Council of Nurses, 2001), nurses still have questions about the nature of their relationship with families in health care. On a
provincial level in Canada, the Order of Nurses of Quebec (ONQ, 2001)
claims that nurses should use a systemic family approach when caring for
patients, but the findings of this clinical project suggest that there is still
much work to be done.
As for discrepancies between the groups of families and nurses, an interesting difference was noted. Families’ experiences of illness are marked by
stress, anxiety, the wish to return to normal, to live like normal families, and
by protection of family members. In contrast, nurses tend to perceive families as being “the problem,” believing the family negatively affects the
patient’s health. Nurses seemed to perceive some families as angry, aggressive, dysfunctional, and “in denial.” No responses to the OQQ by family
members refer to this type of attitude. Is it possible that when families experience stress and anxiety and are looking for ways to learn how to cope with
illness, nurses interpret these family reactions and behaviors as being in crisis
or conflict, and not necessarily in distress? This difference in perceptions and
interpretations is important because it can profoundly influence the way
nurses address the family’s reactions to illness.
Further analysis of nurses’ responses to the OQQ underscored that they
interpret certain families’ behaviors as “denial or dysfunction.” Of course,
no family would define or describe themselves this way. This perception by
nurses has profound implications for family nursing practice. It becomes
complicated and difficult for nurses to work with families if they harbor
such constraining beliefs. For example, what is interpreted as “denial” for
nurses, could be a coping strategy that is useful for the families. If nurses
adopted this more facilitating perspective or belief, it may foster a more collaborative and caring relationship with families (Wright & Bell, 2009).
Nurses would not attempt to change the family’s strategy for coping with
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Duhamel et al. 479
deep illness suffering, but would instead see it as a strength and hopefully
would even commend the family for their efforts to deal with the impact of
illness on their lives and relationships (Houger, Limacher & Wright, 2003,
2006; Wright & Leahey, 2009)
Perhaps nurses’ perception of crisis and conflict in families is daunting
and frightening and arouses feelings of inadequacy, lack of control, and
inability to face this situation. Thinking and feeling this way, nurses may
very likely avoid family members instead of trying to get a better understanding of their situation. This behavior could, in turn, inadvertently enhance the
families’ distress and suffering and indicate that nurses are not “available”
for the expression of the family members’ emotions. Families may withdraw
with fear and frustration and show behaviors that nurses may interpret as conflict and crisis. Such differences affect the quality of the relationship between
families and nurses, especially when families are left alone with their distress

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or suffering. Isolation in families’ experiences related to illness has been welldescribed (Daneault, 2006; Gregory & Longman, 1992; Wright, 2005). It is
important for nurses to reflect on their practice and invite and acknowledge
families’ illness stories. Bringing forth illness stories and understanding the
constraining beliefs that are perhaps enhancing their suffering is also important (Wright & Bell, 2009; Wright, 2005). Changing nurses’ conceptualization
of families in “crisis and conflict” to one of “experiences of illness suffering”
can hopefully open the door to a new kind of conversation that can bring forth
family healing.
The analysis of these two sets of responses by families and nurses triggers several reflections to guide education, research, and practice in family
nursing.
Reflections for Family Nursing Education
Nursing programs, both generalist and advanced practice, need to offer theoretical concepts that challenge the belief that the family “is” the problem.
They should invite nursing students to consider that the impact of illness on
the family and the influence of the family on the illness trajectory is an ongoing, observable process. The belief that “illness is a family affair” (Wright &
Bell, 2009, p. ix) could change the face of nursing practice if fully embraced
by nurse educators. Theoretical courses and clinical practice with families
need to include more ideas about the specific clinical skills required to deal
with family crisis, perception of denial, family members’ expression of anger
and distress, death, and spiritual issues. We believe that all nurses at both the
undergraduate and graduate level need to have courses and practica that will
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480 Journal of Family Nursing 15(4)
enable them to soften the suffering of families in their care and promote
family healing. All advanced practice nurses, regardless of specialty, need to
possess skills to involve families in their care. Teaching methods should aim
at helping students transfer the knowledge and skills for working with families from their nursing education to actual clinical practice. Family Health Experience and Outcomes Essay. To not include
such knowledge and practica in nursing curricula is to ignore both family
research and clinical stories of families who are yearning for these kinds of
nurses and nursing care.
Reflections for Research About Family Nursing Practice
Research studies of family nursing practice need to emphasize family interventions and be more specific in describing and articulating the family nursing
interventions under study (Bell & Wright, 2007; Robinson, 1998; Moules,
2002; Tapp, 2001). Researchers should also consider methods that promote
nurse clinicians’ participation and knowledge transfer in their studies
(Duhamel & Talbot, 2004). Finally, the following questions could be developed to increase knowledge about family nursing interventions: What are the
most effective and brief interventions for what clinical situations? What are
the interventions that best help families express spiritual issues and concerns
in crisis situations? What are the best teaching methods to assist nurses in
improving their family nursing practice? How does family nursing practice
find its proper place in the interdisciplinary health care team? When is the
most appropriate time to ask the family the OQQ?
Reflections for Family Nursing Practice
Nurses’ questions about family interviewing skills stress the need for administrative support to improve their competence and confidence in providing
family care. The highest levels of nursing administration and other administrative health professionals need to also embrace the belief that “illness is a
family affair” (Wright & Bell, 2009, p. ix) in order to make the involvement
of families in health care a routine and valued part of nursing practice. Frequently, the philosophies or mission statements of many large tertiary care
centers state that family-centered care is a significant priority. However, this
philosophy is not always realized in actual practice. Family-centered care is
not an “add on” to nursing practice and should occur in all clinical areas.
But how does one change the larger system and reach administrators who
have the power to influence and encourage the regular involvement of families in clinical settings? We believe that nurse administrators who have been
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Duhamel et al. 481
exposed to systemic thinking and family care in their own master’s and doctoral programs will be strong advocates for the facilitation and implementation
of routine and ritualized family nursing practice. It would also benefit both
families and nurses if on-going family nursing meetings were implemented
in clinical settings to discuss strategies for assisting families in different situations. This could also be an opportunity to offer coaching by clinical nurse
specialists trained in family nursing. Several topics could be discussed in
these meetings, such as the following: How do families express their distress
or anxiety about the impact of the illness on their family relationships? What
are the most useful strategies to cope with the impact of the illness on their
family? How can we help families cope with the onslaught and suffering of
an unwanted illness? What is the role of the nurse in family care?; and, What
are nurses’ expectations of one another in their particular work context?
Conclusion
What would happen if nurses routinely asked family members the OQQ? We
believe that it would greatly enhance the relationship between families and
nurses. The OQQ provides tremendous opportunities for nurses to be aware
of and understand the areas of families’ greatest angst, challenges, sufferings,
and concerns. Of course it does not mean that nurses’ need to have all the
answers to the families’ questions—rather, simply asking the OQQ can give
the message that the nurse cares about the family and wants to be helpful. The
responses of families and nurses in these two clinical projects invited reflections about family nursing education, research, and practice. The similarities
and differences between the two groups confirmed an urgent need for more
relational, systemic, interactional family nursing practice. Family Health Experience and Outcomes Essay.