1 Routinely ask about family issues to understand their impact on the patient’s illness and the impact of the illness on the family.
SOO: this is important for the social & developmental context and illness experience.
- Use open-ended questions to inquire periodically about family issues
- Focus attention as needed on important family issues which may not be directly related to the patient’s medical condition, but may significantly affect their illness or Tx
- Analyze potential conflicts between pt and family members / physician, general family functionality, and the impact of the sick role on the family structure and function
- It can be helpful to have both the pt and family be willing participants in the pt’s Tx plan
- pregnancy as motivation to stop smoking
- death of a family member and grieving leading to noncompliance with medications.
2 Explore family issues:
- periodically
- at important life-cycle points (e.g., when children move out, after the birth of a baby)
- when faced with problems not resolving in spite of appropriate therapeutic interventions (e.g.medication compliance, fibromyalgia, hypertension).
Family Life Cycle:
- Living independently from family
- Committing to a relationship
- Living together
- Raising children / adolescents
- Children leaving home, empty nest
- Retirement
Provide emotional support & education to pt and their family; empower them to take charge of the pt’s management.
Reference:
Crouch Michael A, Leonard R. The Family in Medical Practice. New York: Springer-Verlag; 1987.
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