Family Health over Lifespan Future perspectives of Family

Family Health over Lifespan Future perspectives of Family Care in the Netherlands Dr. M. L. Luttik m. l. a. luttik@pl. hanze. nl 1

Family Health over Lifespan

Caring for patients and their families or family members; we think we do, but research indicates that we actually do not ………… Journal of Applied Hermeneutics Enlivening the Rhetoric of Family Nursing: "there, in the midst of things, his whole family listening" Dianne M. Tapp, Nancy J. Moules 4

Nurse citation “It just seems like an everyday thing…Families are involved everyday And certainly on the unit I’m on, with these patients waiting to go for bypass surgery, families are very concerned and they’re always around’’ From; Tapp & Moules, J of Appl Hermeneutics, 2012 5

Nurses’ attitudes towards the Importance of Family Importance in Nursing Care (FINC-NA) FINC-NA Statements Hospital care (n=85) Home Care (n=321) (totally agree) It is important to find out who belongs to the patient’s family 71% 85% I always find out who belongs to the patient’s family 38% 42% I invite family members to have a conversation at the end of the care period 22% 27% I ask families how I can support them 25% 60% 6

Family caregiving addressed in Hospital Care During admission and discharge discussions nurses mostly addressed practical information regarding patient The mean duration of discharge discussions was 4. 7 minutes mainly addressing medication and organization of care When family caregiving was addressed, nurses did not explore the nature or quality of the family support nor if families needed help or support 7

Family caregiving addressed in Home Care Research question To what extent and how are aspects of family caregiving documented within the nursing intake documentation of patients receiving home care? Method • 60 patient files of patients receiving a substantial amount of professional home care (> 3 times per week and for > 12 weeks) • From 5 different home care organizations in the North of the Netherlands Conclusion • No structural assessment of the family or network was available • Family members are mentioned but in a non-structured way 8

Top 10 of NANDA Nursing Diagnoses most prevalent in Dutch Hospital Care (Int J Nurs Knowl. , Paans et al, 2015) 30 -9 -2020 9

Consequences 30 -9 -2020 10

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Family as the unit of care Families influence the process and outcome of care (Reifman, 1995; Cohen, 1988; Kaakinen et al, 2003; Romito et al, 2013; Luttik et al 2005)

Family as the unit of care Families influence the process and outcome of care (Reifman, 1995; Cohen, 1988; Kaakinen et al, 2003; Romito et al, 2013; Luttik et al 2005) Health and Illness are family events and affect all members of a family (Visser et a, 20014; Arestedt, Persson & Benzein, 2014)

The individual as the unit of care Patient

The individual as the unit of care Patient Caregiver

Family as the unit of care patiënt

Family approach in the Netherlands 17

Research Group Nursing Diagnostics Roles and relationships 18

Mission Nurses’ attitudes towards the Importance of Family in Care Family Importance in Nursing Care (FINC-NA) FINC-NA Statements Nurses graduated in Groningen (totally agree) It is important to find out who belongs to the patient’s family 100% I always find out who belongs to the patient’s family 100% I invite family members to have a conversation at the end of the care period 100% I ask families how I can support them 100% 19

Education Mission statement Nurses, graduated from the School of Nursing at the HUAS in Groningen, view, think and act from the care-situation as a whole in which it is always about the patient or client in conjunction with his family or social system. Nurses feel responsible for the health and well-being of the patient and his family or social system and have the competency to carry out a family (nursing) conversation. 20

Research Mission statement To to gain knowledge and evidence needed to develop effective family focused approaches and interventions supporting families in different phases of life, dealing with different health issues and in different health care settings 21

Research program Ph. D trajectory Family involvement in Hospital Care Ellen Hagedoorn Family Nursing Conversations Susanne Broekema Family and Addiction Carlien Dusseldorp Young adults growing up with a chronically ill family member Hinke van der Werf The Family Approach in Dutch prisons Vacant 30 -9 -2020 Symposium Co. E HA, novmember 2015 22

Innovation Lab Family Care Homecare Hospital care Academie voor Verpleegkunde

Innovation Lab Family Care Family nursing conversations as an evidence-based nursing intervention Education Research Practice 24

Innovation Lab Family Care Research Education Nurse training in Family Nursing Conversations Education Practice Education Research Practice Performing Family Nursing Conversations in practice Research - Evaluation of the training - Nurse Fidelity to the intervention - Benefits of the FNC from the patient/family perspective 25

Research program Nurses’ Perspectives on the Results of a Six-Day Training in Family Nursing Conversations Broekema S, Luttik ML, Steggerda G, Paans W, Roodbol PF. Accepted for publication Journal of Family Nursing, in progress Nurse citation ‘Spending a little more time on a conversation with families eventually saves a lot of time. You are able to anticipate potential problems that can arise at a later stage. ’ 26

Research program Every semester around 40 students involved in applied research Student projects How to further improve the use of Carenzorgt as a digital communication platform for patients, their families and health care professionals? How to implement the Family Nursing Conversation in the Nursing Home? What is the prevalence of the nursing diagnosis; risk for caregiver role strain? Which factors influence the early interaction between parents and new born babies? What is know in the literature about the effectiveness of Family Motivational interview (FMI) as an intervention for family members of clients with an addiction? 30 -9 -2020 27

Research plans Visiting Professor Suzanne Thoyre; Family Care & Newborn babies Maria Muller-Staub; Diagnostics in Family Care Interdisciplinary approaches & Family Care International collaboration through the COST application 28

Thank you for your attention! 30