The findings of this research illuminate possible underlying mechanisms for these observed changes. Specifically, when parents feel accepted, supported, and not blamed by healthcare professionals, they seem to be able to engage in self-reflection specifically related to their parenting styles. In turn, their ability to reflect in the group and make sense of their own thoughts, feelings, and behaviors seems to have a positive influence on the process of change in themselves, their children, and in their relationships with their children and other family members.
Non-compliance is not only an epistemological error but a biological impossibility. This profound statement arises from the influence of Humberto Maturana's revolutionary meta-theory of cognition. The definitions and significant implications of two major theoretical concepts of this meta-theory of cognition, namely structural determinism and objectivity-in-parenthesis, are discussed. These radical concepts challenge the approved North American Nursing Diagnostic Association's nursing diagnosis of non-compliance. Maturana's theory reveals the impossibility of instructive interaction, leading the authors to conclude the non-existence of non-compliant families.
The sudden and accidental death of a child can be one of the most devastating events in the life of a family. This paper describes one couple's reflections of their grief and mourning following the death of their adolescent son as well as the clinical team's reflections of therapy. The uniqueness of this paper is that it offers a "reader's theater" intervention that enabled further change to occur. The clinical team used a belief model, emphasizing that altering constraining beliefs is at the heart of healing from such tragedies as sudden death (Wright, Watson, & Bell, 1996). This approach is operationalized through therapeutic conversations between family members, clinician, and clinical team. Interventions such as reflecting teams, therapeutic letters, and "homework tasks" were used to modify or challenge constraining beliefs of both the family members and the clinical team members. However, the intent to co-author a paper with this couple provided the serendipity intervention of a "reader's theater" that further served to identify, affirm, and solidify facilitating beliefs.
Relationships between nurses and families form the foundation of effective nursing practice. This article describes a study of medical-surgical nurses' perceptions of the impact of a Family Systems Nursing Continuing Education Project (FSNP) Four major themes emerged from the study: 1) reduction in family crises during acute hospitalizations; 2) increased efficiency and productivity of discharge planning; 3) increased family involvement in multidisciplinary conferences with nurse-family interactions described as collaborative; and 4) improvement in nursing competence and confidence while caring for families. Implications for clinical practice, continuing education, and research are presented.
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