Discussion – Family Values a) In their book, Friedman, Bowden, and Jones (2003) argue that health maintenance has turned into one of the central elements of American core value paradigm and is now regarded as one of the key preconditions of wealthy and happy life. I could observe the evidence of this thesis in my own experience when my friends’ grandfather was hospitalized with a hip fracture after a fall. My friend comes from a native American middle-class family with traditional religious and spiritual values. All the family members, i.e. my friend and his parents demonstrated a strong concern about the patient’s fast recovery and engaged actively in communication with the nurse to discuss the most effective strategies for the post-operation period. They showed to be especially attentive to minor details such as a healthy diet and psychological comfort. In my view, this high awareness of health issues, as well as the intensive inclusion into the family member’s treatment, which could be seen across all the age groups (my twenty-year-old friend and his parents who are in their late forties), signifies that health maintenance is prioritized in American culture today.
b) Another example I shall discuss is an example of a family who, due to their cultural background, held specific cognitions about health and medical interventions that are uncharacteristic of classic American worldview. This was a poor class Philippine family that my colleague worked with when their child, a seventeen-year-old girl was hospitalized after an abortion. All the family members showed to be highly uncomfortable discussing the so-called “sensitive issues” which posed significant difficulties to the nurse team who needed to collect all the relevant information in order to design an effective treatment strategy. Moreover, both the patient and her parents expressed resistance to receive any interventions because of their poor awareness of their purpose and effects.

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Discussion – Assessing Family Values
a) Friedman’s et al. (2003) approach to assessing family’s values relies on a structural-functional framework within which a family is regarded as a subsystem which is closely related to other subsystems in the society and holds its individual cognitions about the fundamental institutions such as religious, health, educational, etc. I used this approach to assess the values of my patient’s family because I believed that it addressed a wide spectrum of areas that needed to be explored to acquire a clear understanding of a family value system. In the frame of this approach, I used Friedman’s Assessment Form. This form contained questions regarding six major domains: the basic identification information, family history background, environment-related information, structural data (communication networks, roles within the family, core values, power dispersion, etc.), functional data (social functions, healthcare functions, etc.), and the data related to the strategies that the family used to cope with stressful situations.
b) I believe that Friedman’s approach to assessing family values is an effective approach that provides a nurse with valuable insights into how communication should be built and how the treatment strategy should be designed. Its major strength is that it addresses all areas of a family life. Its disadvantage, however, is that the use of this approach helps a nurse to accumulate such a large quantity of data that it takes one aback because Friedman does not offer a detailed guideline on how this data should be interpreted and integrated into care provision. An alternative to Friedman’s approach that I would like to try applying is Calgary’s Assessment model that addresses a narrower spectrum of categories, i.e. family structure, family development, and functional characteristics (Friedman’s et al., 2003). The simplified structure of this approach can entail benefits in terms of data interpretation.

  • Friedman, M., M., Bowden, V. R., & Jones, E. G. (2003). Family nursing: Research, theory, & practice. Upper Saddle River, NJ: Prentice Hall.