Family Health Care Nursing Theory Practice 5th Edition By Joanna – Test Bank

optimize positive outcomes and prevent or treat negative implications.

Review of Key Terms

Bronfenbrenner’s Bioecological Theory: In this model, Bronfenbrenner (1984, 1995, 2004) identifies five systems that interact: the microsystem, mesosystem, macrosystem, exosystem and chronosystem (see pp. 323–324 in text). Describing the impact of trauma over time on individuals, families, communities, and societies helps both practitioners and policy makers understand the interconnections between trauma and abuse to individuals, families, communities, and societies. Trauma tends to repeat itself without intervention to stop the pattern. Interventions intended to alter these patterns are more effective when chosen and implemented with the complexity and interconnections among systems in mind.

Developmental trauma theory: Recent work describing the survival strategies individuals learn to cope with trauma. These coping strategies interfere with healthy development; trauma has an especially negative impact on attachment (Heller & La Pierre, 2012).

Disaster: Natural- or human-caused event that causes widespread destruction of property, dislocation of people, and immediate human suffering through injury or death. Disasters interrupt meeting basic daily human needs for an extended time, causing a degree of suffering that those affected cannot address easily and that makes recovery difficult (American Red Cross, 2003). Natural disasters include weather and seismic events, such as floods, hurricanes, typhoons, and earthquakes. Human-caused disasters include catastrophic events, such as fires, building collapse, explosions, and acts of terrorism or war using chemical, radioactive, nuclear, biological, or explosive weapons.

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Disaster syndrome: Studies on the impact of war, terror, and natural disasters have identified this term as a combination of PTSD symptoms, including anxiety, dissociation, depression, and grief. Children respond to their family members’ emotional and physical changes related to trauma. Grief can relate to the loss of family members, support, routines and regularity, safety, and normal parental response to children’s needs.

Dysregulation: Unpredictable or irregular sleep and eating patterns. Difficulty regulating moods and emotional responses (National Center for PTSD, 2010).

Family systems theory: Focus is on the interactions among family members and the impact of an individual’s health and behavioral responses on other family members, as well as the impact of other family members’ reactions and health on the individual (Hanson, 2001).

Family violence: Divided into three categories: physical violence, emotional violence, and sexual abuse. It can also include neglect of infants, children, and elderly who require caregiving. Intimate partner violence (IPV), also called domestic violence, increases the risk for PTSD in both victims and witnesses of the violence and is a major public health problem in the United States, affecting approximately one-third of children living in dual parent homes (Kitzmann, 2012).

Hyperarousal: Increased response to environmental stressors or memories with rage, anger, or severe anxiety (National Center for PTSD, 2010).

Plasticity: The ability of the human brain to develop and to recover from injury or stress. Post-traumatic Stress Disorder (PTSD): A response to trauma that is more likely to develop when resiliency traits are lacking. The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) has taken PTSD out of the anxiety category and created a separate category titled “Trauma- and Stressor-Related Disorders” (Freidman et al., 2013; Schmid,

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Petermann, & Fegert, 2013). Four categories of symptoms are included in the DSM-5: (1) intrusive thoughts about the trauma, (2) avoidance of discussion or other stimulus reminding the person of the trauma, (3) increased arousal or sensory sensitivity, and (4) negative cognitions and moods.

Resilience: A concept that attempts to explain why some people who experience the same or similar events will adapt without measurable physical or emotional anxiety, whereas others become acutely or chronically affected or disabled. Refers to individuals who (a) have been exposed to a significant threat or adversity and (b) manifest positive adaptation, or absence of poor adaptation, in spite of the adversity. Research has focused on identifying the factors consistently found in people described as resilient (see p. 330 in text for listing of common resiliency qualities).

Trauma: (1) A wound or physical injury to living tissue caused by an extrinsic agent; (2) a deeply stressing or disturbing experience; (3) a disorder of psyche or behavioral state resulting from severe mental or emotional stress or physical injury; (4) an emotional upset (“Trauma,” 2003).

Reflection Questions

1. Since the terrorist attacks of September 11, 2001, and the disaster of Hurricane Katrina (2005) do you think the United States is better prepared to assist families through the trauma of disasters? Give specifics in your answer that support your position. What can nurses do to advance this cause?

2. Do you agree with the premise advanced in the text (see pp. 335–336) that the United States, as a whole, is suffering from PTSD? Why or why not? What has influenced your answer?

3. Nurses are at increased risk for secondary (vicarious) trauma (developing signs and symptoms of PTSD) from what they witness and are involved with in their workplaces. Repeated or extensive exposure to trauma can lead to burnout or compassion fatigue. How do you plan to prevent this from happening to you in your own practice?

Case Study and Discussion Questions

Knoll Family—An Ecological Approach

This case study offers an example of a family that experienced trauma, and the impact of individual trauma and family trauma on all family members. The events that occurred within this family illustrate the complexities of prolonged stress, pileup of stressors, risk factors, and resiliency characteristics touching the individual, family, community, and nation.

Family Members

Mother: Emma (age 45)

Father: Peter (age 46)

Oldest daughter: Ignes (deceased at age 11 years)

Oldest son: Jason (age 14)

Youngest son: Bradley (age 12)

See Figure 11-5 for the Knoll family genogram.