Journal of Advanced Nursmg. 1991,16,147-153 Preventive work with families: issues facing public health nurses Linda J KnstjansonMN Assistant Professor and Karen I Chalmers MSc(A) Assistant Professor, School of Nursmg, Untoersity of Manitoba, Wmnipeg, Manitoba, Canada Accepted for puUicahon 10 July 1990 KRISTIANSON L J & CHALMERS K I (1991) Journal of Advanced Nurstng 16, 147-153 Preventive work with families: issues facing public health nurses This paper examines the issues that nurses expenence when entenng the family system to work preventively The theoretical basis of family-centred nursing is analysed and the need for empincal work is identified in order to develop a knowledge base for this practice Some unique charactenstics of the public health nursmg role are discussed with emphasis on temtonal issues, power relationships and accountability problems The need for pubhc health nurses to function as advanced generalists across different system levels is recommended and family skills necessary for effective family nursing are exammed The authors identify the unique role of public health nurses because they have access to healthy families and families dealing with early stages of health concerns The authors support the general structure of public health practice as of value for preventive work with families However, clanty regardmg referrals, contractmg and the nghts of chents is called for to facilitate collaborative family-centred nursing INTRODUCTION The aim of reducmg and eliminatmg health problems _ LI I UL u J i-u t. through early detection and mtervenhon IS recognized by For years pubhc health nurses have recognized that ^, , . ^ , i_ r u uu community'care is usually 'family' care and that the family T^ ^ i^c '^t.? ' ^"°"^ "^ .s the pnmary unit of health care Over the past decade (^an^^a Health Survey 1981) there has been an inaeasmg emphasis m the hterature on This paper is designed to contnbute to the undersandmg ,f , , . , .f 1 V. J ' A 'C «,,u, of how public health nurses can work preventively with family-focused care, family-centred nursing and family . , [ .. .. L u uu AUU u i.u . . ,m -.^or /- u. -laaiz rn.. .f nl famihes to promote their health Although we agree With interventions (Bames 1985, Garrett 1985, Gilhss et al . j . . L. I. U uiT a. ^ «-,*,. 1 . ^ LI ,«fl,c c II iaa-> \Ai un the expanded lens approach to community health care that 1989, Pesznedcer k Zahlis 1986, Sullivan 1982, Wnght & , . n r l L U t 4.U ik J ,, ,_ ^ , , uiti« r.A^T includes the family, we share concerns about the methods Leahey 1984) These wntings have been helpful in under- , ^ \u uu u c lU ^ A , , r , . L 1 L t u iix.,r,A used in this care, the theory base tor this practice, and standine how families contnbute to or restore health and C L I_J..I-I. U I . i °" ~! ,' " , A AH, ,,^o,,h,=,l obstades to family-centred care that may be inherent in prevent illness This literature has widened the conceptual i LI u iiu -i_ A li J p. vciuiuiicsa ""=• ' = / some traditional public health practices As welt discussion lens throujzh which health problems are assessed and , t , c J U C uuuu{^i »Yiuui .itcu y regardmg family-focused nursmg can become confusing S ,.,111 , a. A because of different viewpoints about who constitutes AsecondthememthepuWichealthliteratureistheneed ^^ ^^^^ ^^ ^^^ ^^ ^ fanuly-focused for preventive health care breslow 1978, Pender 1987) / mterventions 147