Family Coping Index

Purpose:

• To provide a basis for estimating the nursing needs of a particular family.

Health Care Need

A family health care need is present when:

1. The family has a health problem with which they are unable to cope.
2. There is a reasonable likelihood that nursing will make a difference in the in the family’s ability to cope.

Relation to Coping Nursing Need:

• COPING may be defined as dealing with problems associated with health care with reasonable success.
• When the family is unable to cope with one or another aspect of health care, it may be said to have a “coping deficit”

Direction for Scaling

• Two parts of the Coping index:
  1. A point on the scale
  2. A justification statement
• The scale enables you to place the family in relation to their ability to cope with the nine areas of family nursing at the time observed and as you would expect it to be in 3 months or at the time of discharge if nursing care were provided. Coping capacity is rated from 1 (totally unable to manage this aspect of family care) to 5 (able to handle this aspect of care without help from community sources). Check “no problem” if the particular category is not relevant to the situation.
• The justification consists of brief statement or phrases that explain why you have rated the family as you have.

General Considerations

1. It is the coping capacity and not the underlying problem that is being rated.
2. It is the family and not the individual that is being rated.
3. Rating should be done after 2-3 home visits when the nurse is more acquainted with the family.
4. The scale is as follows:
   • 0-2 or no competence
   • 3-5 coping in some fashion but poorly
   • 6-8 moderately competent
   • 9 fairly competent
5. Justification- a brief statement that explains why you have rated the family as you have. These statements should be expressed in terms of behavior of observable facts. Example: “Family nutrition includes basic 4 rather than good diet.
6. Terminal rating is done at the end of the given period of time. This enables the nurse to see progress the family has made in their competence; whether the prognosis was reasonable; and whether the family needs further nursing service and where emphasis should be placed.

Scaling Cues

• The following descriptive statements are “cues” to help you as you rate family coping. They are limited to three points – 1 or no competence, 3 for moderate competence and 5 for complete competence.

Areas to Be Assessed

1. Physical independence: This category is concerned with the ability to move about to get out of bed, to take care of daily grooming, walking and other things which involves the daily activities.
2. Therapeutic Competence: This category includes all the procedures or treatment prescribed for the care of ill, such as giving medication, dressings, exercise and relaxation, special diets.
3. Knowledge of Health Condition: This system is concerned with the particular health condition that is the occasion of care
4. Application of the Principles of General Hygiene: This is concerned with the family action in relation to maintaining family nutrition, securing adequate rest and relaxation for family members, carrying out accepted preventive measures, such as immunization.
5. Health Attitudes: This category is concerned with the way the family feels about health care in general, including preventive services, care of illness and public health measures.
6. Emotional Competence: This category has to do with the maturity and integrity with which the members of the family are able to meet the usual stresses and problems of life, and to plan for happy and fruitful living.
7. Family Living: This category is concerned largely with the interpersonal with the interpersonal or group aspects of family life – how well the members of the family get along with one another, the ways in which they take decisions affecting the family as a whole.
8. Physical Environment: This is concerned with the home, the community and the work environment as it affects family health.
9. Use of Community Facilities: generally keeps appointments. Follows through referrals. Tells others about Health Departments services