[Orem's family evaluation]

Nurses are beginning to realize that clients' deficits influence family members and, conversely, that family members play an important role in the development and resolution of these deficits. The authors attempted to find published literature describing a family nursing evaluation based upon Orem's conceptual framework. Previous nursing research has described how Orem's model is applied to nursing interventions with individual clients, but none has addressed the application of nursing interventions to multiperson units within a family situation. The authors developed their own concept from their personal and family experiences and a theoretical background of Orem's model. They chose to integrate systemic and communication theory, and developmental and functional approaches with Orem's concept of nursing care of multiperson units. According to the authors, this approach is consistent with Orem's model and represents a holistic vision of the family. Orem emphasizes that the nurse intervening with multiperson units should understand the structure and function of groups and be able to identify the actual ongoing process. Although Orem's theoretical framework is not based upon a systemic approach, the authors believe that it is possible to blend the systemic theory concepts with Orem's model. This article reviews the three basic concepts found within Orem's conceptual framework: self-care; self-care deficit, and nursing systems. The authors also outline their theoretical assumptions for the use of this approach with family nursing interventions, based upon six functional dimensions of the family as described by Epstein et al. and Guttman. In addition, the article provides a concrete example of how nursing evaluation can be structured within this scheme of reference.