Bio-ecological theory
Maximum 4 pages plus reference list.
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Throughout nursing as well as in this course, core to understanding health, health behaviours, and health programs, students are encouraged to study the work of various theorists whose work have not only been foundational to the practice of health care practitioners, but also facilitates an understanding of human psycho-social development, as well as normative and non-normative behaviour patterns across the lifespan.
For the purpose of this assignment the student will explore the approach of Urie Bronfenbrenner whose bio-ecological theory consists of five environmental systems: –
1) the microsystem [where an individual lives]. 2) mesosystem [individual and family experiences within their immediate communities]. 3) exosystem [social settings in which individuals/ families may not have an active role but yet the systems impact the micro and meso systems]. 4) macrosystem – larger systems that represent culture, behaviour patterns, sets societal norms etc. 5) Chronosystem [level of government policies etc.].
Page 1: The student will provide an introduction that matches the scenario they choose to explore from the list below [1 paragraph approx. ½ page]. The student could conclude that paragraph stating e.g. that the situation will be explored in the context of Bronfenbrenner’s bio-ecological theory.
For the other half of page1 the student will describe their understanding of Bronfenbrenner’s theory.
Page 2 & 3: For each of the 5 levels of Bronfenbrenner’s theory the student will describe potential findings/ contributing factors to the situation they choose to explore.
Page 4: The student will describe and discuss hypothetical nursing interventions to address the issues for the client in the scenario they are exploring. Be sure to pull information into the discussion from e.g. CNO documents that may be pertinent, pertinent organizations Clinical Practice guidelines, ethical considerations if any, etc.
Rationale for the assignment: To introduce the learner to the broader contexts that impact population health.
See the next page for hypothetical scenarios. Each student is to choose only ONE of the following 3 scenarios. An example of Bronfenbenner’s model and brief descriptors of each level is included at the end of this appendix.
Katrina aged 16, is from Round Robin reserve community. She moved to Thunder Bay this year to attend high school. She was initially residing in the home of a non-indigenous family, but, on Thanksgiving day she was told by the family that they were having company over for supper and she was not invited to join. Katrina left the home that night choosing not to return as she did not feel welcome. Katrina is the eldest of 5 children all of whom are back in her home community and living with their parents Frances and George. She has no family in Thunder Bay and there is no one else from her community attending her High School. Today, she was brought in by ambulance suffering the effects of hypothermia. Once she is stabilized she identifies that both her parents are not in a stable relationship, there is often verbal and physical abuse in their home, and, both parents are often quite intoxicated. She has difficulty making friends here in Thunder Bay. She feels comfortable at the school as the students are similar to her. However, when she is not at school she experiences racial slurs. She is very homesick and reveals some suicidal ideation.
Using Bronfenbenner ecological systems model [micro, meso, macro, exo, and chrono levels] which has the individual at the center followed by the 5 systems levels, explore some of the issues that impact on Katrina’s well-being. Include information such as developmental tasks appropriate for her age group, what systems play a role for her age group
Mr. Aryn Rudd aged 76 has been on your unit for the past 3 weeks.
PMH:
IDDM diagnosed at age 45. Poorly controlled
Impaired renal function eGFR 25
HTN/ CHF
Smoker since the age of 14. More recently smokes ½ ppd.
COPD which required numerous hospital admissions.
He was admitted following a major right posterior hemorrhagic CVA with left hemiparesis. An incidental finding during his admission has been lung ca.
His wife Ida has been coming to the hospital to visit 2-3 times daily.
Mr. Rudd is being heavily sedated for pain control and often he is not coherent which makes his wife’s visits very distressing for her.
Today Mrs. Rudd states, “I know my husband would not want to live like this. Can we stop his treatments?”
They have 2 adult children who Jacqueline and Harold who live in Alberta. Both Jacqueline and Harold have 2 children of school ages and often cannot make it home to support their parents.
Aryn and Ida have been very active with their church community.
Using Bronfenbenner ecological systems model [micro, meso, macro, exo, and chrono levels] which has the individual at the center followed by the 5 systems levels, what other information would be helpful for the nurse to explore.
Sheera Il-Zibab aged 19 and her husband Raoul 20 have presented for prenatal care at the local Community Health Center. They present with an interpreter provided by the Multi-cultural center. They have recently emigrated [within the last 2 months] from Afghanistan together with their families [i.e. parents and siblings]. They think Sheera may have been pregnant prior to immigration but did not acknowledge this for fear of not been allowed to enter Canada to flee from their war torn country. As a refugee they are provided health care for one year but they did not really know about this or fully understand the process so deferred seeking care. It is also not the norm in their country to seek prenatal care until much later in their pregnancy. However, they were attending classes for newcomers at the multi-cultural center, and, after a health presentation disclosed to the staff that they might be expecting.This triggered more specific education for Sheera and Raoul including the importance of seeking prenatal care as soon as they could.
Use Bronfenbenner ecological systems model [micro, meso, macro, exo, and chrono levels] which has the individual at the center followed by the 5 systems levels, to explore what factors may impact this family and what other information would be helpful for the nurse to explore.
Bronfenbrenner’s Bioecological Systems Theory Model
This bioecological framework supports that what happens outside family units is as important as what happens inside individual members and family units.
First, one should determine the developmental stage of the individual and/or family. Next one can establish what within the micro and mesosystems are at the forefront of the client’s life. Examine how both biological age as well as developmental stage impacts interactions between systems e.g. independent or with assistance such as in the case of a young child, an individual with disabilities, an elderly individual vs a young adult etc.
Knowing these details helps the nurse develop questions she may need to ask to establish not only norms vs deviations from norm, but also help in the formation of an appropriate care plan with client specific interventions.
Microsystems are settings in which people fulfill their roles in families, with peers, in schools, and in neighbourhoods where they are in the most direct interaction with agents around them.
Mesosystems are relationships among major microsystems in which persons or families can actively participate such as families and schools, families and religion, families and healthcare systems etc. One can ask questions such as how does the interaction of families and schools affect families? Can the relationship between individuals/ families and their health care communities be used to help the individual and/or family?
Exosystems are external environments that influence individuals and families indirectly.
The person may not be an active participant within these systems, but the system has an effect on the persons/families. For example, a parent’s job experience affects family life which, in turn, affects the children (parent’s job’s travel requirements, job stress, salary). Furthermore, governmental funding to other microsystems environments—schools, libraries, parks, health care, and day care—affects the experiences of children and families.
Macrosystems Mesosystems and exosystems are set within macrosystems, and together they are the “blueprints” for the ecology of human and family development. Macrosystems form the broad cultural attitudes, ideologies, or belief systems that influence environments in which individuals/ families live.
Chronosystems are time-related contexts where changes occur over time and have an effect on the other four levels/systems of development mentioned earlier. Chronosystems include the patterning of environmental events and transitions over the life course of individuals/families. These effects are created by time or critical periods in development and are influenced by sociohistorical conditions, such as parental divorce, unexpected death of a parent, or a war. Individuals/families have no control over the evolution of such external systems over time.
Within each one of these levels are roles, norms, and rules that shape the environment. Bronfenbrenner’s model of human/family development acknowledges that people develop not in isolation, but rather in relation to their larger environment: families, home, schools, communities, and society. All these interactive, ever-changing, and multilevel environments over time are key to understanding human/family development.
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