The definition of family has always been determined by societal acceptance. By historical reference, the definition of family was linked to blood lines or marriage. Through the years, societal attitudes regarding adoption, foster parenting, divorce, remarriage, and LBGTQ rights have changed the traditional definition (Green, 2018). Today, family is defined by more than blood ties or marriage. It is defined by function, level of commitment and attachment. In fact, some family members may not even live in the same household. According to Wright and Leahey (2012), “The family is who they say they are” (p.55).

The definition of family has always been determined by societal acceptance. By historical reference, the definition of family was linked to blood lines or marriage. Through the years, societal attitudes regarding adoption, foster parenting, divorce, remarriage, and LBGTQ rights have changed the traditional definition (Green, 2018). Today, family is defined by more than blood ties or marriage. It is defined by function, level of commitment and attachment. In fact, some family members may not even live in the same household. According to Wright and Leahey (2012), “The family is who they say they are” (p.55).

Nontraditional family structures need to be acknowleged when working with patients. Perceptions of wellness and the health disparities present are influenced by the dynamics within a family system. For instance, a grandparent raising a grandchild may have different attitudes toward health promotion for the child, health issues of their own, or be experiencing economic disparities. In addition, caregiver roles may differ from a traditional family structure in single parent family. Understanding who is “family”, and how the family functions is key to creating stimulus for change in health promotion. The Calgary Modle of Family Assessment (CMFA) is one tool nurses can use to gain a better understanding of the family dynamics (Green, 2018).

Bowen’s family systems theory can also be used to gain a better understanding of the interactions within a family. The family is made up of individuals that impact the lives of the other individuals within the family. For instance, a parent who has a substance abuse problem creates financial, emotional or even physical consequences for every other individual within the family. Any stressor or change within the unit, can create a ripple effect of negative or positive individual consequences that influence the entire family. Using the CMFA model the nurse can begin assessing the family in the initial assessment. This simple assessment can be utilized to understand the connections and interactions within her patient’s family. Then appropriate nursing interventions can be created that the family as a whole can adopt. Since the family is encouraged to work together toward a common goal, compliance and the incidence of desired outcomes increases (Green, 2018).