The phases of the Family Empowerment Process are interdependent
and overlapping (Gibson, 1995). In addition, progression through
the phases may be stalled or reversed due to a prolonged or severe
challenging phase, disruption in family life, or changes in the health
care situation (Wuest&Stern, 1991). Nurses can help prevent all three
of these events by implementing the Family Empowerment Intervention
(see Table 1). The activities of this intervention are meant to recognize,
promote, and enhance the family’s ability to satisfy the health
care needs of the affected child and to sustain family life. They are
based on an empowerment ideology that maintains all people have
existing strengths and capabilities and all people have the capacity to
grow and become more competent (Dunst & Trivette, 1996).
In this model, the three behaviors of the collaborating phase as delineated
by Wuest and Stern (1991) were chosen to be Family Empowerment
Outcomes (see Table 2). It is proposed that positive Family
Empowerment Outcomes will lead to optimal measures of the Health
Care Outcome, as demonstrated by the family’s ability to satisfy the
health care needs of the child. In turn, optimal measures of the Health
Care Outcome will then lead to favorable measures of Health Services
Outcomes, as demonstrated by lowered health care use and costs.
In the Family Empowerment Model, the central spiraling motif
represents the Family Empowerment Process. At the center of the
Family Empowerment Process is a health care situation, either the initial
diagnosis of the child’s chronic health condition or a lifethreatening
occurrence or relapse. Moving through the dynamic
Family Empowerment Process is not always straightforward, hence the spiral motion and arrows at both ends. Passage through the spirals
of the Family Empowerment Process, however, demonstrates
family growth as the family’s ability to manage the child’s health care
and sustain family life expand. The overall direction of the Family
Empowerment Process is toward Family Empowerment, Health
Care, and Health Services Outcomes. Facilitating this process are
Family Empowerment Intervention activities used by nurses to support
and strengthen the family as it moves along the Family Empowerment
Process.
In conclusion, empowerment is a concept frequently used in health
and social services that mostly remains on an abstract level. In this article,
the scholarly literature on family empowerment in relation to
families of children with a chronic health condition was reviewed and
analyzed with the aim of synthesizing this small knowledge base into
a model that can be tested by research. In addition to testing whether
the intervention leads to desired outcomes, research could help determine
whether outcomes are affected by the phase the family is in
when the intervention is initiated, the particular chronic health condition
of the child, or the socioeconomic and cultural backgrounds of
both the families and their nurses. If indeed there is a new paradigm
of family-health professional relationships, the empowerment of
families of children with a chronic health condition as a nursing intervention
could prove to be the exemplar of this new paradigm.