Developed by Sayumi Nojima, RN, PHN, DSN, and described in “ Kazoku Enpawamento wo motarasu kango jissen” [in Japanese].  This model is used in nursing education and practice in Japan.

Website (Japanese): Helusu Publisher’s Inc.

Developed by Naohiro Hohashi, RN, PHN, PhD and his colleagues. The Concentric Sphere Family Environment Theory (CSFET) is a practice model that takes a holistic approach to the environment that affects the family’s well-being. This model is described in the nursing textbook, “Atarashii Kazoku Kangogaku” [in Japanese] and involves both assessment and intervention. This model has been developed in Japan and an English translation of the Family Environment Map (FEM-E) is now available. For more information see the following publications:

• Hohashi, N., & Honda, J. (2011). Development of the Concentric Sphere Family Environment Model and companion tools for culturally congruent family assessment. Journal of Transcultural Nursing, 22(4), 350-361. doi: 10.1177/1043659611414200
• Hohashi N., & Honda, J. (2015).  Assessment guide for the English version of the Family Environment Map (FEM-E).  Tokyo, Japan: Editex.

Family signs/symptoms as proposed by Hohashi & Hinoue (2010) are “problematic conditions in the family system unit, comprehensively assessed by a nursing professional based on subjective and objective family data.” They form the core of the family assessment model/intervention model on which the Concentric Sphere Family Environment Theory (CSFET), a middle-range family nursing theory, is based. Through the labeling of family symptoms, nursing professionals are able to make use of a common language related to family intervention, enabling intervention in response to the family symptoms, which, for example, might include “Dysfunctional communications within the family,” “Difficulties in formation of family agreements.” Up to the present, the effectiveness of identifying family s/s has been validated through research into family interventions in a clinical setting, with the outcome results reported at a number of academic conferences.  Reference: Hohashi, N., & Hinoue, E. (2010). Family health care nursing based on family signs/symptoms. In N. Hohashi (Ed.), New family health care nursing: Theory, practice and research (pp. 45-51). Tokyo, Japan: Medical Friend Sha. [in Japanese]

Website: http://www.familynursing.org/theory/

Developed by Sharon Denham, DSN, RN and described in “Family Health: A Framework for Nursing” (2003). A free copy of the book is available from: http://www.diabetesfamily.net/family/family-health-model/textbook/. The Family Health Model was created as a result of a comprehensive literature review, the author’s professional nursing practice, life experiences, and findings from a series of three qualitative research studies about ways Appalachian families defined and practiced family health within their households. This ecological model is a way to conceptualize the complex interactive relational systems relevant to families and their health. It is important to note that the Family Health Model is a model of family health, not merely a theory or model to explain the family or its functions. Thus, the context and variables are more inclusive than merely considering family processes. In other words, family health is influenced by the inter-related contextual aspects as well aspects linked with individual members and the family as a whole. Family health involves all members who reside in the household, but includes ways relationships and environments affect health over time. Findings from the qualitative research conducted by the author have provided evidence that indicate a need to conceptualize family health from ecological and process perspectives. Health or its absence can all be viewed from the model’s precepts and ways to consider clinical practice can be considered from a variety of perspectives.

For more information about the model, visit the Website: http://www.diabetesfamily.net/family/family-health-model and hear Dr. Denham provide an explanation of her model. In addition, the Diabetes: A Family Matter http://www.diabetesfamily.net/ program and toolkit http://www.diabetesfamily.net/toolkit/ of materials have been developed from the concepts of the Family Health Model.

Developed by Marie-Luise Friedemann, RN, PhD, and described in “ The Framework of Systemic Organization” (1995).  Website: http://friedemm.info

The practical application of Dr. Friedemann’s theoretical framework has largely been taken up in Europe for the last 35 years. She has written a book in German that is now in its 4th edition. Her framework is integrated in many nursing school curricula throughout German-speaking Europe. One Bachelor program at the Evangelische Fachhochschule Berlin, the first in Germany, is entirely based on Friedemann’s framework.  Dr. Friedemann’s ideas have also influenced family nursing care in Switzerland, Columbia (and across Latin America), and the Philippines. 

A extensive bibliography of Dr. Friedemann’s publications is included on her website: http://friedemm.info

Contact information: Marie-Luise Friedemann PhD, RN, Professor Emerita, Florida International University, Nicole Wertheim College of Nursing and Health Sciences, PO Box 1079, Panacea, Florida 32346; Telephone:  (850) 984-0133