| For purchase of the book - "The framework of systemic organization" go to:www.sagepub.com |
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| OVERVIEW | |
| The Framework of Systemic Organization is a conceptual approach to working with families, individuals and other social systems (organizations, communities). | |
| It is presently taught in family nursing programs and research courses in the United States as well as abroad. The framework has shown to be useful to researchers who explicate theoretical processes and apply them to various health care situations, cultures and health problems, and develop situation-specific theories leading to clinical interventions. In Europe, the framework is becoming increasingly popular as a theoretical foundation for nursing education as well as nursing practice in hospital and home care. | |
| The Framework of Systemic Organization encompasses the grand theory level based on specific philosophical underpinnings that is brought down to a less abstract and measurable mid-range level. Friedemann has expanded the nursing metaparadigm - environment-person-health-nursing to also include "the dynamic concepts of family and family health to guide the explanation of systemic function of individuals, social and environmental systems, and the interactions between them" (Friedemann, 1995, p.x). At the mid-range level, the framework suggests a process applicable to all social systems. Based on a holistic and systemic view of the world, environment, people and families are open macrosystems that strive toward congruence. | |
| Congruence refers to the energy flowing freely between systems that are compatible in patterns and rhythms and attuned to each other. Congruence is fully realized only in an overarching universal order that is reflected and detectable in each human, nature and other systems but cannot be explained with scientific means. As disharmony and tension are inherent in most interacting systems, congruence remains an ideal rather than reality. | |
| Health is congruence experienced within the system and between the system and its environment. As such, it is never fully achieved. Optimal health is the result of a balanced systemic life process and is a highly subjective personal experience. | |
| Culture comprises all of a person's or family's systemic life process. It has two components. Culture maintenance consist of processes that assist in the preservation of tradition, values, beliefs, ideals and the resulting behavior patterns that define a person or family's basic nature, identity or functioning. Culture transformation is the process of adapting cultural beliefs and patterns to a changed environment. As values, beliefs and behavior strategies are changed, the new patterns are integrated in the systemic process and become tradition that is maintained and transmitted to the new generation (culture maintenance). Culture transformation in individuals and families occurs at varying rates, depending on the emphasis placed on culture maintenance and the ability to control "foreign" influence. | |
| THE PROPOSITIONS | |
| Environment
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| 1. All existing things are organized as
open systems of energy and matter in movement.
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| 2. The basic order of the universe is
ruled by conditions largely unknown to humans. It is timeless and limitless, and its power
is awesome. Under universal order all existing systems are connected and congruent in
pattern and rhythm.
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| 3. The organization of systems on Earth
follows an order secondary to and dependent on the order of the universe: the laws of the
earthly conditions of time, space, energy, and matter.
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| 4. The concept of environment comprises all things outside the system in focus. (Friedemann, 1995, p.3) | |
| Person
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| 1. Human perception is limited by the
structure and function of the human body.
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| 2. Persons have the ability to realize
their dependency on natural forces and foresee death. This threat to their systemic
existence has the potential to evoke a disturbance of system processes and incongruence.
All incongruence is experienced as anxiety.
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| 3. Humans have attempted to decrease their
vulnerability by creating an artificial environment or civil system within which they
maintain a sense of control.
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| 4. Persons have the capacity for
transcendence through which they can reestablish congruence with systems of their
environment and with the order of the universe.
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| 5. Culture is the total of human life
patterns. Culture is ever changing through the integration of new knowledge in the human
way of life, leading to new patterns while forgetting old ones and transmitting the new
patterns to the next generation. (Friedemann, 1995, p.5)
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| Health
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| 1. Health is the experience of system
congruence evidenced on all levels of an individual's system, the subsystems, and the
environmental systems of contact.
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| 2. Health is not an absolute. It is never
totally absent and never fully present.
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| 3. Physical disease is a condition that
refers to the organizational disturbance at the organic system level
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| 4. Physical disease and poor health are
not synonymous and neither are lack of physical disease and good health.
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| 5. Physical disease may mirror an
incongruence of life patterns with the order of the universe. It can lead to health if it
reveals to the person the path toward congruence.
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| 6. The crucial determinant of a deficiency in health is anxiety that results from system incongruence, whereas well-being is a sign of high-level health. (Friedemann, 1995, pp. 14-15) The Framework of Systemic Organization takes a contrasting view to the medical model. According to the medical profession, disease signifies pathology and illness refers to unpleasant manifestations of a disease that require medical treatment. In contrast, intervention with this framework implies attention to the congruence of the system, to its systemic patterns that aim at congruence and its exchanges with other systems, in order to reduce the level of anxiety. | |
| Family
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| "The family is a unit with structure
and organization that interacts with its environment. - The family is a system with
interpersonal subsystems of dyads, triads, and larger units defined by emotional bonds and
common responsibilities. -- The family is composed of individuals who each have distinct
relationships with family members, the total family, and contact systems in the
environment. -- Members of the family do not need to be biologically related or live in a
single household. The family is defined as all persons an individual considers to be
family. The family includes all persons who carry family functions and are emotionally
connected to the individual. Consequently, the persons who are emotionally connected are
those the individual is concerned, worried, or upset about." (Friedemann, 1995, p.18)
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| 1. The family embedded in the civil system
is transmitting culture, the total of human system patterns and values.
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| 2. The family shares with the civil
system and the environment at large the responsibility to provide physical necessities and
safety, procreate, teach social skills to its members, provide for personal growth and
development, allow emotional bonding of members, and promote a purpose for life and
meaning through spirituality.
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| 3. The family satisfies its members' needs
for control over their environment and guides them in finding their place in the network
of systems through spirituality.
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| 4. All family processes include
collectively accepted and coordinated behaviors or strategies that aim at regulating the
earthly conditions of space, time, energy and matter in pursuing the systemic targets.
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| 5. Family strategies fall into the four
process dimensions of system maintenance, system change, coherence, and individuation. The
dimensions share collinearity but exist independently in that none is emphasized at the
expense of another in healthy families. (Friedemann, 1995, pp. 16-17.)
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| Family Health
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| 1. Family health encompasses four
observable criteria: the presence of strategies within all process dimensions,
satisfaction of all family members with their family, positive environmental feedback
about family members' execution of roles in community systems, and low anxiety level in
the family.
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| 2. Family health is a dynamic process
that, in response to changing situations, is continually attempting new ways of
reestablishing congruence within the system and with the environment.
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| 3. Family style is the product of weighing
and emphasizing the process dimensions and choosing certain strategies within them.
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| 4. No family style can be judged effective
or ineffective without evaluation of the four criteria of family health.
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| Nursing | |
| (This definition also applies to family
health care executed by other professionals if practiced with this model)
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| 1. Nursing occurs on the various system
levels, from organic systems to the larger social systems in the community.
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| 2. Nursing focused on individuals also
includes the family and the environmental systems of contact. Therefore, all nursing is
family nursing and is practiced in all clinical settings.
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| 3. All nursing interventions at the level
of the family system or the community also heed individuals and their subsystems.
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| 4. Nursing is a process of mutual growth
through spirituality.
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| 5. The goal of nursing is the support of
the clients' systemic processes leading to health, whereas the clients' goal is health.
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| 6. The art of nursing consists of the
nurse's creative ability to shift his or her position from the role of a participant and actor in the system to that of a bystander and shift from one system level to another. (Friedemann, 1995, p. 35)
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| THE SYSTEMIC PROCESS |
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