- Evaluation

Step 8: Test Results and Evaluate Health

Evaluation involves the question whether the agreed-upon individual and/or family goal was reached. 

Evaluation too occurs in collaboration with the clients. It may be done in steps, each time the nurse meets with the family or patient, or as a final assessment. 

Nurse and family will discuss the ideal diagram and/or the specific goal. They will decide what they have accomplished and what still needs to be done. If there are additional moves necessary, a new plan is established to meet the same or a new goal. 

Step 9: Honor all efforts

Positive feedback is of major importance. The nurse highlights strengths and achievements honestly, without exaggeration. This needs to be part of the entire intervention and evaluation process. 

Use of the ASF-E

This instrument (see ASF-E section) is a research tool, but can be used to reinforce the intervention and evaluation process. 

One family member completes the instrument. The results on the ASF-E are only exploratory and have to be backed up by detailed assessment data. They are used as a basis for discussion of the family operation. If there are differences in opinion between the family members, these too serve as a topic for discussion and may lead to some modification of the ASF-E results. The final scores for SM, C, I, and SC can be used to construct a simplified family diagram.  

This process works as a starting point for the family to look at its own process critically. The nurse uses it to stress the positive aspects (high scores on certain items) before looking at areas of deficiency (low scores). 

To evaluate the success of the interventions, the ASF-E is administered once more at the end of the intervention process. The evaluation shows success, if the scores have improved over time and the quadrants in the simplified diagrams have become larger for the four dimensions. Again, this has to be backed up by a qualitative evaluation of the intervention process.