School Work

Marie Luise Friedemann

Nursing theory
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  Marie-Luise Friedemann, RN, PhD   The Framework of Systemic Organization   Mid-Range Biography Marie-Luise Friedemann, RN, PhD Dr. Friedemann is the srcinator of the Framework of Systemic Organization. She grew up in Zurich, Switzerland and graduated from a Business College before immigrating the United States. In San Francisco, she completed a Diploma Nursing program. She then moved with her husband to Michigan. At Wayne State University, she completed her Bachelor's degree in Nursing and assumed a position as public health nurse for Washtenaw County. Two years later, Dr. Friedemann continued her education at the University of Michigan and received a Master's degree in Psychiatric/Mental Health Nursing in 1977. Her academic career started at Eastern Michigan University where she taught psychiatric nursing, community health and substance abuse while working toward a doctoral degree in Community Development at the University of Michigan. She accomplished that goal in 1984. Dr. Friedemann worked at Wayne State University as faculty and researcher for eleven years and shifted to assignments in administration, first at Wayne State University, then at the University of Detroit Mercy before moving on to her current position. She is presently Professor at Florida International University in Miami, Florida where the focus of her work is research. Her research areas are family functioning, family caregiving and substance abuse. In 1991, Dr. Friedemann has reestablished her relationship with her country of srcin. She has carried regular teaching assignments over several years at a school for advanced nursing in Aarau, Switzerland that led to ongoing networking and consulting with educational institutions and hospitals not only in Switzerland, but throughout German speaking Europe. The development of the Framework of Systemic Organization began in 1986 when Dr. Friedemann started her career as faculty at Wayne State University in Detroit. It was driven by a need for a comprehensive approach to family therapy with multi-problem minority families in the inner city. Since conventional family therapy methods were of little use to many of these  families, Dr. Friedemann developed the framework as a means to provide the practitioner and researcher with a guiding structure for their work. She writes in her book (Friedemann, 1995): The Framework of Systemic Organization has evolved through a process of both inductive and deductive thinking processes. It represents a synthesis of my life and professional experiences, my worldview and personality, and is enriched by insights from scientific literature and research. Consequently, bits and pieces of the writing of scientists and practitioners in nursing, such as (Martha) Rogers, (Imogene) King, and (Margaret) Newman, and family specialists and researchers including Kantor and Lehr, Minuchin, Haley, and Beavers -- have been reformulated and become part of my universe of discourse. Today, the evolutionary process is by no means complete. The framework continues to experience growth and change through discussions with groups of professionals, students, and colleagues and through the findings of theory-based research. In 1989, Dr. Friedemann published the first theory articles and in 1995, her book on the Framework of Systemic Organization came out of press, followed by a book written in German that was based on European literature (see literature). Dr. Friedemann's work comprises the framework itself, the Congruence Model, an eight-session approach to families of rehabilitating substance abusers and the ASF-E, a theory-based instrument to assess family functioning that was also translated into three foreign languages and tested in Mexico, Colombia, Finland and Switzerland. 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   1. All existing things are organized as open systems of energy and matter in movement.    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.   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.   4. The concept of environment comprises all things outside the system in focus. (Friedemann, 1995, p.3)   Person   1. Human perception is limited by the structure and function of the human body.   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.   3. Humans have attempted to decrease their vulnerability by creating an artificial environment or civil system within which they maintain a sense of control.   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.   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)   Health   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.   2. Health is not an absolute. It is never totally absent and never fully present.  
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