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Legitimizing is a Family Systems Nursing (FSN) intervention that is more than active listening and validating to comfort individuals and families who experience suffering. Based on a postmodern paradigm, this intervention consists of acknowledging that a person's ideas/experience make sense, given their context or circumstances. This concept is often mentioned when discussing the theoretical components of FSN, but little has been written about how to apply it in clinical practice. In therapeutic conversations, once family members' ideas/experience have been "legitimized" by the nurse and by other family members, the greater the chances are of working together to find solutions to their problem. The purpose of this article is to provide an embellished description, theoretical background, and clinical examples of this underappreciated and underutilized FSN intervention.

While there has been continued growth in family nursing knowledge, the complex process of implementing and sustaining family nursing in health care settings continues to be a challenge for family nursing researchers and clinicians alike. Developing knowledge and skills about how to translate family nursing theory to practice settings is a global priority to make family nursing more visible. There is a critical need for more research methods and research evidence about how to best move family nursing knowledge into action. Enhancing health care practice is a multifactorial process that calls for a systemic perspective to ensure its efficacy and sustainability. This article presents insights derived from lessons learned through recent research experiences of using a knowledge translation model to promote practice changes in health care settings. These insights aim to optimize (a) knowledge translation of a Family Systems Approach (FSA) in practice settings; (b) knowledge translation research processes; and (c) sustainability of desired changes in practice with families in health care settings.

The author's reflections on knowledge transfer/translation highlight the importance of the circular process between science and practice knowledge, leading to the notion of "knowledge exchange." She addresses the dilemmas of translating knowledge into clinical practice by describing her academic contributions to knowledge exchange within Family Systems Nursing (FSN). Teaching and research strategies are offered that address the circularity between science and practice knowledge. The evolution of 20 years of teaching, research, and clinical experience has resulted in the recent creation of a Center of Excellence in Family Nursing at the University of Montreal. The three main objectives of the Center uniquely focus on knowledge exchange by providing (a) a training context for skill development for nurses specializing in FSN, (b) a research milieu for knowledge "creation" and knowledge "in action" studies to further advance the practice of FSN, and (c) a family healing setting to support families who experience difficulty coping with health issues.

The purpose of this study was to evaluate Family Systems Nursing interventions using a methodological approach based on Guba and Lincoln's fourth generation evaluation. The project involved five families in which one member had suffered either a myocardial infarction or a stroke. In this participatory study, family members, patients, nurses, and investigators were considered coresearchers in the research process. Thus, families collaborated with investigators and nurses to develop and evaluate Family Systems Nursing interventions based on the Calgary Family Assessment and Intervention Models. This article presents the research methodology and results that offer practical nursing interventions to help families during the patient's rehabilitation process.

This qualitative study explored the experience of parents and adolescents living with cystic fibrosis prior to the transfer of the adolescent's care from a pediatric to an adult health care facility. Semistructured interviews were conducted with seven families receiving care from a specialized cystic fibrosis clinic; parents and adolescents were interviewed separately, followed by a group interview with members of a health care team comprising eight professionals from the clinic. Interviews were analyzed through a systemic lens which accounts for interaction and reciprocity in relationships. The parents' experience was marked by suffering and uncertainty that remained unexpressed to the health care team, even though team members had known the family since the child was first diagnosed. Findings led to identifying a systemic hypothesis that accounted for the interactions and relational processes between parents and the health care team. This hypothesis may guide the development of systemic family nursing interventions that target this complex, relational, transition process.

The "One Question Question," first coined by Dr. Lorraine M. Wright in 1989, is an interventive question designed to elicit family members' most pressing needs or concerns within the context of a therapeutic conversation. In this article, two clinical projects analyzed the responses to this unique interventive question. The first project analyzed the responses of 192 family members experiencing illness who were asked the question in the context of a therapeutic conversation; families focused on their need to deal with the impact of the illness on the family. The second project examined responses of 297 nurses who were asked the question prior to a 1-week Family Systems Nursing training program; nurses wanted to know how to deal with conflictual relationships between families and health care professionals and how to offer families time-efficient interventions. The responses from both groups, which were markedly different, triggered reflections about teaching, research, and practice in family nursing.

A pilot study was conducted to examine the impact of a Family Systems Nursing educational program on the practice of psychiatric nurses and to explore the nurses' perceptions of the educational program. One year after the program, six nurses were asked to complete logbooks and to participate in an individual semistructured interview based on open-ended questions and on the critical incident approach to describe their family nursing interventions and to explore their perceptions on how the educational program influenced their practice of family nursing care. Content analyses indicated that participant nurses integrated systemic family interventions in their practice and were satisfied with the program.

To promote the integration of Family Systems Nursing (FSN) in clinical practice, we need to better understand how nurses overcome the challenges of FSN knowledge utilization. A qualitative exploratory study was conducted with 32 practicing female nurses from hospital and community settings who had received FSN intervention training and skill development based on the Illness Beliefs Model and the Calgary Family Assessment and Intervention Models. The participants were interviewed about how they utilized FSN knowledge in their nursing practice. From the data analysis, a FSN Knowledge Utilization Model emerged that involves three major components: (a) nurses' beliefs in FSN and in their FSN skills, (b) nurses' knowledge utilization strategies to address the challenges of FSN practice, and (c) FSN positive outcomes. The FSN Knowledge Utilization Model describes a circular, incremental, and iterative process used by nurses to integrate FSN in daily nursing practice. Findings point to a need for re-evaluation of educational and management strategies in clinical settings for advancing the practice of FSN.