PHNC 417: Total Family Care

• Family health nursing is covered in course PHNC 417
• The topic is Total Family Care

Objectives

• Explain family and its types
• Explain the functions of a family
• Explain family health and its determinants
• Describe what components make up family health
• Explain the roles of family and peers in health
• Describe family responsibilities in health and disease
• Explain family health assessment
• Describe data collection methods during assessment

Introduction to the Family

• The family is the unit of service in healthcare delivery
• Health of one family member affects the welfare of others
• Each family is unique and affected by community life
• Health service providers need to understand family traditions, customs, and beliefs
• Family health is part of community health

Defining Family

• A family serves as the primary unit in societies
• Families involves individuals related by blood, social ties, or legal contracts
• Family members live together, share meals, and a common physical and social environment
• Families consists of two or more individuals from same or different kinship groups
• Members have a continuous living arrangement, residing in the same household
• Members share emotional bonds and obligations

Types of Families

• Nuclear Family: Also known as conjugal family or family of procreation consisting of married partners and their offspring
• Non-conjugal Family: A nuclear family with one parent and dependent children
• Polygamous Family: Comprised of multiple spouses and dependent children
• Extended Family: Common type of family with at least three generations - grandparents, married offspring, and grandchildren
• Joint Family: Consists of sets of siblings, their spouses, and their dependent children
• Blended Family: Formed when divorced or widowed parents with children remarry
• Single-parent Family: One parent with children, where the parent is widowed, divorced (and not remarried), or never married
• Matrifocal Family: Family dominantly headed by the mother, with fathers playing a less important role

Functions of the Family

• Socialization of family members occurs
• Families offer economic stability
• Families provide for sexual needs
• Care for dependent members is given
• Emotional support is present for its members
• Social, intellectual, emotional and psychological needs are meet within the family
• Families teach children the rules for behavior and socially approved conduct
• Sense of family identification is provided
• It defines a sickness role with interactions in health, disease, counselling and rehabilitation

Family Health Defined

• Positive interaction happens between family members enabling optimal well-being for all
• The health status includes the impact of one member's health on the family
• Considers the families organization and disorganization on the health status of its members

Determinants of Family Health

• Living and working conditions impact family health
• The physical environment influences family health
• A Psycho-social environment can affect family health
• Education and economic factors play a role
• Health practices are determinants
• Cultural factors play a role
• Gender affects family health

Family Relational Factors with Adverse Effects on Illness

• High interpersonal conflict
• Low relationship satisfaction
• Poor problem-solving skills
• High levels of criticism and blame
• Intrafamilial hostility
• Poor family organization
• Inconsistent family structure
• Family perfectionism and rigidity
• Low family cohesion and closeness
• Lack of extrafamilial support system

Family Relational Factors with Protective Effects on Illness

• Good communication
• Adaptability
• Clear rules
• Mutual support
• Open expression of appreciation
• Commitment to the family
• Spending time together
• Good problem-solving skills
• Extra-familial social connections

Scope and Components of Family Health

• Problems families face: broken homes, drug abuse, juvenile delinquency, disability, unmarried mothers, teenage pregnancy
• Reproductive health: safe motherhood, ANC, delivery care, PNC, family planning, nutritional deficiencies, LBW, STIs/RTIs/HIV/AIDS, legal abortion, infertility services
• Adolescent Health
• Child health: child bearing, nurturing, nutrition, immunization, Growth monitoring
• Child mortality
• Social problems of children: child abuse, abandoned or street children, child labour, juvenile delinquency, battered baby syndrome
• Gender issues: GBV, girls trafficking, gender mainstreaming, FGM, female feoticide
• Aging: Problems of aging, active aging
• Mental health: situation of mental health, causes, prevention, National mental health policy

Roles of Family in Health

• A family can uplift their members health as a teacher, health service provider, and counselor
• Families are motivators, monitors, trainers, controllers and care takers

Role of Peer Groups in Health

• Peers serve as a source of health information
• Help to reduce mental stress and anxiety
• Help with being acquainted on physical and emotional changes
• Give support in acute and chronic illness
• Give support during disability

Family Responsibilities in Health and Disease

• Child nurturing
• Socialization
• Personality formation
• Care of dependents, sick or injured, pregnant, aged, and handicapped
• Stabilization of adult personality
• Address familial susceptibility to diseases
• Manage broken homes
• Sort out problem families

Family Health Assessment

• Establishing a working relationship between family and nurse through trust, confidentiality, and empathy
• It includes two way communication and equal opportunity where family members give their views so that they can solve the problem
• Assessment of health needs is a continuous process that accuracy with increased knowledge

Family Structure Considerations

• Composition and demographic data of family members and their relationship to head of household
• Place of residence
• Communication and decision-making patterns

Socio-Economic and Cultural Characteristics

• Occupation, place of work, and income of each working member
• Educational attainment
• Ethnical background and religious affiliation
• Significant others and their roles
• Relationship to the larger community

Home and Environment

• Housing and sanitation facilities
• Type of neighborhood
• Availability of social, health, communication, and transportation facilities

Health Status of Each Member

• Current and past significant illnesses
• Beliefs and practices conducive to health and illness
• Nutritional and developmental status
• Physical assessment findings and lab results

Values and Practices on Health Promotion

• Use of preventive services
• Adequacy of rest/sleep
• Exercise and relaxation activities
• Stress management
• Immunization status of at-risk family members

Data Collection Methods

• Observation: using sensory capacities, sight, hearing, smell and touch. This method allows for validation and reliability testing
• Physical Examination: inspection, palpation, percussion, auscultation, measurement
• Interview: Completing the health history to determine health status
• Collecting data by asking family members to generate data on wellness conditions and health problems
• Elicit needed responses through effective communication
• Record Review: Reviewing existing records such as the family's clinical and immunization records
• Reviewing the home & environmental conditions
• Laboratory/Diagnostic Tests Performed by nurses or other health workers