Theoretical Bases for Promoting Family Health PDF

Chapter :18 Theoritical Bases for Promoting Family Health Dr. Ahlam Al-Ntour. 10.2024 1 1  Learning Objectives Define the concept of family Discuss characteristics of families Discuss ho...

Chapter :18 Theoritical Bases for Promoting Family Health Dr. Ahlam Al-Ntour. 10.2024 1 1  Learning Objectives Define the concept of family Discuss characteristics of families Discuss how family culture influences values, behaviors and roles Describe functions of family Discuss the role of community health nurse in promoting family health Dr. Ahlam Al-Ntour. 10.2024 2 2 Introduction Community health nurses are intimately involved with families, whether the client is an individual within the context of the family or the family is the unit of care. Health habits, preventive care, diet , exercise and physical activities are developed in the context of family One of the most controversies ( arguments) facing the community health nurse is defining what constitute a family. Community health nurse need to understand and work with many types of families which indicate unique health needs Family health is concerned with how family function together as a unit. Dr. Ahlam Al-Ntour. 10.2024 3 3 Dr. Ahlam Al-Ntour. 10.2024 4 4 Definition of Family The primary social agent in the promotion of health and wellbeing (WHO, 1976) Dr. Ahlam Al-Ntour. 10.2024 5 5  Definition of family- Cont…. Many Theorists (Friedman, Bowden, & Jones 2003; Murray & Zentner, 2000) suggest that family: Consists of two or more individuals who share a residence or live near one another possess some common emotional bond engage in interrelated social positions, roles, and tasks; and share cultural ties and sense of affection (love) and belonging Dr. Ahlam Al-Ntour. 10.2024 6 6  Family health Concerned with how well the family functions together as a unit. ¡It involves not only the health of the members and how they relate to other members, but also how well they relate to and cope with the community outside the family. In fact, family health, like individual health, ranges along a continuum from wellness to illness Family health refers to the health status of a given family at a given point in time (Hanson, 2001). Dr. Ahlam Al-Ntour. 10.2024 7 7  Observations that can be made about families in General Each family is unique with its own distinct problems and strengths, therefore you have to gather information about each particular family to achieve nursing goals Every family shares some universal characteristics with every other families. Dr. Ahlam Al-Ntour. 10.2024 8 8 Universal CHARACTERISTICS OF FAMILIES Every family is a small social system. Every family has its own cultural values and rules. Every family has structure. Every family has certain basic FUNCTIONS Every family moves through stages in its life cycle. Dr. Ahlam Al-Ntour. 10.2024 9 9  Attributes OF FAMILIES AS SOCIAL SYSTEMS Knowing the attributes of living systems or open systems can help strengthen understanding of family structure and function. There are five attributes of open systems that help explain how families function: 1. families are interdependent 2. families maintain boundaries 3. Families exchanges energy with their environment 4. Family are adaptive 4. families are adaptive 5. Families are goal oriented Dr. Ahlam Al-Ntour. 10.2024 10 10  1. Interdependence Among Members All the members of a family are interdependent; Each member’s actions affect the other members, and what affects the family system affects each family member. Example 1: A father might consider some changes to reduce his risk of coronary heart disease. If he cuts back over time the family income will reduce. If he begins to eat different foods, food preparation and patterns of eating will change. His abilities to carry out role as husband and father may be affected Dr. Ahlam Al-Ntour. 10.2024 11 11  Families as systems set and maintain boundaries: ego-boundaries, generation boundaries, and family— (2) Family community boundaries Boundaries These boundaries, which result from shared experiences and expectations, link family members together in a bond that excludes the rest of the world. Also, a greater concentration of energy exists within the family than between the family and its external environment, thereby creating a family system boundary. Dr. Ahlam Al-Ntour. 10.2024 12 12  (3) Energy Exchange Family boundaries are semi permeable; o Although they provide protection and preservation of the family unit, they also allow selective linkage with the outside world. o As open systems, in order to function adequately, families exchange materials or information with their environment. This process is called energy exchange. o All normally functioning living systems engage in such an input– output relationship. o This energy exchange serves to promote a healthy ecologic balance between the family system and the environment that is its immediate community Dr. Ahlam Al-Ntour. 10.2024 13 13  (4) Adaptive Behavior Families are adaptive, equilibrium-seeking systems. In accordance with their nature, families never stay the same. With each pressure or changes the family shifts and accommodate to regain balance and normal lifestyle They shift and change in response to internal and external forces. Dr. Ahlam Al-Ntour. 10.2024 14 14  15 Adaptive Behavior Internally; The family composition changes as: New members are added or members leave through death or divorce. Roles and relationships change as members advance in age and experience. Normative expectations change as members resolve their tensions and differing points of view. Dr. Ahlam Al-Ntour. 10.2024 15 Adaptive Behavior Externally: Families are bombarded by influences from sources such as school, work, peers, neighbors, religion, and government. Consequently, they are forced to accommodate to new demands. Adapting to these influences may require a family to change its behaviors, its goals, and even its values. Like any system Dr. Ahlam Al-Ntour. 10.2024 16 16 (5) Goal Directed Behavior Families as social systems are goal directed. Families exist for a purpose — to establish and maintain, and promotes the development of their members To fulfill this purpose, a family must perform basic functions such as providing love, security, identity, a sense of belonging; assisting with preparation for adult roles in society; and maintaining order and control. In addition to these functions, each family member engages in tasks to maintain the family as a viable unit Dr. Ahlam Al-Ntour. 10.2024 17 17 FAMILY LIFE CYCLE Families grow and develop as the individuals within them mature and adapt to the demands and life changes. A family’s composition, set of roles, and network of interpersonal relationships change with the passage of time Family structures, too, vary with each stage of the family life cycle. Dr. Ahlam Al-Ntour. 10.2024 18 18 FAMILY LIFE CYCLE…… Stages of the Family Life Cycle 1- expansion as new members are added and roles and relationships are increased 19 2- contraction as family members leave to start lives of their own or age and die. Both expansion and contraction are repeated as various members added, children return home, or leave home permanently Dr. Ahlam Al-Ntour. 10.2024 19  Family developmental tasks To progress through the stages of life cycle, a family must carry out its basic functions and the developmental tasks associated with those functions. § Unlike individual developmental tasks that are specific to each age level, family developmental tasks are ongoing throughout the life cycle. § Example all families must provide physical needs of their members at every stage. § Some functions require greater emphasis at certain stages Dr. Ahlam Al-Ntour. 10.2024 20 20 Family developmental tasks Dr. Ahlam Al-Ntour. 10.2024 21 21  Family Culture The family is a unity of interacting persons related by ties of marriage, birth, or adoption whose central purpose is to create and maintain a common culture which promotes the physical, mental, emotional, and social development of each of its members” Family culture is the acquired knowledge that family members use to interpret their experiences and to generate behaviors that influence family structure and function Dr. Ahlam Al-Ntour. 10.2024 22 22  Family culture Three aspects of family culture deserve special consideration: (1) family members share certain values that affect family behavior (2) certain roles are prescribed and defined for family members (3) a family’s culture determines its distribution and use of power. Dr. Ahlam Al-Ntour. 10.2024 23 23  Shared Values and Their Effect on Behavior Every family has its own set of values and rules for operation that can be considered as family culture Some values are explicitly stated: “family matters must always stay within the family.” Such values may give rise to specific operating rules “ do not tell anyone about our problem Like all cultural values, many family values remain outside the conscious awareness of family members. These values, often not verbalized, become powerful determinants of what the family believes, feels, thinks, and does. Family values include those beliefs transmitted by previous generations, religious influences, immediate social pressures, and larger society Dr. Ahlam Al-Ntour. 10.2024 24 24  Prescribed Roles Roles the assigned or assumed parts that members play during day-to-day family living, are bestowed and defined by the family. E.g. Father role assigned to the male adult: as establishing control and rules, administer punishment. Family members play several roles at the same time. This intra-role functioning can be exceptionally taxing. E.g. mother play a role of wife to her husband, mother to her daughter, mother to other children Family members can participate in roles outside the family: politics, community improvement...... Dr. Ahlam Al-Ntour. 10.2024 25 25  Power Distribution Power: the possession of control, authority, or influence over others–assumes different patterns in each family. In some families, power is concentrated primarily in one member; in others, it is distributed on a more democratic basis. Dr. Ahlam Al-Ntour. 10.2024 26 26  Family functioning is defined as those behaviors or activities by family members that maintain the family and meet family needs, individual member needs, and society’s views of family. The interdependence of family members involves a set of internal relationships that influence the effectiveness of family functioning. A complex communication pattern of functioning among family members and the quality of that pattern contribute to the health of the family. Six functions are typical of American families today and are essential for maintenance and promotion of family health: 1-providing affection (to give members affection and emotional support) 2- providing security (meet their members’ physical needs by providing food, shelter, clothing, health care, and other necessities; so doing, they create a secure environment ) Dr. Ahlam Al-Ntour. 10.2024 27 27  FAMILY FUNCTIONS- Cont. 3- instilling identity (The family functions to give members a sense of social and personal identity. Like a mirror, the family reflects back to its members a picture of who they are and how valuable they are to others. Positive reflection provides individuals with a sense of satisfaction, that reflects on a community) 4- promoting affiliation and companionship: give members a sense of belonging throughout life. Communication and conflict management influence its closeness. Family provides its members with affiliation and fellowship that remain unbroken by distance or time, example family members scattered across the countries still one another. Dr. Ahlam Al-Ntour. 10.2024 28 28  FAMILY FUNCTIONS- Cont. 5-providing socialization ( The family functions to socialize the young. Families transmit their culture — their values, attitudes, goals, and behavior patterns — to their members. Through the process of socialization members learn their roles in the family. Lifestyle, food preference, relationships with others, attitudes about religion, equaled rights influenced by family. Socialization influence the degree of independence, some families release their maturing members by degrees preparing them gradually but steadily for adult roles. Other families promote dependent roles and find release painful and difficult. Dr. Ahlam Al-Ntour. 10.2024 29 29  FAMILY FUNCTIONS- Cont. 6-Establishing controls Members’ conduct is controlled by the family‘s definition of acceptable and unacceptable behaviors. Dividing the labor is another aspect of the family control function, families allocate various roles responsibilities and tasks to their members. The family identifies and directs the internal and the external resources Dr. Ahlam Al-Ntour. 10.2024 30 30  Family structures or compositions comprise the characteristics of individuals who make up a family unit FAMILY (age, gender, and number) STRUCTURES Families in its different forms are the basic social unit Families come in many shapes and sizes Dr. Ahlam Al-Ntour. 10.2024 31 31  Traditional Family Traditional family structures are those that are most familiar to us and that are most readily accepted by society 1-Nuclear family—husband, wife, and children living together in the same household. 2-Nuclear-dyad family consists of a husband and wife living together who have no children or who have grown children living outside the home 3-Single-adult families in which one adult is living alone by choice or because of separation from a spouse or children or both. Separation may be the result of divorce, death. 4-Multigenerational families, in which several generations or age-groups live together in the same household Dr. Ahlam Al-Ntour. 10.2024 32 32 Traditional family 5- kin-network, in which several nuclear families live in the same household or near one another and share goods and services. They may own and operate a family business, sharing work and child care responsibilities, income and expenses, and even meal 6-blended family single parents marry and raise the children from each of their previous relationships together. 7-commuter family. Both partners in this family work, but their jobs are in different cities. The pattern is usually for one partner to live, work, and perhaps raise children in the “home” city, while the second partner lives in the other city and commutes home. 8-Augmented families. Extended family member live with and provide significant care to the children, example grandmother taking care of grandchildren Dr. Ahlam Al-Ntour. 10.2024 33 33 Implications for the Community Health Nurse 1. They must be prepared to work with all types of families and accept them as valid. 2- the structure of an individual’s family may change several times over a lifetime. 3- each type of family structure creates different issues and problems that in turn influence a family’s ability to perform basic functions. 4- Each particular structure determines the kind of support needed from nursing or other human service systems. 5- Variation in structure creates variations in family strength and needs that not easily recognized Dr. Ahlam Al-Ntour. 10.2024 34 34  Family as a unit of service has received more emphasis in nursing practice Working with family dictates understanding characteristics and structure, strength, needs of each family Summary Family pattern influence the role and approach of CHN. The family and nurse are partners in establishing in providing health care Nurse should start with family strength which could help in establishing and building positive relationships between them which considered as the esstential starting in CHN work. Dr. Ahlam Al-Ntour. 10.2024 35 35