Family Nursing Concept 2023 Part 1 PDF

FAMILY NURSING FAMILY HEALTH ASSESSMENT The twelve assessment categories for data collection: 1. Family demographics: composition, socio-economic status, ages, education, occupation, ethnicity and religion 2. Physical environment: geography, climate, housing, space, social and political...

FAMILY NURSING FAMILY HEALTH ASSESSMENT The twelve assessment categories for data collection: 1. Family demographics: composition, socio-economic status, ages, education, occupation, ethnicity and religion 2. Physical environment: geography, climate, housing, space, social and political, food availability and dietary habits 3. Psychological and spiritual environment: affectional relationships, mutual respect, support 4. Family structure and roles: family organization, division of labor, allocation and use of authority and power 5. Family functions: providing for family members’ needs 6. Family values and beliefs: raising children, making and spending money 7. Family communication patterns: Frequency and quality of communication 8. Family decision-making patterns: How are decisions made in the family? By whom are they made? How are they implemented? 9. Family problem-solving patterns: Flexibility of family’s approach to problem-solving, nature of solutions 10. Family coping patterns: How does the family handle conflict and life changes, nature and quality of family support systems 11. Family health behaviour: Health history, current physical health of members, use of health resources, health beliefs 12. Family social and cultural patterns: family discipline, limit- setting practices, promotion of members’ creativity  GUIDELINES FOR FAMILY HEALTH ASSESSMENT 1. Focus on the family as a total unit. Family health > sum of individual members 2. Ask goal-directed questions 3. Collect data over time: Allow adequate time 4. Combine quantitative and qualitative data 5. Exercise professional judgment: Involve family with assessment NURSING PROCESS APPLIED TO FAMILIES AS CLIENTS A Home Visit….. is a professional face to face contact made by a nurse to a patient or the family to provide necessary health care activities and to further attain an objective of the agency. It is made to the client or to a responsible member of the family. NURSING PROCESS APPLIED TO FAMILIES AS CLIENTS Working with families where they live: The Home visit purpose: Assist the clients to achieve as high a level of wellness as possible FILIPINO FAMILY  The Filipino Family Based on the Philippine Constitution, Family Code with focus on religious, legal, and cultural aspects of the definition of family.  Section 1 The state recognizes the Filipino family as the foundation of the nation. Accordingly, it shall strengthen its solidarity and actively promote its total development  Section 2 Marriage, as an inviolable social institution, is the foundation of family and shall be protected by the government The government shall defend – The right of spouses to find a family Section 3 in accordance with their religious convictions and the demands of responsible parenthood The right of children to assistance including proper care and nutrition, and special protection from all forms of neglect, abuse, cruelty, exploitation and other conditions prejudicial to their development The right of the family to a family living wage income The right of families or family associations to participate in the planning and implementation of policies and programs of that affect them  Section 4 The family has the duty to care for its elderly members but the state may also do so through just programs of social security  The Filipino Family and its Characteristics The basic social units of Philippine society are the nuclear family Although the basic unit is the nuclear family, the influence of kinship is felt in all segments of social organizations Extensions of relationships and descent patterns are bilateral Kinship circles is considerably greater because effective range often includes the third cousin  Kin group is further enlarged by a spiritual or ceremonial ties. Filipino marriage is not an individual but a family affair  Extended family has a profound effect on daily decisions There is a great degree of equality between husband and wife Children not only have to respect their parents and obey them, but also have to learn to repress their repressive tendencies The older siblings have something of authority of their parents.  A. Structure- UPDATES NUCLEAR- a father, a mother with child/children living together but apart from both sets of parents and other relatives. EXTENDED- composed of two or more nuclear families economically and socially related to each other. Multigenerational, including married brothers and sisters, and the families. SINGLE PARENT-divorced or separated, unmarried or widowed male or female with at least one child. BLENDED/RECONSTITUTED-a combination of two families with children from both families and sometimes children of the newly married couple. It is also a remarriage with children from previous marriage.  A. Structure- UPDATES COMPOUND-one man/woman with several spouses COMMUNAL-more than one monogamous couple sharing resources COHABITING/LIVE-IN-unmarried couple living together DYAD—husband and wife or other couple living alone without children GAY/LESBIAN-homosexual couple living together with or without children NO-KIN- a group of at least two people sharing a relationship and exchange support who have no legal or blood tie to each other FOSTER- substitute family for children whose parents are unable to care for them  B. Decisions in the family (Authority) UPDATES PATRIARCHAL – full authority on the father or any male member of the family e.g. eldest son, grandfather MATRIARCHAL – full authority of the mother or any female member of the family, e.g. eldest sister, grandmother EGALITARIAN- husband and wife exercise a more or less amount of authority, father and mother decides MATRICENTRIC- the mother decides/takes charge in absence of the father (e.g. father is working overseas) PATRICENTIC- the father decides/ takes charge in absence of the mother  Universal Function of the Family by Doode – September 05, 2012 REPRODUCTION - for replacement of members of society: to perpetuate the human species STATUS PLACEMENT of individual in society BIOLOGICAL and MAINTENANCE OF THE YOUNG and dependent members Socialization and care of the children  The Family as a Unit of Care Rationale for Considering the Family as a Unit of Care: The family is considered the natural and fundamental unit of society The family as a group generates, prevents, tolerates and corrects health problems within its membership The health problems of the family members are interlocking The family is the most frequent focus of health decisions and action in personal care The family is an effective and available channel for much of the effort of the health worker  The Family as the Client Characteristics of a Family as a Client The family is a product of time and place- A family is different from other family who lives in another location in many ways. A family who lived in the past is different from another family who lives at present in many ways. The family develops its own lifestyle Develop its own patterns of behavior and its own style in life. Develops their own power system which either be: – Balance-the parents and children have their own areas of decisions and control. – Strongly Bias-one member gains dominance over the others. The family operate as a group A family is a unit in which the action of any member may set of a whole series of reaction within a group, and entity whose inner strength may be its greatest single supportive factor when one of its members is stricken with illness or death. The family has a growth cycle Families pass through predictable development stages (Duvall & Miller, 1990) Stages of Family Development  DEVELOPMENTAL MODEL  Evelyn Duvall  Family developmental theory Approach to studying families Useful in explaining patterned change, the dynamic nature of the family, and how change occurs in the family life cycle.  Stage 1- Beginning family Marital & sexual adjustment  Adjustment to roles Pre-natal education Married couples Without children  Tasks ☻Establishing a mutually satisfying marriage ☻Relating harmoniously to the kin network ☻Planning a family (decisions about parenthood)  Stage 2- Early childbearing Changing roles Parenting Oldest child, birth-30 months  Tasks ☻Setting up the young family as a stable unit (integrating new baby into family) ☻ Reconciling conflicting developmental tasks and needs of various family members ☻Maintaining a satisfying marital relationship. ☻Expanding relationships with extended family by adding parenting and grandparenting  Stage 3- Families with preschool children Discipline Childbearing Accidents Poisoning CD Oldest child, 2 1/2- 6years  Tasks ☻ Meeting family members' needs for adequate housing, space, privacy, and safety. ☻Socializing the children. ☻Integrating new child members while still meeting needs of other children. ☻Maintaining healthy relationships within the family (marital and parent-child) and outside the family (extended family and community).  Stage 4- Families with school age children Balancing time and energy to meet demands of work, children’s needs & activities, adult’s social interests, harmony in marital & in-laws relations. Oldest child, 6-13 years  Tasks ☻ Socializing the children, including promoting school achievement and fostering healthy peer relations of children ☻Maintaining a satisfying marital relationship ☻Meeting the physical health needs of family members  Stage 5- Families with teenagers Open communication, continuing intimacy in marital relation, peer pressure, sex education Oldest child, 13-20 years ☻Balancing freedom with responsibility as teenagers mature and become increasingly autonomous. ☻Refocusing the marital relationship. ☻Open communication between parents and children.  Stage 6- Launching center Releasing children as adults, reestablishing marital dyad, identifying post parental interest, grandchildren, divorce/ separation, menopause First child gone to last child leaving home ☻ Expanding the family circle to include new family members acquired by marriage of children ☻Continuing to renew and readjust in the marital relationship ☻ Assisting aging and ill parents of the husband and wife.  Stage 7- Middle Aged Families Rebuilding marriage & maintaining satisfying relationship with aging parent’s children with their families, retirement plans, health, new career  Parents – Middle Age “empty nest” to retirement  Tasks ☻Strengthening the marital relationship. ☻Providing a health-promoting environment ☻ Sustaining satisfying and meaningful relationships with aging parents and children.  Stage 8 – Aging (retirement & old age) Retirement to death of both spouses ☻ Maintaining a satisfying living arrangement. ☻Adjusting to a reduced income. ☻Maintaining marital relationships. ☻Adjusting to loss of spouse. ☻Maintaining intergenerational family ties ☻Continuing to make sense out of one's existence (life review and integration).  Continuous maintenance of family relationship, income changes & living arrangements physiologic aspects of aging, death of spouse.  12 Behaviors Indicating a Well Family Able to provide for physical emotional and spiritual needs of family members Able to be sensitive to the needs of the family members Able to communicate thought and feelings effectively Able to provide support, security and encouragement Able to initiate and maintain growth producing relationship Maintain and create constructive and responsible community relationships Able to grow with and through children Ability to perform family roles flexibly Able to help oneself and to accept help when appropriate Demonstrate mutual respect for the individuality of family members Ability to use a crisis experience as a means of growth Demonstrate concern of family unity, loyalty and interfamily cooperation  Family Health Task Health task differ in degrees from family to family TASK- is a function, but with work or labor overtures assigned or demanded of the person Duvall & Niller identified 8 task essential for a family to function as a unit:  Eight Family Tasks (Duvall & Niller) Physical maintenance- provides food shelter, clothing, and health care to its members being certain that a family has ample resources to provide Socialization of Family- involves preparation of children to live in the community and interact with people outside the family. Allocation of Resources- determines which family needs will be met and their order of priority. Maintenance of Order- task includes opening an effective means of communication between family members, integrating family values and enforcing common regulations for all family members. Division of Labor – who will fulfill certain roles e.g., family provider, home manager, children’s caregiver Reproduction, Recruitment, and Release of family member Placement of members into larger society –consists of selecting community activities such as church, school, politics that correlate with the family beliefs and values Maintenance of motivation and morale- created when members serve as support people to each other  5 Family Health Tasks (Maglaya, A., 2004) Recognizing interruptions of health development Making decisions about seeking health care/ to take action Dealing effectively health and non-health situations Providing care to all members of the family Maintaining a home environment conducive to health maintenance  Family Roles Nurturing figure- primary caregiver to children or any dependent member. Provider – provides the family’s basic needs. Decision maker- makes decisions particularly in areas such as finance, resolution, of conflicts, use of leisure time etc. Problem-solver- resolves family problems to maintain unity and solidarity. Health manager- monitors the health and ensures that members return to health appointments. Gate keeper-Determines what information will be released from the family or what new information cam be introduced.  Theoretical Approaches to Family Health Care (Family Apgar) Family Models The use of family model provides a perspective of focus for understanding the family Have categorized according to their basic focus as developmental, interactional structural-functional, and systems model  Developmental Models 1. Duvall’s and Stevenson’s Family development model This model is applicable for nuclear families with growing children and families who are experiencing health-related problems.  2. Stevenson’s Family Developmental Model Joanne Stevenson (1977) describes the basic tasks and responsibilities of families in four stages. STAGES HEALTH TASKS Emerging family (from marriage Couple strives for independence from their parents and to develop for 7 to 10 years) a sense of responsibility for family life. Crystallizing family (with teenage To assume responsibility for growth and development of individual children) members and outside organizations Interacting family(children grown Assumption of responsibility for “continued survival and and small grandchildren) enhancement of the nation.” Actualizing family (aging couple Assume the responsibility for sharing the wisdom of age, reviewing alone again) life and putting affairs in order  Views family tasks as maintaining a common household rearing children and finding satisfying work and leisure. Sustaining appropriate health patterns and providing mutual support and acculturation of family members. Nuclear families Examines psychosocial patterns to specific stage of development Does not include family structure, nor it addresses health promotion and health-related concerns that the family may face.  3. Structural- Functional Model Friedman’s Structural- Functional Family Model Was developed from sociological frameworks and systems theory by Marilyn Friedman (1986) The family is the focus of this model as it interacts with supra- systems in the community and with individual family members in the subsystem.  Friedman’s Family Model Components STRUCTURAL COMPONENTS FUNCTIONAL COMPONENTS Family composition Affective Value systems Physical necessities and care Communication patterns Economic Reproductive Role structure Socialization and social placement Power structure Family coping  Structural component examines the family unit- - how it is organized and how members relate to one another - Values, communication network, role system and power while Functional components refers to the interaction outcomes resulting from family organizational structure. The structural-functional components and parts all intimately interrelate and interact; the others affect each component and part. Any type of family and their health-related problems  4. Systems Model Calgary’s Family Model (system’s model) Integrated conceptual framework of several theorists Each is further subdivided into parts that interacts with others and changes the whole family configuration.  This model is comprehensive and incorporates three major areas, namely, the structure, function and development of the family.(3 in 1) It is complex, with too many sub concepts for the health worker to explore and focus. It can be applied to any type of family with any health-related problems