Family Practice Approach & Family Influences on Health & Disease PDF

0 Family praCtiCe approaCh & Family inFluenCes on health and disease I “The P...

0 Family praCtiCe approaCh & Family inFluenCes on health and disease I “The Primary Unit In All Societies” Definitions MCQ FAMILY HOUSEHOLD  Group of persons:  The family differs from household in that:  United by ties of blood, marriage or adoption.  All the members in household may  Interacting & communicating with each other not be of blood relations. in their respective social roles. FAMILY OF ORIGIN FAMILY OF PROCREATION Family into which one is born. Family which one sets up after marriage Types NUCLEAR FAMILY EXTENDED FAMILY  Family that consists of:  Family that consists of: 1. Couple. 1. Couple. 2. Children. 2. Children. 3. Other relatives. Characteristics Characteristics of Family:  All members are living in the same House.  Share similar social Activities.  Share Values & norms.  Have similar Experience of success and failure. Dr. Ziad Mahana 14  FAMILY MEDICINE Community -2 Functions of family CAPRS MCQ Written  CARE Provide social care to every member such as food and shelter.  AFFECTION Provide psychosocial care such as love and warmth. Helping each member to decide his future career  PROVIDING STATUS regarding education & occupation.  REPRODUCTION Maintain essence of family through legal marriage.  SOCIALIZATION Helping each member of the family to acquire social skills. Family Life Cycle  The family life cycle concept views the family as having:  A beginning.  An end.  With a series of sequential stages in between. Basic model of family life cycle: MCQ STAGE BEGINS AT ENDS AT  FORMATION Marriage Birth of 1st child  EXTENSION Birth of 1st child Birth of last child  COMPLETE EXTENSION Birth of last child 1st child leaves home  CONTRACTION 1st child leaves home Last child leaves home/parents  COMPLETE CONTRACTION Last child leaves home/parents Spouse dies  DISSOLUTION Spouse dies Death of survivor Complete Complete Formation Extension Extension Contraction Dissolution Contraction Last child leaves Death of survivor home/parents leaves home Spouse dies Marriage last child 1st child 1st child Birth of Birth of Dr. Ziad Mahana 15  FAMILY MEDICINE Community -2 Family Dynamics D EFINITION OF F AMILY D YNAMICS  The patterns of interactions between family members, which include:  Roles.  Hierarchies.  Communication between family members. Effects of family dynamics: Inter-personal interactions among family members have lasting impacts & Influence the development and well-being of an individual via: psychosocial, behavioral, and physiological pathways.  Family dynamics & the quality of family relationships can have either a Positive impact or Negative impact on health. Factors which have an influence in family dynamics: Written  Spacing patterns: It depends on: A. The number of children in the family. B. The spacing between them.  Sex patterns: a family of all female children has a remarkably different set of role characteristics than one compared of all males.  STRUCTURAL  Age patterns (Family members’ ages): This factor is tied closely to: FACTORS A. The spacing; the size and the birth order of children. B. The relative gap between the ages of the parents & the ages of children.  Family values about: A. Gender roles. B. Responsibilities.  Disability or chronic illness of a family member.  CHANGE IN THE  Issues such as: FAMILY SYSTEM A. Substance use. B. Abusive relationships.  Mild Stress Events  Moderate Stress Events  Severe Stress Events 1. Change residence. 1. Illness. 1. Death.  STRESS EVENTS 2. Changing in 2. Unemployment. 2. Divorce. sleeping or eating 3. Job problems. 3. Marital separation. habits. 4. Outstanding achievements. 4. Trouble with law. Dr. Ziad Mahana 16  FAMILY MEDICINE Community -2 II Role of Family in Health & Disease  Family can maintain its member healthy & well, it can contribute significantly in: MCQ Written  Through the following: 1. By providing good housing conditions. 2. By providing adequate & healthy food and clean water  PREVENTION OF 3. By utilizing preventive measures such as: DISEASES  Immunization.  Periodic health examination.  Health screening.  The family can help its members by many means: DURING 1. Taking the sick individual to the nearest health facility for treatment.  SICKNESS 2. Helping the patient to comply with medical advice. 3. Providing psychological support in crisis situations.  The family can be a source of diseases & health problems: 1. Transmission of genetic disorders. 2. Transmission of communicable diseases. 3. Acquiring bad habits such as: SOURCE OF A. Smoking & drug abuse.  DISEASES B. Eating habits leading to occurrence of conditions such as:  Obesity.  Hyperlipidemia.  Cancers.  Psychiatric disorders. III D EFINITION OF F AMILY M EDICINE Written  The medical specialty which:  Provides continuing overtime, comprehensive health care for the individuals & their families.  Integrates all aspects of patient care including the social, psychological, physical & cultural aspects.  Has a scope that encompasses all ages, sexes, every organ system and every disease. It. Dr. Ziad Mahana 17  FAMILY MEDICINE Community -2 Principles, Characteristics & Services of family medicine Principles Characteristics Basket of Services of Family Practice  It is point of first medical contact within the health care system.  Diagnosis of health problems.  Responsible for the provision of longitudinal continuity of care..  Health maintenance. Written  Continuity of care.  As determined by the needs of the patient.  Has effective communication between doctor & patient.  Health education.  Counselling.  Manages simultaneously both acute & chronic health problems of individual patients.  Management of acute & chronic  Comprehensiveness of care.  Deals with health problems in their physical, psychological, social, health problems. and cultural dimensions.  Makes efficient use of health care resources through..  Coordination of care.  Coordinating care. ---  Working with other professionals in the primary care setting.  Community.  Has a specific responsibility for the health of the community. ---  Develops a person-centered approach..  Family.  Home care.  Oriented to the individual, his/her family, and their community.  Health promotion.  Disease prevention:  Promotes health & wellbeing both  Health-risk assessments.  Prevention.  by appropriate & effective intervention.  Immunization.  Perform screening tests. Dr. Ziad Mahana 18  FAMILY MEDICINE Community -2  Comparison between models of care at family medicine and specialist level of care: MCQ Written FAMILY MEDICINE MODEL SPECIALISTS CARE MODEL Continuous care Fragmented care Multidisciplinary team Single Physician Coordinates with other health team Uncoordinated care Individual, family and Community oriented Individual patient oriented Patient care in context of Family Patient care regardless his family context Appreciates physician-patient relationship Does not Appreciate in a healing, continuous manner. Physician-patient relationship Patient centered. Problem centered. (Recognizes patient concerns, values, believes, needs…) (Concentrates on the problem or disease) Dr. Ziad Mahana 19  FAMILY MEDICINE Community -2 IV FAMILY GENOGRAM = FAMILY PEDIGREE = FAMILY TREE = GENEALOGIC CHART D EFINITION OF F AMILY G ENOGRAM Written  A symbolic picture of the family tree shows important dates & characteristics of siblings, parents, grandparents, cousins, aunts, uncles, and other relatives. Aim of genogram:  Summarize on one page a large amount of information relating to a family →  Providing background essential to continuing & comprehensive care to individual and family. Information included in genogram: Written Index Person  Names & age of each member of family.  Definition: Index Person is the  Type of family (Nuclear or Extended). individual with major reason  Death of family members & the cause of death. for developing genogram.  Marital status of the parents (divorced , separated).  Identified by: Arrow, Double  Pattern of diseases and habits in family (genetic, familial diseases, smoking … etc.) Square or Double circle. Uses of genogram: Written  Allowing family physician to review quickly for family situation.  Allow other physician, nurse and other to assess and understand family quickly.  Building rapport by use family name and knowing who living in the same home.  Demonstrate family relationship.  Identify significant risk factors in family members e.g. Diabetes Mellitus.  Recognize the need for screening.  Promoting life style changes (patient education). Hassan’s genogram Genogram Dr. Ziad Mahana 20  FAMILY MEDICINE Community -2 Which of the following best fits the following definition: “1st child leaves home to Last child leaves home/parents”: A. Extension. B. Complete extension. 1 C C. Contraction. D. Complete contraction. E. Dissolution. Which of the following belongs to role of family in prevention of diseases: A. Helping the patient to comply with medical advice. B. Providing psychological support in crisis situations. 2 E C. Taking the sick individual to the nearest health facility. D. Supporting disabled family member. E. Immunization and screening. Which of the following is true about specialist care model? A. Patient care in context of family. B. Problem centered care. 3 B C. Continuous care. D. Multidisciplinary team. E. Coordinates with other health team. Dr. Ziad Mahana 21