Module-2-The-Family-as-a-Unit-of-Care.pdf

FAMILY HEALTH NURSING Far Eastern University Institute of Nursing SY 2020-2021 Community Health Nursing 1...

FAMILY HEALTH NURSING Far Eastern University Institute of Nursing SY 2020-2021 Community Health Nursing 1 (Family and Individual) Module 2: THE FAMILY AS A UNIT OF CARE INTRODUCTION 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. All of these are basis why the Family is considered to be the unit of care in community health nursing. LEARNING OUTCOME After finishing this module the student will be able to: 1. Enumerate the characteristics of a healthy family 2. Explain the Stages of family development and the developmental tasks per stage 3. Enumerate the family health tasks of the family 4. Discuss the family roles 5. Enumerate the Role of the Health care provider 6. Specify the 12 behaviors of a well family OUTLINE 1. Characteristics of a healthy family 2. Stages of Family Development 3. Family Health tasks 4. Family Roles 5. Role of the Health care provider 6. 12 behaviours of a well family 7. Activity 8. Assessment CHARACTERISTICS OF A FAMILY AS A CLIENT Far Eastern University 1 Manila, Philippines  FAMILY HEALTH NURSING 1. 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. 2. 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. 3. The family operates 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. 4. The family accommodates the needs of the individual members. An individual is unique human being who needs to assert his or herself in a way that allows him to grow and develop. Sometimes, individual needs and group needs seem to find a natural balance; a. The need for self-expression does not over shadow consideration for others. b. Power is equitably distributed. c. Independence is permitted to flourish. 5. The family relates to the community Family develops a stance with respect to the community: The relationship between the families is wholesome and reciprocal; the family utilizes the community resources and in turn, contributes to the improvement of the community. There are families who feel a sense of isolation from the community. Families who maintain proud, ““W Wee keep to ourselves” attitude. Families who are entirely passive taking the benefits fro m the community without either contributing to it or demanding changes to it. Far Eastern University 2 Manila, Philippines  FAMILY HEALTH NURSING 6. The family has a growth cycle Families pass through predictable development stages (Duvall & Miller, 1990) Stages of Family Development Family Life Cycle The family life cycle was developed by Evelyn Duvall, a sociologist. She compiled the average ages at which people complete normal life experiences: marriage, have their first child, have teenagers, have no more children at home and retire. “Duvall’s developmental model is an excellent guide for assessing, analyzing and planning around basic family tasks developmental stage. It is to be noted though that this model does not include the family structure or physiological aspects, which should also be considered for a comprehensive view of the family. This model is applicable for nuclear families with growing children and families who are experiencing health-related problems. Stages and Developmental Tasks in the Family Life Cycle Stage 1. Beginning Family: (newly-wed couples) The married couple establish their home but do not yet have children. Developmental Tasks: Establishing a satisfying home and marriage relationship and preparing for childbirth. Compliance with the PD 965 & acceptance of the new member of the family physical maintenance Involves merging of values brought into the relationship from the families of orientation. Includes adjustments to each other’s routines (sleeping, eating, chores, etc.), sexual and economic aspects. Members work to achieve 3 separate identifiable tasks: Establish a mutually satisfying relationship Learn to relate well to their families of orientation. If applicable, engage in reproductive life planning Stage 2. Childbearing Family: (0-30 months old) From the birth of the first child until that child is 2 1/2 years old. Developmental Tasks: Adjusting to increased family size; caring for an infant; providing a positive developmental environment. Emphasize the importance of pregnancy & immunization & learn the concept of parenting allocation of resources Birth or adoption of a first child which requires economic and social role changes. Oldest child: 2-1/2 years Stage 3. Family with Preschoolers: (3-6yrs old) When the oldest child is between the ages of 2 1/2 and 6. Developmental Tasks: Satisfying the needs and interests of preschool children; coping with demands on energy and attention with less privacy at home. learn the concept of responsible parenthood; division of labor This is a busy family because children at this stage demand a great deal of time related to growth and development needs and safety considerations.. Oldest child: 2-1/2 to 6 years old Far Eastern University 3 Manila, Philippines  FAMILY HEALTH NURSING Stage 4. Family with School Children: (6-12yrs old) When the oldest child is between the ages of 6 and 13. Developmental Tasks: Promoting educational achievement and fitting in with the community of families with school-age children. Reinforce the concept of responsible parenthood; socialization of members Parents at this stage have important responsibility of preparing their children to be able to function in a complex world while at the same time maintaining their own satisfying marriage relationship. Oldest child: 6-12 years old Stage 5. Family with Teenagers: (13-25yrs old) When the oldest child is between the ages of 13 and 20. Developmental Tasks: Allowing and helping children to become more independent; coping with their independence; developing new interests beyond child care. Parents to learn the concept of “let go system” and understands the “generation gap”. Reproduction, recruitment and release of Members A family allows the adolescents more freedom and prepare them for their own life as technology advances-gap between generations increases. Oldest child: 12-20 years old Stage 6. Launching Center: (1st child will get married up to the last child) From the time the oldest child leaves the family for independent adult life till the time the last child leaves. Developmental Tasks: Releasing young adults and accepting new ways of relating to them; maintaining a supportive home base; adapting to new living circumstances. compliance with the PD 965 & acceptance of the new member of the family maintenance of order Stage when children leave to set their own household-appears to represent the breaking of the family. Empty nests Stage 7. The Family of Middle Years: (36-60yrs old) From the time the children are gone till the marital couple retires from employment. Developmental Tasks: Renewing and redefining the marriage relationship; maintaining ties with children and their families; preparing for retirement years. provide a healthy environment, adjust with a new lifestyle and adjust with the financial aspect; placement of members in larger community Family returns to two partners nuclear unit Period from empty nest to retirement Stage 8: Aging Family: (61yrs old up to death) From retirement till the death of the surviving marriage partner. Developmental Tasks: Adjusting to retirement; coping with the death of the marriage partner and life alone. learn the concept of death positively. Maintenance of motivation and morale If more children come into a home, the process repeats itself. Thus, a family can be in several overlapping stages. This requires that the family learns many different developmental tasks and adjustments at the same time. In a family, each person is trying to make it through a specific INDIVIDUAL stage while the family is, as a unit, also going through various stages in the family life cycle. This information by Duvall reviews a family life cycle. In order to better understand individual growth and development, it would be helpful to review Erik Erikson's stages of personality development. Far Eastern University 4 Manila, Philippines  FAMILY HEALTH NURSING Remember that parents are in one stage and their children are in certain other stages depending upon their age. The family has 5 family health tasks: 1. Recognizing interruptions of health development 2. Making decisions about seeking health care/ to take action 3. Providing care to all members of the family 4. Maintaining a home environment conducive to health maintenance 5. Utilize community resources for health care (Maglaya, 2004) Roles of Health Care Provider in Family Health Care HEALTH MONITOR PROVIDER OF CARE COORDINATOR FACILITATOR TEACHER COUNSELOR Family Roles As a unit of care, the family fulfills these roles to each member. 1. Nurturing figure- primary caregiver to children or any dependent member. 2. Provider – provides the family’s basic needs. 3. Decision maker- makes decisions particularly in areas such as finance, resolution, of conflicts, use of leisure time etc. 4. Problem-solver- resolves family problems to maintain unity and solidarity. 5. Health manager- monitors the health and ensures that members return to health appointments. 6. Gate keeper-Determines what information will be released from the family or what new information can be introduced. 12 BEHAVIORS INDICATING A WELL FAMILY Far Eastern University 5 Manila, Philippines  FAMILY HEALTH NURSING 1. Able to provide for physical emotional and spiritual needs of family members 2. Able to be sensitive to the needs of the family members 3. Able to communicate thought and feelings effectively 4. Able to provide support, security and encouragement 5. Able to initiate and maintain growth producing relationship 6. Maintain and create constructive and responsible community relationships 7. Able to grow with and through children 8. Ability to perform family roles flexibly 9. Able to help oneself and to accept help when appropriate 10. Demonstrate mutual respect for the individuality of family members 11. Ability to use a crisis experience as a means of growth 12. Demonstrate concern of family unity, loyalty and interfamily cooperation Far Eastern University 6 Manila, Philippines