Community Health Nursing: The Family PDF

Community Health Nursing: The Family Professor: Klyne Ken T. Cabag, RN  Concept of Family as a Basic Unit of Society Concept of family. The family is the basic unit of society. - Families exist in all sizes & configurations & are essential to the health & survival...

Community Health Nursing: The Family Professor: Klyne Ken T. Cabag, RN  Concept of Family as a Basic Unit of Society Concept of family. The family is the basic unit of society. - Families exist in all sizes & configurations & are essential to the health & survival of the individual members & society as a whole. -As the primary group for the individual, the family serves as the buffer between the needs of the individual & the demands & expectations of society. Concept of Family as a Basic Unit of Society Concept of Family -The role of the family is to meet the needs of society Concept of Family as a Basic Unit of Society Family- a group of people related by blood, marriage, or adoption living together: Concept of Family as a Basic Unit of Society Family- two or more people who live in the same household usually share a common emotional bond & perform certain interrelated social tasks Concept of Family as a Basic Unit of Society Family- Group of people who live together by ties of marriage, blood, or adoption, representing a single household. it is a basic social unit (universal notion) Concept of Family as a Basic Unit of Society Family- According to sociologist, family is a socially recognized group of two or more individuals joined by kinship (adoption, blood, fictive kin, or marriage). Concept of Family as a Basic Unit of Society Family- According to psychologist, family refers to a collection of individual's who consider themselves related.  Family as Clients Family nursing practice emphasizes the need to understand the behavior of the family as a dynamic, functioning unit which affects its capability to help itself and maintain system integrity, or its readiness to work with the nurse in enhancing wellness or addressing problems on health and illness Concept of Family as a Basic Unit of Society Family- -It is composed of two or more persons who are joined by together by bonds of sharing and emotional closeness and who identify themselves as being part of the family.  Family as basic unit of society Philippine Constitution Article X 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.  Family as basic unit of society Philippine Constitution Article X Section 2 Marriage, as an inviolable social institution, is the foundation of family and shall be protected by the state  Family as basic unit of society Philippine Constitution Article X Section 3: The state shall defend.. 1. The right of spouses to found a family in accordance with their religious convictions and the demands of responsible parenthood; 2. 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;  Family as basic unit of society Philippine Constitution Article X Section 3: The state shall defend.. 3. The right of the family to a family living wage income; 4. The right of families or family associations to participate in the planning and implementation of policies and programs of that affect them  Family as basic unit of society Philippine Constitution Article XV 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  THEORETICAL PERSPECTIVE FAMILY SYSTEMS THEORY A living social system within a context in which multiple environmental actions or factors occur over the life course. Composed of interrelated & interdependent individuals who organized into a single unit so as to attain specific family functions or goals.  THEORETICAL PERSPECTIVE FAMILY SYSTEM THEORY. The interrelatedness of components gives rise to new qualities and characteristics that are function of that interrelatedness Has boundaries or filtering mechanisms (norms, values, attitudes & rules) which regulate the amount and flow of energy, information, resources and stimuli to and from the external environment, or between family members or subsystems with separate boundaries affecting each other and the family system  THEORETICAL PERSPECTIVE FAMILY SYSTEM THEORY. As a system has the propensity to evolve and grow so that growth takes place, the system becomes more complex, articulate and discriminate. Transactional processes or interactions among family members, who occupy position/s or role/s, promote or inhibit family functioning  THEORETICAL PERSPECTIVE THEORETICAL PERSPECTIVES The Interactional Approach/Symbolic Interactional Framework Developmental Approach Structural Functional Perspective Family Health Tasks Perspective (utilized as operational framework in Family Nursing Process  FAMILY STRUCTURES AND FUNCTIONS Many types of families exist, & family types change over time as they are affected by birth, work, death, divorce, & the growth of family members  FAMILY STRUCTURES AND FUNCTIONS A. Dyad Family- consists of two people living together, usually a woman & a man, without children. Many single young adults live together as a dyad in shared apartments, dormitories, or homes for companionship & financial security while completing school or beginning their careers  FAMILY STRUCTURES AND FUNCTIONS B. Nuclear Family-composed of a husband, wife, & children. It is the most common structure seen worldwide & throughout history.  FAMILY STRUCTURES AND FUNCTIONS C. The Cohabitation Family- composed of heterosexual couples who live together like a nuclear family but remain unmarried  FAMILY STRUCTURES AND FUNCTIONS D. The Extended (Multigenerational) Family includes not only the nuclear family but also other family members such as grandmothers, grandfathers, aunts, uncles, cousins, & grandchildren  FAMILY STRUCTURES AND FUNCTIONS E. The Single-Parent Family- increase in single- parent families is a result of both the high rate of divorce & the increasingly common practice of women raising children outside of marriage. This has the advantage of offering a child a special parent-child relationship & increased opportunities for self-reliance and independence  FAMILY STRUCTURES AND FUNCTIONS F. The Blended Family-or remarriage or reconstituted family, a divorced or widowed person with children marries someone who also has children. Advantages of blended families include increased security & resources for the new family.  FAMILY STRUCTURES AND FUNCTIONS G. The Communal Family Communes comprise groups of people who have chosen to live together as an extended family. Their relationship to each other is motivated by social or religious values rather than kinship. The values of commune members may be more oriented toward freedom & free of choice than those of a traditional family. Example cults or groups who follow a charismatic leader.  FAMILY STRUCTURES AND FUNCTIONS H. The Gay or Lesbian Family In homosexual unions, individuals of the same sex live together as partners for companionship, financial security, & sexual fulfillment  FAMILY STRUCTURES AND FUNCTIONS I. The Foster Family Children whose parents can no longer care for them may be placed in a foster or substitute home by a child protection agency. Foster parents may or may not have children of their own. They receive renumeration for their care & concern for the foster child. It’s theoretically temporary until children can be returned to their own parents.  FAMILY STRUCTURES AND FUNCTIONS J. Beanpole family A family with four or more generations, each of them small; as each generation lives longer, parent- child relationships last longer.  FAMILY STRUCTURES AND FUNCTIONS K. Single state The never married, separated, divorced, or widowed individual, often characterized by privacy, independence, job mobility, opportunity to develop skills and knowledge and geographic mobility.  FAMILY STRUCTURES AND FUNCTIONS L. Compound - one man/woman with several spouses.  TYPES OF FAMILY BASED ON LOCUS OF POWER OR AUTHORITY 1. Patrifocal or Patriarchal family- a union in which the man has the main authority and decision- making power  TYPES OF FAMILY BASED ON LOCUS OF POWER OR AUTHORITY 2. Matrifocal or Matriarchal- a union in which the woman has the main authority and decision-making power  TYPES OF FAMILY BASED ON LOCUS OF POWER OR AUTHORITY 3. Egalitarian- a union in which the husband-and-wife exercise more or less an equal amount of authority  TYPES OF FAMILY BASED ON LOCUS OF POWER OR AUTHORITY 4. Matricentric-a prolonged absence of the father as in the case of families of Overseas Filipino Workers gives the mother a dominant position in the family, although the father may in a way also share the decision-making power with the mother  TYPES OF FAMILY BASED ON PLACE OF RESIDENCE 1. Patrilocal- requires the newly wed couple to live with or near the residence of the parents/family of the bridegroom  TYPES OF FAMILY BASED ON PLACE OF RESIDENCE 2. Matrilocal- requires the newly-wed couple to live with or near the residence of the bride’s parents/family  TYPES OF FAMILY BASED ON PLACE OF RESIDENCE 3. Bilocal- provides the newly-wed couple the choice of staying with either the groom’s or the bride’s parents depending on factors like the relative’s wealth or status of the families, the wishes of the parents, or certain personal preferences of the bride and the groom  TYPES OF FAMILY BASED ON PLACE OF RESIDENCE 4. Neolocal- permits the couple to reside independently from their parents. They can decide on their own as far as their residence is concerned.  TYPES OF FAMILY BASED ON PLACE OF RESIDENCE 5. Avunculocal- prescribes the newly-wed couple to reside with or near the maternal uncle of the groom.  TYPES OF FAMILIES BASED ON DESCENT 1. Patrilineal- affiliates (associates, partners, joins) a person with a group of relatives through his or her father.  TYPES OF FAMILIES BASED ON DESCENT 2. Matrilineal- affiliates a person with a group of relatives through his or her mother.  TYPES OF FAMILIES BASED ON DESCENT 3. Bilateral- affiliates a person with a group of relatives through both his or her parents.  Family Functions A. Physical Function-is carried out by providing a safe, comfortable environment necessary for growth, development, &  Family Functions B. Economic Function- provide financial aid for member, as well as, meeting monetary needs of society  Family Functions C. Reproductive Function-is met by the birth of children  Family Functions D. Socialization Function- This is of major importance & includes teaching: transmitting beliefs, values, attitudes, & coping mechanisms; providing feedback; & guiding problem-solving.  Universal characteristics of families Socio-economic and cultural characteristics include occupation, place of work, income of each working member, educational attainment of each family member, ethnic background and religious affiliation, significant others and the other roles they play in the family’s life, the relationship of the family to the larger community Characteristics of a Healthy Family Include information on housing and sanitation facilities, kind of neighborhood and availability of social, health, communication, and transportation facilities in the community Family STAGES AND TASKS A. Physical Maintenance A healthy family provides food, shelter, clothing, & health care for its member. Being certain that a family has enough resources to provide for a new or ill member is important in maternal & child health nursing Family STAGES AND TASKS B. Socialization of family members This task involves preparing children to live in the community & to interact with people outside the family. Family STAGES AND TASKS C. Allocation of resources Determining which family needs will be met & their order of priority is allocation of resources. In healthy families, there is justification, consistency, & fairness in the distribution. Resources include not only financial wealth but also material goods, affection, & space Family STAGES AND TASKS E. Allocation of resources Determining which family needs will be met & their order of priority is allocation of resources. In healthy families, there is justification, consistency, & fairness in the distribution. Resources include not only financial wealth but also material goods, affection, & space Family STAGES AND TASKS D. Maintenance of Order This task includes opening an effective means of communication among family members, establishing family values, & enforcing common regulations for all family member Family STAGES AND TASKS E. Division of Labor The issue here is who will fulfill certain roles, such as family provider, caregiver, & home manager Family STAGES AND TASKS F. Reproduction, recruitment & release of family members Who lives in a family often happens more by changing circumstances than by true choice. Having to accept a new infant into an already crowded household may make a pregnancy a less- welcome event or cause reworking of this tasks Family STAGES AND TASKS G. Placement of members into the larger society This task consists of selecting community activities, such as school, religious affiliation, or a political group that correlate with the family’s beliefs & values. Family STAGES AND TASKS H. Maintenance of Motivation & morale A sense of pride in the family group when created, helps members defend the family against threats & serves as support people to each  FAMILY DEVELOPMENTAL STAGES Stage 1: Beginning Families - Establish a satisfying marriage Stage 2: Childbearing Families - Adjust to parenthood; encourage development of infants  FAMILY DEVELOPMENTAL STAGES Stage 3 Families with Preschool Children - Nurture children in growth promoting ways Stage 4 Families with School Children - Socialize and educate children  FAMILY DEVELOPMENTAL STAGES Stage 5 Families with Adolescents -Balance freedom with responsibility as teens mature Stage 6 Families as Launching Centers - Release young adults; maintain supportive home base  FAMILY DEVELOPMENTAL STAGES Stage 7 Families in the Middle Years - Rekindle and rebuild the marriage relationship Stage 8 Aging Families - - Adjust to retirement and death of a spouse  STAGES OF FAMILY DEVELOPMENT Stage 1: Marriage and the Family This stage is referred to as marriage, what occurs during it is also applicable to couples’ forming co-habitation, lesbian/gay, or single alliances when formal marriage does not occur.  STAGES OF FAMILY DEVELOPMENT Stage 1: Marriage and the Family During this first stage of family development, members work to achieve (3) three tasks:  STAGES OF FAMILY DEVELOPMENT Stage 1: Marriage and the Family Stage 1 Tasks: 1. Establish a mutually satisfying relationship 2. Learn to relate well to their families of orientation 3. If applicable, engage in reproductive life planning  STAGES OF FAMILY DEVELOPMENT Stage 1: Marriage and the Family Stage 2 TASKS: The Early Childbearing Family The birth or adoption of a first baby is usually an exciting yet stressful event that requires economic & social role changes. An important nursing role during this period is health education about well-childcare & how to integrate a new member into a family.  STAGES OF FAMILY DEVELOPMENT Stage 1: Marriage and the Family Stage 3 TASKS: The Family with Preschool Children A family with preschool children is a busy family. Children at this age demand a great deal of time because their imagination is at such a peak, and safety considerations such as unintentional injuries (accidents) become a major health problem  STAGES OF FAMILY DEVELOPMENT Stage 1: Marriage and the Family Stage 4 TASKS: The Family with School-Age Children Parents of school-age children have the important responsibility of preparing their children to be able to function in a complex world while at the same time maintaining their own satisfying time. For many families, this is a trying time. Important nursing concerns during this family stage are monitoring children’s health in terms of immunization, dental care, & health care assessments: monitoring child safety related to home or automobile accidents & encouraging a meaningful school experience that will make learning a lifetime concern  STAGES OF FAMILY DEVELOPMENT Stage 1: Marriage and the Family Stage 5 Tasks: The family with adolescent children. The primary goal for a family with teenagers differs considerably from the goal of the family in previous stages, which was to strengthen family ties and maintain family unity.  STAGES OF FAMILY DEVELOPMENT Stage 1: Marriage and the Family Stage 5 Tasks: The family with adolescent children. Now the family must loosen family ties to allow adolescents more freedom and prepare them for life on their own.  STAGES OF FAMILY DEVELOPMENT Stage 1: Marriage and the Family Stage 5 Tasks: The family with adolescent children. As technology advances at a rapid rate, the gap between generations increases; life when the parents were young was very different from what it is for their teenagers  STAGES OF FAMILY DEVELOPMENT Stage 1: Marriage and the Family Stage 5 Tasks: The family with adolescent children. This makes stage 5 a trying stage for both children and adults.  STAGES OF FAMILY DEVELOPMENT Stage 1: Marriage and the Family Stage 5 Tasks: The family with adolescent children. A nurse is a neutral person who can assist families at this stage when communication is  STAGES OF FAMILY DEVELOPMENT Stage 1: Marriage and the Family Stage 6 Tasks: The Launching Center Family. For many families, the stage at which children leave to establish their own households is the most difficult stage because it appears to represent the breaking up of the family.  STAGES OF FAMILY DEVELOPMENT Stage 1: Marriage and the Family Stage 6 Tasks: The Launching Center Family. Parental roles change from those of mother or father to once-removed support people or guideposts  STAGES OF FAMILY DEVELOPMENT Stage 1: Marriage and the Family Stage 6 Tasks: The Launching Center Family. The stage may represent a loss of self-esteem for parents, who feel themselves being replaced by other people in their children’s lives.  STAGES OF FAMILY DEVELOPMENT Stage 1: Marriage and the Family Stage 6 Tasks: The Launching Center Family. A nurse, again, can serve as a counselor to such a family. He / she can help the parents to see that what their children are doing is what they have spent a long time preparing them to do so, & that leaving home is a positive, not a negative step in family growth  STAGES OF FAMILY DEVELOPMENT Stage 1: Marriage and the Family Stage 7 Tasks: The family of middle years When a family returns to a two-partner nuclear unit, as it was before childbearing, the partners may view this stage either as the prime time of their lives (an opportunity to travel, economic independence, & time to spend on hobbies) or as a period of gradual decline (lacking the constant activity & stimulation in the home, finding life boring without them, or experiencing an “empty nest” syndrome)  STAGES OF FAMILY DEVELOPMENT Stage 1: Marriage and the Family Stage 8 Tasks: The family in Retirement or older age Families at this stage are more apt to suffer from chronic & disabling condition than younger ones are. Although families at this stage are not having children, they remain important because they can offer a great deal of support & advice to young adults who are just beginning their families  STAGES OF FAMILY DEVELOPMENT Stage 1: Marriage and the Family Stage 8 Tasks: The family in Retirement or older age Many grandparents care for their grandchildren while the parents are out working  RIGHTS OF THE FAMILY 1. The family has the right to exist and to progress as a family.  RIGHTS OF THE FAMILY 2. Every family has the right to live freely its own domestic religious life under the guidance of the parents, as well as the right to profess publicly and to propagate the faith, to take part in public worship and in freely chosen programs of religious instruction, without suffering  RIGHTS OF THE FAMILY 3. The family has the right to exercise its social and function in the construction of society  RIGHTS OF THE FAMILY 4. Families have the right to be able to rely on an adequate family policy on the part of public authorities in the juridical, economic, social, and fiscal domains, without any discrimination whatsoever  RIGHTS OF THE FAMILY 5. Families have a right to social and economic order in which the organization of work permits the members to live together, and does not hinder the unity, well- being, health and the stability of the family, while offering also the possibility of wholesome recreation  RIGHTS OF THE FAMILY 6. The family has the right to decent housing, fitting for family life and commensurate to the number of the members, in a physical environment that provides the basic services for the life of the family and the community  RIGHTS OF THE FAMILY 7. The families of migrants have the right to the same protection as that accorded other families  FAMILY AS CLIENTS The family is the foreground and individuals are in the background. As a contributor to the etiology of the patient but also as a source of support & affection. The focus is concentrated on each & every individual as they affect the whole family  FAMILY AS SYSTEM The focus is on the family as client, it is viewed as international system in which the whole is more than the sum of its parts. The approach focuses on the individual and family members. The interaction among family members become the target for intervention FAMILY AS BISOCIAL BEING The family shares health risks factors(biological, social & cultural). CHNurse considers & manipulates the human, social, & cultural aspects affecting health & illness through the use of the family as a biosocial agent. “The family can affect the course of illness & influence its recurrence, & that illness impacts on the family & vice versa”  Functional Processes USED by Family 1. Caregiving 2. Cathexis-emotional bonds between individuals and family 3. Celebration-tangible forms of shared meanings 4. Change-dynamic nonlinear process implying altering or modifying the form, direction, and outcome thru alternatives  Functional Processes USED by Family 5. Communication-primary ways to socialize children about health beliefs, values, attitudes and behaviors and use information, knowledge and actions applicable to health 6. Connectedness-ways the family as a system are linked together 7. Coordination-cooperative sharing of resources, skills, abilities, and information within the family and with the larger contextual environment to optimize individual’s health potentials, potentiate the household production of health and achieve family goals.  FAMILY SHOULD BE VIEWED AS a. Provider of social support & buffer zone b. Source of deficit & endurer of illness c. Intervenor of illness d. Change agent of health – promoting healthful living pattern & righteous heart and beautiful mind.  FAMILY HEALTH TASKS PERSEPECTIVE This operational framework is based on the principles that in order to achieve wellness among family members and reduce or eliminate family health problems, the family as a unit performs the following health tasks  FAMILY HEALTH TASKS Recognize the presence of wellness state or health condition/problem; Make decisions about taking appropriate health action to maintain wellness or manage the health problem ; Provide nursing care to the sick, disabled, dependent, or at- risk members; Maintain a home environment conducive to health maintenance and personal development; Utilize community resources for health Community Health Nursing: The Family Even though its easy to forget at times, family is the most important thing in the world. This could mean your mother, your father, your siblings, your spouse, your grandparents, your aunts, your uncles, your cousins, your in-laws – but for some, its simply those with whom we