FAMILY HEALTH CARE
Dr.Amean A. Yasir
Definition of Family
A social system composed of “two or more persons who are joined by bonds of sharing and emotional closeness and who identify themselves as being part of the family” (Friedman, 1998, p. 9
Types of Families
Nuclear conjugal family
Nuclear dyad family
Dual earner family
Extended family
Single-parent family
Step-family (blended family)
Binuclear family
Cohabiting family
Gay or lesbian family
Communal family
Foster family
Skip generation family
Theoretical Approaches to Family Nursing :
Systems models
Family development models
Structural-functional models
Family Systems Models:
System: The family (focal system)
Subsystems: Family members
Suprasystem: Influences external to the family (interacting systems)
Family System Goals:
Maintenance of a steady state
System growth
Family Systems Processes:
Environmental exchange processes
System operation processes
Internal Processes
Environmental Exchange Processes:
Input: Entry of energy, matter, or information into the system
Throughput: Transformation of material in some way
Output: System products discharged into the environment
System Operation Processes:
Limiting energy expenditure
System organization
Preventing system overload
Internal Processes:
Subsystem change processes
Adaptive processes
Entropy
Negentropy
Feedback
Family Development Models:
Families pass through a series of developmental stages in which they must accomplish certain family developmental tasks.
Stage I - Single Young Adult:
Accept self-responsibility
Differentiate self from family of origin
Develop intimate peer relationships
Develop a career and financial independence
(Carter & McGoldrick, 1999)
Stage II - New Couple:
Achieve commitment to the new relationship
Form the marital relationship
Realign relationships with families and friends
(Carter & McGoldrick, 1999)
Stage III - Family with Young Children:
Adjust the marriage to the presence of children
Distribute childrearing, household, and financial tasks
Develop new relationships with family members (parenting and grandparenting)
(Carter & McGoldrick, 1999)
Stage IV - Families with Adolescents:
Adapt to growing independence of adolescent family members
Adjust to increasing frailty of own parents
Change parent-child relationships
Address marital and career issues
Stage V - Launching Children and Moving on:
Accept multiple entries and exits from family structure
Renegotiate the marital dyad
Adapt relationships to accommodate in-laws and grandchildren
Deal with disability and death of one’s own parents
Stage VI - Families in Later Life:
Accept the change in generational roles
Maintain function
Explore new roles
Assure support for middle and older generations
Deal with the death of others and one’s own approaching death
Structural-functional Models:
Structure: Family members and family interaction patterns related to roles, values, communication patterns, and power structure
Function: One of a group of related actions that lead to accomplishment of specific goals Family structural elements affect the family’s ability to carry out socially recognized family functions
Family Functions:
Affective function
Socialization function
Reproductive function
Economic function
Provision of needs function
Assessing Family Health:
Biophysical considerations
Psychological considerations
Physical environmental considerations
Sociocultural considerations
Behavioral considerations
Health system considerations
Biophysical Considerations:
Family members’ age and maturational level
Family members’ physical health status
Genetic inheritance
Psychological Considerations:
Communication patterns
Family relationships
Emotional strengths
Coping abilities
Childrearing practices
Family goals
Physical Environmental Considerations:
Home environment
Safety hazards
Neighborhood
Sociocultural Considerations:
Roles
Culture
Religion
Employment and income
Education level
Community relationships and resources
Behavioral Considerations:
Consumption patterns
Rest and sleep
Exercise and leisure
Safety practices
Health System Considerations:
Family response to illness
Use of health care services
Health insurance status
Planning Family Health Care:
Primary prevention
Secondary prevention
Tertiary prevention
Family Crisis Intervention:
Crisis: The experience of an event or stressor that is beyond the family’s ability to cope.
Types of Crises:
Maturational crises: Arise from normal transitional periods in family development.
Situational crises: Arise from sudden, unexpected, or unpredictable events.
Factors Affecting Susceptibility to Crisis:
The stressor and family perceptions of the stressor
Presence of other stressors
Family coping abilities
Family resources
Structure of a Crisis Event:
Hazardous event gives rise to the potential for crisis
A precipitating event generates crisis
Typical coping mechanisms are used
If successful, crisis is averted
If not, crisis ensues
Assessing a Crisis Situation:
Assess family perceptions of the crisis
Assess factors contributing to crisis
Assess family response to crisis
Assess family coping abilities
Assess family resources
Assess suicide potential
Principles of Crisis Intervention :
Listen actively.
Encourage family members to verbalize their perceptions and emotions experienced.
Encourage family acceptance of reality.
Focus on development of effective coping skills.
Develop social support systems to assist in crisis resolution.
Assist the family in problem solving.
Reinforce new, more effective coping strategies.
. Follow-up to prevent future crises.