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OUR LADY OF FATIMA UNIVERSITY

COLLEGE OF NURSING
NCM 101

FAMILY HEALTH NURSING

Concepts and Definition on Family

I. Family
• A group of people related by blood, marriage or adoption living together (1997 US
Census Bureau)
• Two or more people who live in the same household sharing a common emotional
bond, and perform certain interrelated social tasks (Spradly & Allender, 1996)
• An open and developing system of interacting personalities with structure and process
enacted in relationships among the individual members regulated by resources and
stressors existing within the larger community (Smith & Maurer, 1995)

II. Types of Family


A. Structure
1. Nuclear – a father, mother with child / children living together but apart from both sets
of parents and other relatives.
2. Extended – multigenerational, including married brothers and sisters and the families.
3. Blended or Reconstituted – a combination of 2 or more families with children of both
families and sometimes children of the newly married couple; Remarriage with children
from previous marriage.
4. Compound – one man / woman with several spouses.
5. Communal – more than one monogamous couple sharing resources.
6. Foster – substitute family for children whose parents are unable to care for them.
7. No-kin – a group of at least 2 people sharing a relationship and exchange support who
have no legal blood tie to each other.
8. Single-parent – divorced or separated, unmarried or widowed male or female with at
least one child.
9. Cohabitating or live-in – an unmarried couple living together.
10. Dyad – husband or wife or other couple living alone without children.
11. Gay / Lesbian – homosexual couple living together with or without children.

B. Authority
1. Patriarchal
2. Matriarchal
3. Matricentric
4. Equalitarian

III. Universal Functions of the Family


1. Reproduction for replacement of members in the society to perpetuate the human
species.
2. Status placement of individuals in the society.
3. Biological and emotional maintenance of the young and dependent members.
4. Socialization and care of children.
5. Social control.
IV. Rationale for the Family as a Unit of Care
1. The family is considered the natural and fundamental unit of society.
2. The family as a group generates, prevents, tolerates and corrects health problems
within its membership.
3. The health problems of families are interlocking.
4. The family is the most frequent focus of health decisions and actions in personal care.
5. The family is an effective and available channel for much of the effort of the health
worker.

V. Characteristics of a Family
1. The family is product of time and place
• A family is different from another 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


• Develops its own patterns of behavior and its own style in life
• .Develops their own power systems which may either be:
Balanced – the parents and the children have their own areas of decision and control.
Strongly biased – one member gains control over the others.

3. The family operates as a group


• A family is a unit in which the action of any member may set off a whole series of
reactions within the group, an 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 to the needs of the individual members


• An individual is a 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 overshadow consideration for
others
b. Power is equitably distributed
c. Independence is permitted to flourish

5. The family relates to the community


• The family develops a stance with respect to the community:
a. The relationship between the family is wholesome and reciprocal;
the family utilizes the community resources, and in turn, contributes to the
improvement of the community.
b. There are families who feel a sense of isolation from the
community.
i. Families who maintain a proud “we keep to ourselves” attitude
ii. Families who are entirely passive taking the benefits from the
community without either contributing to it or demanding changes to it.

6. The family has a growth cycle


• Families pass through a predicable developmental stages (Duvall and Miller, 1990)
VI. Family Developmental Stages
Stage 1: Marriage and the Family
• 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:
1. Establish a mutually satisfying relationship.
2. Learn to relate well to their families of orientation.
3. If applicable, engage in reproductive life planning.

Stage 2: Early Childbearing Family


• Birth or adoption of a first child which requires economic and social role changes.
• Oldest child: birth – 2 ½ years

Stage 3: Family with Preschool Children


• This is a busy family because this age demand a great deal of time related to growth
and developmental needs and safety considerations.
• Oldest child: 2 ½ - 6 years

Stage 4: Family with School Age Children


• Parents at this stage have an 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

Stage 5: Family with Adolescent Children


• A family allows the adolescents more freedom and then prepares them for their own life
as technology advances, gap between generations’ increases.
• Oldest child: 12 – 20 years

Stage 6: The Launching Center Family


• Stage when children leave to set their own household and family life – appears to
represent the breaking of the family.

Stage 7: Family of Middle Years


• Family returns to a two-nuclear unit.
• Period from empty nest to retirement.

Stage 8: Family in Retirement or Older Age


• Parents are at their older years beginning of this stage marks retirement of both
spouses from work.

Stage 9: Period from Retirement to death of both spouses

VII. Stevenson’s Family Developmental Model (1977)


1. Emerging Family (from marriage for 7 to 10 years)
• Health Tasks: (couple strives for independence from their parents and to develop a
sense of responsibility for family life).

2. Crystallizing Family (with teenage children)


• Health Tasks: (to assume responsibility for growth and development of individual
members outside organizations).
3. Interacting Family (children grown and small grandchildren)
• Health Tasks: (assumption of responsibility for continued survival and enhancement of
the nation).
4. Actualizing Family (aging couple alone again)
• Health Tasks: (assume the responsibility for sharing the wisdom of age, reviewing life
and putting affairs in order).

VIII. Behaviors Indicating a Well Family


A family who has the ability to:
1. Provide for physical, emotional and spiritual needs of family members
2. Be sensitive to the needs of family members
3. Communicate thoughts and feelings effectively
4. Provide support, security and encouragement
5. Initiate and maintain growth producing relationships
6. Maintain and create constructive and responsible community relationships
7. Grow with and through children
8. Perform family roles flexibly
9. Help oneself and to accept help when appropriate
10. Demonstrate mutual respect for the individuality of family members
11. Use a crisis experience as a means of growth
12. Demonstrate concern for a family unity, loyalty and interfamily cooperation

IX. Eight Family Tasks (Duvall and Miller, 1990)


1. Physical Maintenance – provides food, shelter, clothing and health care for its members
being certain that a family has ample resources to provide.
2. Socialization of family members – involves in preparation of children to live in the
community and interact with people outside the family.
3. Allocation of resources – determine which family needs will be met according to their
order or priority.
4. Maintenance of Order – tasks includes opening an effective means of communication
between family members, integrating family values and enforcing common regulations for
all family members.
5. Division of labor – who will fulfill certain roles e.g., family provider, home manager,
children’s caregiver.
6. Reproduction, recruitment and release of family members.
7. Placement of members into the larger community – consists of selecting community
activities such as school, religious affiliation or political group that correlate with the family’s
beliefs and values.
8. Maintenance of Motivation and Morale – created when members serve as support
people to each other.

X. Levels of Prevention in Family Health


1. Primary Level of Care
• The first contact between the community and other levels of health facility
• Health care is provided by center physicians, public health nurses, rural health
midwives, barangay health workers, traditional healers and others.
• Facilities could be a barangay health stations and a rural health units.

2. Secondary Level of Care


• This serves as referral center for primary health facilities.
• Health care is rendered by physician with basic health training
• Facilities are either privately owned or government operated such as infirmaries,
municipal and district hospitals and out-patient department of provincial hospitals
• Cases could be minor surgeries and some simple laboratory examinations

3. Tertiary Level of Care


• This is the referral center for the secondary care facilities.
• Health care is rendered by specialist
• Facilities include medical centers, regional and provincial hospitals as well as
specialized hospitals.
• Cases may include complicated cases and intensive care

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