THE FAMILY AND FAMILY

HEALTH

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 Family

❑Basic unit of the society

❑ Why? Because without the cohesion(unity) of
the family, there can be no lasting community,
and without a lasting community, there cannot
be a greater society.
❑Two major functions:
✓Reproduction
✓Socialization
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NCM 101/torogi_genes2009

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Other definitions of family:

A number of “two or more

persons joined individuals joined
together by bonds together by bonds of
of marriage, sharing and
emotional
blood or adoption
closeness and who
(Burgess 1963) identify themselves
as being part of the
family (Friedman
1992).
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A group of people Two or more people
related by blood, who live in the
marriage or same household,
adoption living share a common
emotional
together (US bond(friendship or
Census Bureau, partners), and perform
2005). certain
interrelated tasks
(Allender and
Spradley, 2004

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The Concept and Definition of Family

❖ The family is a very important social institution.

❖ It is generally accepted that the family is the first
and oldest social institution in society.
❖ The family is consist of parents and children who
interact with one another. Through this
socialization process, parents are able to hand
down socially accepted cultural practice that
serves as initial training for the young to become
future responsible citizen in the future.

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❖ As a group, the members of the family live
together under one roof and that they constitute a
single housekeeping unit.
❖ It is a universal institution that has the following
common characteristics:
❖ Associate with one another in their respective roles
as husbands and wife, mother and father, son and
daughter or brother and sisters
❖ As the members of the family enjoy life together
playing their different roles, they tend to create a
common culture.

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Family health
nursing
❑ It is that level of
nursing practice
directed or focused
on the family as a
unit of care, with
health as a goal
and nursing at the
medium, channel
or provider of care.

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 FAMILY STRUCTURES AND FUNCTIONS
Family Structures:
a. Based on internal organization and structure
1. Nuclear Family
 Advantage: ability to provide support to family
members
 Small number

 A father ,a mother with a child /children living

together but apart from both set of parents and
other relatives.

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 FAMILY STRUCTURES AND FUNCTIONS
Family Structures:
2. Extended family (multigenerational)
 Nuclear family + other related family or family
member(s)
 Usually with a large number of members

 Composed of two or more nuclear families

economically and socially related to each
other. It includes married brothers or sisters
and the families.

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 FAMILY STRUCTURES AND FUNCTIONS
Family Structures:
3. Binuclear family
 After divorce/separation in which the child is a
member of both their maternal and paternal nuclear
households.

 a social unit composed of an extended family

usually the children and subsequent spouses
of divorced parents.

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 NCM 101/torogi_genes2009

Family Structures and Functions

4. Blended family (step family)

 A divorced, annulled, or widowed spouse with
children marries someone who also has
children
 Otherwise known as remarriage or
reconstituted family

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Family Structures and Functions

5. Dyad family
 Generally viewed as temporary.

 Consist of two people living together, usually a

woman and a man, without children. Ex. Newly
married couple
 This category of family also refers to single
young same sex adults who live together as a
dyad (two individual maintaining a relationship), in
shared apartments, dormitories or homes for
companionship or financial security. 13
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FAMILY STRUCTURES AND FUNCTIONS

b. Adoptive family
1. Agency adoption
 Includes extensive interviewing and a home visit by an
agency social worker to determine whether the couple
can be relied on to provide a safe and nurturing
environment for an adopted child
**Open adoption
 A couple usually contacts an agency by first
attending an informational meeting.

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 NCM 101/torogi_genes2009

FAMILY STRUCTURES AND FUNCTIONS

2. International adoption
 Usually happens among war torn areas
 These are usually the children adopted from
places where war exist.

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FAMILY STRUCTURES AND FUNCTIONS

3. Private adoption
 For families who have exhausted other options
or who cannot wait for the agency adoption
process, private adoption process is an option.
 Adopting parents usually pay a certain amount to
the birth mother
 Advantageous to the birth mother since she can
choose the adoptive parents

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 NCM 101/torogi_genes2009

Family Structures and Functions

c. Alternative family forms:
1. Gay or lesbian family
❑ Homosexual union for companionship, financial
security, and sexual fulfillment

 Homosexual couple living together with or without

children.

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Family Structures and Functions

2. Foster family
❑ Children whose parents can no longer care for them
placed in a foster or substitute home by a child
protection agency
❑ Foster parents may or may not have their own
children and receive remuneration for their care of
the foster child
 Substitute family for children whose parents are
unable to care for them.

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Family Structures and Functions

3. Single-parent family
 Families with children headed by a parent who is
widowed or divorced and not remarried, or by a
parent who had never married.

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 NCM 101/torogi_genes2009

Family Structures and Functions

4. Cohabitation family
❑ Usually temporary
 Cohabit- live together and have a sexual relationship
without being married.
 Composed of heterosexual(male or female) couples
and perhaps with children who live together but
remain unmarried.
 refers to the unmarried individuals in a committed
partnership living together with or without
children. People may live in cohabitation
arrangement, before in between or as an
alternative to marriage.
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Family Structures and Functions

5. Communal family
❑ Comprises 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 (Benokraitus,
2005)
 Also called commune groups of people who live
together, share properties and often follow or set
rules and guidelines for living daily life.

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Family Structures and Functions

d. According to the purposes of assessing families in

maternal and child health nursing:

1. Family of orientation
❑ The family one is born into/ Refer to the family
where you came from
2. Family of procreation
❑ A family one establishes/ A family you yourself
created
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Family Structures and Functions

e. Based on authority
1. Patriarchal- Full authority on the father
❖ Filipino: Eldest brother, grandfather

2. Matriarchal- Full authority of the mother

❖ Filipino: Eldest sister, grandmother

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Family Structures and Functions

3. Egalitarian- father and mother decides
❑ thehusband and wife exercise a more or less equal
amount of authority

4. Matricentric
❑ prolonged absence of the father gives the mother a
dominant position in the family, although the father
may also share with the mother in decision making.

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Family Structures and Functions

f. Based on place of residence
***Domicile- treats as their permanent home.
1. Patrilocal- Family resides/ stays with near
domicile of the parents of the husband.
2. Matrilocal- Family resides/ stays with near
domicile of the parents of the wife.

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 NCM 101/torogi_genes2009

Family Structures and Functions

f. Based on place of residence
3. Bilocal/ ambilocal- societal post marital
residence, couples live near either the
husbands parents or the wife's parents
4. Neolocal—independent residence/ family have
their own residence.
5. Avunculocal— Society in which a married couple
traditionally lives with the man’s mother’s
eldest brother.

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 NCM 101/torogi_genes2009

Family
FAMILY Structures
STRUCTURES ANDand Functions
FUNCTIONS (CONT

g. Based on descent
1. Patrilineal- affiliates a person with a group
of relatives who are related to him
through his father
2. Matrilineal- affiliates a person with a
group of relatives who are related to him
through his father
3. Bilateral- Both parents.
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 FAMILYSTRUCTURES AND FUNCTIONS (CONT..)
NCM 101/torogi_genes2009

Family Structures and Functions

Functions of the FAMILY
1. Provision of Physical needs: food, shelter, clothing,
safety and healthcare
2. Allocation of Resources: careful planning and use
of family money, material good, space and abilities
3. Division of Labor: assigning the workload,
including responsibility for household income and
household management
4. Socialization: guiding towards acceptable standards
of elimination, food intake, sexual drive, respect for
others and their possession and sense of spirituality

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 FAMILYSTRUCTURES AND FUNCTIONS (CONT..)
NCM 101/torogi_genes2009

Family Structures and Functions

Functions of the FAMILY
1. Reproduction, recruitment and release: bearing or
adopting children, adding new members by
marriage, and allowing members to leave
2. Maintenance of Order: interaction and
communication opportunities, discipline, affection,
sexual expression
3. Assistance with fitting into the larger society:
community, schools, spiritual center and
organization
4. Maintenance of motivation and morale:
recognition, affection, encouragement, family
loyalty, help in meeting crisis, philosophy of life,
spirituality
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 ➢ Interactions and communication within the family
❖ are the patterns and interactions we have with different
with different members of our family.

❖ Each family has a unique set of dynamics which will

impact our development, ideas and ways of behaving
as well as how we interact with each other.

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❖Family systems theory
❖Family developmental theory

❖Family stress theory

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 FAMILY THEORIES

Family systems theory

 Allows nurses to “view the family as a unit and thus focus on observing
the interaction among family members rather than studying family
members individually
 ** system—a complex of elements in mutual interaction

 Traditional individual therapy- tends to focus on problems in a linear

manner that is event “A” cased problem “B”. The history of the problem is
explored.
 FST in comparison with traditional, views problem in circular manner,
using what is describe as a systemic perspective, meaning that the event
or problem exist within the context of the relationship
 Both A and B are seen to exist in the context of a relationship, in which
each influences the other.
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 FAMILY THEORIES

 In this theory it requires the assessment of

patterns of interactions, with an emphasis of
what is happening rather than why?
 FST aim to asses the patterns of interactions and
look at why things may be happening instead
of why they happened
 This approach emphasizes the bidirectional
nature of the relationships and moves away
from blaming one person for the dynamic.

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Family developmental theory
 Is an approach to studying families which is useful
in explaining patterned change, the dynamic
nature of the family, and how change occurs in
the life cycle.
 Focuses on the family as it moves in time

 Family members pass through phases of growth,

from dependence, to active independence, to
interdependence.

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Family stress theory
 Hill’s 1949 ABC- X model of family stress remains a
useful tool for identifying the different
components that affect how successfully families
cope with stress.
 This models consist of 3 variables
A(the event); interacting with
B (Family’s crisis meeting resources) ;
interacting with
C (the definition the family makes of the
event); which now produces the
X (the crisis) 35
 Hill’s model of family stress helps to explain why
some families “sink” or fall into crisis when
dealing with stress while other families “swim”
or cope with the stress.

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❖has its own cultural values and rules
❖has structure
❖performs certain basic functions
❖small social system
❖moves through stages in its life cycle

Key points: The basic function and task of a

family focus on providing physical health,
mental health, socializing its members,
reproducing, and providing for economic well
being.
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❑Recognizing signs of health and
development
❑Managing health and non-health crisis
❑Providing health care to its member
❑Providing home environment conducive to
good health and personal development
❑Utilizing community resources for health

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 Eight essential tasks for a family to perform to survive
as a healthy unit (Duvall and Miller, 1990):
❑ Physical maintenance
❑ Socialization of family members
❑ Allocation of resources
❑ Maintenance of order
❑ Division of labor
❑ Reproduction, recruitment, and release of family
members
❑ Placement of members into the larger society
❑ Maintenance of motivation and morale

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 Stages Tasks

Stage 1. From the 1. Establish a mutually

Marriage time of satisfying relationship
and the marriage 2. Learn to relate well to their
family until birth families of orientation
of first child 3. If applicable, engage in
reproductive life planning

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Stage 2. Birth of the 1. Having and adjusting to
The early first baby infant
child- and 2. Supporting all the needs all
bearing continues of the family members
family until 3. Renegotiating marital
firstborn is relationships
in preschool

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Stage 3. First child 1. Adjusting to costs of family
The is between 1 life
family ½ years and 2. Coping with parental loss of
with pre- 5 years old energy and privacy
school 3. Adapting to needs of
children preschool to stimulate
growth & development

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Stage 4. First child 1. Adjusting to the activity of
The is between growing children
family 6-12y/o 2. Promoting joint decisions
with between children and
school- parents
age 3. Encouraging and
children supporting children’s
educational achievements

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Stage 5. First child 1. Maintaining open
The turns 13 communication among
family y/o until members
with first child 2. Supporting ethical and
adolesce departs moral values within the
nt from home family
children 3. Balancing freedom with
responsibility for
adolescents
4. Strengthening marital
relationship
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Stage 6. First child 1. Releasing young adults
The having as a with appropriate ritual and
launchin young adult assistance
g center until the 2. Maintaining supportive
family last child home base
leaves home

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Stage 7. Departure 1. Preparing for retirement
The of last child 2. Maintaining ties with older
family of from home and younger generations
middle (empty nest)
years and
continuous
through
retirement

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Stage 8. Retirement 1. Adjusting to retirement
The and ends 2. Adjusting to loss of spouse
family in with death 3. Closing family house
retireme of both
nt or parents
older age

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LEVELS OF PREVENTION IN FAMILY HEALTH

1. Primary prevention
❑ Includes all efforts made before the
development of illness to promote general
health and well-being
❑ Example: immunization, maintenance of
healthy diet and body weight, safe sex,
cessation of smoking, reduction in alcohol
intake, etc.

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 Levels of Prevention in Family Health

2. Secondary prevention
❑ Involves early detection of health problems so
that treatment can begin before significant
disability occurs
❑ Example: breast self examination, newborn
screening, cancer screening, genetic
counseling

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 Levels of Prevention in Family Health

3. Tertiary prevention
❑ Treatment and rehabilitation of a person who
have developed a disease
❑ Goal: support adaptation to risk; optimal
reconstitution; and establishment of wellness

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 Levels of Prevention in Family Health
❑ The following are more specific importance of rehabilitation:
1. Preventive rehabilitation
✓ Reduce impact and severity of disabilities
✓ Focus is on clients with a disability that can be predicted
2. Restorative rehabilitation
✓ Resume pre-illness level of functioning with minimal residual disability
✓ Focus is on clients who are cured
3. Supportive rehabilitation
✓ Reduce disease-related disability in clients who are receiving
treatment
4. Palliative rehabilitation
✓ Reduce and/or eliminate complication, increase autonomy, provide
comfort and emotional support when there is increasing disability from
progressive disease
✓ Focus is on terminally ill clients and family training

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