CONCEPT OF FAMILY & FAMILY NURSING PROCESS 2.

Has its own cultural values and rules

3. Has structure
Definitions of Family 4. Has certain basic functions:
a. Providing love and affection
Traditional definition:
b. Providing security and acceptance
 A unit of interacting persons (social definition) c. Instilling identity and satisfaction
 Related by ties of marriage, birth or adoption (biological and legal definition) d. Promoting affiliation and companionship
e. Providing socialization
 Central purpose: to create and maintain a common culture which promotes the physical,
f. Establishing controls
mental, emotional, and social development of each of its members. (Duval, 1971)
5. Moves through stages in its life cycle: newly married couple, childbearing, preschool-age,
Recent definitions of family: school-age, teenage, launching center, middle-aged, aging (Duval & Miller, 1985)

 Consists of two or more individuals A. Attributes of Families as Social Systems

 Share a residence or live near one another  Families as open systems”
 Possess some common emotional bond 1. Members are interdependent
 Engage in interrelated social positions, roles, and tasks 2. Maintain boundaries
 Share a sense of affection and belonging (Murray & Zetner, 1997; Friedman, 1998) 3. Exchange energy with their environment
 The family is “who the client says it is” (Bell & Wright, 1993) 4. Are adaptive
5. Are goal-oriented
Regardless of the definition used, the family is still…
As an open system, the family is…
 The basic unit of society
 The social institution that has the most marked effect on its members (Friedman, 1986)  A developing system of interacting personalities
 With structure and process enacted in relationships among the individual members
Trends which have influenced the definitions:  Regulated by resources and stressors
 Existing within the larger community (Smith, C. & F. Maurer, 2000)
Societal changes:

 Increase in the number of men and women working abroad B. Each family has its own cultural values & rules
 More women who work outside the home  Family culture – culture explains why families behave as they do
 Migration of young people to urban centers 3 aspects of family culture:
 Increase in the proportion of single-parent families and other family structures
1. Family members share certain values that affect family behavior
 The family is a product of time and space 2. Certain roles are prescribed and defined for family members
3. A family’s culture determines its distribution and use of power
Each family:
C. Family Structure
1. Is unique – have their own distinct and strengths
 Traditional Family – those that are most familiar and most readily accepted by society
2. Share some universal characteristics with other families – key to understanding each family’s
1. nuclear family
uniqueness
2. nuclear dyad
UNIVERSAL CHARACTERISTICS – every family is… 3. extended family (or multigenerational families)
4. kin network
1. A small social system
D. Family Functions
1. Providing affection and emotional support  These characteristics serve as an intial framework for assessing family health
2. Security and acceptance e.g crisis proof or crises prone family
3. Identity and satisfaction

E. Family Life Cycle Levels of Prevention in Family Health:

 Family life cycle – predictable and sequential pattern of stages
a. Primary Prevention – adults are well prepared for the responsibilities of their union, enter the
2 broad stages: relationship with the necessary personal resources
e.g. family planning, immunization, healthy lifestyle, early valuing
a. Expansion – new members are added
- Roles and relationships are increased b. Secondary Prevention – the family performs interventions to identify needs and seeks out the
b. Contraction – family members leave to start lives of their own or age and die appropriate resources that will bring its members back to wellness at the earliest time.
e.g. health screening
 To progress through stages in the life cycle, a family must:
 Carry out its basic functions and the developmental tasks c. Tertiary Prevention – after a crisis, members recognize the need for help and accept that
help, draw on personal resources to rebuild relationships and bring the family unit to the
highest level of wellness possible
e.g. rehabilitation, counseling
 Family Stages
Family Health Nursing Process:
Why Choose a Family Perspective?

1. Family thinking gives a broader picture.  Family health – concerned with how well the family functions together as a unit; refers to the
health status of the family at a given point in time
2. The family is a unit of care
3. The family assumes a crucial role in maintaining health  Family health nursing – a level of community health nursing practice directed or focused on
4. Dysfunction in one member may be related to disturbance in the whole family the family as the unit of service/care
5. Dysfunction in one member may lead to added stress and depletion of resources of a family Family Nursing Process:

 Families have characteristics that affect… - Systematic approach of identifying health problems initiating appropriate
- Community health nursing service activities designed to meet the specified needs or concerns of the client family
- Effectiveness of community health nurses working with families as a unit of - The family is a partner in care plan design and delivery
care - Family input and validation are essential
- Role of the nurse/health worker: to assist the family coping effectively the
Characteristics of Healthy Families (Olson, 1991; Friendman, 1998; Famorca, et al., 2013): health needs by increasing its capacity to perform the health tasks
1. There is a facilitative process of interaction among family members
2. They enhance individual member development
3. Their role relationships are structured effectively
4. They actively attempt to cope with problems
5. They have a healthy home environment and lifestyle
6. They establish regular links with the broader community
7. Foster responsibility and value service to others
8. Have a sense of play and humor; share leisure time –
 FAMILY NURSING PROCESS c. Ecomap – a diagram of the connections between the family and the other
FAMILY ASSESSMENT systems in its ecological environment
- Allows the health worker to view the family’s
Principles: Family Nursing Practice situation in relation to their environment
1. Work with the family collectively
d. Genogram – provides information about the family’s history of diseases over a
2. Start where the family is
period of time (usually 3 or more generations)
3. Adapt nursing intervention to the family’s stage of development
- Sheds light on family behaviors and problems
4. Recognize the viability of family structure variations\
5. Emphasize family strengths

Steps/Sequence of Activities in Family Nursing Process/Practice:

1. Establishing a working relationship with the family

 Initiating contact (do contract setting)
 Communicating interest in the family’s welfare
 Expressing willingness to help the expressed needs
 Maintaining a two-way communication with family

2. Conducting initial assessment to determine the presence of any health problems

 Assessment – the nurse measures the status of the family as a client, its ability to
maintain health and well-being, and state of functioning.
- The use of methods of data gathering and tools

Methods: interview, health assessment, observation, review of records to arrive at

subjective and objective data

Tools used in Family Assessment:

a. Initial Data Base (IDB) – provides data for the 1st level assessment to identify
wellness conditions, existing health threats, health deficits, and stress points
in the family:
 Family structure, characteristics and dynamics
 Socio-economic and cultural characteristics
 Home and environment
 Health status of each member
 Values and practices on health promotion / maintenance and
disease prevention

b. Family Assessment guide – provides data on gamily health status based on the
characteristics of a health family and family functions
- Can be related to the family’s ability to perform
family functions / health tasks