COMMUNITY HEALTH NURSING

MODULE 3

FAMILY

FAMILY AS BASIC UNIT OF SOCIETY

 Genetic transmission unit
 Matrix of personality of development and the most intimate emotional unit of
society
 Enduring social form in which a person is incorporated
 Lifelong involvement
 Shared attributes
 Genetics – physical and psychological
 Developmental – shared home, lifestyle, social activities
 Sense of belonging
 Security/defense against a potentially hostile environment
 Companionship
 Societal expectations
 Sense of responsibility towards members & others
 Basis of affection/care
 Built-in problems
 Generation gap
 Dependence of members
 Emotional attachment/involvement
 The family endures despite problems
 Resource utilization
 Authority
 Individual sense of responsibility

CLASSIFICATION ACCORDING TO STRUCTURE

A. NUCLEAR FAMILY
‒ A father and mother with/without children living together but apart from both
sets of parents and relatives
‒ Separate dwelling not shared with members of the family of origin/orientation
of either spouse
‒ Economically independent
B. EXTENDED FAMILY
‒ Two or more nuclear families economically and socially related to each other
Unilaterally/ bilaterally extended
‒ Includes 3 generations
‒ Lives together as a group
C. SINGLE PARENT FAMILY
‒ Children < 17 years of age, living in a family unit with a single parent,
another relative or non-relative
‒ May result from:
1. Loss of spouse by death, divorce, separation
2. Out of wedlock birth of a child
3. From adoption
4. Migration (OFWs)
D. BLENDED / RECONSTITUTED FAMILY
‒ Includes step-parents and step-children
‒ Caused by divorce, annulment with remarriage and separation
E. COMPOUND FAMILY
‒ One woman/ man with several spouses
F. COMMUNAL FAMILY
‒ Grouping of individuals which are formed for specific ideological or societal
purposes
‒ Considered as an alternative lifestyle for people who feel alienated from the
economically privileged society
‒ Vary within social context
G. COHABITATION / LIVE-IN
‒ Unmarried couple living together
H. NO-KIN
‒ A group of at least two people sharing a relationship and exchange support
who have no legal or blood tie to each other
I. FOSTER
‒ Substitute family for children whose parents are unable to care for them
J. GAY/ LESBIAN
‒ Homosexual couple living together with/without children

CLASSIFICATION ACCORDING TO FUNCTION

1. Family of PROCREATION - refers to the family you yourself created.
2. Family of ORIENTATION - refers to the family where you came

FAMILY AS A UNIT OF CARE

 The family is considered the natural and fundamental unit of society.
 The family as a group generates, prevents, tolerates and corrects health
problems within its membership.
 The health problems of the family members are interlocking.
 The family is the most frequent focus of health decisions and action in personal
care.
 The family is an effective and available channel for much of the effort of the
health worker.

TYPES OF FAMILY
A. FAMILY AS A CLIENT
‒ The family is the foreground and individuals are in the background
‒ The focus is concentrated on each and every individual as they affect the
whole family
‒ The focus is concentrated on how the family as a whole is reacting to an
event when a family member experiences a health issue
‒ CHARACTERISTICS OF FAMILY AS A CLIENT
1. The family is a product of time and place
‒ A family is different from other 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
‒ Develop its own patterns of behavior and its own style in life.
‒ Develops their own power system which either be:
‒ Balance-the parents and children have their own areas of decisions
and control.
‒ Strongly Bias-one member gains dominance over the others.
3. The family operates as a group
‒ A family is a unit in which the action of any member may set of a
whole series of reaction within a group, and entity whose inner
strength maybe its greatest single supportive factor when one of its
members is
‒ stricken with illness or death.
 4. The family accommodates the needs of the individual members.
‒ An individual is 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;
‒ The need for self-expression does not overshadow consideration for
others.
‒ Power is equitably distributed.
‒ Independence is permitted to flourish

B. FAMILY AS A SYSTEM
‒ The focus is on the family as a client
‒ Viewed as an international system in which the whole is greater than the
sum of its parts
‒ Focuses on the individual and family members become the target for nursing
interventions

FUNCTIONS & DEVELOPMENTAL STAGES

FUNCTIONS OF A FAMILY
1. Biologic Reproduction
2. Child-rearing/Caring Nutrition
3. Health maintenance
4. Recreation

A. ECONOMIC
‒ Provision of adequate financial resources
‒ Resource allocation
‒ Ensure financial security
B. EDUCATIONAL
‒ Teach skills, attitudes and skills relating to other functions
C. PSYCHOLOGICAL/ AFFECTION
‒ Promotes the natural development of personalities
‒ Offer optimum psychological protection
‒ Promotes ability to form relationships with people within the family circle
D. SOCIO-CULTURAL
‒ Socialization of children
‒ Promotion of status and legitimacy
‒ Developmental Stages/ Family Life Cycle
‒ Assess a patient and family developmental concerns
‒ Identifies stages of family development that reflect the biological functions of
raising children
‒ As the family system moves together through time, the individual life cycles
‒ Intertwines with the life cycles of other family members
‒ Families go through different stages for which specific developmental tasks
must be accomplished
‒ Families who are not able to accomplish these tasks may develop difficulties
with subsequent family development.
1. BEGINNING FAMILY
‒ Beginning Family: The couple establishes their home but do not yet have
children.
‒ 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:
a. Establish a mutually satisfying relationship
b. Learn to relate well to their families of orientation
c. If applicable, engage in reproductive life planning
2. CHILDBEARING FAMILY
‒ From the birth of the first child until that child is 2 1/2 years old.
‒ Developmental Tasks:
a. Adjusting to increased family size
b. Caring for an infant
c. Providing a positive developmental environment
3. FAMILY WITH PRESCHOOLERS
‒ When the oldest child is between the ages of 2 1/2 and 6.
‒ Developmental Tasks:
a. Satisfying the needs and interests of preschool children
b. Coping with demands on energy and attention with less privacy at home.
4. FAMILY WITH SCHOOL AGE CHILDREN
‒ When the oldest child is between the ages of 6 and 13.
‒ Developmental Tasks:
a. Promoting educational achievement
b. Fitting in with the community of families with school-age children.
5. FAMILY WITH TEENAGERS
‒ When the oldest child is between the ages of 13 and 20.
‒ Developmental Tasks:
a. Allowing and helping children to become more independent
b. Coping with their independence
c. Developing new interests beyond child care.
6. LAUNCHING
‒ From the time the oldest child leaves the family for independent adult life till
the time the last child leaves.
‒ Developmental Tasks:
a. Releasing young adults and accepting new ways of relating to them
b. Maintaining a supportive home base
c. Adapting to new living circumstances.
7. EMPTY NEST
‒ From the time the children are gone till the marital couple retires from
employment.
‒ Developmental Tasks
a. Renewing and redefining the marriage relationship
b. Maintaining ties with children and their families
c. Preparing for retirement years.
8. AGING FAMILY
‒ From retirement till the death of the surviving marriage partner.
‒ Developmental Tasks
a. Adjusting to retirement
b. Coping with the death of the marriage partner and life alone.
FAMILY HEALTH TASK
 Health task differ in degrees from family to family
 TASK - is a function, but with work or labor overtures assigned or demanded of
the person

Family Health Tasks (DUVALL & NILLER)

1. Physical maintenance – provides food, shelter, clothing, and healthcare to its
members being certain that a family has ample resources to provide
2. Socialization of Family – involves preparation of children to live in the community
and interact with people outside the family.
3. Allocation of Resources – determines which family needs will be met and their
order of priority.
4. Maintenance of Order – task 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 member
7. Placement of members into larger society – consists of selecting community
activities such as church, school, politics that correlate with the family beliefs and
values
8. Maintenance of motivation and morale – created when members serve as
support people to each other

Family Health Tasks (MAGLAYA)

1. Recognizing interruptions of health development
2. Making decisions about seeking health care/ to take action
3. Dealing effectively health and non-health situations
4. Providing care to all members of the family
5. Maintaining a home environment conducive to health maintenance

CHARACTERISTICS OF HEALTHY FAMILY

 Able to provide for physical, emotional and spiritual needs of familymembers
 Able to be sensitive to the needs of the family members
 Able to communicate thoughts and feelings effectively
 Able to provide support, security and encouragement
 Able to initiate and maintain growth producing relationship
 Maintain and create constructive and responsible community relationships
 Able to grow with and through children
 Ability to perform family roles flexibly
 Able to help oneself and to accept help when appropriate
 Demonstrate mutual respect for the individuality of family members
 Ability to use a crisis experience as a means of growth
 Demonstrate concern of family unity, loyalty and inter family cooperation