OPENING PRAYER

NCM 104
FAMILY HEALTH NURSING

MARIA CONCEPCION GUIA-SUAREZ, RN, MAN EMELYN A. BUENASEDA, RN, MAN

LECTURER CHAS- DEAN
OBJECTIVES:
At the end of the lecture, the students must:
• Define Health, Community, Public Health and Family
• Identify the Determinants of Health
• Recognize Family as the Basis Unit of Society and
• Differentiate:
• Family as a Client
• Family as a System
• Discuss the Functions of Developmental Stages
• Explain the Importance of Family Health Task
• Identify the Characteristics of A Healthy Family
DEFINITION OF COMMUNITY
• Community is seen as a group or collection of
locality-based individuals, interacting in social units
and sharing common interests, characteristics, values,
and/or goals.
 DEFINITION OF COMMUNITY
• Allender- "a collection of people who interact with one another
and whose common interests or characteristics form the basis for
a sense of unity or belonging.”
• Lundy and Janes- "a group of people who share something in
common and interact with one another, who may exhibit a
commitment with one another and may share geographic
boundary.”
Clark- a group of people who share common interest, who
interact with with each other and who function collectively
within a, defined social structure to address common concerns.
• Shuster and Goeppinger- "a locality-based entity, composed of
systems of formal organizations reflecting society's institutions,
informal groups and aggregates.
 TWO MAIN TYPES OF COMMUNITY
Maurer and Smith (2009)
A. GEOPOLITICAL COMMUNITIES- also called as territorial communities.
• most traditionally recognized.
• defined or formed by both natural and man-made boundaries and include barangays,
municipalities, cities, provinces, regions and nations.

B. PHENOMENOLOGICAL COMMUNITIES- also called as functional communities.

• refer to relational, interactive groups, in which the place or setting is more abstract, and people
share a group perspective or identity based on culture, values, history, interest and goals.
 DEFINITION OF HEALTH
A. WHO- "a state of complete physical, mental and social
well-being and not merely the absence of disease or
infirmity.
B. Murray- "a state of well-being in which the person is able
to use purposeful, adaptive responses and processes
physically, mentally, emotionally, spiritually, and socially.
C. Pender- "actualization of inherent and acquired human
potential through goal-directed behavior, competent self-
care, and satisfying relationship with others."
D. Modern Concept of Health - refers to optimum level of
functioning of individual, family, community which is
influenced by:
• Ecosystem Factors
Socio-economic status
Hereditary factor - genetic
Health care delivery system
Activities and Behavior
Political factors
Environmental factors
DETERMINANTS OF HEALTH
1. Income and Social Status
2. Education
3. Physical Environment
4. Employment and Working Conditions
5. Social Support Networks
6. Culture
7. Genetics
8. Personal Behavior and Coping Skills
9. Health Services
10.Gender
 INDICATORS OF HEALTH AND ILLNESS
• National Epidemiology Center of DOH,
Philippine Statistics Authority (PSA) and local
health centers/ offices/ departments - provide
morbidity, mortality and other health status related
data.
• Local health centers/ offices/ departments
• Nurses should participate in investigative efforts to
determine what is precipitating the increased
disease rate and work to remedy the identified
threats or risks.
 DEFINITION & FOCUS OF COMMUNITY HEALTH OR
PUBLIC HEALTH
a. C. E. Winslow- "Public health is the science and art of
3P's (1) Preventing disease, (2) Prolonging life, and (3) Promoting health and efficiency
through organized community effort for:

ü sanitation of the environment,

ü control communicable infections,
ü education of the individual in personal hygiene,
ü organization of medical and nursing services for the early diagnosis and preventive treatment
of disease
b. Hanlon
"development of the social machinery to ensure everyone a standard of living adequate
for the maintenance of health, so organizing these benefits as to enable "every citizen to
realize his birthright of health and longevity."
c. Jacobson
achievement of OLOF (Optimum level of Functioning) through health teaching
PUBLIC HEALTH - key phrase definition:
"through organized community effort"
• connotes organized, legislated, and tax-supported
efforts that serve all people through health
departments or related governmental agencies.
9 ESSENTIAL PUBLIC HEALTH FUNCTIONS (WHO)
1. Health situation monitoring and analysis
2. Epidemiological surveillance/ disease prevention and control
3. Development of policies and planning in public health
4. Strategic management of health systems and services for population
health gain
5. Regulation and enforcement to protect public health
6. Human resources development and planning in public health
7. Health promotion, social participation and empowerment
8. Ensuring the quality of personal and population-based health service
9. Research, development, and implementation of innovative public health
solution
 FAMILY
As defined by:
• National Statistical Coordination Board (NSCB, 2008)
"the family is a group of persons usually living together and composed of the head and other persons related to
the head by blood, marriage or adoption. It includes both the nuclear and extended family" to more inclusive
definitions.

• Sociologists
"social unit interacting with the larger society" (Johnson, 2000).

• Other professionals
"a family is characterized by people together because of birth, marriage, adoption, or choice" (Allen et al, 2000,
P. 7).

• Friedman et al. (2003) incorporate the idea of many of a nontraditional definitions:

"a family is two or more persons who are joined together by bonds of sharing and emotional closeness and who
identify themselves as being part of the family”.
TYPES OF FAMILY IN THE COMMUNITY
A. Nuclear Family - consists of father, mother and
children (either adopted or biological)
B. Extended - consists of father, mother, and children
with other relatives
C. Single-Parent - single with children
D. Binuclear/Blended/Reconstituted - extended family
consisting of 2 or more separate household from
separated or divorced parents with children
E. Step Family -remarriage of a widowed person with
children
TYPES OF FAMILY IN THE COMMUNITY
F. Compound - one man/woman with several
spouses
G. Cohabiting family - lived-in unmarried couple
H. Dyad - husband and wife without children
I.Homosexual family - female-female or
male/male, gay/lesbian with or without children
J. Communal family - e.g. bahay-ampunan, Home
for the aged, Kumbento
K. No-Kin - have no legal or blood tie to each other
 FUNCTIONS OF THE FAMILY
• The family is the "buffer" between individuals and society
• The basic unit of the society
• Source of motivation and morale
 THE FAMILY FULFILLS TWO IMPORTANT PURPOSES:
Meets the needs of society through:
• Procreation- reproductive function and child-rearing
• Socialization of family members- transmission of the culture to social
group
• Status placement- social class
• Economic function
• Rural Family
• Urban Family

Meets the needs of individuals through:

• Physical Maintenance (ex. survival needs)
• Welfare and protection (ex. emotional and psychological needs)
 THE FAMILY AS A CLIENT
• "The family is a critical resource." The importance of the family in
providing care to its members has already been established. In this
caregiver role, the family can also improve individual members'
health through health promotion and wellness activities.
• "In a family unit, any dysfunction (illness, injury, separation) that
affects one or more family members will affect the members and
unit as a whole." Also referred to as the "ripple effect" changes in
one member cause changes in the entire family. The nurse must
assess each individual and the family unit.
• "Case finding" is another reason to work with families. While
assessing an individual and family, the nurse may identify a health
problem that necessitates identifying risks for the entire family.
• "Improving nursing care." The nurse can provide better and more
holistic care by understanding the family and its members.
 THE FAMILY AS A SYSTEM
THE GENERAL SYSTEMS THEORY (Minuchin, 2002; von Bertalanffy, 1968, 1972, 1974)
It is a way to explain how the family as a unit interacts with larger units outside the
family (supra system) and with smaller units inside the family (subsystem)
(Friedman,1998).
Each member of the system is, to a certain extent, independent of other members, yet, the
members are in so many ways dependent on each other. Thus, the family is certainly
more than just the sum of its members.

THREE SUBSYSTEMS OF THE FAMILY (Parke, 2002)

Parent-child Subsystem,
Marital Subsystem
Sibling-sibling Subsystem
 DEVELOPMENTAL STAGES OF THE FAMILY
Duvall (Duvall and Miller, 1985)
• developmental states of individuals from prenatal through adult
• the forerunner of a focus on family development

FAMILY LIFE CYCLE

1. Beginning family through marriage or commitment as a couple relationship
2. Parenting the first child
3. Living with adolescents
4. Launching family (youngest child leaves home)
5. Middle-aged family (remaining marital dad to retirement)
6. Aging family (from retirement to death of both spouses)
 FAMILY HEALTH TASKS
Family serves as an essential resource for its members by carrying out health
tasks. An important responsibility of the community health nurse is to develop
the family's capability in performing its health tasks.

• Recognizing interruptions of health or development.

ü This is a requisite step the family has to take to be able to deal purposefully
with an unacceptable health condition.
• Seeking health care.
ü When the health needs of the family are beyond its capability in terms of
knowledge, skill, or available time, the family consults with health workers.
• Managing health and non-health crises.
ü Maturational crises
ü Incidental crises

The family's ability to cope with crises and develop from its experience is an
indicator of a healthy family.
 FAMILY HEALTH TASKS
• Providing nursing care to sick, disabled, or dependent members
of the family.
ü In addition to care of the very young and the very old, many minor illnesses,
chronic conditions, and disabilities require home management by responsible
family members.
• Maintaining a home environment conducive to good health and
personal development.
ü In addition to a safe and healthful physical environment, the home should also
have an atmosphere of security and comfort to allow for psychosocial
development.
• Maintaining a reciprocal relationship with the community and
its health institutions.
ü Just as the family utilizes community resources, the family also takes interest in
what is happening in the community and, depending on the availability of family
members and the family's perception of its need and appropriateness, gets
involved in community events.
 CHARACTERISTICS OF A HEALTHY FAMILY

Otto (1973) and Pratt (1976) characterized healthy families as:

"energized families" and provided descriptions of healthy families to
guide in assessing strengths and coping.
 CHARACTERISTICS OF A HEALTHY FAMILY
DeFrain (1999) and Montalvo (2004) helped to identify healthy families. They
suggest the following traits of a healthy family:

• Members interact with each other;

• they communicate and listen repeatedly in many contexts.
• Healthy families can establish priorities.
• Members understand that family needs are priority.
• Healthy families affirm, support, and respect each other.
• The members engage in flexible role relationships, share power, respond to change,
support the growth and autonomy of others, and engage in decision making that
affects them.
• The family teaches family and societal values and beliefs and shares a spiritual core.
• Healthy families foster responsibility and value service to others.
• Healthy families have a sense of play and humor and share leisure time.
• Healthy families have the ability to cope with stress and crisis and grow
from problems.
• They know when to seek help from professionals.
 END OF LECTURE
ARE YOU READY FOR THE QUIZ?
 TEXTBOOKS AND REFERENCE MATERIALS:
qZenaida U. Famorca, Mary A. Nies, Melanie McEwan, A. M. (2019). Nursing Care of the Community: A
Comprehensive Text on Community and Public Health (Philippine Edition 7th ed.).

qhttps://www.youtube.com/watch?v=NH2uAHSSAqI