St.
Scholastica’s College Tacloban Inc COMMUNITY HEALTH NURSING
Maharlika Highway, Brgy. Campetic Palo, Leyte
THE FAMILY
 The basic unit of society, and is
shaped by all forces surround it.
- Values, beliefs, and customs of society
influence the role and function of the family
(invades every aspect of the life of the
family)
 Is a unit of interacting persons bound
by ties of blood, marriage or
adoption.
- Constitute a single household, interacts
with each other in their respective familial
roles and create and maintain a common
culture.
 An open and developing system of
interacting personalities with
structure and process enacted in
relationships among the individual
members regulated by resources and
stressors and existing within the
larger community (Smith & Maurer,
1995)
 Two or more people who live in the
same household (usually), share a
common emotional bond, and
perform certain interrelated social
tasks (Spradly & Allender, 1996)
 An organization or social institution
with continuity (past, present, and
future). In which there are certain
behaviors in common that affect each
other.
THE FILIPINO FAMILY
 Based on the Philippine Constitution,
Family Code with focus on religious,
legal, and cultural aspects of the
definition of family.
Section 1
 The state recognizes the Filipino
family as the foundation of the
nation. Accordingly, it shall
strengthen its solidarity and actively
promote its total development
Section 2
 Marriage, as an inviolable social
institution, is the foundation of
family and shall be protected by the
state.
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Section 3
The state shall defend:
 the right of spouses to found a family
in accordance with their religious
convictions and the demands of
responsible parenthood
 the right of children to assistance
including proper care and nutrition,
and special protection from all forms
of neglect, abuse, cruelty,
exploitation and other conditions
prejudicial to their development
the right of the family to a family
living wage income
 the right of families or family
associations to participate in the
planning and implementation of
policies and programs of that affect
them.
Section 4
 The family has the duty to care for
its elderly members but the state may
also do so through just programs of
social security
The Filipino Family and its
Characteristics
 The basic social units of Philippine
society are the nuclear family
 Although the basic unit is the nuclear
family, the influence of kinship is
felt in all segments of social
organizations
 Extensions of relationships and
descent patterns are bilateral
 Kinship circles is considerably
greater because effective range often
includes the third cousin
 Kin group is further enlarged by a
finial, spiritual or ceremonial ties.
Filipino marriage is not an individual
but a family affair
 Obligation goes with this kingship
system
 Extended family has a profound
effect on daily decisions
 There is a great degree of equality
between husband and wife
 Children not only have to respect
their parents and obey them, but also
have to learn to repress their
repressive tendencies
 The older siblings have something of
authority of their parents.
 St. Scholastica’s College Tacloban Inc
Maharlika Highway, Brgy. Campetic Palo, Leyte
TYPES OF FAMILY
 There are many types of family.
 They change overtime as a
consequence of BIRTH, DEATH,
MIGRATION, SEPARATION and
GROWTH OF FAMILY
MEMBERS
A. Structure
NUCLEAR
 a father, a mother with child/children
living together but apart from both
sets of parents and other relatives.
EXTENDED
 composed of two or more nuclear
families economically and socially
related to each other.
Multigenerational, including married
brothers and sisters, and the families.
SINGLE PARENT
 divorced or separated, unmarried or
widowed male or female with at least
one child.
BLENDED/RECONSTITUTED
 a combination of two families with
children from both families and
sometimes children of the newly
married couple. It is also a
remarriage with children from
previous marriage.
COMPOUND
 one man/woman with several
spouses
COMMUNAL
 more than one monogamous couple
sharing resources
COHABITING/LIVE-IN
 unmarried couple living together
DYAD
 husband and wife or other couple
living alone without children
GAY/LESBIAN
 homosexual couple living together
with or without children
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COMMUNITY HEALTH NURSING
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
FOSTER
 substitute family for children whose
parents are unable to care for them.
FUNCTIONAL TYPE:
 Family of procreation- refers to the
family you yourself created.
 Family of orientation-refers to the
family where you came from.
B. Decisions in the family (Authority)
PATRIARCHAL
 full authority on the father or any
male member of the family e.g.
eldest son, grandfather.
MATRIARCHAL
 full authority of the mother or any
female member of the family, e.g.
eldest sister, grandmother
EGALITARIAN
 husband and wife exercise a more or
less amount of authority, father and
mother decides
DEMOCRATIC
 everybody is involve in decision
making
AUTHOCRATIC
LAISSEZ-FAIRE
 “full autonomy”
MATRICENTRIC
 the mother decides/takes charge in
absence of the father (e.g. father is
working overseas)
PATRICENTIC
 the father decides/ takes charge in
absence of the mother
 St. Scholastica’s College Tacloban Inc
Maharlika Highway, Brgy. Campetic Palo, Leyte
C. Decent (cultural norms, which affiliate
a person with a particular group of
kinsman for certain social purposes)
PATRILINEAL
 Affiliates a person with a group of
relatives who are related to him
though his father.
THE FAMILY AS A UNIT OF CARE
BILATERAL
 both parent
MATRILINEAL
 related through mother
D. Residence
PATRILOCAL
 family resides / stays with / near
domicile of the parents of the
husband
MATRILOCAL
 live near the domicile of the parents
of the wife
Ackerman States that the Function of
Family are:
 Ensuring the physical survival of the
species
 Transmitting the culture, thereby
insuring man’s humanness:
- Physical functions of the family are met
through parents providing food, clothing and
shelter, protection against danger provision
for bodily repairs after fatigue or illness, and
through reproduction
- Affectional function – the family is the
primary unit in which he child test his
emotional reactions
- Social functions – include providing social
togetherness, fostering self esteem and a
personal identity tied to family identity,
providing opportunity for observing and
learning social and sexual roles, accepting
responsibility for behavior and supporting
individual creativity and initiative.
UNIVERSAL FUNCTION OF THE
FAMILY BY DOODE
 Reproduction – for replacement of
members of society: to perpetuate the
human species
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COMMUNITY HEALTH NURSING
 Status Placement of individual in
society
 Biological and Maintenance Of The
Young and dependent members
 Socialization and care of the
children;
 Social control
 Rationale for Considering the 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
THE FAMILY AS THE CLIENT
 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.
 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.
 The family operate 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 may be its greatest single
supportive factor when one of its
members is stricken with illness or
death.
 St. Scholastica’s College Tacloban Inc
Maharlika Highway, Brgy. Campetic Palo, Leyte
 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 over shadow consideration for
others.
- Power is equitably distributed.
- Independence is permitted to
flourish.
 The family relates to the community
-Family develops a stance with
respect to the community:
-The relationship between the
families is wholesome and
reciprocal; the family utilizes the
community resources and in turn,
contributes to the improvement of
the community.
- There are families who feel a
sense of isolation from the
community.
- Families who maintain proud,
“We keep to ourselves” attitude.
- Families who are entirely
passive taking the benefits from the
community without either
contributing to it or demanding
changes to it.
 The family has a growth cycle
- Families pass through
predictable development stages
(Duvall & Miller, 1990)
STAGES
Stage 1: Marriage & 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:
- Establish a mutually satisfying
relationship
- Learn to relate well to their
families of orientation
Otida I BSN 2-E
COMMUNITY HEALTH NURSING
- 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: 2-1/2 years
Stage 3: Family With Pre-School Children
 This is a busy family because
children at this stage demand a great
deal of time related to growth and
development needs and safety
considerations.
 Oldest child: 2-1/2 to 6 years old
Stage 4: Family With School Age Children
 Parents at this stage have 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 old
Stage 5: Family With Adolescent Children
 A family allows the adolescents
more freedom and prepare them for
their own life as technology
advances-gap between generations
increases
 Oldest child: 12-20 years old
Stage 6: The Launching Center Family
 Stage when children leave to set their
own household-appears to represent
the breaking of the family
 Empty nests
Stage 7: Family Of Middle Years
 Family returns to two partners
nuclear unit
 Period from empty nest to retirement
Stage 8: Family In Retirement/Older Age
Stage 9: Period From Retirement To Death
Of Both Spouses
12 BEHAVIORS INDICATING A WELL
FAMILY
 Able to provide for physical
emotional and spiritual needs of
family members
 St. Scholastica’s College Tacloban Inc COMMUNITY HEALTH NURSING
Maharlika Highway, Brgy. Campetic Palo, Leyte

 Able to be sensitive to the needs of Placement of members into larger society

the family members
 consists of selecting community
 Able to communicate thought and
activities such as church, school,
feelings effectively
politics that correlate with the family
 Able to provide support, security and
beliefs and values
encouragement
 Able to initiate and maintain growth Maintenance of motivation and morale
producing relationship
 created when members serve as
 Maintain and create constructive and
support people to each other
responsible community relationships
 Able to grow with and through
children FAMILY ROLES
 Ability to perform family roles Nurturing figure
flexibly
 Able to help oneself and to accept  primary caregiver to children or any
help when appropriate dependent member.
 Demonstrate mutual respect for the
Provider
individuality of family members
 Ability to use a crisis experience as a  provides the family’s basic needs.
means of growth
Decision maker
 Demonstrate concern of family unity,
loyalty and interfamily cooperation  makes decisions particularly in areas
such as finance, resolution, of
conflicts, use of leisure time etc.
8 FAMILY TASKS
Problem-solver
Physical maintenance
 resolves family problems to maintain
 provides food shelter, clothing, and
unity and solidarity.
health care to its members being
certain that a family has ample Health manager
resources to provide
 monitors the health and ensures that
Socialization of Family members return to health
appointments.
 involves preparation of children to
live in the community and interact Gate keeper
with people outside the family.
 Determines what information will be
Allocation of Resources released from the family or what new
information cam be introduced
 determines which family needs will
be met and their order of priority.
HEALTH AS A GOAL OF FAMILY
Maintenance of Order
HEALTH CARE
 task includes opening an effective
HEALTH DEFICIT
means of communication between
family members, integrating family  this refers to conditions of health
values and enforcing common breakdowns or advent of illness in
regulations for all family members. the family
Division of Labor HEALTH THREAT
 who will fulfill certain roles e.g.,  these are the conditions that make it
family provider, home manager, more likely for accidents, disease or
children’s caregiver failure to thrive or develop to occur.
Reproduction, Recruitment, and Release of FORESEEABLE CRISIS
family member
 these are anticipated periods of
unusual demand on the family in
terms of time or resources

Otida I BSN 2-E

 St. Scholastica’s College Tacloban Inc
Maharlika Highway, Brgy. Campetic Palo, Leyte
WELLNESS POTENTIAL
 this refers to states of wellness and
the likelihood for health maintenance
or improvement to occur depending
on the desire of the family
ROLES OF HEALTH CARE
PROVIDER IN FAMILY HEALTH
CARE
 HEALTH MONITOR
 PROVIDER OF CARE
 COORDINATOR
 FACILITATOR
 TEACHER
 COUNSELOR
FAMILY HEALTH NURSING
PROCESS
 DATA COLLECTION: METHODS
AND TOOLS
 DATA ANALYSIS or
INTERPRETATION
 PLANNING
 IMPLEMENTATION
 EVALUATION PHASE
ASSESSMENT PHASE
 first major phase of nursing process
in family health nursing
 Involves a set of action by which the
nurse measures the status of the
family as a client. Its ability to
maintain wellness , prevent, control
or resolve problems in order to
achieve health and wellness among
its members
 Data about present condition or
status of the family are compared
against the norms and standards of
personal , social, and environmental
health, system integrity and ability to
resolve social problems.
 The norms and standards are derived
from values, beliefs, principles, rules
or expectation.
TWO MAJOR TYPES
FIRST LEVEL ASSESSMENT
 a process whereby existing and
potential health conditions or
problems of the family are
determined ( HT, HD, WP or FC)
Otida I BSN 2-E
COMMUNITY HEALTH NURSING
SECOND LEVEL ASSESSMENT
 defines the nature or type of nursing
problem that family encounters in
performing health task with respect
to given health condition or problem
and etiology or barriers to the
family’s assumption of the task
DATA COLLECTION METHODS
OBSERVATION
 done through use of sensory
capacities
 The nurse gathers information about
 the family’s state of being and
behavioral responses
the family’s health status can be
inferred from the s/sx of problem
areas:
a. communication and interaction
patterns expected ,used, and tolerated
by family members
b. role perception / task assumption
by each member including decision
making pattern
c. conditions in the home and
environment
 Data gathered though this method
have the advantage of being
subjected to validation and reliability
testing by other observers
PHYSICAL EXAMINATION
 significant data about the health
status of individual members can be
obtained through direct examination
through IPPA, Measurement of
specific body parts and reviewing the
body systems
 data gathered from P.A form
substantive part of first level
assessment which may indicate
presence of health deficits (illness
state )
INTERVIEW
 Productivity of interview process
depends upon the use effective
communication techniques to elicit
needed response PROBLEMS
ENCOUNTERED:
- How to ascertain where the client
is in terms of perception of health
 St. Scholastica’s College Tacloban Inc
Maharlika Highway, Brgy. Campetic Palo, Leyte
condition or problems and the
patterns of coping utilized to resolve
them
- Tendency of community health
worker to readily give out advice,
health teachings or solutions once
they have identified the health
condition or problems.
 Provisions of models for phrasing
interview questions utilization of
deliberately chosen communication
techniques for an adequate nursing
assessment.
confidence in the use of
communication skills
 Being familiar with and being
competent in the use of type of
question that aim to explore,
validate, clarify, offer feedback,
encourage verbalization of thought
and feelings and offer needed
support or reassurance.
TYPES:
 completing health history of each
family member
 Health history determines current
health status based on significant
 PAST HEALTH HISTORY e.g.
developmental accomplishment,
known illnesses, allergies, restorative
treatment, residence in endemic areas
for certain diseases or sources of
communicable diseases.
 FAMILY HISTORY e.g. genetic
history in relation to health and
illness.
 SOCIAL HISTORY e.g. intra-
personal and inter-personal factors
affecting the family member social
adjustment or vulnerability to stress
and crisis\
 Collecting data by personally asking
significant family members or
relatives questions regarding health,
family life experiences and home
environment to generate data on
what wellness condition and health
problem exist in the family ( first
level assessment) and the
corresponding nursing problems for
each health condition or problem (
2nd level assessment)
RECORDS REVIEW
Otida I BSN 2-E
COMMUNITY HEALTH NURSING
 Gather information through
reviewing existing records and
reports pertinent to the client
 Individual clinical records of the
family members, laboratory and
diagnostic reports, immunization
records reports about home and
environmental conditions
LABORATORY/ DIAGNOSTIC TEST
DATA ANALYSIS
 CRITERIA FOR ANALYSIS:
 PROCESS FOR ANALYSIS:
- Sorting Of Data
- Clustering Of Related Cues
- Distinguishing Relevant From
Irrelevant Cues
- Identifying Patterns
- Comparing Patterns
- Interpreting Results Of
Comparison
- Making Inferences And
Drawing Conclusions
FAMILY NURSING CARE PLAN
(FNCP)
 Is the blueprint of the care that the
nurse designs to systematically
minimize or eliminate the identified
health and family nursing problems
through explicitly formulated
outcomes of care (goals and
objectives) and deliberately chosen
set of interventions, resources and
evaluation criteria, standards,
methods and tools.
STEPS OF FSNCP
 The prioritized condition/s or
problems
 The goals and objectives of nursing
care
the plan of interventions
 The plan of evaluating care
 St. Scholastica’s College Tacloban Inc COMMUNITY HEALTH NURSING
Maharlika Highway, Brgy. Campetic Palo, Leyte

This is a schematic presentation of the

nursing care plan process. It starts with a
list of health condition or problems
prioritized according to the nature,
modifiability, preventive potential and
salience. The prioritized health condition
or problems and their corresponding
nursing problems become the basis for
the next step which is the formulation of
goals and objectives of nursing care. The
goals and objectives specify the expected
health/clinical outcomes, family
response/s, behavior of competency
outcomes

Otida I BSN 2-E