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INDIVIDUAL, FAMILY, & COMMUNITY HEALTH

CHAPTER 7, 16, AND 24

N101
 Individual, Family & Community Health
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 Objectives:
◼ Describe the roles and functions of the family within the
Jordanian context.

◼ Explain the importance of familism in the context of Jordanian

culture as opposed to the western concept of individualism.

◼ Explain the meaning of holism to nursing practice within the

context of Jordan.

◼ Understanding the meaning of homeostasis concept.

◼ Explain human needs.

Individual, Family & Community Health
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 Nurses assess and plan health care for three types

of clients:
◼ The individual
◼ The family
◼ The community

 The individual’s beliefs and values and the

support from the family and reinforced by the
community influence or affect the individual’s
health practices.
 1 Individual Health
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 Concept ‫ مفهوم‬of individuality

 Concept of Holism ‫الشمولية‬

 Concept of Homeostasis ‫التوازن‬

 Individual Health
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Dimensions ‫ أبعاد‬of Individuality

Person’s total
character:
behaviors, attitudes,
emotional state,
abilities, appearance

Perceptions Self-identity
(‫)اإلدراك‬: ways the ‫;الهوية الذاتية‬
person interprets the perception of self as a
environment/a separate & distinct
situation which affects entity alone and in
how he feels and acts interactions with
to the situation others
 Concept of Individuality
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 Each individual is a unique ‫ ال نظير له‬being (genetics,

experience and environmental interactions).

 Nurses should focus on total and individualized care

when providing nursing care to any client:
 Total care involves the general principles that apply to a client
in term of age and medical condition.

 Individualized care involves applying the general principles

taking into consideration information particular for a client as
an individual.
 Concept of Individuality
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 An example explains total and individual care:

 School-age child with epilepsy ‫ داء الصرع‬who wants to
engage in the school swimming team;
◼ Participating in physical activities is a
developmental stage that all school-age children
would like to experience
◼ However, because the child has epilepsy swimming
would not be appropriate for him because of the
risk for accidents and injury
◼ Other physical activity may be better such as soccer
team
 Holism
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 An individual is NOT assembly of parts and processes.

 Holism views a person as a whole/complete with all areas relate to
each others.
 Holism considers the relationship between the individual and
external environment and others.
 Example:
 When providing family-centered nursing care for a mother who
has a child with Thalassemia ‫الثالسيميا‬, a nurse should consider
how the illness affects the family relationships, mother’s energy
level, rest & sleep, usual activities, mood sense of well-being
and financial status ‫الوضع المالي‬
 Homeostasis
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 Homeostasis: Balance: Equilibrium ‫توازن‬

 Homeostasis does not apply immobility of the system

 Human being, as separate from the external environment,

is constantly endeavoring ‫ تسعى‬to maintain physiological
equilibrium or balance through adaptation ‫ تكيف‬to the
environment (Cannon, 1939)

 Types of homeostasis: Physiological and psychological

 Physiological Homeostasis
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 Refers to a relative stability of the body’s internal

environment.

 Homeostasis mechanisms have main characteristic which

are:
 Self-regulating: Automatic response to changing in a healthy
person.
 Compensatory (counterbalancing ‫) موازنة‬: The body’s response to
abnormal situation such as cold to maintain normal body
temperature despite the exposure to cold.
 Other several feedback mechanisms.
 Psychological Homeostasis
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 Refers to emotional balance or mental well-being.

 In order for a person to maintain psychological

homeostasis or stability a person should have:
◼ Stable physical environment (basic needs must be met, feed,
feels safe & secure)
◼ Stable psychological environment (feelings of love and trust)
◼ Healthy role models (adults) so children can learn from them
the values and customs of the society
◼ A life experience; satisfying experience to counterbalance the
frustrating ‫ محبط‬ones
 Assessing the Health of Individuals
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 Health history & Physical examination

 Physical fitness assessment
 Lifestyle
 Health risk appraisal ‫تقييم‬
 Health beliefs system
 Life-stress ‫ توتر‬review
 Theoretical Framework:
Health promotion of individual and families
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 The two major theoretical frameworks are:

 Needs theories
◼ Rank ‫ مرتبة‬human needs according to its importance
for a person’s survival
 Developmental stage theories
◼ Categorize a person’s behaviors or tasks into age
ranges groups
◼ Describe characteristics associated with the majority
of individuals at a certain developmental stage (e.g.
infancy period)
 Theoretical Framework:
Needs theories
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 Maslow’s Hierarchy of Needs

 Kalish’s Hierarchy of Needs

 Theoretical Framework:
1. Maslow’s Hierarchy of Needs
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 Maslow’s Hierarchy of Needs

 Human needs are ranked on an ascending ‫ تصاعدي‬scale
according to essentiality ‫ اإلستخدامات األساسية‬of the needs for
survival ‫بقاء‬

 There are five levels of human needs (See next slide)

 Theoretical Framework: Maslow’s
Hierarchy of Needs
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
 Theoretical Framework:
Maslow’s Hierarchy of Needs
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
 Theoretical Framework:
Maslow’s Hierarchy of Needs
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 Self-esteem needs: feelings of independence, competence, self-

respect, recognition ‫تقدير‬, respect, appreciation).
 Self-actualization ‫تحقيق الذات‬
 Sees life clearly and realistically & Accepts the world for what it is
 Open to new ideas
 Has superior perception
 Understand art, music, politics and philosophy
 Highly creative, flexible and courageous
 Dedicated to some work
 Self-confident and self-respected
 Highly independent
 Friendly and loving
 Theoretical Framework:
2. Kalish’s Hierarchy of Needs
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 Kalish’s Hierarchy of Needs:

 Adapted Maslow’s hierarchy of needs and added another level

 Kalish’s hierarchy consists of six levels of needs

 The sixth level refers to stimulation ‫ تحفز‬needs which comes

between the physiologic and safety needs.

 Stimulation needs include activity, exploration ‫استكشاف‬,

manipulation ‫ معالجة‬and novelty ‫ حداثة‬to achieve optimal growth
and development (for children).
 Theoretical Framework:
Kalish’s Hierarchy of Needs
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Self-
actualization

Self-Esteem

Love & Belonging

Safety & Security

Stimulation: sex, activity,
exploration, manipulation, novelty

Physiologic
 2 Family Health
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 Family is the basic unit of the society

 Family consists of a group of people who are considered to be

significant to each other

 Family consists of persons (structure) and their responsibilities

within the family (roles)

 Family-centered nursing refers to:

 The interest in family health as a unit

 Considered the impact of the family on the health, values and

productivity of individual family members
 Family Health:
Functions of the Family
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1) Providing adequate nutrition and health care

services for physical growth and health

2) Creating an atmosphere that influences

cognitive and psychosocial growth of its
members

3) Family’s unique values and beliefs affect family

members health care practices
 Roles & Functions of the family in
Jordan
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 Family Health:
Types of Families
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 Traditional family
 Nuclear family: Parents and their offspring. The
mother assumes nurturing role and the father provides
the money
 Extended family/ Intra-generational: Relatives of
nuclear family aunts, grandparents, uncles

 Two-career family
 Both parents work outside to provide money

 Finding an affordable ‫ بأسعار معقولة‬child care is a great

stress to the family
 Family Health:
Types of Families
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 Single-parent family
 Stresses of a single-parent family are financial concerns, work
overload ‫ العمل الزائد‬and fatigue ‫ تعب‬and social isolation

 Adolescent family
 These parents are emotionally, physically and financially are ill
prepared to take the responsibilities of parenthood

 Blended/step family: family units who join together to form new

families.

 Single adults living alone: adults who live alone

 Theoretical Framework:
Assess Family Health
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 Theoretical frameworks provide a context or

structure to view health and health promotion for
families.
 There are two theories in family health:

◼Systems theory: Family is continually interacting with

and influenced by other systems in the community.
◼Structural-functional theory: Focuses on the
relationships among family, Family members function in
harmony, working toward shared goals such as provided care
and services to members.
 Family Assessment
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 It gives an overview of the family process and helps the nurse

identify
◼ strengths
◼ resources
◼ weaknesses of the family

 Describes health status of the family and its individual members.

 Assessment begins with a complete health history. This provides

information about existing or potential health problems.
 Family Assessment
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 Health beliefs
 Family communication patterns

 Family coping mechanisms

 Family violence

 Risk for health problems

◼ Hereditary or genetic factors

◼ Sex
◼ Ethnicity
◼ Sociologic factors
◼ Lifestyle practices
 Family Assessment
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 Genogram enables a nurse to visualize how family members

are genetically related and assess pattern of chronic diseases

 Ecomap for each family member or a family as a unit

provides information about the family/individual interactions
with external community environment such as school, work.
Interactions such as health beliefs and lifestyle behaviors
 Family Assessment: Genogram
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
 Family Assessment: Ecomap
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
 Family Assessment: Ecomap
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
 3 Community Health
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 A community is a collection of people who share some attribute

‫ صفة مميزة‬of their lives and interact with each other in some way.

 Also a community can also be defined as a social system in

which the members interact ‫ تفاعل‬formally or informally and
form networks that operate for the benefit of all people in the
community.

 Community health nursing focuses on promoting and preserving

the health of population groups.
 Functions of a Community
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1. Production, distribution and consumption of goods & services.

2. Socialization: The process of transmitting values, knowledge,
culture and skills to others.
3. Social control: The way in which order is maintained in a
community (Laws, policies, regulations).
4. Social inter-participation: Social activities that are designed to
meet people’s need of companionship.
5. Mutual support: The community’s ability to provide resource
at a time of illness and disaster.
 Aspects of a Community Subsystem
Assessment
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 Physical environment
 Education
 Safety and transportation
 Politics & government
 Health & social services
 Communication
 Economics
 Recreation ‫استجمام‬