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Family life

A Family
• The family is small social system made up of
individuals related to one another, biologically
or by reason of strong affection and loyalty,
that comprises a permanent household and
persists over decades.
• Member enter through birth, adoption, or
marriage and leave by death, therefore, the
roles of members change over time and
through the history of the groups.
Function of family
• Support to another.
This support can be physical, financial,
social, or emotional or combination of these.
The support is provided through an organized
network of interdependent family roles.
• Establishment of autonomy and
independence for each member. The family
facilitates personal growth of individuals
within the family.
Function of family
• Support to another.
This support can be physical, financial,
social, or emotional or combination of these.
The support is provided through an organized
network of interdependent family roles.
• Establishment of autonomy and
independence for each member.
The family facilitates personal growth of
individuals within the family.
Function of family
• Creation of rules that govern the conduct of
family members.
Family rules are largely unwritten. They are
established by informal decision marking
process. The rules deals with privacy,
interaction patterns, authority and decision
marking.
• Communication with one another.
Communication is the key function without
which other are not possible. This can be
verbal, non verbal, implied messages.
Function of family
• Adaptation to change in the environment.
The ability to adapt, change, and grow is
essential for long term progression through a
family’s life cycle. A change can be first order
or second order change. First order change,
e.g. the family’s move to new place. Second
order change, e.g. a family members leaving
for study abroad.
Family life cycle.
• The family goes through a number of predictable
transitions. Families are most vulnerable during
the transition from one developmental stage
• The physician with an understanding of individual
development, can form good hypothesis about
problems that his patients are experiencing, and
are thus able to help family members prepare for
these problems and to help to solve them.
• The success at the completion of each stage
leads to happiness and success with later
tasks. Failure of these tasks leads of
unhappiness, disapproval by society, difficulty
with later tasks.
• Conflict of developmental tasks between
family members lead to tensions in family life.
The family’s influence on the
individual’s health
• Genetic influence.
• Influence on diseases
• Influence on child development
• Influence on morbidity and mortality in adults
• Influence on recovery from illness
• Genetic influence
The family endows its genetic heritage to
the individual and this includes genetically
transmitted disease: single gene defect, e.g.
thalassaemia, chromosomal disorder, e.g.
Down syndrome, and multifactorial genetic
influence, e.g. diabetes mellitus.
• Influence on diseases
Transmissible diseases may be disseminated
from one member to another, e.g. streptococcal
sore throat, viral conjunctivitis, worm infections.
• Influence on child development
There is evidence of relationship between
family pathology and childhood disorders, both
physical (e.g. accident, enuresis) and behavioral
(aggression, social withdrawal)
• Influence on morbidity and mortality in adults
There is well documented increased mortality
in widows during the first year of bereavement.
Bereavement is also associated with increased
consultation rate in family members.
• Influence on recovery from illness
Family support is an important factor in
determining the outcome of all kinds of illnesses,
especially chronic illness and disability. Religious
cultural beliefs of family members are also
important determinants of coping and recovery.
Functional and dysfunctional families
• Physicians who follows the same patients over
long periods of time come to recognize that at
the two extremes, are the happy and
unhappy features.
• Functional families radiate a sense of integrity
and caring. Adults members espouse and live
by clear human values, express feeling
appropriately, communicate effectively, and
share power while negotiating decisions.
• Dysfunctional families, instead of integrity,
radiate a sense of chaos or rigidity. There is a high
level of chronic underlying tension in such family.
Family members may adopt personal values from
authority figures, such as parents or clergy, or
from friends or other peers without considering
their logical and emotional consistency.
• Family members may form values by reacting in
opposition to espoused or actual values of
influential people, again without of their merits
or drawbacks.
• An understanding of family in term of the its
struggles to be functional will enable the family
physician to make more correct diagnosis and
also intervene more appropriately.
• Helping individuals from dysfunctional families to
recognise that there are more healthy ways to
respond to the situations of the day is often the
start toward a more functional individual and
family.
Level of physician involvement in the
family
• Level 1. Minimal emphasis on the family. The
interaction is limited to the patient only.

• Level 2. Providing medical information and


advice. This consists of teaching at least one
family member about the patient’s illness
either as a once-off an ongoing series of
educational sessions.
• Level 3. Providing feeling and support.
Family support is enhanced by convening the
family members and encouraging them ti discuss
their concern.

• Level 4. Systematic assessment and planned


intervention. Family physician engages the family
members, including the reluctant ones in a
planned family conference or a series of
conferences.
• Level 5. Family therapy.
The Family physician has the ability to handle
intense emotions in the families and self and
to maintain neutrality in the face of strong
pressure from family members or other
professionals.
Assessment of family dynamic
• Structure ; genogram
• Relationship of the members
• Impact on members.
genogram
• A biopsychosocial family tree. It records the
family in its life cycle, family illness and
relationships.
• Thanks for your attention
EFEK SOCIAL BUDAYA DAN KEHIDUPAN
KELUARGA
• SOSIAL:
• STRATA SOSIAL
• PENDIDIKAN
• EKONOMI/PENDAPATAN
• BUDAYA:
• JUMLAH KELUARGA
• KEBIASAAN/ADAT ISTIADAT
• NILAI/NORMA