THE FAMILY

Mae Joanne M. Bongat, MAN

Assistant Professor
 Definition of Family
Family
Basic unit in society.
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.
 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)
 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.
 Section 3
• The state shall defend –

1. The right of spouses to found a family in accordance with their

religious convictions and the demands of responsible parenthood

2. 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

3. The right of the family to a family living wage income

4.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

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.

Extended family has a profound

effect on daily decisions something
of authority of their parents.
 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.
 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
 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
 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.
 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
EGALITARIA husband
and wife exercise a
more or less amount of
authority, father and
mother decides
DEMOCRATIC

everybody is
involved in decision
making
 AUTHOCRATIC
 Effective when
action is needed
during an
emergency.
 Stressful on
followers
 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
 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
 Bilateral- both parents
 Matrilineal – related through mother
 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

1. Insuring the physical survival

of the species
2. 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 the child test
his emotional reactions
Social functions
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

Status placement of individual in society

Biological and maintenance of the young and
dependent members

Socialization and care of the children;

Social control
 The Family as a Unit of
Care
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

Characteristics of a Family as a 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 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
 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.
1. The need for self-expression does not over -
shadow consideration for others.
2. Power is equitably distributed.
3. Independence is permitted to flourish.
 The family relates to the
community

 Family develops a stance with

respect to the community:
1. 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.
2. 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)
 FUNCTIONS DEVELOPMENTAL
STAGES

Stage 1: MARRIAGE & THE FAMILY

 Includes adjustments to each other’s
routines (sleeping, eating, chores,
etc.), sexual and economic aspects.
 Members work to achieve 3 separate
identifiable tasks
1. Establish a mutually
satisfying relationship
2. Learn to relate well to their
families of orientation
3. 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

1. Able to provide for physical emotional

and spiritual needs of family members
2. Able to be sensitive to the needs of
the family members
3. Able to communicate thought and
feelings effectively
4. Able to provide support, security and
encouragement
5. Able to initiate and maintain growth
producing relationship
6. Maintain and create constructive and
responsible community relationships
7. Able to grow with and through
children
8. Ability to perform family roles
flexibly
9. Able to help oneself and to
accept help when appropriate
10. Demonstrate mutual respect for the
individuality of family members
11. Ability to use a crisis experience as a means
of growth
12. Demonstrate concern of family unity, loyalty
and interfamily cooperation
 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
•Duvall & Niller identified 8 task
essential for a family to function as a
unit:
 Eight Family Tasks

1. Physical maintenance- provides

food shelter, clothing, and health care
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.
5 Family Health Tasks (Maglaya, A., 2004)

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
 Family Roles
• Nurturing figure– primary caregiver
to children or any dependent member.
• Provider – provides the family’s
basic needs.
• Decision maker– makes decisions
particularly in areas such as finance,
resolution, of conflicts, use of leisure
time etc.
• Problem-solver– resolves family problems
to maintain unity and solidarity.
• Health manager– monitors the health and
ensures that members return to health
appointments.
• Gate keeper-Determines what
information will be released from the family
or what new information cam be introduced.
FAMILY NURSING
PROCESS
 Theoretical Approaches to Family
Health Care

Family Models
• the use of family model provides a
perspective of focus for understanding the
family
• have categorized according to their
basic focus as developmental, interactional
structural-functional, and systems model
 Health as a Goal of Family Health
Care

•Health Deficit- this refers to conditions of

health breakdowns or advent of illness in the
family

•Health Threat- these are the conditions that

make it more likely for accidents, disease or
failure to thrive or develop to occur.
 Foreseeable Crisis- these are anticipated periods of
unusual demand on the family in terms of time or
resources
 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 Care 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
1. First Level Assessment - a
process whereby existing and
potential health conditions or
problems of the family are
determined (WS, HT, HD, SP or
FC)
2. 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: Select
Appropriate Method
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
 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:
• 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:
1. Completing health history of each
family member
•family history e.g. genetic history
in relation to health and illness
• 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.
SOCIAL HISTORY e.g. intra-
personal and inter-personal factors
affecting the family member social
adjustment or vulnerability to stress
and crisis.
2. 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
• 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
 Analyze Data to Identify Needs
and Problems
1. criteria for analysis:
2. 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
 Health Needs and Problems of the Family

• A situation which interferes with the

promotion and / or maintenance of health
•It is a health problem when it stated as
the family’s failure to perform adequately
specific health task to enhance the
wellness state or manage a health problem
THANK
YOU