Filipino Family and Its Characteristics, Care or Normal Families, Care of Families at Risk

Family

It is considered the basic unit of society and the primary unit of health care in community nursing.

Nuclear Family

Extended Family

Single-Parent Family

Blended Family (Reconstituted Family)

Joint Family

Childless Family

Foster Family

Adoptive Family

Same-S*x Family

9 Types of families

Nuclear family

Father, Mother, and Children

Also called traditional family

Extended family

Nuclear family + relatives

Single-Parent Family

One parent only family

Blended Family

Two families joined together

Joint Family

Multiple generations living together

Childless Family

Couple without children

Foster family

A family that provides temporary care for children who cannot live with their biological parents.

Adoptive Family

Parents legally assume responsibility for a child who is not biologically theirs

Same-s*x family

Family composed of same-s*x partners raising children or living together

Physical Function

Economic Function

Reproductive Function

Socialization Function

Emotional Function

Educational Function

Protective Function

7 Functions of the family

The family provides care, support, and socialization

Game Changer:

What is the key concept of family?

Family development

Game Changer:

___ is a continuous process where families face predictable tasks at each stage

Evelyn Duvall’s Family Development Theory

Theory where Duvall identified 8 stages of the family life cycle based on presence and age of children and family developmental tasks

1. Beginning Family

2. Childbearing Family

3. Family with Preschool Children

4. Family with School-Age Children

5. Family with Teenagers

6. Launching Family

7. Middle-Aged Parents

8. Aging Family

Family Life Cycle: Stages and Tasks (Duvall)

Beginning Family

Newly Married Couple

Family Task:

Establish a mutually satisfying marriage

Adjust to living together

Develop financial stability

Plan for children

Childbearing Family

Birth of First Child – 30 Months

Family Task:

Adjust to parenthood

Adapt to infant care

Establish roles as parents

Provide physical care for infant

Family with Preschool Children

First Child: 2½–6 Years

Family Task:

Meet needs of preschool child

Encourage development and independence

Socialize children

Maintain marital relationship

Family with School-Age Children

First Child: 6–13 Years

Family Task:

Support educational development

Encourage achievement

Promote peer relationships

Maintain communication

Family with Teenagers

First Child: 13–20 Years

Family Task:

Allow increasing independence

Adjust family relationships

Support adolescent identity development

Prepare for children leaving home

Launching Family

First Child Leaves Home Until Last Child Leaves

Family Task:

Release young adults

Maintain supportive relationships

Adjust to reduced family size

Develop new interests

Middle-Aged Parents

Empty Nest to Retirement

Family Task:

Maintain marital relationship

Adjust to aging parents

Prepare for retirement

Maintain social involvement

Aging Family

Retirement to Death of Both Partners

Family Task:

Adjust to retirement

Cope with aging changes

Maintain relationships

Accept loss and bereavement

Genogram

Game Changer:

It is a family medical history map.

A ___ is a graphic representation of a family tree that shows:

• Family structure

• Relationships

• Health history

• Patterns across generations

□ Male

○ Female

◇ Unknown gender

Symbols used in genogram

Marriage/partnership

Horizontal line in genogram

Parent-child relationship

Vertical line in genogram

Close relationship

Double line in genogram

Distant relationship

Broken line in genogram

Conflict relationship

Zigzag line in genogram

Genogram

Ecomap

Family APGAR

Family Assessment Tools

Ecomap

Game Changer:

A diagram showing family relationships with…

• Community

• Organizations

• Social support systems

Assesses:

• External resources

• Stressors

Family APGAR

Game Changer:

Measures family function developed by Gabriel Smilkstein.

A – Adaptation

Ability to use resources during problems

P – Partnership

Sharing decisions and responsibilities

G – Growth

Personal development supported by family

A – Affection

Emotional relationships

R – Resolve

Commitment of time and resources

Family A.P.G.A.R. meaning

Family Coping Index

Assesses:

• Family ability to manage problems

Areas:

• Physical independence

• Therapeutic competence

• Knowledge of health condition

• Emotional competence

• Family interaction

Friedman Family Assessment Model

Structural

• Family composition

• Roles

• Relationships

Developmental

• Family life cycle stage

Functional

• Communication

• Coping

• Decision-making

Maglaya’s Typology of Nursing Problems in Family Nursing Practice

Game Changer:

This states that family nursing problems are classified into

1. Wellness Condition

2. Health Deficit

3. Health Threat

4. Foreseeable Crisis

Wellness condition

A state where family has potential for improvement.

Examples:

• Readiness for enhanced nutrition

• Desire to improve health practices

Health Deficit

A failure in health maintenance.

Examples:

• Presence of illness

• Poor nutrition

• Untreated hypertension

Health Threat

A condition that may lead to illness.

Examples:

• Smoking

• Poor sanitation

• Unsafe environment

Foreseeable Crisis

Expected developmental events requiring adjustment.

Examples:

• Pregnancy

• Marriage

• Birth of a child

• Retirement

Assessment

Diagnosis

Planning

Implementation

Evaluation

Family Nursing Process

normal or healthy family

A ___ is one that is able to:

• Maintain physical and emotional well-being

• Perform expected family roles

• Adapt to developmental changes

• Solve problems effectively

• Utilize available resources

Assessment determines the family’s strengths, resources, health practices, and areas for improvement.

1. Family Structure Assessment

2. Family Developmental Assessment

3. Physical Health Status Assessment

4. Family Function Assessment

5. Environmental Assessment

6. Socioeconomic Assessment

Areas of Family Health Assessment

Family Structure Assessment

Identify the assessment

• Who are the members of the family?

• Who makes decisions?

• Who provides support?

Tool: Genogram

Family Developmental Assessment

Identify the assessment

Determines:

• Current family life cycle stage

• Developmental tasks being accomplished

Based on:

• Evelyn Duvall’s Family Development Theory

Example:

Family with infant

• Adjustment to parenthood

• Infant care

• Role changes

Physical Health Status Assessment

Identify the assessment

Individual Health

• Medical history

• Current illnesses

• Immunization status

• Nutrition

• Lifestyle practices

Family Health Practices

• Health-seeking behavior

• Preventive care

• Use of health services

Family Function Assessment

Identify the assessment

Communication

• How family members express feelings

Decision-making

• Who makes important decisions

Roles

• Responsibilities of members

Coping ability

• Response to stress

Tool:

• Family APGAR

Environmental Assessment

Identify the assessment

Assess:

Home Environment

• Safety

• Cleanliness

• Ventilation

• Lighting

Sanitation

• Water supply

• Waste disposal

• Toilet facilities

Community Resources

• Health centers

• Schools

• Social support

Tool:

• Ecomap

Socioeconomic Assessment

Identify the assessment

Includes:

• Income

• Employment

• Education

• Access to healthcare

• Social support

Nursing diagnosis

A ___ identifies the family’s health strengths, potential problems, and readiness for improvement. Normal families commonly have wellness diagnoses rather than illness-focused diagnoses.

Problem

Related Factors

Evidence

Nursing Diagnosis Format

Example: Readiness for enhanced family processes related to desire to improve family communication as evidenced by expressed interest in strengthening family relationships.

Planning

___ involves establishing goals and selecting appropriate interventions to maintain and improve family health.

Family-Centered Approach

Establish Priorities

Principles of Family Care Planning

Family-Centered Approach

Principle of family care planning where the family is included in:

• Identifying needs

• Setting goals

• Making decisions

Establish Priorities

Principle of family care planning where we consider

A. Nature of Problem

• Health promotion

• Prevention

• Treatment

B. Modifiability

• Can the family change the situation?

C. Preventive Potential

• Can intervention prevent future problems?

D. Family Resources

• Available support and abilities

S – Specific

M – Measurable

A – Achievable

R – Relevant

T – Time-bound

Meaning of S.M.A.R.T. planning

Wellness

Game Changer:

Healthy families commonly have ___ nursing diagnoses.

Planning

Game Changer:

___ should involve the family as an active partner.

Evaluation

Game Changer:

___ focuses on changes in family health behaviors and achievement of goals. It determines whether nursing interventions achieved desired outcomes.

Were Goals Achieved?

Did Family Demonstrate Improved Health Behaviors?

Did Family Utilize Resources?

Did Family Improve Coping and Function?

Family Evaluation Questions

healthy family

Game Changer:

"A ___ wants to improve lifestyle practices and communication"

• Readiness for Enhanced Family Processes / Health Management.

Structure Evaluation

Process Evaluation

Outcome Evaluation

3 types pf evaluation

Family Nursing Process Summary (PNLE) Review

A – Assess the family

D – Diagnose family needs

P – Plan goals

I – Implement interventions

E – Evaluate outcomes

Family A.D.P.I.E. meaning

Families at risk

___ is a family that has an increased possibility of experiencing health problems, developmental difficulties, or inability to perform health-related functions because of internal or external factors.

They do not necessarily have an illness; they have factors that increase the chance of health problems.

Biological/Health Risks

Environmental Risks

Socioeconomic Risks

Family Functioning Risks

Lifestyle Risks

Types of Family Risk Factors

Risk factors

Family strengths

Available resources

Health needs

Ability to cope

The goal of Assessment of At-Risk Family’s Health Status is to identify these factors

A – Adaptation

P – Partnership

G – Growth

A – Affection

R – Resolve

Game Changer:

Family A.P.G.A.R. (At Risk)

Communication - Ability to express needs

Roles - Responsibilities of members

Coping Mechanisms - Response to stress

Support System - Availability of assistance

How do we assess Family function (at risk)?

Family APGAR

What tool do we use to assess Family function (at risk)?

Individual Health Conditions

Preventive Health Practices

Maternal and Child Health

Health Status Assessment for Families at risk

Housing

• Space

• Ventilation

• Safety

Sanitation

• Water source

• Toilet facilities

• Garbage disposal

Assess availability of:

• Health centers

• Social services

• Support programs

Environmental Assessment

Inability

Nursing diagnoses for families at risk focus on the family’s ___, risk, or readiness related to health management.

To reduce risks, strengthen family capacity, and promote health

Goal for Planning of At-Risk Family Care

1. Nature of the Problem

2. Modifiability

3. Preventive Potential

4. Family Resources

Prioritize Family Problems (at risk)

Family at risk

Game Changer:

• ___ = increased possibility of health problems due to risk factors.

• Assessment focuses on risks, strengths, resources, and coping abilities.

• Genogram = family structure and hereditary health patterns.

• Ecomap = family connection with community resources

1. Preparation

2. Introduction

3. Assessment

4. Intervention

5. Termination

6. Documentation

6 Steps of home visit

Manage health problems

Game Changer:

Priority nursing intervention for families at risk is to strengthen family ability to ___.

Health Behavior Changes

Family Ability to Manage Problems

Environmental Improvements

Achievement of Goals

Evaluation criteria for families at risk

Home visits

Game Changer:

___ are essential in assessing actual family conditions.

Evaluation

Game Changer:

__ of families at risk focuses on improved health behaviors and reduced risks.

A – Assess risks

T – Teach health practices

R – Reduce hazards

I – Improve coping

S – Strengthen resources

K – Keep evaluating

Game Changer:

A.T. R.I.S.K. Family Care meaning

self-reliance

Game Changer:

Family at Risk Nursing Goal: "Move the family from risk → resilience → ___."

Health Threat

Health Deficit

Foreseeable Crisis

Family At Risk Nursing Problems (Maglaya Classification)