NCM 104 2M - The Arts and Science of Family and Community Health Nursing

1. The individual

2. The family

3. The population groups (aggregates)

4. The community

LEVELS OF CLIENTELE IN COMMUNITY AND PUBLIC HEALTH NURSING

Family

is a group of persons usually living together and composed of the head and the other persons related to the head by blood, marriage, or adoption.

Family

Social unit interacting with the larger society.

Family

characterized by people together

because of birth, marriage, adoption,

or choice.

Family

is composed of two or more persons who are joined together by bonds of sharing and emotional closeness and who identify themselves as being part of the it

Family Nursing

is the practice of nursing directed towards maximizing the health and well-being of all individuals within a family system.

Family Forms

are patterns of people considered by family members to be included in the family.

Family Structure

Made up of individuals and the roles

they play.

Gender awareness

The awareness of the difference in rules and relations between women and men it recognizes that the life experience expectation and needs of women and men are different.

Gender

It is a concept of maleness or femaleness of an individual; it does not focus on the anatomical structure or the physical outlook

-Nuclear Family

-Dyad Family

-Extended Family

-Blended Family

-Compound family

-Cohabiting family

-Single parent

-The gay or lesbian family

TYPES OF FAMILIES

Nuclear Family

defined as the family of marriage, parenthood, or procreation; composed of husband, wife, and their immediate children (natural, adopted, or both)

Dyad Family

consisting of only husband and wife, such as newly married couples and "empty nesters."

Extended Family

consisting of three generations, which may include married siblings and their

families and/or grandparents

Blended Family

which results from a union where on or both spouses bring a child or children from a previous marriage into a new living arrangement.

Compound family

where a man has more than one spouse;

Cohabiting family

which is commonly described as "live-in" arrangement between unmarried couple who are called common-law spouses and their child or children from such an arrangement.

Single parent

which results from the death of a spouse, separation, or pregnancy outside of wedlock

The gay or lesbian family

is made up of a cohabiting couple of

the same sex in a sexual relationship

-Traditional Family

-Two-career Family

-Adolescent family

-Foster family

-Intragenerational family

TYPES OF FAMILIES IN TODAY'S

SOCIETY

Traditional Family

also is a nuclear family

Two-career Family

both mother and father focuses more on their career than that of their offspring.

Adolescent family

Teen parent/Immature parenting

Foster family

Determine who has legal responsibility to sign for health care for the child

Intragenerational family

The chains of relationships between aging parents, adult children and grandchildren

-Patrilineal

-Bilateral

-Matrilineal

TYPES OF FAMILY ACCORDING TO

DESCENT

Patrilineal

affiliates a person with a group of relatives who are related to him through his father

Bilateral

both parents a system of family lineage in which the relatives on the mother's side and father's side are equally important for emotional ties or for transfer of property or wealth.

It is a family arrangement where descent and inheritance are passed equally through both parents

Matrilineal

Related through the mother.

-Patrilocal

-Matrilocal

TYPES OF FAMILY ACCORDING TO

LOCATION OF 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.

-Patriarchal family

-Matriarchal family

-Modern Democratic family

-Autocratic family

-Laissez-Faire

-Matricentric

-Patricentric

TYPES OF FAMILY ACCORDING TO DEGREE OF AUTHORITY

Patriarchal family

authority is exercised by the father and descent is traced through him.

Matriarchal family

members of the family live together under the authority of the mother through her.

Modern Democratic family

everybody is involved in decision making.

Autocratic family

right, strict manners of parenting. Children are not allowed to talk back. Parents are the team player.

Laissez-Faire

Full autonomy. Parents do not mind what the children are doing. Everyone has the power to do whatever they want to do. Everyone is independent.

Matricentric

the mother decides/takes charge in absence of the father.

Patricentric

the father decides/takes charge in absence of the mother.

1. Procreation.

2. Socialization of family members.

3. Status placement.

4. Economic function.

FUNCTIONS OF THE FAMILY

Rural Family

is a unit of production where the whole family works as a team, participating in farming, fishing, or cottage industries.

Urban Family

is more of a unit of consumption where economically productive members work separately to earn salaries or wages.

1. Physical maintenance.

2. Welfare and protection.

The family meets the needs of the

individuals through:

-Recognizing interruptions of health or development.

-Seeking health care.

-Managing health and non-health crises.

-Providing nursing care for the sick, disabled, or dependent members of the family.

-Maintaining a home environment conducive to

good health and personal development.

-Maintaining a reciprocal relationship with the

community and its health institutions.

FAMILY HEALTH TASKS

-Family Flexibility

-Family Resiliency

-Family Hardiness (Durability)

ATTRIBUTES TO A HEALTHY FAMILY

Family Flexibility

Being able to adapt the way you

think and communicate with those

around you.

You are not isolated on your own

thinking and you don't just stick to

that kind you're able to open up for

suggestions on those around you.

Family Resiliency

The ability to withstand and rebound

from crisis and adversity

Since family is a group or a unit they

stand together and be able to face

such adversity

Family Hardiness (Durability)

Family's ability to work together

cohesively, combating stressors and

finding solutions to problems.

1. Marriage: joining of families

2. Families with young children

3. Families with adolescents

4. Families as launching centers

5. Aging families

STAGES OF THE FAMILY LIFE CYCLE

Marriage: joining of families

a. Formation of identity as a

couple

b. Inclusion of spouse

realignment of relationships

with extended families.

c. Parenthood; making

decisions

Families with young children

a. Integration of children into

family unit.

b. Adjustment of tasks; child

rearing, financial, and

household.

c. Accommodation of new

parenting and grand

parenting roles.

Families with adolescents

a. Development of increasing

autonomy for adolescents

b. Midlife reexamination of

marital and career issues

c. Initial shift towards concern

for older generation

Families as launching centers

a. Establishment of

independent identities for

parents and grown children.

b. Renegotiation of marital

relationship

c. Readjustment of

relationships to include in-

laws and grandchildren.

d. Dealing with disabilities and

death of older generation

Aging families

a. Maintaining couple and

individual functioning while

adapting to the aging

process

b. Support role of the middle

generation

c. Support and autonomy of the

older generation

d. Preparation for own death

and dealing with the loss of

spouse and/or siblings and

other peers.

Roles

a pattern of behavior that

goes with a certain position.

-Biology (Sex)

-Gender role

-Gender identity

GENDER SENSITIVITY ISSUES (Three interactive parts)

E.O. 209; Family code of the Philippines

Marriage, legal separation,

rights and obligations

between husband and wife,

property relations between

husband and wife.

Responsible Parenthood and

Reproductive Health Act of 2012 R.A.

10354

The state shall protect and promote

the right to the health of women

especially mothers in particular and

of the people in general and instill

health consciousness among them.

Protects the children and the mother

Father

Acknowledge as head of the family

Commands full authority in the

family

Mother

Considered as the light of the house

or "ilaw ng tahanan."

Responsible in all housekeeping

activities, taking care of the children,

planning of meals and budgeting

family income.

Eldest

Helps the mother

Middle

Assumes the roles of the

eldest

Youngest

Most loved, always gets the

special treatment

The general systems theory

(Minuchin and von Bertalanffy)

a way to explain how the family as a unit interacts with larger units outside the family and with smaller units inside the family

Genogram

A tool that helps the nurse outline the family's structure. It is a way to diagram the family.

Family health tree

Provides a mechanism for recording the family's medical and health histories.

Ecomap

Used to depict a family's linkages to its suprasystems.

Family interviewing

Medium for providing family intervention.

Family Coping Index

this tool is based on the premise that

nursing action may help a family

in providing for a health need or

resolving a health problem

promoting the family's coping

capacity.

NANDA (North American

Nursing Diagnosis

Association)

serves as a common framework of

expressing human responses to

actual and potential health problems.

Observation

data gathering method that uses sensory capacities

Physical Examination

Utilizes inspection, palpation, percussion, auscultation, measurement of the specific body part and reviewing of the body systems.

Interview

Completing the health history (determines the current health status based on the significant past health history)

First-Level Assessment

Process whereby existing and potential health conditions or problems are categorized

Wellness state/s

physical, mental and social well-being. Readiness and willingness

Health threat

risk factors; possibilities that could lead to illness

Health deficit

health breakdown, deviation from normal to abnormal, either diagnosed or undiagnosed

Stress points / foreseeable crisis

expected problem. Anticipated periods of unusual demand on the individual or family in terms of adjustment/family resources.

Second Level of Assessment

The nature or type of nursing problem that the family encounters in performing the health tasks with respect to a given health condition or problem, and the etiology or barriers to the family's assumption of these task

-Priority Setting

-Establishing goals and objectives

-Determining appropriate interventions

FORMULATING PLAN OF CARE

Priority Setting

The determining sequence in

dealing with identified family needs and problems. This is necessary because the nurse cannot possible deal with all identified family needs all at once.

Family safety

A life-threatening situation is given top priority

Family perception

given to the need that the family recognizes as most urgent and/or important

Practicality

Together with the family, the nurse looks into existing resources and constraints.

Projected effects

the immediate resolution of a family concern gives the family a sense of

accomplishment and confidence in

themselves and the nurse.

goal

is a desired observable family response to planned interventions in response to a mutually identified family need.

Objectives

define the desired step-by-step family

responses as they work toward a goal.

Specific

Measureable

Attainable

Relevant

Time-bound

S.M.A.R.T.

Supplemental interventions

are actions that the nurse performs on

behalf of the family when it is unable to do things for itself, such as providing direct nursing care to a sick or disabled family member

Facilitative interventions

refer to actions that remove barriers to appropriate health action, such as assisting the family to avail of maternal and early child care services.

Developmental interventions

aims to improve the capacity of the family to provide for its own health needs, such as guiding the family to make responsible health decisions. This type of intervention is directed towards family empowerment.

Implementation

is the step when the family and or the nurse execute the plan of action

Apathy

may be a manifestation of the family's feelings of hopelessness and powerlessness

Indecision

may result in the family allowing events to just happen

Imposing ideas

keeps the family from taking responsibility for decision making and appropriate action.

Negative labeling

the nurse may label the family as stubborn (Matigas ang ulo) if it is unable to comply with the instructions.

Overlooking family strengths

usually results from the tendency of the nurse to focus on family problems and weaknesses.

Neglecting cultural and gender implications of family interventions

the nurse when he/she fails to consider this, may risk making the plan unacceptable to the family.

Evaluation

is determining the value of nursing care that has been given to a family.