CHN-FAMILY TYPE

DEFINITION OF FAMILY

WHAT IS FAMILY? 

  • Basic unit in society , and is shaped by all forces that surround it.


VALUES, BELIEFS, AND CUSTOMS OF SOCIETY 

  • influence the role and function of the family (invades every aspect of the life of the family).


TYPES OF FAMILY IN THE COMMUNITY 

WHAT IS NUCLEAR FAMILY?

  • consist of father,mother and children 


WHAT IS EXTENDED?

  • consist of father, mother, children and other relatives.


WHAT IS SINGLE- PARENT?

  • SINGLE with children


WHAT IS BINUCLEAR/BLENDED/ RECONSTITUTED?

  • Extended family consisting of 2 or more separate households from separate households from separated or divorced parents with children.


WHAT IS STEP FAMILY?

  • REMARRIAGE of a widowed person with children 


WHAT IS A COMPOUND FAMILY?

  • one man/woman with several spouses


WHAT IS A COHABITING FAMILY?

  • Lived-in unmarried couple


WHAT IS A DYAD FAMILY?

  • Husband and wife without children 


WHAT IS A HOMOSEXUAL FAMILY?

  • Female- female,male to male, gay, lesbian without or with children.


WHAT IS A COMMUNAL FAMILY?

  • E.g .bahay-ampunan, home for the aged, kumbento


WHAT IS NO-KIN?

  • Have no legal or blood tie to each other.         

FUNCTIONAL FAMILY TYPES

WHAT IS FAMILY OF PROCREATION?

  • refers to the family you yourself created.


WHAT IS FAMILY ORIENTATION?

  • refers to the family where you came from.


FAMILY TYPE BASED ON WHO MAKE DECISIONS(AUTHORITY)

WHAT IS PATRIARCHAL?

  • Full authority on father or any male member of the family ,e.g. eldest son,grandfather.


WHAT IS MATRIARCHAL?

  • Full authority on mother or any female member of the family e.g eldest sister, grandmother.


WHAT IS EGALITARIAN?

  • Husband and wife exercise a more or less amount of authority, father and mother decides


WHAT IS DEMOCRATIC?

  • Everybody is involved in decision making


WHAT IS AUTOCRATIC?

  • refers to a rigid parenting style also known as the authoritarian style. 


WHAT IS LAISSEZ - FAIRE?

  • Full authority


MATRICENTRIC 

  • The mother decides/ takes authority in absence of the father (e.g father is working overseas)


PATRICENTRIC

  • The father decides/takes over in absence of the mother








FAMILY TYPES BASED ON DECENT 

  • CULTURAL NORMS,which affiliate a person with a particular group of kinsman of certain social purposes


WHAT IS PATRILINEAL?

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


WHAT IS BILATERAL?

  • Both parents

WHAT IS MATRILINEAL?

  • Related through mother

WHAT IS PATRILOCAL?

  • Family resides/ stays with/ near domicile of the parents of the husband 

WHAT IS MATRILOCAL?

  • Live near the domicile of the parents wife



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.



12 BEHAVIORS INDICATING A WELL FAMILY

  •  Able to provide for physical ,emotional and spiritual.

  • Able to be sensitive to the needs of the family members.

  • Able to communicate thoughts and feelings effectively.

  •  Able to provide support , security and encouragement.

  • Able to initiate and maintain growth producing relationship

  • Maintain and create constructive and responsible community relationships.

5 FAMILY HEALTH TASKS (Maglaya, A., 2004)

  • Recognizing interruptions of health development 

  • Making decisions about seeking health care/ to take action 

  • Dealing effectively in health and non-health situations.

  • Maintaining a home environment conducive to health maintenance. 


FAMILY APGAR QUESTIONNAIRE (Smilkstein,1978)

  • It is a tool that qualitatively measures family functioning.

  • It is a 10 to 15 -minute paper and pencil technique that elicits the patient’s perception and level of satisfaction on the current state of her family members relationships 

( Smilkstein,1978) 

  • This 5-item questionnaire serves as a rapid screening instrument for family dysfunction.


FAMILY APGAR QUESTIONNAIRE (Smilkstein,1978)


A

ADAPTATION

The capability of the family to utilize and share inherent resources.

P

PARTNERSHIP

Measures the satisfaction attained in solving problems by communication.

G

GROWTH

Refers to the freedom to change both physical and emotional growth.

A

AFFECTION

It is the intimacy and emotional interaction in the family .

R

RESOLVE

The members are satisfied with the commitment made by other members of the family.


FAMILY APGAR QUESTIONNAIRE (Smilkstein,1978)


WHEN TO USE APGAR?

  • When the family will be directly involved in caring for the patient.

  • When treating a new patient in order to get info to serve as a general view of family function.

  • When treating a patient whose family is in crisis.

  • When a patient's behavior makes you suspect a psychosocial problem due to family dysfunction.




FAMILY APGAR QUESTIONNAIRE (Smilkstein,1978)

SCORING:

Check one of the three choices:

Total Score: 

  • 7-10 = suggest a highly functional family

  • 4-5 = moderately dysfunctional family

  •  0-3 = severely dysfunctional family


FAMILY HEALTH NURSING PROCESS


  • A systematic approach of solving an existing problem/ meeting the needs of family.


  • R apport

  • A assessment

  • P lanning 

  • I ntervention

  • E valuation


  1. RAPPORT

  • Trust building

  • Knowing your client

  • Adjusting to the situation and environment

  • RESPECT


  1. ASSESSMENT

  •  First major phase of nursing process

  • Involves a set of actions 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 the 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 expectations.


II. ASSESSMENT

Data collection methods: select appropriate method


OBSERVATION

  •  The family’s health status can be inferred from the s/sx of problems 

  • A. COMMUNICATION AND INTERACTION PATTERNS 

ASSESSMENT

  • Expected ,used,and tolerated by family members

  •  B. ROLE PERCEPTION /TASK ASSUMPTION 

  • Each member including decision patterns

  • C. CONDITIONS IN THE HOME AND ENVIRONMENT


PHYSICAL EXAMINATION

  • Significant data about the health status of individual members can be obtained by direct examination through IPPA.

  • MEASUREMENT OF SPECIFIC BODY PARTS AND REVIEWING THE BODY SYSTEMS. 

  • Data gathered from p.e form substantive part of first level assessment which may indicate presence of health deficits (illness started).




INTERVIEW

  • PRODUCTIVITY OF INTERVIEW PROCESS DEPENDS UPON THE USE EFFECTIVE COMMUNICATION TECHNIQUES TO ELICIT NEEDED RESPONSE problems encountered


RECORDS REVIEW (e.g laboratory or diagnostic tests)

  • Gather information through reviewing records AND REPORTS PERTINENT TO THE CHN.

  • Individual clinical records of the family members , laboratory and diagnostic records immunization records report about environmental conditions.

QUESTIONNAIRE /INTERVIEW

  • Mostly patronized & used in CHN

  • See the ATTACHED DYCI FAMILY SURVEY


II. ASSESSMENT

TYPOLOGY OF NURSING PROBLEMS

  • FIRST LEVEL ASSESSMENT 

  • TO DETERMINE PROBLEMS OF FAMILY 

  • Sources of problems using IDB

  • Family :use of Initial Data Base (IDB)

  • Nature ; Health Deficit (HD), Health Threat (HT),Foreseeable Crisis (FC) 


  • 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.


INITIAL DATA BASE FOR FAMILY NURSING PRACTICE 

  •   FAMILY STRUCTURE,CHARACTERISTICS, AND DYNAMICS

  • Family structure and characteristics

  • Socio-economic and cultural factors 

  • hOme and environmental factors 

  • Health assessment of each member

  • Value placed on prevention of disease





INITIAL DATA BASE FOR FAMILY NURSING PRACTICE 

  •   FAMILY STRUCTURE,CHARACTERISTICS, AND DYNAMICS

  • MEMBERS of the household and relationships to the head of the family 

  • Demographic data- age,sex,civil status , position in the family 

  • Place of residence of each member - whether living with the family or elsewhere


INITIAL DATA BASE FOR FAMILY NURSING PRACTICE 

  •   FAMILY STRUCTURE,CHARACTERISTICS, AND DYNAMICS

  • Type of family structure - e.g matriarchal or patriarchal , nuclear or extended

  • Dominant family members in terms of decision- making , especially in matters of health care 

  • General family relationship/dynamics - presence of any readily observable conflict between members; characteristics communication patterns among members.



INITIAL DATA BASE FOR FAMILY NURSING PRACTICE 

  • Socio-economic and cultural characteristics

  • Income and expenses

  • occupation , place of work and income of each working members 

  • Adequacy to meet basic necessities

  • Who makes decisions about money and how it spent 

  • Educational attainment of each other 

  • Ethnic background and religious affiliation 

  • Significant others- role(s) they play in family life

  • Relationship of the family to larger community- nature and extent of participation  of the family in community activities.