• The family is a group of persons usually living together and composed of the head and other persons related to the head by blood, marriage, or adoption. (National Statistical Coordination Board, NSCB 2008)

• The family is a social unit interacting with the larger society. (Johnson, 2000)

• A family is characterized by people together because of birth, marriage, adoption or choice. (Allen et al., 2000)

• A family is a two or more persons who are joined together by bonds of sharing and emotional closeness and who identify themselves as being part of the family. (Freidman et al., 2003)

Types of Family

1. Nuclear Family

   • husband, wife, and their immediate children natural, adopted or both

2. Dyad Family

   • husband and wife

3. Extended Family

   • consist of three generations

   • married sibling, or grandparents

4. Blended Family

   • one or both spouses brings a child or children from previous marriage into one living arrangement

5. Compound Family

   • where a man has more than one spouse

6. Cohabiting Family

   • live-in arrangement between an unmarried couple

7. Single Parent

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

8. The Gay or Lesbian Family

   • cohabiting couple of the same sex

Functions

1. PROCREATION

   • Despite the changing forms of the family, it has remained the universally accepted institution for reproductive functions and child rearing.

2. SOCIALIZATION OF FAMILY MEMBERS

   • Socialization is the process of learning how to become productive members of society.

   • It involves transmission of the culture of a social group.

3. STATUS PLACEMENT

   • Society is characterized by a hierarchy of its members into social classes.

   • The family confers it’s societal rank on the children. Depending on the degree of social mobility in a society, the family and the children’s future families may move from one social class to another

4. ECONOMIC FUNCTION

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

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

5. PHYSICAL MAINTENANCE

   • The family provides for the survival need (food, shelter, and clothing) of its dependent members, like young children and the aged.

6. WELFARE AND PROTECTION

   • The family supports spouses or partners by providing for companionship and meeting affective, sexual, and socioeconomic needs.

   • By developing a sense of love and belonging, the family gives the children emotional gratification and psychological security.

Why it is Important for Nurses to Work with Families

1. The family is a critical resource

2. Improving Nursing Core

3. dysfunctions that affects one or more family members will affect the members and unit as a whole

4. “Case finding”

1. Family as a Client

   • Community health nursing has long viewed the family as an important unit of healthcare, with awareness that the individual can be best understood within the social context of the family

2. Family as a System

   • General System Theory - It is way to explain how the family as a unit interacts with larger units outside the family and with smaller units inside the family.

   • Three Subsystem of Family (Parke 2002)

     • Parent-Child Subsystem

     • Marital Subsystem

     • Sibling-sibling Subsystem

3. Heads of the Family

   • Head of the family refers to as head of the house holds and the person who provides for and supervises a family

   • Matriarchal - the familyhead is Mother

   • Patriarchal - the family.head is Father

Developmental Stages of the Family

Family Life Cycle

1. Beginning family through marriage or commitment as a couple relationship

2. Parenting the first child

3. Living with adolescent(s)

4. Launching family (youngest child leaves home)

5. Middleaged family (remaining marital dyad to retirement)

6. Aging family (from retirement to death of both spouses)

Stages and Tasks of Family Cycle

1. Marriage: Joining of Families

   • Formation of identity as a couple

   • Inclusion of spouse in realignment of relationships with extended families

   • Parenthood: making decisions

2. Families with young Children

   • Integration of children into family unit

   • Adjustment of tasks: child rearing, financial and household

   • Accommodation of new parenting and grandparenting roles

3. Families with Adolescents

   • Development of increasing autonomy for adolescents

   • Midlife reexamination of marital and career issues

   • Initial shift towards concern for the older generation

4. Families as Launching Centers

   • Establishment of independent identities for parents and grown children

   • Renegotiations of marital relationship

   • Readjustment of relationships to include in-laws and grandchildren

   • Dealing with disabilities and death of older generation

5. Aging Families

   • Maintaining couple and individual functioning while adapting to the aging process

   • Support role of middle generation

   • Support and autonomy of older generation

   • Preparation for own death and dealing with loss of spouse and/or siblings and other peers

Family Health Tasks

Health Tasks according to Freeman and Heinrich (1981)

• Recognizing interruptions of health or development.

• Seeking health care.

• Managing health and nonhealthy crisis. The family’s ability to cope with crisis and develop from its experience is an indicator of a healthy family.

• Providing nursing care to sick, disabled or dependent family members of the family

• Maintaining a home environment conducive to good health and personal development. The home should also have an atmosphere of security and comfort to allow for psychosocial development.

• Maintaining a reciprocal relationship with the community and it’s health institutions.

Characteristic of a Healthy Family

1. Members Interact

2. Establish Priorities

3. Affirm, Support, and Respect Each Other

4. Flexible Role Relationships

5. Family Teaches Family

6. The Ability to Cope With Stress and Crisis

7. A Sense of Play and Humor

8. Foster Responsibility and Value Service to Others

Traditional Filipino Family Values and Traits

1. Paggalang (Respect)

   • to give respect to a person.

   • Filipinos are accustomed to using the words “po,” “opo,” and “ho” when they are conversing with older people or, sometimes, with those who are in a high role or a prestigious member of society. Using these words is customary in the Philippines, and it shows a sign of respect if you do so

2. Pakikisama (Helping Others)

   • connotation of getting along with people in general.

   • Therefore, this trait usually fosters general cooperation and performing good or helpful deeds, which can lead to others viewing you in a favorable light.

3. Utang na Loob (Debt of Gratitude)

   • Utang na Loob means to pay your debt with gratitude.

   • With utang na loob, there is usually a system of obligation.

   • Repay the favors done to them by their elders.

4. Pagpapahalaga sa Pamily (Prioritizing Family)

   • putting importance on your family.

   • This implies that a person will place a high regard on their family and prioritize that before anything else.

5. Hiya (Shame)

   • This controls the social behaviors and interactions of a Filipino.

   • It is the value that drives a Filipino be obedient and respectful to their parents, older siblings, and other authorities.

Traditional Health Care Practices in the Philippines

1. Hilot (Healing)

   • Hilot or massage makes use of the most popular and useful herbs: tanglad, lagundi, sambong and more native plants that have healing and therapeutic properties

   • Types of Manghihilot

     • Comadrona – expert in post-natal massage.

     • Acupressurist – aligns nerves and balances electrical energy.

     • Reflexologist – drains excess energy.

     • Herbalist – uses herbal in healing

2. Cupping Therapy (Bentosa)

   • a form of alternative medication that uses “cups” on the skin to create suction.

   • This suction is trusted to help in mobilizing blood flow and promote the healing of a broad range of medical ailments