Family Health

1. Miss Najwa Subuh

2. Family Health Miss Najwa Subuh

3. Assessment of Families Family functioning is those behaviors or activities by familymembers that maintain the family & meet family needs, individualmember needs, and society’s views of family. Family healthis concerned with how well the family functions together as a unit. It involves not only the health of the members and how they relate to other members, but also how well they relate to and cope with the community outside the family. In fact, family health, like individual health, ranges along a continuum from wellness to illness. Miss Najwa Subuh

4. Family Health Practice Guidance • Family nursingis a kind of nursing practice in which the family is the unit of service It isn’t merely a family-oriented approach in which family concerns that affect the health of an individual are taken into account. • Family nursing asks how one provides health care to a collection of people. Miss Najwa Subuh

5. Universal Characteristics of Families 1. Every family is a small social system. 2. Every family has its own cultural values & rules. 3. Every family has structure. 4. Every family has certain basic functions. 5. Every family moves through stages in its life cycle Miss Najwa Subuh

6. FAMILY CULTURE • Birth, or adoption, whose central purpose is to create and maintain a common culture which promotes the physical, mental, emotional, and social development of each of its members • Is the acquired knowledge that family members use to interpret their experiences and to generate behaviors that influence family structure and function Miss Najwa Subuh

7. It arises from a significant body of literature in the social and behavioral sciences; • Each family has a “culture” that strongly influences its structure and function. Culture explains why families behave as they do • Aspects of family culture deserve: (1) family members share certain values that affect family behavior; (2) certain roles are prescribed and defined for family members; (3) a family’s culture determines its distribution and use of power. Miss Najwa Subuh

8. Family structuresor compositions comprise the collective characteristics of individuals who make up a family unit (age, gender, & number). • A growing body of research on family structure & function shows that families have changed dramatically since the nuclear family was the dominant form. Family structures fall into two general categories: traditional & nontraditional Miss Najwa Subuh

9. Implications for the CHN First, CHN can no longer hold to a myth that idealizes the traditional nuclear family. They must be prepared to work with all types of families and accept them as valid. Miss Najwa Subuh

10. Second, the structure of an individual’s family may change several times over a lifetime. A girl may be born into a kin-network, shift to a nuclear family when her parents move, and become part of a single-parent family when her parents are divorced. Finally, each type of family structure creates different issues and problems that, in turn, influence a family’s ability to perform basic functions. Each particular structure determines the kind of support needed from nursing or other human service systems Miss Najwa Subuh

11. FAMILY FUNCTIONS • providing affection, • providing security, • instilling identity, • promoting affiliation, (5) providing socialization, (6) establishing controls Miss Najwa Subuh

12. FAMILY LIFE CYCLE • There are two broad stages in the family life cycle: one of expansionas new members are added and roles and relationshipsare increased, & one of contractionas family membersleave to start lives of their own or age &die. Miss Najwa Subuh

13. Stage 1: Married couples(without children)Stage 2: Childbearing families(birth-30months) Stage 3: Families with pre-school children(2 1/2-6years) Stage 4: Families with schoolchildren( 6-13 years) Stage 5: Families with teenagers(13-20 years) Stage 6: Families as launching centers(first child gone to last child leaving home) Stage 7: Middle-age parents(“empty nest” to retirement) Stage 8: Aging family members(retirement to death of both spouses Miss Najwa Subuh

14. Characteristics of Healthy Family 1. A facilitative process of interaction exists among family members. 2. Individual member development is enhanced. 3. Role relationships are structured effectively. 4. Active attempts are made to cope with problems. 5. There is a healthy home environment & lifestyle 6. Regular links with the broader community are established Miss Najwa Subuh

15. Legitimate source of authority that is supported and consistent over time, • Stable and consistent system of rules, • Consistent and regular nurturing behaviors, • Effective child-rearing practices, • Stable and well-maintained marriages, • Set of agreed-upon goals toward which the family and individuals work, • Sufficient flexibility to change in the face of both expected and unexpected stressors. Miss Najwa Subuh

16. Causes of unhealthy family: (1) a knowledge deficit regarding community resources, (2) previous negative experiences with community services, (3) a lack of connection with the community because of family expectations or cultural practices. Miss Najwa Subuh

17. It is important for the community health nurse to assess the family’s relationship with the broader community, in addition to structural and developmental variations, interaction, coping strategies, and lifestyle. • With a comprehensive family assessment, the nurse has a base from which to begin a plan of care. Miss Najwa Subuh

18. Role of the Family Health Nurse • Help individuals and families to cope with illness and chronic disability, or during times of stress, by spending a large part of their time working in patients homes and with their families. • Give advice on lifestyle & behavioral risk factors, as well as assisting families with matters concerning health. • Identify the effects of socioeconomic factors on a family's health & refer them to the appropriate agency. Miss Najwa Subuh

19. Facilitate the early discharge of people from hospital by providing nursing care at home, & they can act as the lynchpin between the family and the family health physician • The four major types of intervention by Family Health Nurses is primary, secondary and tertiary prevention, and crisis intervention/direct care. At the level of primary prevention, they assess the possible presence of harmful stressors or threats to health and work pro-actively to prevent these from impinging on the family. Miss Najwa Subuh

20. Help the family build up their resources by providing health education and support, & by assisting them to mobilize other resources, monitoring the integrity of the system pro-actively by identifying potentially harmful stressors. • At the level of secondary prevention, they may become actively involved in screening and vaccination programs, they will detect the onset of health problems at an early stage, prompting quick action to minimize disruption of the individual and the family and calling on other relevant expert resource personnel as necessary. Miss Najwa Subuh

21. In tertiary prevention, they are involved in rehabilitation & rebuilding the family's resources. • The fourth mode of intervention, the provision of direct care, is the traditional role of the nurse when the family's or individual's coping mechanism has been breached, for example by illness. Miss Najwa Subuh

22. Principles guide and enhance family nursing practice • work with the family collectively, • start where the family is, • adapt nursing intervention to the family’s stage of development, • recognize the validity of family structural variations, • emphasize family strengths Miss Najwa Subuh

23. Emphasize Family Strengths • CHN tend to focus their attention on family weaknesses, looking for & referring to them as needs or problems. • This negative emphasis can be devastating to a family and can undermine any hope of a truly therapeutic relationship between nurse and client. • Instead, families need their strengths reinforced. Emphasizing a family’s strengths makes people feel better about themselves. It fosters a positive self-image, promotes self-confidence, and often helps the family address other problems. Miss Najwa Subuh

24. FAMILY HEALTH ASSESSMENT Tools used to assess family’s level of health: • a conceptual framework on which to base the assessment, • a clearly defined set of assessment categories for data collection, • a method for measuring a family’s level of functioning. Miss Najwa Subuh

25. Conceptual Frameworks • A conceptual framework is a set of concepts integrated into a meaningful explanation that helps one interpret human behavior or situations. • Three frameworks that are: the interactional, structural- functional, and developmental frameworks. Miss Najwa Subuh

26. The interactional framework describes the family as a unit of interacting personalities and emphasizes communication, roles, conflict, coping patterns, & decision-making processes. • This framework focuses on internal relationships but neglects the family’s interactions with the external environment Miss Najwa Subuh

27. The structural-functional framework describes the family as a social system relating to other social systems in the external environment, such as church, school, work, and the health care system. • This framework examines the interacting functions of society and the family, considers family structure, and analyzes how a family’s structure affects its function. Miss Najwa Subuh

28. The developmental framework studies families from a life-cycle perspective by examining members’ changing roles and tasks in each progressive life-cycle stage. • This framework incorporates elements from interactional and structural-functional approaches so that family structure, function, and interaction are viewed in the context of the environment at each stage of family development. Miss Najwa Subuh

29. Data Collection Categories • family strengths and self-care capabilities, • family stresses and problems, • family resources. • Family demographics 2. Physical environment;geography, climate, housing, space, social & political structures, food availability & dietary patterns, and any other elements in the internal or external physical environment that influence a family’s health status. Miss Najwa Subuh

30. 3. Psychological and spiritual environment; affectional relationships, mutual respect, support, promotion of members’ self-esteem and spiritual development 4. Family structure & roles; family organization, socialization processes, division of labor, and allocation and use of authority and power. 5. Family functions; family’s ability to carry out appropriate developmental tasks & provide for members’ needs Miss Najwa Subuh

31. 6. Family values and beliefs; raising children, education, work, religion, making & spending money, health 7. Family communication patterns 8. Family decision-making patterns 9. Family problem-solving patterns Miss Najwa Subuh

32. 10. Family coping patterns; how a family handles conflict & life changes, the nature & quality of family support systems 11. Family health behavior; familial health history, current physical health status of family members, family use of health resources, and health beliefs. 12. Family social & cultural patternscomprise family discipline and limit-setting practices; promotion of initiative, creativity, and leadership; cultural adaptations to present circumstances Miss Najwa Subuh

33. The genogram • The genogram displays family information graphically in a way that provides a quick view of complex family patterns. • Usually three or more generations and significant life events are included (e.g., birth, death, marriage, divorce, illness). • Identifying characteristics (e.g., race, religion, social class), occupations, & places of family residence are also noted. Again, this tool is used jointly with the family. Miss Najwa Subuh

34. HEALTH ASSESSMENT Guidelines assessment of family health : 1. Focus on the family as a total unit. 2. Ask goal-directed questions. 3. Collect data over time. 4. Combine quantitative and qualitative data. 5. Exercise professional judgment. Miss Najwa Subuh

35. Nursing Process Components • Assessing, planning, implementing, and evaluating nursing care are steps used to deliver care to clients in acute care settings and in the extensive clinic system. These same steps are used with families & aggregates in CHN. Miss Najwa Subuh

36. Assessment of Home Environmental • Conditions in the neighborhood and home environments. While traveling to and arriving at the family home, you have been gathering information about resources & barriers encountered by the family. • It is important to remember that neighborhood conditions and even the physical appearance of the apartment or house may belie the family’s values, resources, and goals. Miss Najwa Subuh

37. Planning to Meet the Health Needs of Families During Home Visits • The greatest barrier to a successful family health visit is a lack of planning and preparation. A visit is not successful just because the nurse enters a home or other setting where clients are present. • A successful family health visit takes much planning and preparation & requires accurate documentation and follow-up. • In addition, safety measures must be followed, not only while traveling in the neighborhood, but also in the home. Miss Najwa Subuh

38. Implementing Plans for Promoting the Health of Families Miss Najwa Subuh

39. Assessing, Teaching,& Referring • Assessing family health may be done informally through observation and occasional questioning. • Specific questions may be asked of each family member, and such information as health data and family history may be included. Physical data such as height, whg, P, Temp, & BP are recorded on an assessment tool. • With young children, specific assessment questionnaires\tests are meeting G&D tasks. (DDST). Miss Najwa Subuh

40. Characteristics of Healthy families 1. A facilitative process of interaction exists among family members. 2. Individual member development is enhanced. 3. Role relationships are structured effectively. 4. Active attempts are made to cope with problems. 5. There is a healthy home environment and lifestyle. 6. Regular links with the broader community are established Miss Najwa Subuh

41. Empowering Families • The ultimate goal is to assist the family in becoming independent of your services. This is accomplished by the approach used in conducting the visit. • Four thoughts will help to clarify working relationship with families: • The family functioned in a manner that worked for them before you ever met them. • If you ever feel obliged to do something for a family, consider who did this before you were available. • Find family strengths even in the most deprived family situation. • If you were in a similar situation, would you manage, cope, or function as well as the members of this family? Miss Najwa Subuh

42. Evaluating Implemented Family Health Plans • The evaluation process leads to a reassessment of your work with the family & a determination of what is needed in preparation for the next visit. • Evaluation of the structure- process of the visit & your self-evaluation can be done informally in a reflective manner. Outcomes are documented in the client record, and the evaluation becomes formalized. • A thorough evaluation also assists you in making the most appropriate referrals Miss Najwa Subuh

43. Miss Najwa Subuh

44. Families in Crisis • Facing Violence from Within and Outside the Family • Family crisisis a stressful and disruptive event (or series of events) that comes with or without warning and disturbs the equilibrium of the family. A family crisis can also result when usual problem-solving methods fail. Miss Najwa Subuh

45. Developmental Crises • People feel threatened by the demands placed on them and have difficulty making the changes necessary to fit the new stage of development. • During the process of normal bio-psychosocial growth, people go through a succession of life cycle stages, from birth through old age. • Transitions from one stage to the next require changes in roles and behavior. Miss Najwa Subuh

46. Developmental crises arise from both physical and social changes. Each new life stage confronts people with changed relationships, responsibilities, and roles. • The transition to parenthood, for example, demands a change in role from caring for oneself and one’s mate to include nurturing, caring for, and protecting a completely helpless infant. Relationships with adults, children, and even one’s own parents also change. Miss Najwa Subuh

47. Situational Crises • Is a stressful, disruptive, event arising from external circumstances that occurs suddenly, often without warning, to a person, group, aggregate, or community. • CHN see an almost infinite variety of situational crises, including debilitating disease, economic misfortune, unemployment, physical abuse, divorce, unwanted pregnancy, sudden death of a loved one. Miss Najwa Subuh

48. Family Violence Against Children • As a cause of morbidity among children, communicable diseases “are coming under control through a combination of health promotion, prevention and simplified standard treatment regimens. • But at the same time, the healthy G&D of many children is threatened by very rapid, often disruptive social, cultural and economic changes” Miss Najwa Subuh

49. Major Differences between developmental crisis and situational crisis Miss Najwa Subuh

50. Miss Najwa Subuh