Promoting Family

Health

LOGO

Dr. Samer Khader Alnawajha

Contents

Introduction & definitions

Attributes of families as a social system

Family structure

Family functions

Family life cycle

Introduction

❖The family as the unit of service has received

increasing emphasis in nursing over the years.
❖Today family nursing has an important place in
nursing practice, particularly in community health
nursing.
❖Its significance results from recognition that the
family itself must be a focus of service, that
family health and individual health strongly
influence each other, and that family health
affects community health.
▪
Definition of family

❖Consists of 2 or more individuals who share a

residence or live near one another, possess some
common emotional bond, engage in interrelated
social positions, roles and tasks, and share a
sense of affection and belonging.

❖As community health nurse, effectiveness

depends on knowing how to work with a family as
a unit of care.
Family functioning

❖ Is defined as those behaviors or activities by family

members that maintain the family and meet family needs,
individual member needs and society's views of family.

❖ Interdependence of family members involves a set of

internal relationships that influence the effectiveness of
family functioning.
Family health

❖Is concerned with how well the family functions

together as a unit.
❖It involves not only the health of each member
and how they relate to other members, but also
how well they relate to and cope with the
community outside the family.
❖ Family health, like individual health

❖ ranges along a continuum from wellness to

illness.

❖ A family may be at one point on that continuum

now and at a much different point 6 months
from now
Family health

Point in
time

Wellness
Continuum
Like individual
health
6 months

Illness
Family health
❖ refers to the health status of a given family at a
given point in time

❖ It includes all the attitudes, beliefs, knowledge,

and habits that families use to obtain, sustain, or
regain maximum health
 Universal characteristics of family

Several observations can be made about families

in general

❖ First: each family is unique, has own distinct problems and

strength.

❖ Second: every family shares some universal characteristics

with every other family.
 Universal characteristics of family

Five important family universals for CHN are:

1. Every family is a small social system
2. Every family has its own cultural values and roles.
3. Every family has structure.
4. Every family has certain basic functions.
5. Every family moves through stages in its life cycle.
Attributes of families as a social system

Maintain boundaries

Exchange energy
Families are A C with their
interdependent environment

Attributes
of families

Goal oriented E D Adaptive

Attributes of families as a social system

❖ Knowing the attributes of living systems or open

systems can help strengthen understanding of
family structure and function

1. Families are interdependent

Each members action affect the other member.
Example
❖ consider the changes a father might make to
reduce his risk of CAD.
❖ If he cuts back on working overtime, the family’s
income will be reduced.

❖ If he begins to eat different foods, food

preparation and eating patterns in the family will
be altered.
❖ If he starts a new exercise program three
evenings a week, this may upset other family
routines.
❖ Even his ability to carry out his usual roles as
husband and father may be affected if he has
less time to help his children with their
homework or share household chores with his
wife.
Attributes of families as a social system

2. Family boundaries
❖ Families as systems set and maintain boundaries that
include some people as members while excluding
others
❖ These boundaries, which result from shared experiences
and expectations, link family members together in a
bond that excludes the rest of the world.

❖ Also, a greater concentration of energy exists within

the family than between the family and its external
environment thereby creating a family system boundary.
Attributes of families as a social system

3. Exchange energy with their environment

❖ Family exchange materials or information with their
environment
❖ this serves to promote a healthy ecological balance
between the family system and the environment that is
its immediate community.

❖ A family’s successful progress through its

developmental stages depends on how well the
family manages this energy exchange.
For example
❖ A child-bearing family needs adequate food, shelter, and
emotional support, as well as information on how to
accomplish its developmental tasks.

❖ The family also needs community resources, such as

health care, education, and employment, all of which are
forms of environmental input.
❖ In return, the family contributes to the community by
working and by consuming goods and services.
Attributes of families as a social system

4. Adaptive behavior
❖ Families are adaptive, equilibrium-seeking systems
❖ Family never stay the same.
❖ They shift and change in response to internal and
external forces.

Internal change
❖ members adding or leaving through death or
divorce
❖ Roles and relationships change as members
advance in age and experience; normative
expectations change as members resolve their
tensions and differing points of view.
Attributes of families as a social system

External influence
❖ from sources such as school, work, peers, neighbors,
religion, and government consequently.
❖ Adapting to these influences may require a family to
change its behaviors, its goals, and even its values.
Like any system
❖ The family needs a state of quasi-equilibrium to
function
❖ With each new set of pressures, the family shifts
and accommodates to regain balance and maintain a
normal lifestyle.
Attributes of families as a social system

5. Goal directed behavior

❖ Families as social systems are goal directed.
❖ Families promotes the development of their
members.

A family must perform basic functions, such as

❖ Providing love, security, identity, a sense of
belonging; assisting with preparation for adult
roles in society; and maintaining order and
control.
❖ each family member engages in tasks to maintain
the family as a viable unit.
Family structure

Family culture
Is the acquired knowledge that family members
use to interpret their experience and to generate
behaviors that influence family structure and
function.
Three aspects of family culture deserve
special consideration

Aspect (3)

Aspect (2) A family's

Aspect (1) culture
Certain roles determines its
Family are distribution
members prescribed and use of
share certain and defined power
vales and for family
affect family members
behavior
Family structure:

❖Families come in many shapes and sizes.

❖ The varying family structures or compositions

comprise the characteristics of individuals
who make up a family unit (age, gender, and
number).
Family structure categories

Categories

Traditional Non traditional

families families
Are most familiar
to us and that are
They are not
most readily
traditionally
accepted by
socially acceptable
society
1. Traditional families

Traditional families

Types

Nuclear Single Multige-

Nuclear
family adult nerational
dyad
1. Traditional families

Traditional families

Types

Kin- Blended Single Commuter

network family parent
 1. Traditional families

❖ Nuclear family: husband, wife, and child. Living together in

the same household.
❖ Nuclear dyad family: consists of a husband and wife
living together who have no children or who have
grown children living outside the home.

❖ Single adult family: adult is living alone by choice or as a

result of separation from spouse and/or children.
❖ Multigenerational family: several generations or age groups
are living together in the same household.
1. Traditional families

❖ Kin-network family: several nuclear families live in the

same household, or near one another.
❖ Blended family: single parents marry and raise the
children from each of their previous relationship together.
❖ Single parent family: either father or mother caring for
a child or children as a result of temporary relationship or
legal separation.
❖ Commuter family: both parents in this family work, but
their jobs in different cities.
 2. Non traditional families

They are not traditionally socially acceptable such as:

❖ Unmarried single parents family → One parent (never

married) and children
❖ Cohabitating partners → 2 adults (heterosexual,
homosexual, or “just friends”)
❖ Commune family → Two or more monogamous
couples Sharing children
 2. Non traditional families

❖ Group marriage commune family → Several adults

“married’’ to each other Sharing childrearing

❖ Group net work family → Reciprocal nuclear

households or single members

❖ Homeless families → Any combination of family

members previously mentioned
 2. Non traditional families

❖ Foster family
✓ Husband and wife or single adult
✓ Natural children (possibly)
✓ Foster children

❖ Gangs family → Males and females usually of same

cultural or ethnic background
Implication for the community health
nurse

He/she must be prepared to

work with all types of families

Must realize that the family

structure may change over Implication
lifetime For CHN

Must realize that each family type

structure create different issues and
problems that, influence a family’s
ability to perform its basic functions.
Family functions

Family functions
every family has (6) basic functions which are essentials for
family health promotion.

1. Providing affection
▪ Give love and emotional support to the members
▪ Sharing of gifts during holiday
▪ Love for family members
▪ Continued affection creates an atmosphere of nurturance and
care for all family members, which is necessary for health,
development, and survival
Family functions

2. Providing security and acceptance

▪ Meet their members physical need (food, shelter, clothing
▪ Acceptance of individual members
▪ They can learn, make mistakes, and grow in a secure
environment.
▪ This contributes to their mental and emotional health and
equips them with the skills necessary to cope with the outside
world.
Family functions

3. Instilling identity and Satisfaction

▪ Like a mirror, the family reflects back to its members a
picture of who they are and how valuable they are to others.
▪ Positive reflections provide the individual with a sense of
satisfaction
▪ Needs fulfilment in the home determines satisfaction in the
outside world
▪ Roles learned within the family also give members a sense of
identity
Family functions

4. Promoting affiliation and companionship

▪ Development of communication pattern
▪ Establishment of durable bond not broken by distance, time…
ex. gathering during holiday, wedding …even when scattered.
▪ If communication patterns are effective, then affiliation ties are
strong and needs for belonging are met.
Family functions

5. Providing socialization
▪ Families transmit their culture—their values, attitudes,
goals, and behaviour patterns—to their members.
▪ children learn to control bodily functions, eat with utensils,
dress themselves, manage emotions, and behave according to
sociocultural prescriptions for their age and sex.
▪ Members also learn their roles in the family.
▪ Lifestyle, food preferences, relationships with other people,
ideas about child rearing, and attitudes about religion,
6. Establishing control
▪ Conduct of members is controlled by the family’s definition
of acceptable and unacceptable behaviours
▪ Children growing up in a family quickly learn what is “right”
and what is “wrong” by family standards.
▪ Families allocate various roles, responsibilities, and tasks to
their members to ensure the provision of income, household
management, child care, and other essentials
▪ Families also regulate the use of internal and external
resources.
▪ The family identifies and directs the use of internal resources,
such as member abilities, financial income, or material assets.
Family life cycle

Family life cycle:

There are (2) broad stages in the family cycle:
a. Expansion stage: as new members are added
and roles and relationships are increased.
b.Contraction stage: as family members leave to
start lives of their own, or age and die.
 Phases of family life cycle

1. Forming a partnership
Male partner

Female partner
1
Phases of family life cycle

2. Childbearing
Partner –father

Partner-mother

Infant child
Phases of family life cycle

3. Preschool-age
Partner father

Partner mother
3

Child, siblings
Phases of family life cycle

4. Pre-school-age
Partner –father

Partner-mother
4

Child, siblings
Phases of family life cycle

5. School-age
Partner father

Partner mother
5

Child, siblings
Phases of family life cycle

6. Launching center
Partner-father-
grandfather

Partner-mother-
grandmother
6

Child, siblings,
aunt or uncle
Phases of family life cycle

7. Middle-aged parents
Partner father
grandfather

Partner mother
grandmother
7
Phases of family life cycle

8. Aging family members

Partner-mother-
grandmother

Widow or
widower
8

Partner-father-
grandfather
 Samer K. Alnawajha
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