Nursing Care of The Community: Edna R. Javier RN Man Faculty, College of Nursing

Nursing Care of the Community
EDNA R. JAVIER RN MAN

FACULTY, COLLEGE OF NURSING
Objectives
Upon completion of this chapter, the student will

be able to :
1. State a definition of family.
2. Identify characteristics of the family that have
implications for community health nursing
practice.
3. Define family nursing.
4. Utilize the nursing process in the care of
individuals within the family and the care of the
family as a whole.
Definitions of a Family
• “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. It includes both the nuclear and
extended family”.
–National Statistical Coordination Board, 2008
• “A family is 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”.
–Friedman, Bowden and Jones, 2003
Definitions of a Family (continued)
• The community health nurse interacts with

communities made up of many types of
families.
• When faced with great diversity in the

community, the community health nurse must
formulate a personal definition of family and
be aware of the changing definition of family
held by other disciplines, professionals, and
family groups.
CHARACTERISTICS OF HEALTHY FAMILIES
Members interact Flexible role

with each other relationships
Establish Teaches family &

priorities societal values
Affirm, Have sense

support & of play &
respect each humor
other
CHARACTERISTICS OF HEALTHY FAMILIES
Foster responsibility & value

service to other
Ability to cope with stress

& crisis
TYPES OF FAMILY STRUCTURES
TYPES OF FAMILY STRUCTURES
TYPES OF FAMILY STRUCTURE
TYPES OF FAMILY STRUCTURE
Family Forms: DYAD
• consisting only of husband and wife,

such as newly married couples and
“empty nesters”
Family Forms: COMPOUND FAMILY
• a man has more than one spouse

• approved by Philippine authorities only
among Muslims by virtue of Presidential
Decree No. 1083
• also known as the Code of Muslim
Personal Laws of the Philippines (Office of
the President, 1977);
Family Forms: COHABITING FAMILY
• described as a “live-in” arrangement

between an unmarried couple who are
called common-law spouses and their child
or children from such an arrangement
Family Forms: Gay or Lesbian Family
made up of a cohabiting couple of the

same sex who have a sexual relationship.
The homosexual family may or may not

have children
same-sex marriage is not legally

acceptable
FAMILY CODE
• E.O. No. 209

• states that marriage is a special contract of
permanent union between a man and a
woman entered into in accordance with law
for the establishment of conjugal and family
life
FUNCTIONS OF FAMILY
Family as a Client
• Community health nursing has long viewed

the family as an important unit of health
care, with awareness that the individual can
be best understood within the social
context of the family.
• Observing and inquiring about family

interaction enables the nurse in the
community to assess the influence of family
members on each other.
Stages and Tasks of the Family Life Cycle
I. Marriage: joining of families

– a. Formation of identity as a couple
– b. Inclusion of spouse in realignment of
relationships with extended families
– c. Parenthood: making decisions
II. Families with young children

– a. Formation of identity as a couple
– b. Inclusion of spouse in realignment of
relationships with extended families
– c. Parenthood: making decisions
(continued)
III. Families with adolescents
– a. Development of increasing autonomy for adolescents
– b. Midlife reexamination of marital and career issues
– c. Initial shift toward concern for the older generation
IV. 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
(continued)
V. Aging families
– a. Maintenance of couple and individual functioning
while adapting to the aging process
– b. Support role of middle generation
– c. Support and autonomy of older generation
– d. Preparation for own death and dealing with the
loss of spouse and/or siblings and other peers
Family Health Tasks
(from Friedman and Heinrich, 1981)
1. Recognizing interruptions of health or

development.
2. Seeking health care.
3. Managing health and non-health crises.
4. Providing nursing care to sick, disabled or
dependent members of the family.
5. Maintaining a home environment conducive
to good health and personal development.
6. Maintaining a reciprocal relationship with the
community and its health institutions.
Family Data
• Family Health Tree: Based on the genogram, the

family health tree provides a mechanism for
recording the family's medical and health
histories .
– Causes of death of deceased family members
– Genetically linked diseases
– Environmental and occupational diseases
– Psychosocial problem
– Infectious diseases
– Familial risk factors from health problems
– Risk factors associated with the family's methods of
illness prevention (eg: pap smears and immunizations)
– Lifestyle-related risk factors
Family Data
• Ecomap: Tool that is used to depict a family's

linkages to other systems.
– The important nurturant or conflict-laden
connections between the family and the world.
– The flow of resources, or the lacks and
deprivations.
– The nature of the interfaces and points to conflicts
to be mediated, bridges to be built, and resources
to be sought and mobilized.

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Nursing Care of the Community

EDNA R. JAVIER RN MAN

Upon completion of this chapter, the student will

• “The family is a group of persons usually living

• “A family is two or more persons who are joined

• The community health nurse interacts with

• When faced with great diversity in the

Members interact Flexible role

Establish Teaches family &

Affirm, Have sense

Foster responsibility & value

Ability to cope with stress

• consisting only of husband and wife,

• a man has more than one spouse

• described as a “live-in” arrangement

made up of a cohabiting couple of the

The homosexual family may or may not

same-sex marriage is not legally

• E.O. No. 209

• Community health nursing has long viewed

• Observing and inquiring about family

I. Marriage: joining of families

II. Families with young children

IV. Families as launching centers

1. Recognizing interruptions of health or

• Family Health Tree: Based on the genogram, the

• Ecomap: Tool that is used to depict a family's

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