VI.

Central value of family concept

A. The family as a unit of care
We found that effects of illness in the family seemed to differ markedly by whether the ill
person was a dependent; our 8-year old patient with PDA is completely dependent to her
parents since the disease is congenital and was reported as most consuming than a spouse’s
illness or her normal sibling. There are no family members with the same condition as hers.
Everyone except our patient was reported healthy and can function normally.
The patient lives in an unilaterally extended family but economically independent in major
family needs. They are closely knit with good relationship to all family members up to third
degree. They are externally patriarchal and authority is based on seniority. The patient is taken
cared of most of the time by her mother together with her younger sibling. Their main source of
financial support for health related concern is from her father working as pedicab driver.

B. The family life cycle

The stages of the family life cycle are:
*Independence or unattached young adult
*Coupling or marriage
*Parenting, Family with young children
*Family with adolescent
*Launching adult children
*Retirement of senior years or Family on

The stress of daily living and coping with a chronic medical condition such as Patent Ductus
Arteriosus (PDA) including financial problems greatly affects in passing through the stages of
family cycle. Having this condition is giving her limits to her physical development. Due to her
condition, mild to moderate incapacitation where identified in cognition, movement, energy
level and physical function. With this ongoing crisis, patient will missed lifeskills and a longer
delay in her transition from independence to marriage.

C. The impact of illness on the family

While the “collateral” effects of health has been widely noted, Illness affects all family members
beyond the affected patient. Most notable in our interview is the bigger allocation of father’s
income to complete maintenance medications for our patient. This is widely affect the family’s
overall coverage to other non-health domains such as food, education and other needs by
having an ill relative. The father is a pedicab driver with a minimum income per day, this causes
spillover effects on his physical health such that he needs to work hard for his family’s needs.
The mother also had to physically transport the patient to school because it require physical
assistance to her daily function that are disabling.