FAMILY STRUCTURES
” Feeling a
How well a family works together when times are good and
how well it can organize itself against potential threats
depends on both its structure (who its members are) and its
function (the activities or roles family members carry out).
Recognizing different family structures can help you better
focus on family-centered care as well as provide a family-
friendly environment for health care.
FAMILY
- U.S. Census Bureau (USCB, 2010) as “a group of
people related by blood, marriage, or adoption living
together.”
- Allender (2013) defines the family in a much broader
context as “two or more people who live in the same
household (usually), share a common emotional bond,
and perform certain interrelated social tasks.”
Family Types
What type of family a person belongs to changes over time as
a family is affected by birth, death, possibly divorce, and the
growth of family members.
For the purposes of assessing families, two basic family types
can be described:
• Family of orientation (the family one is born into; or
oneself, mother, father, and siblings, if any)
• Family of procreation (a family one establishes; or
oneself, spouse or significant other, and children, if any)
The Dyad Family
- 2 people living together without children.
- usually refers to single young adults who live together in
shared apartments or dormitories for companionship and
financial security while completing school or beginning
a career
- generally viewed as temporary arrangements, but this
could extend into a lifetime arrangement
• Positive aspects: Companionship, possibly shared
resources
• Potential negative aspects: Often a short-term
arrangement so can result in a sense of loss when the
relationship ends
The Cohabitation Family
- composed of couples, perhaps with children, who live
together but remain unmarried
- Although such a relationship may be temporary, it may
also be as long-lasting and as meaningful as a more
traditional alliance.
- Many couples choose cohabitation as a way of getting to
know a potential life partner before marriage because of
the hope this will make their eventual marriage stronger.
- Statistically, however, couples who cohabit before
marriage have a higher divorce rate than those who do
not.
- This probably happens because cohabitation couples
enter the union thinking, “If this living arrangement
doesn’t work, I can leave with no trouble.
union can be easily broken this way may influence the
couple not to work at the relationship. That is a contrast
to married couples who theoretically enter a union with
an “until death do I part” philosophy, prompting them to
work (sometimes very hard) to make a marriage last.
- Long-term cohabitation unions of this type are growing
in number because of the pressure to adhere to a
monogamous relationship to avoid contracting sexually
transmitted infections, the advantage of shared incomes,
and widespread acceptance of cohabitation by society
• Positive aspects: Companionship, possibly financial
security; encourages a monogamous relationship
• Potential negative aspects: As with dyad families, may
result in a feeling of loss if only short term and the breakup
isn’t desired by both partners
The Nuclear Family
- composed of a husband, wife, and children
- In the past, it was the most common family structure
seen worldwide.
- The biggest advantage of a nuclear family is its ability to
provide support to family members because, with its
small size, people know each other well and can feel
genuine affection and support for and from each other.
• Positive aspects: Support for family members; sense of
security
• Possible negative aspects: May lack support people in a
- crisis situation
The Polygamous Family
- polygamy (a marriage with multiple wives or husbands)
has been illegal in the United States since 1978, such
families are not an unusual arrangement worldwide, so
new immigrants may report they have been raised in this
type of family (or may still be living in this
arrangement).
- This category can be further divided into
o polygyny (a family with 1 man & several wives)
o polyandry (1 wife with >1 husband)
• Positive aspects: Companionship; shared resources
• Possible negative aspects: Not sanctioned by law;
disapproval by community; decreased value of women
The Extended (Multigenerational) Family
- includes not only a nuclear family but also other family
members such as grandmothers, grandfathers, aunts,
uncles, cousins, and grandchildren
- advantage; contains more people to serve as resources
during crises and provides more role models for behavior
or values (Keene, Prokos, & Held, 2012)
- In a typical extended family, however, there is usually
only one main income provider, a situation which can
strain the family’s resources, and to include all family
members in shared decisions may be difficult. When
assessing such families, remember that, because many
members are present, a parent’s strongest support person
may not be their spouse, and a child’s primary caregiver
may not be his or her biologic parent. The grandmother,
 an aunt, or another sibling, for example, may provide the
largest amount of support or child care, so may be the
person best prepared to talk about a child’s health.
Helping the family maintain meaningful communication
between all members is an important nursing
responsibility (Box 2.3).
• Positive aspects: Many people for child care and member
support
• Possible negative aspects: Resources may be stretched thin
because of few wage earners

SOURCE:
Pillitteri, A. (2014). Maternal & child health nursing, care of the
child bearing & childrearing family (7th ed.).