Unit 8

Family health
• Definition of family and its types, functions
• Family health nursing
 Definition of family
• The family involves people who are related in
a traditional or non traditional sense by
marriage, blood, adoption or friendship.
Jarris L (1985)
• “A group of two or more persons related by
birth, marriage or adoption and residing
together in a household”.
US Bureau of census (1980)
• A group of individuals bounded together by
the common interest of the members.
Hymovic.
• A family is a group of individuals bonded
together by the common interests of its
member.
• “Family is represented by two or more
individuals, belongings to the same or different
connection groups, who are involved in a
continuous living arrangement, usually residing in
the same household, experiencing common,
emotional bonds and sharing certain obligations
towards each other and towards others.
Stanhope, Lancaster 1992.
 Types of Family

• On the basis of structure

• On the basis of authority
• On the basis of residence
• On the basis of marriage
 On the basis of structure

• Single /Nuclear Family:

consist of husband, wife and
perhaps one or more children.

• Joint /Extended family:

consists of number of married couple
and their children.
• Single parent:
• either one parent living with his/her children without
other relatives or other parents.
• This can be either a father or a mother who is singly
responsible for the raising of a child. The child can be
by birth or adoption. They may be a single parent by
choice or by life circumstances.
• Blended or reconstituted family:
• The blended or reconstituted family (also called the
step family) arises when adults remarry & bring
together their children from previous marriages.
• Social contract family & cohabitation:
– It involves an unmarried couple living together & sharing
roles & responsibilities.
• Homosexual family:
• A family group made up of a same-sex couple. form family
units. Many of these family structures consist of either
natural children from a heterosexual relationship) or
adopted or foster children.
• Adoptive family:
• A family unit with adopted children. A fammily where one
or more of the children has been adopted.
• Foster family:
– Foster family allows for the care, supervision &
nurturing of children whose parents are unable to
care for them. The length of stay in the foster
home may be temporary & depends on the
individual circumstances. A family where one or
more of the children is legally a temporary
member of the household.
• Co-custody family:
– An arrangement where divorced parents both have legal
responsibility for their children. May live alternative with
their parents or regular visit.
• Conditionally separated families:
•Separated from the rest of the family due to employment,
hospitalization etc.
•Gay or Lesbian family:
•Where one or both parents sexual orientation is gay or
lesbian. This may be two parent, adoptive, single parent or
extended family.
•Migrant family:
•A family that moves regularly to places where they have
employment.
 On the basis of authority

• Patriarchal family:
– The head of the family is father.

• Matriarchal family:
– The head of the family is mother.
 On the basis of residence

• Matrilocal family:
– husband goes to wife's house.

• Patrilocal family:
– wife goes to husband's house.
 On the basis of marriage

• Monogamous family:
– husband & wife.

• Polygamous family:
– family with one husband & many wives.

• Polyandrous family:
– family with one wife and many husbands
 Concept of family
• Biological
• Psychological
• Economical
• Sociological
• Systems theory
• Biological
– Based on biological functions of the family.
“Collective enterprise based on relationships
defined by birth and marriage.”
• Psychological
– Concerned with family relationship and
prevention of mental illness. Basic unit of growth
experience and adaption , health and illness.
• Economical
– Family works together to meet their material
needs.
• Sociological
– How family as group functions socially using the
group process and dynamics and how the family
as a group relates to the larger society.
• Systems theory
– Applicable for community health nursing with the
focus on external and internal relationships and
dynamics.
 Characteristics of Family:-
• Every family is a small social system.
• Every family has its own cultural values and
rules.
• Every family has its own structure.
• Every family performs certain basic function.
• Every family moves through stages of life
cycle.
 Healthy families are characterized
by:-
• A sense of togetherness that promotes
capacity to change.
• A balance between mutual and independent
action on the part of family members.
• Nurturance and resources for growth and
provisions.
• Mastery of developmental task leading to
interdependence and ability to meet demands
for survival and development.
 Functions of the family:-
• The functions of family system are tied to the
needs of its members as assessed by the family
and larger society.
( Padreck, Yuen, Daley and Hawkins, 1998)
• Residence or housing
• Division of labor
• Reproduction
• Socialization
• Economic control
• Protection/ Social care
• Residence or housing:
– Provide a clean and decent residence to its
members.

• Division of labor:
– Assigns roles and responsibilities and the duties to
all of its members accordingly to their age, sex or
work performance
• Reproduction
– Children are reproduced in order to continue the
races.
• Socialization
– Family functions in the key role in the socialization
of its members by teaching the values of society
and transmitting culture, values, norms, beliefs,
general codes of conduct from one generation to
another.
• Economic control
– Inheritance of the property and the ownership
and or control of certain kinds of property like
farm, shop etc are handed from generation to
generation
• Protection/ Social care
– Family provides social care by giving status to its
family members in the society, protecting its
members from insult, defamation etc regulating
marital activities of its members.
• Generating affection:-
– Affection is generated between spouses, between
parents and children and among member of
generations.
• Providing personal security and acceptance:-
– The family provides a home base with the stability
that allows the family members to develop
naturally in their own way and their own pace.
• Giving satisfaction and sense of purpose:-
– In the family setting the family members enjoy life
with each other through satisfying activities.
• Ensuring continuity of companionship:-
– In most cases family associations that provide
sympathetic companionship and encouragement
can be expected to endure.
• Providing social placement and socialization:-
– The family serves as the transmitter of culture
from one generation to the next and prepares
family members for their place in social hierarchy.
• Imposing control and sense of what is right:-
– Within the family ,members first learn the rules,
rights, obligations and responsibilities,
characteristics of human Societies.
 The health related functions and task
of the family are:-
• Provision of adequate food, shelter, and clothing.
• Maintenance of health-supporting physical home
environment.
• Maintenance of health-supporting psychosocial
environment.
• Provision of resources for maintenance of
personal hygiene.
• Provision for meeting spiritual needs.
• Health Education.
• Health promotion.
• Health and illness decision making.
• Recognition of health disruption.
• Seeking health care, illness care and dental care.
• First aid.
• Supervision of medications.
• Illness care.
• Rehabilitation care.
• Involvement with community’s health.
 Family Health:-

• A state of positive interaction between

members which enables each member of the
family to enjoy optimum physical, mental
social and spiritual well being not just the
absence of disease or deformity, when there is
a healthy interaction among family members,
society gets healthy individuals.
• Healthy members in a society are a good sign
of national prosperity.
 Family Health Nursing

• level of community health nursing practice

directed or focused on the family as the unit of
care, with health as the goal and nursing as the
medium, channel or provider of care.
• It is concerned with the total health of an
individual, family and community.
• There is no limitation in delivery care i.e.
irrespective of age, sex, ethnic group and type of
disease, due to care is provided within his/her
capacity.
 Objectives of Family Health Care

• Identifies and appraises health problems of the

family.
• Ensures family’s understanding and acceptance of
the problem.
• Provides nursing services according to health
needs of the family.
• Helps to develop the competence in the
members to take care of their family as and when
required and to find out remedial measures to
solve health problems.
• Contributes desired materials to personal and
social development of the family members.
• Helps to promote the utilizing of available
resources to maintain all aspects of health of
the family.
• Provides health education
 Principles of family Health care:-

• In providing care to the family, we have to follow

following principles:-
• Establishing good professional relationship with
the family.
• Proper health education and guidance should be
provided to family to take care of themselves
according to their needs, intelligently.
• Gather all relevant information about family to
identify problems and set priorities.
• Provide need based support and services to the
family to improve their health status.
• Health care services should be provided to the
family irrespective of sex, age, income, religion
etc.
• Duplication of health services should be avoided
and there is need to coordinate services with
other disciplines providing health services.
• Proper health messages to be communicated to
family in every contact.
• Nursing process: - It has traditionally been
defined as a systematic method for assessing
health status, diagnosing health care needs,
formulating a plan of care, initiating plan and
evaluating the effectiveness of plan. The use
of nursing in providing individualized cure
requires the nurse to rely on scientific
knowledge to make clinical nursing judgment
and set priorities.
• Phase of nursing process:-
• The nursing process consist of 5 sequential
and interrelated phase.
• Assessment phase
• Diagnosis phase
• Planning phase
• Implementation phase
• Evaluation phase
• 1. Assessment phase: - This phase includes the collection and analysis of factual information relevant to the client’s status, his capacity to solve
health problems and his environment. In family nursing practice, there are 3 sources of data that reflect the family’s health status as a functing unit.
• The first source is the health status of family members. The second source of data is the family’s status as a functioning unit expected to promote
wellness among it members. The last source of data is the family environment, home and community.
• 2. Diagnosis Phase:-The term refers to a nursing diagnosis in a judgement about individual, family or community responses to actual and potential
health problems and life processes. During this phase, collected data are critically analysed and the interpreted. Analyses of data taken from first
source reflect deviations in health development of individual. Analyses of data taken from second source reflect the nature and extent of the family’s
performance of specific health tasks to meet physical, social and emotional needs of its members. Analyses of data taken from last source help define
the conditions in the home and environment that interfere with the promotion and or maintenance of health and recovery from illness.
• 3. Planning phase:-It is a systematic approach in developing a plan of action based on a careful assessment .In the planning phase of nursing process,
the strategies are developed to prevent, minimized or correct the problems identified in the nursing diagnosis. It consists of several steps including
establishing priorities, setting objectives, writing interventions, recording diagnosis and outcomes of nursing interventions in an organized way to
complete the nursing care plan.
• 4. Implementation:-With the nursing assessment reflecting what the family is experiencing and why, the intervention phase commenceses.During
this phase the nurse formulates the goals, objectives and the nursing actions which hopefully will help the family overcome the obstacles to healthy
functioning. After making out this blueprint of the nursing care, the nurse carries out the plan utilizing her own resources, those of the family, and
the resources available in the community.
• 5. Evaluation:-As each nurse family action is implemented to achieve the stated goals and objectives, the evaluation phase is done to demonstrate
whether or not the intended results did occur. The nurse assesses the progress of the client in corrective measures if required and revise the nursing
care plan. Evaluation can be done on the basis of 3 boarder lines i.e. physical condition, psychological status and knowledge.