CONCEPT OF A PERSON AS

AN INDIVIDUAL AND AS A
MEMEBR OF FAMILY

EXZUR A. CHAVEZ RN
MAN-CHN
 CONTENT
1. Concept of a Family
2. Family Characteristics, structures and
functions
3. Stages of Family
4. Filipino Culture, Values and Practices in
relation to HC
• Family
Definition of Family
 Basic unit in society, and is shaped by all forces surround it.
o Values, beliefs, and customs of society influence the role and function of
the family (invades every aspect of the life of the family)
 Is a unit of interacting persons bound by ties of blood, marriage or adoption.
o Constitute a single household, interacts with each other in their respective
familial roles and create and maintain a common culture.
 An open and developing system of interacting personalities with structure and
process enacted in relationships among the individual members regulated by
resources and stressors and existing within the larger community (Smith &
Maurer, 1995)
 Two or more people who live in the same household (usually), share a common
emotional bond, and perform certain interrelated social tasks (Spradly &
Allender, 1996)
 An organization or social institution with continuity (past, present, and future). In
which there are certain behaviors in common that affect each other.
 The Filipino Family
 Based on the Philippine Constitution of the Republic of the Philippines – Article
XV, Family Code with focus on religious, legal, and cultural aspects of the
definition of family

• Section 1
• The state recognizes the Filipino
family as the foundation of the
nation. Accordingly, it shall
strengthen its solidarity and
actively promote its total
development
 The Filipino Family
 Based on the Philippine Constitution of the Republic of the Philippines – Article
XV, Family Code with focus on religious, legal, and cultural aspects of the
definition of family

• Section 2
Marriage, as an inviolable social
institution, is the foundation of
family and shall be protected by the
state.
 The Filipino Family
 Based on the Philippine Constitution of the Republic of the Philippines – Article
XV, Family Code with focus on religious, legal, and cultural aspects of the
definition of family
• Section 3
• The state shall defend –
1. The right of spouses to found a family in accordance
with their religious convictions and the demands of
responsible parenthood
2. The right of children to assistance including proper care
and nutrition, and special protection from all forms of
neglect, abuse, cruelty, exploitation and other conditions
prejudicial to their development
3. The right of the family to a family living wage income
4. The right of families or family associations to participate
in the planning and implementation of policies and
programs of that affect them
 The Filipino Family
 Based on the Philippine Constitution of the Republic of the Philippines – Article
XV, Family Code with focus on religious, legal, and cultural aspects of the
definition of family

• Section 4

 The family has the duty to care for its elderly members but
the state may also do so through just programs of social
security
 The Filipino Family and its Characteristics
• The basic social units of Philippine society are the nuclear family
1. Although the basic unit is the nuclear family, the influence of kinship is felt in
all segments of social organization.
2. Extensions of relationships and descent patterns are bilateral
3. Kinship circles is considerably greater because effective range often
includes the third cousin
4. Kin group is further enlarged by spiritual or ceremonial ties. Filipino
marriage is not an individual but a family affair
5. Obligation goes with this kinship system
6. Extended family has a profound effect on daily decisions
7. There is a great degree of equality between husband and wife
8. Children not only have to respect their parents and obey them, but also
have to learn to repress their repressive tendencies
9. The older siblings have something of authority of their parents.
 Types of Family
• There are many types of family. They change
overtime as a consequence of BIRTH, DEATH,
MIGRATION, SEPARATION and GROWTH OF
FAMILY MEMBERS
 Types of Family
A. Structure
B. Decisions in the family (Authority)
C. Decent (cultural norms, which
affiliate a person with a particular
group of kinsman for certain social
purposes)
D. Residence

According to Structure
NUCLEAR- a father, a mother with
child/children living together but
apart from both sets of parents
and other relatives.
. COMPOUND-one man/woman with
COHABITING/LIVE-IN-unmarried
couple living together
FOSTER- substitute family for
children whose parents are unable to
care for them
NON-KIN- a group of at least two
people sharing a relationship and
exchange support who have no legal
or blood tie to each other
Types of Family
EXTENDED- composed of two or SINGLE PARENT- divorced or
more nuclear families separated, unmarried or widowed
economically and socially related male or female with at least one
to each other. Multigenerational, child.
including married brothers and
sisters, and the families.
COMMUNAL-more than one
several spouses monogamous couple sharing
resources
DYAD—husband and wife or other GAY/LESBIAN-homosexual couple
couple living alone without children living together with or without children
BLENDED/RECONSTITUTED-a combination of two families with children
from both families and sometimes children of the newly married couple. It is
also a remarriage with children from previous marriage
 According to Decisions in the
family (Authority)
PATRIARCHAL – full authority on the
father or any male member of the
family e.g. eldest son, grandfather
EGALITARIAN- husband and wife
exercise a more or less amount of
authority, father and mother decides
AUTHOCRATIC-
MATRICENTRIC- the mother
decides/takes charge in absence of
the father (e.g. father is working
overseas)
Types of Family
MATRIARCHAL – full authority of the
mother or any female member of the
family, e.g. eldest sister, grandmother
DEMOCRATIC – everybody is involve
in decision making
LAISSEZ-FAIRE- “full autonomy
PATRICENTIC- the father decides/
takes charge in absence of the mother
 Types of Family
Decent (cultural norms, which affiliate a person with a particular group of
kinsman for certain social purposes)

PATRILINEAL – Affiliates a person with a group of relatives who are

related to him though his father

BILATERAL- both parents

MATRILINEAL – related through mother

 Types of Family
According to Residence

PATRILOCAL – family resides / stays with / near domicile of the parents

of the husband

MATRILOCAL – live near the domicile of the parents of the wife

 FUNCTIONAL TYPE:
FAMILY OF PROCREATION- refers to the family you
yourself created.

FAMILY OF ORIENTATION- refers to the family where you

came from.
 Nathan Ward Ackerman States that the Function of
Family are:

1. Transmitting the culture, thereby 2. Insuring the physical survival of

insuring man’s humanness the species
Physical functions of the family are met
through parents providing food, clothing
and shelter, protection against danger
provision for bodily repairs after fatigue or
illness, and through reproduction
Affectional function – the family is the
primary unit in which the child test his
emotional reactions
Social functions – include providing social
togetherness, fostering self esteem and a
personal identity tied to family identity,
providing opportunity for observing and
learning social and sexual roles, accepting
responsibility for behavior and supporting
individual creativity and initiative.
 Universal Function of the Family by
Doode
REPRODUCTION – for replacement of members of society: to perpetuate
the human species

STATUS PLACEMENT of individual in society

BIOLOGICAL and MAINTENANCE OF • Socialization and care of the

THE YOUNG and dependent children;
members • Social control
 The Family as a Unit of Care
Rationale for Considering the Family as a Unit of Care:
• The family is considered the natural and fundamental unit of
society
• The family as a group generates, prevents, tolerates and
corrects health problems within its membership
• The health problems of the family members are interlocking
• The family is the most frequent focus of health decisions and
action in personal care
• The family is an effective and available channel for much of
the effort of the health worker
 The Family as the Client
Characteristics of a Family as a Client

1. The family is a product of time and place-

2. The family develops its own lifestyle

3. The family operate as a group

4. The family accommodates the needs of the individual members.

5. The family relates to the community

6. The family has a growth cycle

The family is a product of time and place

1. A family who lived in the past is different from another family

who lives at present in many ways
2. A family is different from other family who lives in another
location in many ways
The family develops its own lifestyle

Develop its own patterns of behavior and its own style in

life.
Develops their own power system which either be:
Balance-the parents and children have their own
areas of decisions and control.
Strongly Bias- one member gains dominance over
the others.
The family operate as a group

A family is a unit in which the action of any member may set of a whole series
of reaction within a group, and entity whose inner strength may be its greatest
single supportive factor when one of its members is stricken with illness or
death.

The family accommodates the needs of the individual members.

An individual is unique human being who needs to assert his or herself in a way
that allows him to grow and develop.

Sometimes, individual needs and group needs seem to find a natural balance;
1. The need for self-expression does not over shadow consideration
for others.
2. Power is equitably distributed.
3. Independence is permitted to flourish.
The family relates to the community

Family develops a stance with respect to the community:

1. The relationship between the

families is wholesome and reciprocal;
the family utilizes the community
resources and in turn, contributes to
the improvement of the community.

2. There are families who feel a sense Families who maintain proud, “We
of isolation from the community. keep to ourselves” attitude.

Families who are entirely passive

taking the benefits from the community
without either contributing to it or
demanding changes to it
The family has a growth cycle

Families pass through predictable development stages (Duvall & Miller, 1990)
STAGES:
Stage 1: MARRIAGE & THE FAMILY
Involves merging of values brought into the
relationship from the families of orientation
Includes adjustments to each other’s
routines (sleeping, eating, chores, etc.),
sexual and economic aspects.
Members work to achieve 3 separate 1. Establish a mutually satisfying relationship
2. Learn to relate well to their families of
identifiable tasks:
orientation
3. If applicable, engage in reproductive life
planning

Stage 2: EARLY CHILDBEARING FAMILY 1. Birth or adoption of a first child which requires
economic and social role changes
2. Oldest child: 2-1/2 years
FAMILY WITH PRE-SCHOOL 1.This is a busy family because children at this
Stage 3: stage demand a great deal of time related to
CHILDREN 
growth and development needs and safety
considerations.
2. Oldest child: 2-1/2 to 6 years old
 FAMILY WITH SCHOOL AGE 1. Parents at this stage have important responsibility of
Stage 4: preparing their children to be able to function in a
CHILDREN
complex world while at the same time maintaining
their own satisfying marriage relationship.
2. Oldest child: 6-12 years old

FAMILY WITH ADOLESCENT 1. A family allows the adolescents more freedom and
Stage 5: prepare them for their own life as technology
CHILDREN 
advances-gap between generations increases
2. Oldest child: 12-20 years old

THE LAUNCHING CENTER 1. Stage when children leave to set their own
Stage 6: household-appears to represent the breaking of the
FAMILY  family
2. Empty nests

Stage 7: FAMILY OF MIDDLE YEARS  1. Family returns to two partners nuclear unit
2. Period from empty nest to retirement

Stage 8: FAMILY IN
RETIREMENT/OLDER AGE 

Stage 9: PERIOD FROM RETIREMENT

TO DEATH OF BOTH
SPOUSES 
 12 Behaviors Indicating a Well Family
Able to provide for physical emotional and spiritual needs of family members
Able to be sensitive to the needs of the family members
Able to communicate thought and feelings effectively
Able to provide support, security and encouragement
Able to initiate and maintain growth producing relationship
Maintain and create constructive and responsible community relationships
Able to grow with and through children
Ability to perform family roles flexibly
Able to help oneself and to accept help when appropriate
Demonstrate mutual respect for the individuality of family members
Ability to use a crisis experience as a means of growth
Demonstrate concern of family unity, loyalty and interfamily cooperation
 Family Health Task
• Health task differ in degrees from
family to family
• TASK- is a function, but with work or labor overtures
assigned or demanded of the person
• Duvall & Niller identified 8 task essential for a family to
function as a unit:
 Eight Family Tasks (Duvall & Niller

1. Physical maintenance- provides food shelter, clothing, and health care to its members being
certain that a family has ample resources to provide

2. Socialization of Family– involves preparation of children to live in the community and interact
with people outside the family.

3. Allocation of Resources- determines which family needs will be met and their order of priority.

4. Maintenance of Order– task includes opening an effective means of communication between

family members, integrating family values and enforcing common regulations for all family
members.

5. Division of Labor – who will fulfill certain roles e.g., family provider, home manager, children’s
caregiver

6. Reproduction, Recruitment, and Release of family member

7. Placement of members into larger society –consists of selecting community activities such as

church, school, politics that correlate with the family beliefs and values

8. Maintenance of motivation and morale– created when members serve as support people to
each other
 5 Family Health Tasks
(Maglaya, A., 2004)

1. Recognizing interruptions of health

development
2. Making decisions about seeking health care/ to
take action
3. Dealing effectively health and non-health
situations
4. Providing care to all members of the family
5. Maintaining a home environment conducive to
health maintenance
 Family Roles
Nurturing figure– primary caregiver to children or any dependent
member.
Provider – provides the family’s basic needs.
Decision maker– makes decisions particularly in areas such as
finance, resolution, of conflicts, use of leisure
time etc.
Problem-solver– resolves family problems to maintain unity and
solidarity.
Health manager– monitors the health and ensures that members
return to health appointments.
Gate keeper- Determines what information will be released
from the family or what new information can be
introduced.
 Theoretical Approaches to
Family Health Care
Family Models • the use of family model provides a perspective of focus for
understanding the family
• have categorized according to their basic focus as developmental,
interactional structural-functional, and systems model

Evelyn Duvall’ (1977) family developmental framework provides guide

to examine and analyze the basic changes and developmental tasks
common to most families during their life cycle. Although each family
Developmental Models has unique characteristics normative patterns of sequential
Duvall’s and Stevenson’s development are common to all families
Family development model
These stages and developmental tasks illustrate common family
behaviors that may be expected at specific times in the family life
cycle. The stages are marked by the age of the oldest child however
some overlapping occurs in families with several children.
Duvall’s developmental model is an excellent guide for assessing, analyzing and planning
around basic family tasks developmental stage, however, this model does not include the
family structure or physiological aspects, which should be considered for a
comprehensive view of the family. This model is applicable for nuclear families with
growing children and families who are experiencing health-related problems.

STAGES OF DEVELOPMENT BASIC FAMILY TASK

Beginning Families Early childbearing Physical maintenance
Families with preschoolers Allocation of resources
Families with school children Division of labor
Families with teen-agers Socialization of members
Launching center families Reproduction, recruitment and release
of Members
Middle-aged families Maintenance of order
Aging Families Placement of members in larger
community Maintenance of motivation
and morale
 Stevenson’s Family Developmental Model
Joanne Stevenson (1977) describes the basic tasks and responsibilities of
families in four stages.
•She views family tasks as maintaining a common household rearing children
and finding satisfying work and leisure. It also includes sustaining appropriate
health patterns and providing mutual support and acculturation of family
members.
•This model is useful for nuclear families because it examines psychosocial
patterns to specific stage of development, however, it also does not include
family structure, nor it addresses health promotion and health-related concerns
that the family may face.

 STAGES  HEALTH TASKS

 Couple strives for independence from their parents and to
Emerging family (from marriage for 7 to 10 years)
develop a sense of responsibility for family life.
 To assume responsibility for growth and development of
 Crystallizing family (with teenage children)
individual members and outside organizations
 Assumption of responsibility for “continued survival and
 Interacting family(children grown and small grandchildren)
enhancement of the nation.”
 Assume the responsibility for sharing the wisdom of age,
 Actualizing family (aging couple alone again)
reviewing life and putting affairs in order
 Structural- Functional Model
• Friedman’s Structural- Functional Family Model
• Was developed from sociological frameworks and systems theory by
Marilyn Friedman (1986)
• The family is the focus of this model as it interacts with supra-systems
in the community and with individual family members in the subsystem.
• Structural component examines the family unit, how it is organized and
how members relate to one another in terms of values, communication
network, role system and power while functional components refers to
the interaction outcomes resulting from family organizational structure.
• The structural-functional components and parts all intimately interrelate
and interact; the others affect each component and part.
• This model provides a broad framework for examining the interactions
among family and within the community. This incorporates physical,
psychosocial and cultural aspects of the family along with interacting
relationships.
• This model is very applicable to any type of family and their health-
related problems
 Friedman’s Family Model
Components
 STRUCTURAL
 FUNCTIONAL COMPONENTS
COMPONENTS
 Family composition  Affective

 Value systems  Physical necessities and care

 Communication patterns  Economic

 Role structure  Reproductive

 Socialization and social placement

 Power structure
Family coping
 Calgary’s Family Model
(system’s model)
• Is an integrated conceptual framework
of several theorists.
• Model is based on three major
categories: family structure, function
and development. Each is further
subdivided into parts that interacts with
others and changes the whole family
configuration.
https://www.youtube.com/watch?v=DETPP2l7tc0
 Family Apgar Questionnaire
(SMILKESTEIN, 1978)
 ALWAYS  SOMETIMES  HARDLY EVER
(2 PTS.) (1 pt.) (0 PT.)

 I am satisfied with the help I receive

from my family when something is
troubling me.
 I am satisfied with the way my family
discovers items of common interest and
shares problem-solving with me.
 I find that my family accepts my wishes
to take on new activities or make
changes in my lifestyle.
 I am satisfied with the way my family
expresses affection and responds to my
feelings such as anger, sorrow and love
 I am satisfied with the way my family
and I spend time together.

Scoring:
Check one of the three choices:
Total Score:
• 7-10 = suggests a highly functional family
• 4-6 = moderately dysfunctional family
• 0-3 = severely dysfunctional family
 Health as a Goal of Family
Health Care
HEALTH DEFICIT- this refers to conditions of health breakdowns or
advent of illness in the family
HEALTH THREAT- these are the conditions that make it more likely for
accidents, disease or failure to thrive or develop to
occur
FORESEEABLE CRISIS- these are anticipated periods of unusual demand
on the family in terms of time or resources
WELLNESS POTENTIAL- this refers to states of wellness and the likelihood
for health maintenance or improvement to occur
depending on the desire of the family
 Virtual Exercise:
• Mechanics:
• I will be mentioning different example
of situation, health status or incidence.
What you are going to do is to
determine whether it is HD,HT,FC or
WP on a group chat.
 Roles of Health Care Provider in
Family Health Care
• HEALTH MONITOR
• PROVIDER OF CARE
• COORDINATOR
• FACILITATOR
• TEACHER
• COUNSELOR
 Family Health Care Process
• DATA COLLECTION: METHODS AND
TOOLS
• DATA ANALYSIS or INTERPRETATION
• PLANNING
• IMPLEMENTATION
• EVALUATION PHASE
 ASSESSMENT PHASE
1. First major phase of nursing process in family health
nursing
2. Involves a set of action by which the nurse measures the
status of the family as a client. Its ability to maintain wellness ,
prevent, control or resolve problems in order to achieve health
and wellness among its members
3. Data about present condition or status of the family are
compared against the norms and standards of personal , social,
and environmental health, system integrity and ability to resolve
social problems.
4. The norms and standards are derived from values, beliefs,
principles, rules or expectation.
 TWO MAJOR TYPES

FIRST LEVEL a process whereby existing and

ASSESSMENT- potential health conditions or
problems of the family are
determined (WS, HT, HD, SP or
FC)
SECOND LEVEL defines the nature or type of
ASSESSMENT- nursing problem that family
encounters in performing health
task with respect to given health
condition or problem and etiology
or barriers to the family’s
assumption of the task
 DATA COLLECTION METHODS:
SELECT APPROPRIATE METHOD
OBSERVATION Done through use of sensory capacities

The nurse gathers information about the family’s

state of being and behavioral responses
The family’s health status can be inferred from the a. communication and interaction
s/sx of problem areas patterns expected ,used, and
tolerated by family members
b. role perception / task
assumption by each member
including decision making patterns
c. conditions in the home and
environment
PHYSICAL significant data about the health status of
EXAMINATION individual members can be obtained through
direct examination through IPPA, Measurement of
specific body parts and reviewing the body
systems
data gathered from P.A form substantive part of
first level assessment which may indicate
presence of health deficits (illness state )
INTERVIEW Productivity of interview process depends
upon the use effective communication
techniques to elicit needed response
PROBLEMS ENCOUNTERED:
How to ascertain where the client is in
terms of perception of health condition or
problems and the patterns of coping utilized
to resolve them
Tendency of community health worker to
readily give out advice, health teachings or
solutions once they have identified the
health condition or problems.

Provisions of models for phrasing interview

questions utilization of deliberately chosen
communication techniques for an adequate
nursing assessment.

Confidence in the use of communication

skills

Being familiar with and being competent in

the use of type of question that aim to
explore, validate, clarify, offer feedback,
encourage verbalization of thought and
feelings and offer needed support or
reassurance.
TYPES completing health history of each family member Health history determines current
health status based on
significant PAST HEALTH
HISTOI\RY e.g. developmental
accomplishment, known illnesses,
allergies, restorative treatment,
residence in endemic areas for
certain diseases or sources of
communicable diseases.

FAMILY HISTORY e.g. genetic

history in relation to health and
illness.

SOCIAL HISTORY e.g. intra-personal

and inter-personal factors affecting
the family member social adjustment
or vulnerability to stress and crisis

Collecting data by personally asking significant family

members or relatives questions regarding health, family life
experiences and home environment to generate data on
what wellness condition and health problem exist in the
family ( first level assessment) and the corresponding
nursing problems for each health condition or problem ( 2nd
level assessment)
RECORDS REVIEW Gather information through reviewing
existing records and reports pertinent
to the client

Individual clinical records of the

family members, laboratory and
diagnostic reports, immunization
records reports about home and
environmental conditions

LABORATORY/ DIAGNOSTIC TEST

ANALYZE DATA TO IDENTIFY CRITERIA FOR ANALYSIS:

NEEDS AND PROBLEMS

PROCESS FOR ANALYSIS • SORTING OF DATA

• CLUSTERING OF RELATED
CUES
• DISTINGUISHING RELEVANT
FROM IRRELEVANT CUES
• IDENTIFYING PATTERNS
• COMPARING PATTERNS
• INTERPRETING RESULTS OF
COMPARISON
• MAKING INFERENCES AND
DRAWING CONCLUSIONS
 Health Needs and Problems
of the Family
• A situation which interferes with the promotion
and / or maintenance of health
• It is a health problem when it stated as the
family’s failure to perform adequately specific
health task to enhance the wellness state or
manage a health problem