Family as a unit of

care – now more

than ever

dr. Nur Afrainin Syah, M.Med.Ed, PhD, SpDLP

Fakultas Kedokteran Universitas Andalas

With Courtesy to Prof Zorayda Leopando

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 Trigger questions

•What are the activities you do together

as a family to maintain/ promote health?
•How frequent do you visit your doctor
for health and wellness?
ROAD MAP OF SESSION

• The Family and its

function
• Family as a system
• Family as a unit of
health care
• Classification of
families
THE FAMILY AND
ITS FUNCTION
The family …
• small social system
• individuals related to each other
• comprising a permanent
household that persist over years
 Functions of Family
• Reproduction With other institutions
• Biological •Economics
maintenance •Citizenship and
• Socialization political behavior
• Welfare and •Religion
protection •Education

Diminished functions in modern times :

political, religious, status placement
 Family structure
• Nuclear
• Extended
• Single parent family
• Blended
• Communal/ corporate
FAMILY AS A SYSTEM
 System

• an entity composed of discrete

parts which are connected in such
a way that a change in one part
results in changes in all of the
other parts. Allan Dionisio, 2013
 Family Systems Theory

• Parts or CHANGE🡪
members •Circularity
• a change in one
part results in •Equilibrium
changes in all
parts. •Homeostasis
 Structures of Family Dynamics

• Rules of behavior

• Boundaries – subgroup

• Roles played by different members

• Coalition and power structures

 Implications to family physician

• recognizes the pivotal role of the family in

the healing process
• Power structure in health decision making
• Rules on Medical Issues
• Medical Roles🡪 Hierarchy
• Neutrality in the midst of coalition
• Homeostasis and equilibrium vs
compliance issues
FAMILY AS A UNIT OF
HEALTH CARE
 The family and health

Social context of illness

And recovery

Culture and Lifestyle

religion Diseases

Family Interventions
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 The family in health
• Primary social agent in promotion of health
and well being

• Primary source of health beliefs/ related

behaviors, stress and emotional support

• Family oriented approach 🡪most effective

and efficient way to prevent disease and
promote health
What does health mean to your family?
Physical

Health
&
Well Being
Mental Social

and not merely the absence

of disease or infirmity
WHO Constitution
 Family participation in prevention
Levels of Participation of family
prevention
Primary * Common lifestyle
prevention * Health maintenance
* Family life education
Secondary * Monitoring of well-being
prevention * Encouraging consultation
* Compliance monitoring
•Prevention of transmission of communicable
disease
Tertiary Chronic conditions
prevention •Balanced support between compliance
monitoring & appropriate independent
activity
* Adjustment of all members to changes
* Coping with crisis created by serious illness
CLASSIFICATION OF
FAMILY
Classification of Family
• Healthy Family
• Family at Risk
• Family with Problem
Characteristics of healthy family
• Open to change
• High self worth
• Functional defenses
• Clear rules discussed
• People take risk to express feelings
• Can deal with stress
• Welcomes life stages
• Clear hierarchy
• Affect is open
 Questions to identify the family at risk
• What family need to maintain or restore its
health
• Presence of physical, psycho-emotional, or
socioeconomic threats to the health of this
family
• What capacity does this family have to make
healthy choices?
• What family need from society to optimize its
health
• How to promote a balance between the family’s
needs and expectations and the constraints of
the health care system

Bersick, 2006
 Risk Factors
A risk factor increases your risk of developing a disease or
health problem
environment
behaviors and lifestyle

Genes
Risk Factors for Disease

Environment
Risk factors : Behavior and lifestyles

• Lack of
exercise
• Poor diet
• Obesity
• Smoking
Risk Factors for Disease
Genes
Grandmother

Mother

Child
Family history is a risk factor for common diseases

Population-based studies RR estimates

* CHD 2-5
* Asthma 2-4
* Colorectal cancer 2-5
* Type II diabetes 2-6
* Breast cancer 2-6

AJPM Feb 2003

Family with Problem
 Summary
• We have discussed the family, its functions
• We also have discussed the family as a
system-> structure, rules, boundaries
• We highlighted the family a our greatest
ally in health care, delineating its role at all
level of prevention.
• Classification of families as to healthy, at
risk and with problems
Strengthened FAMILY,
Strengthened NATION