Family and Family

Nursing Process
 The Family

• > group of persons usually living together and composed of the head and
other persons related to the head by blood , marriage or adoption.
• >social unit interacting with a larger society ) according to sociologist )
• > two or more persons who are joined together by bonds of sharing and
emotional closeness and who identify themselves as being part of the
family.
 Different forms of Family

• 1. Nuclear family- family of marriage, parenthood or procreation

( husband, wife, immediate children - natural or adopted )
• 2. Dyad family- newly married husband and wife ( empty nesters )
• 3. Extended family – consisting of three generation
• 4. Blended family – union where one or both spouses bring a child or
children from previous marriage into a new living arrangement.
• 5. Compound family –where a man has more than one spouse ( Muslim )
• 6. Cohabitating family- live in arrangement between an unmarried couple
who are called common-law spouse and their child or children.
• 7. Single parent – result from the death of a spouse, separation or
pregnancy out of wedlock.
 Functions of Family

• Two important purposes:

• I. To meet the needs of the society
• 1. Procreation-for reproductive function and child rearing.
• 2. Socialization of family members –how to become productive members of
society.
• 3. Status placement .-by hierarchy of its members into social classes.
• 4. Economic function- rural family- production like farming, fishing or cottage
industry. Urban-more of unit consumption, working to earn.
• II. To meet the needs of individual family members
• 1. Physical Maintenance – provides for survival needs especially
young and elderly
• 2. Welfare and protection - providing for companionship, meeting
affective , sexual and socio economic needs. Sense of love and
belongingness, psychological security. Family as source of motivation
and morale for each members.
 Family Life Cycle

• 1. Beginning family through marriage or commitment as couple

relationship.
• 2. Parenting the first child.
• 3. Living with adolescents.
• 4. Launching family
• 5. Middle-aged family ( remaining marital dyad to retirement )
• 6. Aging family
 Stages and Tasks of Family Life Cycle

• 1. Manage joining a family

• a.. formation of identity as a couple
• b. inclusion of spouse in realignment of relationship to extended family
• c .parenthood : making decisions
2. Families with young children
a, . Integration of children in family unit
b. adjustment of tasks: child rearing , financial, household
c. accommodation of new parenting and grandparenting
• 3. Families with adolescents
• a. development of increasing autonomy for adolescents
• b. midlife reexamination of marital and career issues
• c. initial shift towards concern for the older generation
• 4. Families as launching centers
• a. establishment of independent identities for parents and grown
children
• b renegotiation of marital relationship
• c readjustment of relationship to include in –laws and grandchildren
• d dealing with disabilities and death of old generation
• 5. Aging families
• a maintaining couple and individual functioning while adapting to the
aging process
• b support role of middle generation
• c support and autonomy of older generation
• d preparation for own death and dealing with the loss of spouse and/or
siblings and other peers
 Family Health Tasks

• >the family serves as an essential resource for its members by carrying out health
tasks.
• > The first family health task is providing its members with means for health
promotion and disease prevention.
• Breastfeeding
• Healthy diet for older family members
• Immunization of children
• Teaching hygiene
 Other Health Tasks of the Family according to Freeman
and Heinrich

• 1. Recognizing interruptions of health or development.

• 2. Seeking health care.
• 3. Managing health and non health crises
• 4. Providing nursing care to sick ,disabled or dependent members of family
• 5. Maintaining a home environment conducive to good health and personal
development
• 6 Maintaining a reciprocal relationship with the community and its health
institution.
 Characteristics of a Healthy Family

• 1. Members interact with each others.

• 2.Healthy families can establish priorities.
• 3. Healthy families affirm, support and respect each others.
• 4. Members engage to flexible role, relationship, share power, respond to
change, support the growth and autonomy of others, engage indecision
making
• 5. Family teaches family and societal values, beliefs and share spiritual
core.
• 6. Healthy families foster responsibility and value service to others.
• 7. Healthy families have a sense of play , humor and leisure time.
• 8. Healthy families have the ability to cope with stress and crisis and grow
from problems.
 Family Nursing Process

• Family nursing is the practice of nursing directed towards maximizing the health
and well-being of all individuals within a family system.
Family Health Assessment – guidelines is information about the environment, or
community context and information about the family.
Assessment through ;
>interviews – family members
>observation of individual family members , environment
> physical examination and other health assessment, height, weight etc
• Secondary data - - review of records, health center records .
• Genogram – tool that helps the nurse outline the family’s structure.
generally three generations.
• Family health tree – provides a mechanism for recording the family’s
medical and health histories.
 Nurse should point the following on the health tree.

• > cause of death of deceased family members

• >genetically linked diseases
>environmental and occupational diseases
• >psychological problems
• >infectious diseases
• > familiar risk factors from health problems
• > risk factors associated with family’s methods of illness prevention
• >lifestyle- related risk factors
 Ecomap – another classic tool used to depict family’s linkages to
its suprasystem. Connection between the family and the world.

• > demonstrates the flow of resources or lacks and deprivations.

• >ecomap – agencies that are significant to the family - people, institutions
like health centers, school, church, work
• > the nurse can use these tools for family assessment with families in
every health care setting.
• > helps increase the nurse awareness of the family within the community
and guide the nurse and family in assessment and planning
 Assessment tools and the process

• Family interviewing
• Manners
• Therapeutic questions
• Genogram and ecomap
• Commending family or individual strenghts
Family Data Analysis- done by comparing findings with accepted
standards for individual family members and family unit.

• System of organizing family data;

• 1. Family structure and characteristics – household membership
• 2. Socioeconomic characteristics- social integration ,educational
experiences
• 3. Family environment – physical environment
• 4. family health and health behaviors- ADL, health care resources