family assessment tools

1. Family as a Unit of Care

2. HOW DO WE DEFINE “FAMILY”

3. • Textbook definition – group of (2) or more persons related by
birth, marriage, adoption, or emotional ties residing together
in a single household

4. • Sociologic viewpoint – enduring social form in which a person is
incorporated
• Biologic viewpoint – genetic transmission unit
• Psychologic viewpoint – matrix of personality development and
the most intimate emotional unit of society

5. Family as very special unit
• Lifelong involvement
• Shared attributes
• Sense of belonging
• Societal expectations
• Built-in problems
• Enduring problems

6. FILIPINO FAMILY
❑Closely knit ❑High value on education of members
❑Bilaterally extended ❑Predominantly Catholic (80%) of
population
❑Strong family orientation ❑Child-centered
❑Authority is based on seniority / age ❑Average number of members is (5)
❑Externally patriarchal, internally
matriarchal
❑Environmental stress: economic,
political, urbanization and
industrialization, health problems

7. FAMILY STRUCTURE
• Nuclear / small families
• Extended families
– Lineal families
– Joint families
• Single parent families
• Blended families
• Adoptive families
• Foster families

8. NUCLEAR FAMILIES
• Married couple (or divorced or widowed parent) with unmarried children
• Married couple without children

9. EXTENDED FAMILIES
• Maybe Unilaterally extended or bilaterally extended
• Number of nuclear families linked together by virtue of the kinship
between parents and children or between siblings
• Families of orientation are merged with families of procreation
• It maybe Lineal or Joint

10. EXTENDED FAMILIES (LINEAL)
• Consisting of (2) or more generations with each generation composed of one
married couple (or a divorced person, widow, or widower)

11. EXTENDED FAMILIES (JOINT)
• Consisting of (2) or more married couples (or divorced persons, widows, or
widowers) of the same generation (siblings)

12. SINGLE PARENT FAMILY
• Children <17yrs, living with family with single parent, another
relative, or a non-relative
• Maybe due to loss of spouse by death, divorce, separation,
desertion
• Out of wedlock birth of a child
• From an adoption
• OFWs

13. BLENDED FAMILIES
• Includes step-parents and step-
children
• Caused by divorce, annulment
with remarriage and separation

14. COMMUNAL / CORPORATE FAMILY
• Group of individuals which are formed for specific ideological or societal
purposes
• Considered as an alternative lifestyle for people who feel alienated form the
predominantly economically oriented society

15. WHAT IS A WELL FUNCTIONING FAMILY?

16. Clear with distinct roles and boundaries
between integral family members and those in the
extended families
Encouraging individuality and high
degree of differentiation – children and
adult are able to develop their own interests
Rules are clear and reasonable with
flexibility to adapt to change through growth of
children
Good / well established communication
Authority or power is clearly vested in
individuals, with flexibility to allow shifts as
the children matures
Full range of emotions is acceptable,
appropriate, and encouraged
Conflicts are resolved through
bargaining and negotiations to whom all
family members are able to participate
Good sharing mechanism for tasks and
chores, with clear understanding of who
performs what
Individual differences in energy levels,
perception of time and space
requirements are respected
High esteem both for the individual and
the family develops naturally
FAMILY ATTRIBUTES
Schlesinger, 1988

17. INTERDEPENDENCE
Each member’s action affect the others
MAINTENANCE OF BOUNDARIES
Ego as well as generational boundaries
ADAPTIVE
As there are new roles, additions and
relationships
EXCHANGE OF ENERGY WITH THE
ENVIRONMENT
Response to changes in internal and external
forces
SOCIAL ATTRIBUTES
Philadelphia University (2003)

18. WHY STUDY “FAMILY”?

19. 1. FAMILY IS THE SOCIETAL CONTEXT FOR HEALTHCARE
❑Transmission of infectious / communicable diseases
❑Health behavior requirements in the unit
❑Resource utilization / source of support
❑Health and illness definitions
❑Health decisions / approaches and strategies

20. 2. PATIENT’S PROBLEM IS THE FAMILY’S PROBLEM
❑Family plays a role in the health of it’s members
❑Health promotion/maintenance and illness/injury prevention
❑Coping with stressful life events
❑Health and illness appraisal
❑Interaction and level of functioning to specific illness
❑Help seeking or deciding on issues of seeking medical support
❑Family adaptation / coping with illness including care giving, strict adherence to
prescribed treatment and lifestyle advice

21. 3. FAMILY IS THE GREATEST ALLY IN THE PATINET’S TREATMENT
❑90% of cases are ambulatory / out-patient consultations with home
confinement / prescriptions

22. 4. PRESENCE OF THE FAMILY IN THE INTERVIEW / CONSULTATION
❑Family’s influence on the patient’s personality, values, beliefs and experiences
❑Family’s influence on the physician’s personality, values, beliefs and
experiences

23. FAMILY PRACTICE
• Specialty that provides continuing,
comprehensive and coordinated
healthcare for the individual and family
• Due to its wide scope of our specialty enables us not only to
CURE the patient but to provide CARE for our patients

24. patient
FAMILY
• The way a patient reacts in an illness depends a lot on his family
• Many health problems seen in practice can neither be understood nor
successfully dealt with when considered as isolated phenomena affecting
only one person
COMMUNITY

25. BIOSPHERE
SOCIETY-NATION
ORGANELLE
CELL
TISSUE
ORGAN
SYSTEM
PERSON
FAMILY
COMMUNITY
MOLE
CULE
CULTURE-SUBCULTURE

26. FUNCTION
AL family
Stressful event
Family in
DISEQUILIBRIUM
Adequate resource
ADAPTATION/
COPING
INADEQUATE RESOURCE
Family in
CRISIS
EXTRA-FAMILIAL
RESOURCES
MALADAPTATION
PATHOLOGIC DEFENSE
MECHANISM
Family in
PATHOLOGIC
DISEQUILIBRIUM
Stressful event
FAMILY IN
TERMINAL
DISQUILIBRIUM
Smilkstein’s
cycle of
Family function