Family Definition and Types: Understanding the Structure and Functions of Families

1. 14 CHAPTER

2. Family Definition • Social system of two or more people • Define themselves as a family • Share bonds of emotional closeness

3. Family Definition • Asocial unit interacting with larger society( Johnson, 1984). • A primary group of people living in a household proximity and intimate relationship( Helvic, 1981).

4. Family Definition • According to Stuart(1991) family has five critical attributes: • The family is a system or unit. • Its members may or may not be related or may or may not live together. • The unit may or may not contain children. • There is commitment and attachment among unit members that include future obligation. • The unit care-giving functions consist of protection, nourishment, and socialization of its members.

5. Types of Families • Nuclear • Extended • Single-parent families • Stepfamilies • Cohabitating • Two-wives families

6. Nuclear • Nuclear conjugal: husband, wife, and children • Nuclear dyads: married couple without children under 18 living in home • Children may be biological or adopted • Dual-earner: two working parents with or without children

7. Extended • Include family members other than spouses or children • May include stepkin • Share expenses and tasks • Live in close proximity and provide mutual support

8. Single-parent • Most common family served by community health nurse • Consists of adult woman or man and children • Many causes

9. Stepfamilies • Two adults, at least one of whom has remarried • Can include children from previous marriage • Can include children from the new marriage

10. Cohabitating • Man and woman living together without marriage • Include anyone from teens to retired elderly • Different reasons for cohabitation

11. Two-wives families - Not living in same house, but same building or neighborhood

12. Family Functions • The family acts to achieve a balance between individuals needs and family needs and goals. This is accomplished through family function

13. Family Functions • Three decades ago the functions of the family were delineated as: • Social • Reproduction • Economic • Cooperation and sexual relation

14. Family Functions • Today the function of the family has expanded to include • Affective • Security • Seek of belonging • Identity • Control of functions • Socialization • Reproductive • Economic • Provision of needs

15. Family Values • Are apparent in relation to their views regarding: • Recreation • Education • Health practices

16. Family Values/recreation • All members included priorities

17. Family Values/ Education • Exciting • Important • Threatened by teacher • Teacher → Friend • Teacher → Authority figure

18. Family Values/ Health practices • Nutritional status • Recreation • Exercise activities • Sleeping patterns • Use of health resources

19. Family Life-style • Certain aspects of the way a family conducts: • Day to day living • Communication patterns • Decision making abilities: • Process • Person • Crises response • Values and attitudes toward health • Do not forget there are differences between your perception and the family perception

20. Family dynamics • Balance of power and division of labor(roles) • If imbalance effect occurs then: • Divorce • Run away • Violence

21. Calgary Family Assessment Model(CFAM) • Three Major Categories: • Family Structural Assessment • Family Developmental Assessment • Family Functional Assessment

22. Family Structural Assessment • Internal Structure: who is in the family and how they are connected • External Structure: Connection of family members to those outside • Context: relevant background

23. Family Structural Assessment • Internal Structure • Family composition: • all members of household as defined by the family • Rank order : • position of children in family with respect to age • Subsystems: • smaller clusters within family e.g. husband-wife • Boundary: • to protect the differentiation of subsystems, may be clear, diffuse, rigid.( who participate &how)

24. Family Structural Assessment • External Structure • Culture • Religion • May influence values & health care practices. • Social class • Education, income level, occupation • Environment • Home, neighborhood, community • Extended family(origin).

25. External Structure/ Culture • Culture refer to the country of origin as well as to the set of values and rules within which the family operates • Culture is transmitted by: • Social pressure • Previous generations • Religious influences

26. External Structure/ Culture • Family rules are not written, they are abstracts • Values and rules affect the members view of healthcare, education and daily living.

27. External Structure/ Culture • A cultural Assessment would include: • The family's definition of health and illness • The family's approach to health maintenance & a disease prevention • Family's beliefs regarding illness-cure treatment ( folk medicine) • Cultural preference related to food • Degree of identification with cultural group • Family functioning • Child rearing practices

28. External Structure/Environment • Internal environment • Home • Space • External environment • Neighborhood • Industry • Crime rate • Sanitation

29. External Structure/extended family • Those in family of origin( parents & sibs) • Family of procreation(Spouse & children) • Present generation & step relatives

30. Structural Assessment Tools • Genograms and Ecomaps. • Genogram: is a diagram of the family, it shows the structure of intergenerational relationships.

31. Structural Assessment Tools • Ecomap: is a diagram of the family's contact with others outside of immediate family. it pictures the important connections between the family and the world • Used to diagram family structures and relationships

32. SampleFamily Genogram.

33. Sample Family Ecomap.

38. Family Functional Assessment • Instrumental functioning • Expressive Functioning

39. Family Functional Assessment • Instrumental functioning • Daily Living • Eating • Sleeping • Preparing Meals • Changing dressing • Injection

40. Family Functional Assessment • Expressive Functioning • Emotional communication • Verbal • Non-verbal • Circular • Problem-solving • Roles • Control(money,vocations) • Beliefs • Alliances( focus on the directionality,balance of the relationships between family members)

41. Emotional communication • Range & type of emotions or feelings expressed • Generally a wide range from happiness to sadness or anger. • Families with emotional difficulties often have a narrow range of expression.

42. Verbal communication • Direct vs. indirect • Direct message sent to the intended target • Clear vs. Masked • “Say what you mean & mean what you say” to the intended recipient leads to clear & direct communication. • Masked communication give distorted message.

43. Non-Verbal communication • Highly influences by culture • Body posture(e.g. Slumped) • Eye contact(e.g. intense, minimal) • Touch, gestures, facial expressions. • Proximity & distance between family members • Para-verbal communication ( crying, tone)

44. Circular Communication • Reciprocal communication between people. • Circular pattern diagrams show and simplify repetitive sequence of interaction. • Three components: • Affect(emotional status) • Behavior • Cognition(thoughts, ideas, beliefs)

45. Communication Patterns • Influence family relationships, dynamics, and parental effectiveness

46. FamilyCommunication Patterns.

47. Problem Solving • Strongly influenced by family's beliefs about its abilities and past successes. • Who identifies the problem? • What are the families solution patterns? • What resources are relied upon for help- inside the family or external?

48. Family Roles • Established patterns of behaviors for family members • How do family members cope with their roles? • Formal vs. informal roles • Is their role conflict or role strain • Does family belief that roles need to be altered

49. Family Roles • Socially-expected behavior patterns • Determined by a person’s position or status within a family

50. Roles Are Formal or Informal • Formal roles • Expected sets of behaviors associated with family positions • Informal roles • Expected behaviors not associated with position