Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.

The Family as a Unit of Care

17,706 views

Published on

Published in: Health & Medicine
  • Be the first to comment

The Family as a Unit of Care

  1. 1. THE FAMILY AS A UNIT OF CARE<br />Aileen B. Pascual, MD, DPAFP<br />10 July 2010<br />
  2. 2. The Biopsychosocial Approach<br />PSYCHOLOGICAL<br />SOCIAL<br />HEALTHILLNESS<br />BIOLOGICAL<br />
  3. 3. BIOSPHERE<br />SOCIETY-NATION<br />CULTURE-SUBCULTURE<br />COMMUNITY<br />FAMILY<br />PERSON<br />SYSTEM<br />ORGAN<br />TISSUE<br />CELL<br />ORGANELLE<br />MOLE<br />CULE<br />
  4. 4. BIOSPHERE<br />SYSTEM<br />SOCIETY-NATION<br />ORGANS<br />CULTURE-SUBCULTURE<br />TISSUES<br />COMMUNITY<br />CELLS<br />FAMILY<br />ORGANELLES<br />TWO-PERSON<br />MOLECULES<br />PERSONAL (EXPERIENCE & BEHAVIOR)<br />ATOMS<br />SUBATOMIC<br />Engel’s Hierarchy of Systems<br />
  5. 5. COMMUNITY<br />FAMILY<br /> PERSON<br />
  6. 6. POSSIBLE DISEASE<br />BIO-PSYCHO-SOCIAL<br />DATA<br />BIOMEDICALA<br />Medical History<br />Physical Examination<br />Diagnostic Tests<br />Psychosocial issues <br />and health beliefs<br />Impact of illness<br />Family assessment<br />
  7. 7. The Family<br />
  8. 8. SHARED FUTURE<br />SHARED<br />PAST<br />
  9. 9. Definition<br />Genetic transmission unit<br />Matrix of personality of development and the most intimate emotional unit of society<br />Enduring social form in which a person is incorporated<br />
  10. 10. Classification according to Structure<br />
  11. 11. NUCLEAR FAMILY<br />Parents, dependent children<br />Separate dwelling not shared with members of the family of origin/orientation of either spouse<br />Economically independent<br />
  12. 12. EXTENDED FAMILY<br />Unilaterally extended<br />Bilaterally extended<br />Includes 3 generations<br />Lives together as a group<br />Kinship network provides function to all members<br />
  13. 13. SINGLE PARENT FAMILY<br />Children < 17 years of age, living in a family unit with a single parent, another relative or non-relative<br />May result from:<br />Loss of spouse by death, divorce, separation, desertion<br />Out of wedlock birth of a child<br />From adoption<br />Migration (OFWs)<br />
  14. 14. BLENDED FAMILY<br />Includes step-parents and step-children<br />Caused by divorce, annulment with remarriage and separation<br />
  15. 15. COMMUNAL FAMILY<br />Grouping of individuals which are formed for specific ideological or societal purposes<br />Considered as an alternative lifestyle for people who feel alienated from the economically privileged society<br />Vary within social context<br />
  16. 16. The Filipino Family<br />
  17. 17. The Filipino Family<br />Closely knit<br />Bilaterally extended<br />Authority based seniority/age<br />Externally patriarchal, internally matriarchal<br />High value on education of members<br />
  18. 18. The Filipino Family<br />Predominantly Catholic<br />Child-centered<br />Average number of members is 5<br />Environmental Stresses: <br />Economic<br />Political<br />Urbanization<br />Industrialization<br />Health problems<br />
  19. 19. Attributes & Characteristics<br />
  20. 20. The Family as a Very Special Unit<br />Lifelong involvement<br />Shared attributes<br />Genetics – physical and psychological<br />Developmental – shared home, lifestyle, social activities<br />Sense of belonging<br />Security/defense against a potentially hostile environment<br />Companionship<br />
  21. 21. The Family as a Very Special Unit<br />Societal expectations<br />Sense of responsibility towards members & others<br />Basis of affection/care<br />Built-in problems<br />Generation gap<br />Dependence of members<br />Emotional attachment/involvement<br />The family endures in spite of problems<br />Resource utilization<br />Authority<br />Individual sense of responsibility<br />
  22. 22. Family Strengths<br />The ability to provide for the family’s needs:<br />Physical - space management, balanced meals, general health status<br />Emotional - helping family members recognize and develop their capacity for sensitivity for each other’s needs<br />Spiritual/Cultural – sharing of basic beliefs and cultural values<br />
  23. 23. Family Strengths<br />Child-rearing practices & discipline:<br />Capacity of parents to respect each others’ views and decisions on child-rearing practices<br />Capacity of single parent to be consistent and effective in raising children<br />
  24. 24. Family Strengths<br />Communication<br />Ability to communicate and express a wide range of emotions and feelings both actively and non-verbally<br />Support, Security and Encouragement<br />Capacity of the family to provide its members with feelings of security and encouragement<br />Balance in pattern of family activities<br />
  25. 25. Family Strengths<br />Responsible Community Relationships<br />Capacity of family members to assume responsibility through participation in social, cultural or community activities<br />Self-Help and Accepting Help<br />Ability of family members to seek and accept help when they need it<br />
  26. 26. Family Strengths<br />Flexibility of family function and roles<br />Ability to “fill in” of one member for another during times of illness of when needed<br />Crisis as a means of growth<br />Ability to unite and become supportive during a crisis or traumatic experience<br />
  27. 27. Family Strengths<br />Family unity, loyalty and intra-familial cooperation<br />Ability to recognize and use family traditions and rituals that promote unity and pride<br />
  28. 28. Why study the Family ?<br />
  29. 29. Transmission of infectious disease<br />Health behavior is acquired from the family<br />
  30. 30. Psychosocial stress can occur within the family<br />Source of social support<br />
  31. 31. Defines health and illness<br />Makes health decisions<br />
  32. 32. Cause of illness or problem<br />Resource for prevention or cure; solution of the problem<br />
  33. 33. Basic Areas of Function<br />Biologic<br />Reproduction<br />Child-rearing/Caring<br />Nutrition<br />Health maintenance<br />Recreation<br />Economic<br />Provision of adequate financial resources<br />Resource allocation<br />Ensure financial security<br />
  34. 34. Basic Areas of Function<br />Educational<br />Teach skills, attitudes and skills relating to other functions<br />Psychologic/Affection<br />Promotes the natural development of personalities<br />Offer optimum psychological protection<br />Promotes ability to form relationships with people within the family circle<br />Socio-Cultural<br />Socialization of children<br />Promotion of status and legitimacy<br />
  35. 35. POSSIBLE DISEASE<br />BIO-PSYCHO-SOCIAL<br />DATA<br />BIOMEDICALA<br />Medical History<br />Physical Examination<br />Diagnostic Tests<br />Psychosocial issues <br />and health beliefs<br />Impact of illness<br />Family assessment<br />
  36. 36. Family Assessment Tools<br />Function<br />APGAR<br />Family Map<br />Lifeline<br />SCREEM<br />Development<br />Family Life Cycle<br />Anatomy<br />Genogram<br />
  37. 37. Family Anatomy Genogram<br />
  38. 38. Genogram<br />Visual map of connections among family members<br />“pedigree”<br />
  39. 39. Genogram<br />Includes the following:<br />Names<br />Ages<br />Marital status<br />Former marriages<br />Children<br />Households, significant illnesses<br />Dates of traumatic events (death)<br />Occupations<br />
  40. 40. Genogram<br />May reveal transgenerational family patterns, dysfunctional emotional patterns, or common medical problems<br />
  41. 41. How to Construct a Family Genogram<br />Each generation is identified by a Roman numeral<br />The firstborn of each generation is farthest to the left, with siblings following to the right, in order of birth<br />If the children have spouses, connect the spouse to them using a horizontal line<br />If they have children, connect the children to them using a vertical line <br />
  42. 42. How to Construct a Family Genogram<br />The family name is placed above each major family unit<br />Given names and ages are placed below each symbol<br />One member of the family is of greater medical significance because of an illness and gets to become known as the INDEX patient; and is identified with an arrow<br />Date when the chart was developed so ages can be adjusted<br />
  43. 43. Persons living in the same household are enclosed with a heavy line<br />Significant diseases in the family can be illustrated using symbols which should appear in the legend<br />Death including date and cause is illustrated with a slash line<br />Dates of marriages and separation are indicated<br />How to Construct a Family Genogram<br />
  44. 44. Genogram Symbols<br />Male<br />Female<br />Unknown sex<br />Pregnancy<br />Induced abortion<br />Spontaneous abortion<br />Index patient, <br />Name, Age<br />Bert, 5<br />Jane, 12<br />May,29<br />Roy, 50<br />
  45. 45. Genogram Symbols<br />Dizygotic<br />Twins<br />Daughter<br />Son<br />Monozygotic <br />Twins<br />Unknown sex of child<br />A<br />Adopted<br />
  46. 46. 2008<br />2008<br />2008<br />Genogram Symbols<br />Death<br />And Cause<br />RHD<br />Stroke<br />Pneumonia<br />MI<br />Not married and <br />Year started living together<br />Marriage and Year<br />2008<br />Separation and Year<br />Divorce and Year<br />
  47. 47. 1990<br />Genogram Symbols<br />Individuals living together<br />
  48. 48. 1990<br />Genogram Symbols<br />Marital Discord<br />
  49. 49. FAMILY GENOGRAMGALMAN- AQUILINO FamilyAPRIL 11, 2009<br />AQUILINO<br />GALMAN<br />A<br />RUEL , 65<br />MARTHA, 62<br />KYLA, 19<br />KEVIN 29<br />Legend<br />PNEUMONIA<br />ASTHMA<br />
  50. 50. Genogram Samples<br />E. Family<br />Bulacan<br /> 2010<br />Joseph, 35<br />Alice, 33<br />Beth, 2<br />May, 5<br />
  51. 51. Family Assessment Tools<br />Function<br />APGAR<br />Family Map<br />Lifeline<br />SCREEM<br />Development<br />Family Life Cycle<br />Anatomy<br />Genogram<br />
  52. 52. Family DevelopmentFamily Life Cycle<br />
  53. 53. Family Life Cycle<br />Assess a patient and family developmental concerns<br />Identifies stages of family development that reflect the biological functions of raising children<br />As the family system moves together through time, the individual life cycles intertwines with the life cycles of other family members<br />
  54. 54. Family Life Cycle<br />This connection among generations reflects oscillation of the family system from developmental periods of family closeness (centripetal) to periods of relative distance (centrifugal).<br />When illness occurs during a centripetal period, the family may be more easily mobilized to care for the ill member than it is during a centrifugal period.<br />
  55. 55. Life Cycle Stages<br />Families go through different stages for which specific developmental tasks must be accomplished.<br />Families who are not able to accomplish these tasks may develop difficulties with subsequent family development.<br />
  56. 56. Family Life Cycle<br />
  57. 57. Family Assessment Tools<br />Function<br />APGAR<br />Family Map<br />Lifeline<br />SCREEM<br />Development<br />Family Life Cycle<br />Anatomy<br />Genogram<br />

×